Rival Truths Common Sense and Social Psychological
Explanations in Health and Illness 1st Edition
Visit the link below to download the full version of this book:
https://medipdf.com/product/rival-truths-common-sense-and-social-psychological-e
xplanations-in-health-and-illness-1st-edition/
Click Download Now
For John, Jack, and Harry
Contents
List of figures ix
List of tables xi
List of activities xiii
Acknowledgements xv
1 Introduction and overview 1
2 Do I have a symptom? How do I know what I feel? 22
3 I’ve got a symptom. Am I ill? 55
4 I’m ill! Shall I see my doctor? 80
5 I’ve seen my doctor, but I’m still not sure: Doctor–patient
communication 114
6 “I’m very well thank you.” But how do I know I’m well? 147
7 Resisting common sense: Menstruation and its consequences on
women’s health, behaviour, and social standing 188
8 Deconstructing common sense: Review and future directions 218
References 228
Author Index 255
Subject Index 00
Figures
1.1 Craving chocolate can be represented as a menstrual symptom caused
by hormones. Article from Company with permission 3
1.2 Systems of the biopsychosocial model (after Engel, 1974, 1977) 10
2.1 Common sense models of symptom perception 24
2.2 A visual aid to communication about pain (reproduced by kind
permission of the team at the Pain Management Centre, Frenchay
Hospital) 31
2.3 The way to a man’s heart . . . Reproduced with permission from
CartoonStock www.CartoonStock.com 38
2.4 A schematic representation of the Gate Theory of pain (after
Melzack & Wall, 1988) 49
3.1 A common sense model of symptom appraisal 57
3.2 Some examples of labels (identity information) for a schema used
to process chest pain 62
3.3 This advertisement for Action Aid helps us to reflect on our
expectations about the typical victim of diarrhoea. Reproduced
with permission from Action Aid 66
4.1 A common sense model of illness behaviour: seeking professional
help for symptoms appraised as serious 82
4.2 Don’t die of embarrassment. Reproduced with permission from
the Bristol Evening Post 87
4.3 The Health Belief Model: The example of a man who has pain
in his testicles, which he fears indicates cancer 88
4.4 The Theory of Planned Behaviour: The example of a man who
has pain in his testicles, which he fears indicates cancer 93
4.5 Drive Reduction Model of fear 97
4.6 Protection Motivation Theory 98
4.7 A working model of stress (annotated with respect to a man who
has perceived pain in his testicles which he fears indicates cancer) 101
4.8 Beating the macho barrier. Reproduced with permission from
the Bristol Evening Post 105
4.9 A social psychological model of professional help seeking for a
given salient identification 111
x Figures
5.1 A common sense model of doctor–patient communication 115
5.2 Freud’s library. Reproduced with permission from the Freud
Museum, London 125
5.3 Interview with a thespian 133
5.4 A social psychological model of doctor–patient communication 138
6.1 A common sense model of judging subjective health status (1) 150
6.2 A common sense model of judging subjective health status (2) 151
6.3 Towards a social psychological model of judging subjective
health status: Some elements 183
6.4 A social psychological model of judging subjective health status
for a schoolboy with asthma, whose goal is to maintain self-esteem 185
7.1 A common sense model of the relationship between menstrual
pathology and related problems in a woman’s life. 190
7.2 The matriarch seated is my great grandmother. She had 16 plus
or minus 2 children who grew to adulthood. I can only identify
one other on the photograph. The woman in the back row on the
left is her sister, who had 17 children, although only 5 survived.
These women would have experienced far fewer menstrual periods
than I, a woman with just two children. How do you suppose their
attitudes to periods compared with those of women of today? 196
7.3 Jane Couch. Photograph by Antonio Olms. Copyright © Antonio
Olms 205
7.4 Towards a social psychological model of menstrual problems 214
Tables
1.1 Five aspects of being human (after Stevens, 1996a) 11
2.1 Types of inaccuracy of symptom perception 26
2.2 Comparisons between attitudes and personality traits (after Ajzen,
1988) 41
3.1 ‘Symptoms of a cold: Having a cold and self-categorising as a
cold-sufferer are both important.’ 77
4.1 Stages in delaying seeking professional medical help
(after Safer et al., 1979) 85
4.2 Target, action, context, and time elements relevant to a visit to
the GP for a man with pain in his testicles 91
4.3 Typical items from the Multidimensional Health Locus of
Control Scale 95
5.1 Seven communication skills 142
6.1 A subjective health status measure for UK teenagers 160
7.1 Depression and anxiety scores in women (source: Golub, 1992) 198
7.2 Common words for menstrual periods in American Folk Speech
(source: Golub, 1992) 210
Activities
1.1 Key systems and contexts of well-being 13
2.1 Consider whether you are currently experiencing any of the
symptoms on the checklist below 23
3.1 Consider how actions and appraisals of the chest pain will vary
according to its identity 62
3.2 Reproduced with permission. Copyright © Prof. (RC) Dr. Gunther
von Hagens, Institute for Plastination, Heidelberg, Germany 68
3.3 Give 10 answers to the question “ Who are you?” 75
4.1 Insights into seeking help for medical symptoms 84
5.1 Opportunity survey of experiences of communication with doctors 120
5.2 Insights into communication 128
6.1 How are you? 148
6.2 What does health mean to you? 158
6.3 How do you expect to feel when you are ‘head over heels’ in
love? How do present day expectations about this role differ from
the ‘loveris maladye’ of the late fourteenth century? 164
7.1 Below is a page out of the health booklet which is given to new
parents and in which their child’s progress is recorded. Parents will
remember the anxiety and/or pride about their baby’s weight gains
when first the midwife and then the health visitors made frequent
visits, with scales. Give 5 reasons for a weight profile below that
of the 3rd centile. Are your reasons based on medical, statistical
or social expectations? What evaluation would you be likely to
give, if you were that child’s anxious parent? Copyright © Child
Growth Foundation 192
Acknowledgements
I would like to thank Peter Robinson for his patience, kindness, and constructive
comments. I would also like to thank John Telfer, Steve Arnott, Kyra Neubauer,
Mo and Jim Milne, Mike Pugh, Nick Ambler, and Norman Freeman.
1
Introduction and Overview
The first aim of this chapter is briefly to introduce the key concepts and perspectives
that underpin the chapters that follow. Its second aim is to explain their overall
purpose and structure. In the first section “common sense” is defined, and the
relationship between common sense and a particular way of thinking about health
and illness, known as the “medical model”, is discussed. In the second section
four common sense views of health and illness based on the medical model are
identified and challenged, in order to outline four of the main purposes of this book.
In the third section the biopsychosocial model of health and illness is introduced.
As its name suggests, social psychological influences play an important role in
this model. Their importance justifies the social psychological bases of this book.
In the fourth section the focus is on social psychology itself. From the diversity of
approaches in social psychology, four levels of analysis will be described in order
to explain both the order of chapters and the emphasis of their content.
1. Common Sense and the Medical Model
To state the obvious, human beings have physical bodies. By means of our bodies
we move around in our world and interact with others. Our bodies influence how
others perceive and interact with us and how we feel and think about ourselves.
Indeed, our very survival as individuals depends upon the survival of our physical
bodies. Most of us rejoice when we feel fit and healthy; most of us fear threatening
pathological processes when we feel ill. The importance of the physical reality of
our bodies is common sense in our society.
The Oxford English Dictionary defines “common sense” in two relevant ways,
which focus on individuals and communities respectively. In the first, common sense
is “the endowment of natural intelligence possessed by rational beings; ordinary,
normal or average understanding; the plain wisdom which is everyman’s [sic]
inheritance;” or “more emphatically, good, sound practical sense; combined tact and
readiness in dealing with the everyday affairs of life; general sagacity” and “ordinary
or untutored perception”. In the second definition, common sense is defined as “the
general sense, feeling or judgement of mankind [sic] or a community”.
2 Rival Truths
In the chapters that follow, “common sense” will be used in both of these senses.
Most often, a common sense view will be described in order to identify a familiar,
rational starting point for theorising about an issue of health or illness. In these
cases, the term will simply reflect the views of friends, acquaintances, students,
media, or myself. These will be taken to reflect an everyday understanding of the
issue. Occasionally, (particularly in Chapter 6) the term “common sense” will be
used in the second sense, in which case it will more formally describe empirical
studies of lay beliefs.
There is an interesting paradox inherent in the nature of common sense views
of health and illness: healers who can relieve suffering and postpone death acquire
power, wealth, and status in most societies (Stainton Rogers, 1991). Furthermore,
within each society, one system of healing generally develops an official status,
which gives it precedence over the others. In Britain (as well as most Western and
many other countries) biomedicine is the healing system that enjoys this status
(Helman, 2000). Medical professionals not only control access to many resources,
but also have the power to construct public knowledge about health and illness.
The result is that medicalised clichés and ways of seeing the world are often taken
for granted as common sense (Bartlett, 1998; Stainton Rogers, 1991).
For example, Cornwell (1984) interviewed 15 women and 9 men in the East
End of London in order to gather common sense ideas about health and illness.
She found that their theories seemed (or tried) to be medical in form and content.
Prefixes such as “They [i.e. doctors] say” frequently showed a deference to medical
authority and there was a general acceptance that health is a matter for experts. A
glance at current media paints a similar picture. Terms such as “road rage”, “stress”,
“premenstrual syndrome”, and “false memory syndrome” sound like medical
problems that people have. In turn, this gives the impression that it is they, as
opposed to their social experiences or circumstances, that require treatment. A
similar, but funnier, example is the representation of liking to be fed chocolate by
a handsome man as a menstrual symptom! (See Figure 1.1 and Section 2.4, below,
where the example will be developed along more critical lines.) My argument is
that common sense, or what everybody “knows” already about health and illness,
has been medicalised. Therefore, it is appropriate briefly to describe the key
characteristics of the medical model.
The medical model is based on scientific rationality which emphasises objective
reality, precise measurement, and the elucidation of cause–effect laws, generally
by means of hypothesis testing and experimentation (Helman, 2000; Still, 1996b).
Since the scientific attitude is that individual opinions are unlikely to be objective
because of interpretative bias, the interpretations of scientists are backed up by data
which are open to public scrutiny and which can be (dis)confirmed by others. The
assumption is that scientific explanations describe reality and therefore, have the
authority of “truth” (Devalle, 1996).
The essence of the medical model is a scientific paradigm within which
abnormalities of the structure and function of body organs and systems can be
identified and named (Helman, 2000). Although there is an acknowledgement
FIGURE 1.1 Craving chocolate can be represented as a menstrual symptom caused by hormones.
Article from Company with permission.
