Thinking differently about thinking positive: a discursive approach to cancer patients' talk
Thinking differently about thinking positive: a discursive approach to cancer patients' talk
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DOI：
10.1016/s0277-9536(99)00337-8
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发表时间：
2000-03-01
影响因子：
5.4
通讯作者：
Kitzinger, C
中科院分区：
文献类型：
--
作者：
Wilkinson, S;Kitzinger, C
有大量关于应对癌症的社会科学和心理肿瘤学文献声称，“积极思考”与个人的发病率和死亡率以及他们的整体心理健康水平相关，并且推而广之，与个人的发病率和死亡率及其整体心理健康水平有因果关系。利用我们自己的数据，其中乳腺癌妇女群体谈论“积极思考”，本文从话语的角度，通过挑战他们所依据的数据分析，质疑这种说法的基础。我们发现，以往的文献绝大多数依赖于自我报告的数据，这是被认为提供了或多或少准确的描述的发言者的心理状态（即他们的心理调整或应对方式）。相比之下，话语方法将谈话作为一种行动形式来探索，这种行动形式是为当地的对话背景设计的，并且详细关注关于“积极思考”的陈述在它们发生的背景下对说话者的实际意义。我们发现，“积极思考”的功能不是作为一个准确的报告的内部认知状态，而是作为一个会话的成语，其特点是简洁性和一般性，并总结了社会规范的道德要求;我们还表明，即使是那些乳腺癌患者报告“积极思考”也可以积极抵制其道德处方。最后，我们勾勒出我们的分析的影响，分析癌症患者的谈话更普遍和未来的研究应对癌症。(C)2000爱思唯尔科技有限公司版权所有。
There is an extensive social science and psyche-oncology literature on coping with cancer which claims that "thinking positive" is correlated with - and, by extension, causally implicated in - individuals' morbidity and mortality rates, and their overall level of mental health. Drawing on our own data, in which groups of women with breast cancer talk about "thinking positive", this paper interrogates the basis of such claims from a discursive perspective, by challenging the data analyses upon which they are based. We show that previous literature overwhelmingly relies on self-report data, which are taken as offering more or less accurate depictions of speakers' psychological states (i.e. their mental adjustment or coping style). A discursive approach, by contrast, explores talk as a form of action designed for its local interactional context, and pays detailed attention to what statements about "thinking positive" actually mean for speakers in the contexts in which they occur. We show that "thinking positive" functions not as an accurate report of a internal cognitive state, but rather as a conversational idiom, characterised by vagueness and generality, and summarising a socially normative moral requirement; we also show that even those breast cancer patients who report "thinking positive" can also actively resist its moral prescriptions. Finally, we sketch out the implications of our analysis; for analyses of cancer patients' talk more generally and for future research on coping with cancer. (C) 2000 Elsevier Science Ltd. All rights reserved.