05-02-2007 - S208 Week 5

S208 Week 5 2 May 2007 Berger and Luckmann  sociology of knowledge  key: knowledge about everyday life. how do we know what we know, and what exists in the world? epistemological and ontological issues.  we take for granted the world’s realness and the way that things are. the conventional, routine everyday-ness quality.  on the one hand, much of the language here seems very phenomenological. yet very unconscious, taken-for-granted way.  they were trying to build up how it is that we exist in our everyday world and navigate it in such an unthinking manner.  there’s an enormous amount of tacit, everyday knowledge that we mobilize as we go through our everyday world. they were trying to articulate and analyze how that happens.  John: what about knowledge that doesn’t arise from lived experience?  Beth T: typification  we perceive our bodies in a very immediate, intimate, sensual way  biomedical knowledge / way of thinking might be taken up in many people’s typified way of approaching their bodies or in their senses of illness. so in a way, it becomes part of our everyday reality.  reference to the here and now concerns the quality of that everyday reality. everyday reality is intersubjectively experienced. the here and now is what is present for me now is the same as what is present for all of you; it’s that aspect of reality that is intersubjectively shaped. it’s this particular reality amongst all of us now that they’re trying to impart/get a handle on.  there was always risk, but now we can do something about future risk in the present. it’s our responsibility to do something about it now. that’s how something in the future impinges on the here and now.  Krista: the primacy of face-to-face experience  B&L talk about how other forms of interaction are always seen in reference to face-to-face interaction (the prototypical aspect)  distinction between face-to-face (interactions par excellence) and interactions w/ varying degrees of familiarity and strangeness, and of intimacy  how would you classify Stephen Hawking’s face-to-face interactions?  how would people see him / what meaning would people attach to what he says if he wasn’t a famous physicist?  burgeoning subfield within sociology re: social constructions of identity  B&L are talking about the completely unconscious and unremarkable ways of interaction  they’re talking about how we experience our world as is ----------

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some social constructionists would look at the science of global warming and argue there have been certain influences on the path that that knowledge has taken. others would argue that whether or not it is occurring, global warming impels us to act in certain ways there are different degrees to which social constructionists will buy into the idea of an object reality. but it’s just not part of their project to figure out whether certain things exist. there’s a continuum of the extent to which these theorists will valorize the obdurate external reality  what are the consequences of standing along one point of the continuum or another – for our ability to problematize? John: time is socially constructed ----------

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Smith – Black Lung Bury - social construction as an approach in the sociology of medical knowledge. he talks about different varieties/positions that describe different locations along this continuum. using the case study of black lung, this is an example of which location along the continuum?  what people refer to when they talk about the strong version of social constructionism is that end of the continuum where there is no reality beyond what we construct.  Smith, however, believes there is a “right way” to diagnose black lung  major fault line between those who own the mode of production, and the workers  Bury: material ______: one’s social interests (e.g., producers vs. workers) determines what kinds of knowledges on produces  Crawford talks about the increasingly crucial role of the idiom of health in differentiating who belongs and who doesn’t belong; who’s self and who’s we; who’s us and who’s the other. he sees this as having profoundly political consequences when we’re talking about things/situations defined as real and their consequences, one of the things she talks about is ‘what becomes the problem?’ at different stages, different things were conceptualized as the problem. and those definitions have consequences for what needs to be fixed, or what constitutes the fix. when you define the problem as being coal dust, then the solution that follows from that is finding some technical way to minimize the dust. that displaces our focus and our problematization of the larger workforce relations, the power relations that exist between the mine owners, coal industry, and mine workers that is a central theme of much medical knowledge work. what constitutes the problem is constructed in particular ways; and what implications follow from those constructions? and how does that deflect the emphasis from other sources/problems? Hunt et al – Hypoglycemia the authors are anthropologists, which is why we see an emphasis on cultural values, and somewhat less attention to structure in what ways does this article exemplify constructionism? John: the way the symptoms were interpreted was attributed to diet Erica: there are people who have made this a reality amidst all the different symptoms. social forces have come into play into making hypoglycemia more legitimized

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we’re not taking on medical knowledge per se. it’s a concept that had much more utility in explaining people’s everyday symptoms. it was an illness construct that was taken up much more by people, laypeople first, and was then increasingly taken up within biomedicine. here’s an example in which something actually became crystallized as a more or less everyday kind of concept first, and then was taken up in biomedicine. it’s not just a topdown process. although we talk about biomedicine having much power, you can interpret this as an instance where a construct capturing an everyday reality gives it the ballast for being a much more biomedicalized entity (down-to-top) they talked about most of the people being diagnosed being middle-class women  raises empirical questions re: potentially gendered phenomenon. disproportionate diagnosis. many of the symptoms it is associated with have gendered qualities and phenomena (hormonal disruption, control over eating, etc.)  Amy: I don’t think of it as much as a disease as it is a constellation of symptoms why is getting a diagnosis so important?  Cindy: feeling one belongs  Martine: Crawford article – diagnosis puts you in risk groups (of risky behaviors).  there are some very instrumental/basic reasons why one would want a diagnosis. a diagnosis is often attached to certain universal strategies re: how to cope. once you have access to the diagnosis, you have access to those strategies (instrumental level). on a more theoretical level, medicine is an important source of meaning-making. when we talk about the utility and meaning of having a diagnosis. shapes your symptoms as well as what you do with it. social systems you enter. power of biomedical thinking, of scientific rationality, of a particular way of looking at your body, of looking at your past/present/future and how you might shape your future. historically, it’s a very specific influence that biomedicine has. in part, that’s why we desire a diagnosis. we’re most often talking about a medical diagnosis. it has so much power to legitimate or delegitimate what you’re actually experiencing. value-added.. on one level, hypoglycemia could just be a conglomeration of different kinds of symptoms that describe a physiological entity. but the ways it’s taken up by laypeople and even by professionals draws on a whole series of cultural values and themes and notions of responsibility and empowerment and sense of control over one’s life. that in part is one way in which we could think of a diagnosis being socially constructed. in this article, they’re trying to explore how a diagnosis draws on a whole set of nonmedical, nonliteral, nonphysical/nonphysiological ideas. that in part is what gives it power, significance, and meaning. it’s not simply a medical entity. it’s a cultural entity that has the power to shape the way people see their lives and what they can do to change their circumstances and how they are to interpret the experiences they’re going through Crawford the dichotomies/boundaries that receive our attention – the bases for othering – depend on what’s most salient in a particular social interaction. it’s an ongoing process we engage in when we look at somebody. we wonder why someone gets a disease. in part, that process is a reflection upon ourselves (what am I doing that puts me at less risk?) – and an attempt to distance why that person has that disease from ourselves.

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Crawford’s point isn’t that everything is self-referential; it’s that with discourses re: health (health as central cultural value), any talk about health – inasmuch as it is about trying to understand why certain people are healthy and others are not – all of that talk ends up being about policing the boundaries and maintaining and deciding where that boundary is between the healthy self and the unhealthy other how you try to define the problem (e.g., lack of healthy habits as opposed to placing the blame elsewhere) distinguishes between they and us. consequential for how we define what the problem is, and how we’ll try to fix the problem. it becomes an issue of personal responsibility and knowledge as opposed to, say, providing free dental services seeming irreconcilability between social interaction building up society, yet at the same time our experience of interactions to some degree is determined/shaped by these typified schemes, typifications about who somebody is. Crawford is identifying typifying schemes re: what constitutes a healthy (moral, responsible, controlled, autonomy, self-controlling individual) vs. people who aren’t. how one becomes healthy, how one becomes unhealthy. these all become typified ways in which we interact with one another he talks about the impulsion to target behaviors; the way in which we pick out predispositions of people as distinguishing who’s healthy and who’s unhealthy. we look at things that are particularly intrinsic to those groups. statistical risk factors; this is where public health comes into play. these are a scientized encapsulation of how these essential risk characteristics of groups become these typified, routinized, stereotypical ways in which we regard those groups, and understand how these groups come to have particular disease (it’s b/c of their intrinsic qualities). you see this type of discourse a lot in public health and biomedicine (people adopting healthy lifestyles or unhealthy habits) other value-added: what happens when something becomes seen as a scientific way of understanding – it loses its historical/cultural coloring. it becomes seen as “fact,” even though constructions would point out that scientific views are in themselves constructions  Alyssa: studies based on variables. the variables themselves are constructed. presumptuous to argue that those variables/models can explain things  ontological exercise – what will go into the universe of things you pay attention to?  Amy: even socioeconomic status is socially constructed. controlling for socioeconomic status is only controlling for one variable, like income level