Cultural narratives of distress

Cultural narratives of distress
Every culture offers narratives or sets of meanings for making sense of emotional distress, unusual psychological experiences and norm-breaching behavior (see Harper in
this issue). Some of these narratives are more dominant, privileged and therefore more
culturally available than others. In modern Western cultures, the most privileged narratives are medical, conveyed through language (e.g. symptoms, disorders, illness, treatment); institutions (e.g. hospitals, clinics, medical schools); practice (e.g. psychiatric
diagnosis, hospitalization, administration of drugs) and research (e.g. widely reported
searches for biological or genetic causes). Such narratives not only shape meanings but
create certain identities and possibilities for action, while closing down others (Davies &
Harre, 1990).
Ideological power is obviously relevant here, as medical narratives are often unquestioningly reproduced in textbooks, research papers, professional education, explanations
given to service users, media reports, storylines in drama and literature, and so on.
Economic and legal power also play an important part. The medical narrative is supported by journal publishers and research funders, who may demand or expect its use
in research proposals or reports. It is also strongly supported by pharmaceutical companies through drug marketing and payments to medical professionals and researchers,
including those who devise diagnostic systems (Cosgrove & Wheeler, 2013).
Some service users and their families welcome a medicalised understanding which
seems to offer validation of distress, relief from responsibility and hope of ‘treatment’;
such an understanding, in the form of a diagnosis, may be necessary to access help. For
others, a medical narrative adds to their distress and is seen as the imposition of an
unwanted, defective identity and unwanted physical interventions. Alternative meanings
are far less culturally available, for example that distress and troubling behavior are
highly meaningful responses to life circumstances or that psychotropic drugs do not
JOURNAL OF CONSTRUCTIVIST PSYCHOLOGY 7target specific disorders and can increase disability (Moncrieff, 2009; Whitaker, 2010).
When people adopt these alternative meanings, they may not be validated by those
around them or by professionals, so that the more dominant meaning prevails (PTMF,
Chapter 7); Leeming et al., 2009)