Repressive authenticity in the quest for legitimacy: Surveillance and the contested illness lawsuit

Narrative reconstruction of mental illness as a work-stress-induced disorder: Processes, consequences and implications

Stress-induced mental illnesses have become the focus of increasing international attention, particularly in Japan since the 1990s, where judiciary cases and welfare-state initiatives established causal links between work stress and mental illness. However, how individuals retrospectively construct this causality remains a marginal topic in the literature. This ethnographic article explores the ways in which male workers seeking compensation for their condition (depression and adjustment disorder) reconstruct aetiology narratives and to what avail. This paper demonstrates two themes: (1) how objectivising stress (related to specific formats of worker compensation), no-faulting (dispensing with individual blame to view stress as pervasive in the workplace) and negotiating blame (seeking explanation in terms of individual psychology) construct a case, and (2) how narrative reconstruction functions as both a barrier to recovery and way of working towards recovery and collective function. It is argued that the narrative reconstructions of workers, who become unwell and seek recognition, suggest uncertain self-victimisation despite the broader understanding of mental illness in contemporary Japan. The findings imply the heuristic potential of relativising causality and treating analytical dichotomies, including causality-narrative, victimhood-agency and fact-fiction, not as contradictory alternatives, but as different analysis levels, to better understand ambiguous illness narratives.

Fibromyalgia, Chronic Fatigue Syndrome, and Multiple Chemical Sensitivity: Illness Experiences

Fibromyalgia, chronic fatigue syndrome/myalgic encephalomyelitis, and multiple chemical sensitivity can be considered contested illnesses. The questioning of the status of these conditions as real diseases reduces feelings of legitimacy in those affected. The purpose of this study was to analyze subjectivity construction processes in people with these diseases. A qualitative exploratory study was conducted from the perspective of hermeneutic phenomenology and ethnosociology. We used life stories for compiling data (13 informants were interviewed face-to-face), and sociological discourse analysis was developed. Three main categories were identified: (a) self and grieving; (b) images and practices relating to fibromyalgia, chronic fatigue syndrome/myalgic encephalomyelitis, and multiple chemical sensitivity; and (c) relationships with health professionals. This study shows that daily experiences of people living with these diseases are marked by stigmatization processes. The ultimate purpose of nursing care for people with these conditions should be to reduce their vulnerability and exclusion.

From individual coping strategies to illness codification: the reflection of gender in social science research on multiple chemical sensitivities (MCS)

INTRODUCTION

Emerging fields such as environmental health have been challenged, in recent years, to answer the growing methodological calls for a finer integration of sex and gender in health-related research and policy-making.

METHODS

Through a descriptive examination of 25 peer-reviewed social science papers published between 1996 and 2011, we explore, by examining methodological designs and theoretical standpoints, how the social sciences have integrated gender sensitivity in empirical work on Multiple Chemical Sensitivities (MCS). MCS is a "diagnosis" associated with sensitivities to chronic and low-dose chemical exposures, which remains contested in both the medical and institutional arenas, and is reported to disproportionately affect women.

RESULTS

We highlighted important differences between papers that did integrate a gender lens and those that did not. These included characteristics of the authorship, purposes, theoretical frameworks and methodological designs of the studies. Reviewed papers that integrated gender tended to focus on the gender roles and identity of women suffering from MCS, emphasizing personal strategies of adaptation. More generally, terminological confusions in the use of sex and gender language and concepts, such as a conflation of women and gender, were observed. Although some men were included in most of the study samples reviewed, specific data relating to men was undereported in results and only one paper discussed issues specifically experienced by men suffering from MCS. Papers that overlooked gender dimensions generally addressed more systemic social issues such as the dynamics of expertise and the medical codification of MCS, from more consistently outlined theoretical frameworks. Results highlight the place for a critical, systematic and reflexive problematization of gender and for the development of methodological and theoretical tools on how to integrate gender in research designs when looking at both micro and macro social dimensions of environmental health conditions.

CONCLUSIONS

This paper contributes to a discussion on the methodological and policy implications of taking sex and gender into account appropriately in order to contribute to better equity in health, especially where the critical social contexts of definition and medico-legal recognition play a major role such as in the case of MCS.