Affecting qualitative health psychology

Examining the understandings of young adult South African men who stutter: The question of disability

BACKGROUND

A disability studies approach seeks to understand and address political and social issues that affect disabled individuals. Disability studies scholars employ various models of disability to address and oppose the oppression and discrimination of disabled individuals. A disability studies approach, however, has largely been absent in studies that have investigated the lived experiences of people who stutter.

AIM

To examine the understandings young adult South African men who stutter hold of whether, and in what way, stuttering may be considered to be a disability.

METHODS & PROCEDURES

A total of 15 men who stutter, aged 20-39 years, participated in the study. Semi-structured interviews and two focus groups discussions were conducted to collect data for the study. The data were analysed according to a phenomenological approach and the affective turn in social research.

OUTCOMES & RESULTS

The results indicated that some men in this study understood stuttering as a speech disorder that can be controlled, while other men constructed stuttering as a disability, subjectively positioning themselves either as disabled or non-disabled men.

CONCLUSIONS & IMPLICATIONS

This article emphasizes the importance of adopting a disability studies approach when examining the lived experiences of people who stutter and enhancing intervention strategies to adequately address the disabled needs of such individuals.

WHAT THIS PAPER ADDS

What is already known on the subject? The past few decades have seen researchers investigating the personal and social experiences of people who stutter. However, empirical studies exploring the disabling experiences of people who stutter have been absent from the existing body of knowledge. What this paper adds to existing knowledge? This research aimed to provide comprehensive insight into the disabling experiences of people who stutter. The results gave an insight into the oppression and disablism experienced by people who stutter. More specifically, the findings demonstrated how individuals who stutter are disabled by oppressive communication practices that dominate spaces of education and employment. What are the potential or actual clinical implications of this work? Several men in this study attended speech therapy to gain control over their stuttering. For a number of participants, speech therapy proved a valuable experience, while others saw speech therapy as being out of touch with their lived reality of stuttering. Speech and language therapists are encouraged to employ a disability studies approach in order to enhance intervention strategies to adequately address the disabling needs of people who stutter.

Embodying health behaviours in everyday life: the social and gendered practices of female senior managers

Objective: This article extends current theorising around health behaviours using insights from a study with women working in senior management positions in Switzerland. The study aimed to explore the meanings they attached to their everyday activities and examine implications for health and wellbeing by drawing on 1) social practices theory, 2) a socio-constructionist approach to gender, and 3) conceptualisations of embodiment.Design: Twenty female senior managers were interviewed at two time points six months apart: the first interview elicited highly-detailed, descriptive accounts of activities during the previous day, while in the second interview participants reflected on their previous accounts and discussed the meanings they ascribed to their activities. A thematic and narrative analysis of both sets of transcripts was conducted.Results: Three main themes captured the ways female senior managers talked about their everyday behaviours, all focused around their bodies: 'Functional bodies: Being on-the-go and meeting responsibilities'; 'Limiting bodies: Threats to everyday activities'; and 'Intentional bodies: Activities for wellbeing'.Conclusions: Results are considered in terms of contemporary postfeminist/neoliberal discourses in Western societies, how these are shaping and affecting everyday practices and subjectivities, and their consequences for women's health and wellbeing at work.

Life is precious: Sarcoma/giant-cell tumors survivors' perspectives on their psychological journey

OBJECTIVES

Although surviving bone resection/limb salvage surgery treatment is the beginning of the journey towards recovery, the importance of providing patients with post-operative psychological support is often overlooked by health professionals. Hence, patients typically are left to their own devices in terms of ensuring their mental health and well-being. Methodological Approach and Participants: This qualitative analysis of seven long-term sarcoma survivors' reflective journal entries provides insights into the different phases of distress, resilience building, resilient growth and advice-giving that they moved through during their survivorship journey.

INTERPRETATION

Our findings identify the fragility of patient resilience and highlight areas for future research.

'Good' patient/'bad' patient: clinical learning and the entrenching of inequality

This article develops sociological understanding of the reproduction of inequality in medicine. The material is drawn from a longitudinal study of student experiences of clinical learning that entailed 72 qualitative in-depth interviews with 27 medical students from five medical schools in the USA. To highlight the subtle, yet powerful, ways in which inequality gets entrenched, this article analyses ideas of the 'good' and the 'bad' patient. Bad patients question not only biomedical knowledge but also medical students' commitment to helping people. Good patients engage with medical students in a manner that upholds biomedical knowledge and enables students to assume the role of the healer and the expert. At the same time, good patients possess cultural skills that align with those of medical practitioners. This alignment is, furthermore, central to definitions of the good patient. Distinctions drawn between good and bad patients thus both embody as well as enforce social inequality. The subtle reproduction of inequality is, however, difficult to discern because judgements about patients entwine with emotion.

The affective atmospheres of surveillance

The spaces that surveillance produces can be thought of as ambiguous, entailing elements that are ethereal yet material, geographical yet trans-geographical. Contemporary surveillance systems form numerous connections that involve multiple times, spaces, and bodies. Owing to their ubiquity, normalization, and yet clandestine characteristics, they seem to produce an almost unnoticed aspect of everyday life. The impacts, then, of contemporary surveillance systems appear to be particularly experienced on the margins of consciousness. Thus we find that an empirical analysis of this realm of experience is possible but requires one to look for such things as disruption, disfluency, and hesitation in the text of speech acts rather than clear representation. Through empirical analysis of narratives concerning everyday experiences of living with contemporary surveillance systems, this paper focuses on their possible affective impacts. In turn, we find it more fitting to think about the so-called “surveillance society” in terms of producing “atmospheres” rather than “cultures or assemblages,” and “affects” rather than “emotions.”

Complementary and alternative medicines, embodied subjectivity and experiences of healing

Despite a paucity of scientific evidence, complementary and alternative medicines have been found to give rise to feelings of control, empowerment, and agency. These healing experiences call for the development of analytical frameworks beyond biomedical ideas of scientific effect. This article is premised on a phenomenological understanding of embodied subjectivity as paving way for more nuanced understanding into experiences of healing. As such, this article contends that ill health transcends the biomedical body. Healing experiences are also entwined with the values and ideals that are normalized in the complementary health sphere. Discourses of health and wellness thus also play a role in the generation of healing experiences. I draw on qualitative research with clients and practitioners involved in complementary and alternative medicines in England. I will first introduce phenomenological ideals of the body, and the methods underlying the data that are drawn on. I will then turn to interviewee perspectives on the interconnectedness of the mind and the body, before outlining client experiences of alternative health practices. I argue that ideals, such as awareness, that are emphasized in the holistic health domain are important for the generation of healing experiences. Healing experiences also, however, emerge through the caring touch of trusted practitioners. This article will finally turn to the intersections between embodied experience and social inscription.

Response to commentaries on ‘Beyond Belief’

A set of commentaries on Cromby (2012) are considered with respect to three themes: the relations between feeling and thinking, between theory and empirical research, and between health beliefs and beliefs in religion/spirituality. Clarifications of key issues are suggested, and the difference between health and other beliefs is briefly illustrated with reference to beliefs associated with smoking tobacco.

Challenges for health psychology: Theorizing belief and beyond

We are supportive of Cromby’s challenge to further develop ‘belief’ as a concept relevant for health psychology. Drawing on the wider “affective turn” in the social sciences, Cromby demonstrates the importance of theorising the sociality of thinking and feeling for fundamental health psychology conceptualisations. These theorisations might usefully be applied to key health psychology topics, such as social cogntion models, beliefs about adherence, medications, diagnoses, and illness perceptions. Cromby’s approach to beliefs might also be beneficial for fostering a more contextual and culturally oriented health psychology, as well as a greater (and much needed) engagement with notions of embodiment. Cromby’s arguments raise many questions for health psychology research practice and deserve close attention and consideration by health psychologists.

Beyond belief

Psychology, including health psychology, frequently invokes the concept of belief but almost never defines it. Drawing upon scholarship associated with the ‘affective turn’, this article argues that belief might usefully be understood as a structure of socialized feeling, contingently allied to discursive practices and positions. This conceptualization is explained, and its implications for health psychology discussed with respect to research on religiosity and spirituality and debates about the value of social cognition models such as the theory of planned behaviour.