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  2. Abstract

In this paper I demonstrate the way in which people's beliefs about the aetiology of their particular affliction (arthritis) need to be understood as part of a more comprehensive imaginative enterprise which I refer to as narrative reconstruction. The intrinsically teleological form of this enterprise means that identified ‘causes’ represent r only putative efficient connexions between the disease and antecedent factors but also narrative reference points between the individual and society in an unfolding process which has become profoundly disrupted. Through the presentation of case material taken from lengthy interviews I illustrate the way in which my question to the subjects about the cause of their disease: ‘Why do you think you got arthritis?’ was translated by them into a narrative reconstruction of their changing relationship to the world in which they live and the genesis of illness within it.

  • 1

    . The Arthritis and Rheumatism Council for Research, Reports on Rheumatic Diseases. Collected Reports 1959–1977, London: ARC, 1978, p. 6.

  • 2

    . D. Locker, Symptoms and Illness: The Cognitive Organization of Disorder, London: Tavistock, 1981.

  • 3

    . P. H. N. Wood (ed.), The Challenge of Arthritis and Rheumatism: A Report on Problems and Progress in Health Care for Rheumatic Disorders, London: British League Against Rheumatism/Arthritis and Rheumatism Council, 1977.

  • 4

    . The term ‘genesis’ is used by Claudine Herzlich in her monograph: Health and Illness: A Socio-Psychological Approach, London: Academic Press, 1979. Although I employ a somewhat different definition, I have been much influenced by both the style and substance of that excellent book.

  • 5

    . For example, J. H. Mabry, ‘Lay concepts of aetiology’, J. Chron. Dis., vol. 17 1964, pp. 37186. ; R. G. Elder, ‘Social class and lay explanations for the aetiology of arthritis’, J. Hlth. Soc. Behav., vol. 14 1973, pp. 2838. ; M. Linn, B. Linn, and S. Stein, ‘Beliefs about causes of cancer in cancer patients’, Soc. Sci. Med., Vol. 16, 1982, pp. 8359. ; R. Pill and N. Stott, ‘Concepts of illness causation and responsibility: some preliminary data from a sample of working class mothers’, Soc. Sci. Med., vol. 16, 1982, pp. 4352. ; M. Blaxter, ‘The causes of disease: women talking’, Soc. Sci. Med., vol. 17, 1983, pp. 5969.

  • 6

    . M. Bury, ‘Chronic illness as biographical disruption’, Sociology of Health and Illness, vol. 4, no. 2, 1982, pp. 16782.

  • 7

    . See P. Berger and B. Berger, Sociology: A Biographical Approach, Harmonds-worth: Penguin, 1976;C. W. Mills, The Sociological Imagination, Harmonds-worth: Penguin, 1970; D. Bertaux (ed.), Biography and Society: The Life History Approach in the Social Sciences, New York: Sage, 1981.

  • 8

    . R. Musil, The Man Without Qualities, Two: The Like of It Now Happens (II), London: Picador, 1979, p. 436.

  • 9

    . The terms ‘practical consciousness’ and ‘discursive consciousness’ are borrowed from: A. Giddens, Central Problems in Social Theory: Action, Structure and Contradiction in Social Analysis, London: Macmillan, 1979, p. 5.

  • 10

    . M. Linn et al., op. cit., p. 838.

  • 11

    . G. Orwell, ‘Shooting an elephant’, in, Inside the Whale and Other Essays, Harmondsworth: Penguin, 1962, p. 93.

  • 12

    . R. G. Collingwood, The Idea of History, Oxford: Clarendon Press, 1946, p. 247.

  • 13

    . This idea of the relationship of past to present is similar to that of G. H. Mead. For a useful exposition see: D. R. Mains, N. M. Sugrue, and M. A. Katovich, ‘The sociological import of G. H. Mead's theory of the past’, Am. Social. Rev., vol. 48, 1983, pp. 16173.

  • 14

    . Probably the best version of Hume's ideas on causality and related issues may be found in: David Hume, A Treatise of Human Nature, Oxford University Press, 1978. This includes a helpful analytic index by L. A. Selby-Bigge.

  • 15

    . R. Bambrough, The Philosophy of Aristotle, New American Library, Mentor, 1963.

  • 16

    . R. Nisbet, Social Change and History: Aspects of the Western Theory of Development, New York: Oxford University Press, 1969, p. 27.

  • 17

    . A. MacIntyre, After Virtue: A Study in Moral Theory, London: Duckworth, 1981.

  • 18

    . N. S. Weiss, ‘Inferring causal relationships: elaboration of the criterion of “dose-response”’, Am. J. Epidem., vol. 113, no. 5, 1981, pp. 48790.

  • 19

    . A. Young, ‘The discourse on stress and the reproduction of conventional knowledge’, Soc. Sci. Med., vol. 14B, 1980, pp. 13346.

  • 20

    . A. MacIntyre, op. cit., p. 202.

  • 21

    . For example, M. Taussig, ‘Reification and the consciousness of the patient’, Soc. Sci. Med., vol. 14B, 1980, pp. 313.

  • 22

    . For example, R. Elder, op. cit.; R. Pill and N. Stott; op. cit.

  • 23

    . M. Linn, et al., op. cit.

  • 24

    . A. MacIntyre, op. cit.

  • 25

    . G. Lewis, Knowledge of Illness in Sepik Society, London: Athlone Press, 1975, p. 197.

  • 26

    . M. Blaxter, op. cit., p. 68.

  • 27

    . J. Comaroff and P. Maguire, ‘Ambiguity and the search for meaning: childhood leukaemia in the modern clinical context’, Soc. Sci. Med., vol. 15B, 1981, p. 119.

  • 28

    . J-P. Sartre, Sketch fora Theory of the Emotions, London: Methuen, 1971.

  • 29

    . E. A. Early, ‘The logic of well-being: therapeutic narratives in Cairo, Egypt’, Soc. Sci. Med., vol. 16, 1982, p. 1496.