2.2.3 Elizabeth Belk Elizabeth Belk was living in Hamilton, South Lanarkshire. Unlike Florence Foster and Thomas Marnie, she owned her home, but
2.1.1 Ian Traenor Ian Traenor used to be a former employee of Scottish Hydroelectric. At the time of the recording, he had ‘crossed over to the
5 Audio clip 2: Danny Danny is 49 and sleeps rough in the city, as he has done for very many years. He was born and bred in Northern Ireland, and recounted some happy childhood memories. He became a civil servant in London, working for the Department of Health and Social Security, as a higher executive officer, but lost his job and his wife through drink. After sleeping rough on the streets of London for a while, he returned to Belfast. After robbing a chemist's shop, he was sent to prison for seven years, for rob
1 The Swansea Cyrenians In this unit, you will hear from four people who have been helped by a secular voluntary organisation offering support and assistance to the homeless. The Swansea Cyrenians is one of several organisations that are in touch with homeless people in Swansea. Since 1973, it has been helping some of the most vulnerable people in society, including those who have suffered from homelessness. At the time of the recordings, in 1999, the organisation was running a number of schemes to help
References 7 Moving to a positive paradigm Aaron Antonovsky (1984) has called the emphasis on illness and disease the pathogenic paradigm and has stated that this disease-focused paradigm has dominated our healthcare system. He claims that there are five important consequences of this domination: ‘We have come to think dichotomously about people, classifying them as either healthy or diseased’ (p. 115). Those categorised as ‘healthy’ are normal, those categorised as non-healthy or ‘d 3.5 People's views on health Health accounts, as well as being based in the experience of health, also relate to health behaviour. People's accounts of health are likely to be different at different stages in their lives. Two health promotion researchers, Backett and Davison (1992), have investigated the perceptions of health at different stages of life. Their work is based on two qualitative studies conducted in Edinburgh and South Wales. In these studies, health was also linked to health behaviours. The stage of life w 3.3 Health and ethnicity Clearly ethnicity, religion and culture have a great deal of influence on the way people view health. It was noted in the introduction to Section 2 that most of the early work was on health beliefs and that it was anthropological, focusing on ‘other’ cultures. Britain is a multicultural, multiracial society, yet attention 3.2 Health and the middle class In contrast, a study which focused on white, middle-class men and women between the ages of 35 and 55 (Saltonstall, 1993) found that respondents' views of health were closely connected to wellbeing, and this condition of being was related to ‘capacity, performance and function’ (p. 8). Saltonstall reports that the respondents, both male and female, catalogued what he called a ‘health inventory’ which included things they felt they had and things they thought they were expected to do t Acknowledgements Except for third party materials and otherwise stated (see terms and conditions), this content is made available under a Creative Commons Attribution-NonCommercial-ShareAlike 2.0 Licence Grateful acknowledgement is made to the following for permission: References Acknowledgements The content acknowledged below is Proprietary (see terms and conditions) and is used under licence. Grateful acknowledgement is made to the following sources for permission to reproduce material in this unit: Reading 1: Perkins, R. (1999) ‘Madness, distress and the language of inclusion, Openmind, Vol 98, Jul/Aug 1999, © 1999 Mind (National Association for Mental Health). Reading 2: Rose, D (2001) 2.7 The failure of CAM therapeutic relationships: breach of boundaries In this section, failures caused by breach of boundaries are discussed under the following headings: ‘wounded healers’ creating dependency to satisfy practitioners’ emotional and financial needs sexual abuse and exploitation. To reiterate a point made earlier, breaches of the therapeutic relationship cover a spectrum. Some breaches invariably thwart a successful therapeutic outcome (for example, 2.5 The therapeutic relationship as a placebo Mitchell and Cormack propose that the relationship aspect of a therapeutic encounter can be as important as the technical dimensions of healing (Mitchell and Cormack, 1998). CAM practitioners argue that the therapeutic relationship itself may be an important tool in healing. Critics of CAM turn this argument on its head, suggesting that CAM is, in fact, no more than a powerful form of placebo. What they generally mean is that it is not the specific treatments used that evoke a healing respons 2.4.2 Holism and ideas about the body Reductionist medical approaches have been criticised for providing a fixed, mechanistic view of the body, which fails to capture the patient's experience. The power associated with biomedical diagnoses and expertise means that patients’ explanations for their illnesses are often overlooked or dismissed. Does holism, which seeks to treat the mind, body and spirit, fare any better in giving patients a sense of control or ownership of what their illness means? This question is often reframed i 2.4.1 Reductionism and ‘ownership’ of the body Social scientists interested in changing relationships between workers and users of health care often draw attention to what is termed the loss of ownership or loss of governance of the body. These terms mean that a person's body is treated in some health situations as more important than the person themselves. It is almost as if they are purely a case, an example of a type of disease, or a set of symptoms. Traditionally, such criticisms were levelled against biomedical approach 2.4 Ownership, control and ideas about the body This section focuses on the extent to which a person becomes invisible when a practitioner rigidly adheres to a specific view of health and disease, and fails to accept that others (specifically the person they are treating) may have different ideas about illness or, indeed, about their body. The imposition of a fixed view of illness and disease can be extremely disempowering for people seeking help. 2.3.3 CAM and the ‘tyranny of health’ Some commentators criticise the very idea of the ‘therapy culture’. The issue for them is not how to get people more involved with their health and the therapeutic relationship, but the unhealthy attitude many people have towards seeking perfect health in the first place. How healthy is it for people to constantly turn to professionals or therapists for advice on health care and lifestyle? Should people believe that being in the best of health is the main concern in their lives? The cultu 2.3.2 Responsibility for the causes of ill health Doyal and Pennell (1979) write from the perspective of political economy and argue that there is a continual state of conflict hidden within health experiences and health care relationships. Society produces ill health through an unrelenting drive towards profit and a failure to put the health and wellbeing of individuals first. Work and everyday social life are bound up with taking risks. Many workers experience stress and some occupations involve the risk of physical injury. Social class gr 2.3 Changing notions of the therapeutic relationship and responsibility The shift in practitioner-patient relationships in the last 30 years was described earlier in this book. In addition, Budd and Sharma note that in industrialised societies the nature of the majority of illnesses presented to doctors has changed from acute to chronic and, along with this, the nature of the healing relationship has also changed (1994, p. 11). For many long-term conditions, orthodox treatment can provide only short-term gains. Instead, the key issue is the management of symptoms
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