Doctoral Dissertation Improvement Grant: Ideologies of Communication in a Los Angeles Pediatric Pain Clinic

研究生玛拉·布赫宾德将在埃莉诺·奥克斯博士的指导下，通过对洛杉矶多学科儿科疼痛诊所的案例研究分析，调查文化过程对疼痛沟通的中介作用。具体目的是研究：1)青少年如何通过语言和非语言实践交流疼痛经验；2)临床医生如何通过反复的医疗咨询将家庭融入到疼痛管理和疼痛沟通的文化组织意识形态中；3)这些意识形态是如何被家庭在日常生活中实施、制定、拒绝或改变的。虽然以前的人类学工作已经将改变的态度、感觉和实践描述为特定疼痛治疗方法的结果，但很少有民族志研究考虑到正在进行的文化和相互作用过程，这些过程是通过这些转变形成的。研究人员将采用纵向民族志设计和语言社会化框架来跟踪青少年慢性疼痛患者在临床和家庭环境中，在诊所登记之前和之后如何体验和交流疼痛。主要采用四种方法：1)在家庭和诊所进行参与式观察；2)这些环境中重点活动的纵向音频/视频记录；3)对青少年、其父母和诊所工作人员进行深入访谈；4)青少年自录视频日记。通过纵向记录和分析语言和非语言交流实践，本研究将阐明青少年及其家庭是否以及如何在不断变化的社会和文化框架中调整他们对疼痛的倾向和疼痛交流实践。在这样做的过程中，这项研究不仅将调查疼痛交流的社会组织，而且还将理论化生殖和变化的文化过程，通过这些文化过程，新的交流形式和主体性随着时间的推移而出现。这一发现将对研究人员开发儿童慢性疼痛患者及其家属的社会心理干预具有潜在的兴趣。该奖项还将支持社会科学家的教育。

Graduate student Mara Buchbinder, directed by Dr. Elinor Ochs, will investigate the cultural processes mediating the communication of pain through a case study analysis of a multidisciplinary pediatric pain clinic in Los Angeles. The specific objectives are to examine: 1) how adolescents communicate pain experience through verbal and non-verbal practices; 2) how clinicians socialize families into culturally organized ideologies of pain management and pain communication through repeated medical consultations; and 3) how such ideologies are implemented, enacted, rejected, or transformed by families in their everyday lives. While previous anthropological work has described changed attitudes, feelings, and practices as outcomes of particular pain treatment approaches, few ethnographic studies have considered the ongoing cultural and interactional processes through which such transformations take shape. The researcher will employ a longitudinal ethnographic design and a language socialization framework to track how adolescent chronic pain sufferers experience and communicate pain in clinical and family settings, before and after enrollment in the clinic. Four primary methods will be used: 1) participant observation in families'homes and in the clinic; 2) longitudinal audio/video recordings of focal activities in these settings; 3) in-depth interviews with adolescents, their parents, and clinic staff; and 4) adolescents' self-recorded video diaries. By documenting and analyzing verbal and non-verbal communicative practices longitudinally, the research will illuminate whether and how adolescents and their families adjust their disposition toward pain and practices of pain communication within shifting social and cultural frameworks. In so doing, the study will not only investigate the social organization of pain communication, but it will also theorize the cultural processes of reproduction and change through which new forms of communication and subjectivity emerge over time. The findings will be of potential interest to researchers developing psychosocial interventions for pediatric chronic pain sufferers and their families. This award also will support the education of a social scientist.