Garcia, João Otavio

Leite, Andre

Vianna, Eduardo

English

Tidsskrift.dk (Det Kongelige Bibliotek)

OUTLINES - CRITICAL PRACTICE STUDIES• Vol. 23, No. 1 • 2022 • (01-04) •www.outlines.dkEditorialResearch as praxis: challenginginequalities in systems of careEduardo Vianna¹, João Otavio Garcia² & André Luis Leite ³¹LaGuardia Community College and Graduate Center - CUNY, New York, USA² Federal University of Santa Catarina, Florianópolis, Brazil³ Pontifical Catholic University of São Paulo, BrazilWe proudly announce the latest Outlines Critical Practice Studies issue! Bringingto fruition the transformative power of knowledge, and embracing the journal'scommitment to interdisciplinarity, the authors in this issue advance social justice-orientedresearch agendas and bring powerful insights on urgent problems of our time. Perhaps notsurprisingly after two years of a pandemic, the articles in this issue critically interrogatesocial practices of care, including medical and social practices. The articles publishedherein, though representing different voices and stances, powerfully channel a sharedethical-political commitment to carry out research as praxis to move beyond the status quoby challenging inequalities in a range of systems of care.The issue opens with a thought-provoking article by Joanne Hunt about theentanglement of medically unexplained symptoms (MUS) with medical practice at theintersection of other social practices, including their underpinning theoretical frameworks.1Vianna, Garcia & Leite • 2The article reveals disablement to be as much a product of structural, institutional, andinterpersonal misuse of power, as it is a product of biology. It suggests that psychosocialdistress in MUS, far from being a predisposing or primary perpetuating factor, is largelysecondary to such misuse of power. In other words, the author makes the well supportedclaim that the ‘seeking to avoid mental health stigma’ narrative of MUS functions as ameans to further misrepresent, other, and deflate the credibility of people labeled withMUS. This raises the question of whether the ‘biopsychosocial’ (BPS) discourse, despiteits apparent liberatory appeal, ultimately serves to disempower patients suffering fromMUS. Consistent with a critical approach, she contends that BPS discourse hasover-emphasised the role of individual factors and eschewed analysis of socio-structuralcontext. In particular, attention is paid to clinical and therapeutic settings wherein thepatient-practitioner relationship is an important contextual factor, necessitating practitionerreflexivity. The fact that the author is a person diagnosed with medically unexplainedsymptoms and a background on psychological therapies brings a fresh look into this issuefrom her unique position as someone who knows first-hand about the perils of thepsychologization of such symptoms. Hunt inspires us to take a careful look into thesediscourses and calls for a more reflexive and critical view of the biopsychosocial model”as well pointed out by the reviewers. Moreover, the article critically unpacks the notion of‘gains of suffering’, demonstrating how it disempowers patients by serving as “furtherevidence of dysfunctional illness behavior.” Brilliantly, the author turns this concept on itshead and applies it to examine practitioners’ own gains in eschewing reflexity. Arguably,this is the main import of the manuscript, to discuss the how “lack of reflexivity on thepart of actors and institutions whose practice and policy derives from BPS theorizing andthose whose vested interests have given rise to and reinforced such theorizing, notably inOUTLINES - CRITICAL PRACTICE STUDIES • Vol. 23, No. 1 • 2022www.outlines.dkEditorial: Research as praxis • 3the psy professions, is contributing to the persistence of BPS hegemony and furthering ofpatient harm.” Furthermore, the article offers a penetrating analysis disclosing theimportant but tacitly hidden link between BPS discourse and a broader agenda of austeritymanagement, which dominates health and social policy. This missing link is revealed bydemonstrating how individualistic psychosocial discourse (and practice) about patients’symptoms are crafted without considering the broader social context.Another critical interrogation of health care practice, Nina Nissen challenges takesa surprising new look not only at Western herbal medicine (WHM) but also at our ways ofknowing about it. Her innovative photo essay departs from conventional academic genresby experimenting with an alternative format of ‘doing and sharing knowledge’. The articlelives up to Outlines’s mission to push the publishing envelope further, by experimentingdifferent formats and writing styles, seeking to analyze core discussions about humandevelopment and taking publishing as a form of (critical) practice. The author lays out ananthropological discussion about the necessity of looking into practices of western herbalmedicine, with a specific attention to the mediating materiality of technologies. Thisincludes spatial and aesthetic arrangements and displays of knowledge that we take forgranted, such as by relying on the presence of medical measurement instruments, spaces,and recipes, and the possible relations between these technologies and the traditionalmodels of medicine. On the surface, this strategy may seem as an attempt to question thelegitimacy of so-called natural medicines by exposing how they often borrow the tools andpractices of traditional western medicine. However, this beautifully illustrated workevinces the strategically negotiated legitimacy of WHM at the intersection with traditionalpractices. Rather than deconstructing the validity of Western herbal medicine, Nissen’sarticle draws attention to how everyday technologies contribute to its production.OUTLINES - CRITICAL PRACTICE STUDIES • Vol. 23, No. 1 • 2022www.outlines.dkVianna, Garcia & Leite • 4Straddling this fine line, the evocative edge of this photo essay invites readers to fold backthe analysis and consider how the legitimacy of mainstream medical practices is reliant onthe mediating materiality of those technologies.Last but not least, the issue closes with an article by Karl Eriksson and AsbjørnStorgaard which “makes a substantial, original, and creative contribution to the topic ofthe peer-relation in the field of social work. Readers will appreciate how the authorsadvance our understanding of peer relations, in particular by elucidating the emancipatorypotential of solidarity in practices of mutual care and support  groups in self-help groups,such as Alcoholic Anonymous (AA). The text will certainly catch the readership’sattention by drawing an unexpected link between Saint Paul's letters to the FirstThessalonians and peer-relation practices. As one reviewer put it, “I asked myself at theoutset what this biblical text could help in the understanding of such practices ofrelationship between peers?” The link is that, according to Heiddegger, Saint Paulit placedhimself as an equal, suffering the same uncertainties and anxieties as the other Christiansof his ancient community. The thrust of this discussion is to understand the potential ofpractices between peers, which, according to the authors, consist of practices that are notmediated by hierarchical relationships, knowledge or power. In other words, the authorsexplore how the non-hierarchical and non-professionally mediated position of peers inthese groups promotes a common, collective, and horizontal listening. Importantly, this isoften the last resort for those seeking recovery, as the afflictions of one are also theaffliction of another, so the feeling of collectivity, of sharing their struggles in recoveringfrom addiction creates a sense of collectiveness that is fundamental to the treatment. Thearticle then offers a fresh perspective to researchers interested in the potential of thenon-hierarchical partnerships as a tool to foster active engagement in problem solving.OUTLINES - CRITICAL PRACTICE STUDIES • Vol. 23, No. 1 • 2022www.outlines.dk

Research as praxis:: challenging inequalities in systems of care

https://tidsskrift.dk/outlines/article/download/134236/179222

Research as praxis:: challenging inequalities in systems of care

Abstract

Similar works

Full text

Available Versions

Tidsskrift.dk (Det Kongelige Bibliotek)