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THE SELF IN SICKNESS AND IN HEALTH

THE SELF IN SICKNESS AND IN HEALTH. Clara Valverde RN BSc Aquo Training Team www.equipoaquo.com formacionsalud@hotmail.com. The interruption of one’s biography. While healthy, one takes for granted one’s body And what else? What changes with illness?

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THE SELF IN SICKNESS AND IN HEALTH

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  1. THE SELF IN SICKNESS AND IN HEALTH Clara Valverde RN BSc Aquo Training Team www.equipoaquo.com formacionsalud@hotmail.com

  2. The interruption of one’s biography • While healthy, one takes for granted one’s body • And what else? • What changes with illness? • How would one be seen differently? (social meanings) • How would it affect one’s idea of “success”? • How would it interrupt one’s biography?

  3. Medicalization of society • How does it feel to be a patient? • How does the health care system see the patient? • Gender differences. • How does the patient see the health care system?

  4. Medicalization of society • What does the doctor want to talk about? • What does the patient want to talk about?

  5. Medicalization of society • Medicalization is a social process in which bodies and social circumstances are defined from a biomedical perspective requiring biomedical intervention.

  6. Today it is not the stethescope nor the scalpel that does the fundamental work of medicine; it is the ideas conveyed in words that persuade us that what is done is right and good. Trish Greenhalgh Under the Medical Gaze

  7. Medicalization of society • The “battle of narratives” in the doctor’s office • (Arthur Kleinman, Arthur Frank, Abel and Browner, Rita Charon, T. Greenhalgh, C.Mattingly, L.Garro)

  8. The doctor hides his doubts and fears behind a shield of invincibility and he forgets that it is only a shield. Eric J.Cassell The Healer’s Art

  9. Medicalization of the self • How does the doctor take power? • How does the patient give the doctor power? • Possible problems with this situation?

  10. Science’s job now-a-days is not so much to tell The Truth, but to tell a truth and then make it look like The Truth. David Locke Science as Writing

  11. Medicalization of the self • Embodied knowledge: what one feels in one’s body. • Empathic knowledge: another’s experience that one identifies with. (Abel and Browner 1998)

  12. Scientists make things that are only probably true seem definitely true. David Locke

  13. Truth claims • What are some “truth claims” that doctors make that are reproduced in society? • How are they reproduced?

  14. Expected Illness Behaviours • What does society expect the ill person to do, not to do, to be like, not to be like, to look like, not to look like? • What does society expect the ill person to think, hope for? • Are some behaviours seen as “better” than others?

  15. To always be looking for a cure is not an adaptative behaviour. M.J. Montbriand

  16. Expected Illness Behaviours • How does society see slowness, weakness, confusion, vulnerability? • Could they be accepted values, just as accepted as the “can-do” attitude?

  17. I wake up with it. I feel like I’ve done something wrong. I have this horrible feeling, like I’m really bad, like I should make up to someone, even get forgiveness. I often can’t shake it till I’m on my way to work. Sometimes at night I dread going to sleep ‘cause I know I will wake up with it. Moira, legal assistant, lives with lupus Sick and Tired of Feeling Sick and Tired: Living with Invisible Chronic Illness (Donoghue and Siegel 2000)

  18. Expected Illness Behaviours Guilt: • How does “blaming the victim” work? • Why does it work? • Who does it?

  19. Medical encounters tend to convey ideologic messages supportive of the current social order. Howard Waitzkin

  20. Invisible Chronic Illnesses or Disabilities • How does it affect one’s self having an illness or disability that is invisible? • Advantages and disadvantages of the fact that it is invisible

  21. Three types of invisibility in the new chronic illnesses such asChronic Fatigue Syndrome-Myalgic Encephalitis (CFS-ME), Multiple Chemical Sensitivities (MCS), Fibromyalgia (FMS), Gulf War Syndrome (GWS), etc: • 1. The person is not seen because s/he is at housebound • 2. S/he has no outer signs of the illness (“but…you don’t look sick”) • 3. When s/he says s/he has CFS, MCS, FMS or GWS, people do not believe him/her Juliene Lipson PhD UCSF

  22. Diagnosis or Definition? • What are the advantages of having the diagnosis? • What are the disadvantages of having the diagnosis?

  23. Reclaiming the Self • What would help the ill person find his own definition of what it is to have that illness, to find meaning to his or her new life? • What would hinder?

  24. I have changed. Like you. But in a different way. Paul Verlaine

  25. Thank you! formacionsalud@hotmail.com

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