Identity, environment and mental wellbeing in the veterinary profession

Mental health and career dissatisfaction are of increasing concern to the veterinary profession. The influence of identity on the psychological wellbeing of veterinarians has not been widely explored. Twelve recent veterinary graduates were enrolled in a private social media discussion group, and their identities investigated through narrative inquiry: a methodology which enables identity priorities to be extrapolated from stories of experience. Two distinct variants of the veterinary identity were identified: an academic, ‘diagnosis-focused’ identity, which prioritised definitive diagnosis and best-evidence treatment; and a broader ‘challenge-focused’ identity, where priorities additionally included engaging with the client, challenging environment or veterinary business. Contextual challenges (such as a client with limited finances or difficult interpersonal interactions) were seen as a source of frustration for those with a diagnosis-focused identity, as they obstructed the realisation of identity goals. Overcoming these challenges provided satisfaction to those with a challenge-focused identity. The employment environment of the graduates (general veterinary practice) provided more opportunities for those with a challenge-focused identity to realise identity goals, and more markers of emotional wellbeing were apparent in their stories. Markers of poor emotional health were evident in the stories of those with a diagnosis-focused identity

Alliances in action: Opportunities and threats to solidarity between workers and service users in health and social care disputes

This paper reflects upon the recent mental-health nurses' strike following the sacking of Karen Reissman by Manchester Mental Health and Social Care Trust. Nursing strikes are rare, though there is a significant strand of militancy in the history of nursing. Analysis of the Manchester dispute and associated media coverage is relied on as a point of departure for a more general discussion around issues of solidarity and connections between trade union and service-user activism. These issues are explored in a context of the industrial and social relations of mental-health care. It is argued that regressive, stereotypical representations of mental health, which appeal to fears surrounding public safety, are a feature of this industrial-relation territory. This paper proposes that social relations of work and connections with the wider community could be transformed by a dual strategy: pursuing a more progressive and inclusive understanding of mental health and building stronger alliances between trade union, community and service-user activists

How patients contribute to an online psychoeducation forum for bipolar disorder: a virtual participant observation study

Background: In a recent exploratory randomized controlled trial, an online psychoeducation intervention for bipolar disorder has been found to be feasible and acceptable to patients and may positively impact on their self-management behaviors and quality of life. Objective: The objective of the study was to investigate how these patients contribute to an online forum for bipolar disorder and the issues relevant for them. Methods: Participants in the intervention arm of the Bipolar Interactive PsychoEDucation (“BIPED”) trial were invited to contribute to the Beating Bipolar forum alongside receiving interactive online psychoeducation modules. Within this virtual participant observation study, forum posts were analyzed using thematic analysis, incorporating aspects of discourse analysis. Results: The key themes which arose from the forum posts included: medication, employment, stigma, social support, coping strategies, insight and acceptance, the life chart, and negative experiences of health care. Participants frequently provided personal narratives relating to their history of bipolar disorder, life experiences, and backgrounds, which often contained emotive language and humor. They regularly sought and offered advice, and expressed encouragement and empathy. The forum would have benefitted from more users to offer a greater support network with more diverse views and experiences. Conclusions: Online forums are inexpensive to provide and may offer peer support and the opportunity for patients to share their experiences and explore issues related to their illness anonymously. Future research should focus on how to enhance patient engagement with online health care forums

‘Super disabilities’ vs ‘Disabilities’?:Theorizing the role of ableism in (mis)representational mythology of disability in the marketplace

People with disabilities (PWD) constitute one of the largest minority groups with one in five people worldwide having a disability. While recognition and inclusion of this group in the marketplace has seen improvement, the effects of (mis)representation of PWD in shaping the discourse on fostering marketplace inclusion of socially marginalized consumers remain little understood. Although effects of misrepresentation (e.g., idealized, exoticized or selective representation) on inclusion/exclusion perceptions and cognitions has received attention in the context of ethnic/racial groups, the world of disability has been largely neglected. By extending the theory of ableism into the context of PWD representation and applying it to the analysis of the We’re the Superhumans advertisement developed for the Rio 2016 Paralympic Games, this paper examines the relationship between the (mis)representation and the inclusion/exclusion discourse. By uncovering that PWD misrepresentations can partially mask and/or redress the root causes of exclusion experienced by PWD in their lived realities, it contributes to the research agenda on the transformative role of consumption cultures perpetuating harmful, exclusionary social perceptions of marginalized groups versus contributing to advancement of their inclusion

Now I can feel myself!

This paper addresses the visual discourse of psychopharmaceuticals, such as Prozac, in order to investigate the network of relationships of affects, advertising, design and the production of new identity practices. As psychopharmaceuticals enter the public sphere through television and print advertisements, as well as first person narratives increasingly promoted in the media, the cultural discourse surrounding their use and the identity of the users are also changing. Drawing from a Spinozist notion of affect, ‘the trace of one body upon another’, as well as from a semiotic analysis of advertisements, I intend to examine the identity practices and the type of embodiment emerging in, and envisioned by, the increasingly normalised object ‘psychopharmaceutical’. The centrality of affects in the constitution of subjectivity is increasingly relevant to contemporary critical theory (see the notion of ‘affective turn’, Clough). Addressing the network of affective investments we exchange with objects is crucial for an understanding of how embodied subjectivities mutate accordingly to the objects they interact with. Against the theoretical backdrop provided by what Nikolas Rose calls the ‘pharmaceutical biopolitics of the neurochemical self’, the analysis of packaging, colour, visual and textual language of their advertising suggests how new scripts of selfhood are inscribed in the relationship between users and psychopharmaceuticals. The ensuing dialogue among chemistry, affects and design creates narratives of the self as a myth-making operation in which psychopharmaceuticals perform as objects imbued with magic properties

‘There’s no pill to help you deal with the guilt and shame’: Contemporary experiences of HIV in the United Kingdom

© The Author(s) 2017. The experience of living with HIV, in the global north, has changed significantly over the past 20 years. This is largely the result of effective biomedical methods of treatment and prevention. HIV is now widely considered to be a long-term condition like many others – it has been argued that HIV has been ‘normalised’. Drawing on online qualitative survey data, with respondents aged 18–35 years, diagnosed with HIV in the past 5 years, this research explores contemporary subjective experiences of being diagnosed, and living, with HIV in the United Kingdom. The data reveal ambiguous experiences and expectations, as the ‘normative’ status of HIV exists alongside ongoing experiences of fear, shame and stigma – maintaining its status as the most ‘social’ of diseases. In rendering HIV ‘everyday’, the space to articulate (and experience) the ‘difference’ which attaches to the virus has contracted, making it difficult to express ambivalence and fear in the face of a positive, largely biomedical, discourse. In this article, the concepts of normalisation and chronicity provide an analytical framework through which to explore the complexity of the ‘sick role’ and ‘illness work’ in HIV

Identity dynamics as a barrier to organizational change

This article seeks to explore the construction of group and professional identities in situations of organizational change. It considers empirical material drawn from a health demonstration project funded by the Scottish Executive Health Department, and uses insights from this project to discuss issues that arise from identity construction(s) and organizational change. In the course of the project studied here, a new organizational form was developed which involved a network arrangement with a voluntary sector organization and the employment of “lay-workers” in what had traditionally been a professional setting. Our analysis of the way actors made sense of their identities reveals that characterizations of both self and other became barriers to the change process. These identity dynamics were significant in determining the way people interpreted and responded to change within this project and which may relate to other change-oriented situations

Unmet goals of tracking: within-track heterogeneity of students' expectations for

Educational systems are often characterized by some form(s) of ability grouping, like tracking. Although substantial variation in the implementation of these practices exists, it is always the aim to improve teaching efficiency by creating homogeneous groups of students in terms of capabilities and performances as well as expected pathways. If students’ expected pathways (university, graduate school, or working) are in line with the goals of tracking, one might presume that these expectations are rather homogeneous within tracks and heterogeneous between tracks. In Flanders (the northern region of Belgium), the educational system consists of four tracks. Many students start out in the most prestigious, academic track. If they fail to gain the necessary credentials, they move to the less esteemed technical and vocational tracks. Therefore, the educational system has been called a 'cascade system'. We presume that this cascade system creates homogeneous expectations in the academic track, though heterogeneous expectations in the technical and vocational tracks. We use data from the International Study of City Youth (ISCY), gathered during the 2013-2014 school year from 2354 pupils of the tenth grade across 30 secondary schools in the city of Ghent, Flanders. Preliminary results suggest that the technical and vocational tracks show more heterogeneity in student’s expectations than the academic track. If tracking does not fulfill the desired goals in some tracks, tracking practices should be questioned as tracking occurs along social and ethnic lines, causing social inequality

‘Blindness to the obvious’?: Treatment experiences and feminist approaches to eating disorders

Eating disorders (EDs) are now often approached as biopsychosocial problems, but the social or cultural aspects of the equation are often marginalised in treatment - relegated to mere contributory or facilitating factors. In contrast, feminist and socio-cultural approaches are primarily concerned with the relationship between EDs and the social/ cultural construction of gender. Yet although such approaches emerged directly from the work of feminist therapists, the feminist scholarship has increasingly observed, critiqued and challenged the biomedical model from a scholarly distance. As such, this article draws upon data from 15 semi-structured interviews with women in the UK context who have experience of anorexia and/or bulimia in order to explore a series of interlocking themes concerning the relationship between gender identity and treatment. In engaging the women in debate about the feminist approaches (something which has been absent from previous feminist work), the article explores how gender featured in their own understandings of their problem, and the ways in which it was - or rather wasn’t - addressed in treatment. The article also explores the women’s evaluations of the feminist discourse, and their discussions of how it might be implemented within therapeutic and clinical contexts

Researching Across Two Cultures: Shifting Positionality

Embodied and creative research methods provoke honesty, emotion, and vulnerability in participants, which add to the richness of the stories they tell and are willing to share. The positionality of the researcher is less of “interviewer” and more “co-producer” or participant in a dialogue. Visual and creative approaches invite participants to share in ways in which they are not able or willing through words alone. The data and outputs they produce, with film, art, or objects, can in turn affect those who see it more than written text and need to be analysed and disseminated along with more traditional transcripts, articles, and presentations. In the context of investigating sensitive issues such as those around embodied identity, these methods, which use embodied methods to explore embodied research questions, may feel the most appropriate. These approaches lie along the boundary of therapy and research, asking much of researchers who are unlikely to have received therapeutic training or ongoing support. Due to this deficit, the researched may find that their experience is not held or contained in a way that the content would demand. Similarly, the data themselves lie on the boundary of art and research, in that they can be seen as more than a tool to facilitate reflection, but as artifacts in their own right. What are the implications in this scenario? Where should we position ourselves and our work along these boundaries? Who holds the space for the researcher and the researched if both are made vulnerable