COMM 321 1st Test

Where does "The Body That Speaks" come from?

Historical religious confessional trials (Judeo Christian). Shows up in early Viennese psychoanalytical practice, then to World War I and veteran's hospitals of WW2 then German / American psychosomatic medicine.

Good stories

are also scripts or guides to action. Things that provide us with a store of specific, social roles, cues, reference points that tell us how to behave or how to feel (what to experience) in different situations.

Practical Politics

campaigns for California's Proposition 215, AZ prop 200, OR medical marijuana law, each of which aimed to legalize doctors prescription of marijuana for medical purposes

What does placebo mean?

indirect means, mollifying objects. (i.e. sugar pills instead of real medicine) doctors would give these when they thought nothing was really wrong with them.

Power

is intimately tied to discourse-power cannot be established, consolidated, or implemented with out the production, accumulation, circulation, and functioning of discourse. Domination is built into the very understanding of the common activity, whatever forms the substance of a relationship. (Bio-power: power over our bodies)

Benefits of breastfeeding

life-affirming choice b/c of the nutritional and immunological effects, enhanced bonding between mother and infant

Ethnocentrism

our view that our culture's way of doing things is right and appropriate.

Dysappearance

personal disturbance that tends to make us feel self-conscious

Juxtapositioning Narratives

placing and reviewing narratives together in order to compare and contrast effectively and gain a better understanding of what is meant by the narrative

Borderlands

providers find themselves positioned between their views of what constituted efficient and effective care and of what constituted noncompliance (by the Lee family over Lia).

What is the irony of "Eastward Journeys" stories?

rarely, if ever, take us into another world; they just take us deeper into ourselves.

Body politic

set of communication routines where experts' knowledge of our bodies transforms us into objects of knowledge, and the support for those routines becomes the "political technology of the body." EX: when you are sick take this medicine, and then afterwards you know every time you feel those symptoms you reach for the same medicine (?)

Politics

structure of diverse interests about a particular issue or the process of communicating these interests. BASICALLY: who gets what portion of the pie?

"Psychosomatic" & how did it become a part of the narrative "the body speaks"?

symptoms associated with disorders that tell a tale, and represent some coded message from the unconscious. Interactions between pathologies of mind and body.

How would you briefly summarize the Eastern Journeys' narrative?

-Aims to help us find ways to improve our health and well being. -Seeks the healing practices of ancient eastern cultures we have never known. -Stress in modern West has damaged our hearts, undermined our immune system, make us unhappy. The people in East can help us get back on track and connect our mind, body, and should through ancient practices.

Early Depictions of AIDS

"Gay Plague" Homosexuals first had it then later intravenous drug users and prostitutes. Media showed it as a hazard to the gay lifestyle. Looked like a victim of an act you could have avoided. Doctor looks like hero. People are shunned from society. "And The Band Played On"

Name of Herbert Benson's study

"The Relaxation Response"

Active Participation

(better than passive) "in activities focused on disease prevention, health promotion, and maintenance of physical, emotional, and spiritual well-being." Instead of just taking doctors orders they work WITH the doctor to create the best plan possible for recovery or good health.

What forms did the power of suggestion take?

-Demonic Possession -Mesmer's ritual of animal magnetism -hynosis

Why is mind-body medicine such a distinctly storied world?

-These stories main task as narratives is to knit together domains of experiences that we struggle otherwise to relate: the medical and the moral, the biological and biographical, the natural and cultural. - (Example): A story about mind- body processes can begin in the realm of human affairs and morality ("His boss was forever screaming at his employees) and in the realm of pathophysiology ("One day he suddenly keeled over with a heart attack")

Story Structure

1) Selects relevant events and sequences them (normally chronologically), in ways that direct the imagination along a particular trajectory. 2) Identifies relationship among the sequenced events, often/not always implying a thread of linear causality running across them. 3) Ends often with a final event that implicitly affirms the importance of certain values. Certain actions lead to good or bad outcomes. Best stories leave us with a sense of satisfaction for this reason.

What two groups got involved in so tires about the power of the human mind?

1. Doctors & Scientists. All headings have a natural explanation. (mental not supernatural) 2. Patients: extols the virtually divine power that exists in each individual

In what ways does mind-body medicine offer something for everyone?

1. Power of suggestion: patients own abilities to control and make sense of their own experiences. 2. The body that speaks: for those who believe in the healing power of the examined life 3. The power of positive thinking: for advocates of patient-initiated practices and those most skeptical of medicine's arrogance 4. Broken by modern life: for those most committed to the power of modern lab science to crack the secrets of the mind, body connection. 5. Healing ties: and for those who are drawn to both the more folksy and homegrown. 6. Eastward journeys: more exotic and romantic forms of medical, social, and moral redemption.

Key aspect of communication between parents of disabled child

1. Technical Decisions 2. Moral Decisions

Routine hospital procedures

1. women "prepped": hospital gown & vaginal exam, enema& shaving of pubic hair 2. monitor baby's heartbeat 3. wide variety of methods used for inducing labor. either because she is past due or making no progress in labor. IV can be administered 4. surgical incision to open the birth passage 5. last routine procedure used in birth of a baby boy is circumcision.

Rhetoric of birthing

3 parts: 1. meta-narratives (the culturally embedded expectations) i.e. morning sickness, bloating, cravings 2. Public narratives (medically, professionally, politically, publicly defined) i.e. what your doctor will tell you in his office 3. individual narratives (lay, informal, or personal) what we learn from ourselves. (more info p. 139-140)

% of hospital births today

97-99%

Stigma

A mark of disgrace associated with a particular circumstance, quality or person From Erving Goffman, he suggests that loss of control over our bodies created a spoiled identity that for most people is embarrassing and stigmatizing

Public Arena

A more socially formulated environment than an actual physical site. Can include any situation that places citizens in contact so that the interchange of ideas may occur. Media forums increasingly are stimulating and facilitating dialogue among various sectors of the society. The saliency and persuasiveness of these arguments in turn provide the basis for policy making.

Transformation

A move from disembodiment to embodiment. Can ease tensions of difference / indifference, stimulate interest in understanding those afflicted in ways we have not personally experienced, and thus transcend the "othering" (distancing) that routinely occurs for persons who are ill, disabled, ore fell disembodied. One step towards transformation is listening to voices of people in sickness and in health. BASICALLY: when we listen to those who are ill our mind is opened to more thoughts and more understanding.

Gate keepers

A primary-care provider, often in the setting of a managed-care organization, who coordinates patient care and provides referrals to specialists, hospitals, laboratories, and other medical services.

What is the narrative "The Body Speaks"?

A talking body. Body that can converse with its owner conveying messages about things going on in ones life that they are having difficulty consciously confronting. -Body stands at the center of a narrative about the dangers of repression and the healing powers of confession. (Being in touch with your body and listening to what it is trying to tell you)

Possible Life Changes People May Encounter Through Narratives

After Christopher Reeve's accident he saw his life as a journey, with more possibilities than limitations, instead of his life being divided into two parts: pre and post accident.

Managed Care

Arrangement in which an insuring organization accepts the risk for providing a defined set of health services, using an identified set of providers for a specified population in return for a fixed payment rather than a fee for service. They are in the form of HMO's, PPO's, and other reimbursement networks. Primary physicians have become the "gate keepers" to more specialized services. EX: you have to ask your doctor to refer you to a dermatologist.

Logical Reasoning

Based on structured observations that prove what we experience

Cultural Forms of Knowledge

Can facilitate and constrain health behaviors. Without more global and political insights, we possess only limited understanding of similarities and differences among cultures with respect to human care, health, and illness. The language and other symbols representing vitality and illness, disease and treatment, and well-being and disability are laden with ambiguity and connotations that function to add layers of meaning and often difficulties in mutual understanding during attempts to communicate health. BASICALLY: know more cultures = understand various health styles

Legitimation Masquerading

Circumstances wherein what we accept as legitimate in our society often has never endured any public scrutiny; instead, we create the opportunity for individuals to learn the "expert" knowledge concerning decisions about their treatment and their lives.

What did we learn Japanese culture?

Close knit community that provided its members with a great deal of stress reducing emotional and social support contributed to health benefits. Lived longer because they had developed a culture that had learned to exploit the power of healing ties.

Who does Harrington discuss as the most influential contributors to the notion that the body speaks & why?

Considered by Freud in attempt to explain hysteria. New narrative for history of medicine, product of only the last years of the 19th century

Webster Work

Created by Mary Daly Carefully consider the meaning of words, both in their original definitions and in the diverse connotations that people assign to them. Take words and newly hyphenate them to accent the true meaning. EX: disabled --> dis-abled

Health Citizenry

Creating your own interpretation and meaning to words such as "healthy and unhealthy" "wellness and illness" "medicine and healing." Full range of health-related activities in which people (both patient and practitioner) participate and interact with one another.

Ethnocultual / Familial

Cultural traditions, styles, customs, rituals, and values that form patterns for everyday living, expression, and social interaction, which are often inculcated or learned through the family.

Narrative Reasoning

Designed to understand the whole by integrating parts of our experience, often in ways we cannot prove but know intuitively.

What does Harrington see as the potential of mind-body medicine?

Destabilize and creatively redraw tried "two cultures" approaches to knowledge of what it means to humans. (Harrington draws all her examples, ways of healing through different cultures, and narrative stories to introduce people to a new way of medicine)

Resource for men and women to learn about alternatives to medicalized birth

Doula, Lamas class, Birthing Centers

Medicalizing

Due to the advanced bio technology and specialization, many ordinary and crucial aspects of human development have become "medicalized," subject to the expertise of physicians and other health pros. Medical management can be helpful and often improve quality / longevity of life, however, a pervasive feeling now exists that control has shifted AWAY from the individuals who lives are at stake. opposes changing the name of menopause to estrogen-deficiency disease, because a replacement of the hormone estrogen may be problematic

Allopathic Medicine

Essentially biomedical therapies. Taking chemical prescription medicine, surgery, chemo, etc.

Normalcy explanation

Explanations that foster reassurance. Expressing the normality of illness. Appear to address children's emotional and cognitive needs. By framing an illness as a normal course of affairs, children get the sense that their experience is typical. As such, their illness is understandable and manageable. This communication process appears to best reduce children's anxiety and uncertainty.

How long has the power of suggestion existed in our culture?

For only about a century

Homo Narrans

Formed by rhetorical theorist Walter Fisher. Humans can be distinguished by their innate STORYTELLING tendency. People are, by nature, storytellers, so communications takes the form of narratives, stories that we use to explain and exemplify our ideas, and recount and account for decisions. (why this entire book is made up of stories.)

Theorizing about Communication

Forming Theories-rationales, guesses, or explanations from the stories we tell or hear about everyday health practices.

Structure of a Health Narrative

Foundation for understanding health communication. Use it as a framework for understanding the personal complexities of communication in health and illness in diverse contexts-families, health care settings, policy and legislation, and mass media campaigns. Use the personal narrative to reveal embodiment and identity in the contexts of health and illness.

Contextualization

Individuals create coherence or meaning based on what is "true" from their positioning in particular cultural communities or political contexts. "I believe that doing yoga every morning keeps me young because I live by the beach and do it religiously."

Culturally Sensitive Model & Layers of Meaning

Insight regarding the complex & multiple layers of meaning that each participant brings to their relationships and conversations about health and illness. (there are 5): 1. Ideological 2. Sociopolitical 3. Institutional / Professional 4. Ethnocultural / Familial 5. Interpersonal Layer of Meaning

How would you describe the narrative of "healing ties"

Insists that we suffer so much from stress, not because modern life is so overwhelming in its demands but because it [stress] has robbed us of community and of intimacy, leaving us with no friends, no network of supportive comrades, to buffer and aid us in facing lifes challenges. Nostalgia narrative of mind-body medicine

Historical Views of Women Birthing

It used to be done in the "Red Tent," with family and friends all around in support and to help. Then hospitals, and then birthing centers for the more progressive.

What's happened to medical care

Knowledge & technology evolved, medical care is now more fragmented and specialized. We've lost sense of familiarity (house calls) but gained miracles and expectations that science can cure all. Slowly moving from tiered-approach (only the rich and middle class get care) to a blanket (everyone gets to afford it).

Biomedical Self

Literally what your chemical make up is (genes and DNA). Are you allergic to anything? Do you have a history of diabetes in your family?

Stima & Communication

Many people speak openly now about their health and illness to help reverse their spoiled identity. This openness makes the public more aware and reduces stigma towards certain illness and disease.

Membership in a cultural community

Maybe born into community our health comm is influenced by our present memberships in several other cultural communities. You can choose to join which ever one (gym membership, support group, etc.)

Infertility research focuses predominantly on

Men

Types of Reasoning

Narrative Reasoning & Logical Reasoning

Institutional / Professional

Organization of health care and related services by professional and corporate categories; EX: federal and state gov'ts, HMOs (health maintenance organizations), and professions such as medicine, nursing, and social services. Also includes professional versus lay understanding (?) of health problems and issues. EX: commodification (marketing) of health care practitioner / lay person.

Spoiled Identity

People are ashamed of their disease. Create crisis of communication that lead people to engage in strategies to feel more in control and to become embodied in ways that manage their "sick" identity.

How did placebo become a part of the power of suggestion?

Placebo effect would produce effects that were more real: more biologically and therapeutically significant to the psychological mind.

What did we learn about the positive power of the placebo effect?

Psychosomatic phenomena. Noted biochemistry to placebo responses (EX: placebo responders reported decrease in pain).

What part did traditional Chinese medicine play in the history of mind-body medicine?

Qigong was a combination of diverse rituals that included: martial arts, meditation, and longevity/endurance rituals. Acupuncture also comes from ancient chinese rituals. All the basis of the mind-body concept.

What was David Spiegels contribution to the narrative of healing ties?

Recorded that cancer patients that interacted with people in a support group to help cope and learn, lived happier, longer lives than those who dealt with cancer alone. Bonding sessions with other patients.

Elements of a Story

Scene - the physical setting Characters - people featured in the story Motive - the underlying reasons of certain actions Plot - the development of the story Voices - from the point of view, of the narrator Telling - the manner of how the story is actually told

Why does Harrington focus on stories as the best way to understand the history of mind-body medicine?

Stories inspire people to: -turn their backs on conventional remedies -defer to new kinds of healers -embark on unaccustomed travels -undertake new kinds of practices

Othering

Stories that are offered with best intentions and are not experienced as supporting or understanding.

How does Harrington define the word "story" and what does she mean by a "good story"

Story: more or less true or untrue, more or less grounded in scientific data, more or less self interested.

Interpersonal Layer of Meaning

The dynamics of style, intimacy, and roles played out in human interactions. EX: individual differences

What was the "fabulous confluence of factors guaranteed to open the mind to any and all influences"

The healings at Lourdes were evidence that the natural healing powers of the mind were far more extensive than the medical. Bernheim realized how powerful the mind was and called it "faith" which would perform miracles.

Ideological

The philosophical "truths" or ethical underpinnings of society; EX: The American emphasis on values of independence and individualism versus other societies' value of community.

Sociopolitical

The politics surrounding the primary social bases of power. EX: race, class, gender

How would you describe the narrative of "broken by modern life"?

We suffer from disease because we live in a modern world that challenges our energies beyond capacity. The effect that stress has on our health, creates complication in the mind, body, and soul, caused from our fast paced life styles. RESULT: stress, nervousness, and anxiety

Health Communication

The symbolic process by which people, individually and collectively, understand, shape and accommodate to health and illness. Involves a wide range of messages and media in the context of health maintenance , health promotion, disease prevention, treatment, and advocacy. Variations in: situations, structures, roles, relationship, identities, goals, strategies of social influence.

Technological KNowledge

The things that doctors know about, diagnosis, chemical, doctor terms. Something a day to day person may not understand or know

Regardless of the evidence against Spiegel's findings, why do people continue to attend cancer support groups?

They stay in the group because they learn from one another, how to live better with cancer and how to die better from cancer, something they could not learn from their culture. Helped them ease into dying knowing that they were not dying alone; they gave each other the gift of connection and compassion to one another.

Humanistic Knowledge

Things day to day people will know and understand. What a common cold is. But they may not know the virus term. Doctors and patients have a disconnect between these two terms because our range of knowledge is not the same. There is also a disconnect on how to explain to someone in and understanding way.

reducing stigma

Turning illness into a story is a form of control & opportunity for others to communicate caring and understanding

Passing

Turning illness into story is a form of control and opportunity for others to communicate caring and understanding.

How was the power of suggestion an interpersonal drama b/w doctor and patient?

Vulnerable, naive, needy person (often patient) interacts with authority figure (doctor, healer, hypnosis, priest). Knowledge that comes from the authority brings no skepticism -Authority figure words can open up channels of communication between a patients mind/body that are impassable (doc says your going to die and you believe you will...you most likely will)

Embodiment

We are conscious of the body, looking at it, sensing it, but at the same time feeling disembodied by the alien nature of novel sensations in illness, cyclical body changes, and dysfunction. (This term might have been DISembodiment?)

Narratives as Opportunities to Talk & Think Differently

When hearing others stories, we are able to put certain ideas or beliefs in context and real-life situations that may alter or enhance our way of thinking

How is the power of thinking interconnected with American feminism?

Women were considered to be frail / weak, mind-cure offered them a way of conquering their physical limitations.

Biocultural Self

Would probably be more focused on what kinds of things your religion, family, etc. allow you to do. If using marijuana as a medicine is seen as a positive or negative in your family.

Epiphany

a discovery of what one has always been but has never understood·

Lia Lee's story illustrates what?

complexity of what creates and contributes to the seemingly unbridgeable chasm b/w the culture of American medicine and the culture of the Hmong

Controversy of Medical Marijuana

controversy arose and opinions were sharply debated over the value of its medicinal properties relative to the risks posed by its use.

Herbert Benson MD's work: what claims were made about the health benefits of transcendental meditation?

decrease in their metabolism, breathing rate and brain wave frequency.

Natural birth

defined as the approach to birthing that is non-technological: No drugs, no technological monitoring, no espisiotomy, supportive, and affirming b/c the woman has more responsibility, autonomy, and control of birth.

Chicago Syphilis Congrol Program

demonstrates that the complex interrelationships of individuals and circumstances can help or confound any organization's best laid plans. (more info pg 111)

Medical Figures of Speech

due to the medical perspective being so ingrained into our society, its metaphors often spill over to non-health related arenas and often stigmatize people with certain disease. EX: the computer became "infected with contagious viruses."

Prop 215

each of which aimed to legalize doctors prescription of marijuana for medical purposes

What most astounded Herbert Benson?

effects that meditation produced on visceral and autonomic functioning. These two conditions seemed to amount to a systematic reversal of the fight or flight or stress response. (making them calmer).

Culture:

group or community of people who share a set of beliefs, values, and attitudes that guide their behavior. Don't have to be in just one.

Progressive Ideology

how people in our society tend to become blind supporters and subjects of technology. How we depend and put faith in an elite group of specialists solely because of their technical expertise.

Passive Participation

the patient is a compliant recipient of medical directives