The Intersection of Social Sciences and Mental Health

 
The Social Sciences
and Mental Health
 
School of Geography, Politics and Sociology, Newcastle University
 
 
Outline
 
Introduction
 
Relevance of the Session
 
The Social of the Social Sciences
 
Social Science in Medicine and Social Science of Medicine
 
Sociocultural Effects in Mental Illness
 
Theoretical Perspectives
 
 
Relevance of the Session
 
 
The More Social of the Social
Sciences
 
 
 
 
Methodology
 
Social
 ---------------------------------------------------------------- 
Individual
 
Intersubjective
           
Rational Agent
(Relations/Interactions)
 
The More Social of the Social
Sciences
 
 
 
 
Methodology
 
Social
 ---------------------------------------------------------------- 
Individual
       
Ontology
Intersubjective
           
Rational Agent
(Relations/Interactions)
 
The More Social of the Social
Sciences
 
Sociology
 
 
Anthropology
 
 
Social Theory
 
 
Social Psychology
 
Sociology
 
Intersubjectivity: Relationships/Interactions
 
Sociology
 
Intersubjectivity: Relationships/Interactions
 
Map and analyse patterns of relationships and interactions
 
Sociology
 
Intersubjectivity: Relationships/Interactions
 
Map and analyse patterns of relationships and interactions
 
Conservation
Change
Social Facts
Power Relations: social stratification/systemic inequality
Lifeworld
 
Anthropology
 
Study of human cultural diversity
 
 
Ethnographic methodology
 
 
Historically rooted colonialism
 
 
Close relationship with Cultural Psychiatry
 
Social Theory
 
Theoretical arm of the social sciences
 
Models social systems
 
Social Psychology
 
Rules and conventions that structure and regulate people’s
interactions and relationships.
 
Generally more methodologically individualist
 
Social Science
IN                         OF
 
Medicine
 
Sociocultural Effects in Mental
Illness
 
Wen-Shing Tseng (2001) 
Handbook of Cultural Psychiatry 
San Diego:
Academic Press
 
Sociocultural Effects in Mental
Illness
 
Wen-Shing Tseng (2001) 
Handbook of Cultural Psychiatry 
San Diego:
Academic Press
 
Pathogenic
Pathoselective
Pathoplastic
Pathoelaborating
Pathofacilitative
Pathoreactive
 
Pathogenic Effects
 
Sociocultural Causation
 
Cultural ideas and beliefs contribute directly to stress and the
formation of disorder
e.g. 
 
Spoiled selfhood
Anorexia
Nonsuicidal Self-injury
Koro
Dhat
 
Pathoselective Effects
 
Culturally influenced reaction patterns
e.g. 
 
Japanese family suicides
Malayan Amok (?)
US Mass Shootings (American Amok?)
 
Pathogenic + Pathoselective + Social Causation
e.g. Zar Spirit Possession (‘The Excuse’)
 
Pathoplastic Effects
 
Form/Content distinction
e.g.  Paranoid delusions
 
Pathelaborating Effectrs
 
Patterns of behaviour are exaggerated or amplified to a
(pathological?) extreme
e.g. 
 
Japanese suicide (see Tseng, 2001)
Sati in historical Hindu culture: non-pathogenic suicide? (See
Bhugra, 2005)
 
Pathofacilitative Effects
 
Some types of psychopathology may be more common in some
cultures than others due to facilitating cultural ideas, values and
practices
e.g. 
 
Anorexia
Mass shootings
Bi-polar
 
Pathoreactive Effects
 
How people expressing distress/disorder, 
and those around them
,
react to the distress/disorder due to the mediation of cultural ideas
and values.
e.g. 
 
PTSD
Panic Attacks
 
Strongly affected by expert/medical discourse, but . . .
Looping effects (see Hacking, 1998, 2002)
 
Theoretical Perspectives
 
Social Causation
 
Hermeneutics
 
Social Constructionism/Constructivism
 
Social/Critical Realism
 
Adapted from Rogers and Pilgrim (2014) 
A Sociology of Mental Health and
Illness
 (5
th
 edition) Berkshire: McGraw-Hill
 
Social Causation
 
Epidemiology but with an eye on social, cultural, economic and
political causation
 
Big in the post-war period, but led to anti-psychiatry
 
Social causation accepts diagnostic categories as valid and uses
these to look for correlations with social data
 
Particular focus on socioeconomic inequality (see U’ren (2011) 
The
Social Perspective 
Toronto: University of Toronto Press)
 
Social Causation
 
Weakness of social causation approach:
 
Looks over the lived experience of individual people
 
Conceptual questions over validity of categories
 
Tends to map cases not causes
 
Correlation is not causation
 
Hermeneutics
 
Hermeneutics = ‘interpretation’
 
Strong conceptual connection to the idea of idiomatic
psychopathology and culture bound syndromes
 
Also to classic conversion hysteria (Freud)
 
Enters sociology through ‘Critical Theory’ and the Frankfurt School
 
Hermeneutics
 
 
 
 
What connections can be established, in a specific social group, in
 
a specific period of time, in specific countries, between the group,
 
the changes in the psychic structure of its individual members and
 
the thoughts and institutions that are a product of that society, and
 
that have, as a whole, a formative effect upon the group under
 
consideration?
   
- Max Horkheimer
 
Hermeneutics: the case of self-
injury
 
 
Nonsuicidal self-injury as an idiom of personal distress, emotional
dysphoria and social estrangement
 
The meanings in the idiom are related to the ‘language’ of the
idiom
 
Meanings nest along ‘axes of continuity’
 
Hermeneutics: the case of self-
injury
 
An example of an axis of continuity:
I felt so strange that evening—numb but silently screaming in pain. Why
couldn’t I scream out loud? Why couldn’t I show people how much pain I
felt inside?...As the night drew in, I sat alone and in silence, holding back
the tears I was too afraid to show. My mind was flooded with disturbing
memories, most of which had been buried for a very long time. The wall
that had contained these memories took many years to build, yet within
hours it had fallen allowing the thoughts and images to torment me once
more, I couldn’t push them back to rebuild it....My mind jumped from one
event in my disastrous childhood to another—I had no control and the
volcano inside me was growing dangerously close to eruption. I’d had an
unusual thought the night before. It was a thought I didn’t want to listen to,
but a voice deep inside said it would calm the turmoil. My gaze drifted to
the discarded plastic that once held four cans of beer together: as the
melted plastic landed on the flesh of my forearm, the screaming inside
suddenly stopped and I drifted off to sleep - Allie
 
Hermeneutics: the case of self-
injury
 
An example of an axis of continuity:
 
 
The Expressive Imperative
 
 
 
The Psychodynamic Subject
 
 
 
Homo Clausus
 
Social Constructionism
 
Also known as ‘Social Constructivism’
 
The social construction of what?
Things
Representations (ideas, knowledge, concepts, categories)
 
Things: anti-realism about, and social construction of, mental illness:
Thomas Szasz
 
Ideas: Michel Foucault
 
Michel Foucault: le homme bogey
 
Michel Foucault
 
Power/knowledge
 
Genealogy
 
The rise of the total institutions
 
The history of psychiatry
 
But a word of caution . . .
 
Social (or Critical) Realism
 
A lot like social constructionism, but with a reminder that reality is
(behind the representation of reality) really real, and it is not
frictionless
 
Emphasises the role people have as agents in the construction and
reconstruction of our maps of reality
 
Contra hermeneutics, causes may operate beyond the experience
of social actors
 
Construal more than construction
 
Thank you for you time!
 
Contact me: 
peter.steggals@newcastle.ac.uk
 
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Delve into the dynamic relationship between social sciences and mental health, examining the sociocultural influences on mental illness through various theoretical perspectives. Explore methodologies in sociology and anthropology that analyze interpersonal relationships, power dynamics, and cultural diversity in the context of mental health research.

  • Social sciences
  • Mental health
  • Sociology
  • Anthropology
  • Sociocultural influences

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  1. The Social Sciences and Mental Health Dr Pete Steggals peter.steggals@newcastle.ac.uk School of Geography, Politics and Sociology, Newcastle University

  2. Outline Introduction Relevance of the Session The Social of the Social Sciences Social Science in Medicine and Social Science of Medicine Sociocultural Effects in Mental Illness Theoretical Perspectives

  3. Relevance of the Session

  4. The More Social of the Social Sciences Methodology Social ---------------------------------------------------------------- Individual Intersubjective Rational Agent (Relations/Interactions)

  5. The More Social of the Social Sciences Methodology Social ---------------------------------------------------------------- Individual Ontology Intersubjective Rational Agent (Relations/Interactions)

  6. The More Social of the Social Sciences Sociology Anthropology Social Theory Social Psychology

  7. Sociology Intersubjectivity: Relationships/Interactions

  8. Sociology Intersubjectivity: Relationships/Interactions Map and analyse patterns of relationships and interactions

  9. Sociology Intersubjectivity: Relationships/Interactions Map and analyse patterns of relationships and interactions Conservation Change Social Facts Power Relations: social stratification/systemic inequality Lifeworld

  10. Anthropology Study of human cultural diversity Ethnographic methodology Historically rooted colonialism Close relationship with Cultural Psychiatry

  11. Social Theory Theoretical arm of the social sciences Models social systems

  12. Social Psychology Rules and conventions that structure and regulate people s interactions and relationships. Generally more methodologically individualist

  13. Social Science IN OF Medicine

  14. Sociocultural Effects in Mental Illness Wen-Shing Tseng (2001) Handbook of Cultural Psychiatry San Diego: Academic Press

  15. Sociocultural Effects in Mental Illness Wen-Shing Tseng (2001) Handbook of Cultural Psychiatry San Diego: Academic Press Pathogenic Pathoselective Pathoplastic Pathoelaborating Pathofacilitative Pathoreactive

  16. Pathogenic Effects Sociocultural Causation Cultural ideas and beliefs contribute directly to stress and the formation of disorder e.g. Spoiled selfhood Anorexia Nonsuicidal Self-injury Koro Dhat

  17. Pathoselective Effects Culturally influenced reaction patterns e.g. Japanese family suicides Malayan Amok (?) US Mass Shootings (American Amok?) Pathogenic + Pathoselective + Social Causation e.g. Zar Spirit Possession ( The Excuse )

  18. Pathoplastic Effects Form/Content distinction e.g. Paranoid delusions

  19. Pathelaborating Effectrs Patterns of behaviour are exaggerated or amplified to a (pathological?) extreme e.g. Japanese suicide (see Tseng, 2001) Sati in historical Hindu culture: non-pathogenic suicide? (See Bhugra, 2005)

  20. Pathofacilitative Effects Some types of psychopathology may be more common in some cultures than others due to facilitating cultural ideas, values and practices e.g. Anorexia Mass shootings Bi-polar

  21. Pathoreactive Effects How people expressing distress/disorder, and those around them, react to the distress/disorder due to the mediation of cultural ideas and values. e.g. PTSD Panic Attacks Strongly affected by expert/medical discourse, but . . . Looping effects (see Hacking, 1998, 2002)

  22. Theoretical Perspectives Social Causation Hermeneutics Social Constructionism/Constructivism Social/Critical Realism Adapted from Rogers and Pilgrim (2014) A Sociology of Mental Health and Illness (5thedition) Berkshire: McGraw-Hill

  23. Social Causation Epidemiology but with an eye on social, cultural, economic and political causation Big in the post-war period, but led to anti-psychiatry Social causation accepts diagnostic categories as valid and uses these to look for correlations with social data Particular focus on socioeconomic inequality (see U ren (2011) The Social Perspective Toronto: University of Toronto Press)

  24. Social Causation Weakness of social causation approach: Looks over the lived experience of individual people Conceptual questions over validity of categories Tends to map cases not causes Correlation is not causation

  25. Hermeneutics Hermeneutics = interpretation Strong conceptual connection to the idea of idiomatic psychopathology and culture bound syndromes Also to classic conversion hysteria (Freud) Enters sociology through Critical Theory and the Frankfurt School

  26. Hermeneutics What connections can be established, in a specific social group, in a specific period of time, in specific countries, between the group, the changes in the psychic structure of its individual members and the thoughts and institutions that are a product of that society, and that have, as a whole, a formative effect upon the group under consideration? - Max Horkheimer

  27. Hermeneutics: the case of self- injury Nonsuicidal self-injury as an idiom of personal distress, emotional dysphoria and social estrangement The meanings in the idiom are related to the language of the idiom Meanings nest along axes of continuity

  28. Hermeneutics: the case of self- injury An example of an axis of continuity: I felt so strange that evening numb but silently screaming in pain. Why couldn t I scream out loud? Why couldn t I show people how much pain I felt inside?...As the night drew in, I sat alone and in silence, holding back the tears I was too afraid to show. My mind was flooded with disturbing memories, most of which had been buried for a very long time. The wall that had contained these memories took many years to build, yet within hours it had fallen allowing the thoughts and images to torment me once more, I couldn t push them back to rebuild it....My mind jumped from one event in my disastrous childhood to another I had no control and the volcano inside me was growing dangerously close to eruption. I d had an unusual thought the night before. It was a thought I didn t want to listen to, but a voice deep inside said it would calm the turmoil. My gaze drifted to the discarded plastic that once held four cans of beer together: as the melted plastic landed on the flesh of my forearm, the screaming inside suddenly stopped and I drifted off to sleep - Allie

  29. Hermeneutics: the case of self- injury An example of an axis of continuity: The Expressive Imperative The Psychodynamic Subject Homo Clausus

  30. Social Constructionism Also known as Social Constructivism The social construction of what? Things Representations (ideas, knowledge, concepts, categories) Things: anti-realism about, and social construction of, mental illness: Thomas Szasz Ideas: Michel Foucault

  31. Michel Foucault: le homme bogey

  32. Michel Foucault Power/knowledge Genealogy The rise of the total institutions The history of psychiatry But a word of caution . . .

  33. Social (or Critical) Realism A lot like social constructionism, but with a reminder that reality is (behind the representation of reality) really real, and it is not frictionless Emphasises the role people have as agents in the construction and reconstruction of our maps of reality Contra hermeneutics, causes may operate beyond the experience of social actors Construal more than construction

  34. Thank you for you time! Contact me: peter.steggals@newcastle.ac.uk

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