Health Research: Where Medicine Meets Martial Arts Studies?

By George Jennings

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The martial arts may appear mysterious or homogenous at first glance

Why Medical Research Needs Martial Arts Studies

 We all know what medical research involves, or at least we think we do. It is well established around the world as a dominant worldview to understand the psychological and biological world. It can ask and answer questions relating to physical health, the structure of the body, the reasons behind illness and ways to cure or offset it. But can it really pose and solve all problems relating to health? Rapid weight loss among athletes, concussion in training and competition and novel forms of movement therapy have obvious physical components, but perhaps also sociocultural, historical and even geopolitical ones.

The world’s martial arts include a variety of systems and stylised forms. Some are divided into families or lineages. Others are organised in official or breakaway federations. This complexity and diversity has enabled the newly coined ‘martial arts studies’ to borrow from traditions such as anthropology, cultural studies, film studies, history, philosophy and sociology. Specialists ask questions regarding the changes in fighting systems over time, the ways in which they are taught, the role of culture and language in their pedagogy and the exercises that help transform the people that practice them. They raise questions from a highly sensitive cultural, political and social dimension, and might aid medical studies following a biomedical standpoint. For example, with head injuries in combat sports: what are the cultural, moral and pedagogical issues behind this issue? Can we glean information from the different rules, tournaments and styles?

Uniting Tai Chi (Chuan) with Health Research

In terms of these styles, Tai Chi Chuan (sometimes spelt Taijiquan) is one of the most common forms of structured exercise in the world, although in a more technical sense, it is also a martial art that involves weapons and partner training (the ‘chuan’ represents a ‘fist’). There is a spear and sword sequence, and even stamping and explosive techniques in the supposedly original Chen style. The Tai Chi (the ‘grand ultimate’), generally understood as a gentle exercise in contemporary society, has been studied extensively as a medical intervention. The solo exercises of the form and its corresponding warm-ups can be helpful for elderly populations prone to falling, who have formed the base sample for hundreds of clinical trials.

This research often briefly situates Tai Chi in terms of its history (often a folkloric one), and gives a basic account of its various styles (Yang, Chen, Wu, simplified, etc.) before focusing on interventions using simplified formats of the art. This introduction does not normally use the increasingly rich literature on its history, culture, pedagogy and language. By overlooking martial arts studies, medical research does not explain the subtle differences between styles, pedagogies of schools or critique the history of the art. Martial arts studies could be useful in this regard, by illuminating the specific ways of teaching, the particular techniques and movements, unique warm ups and drills, and the metaphors that make lessons more meaningful for students and patients alike. So, the established and reputed field of medicine could learn from the emerging field of martial arts studies.

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A popular form of Tai Chi often adapted for elderly or ‘frail’ populations

Beyond the Martial: Health Research Aided by ‘Studies’

I have used the example of martial arts studies and how it can help inform detailed and thoughtful research projects by health researchers. Yet this potential union between fields of knowledge known as ‘studies’ and typically experimental forms of research known as ‘science’ is not unique to the world’s fighting systems. Psychologists can work with historians. Neuroscientists can work with sociologists. And ethicists can work with sports doctors. Health and wellbeing are not just the remit of science: They are central themes for the social sciences and humanities, too. Art therapy, social mindfulness, and biopsychosocial research are all emerging trends in doctoral training and funding. The creative, historical and expressive elements of humanity could then be explored in greater detail in the lab and be appraised and critiqued by experts from a variety of backgrounds. I hope this blog stimulates further discussion on this possibility from all spectrums of academia and beyond.

Dr. George Jennings is Lecturer in Sport Sociology / Physical Culture at Cardiff Metropolitan University, Wales, where he teaches modules relating to social theory and research methods. His main research interest is in martial arts cultures, pedagogies and philosophies as explored through various qualitative strategies. George is one of the convenors of the Documents Research Network (DRN), an association dedicated to scholarship where documents are used as data across the disciplines (http://www.documentsresearch.net), and is an active member of the Martial Arts Studies Research Network. His earlier exploratory research examined martial arts associations in Britain and Mexico and he is currently interested in martial arts and health from a critical, interdisciplinary and theoretical perspective.

Marketing ‘childhood obesity’ and ‘health’

By Darren Powell 

It seems like not a day goes by when I read or hear about ‘junk food’ marketing and the effect this is having on ‘childhood obesity’. The dominant narrative tends to go like this: ‘Children today are too fat. Children’s over consumption of junk food is the main cause. The marketing of junk food is a significant part of the problem. Removing junk food marketing is an obvious solution.’

A number of countries across the Global North (such as the United Kingdom, Australia and New Zealand) have introduced regulatory controls on food and drink marketing that relates to ‘junk food’ – products deemed too high in fat, sugar and salt (also known as HFSS). (And when I say regulatory controls, in most cases this means self-regulation by the advertising industry.)

These controls take many forms, but often includes commitments by corporations and their advertisers to not advertise HFSS food or drink during children’s television programmes, not use brand generated characters (e.g. Ronald McDonald) or licensed TV/film characters (e.g. Dora the Explorer) on HFSS marketing, and not sponsor children’s sport with HFSS products.

Despite this now being a ‘common-sense’ approach to solving the ‘childhood obesity crisis’, I am not convinced that this will be healthy for children, fat or otherwise. My concern is that the demonization and pathologization of both ‘junk food’ advertisements and fat children, combined with the recent turn to regulating ‘junk food’ marketing to children, may have unhealthy consequences for children.

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Stricter regulatory controls (or at least the threat of stricter regulations) and the public backlash against ‘junk food’ advertising has created a new opportunity for corporations and their advertisers: marketing healthy products and healthy lifestyles to children.

Indeed, it seems as though anti-obesity campaigners and politicians are fully onboard with the idea that replacing ‘unhealthy’ marketing with ‘healthy’ marketing is inherently healthy; that using the same marketing strategies as before (e.g. brand mascots, TV advertisements, sport sponsorship), but now to promote fruit, vegetables, milk, physical activity and healthy lifestyles, is widely positioned as a simple solution to children’s fat bodies and allegedly unhealthy behaviours. What is rarely critiqued though is the ways in which these so-called healthy marketing practices may impact children’s health knowledge, health practices, and health identities in potentially unhealthy ways.

We must first recognise that the term ‘health’ is not one thing for all people. Western views of health tend to privilege biomedical science, individualism, and the non-fat body. This narrow notion of health is also at play in the marketing of health to children, where advertising is positioned as only being unhealthy because it promotes a particular sort of food that ‘will’ make children fat or fatter. It is not the only perspective of health though.

In the New Zealand context, for instance, a unidimensional focus on tinana (physical dimension) as a main indicator of healthy food and healthy bodies does not align well with Māori perspectives of health and wellbeing that may also encompass wairua (spiritual), hinengaro (mental and emotional), and whānau (close and wider family), as well as te whenua (the land, identity and belonging), te reo (language), te taiao (the environment) and whanaungatanga (extended family and relationships).

For instance, from a physical health and ‘healthy marketing’ perspective, bananas may be considered healthy (not necessarily for all children though). However, as journalist Tess McClure reported, workers on banana plantations in the Philippines were “forced to work 18 hour days, paid as little as 30 cents per hour, constantly exposed to toxic chemicals, and threatened with violence or death when they campaign for better conditions.”[1] If a child’s understanding of health is inextricably interconnected with multiple elements, such as the ethical production of food, bananas may actually be unhealthy.

In short, when policymakers and other stakeholder deem that health is primarily individualistic and physical, what is healthy for ‘others’ is ignored or even subjugated.

Furthermore, this current shift to ‘healthy’ marketing may also silence strong arguments that all advertising and marketing – whether for food, toys, or clothes– is potentially ‘unhealthy’ for children.

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A number of critics of the ‘corporate assault’ on children share a concern that as children are increasingly targeted as consumers, their experiences of childhood may be diminished. How children see themselves and others in terms of class, culture, gender, sexuality, health and worth are being re-shaped by advertising; their identities re-aligned with the goals of neoliberalism, capitalism and corporations. The child-citizen is now imagined as the child-consumer.

Given that Westernised views of health dominate public health imperatives and children’s understanding of health, it is necessary to examine how the marketing of ‘health’ may ignore or even colonise the health knowledge, practices and identities of ‘others’.

Academics and advocates need to continue to search for means to challenge taken-for-granted assumptions that ‘fat is bad’ and ‘healthy marketing is good’ for all children. We need to pay closer attention to how advertising – all advertising – may be ‘dangerous’. And we need to continue to illuminate the ways in which marketing policies and practices may have unintended, even unhealthy, consequences for all children.

 

Author information:

Darren Powell is a Senior Lecturer in the Faculty of Education and Social Work, University of Auckland, New Zealand. He is a recent recipient of a Royal Society Te Apārangi Marsden Fund Fast-Start Grant to conduct a research project about the impact of marketing ‘health’ to children.

References

[1] McClure, T. (2016). Banana Republic: the ugly story behind New Zealand’s most popular fruit. Retreived from https://www.radionz.co.nz/national/programmes/checkpoint/audio/201808688/banana-republic-the-ugly-story-behind-new-zealand’s-most-popular-fruit

Book review: Laura Ellingson (2017). Embodiment in qualitative research. Routledge.

Book review by Craig Owen

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In this text, Laura Ellingson provides a theoretical approach, a methodological philosophy, and a range of practical tips and examples for how to attend to the meaningful presence of your own and your research participants’ bodies throughout all stages of the research process.

Laura starts by taking a poststructuralist approach to theorising embodiment. She calls on us to recognise how the body is always in a process of becoming, a liminal state that is shifting and never fixed or finalised. The goal of research on embodiment is thus to shine a light on this dynamic process, to capture snapshots of these transitions, changes and movements of the body over time.

To achieve this goal, Laura sketches out the benefits of a flexible and inclusive methodology, one that is open to embracing a wide range of methods and theories, and one not afraid of crossing paradigmatic, methodological and disciplinary boundaries. Adopting this approach allows us to openly acknowledge how qualitative research, just like everyday life, is a messy business. By embracing the mess, that is, being open to mistakes, mis-directions, unexpected opportunities and unanticipated tangents in research practice, we are better placed to engage with the multiple, slippery and fuzzy realities of embodied life. For Laura, such an approach is not haphazard, nor lacking in rigor, but rather reflects “a creative, generative commitment to embodied pragmatism” (p.192).

To help bring the body into our research in a more deliberate and creative manner, Laura also provides a range of practical guidelines and flexible starting points for experimentation. She encourages us to actively engage with sensuousness, to (re)learn our own senses, carefully attending to how, through our engagements in new research contexts and interactions, we and others learn new skills of how to see, taste, feel and hear in different ways.

Of course, reflexivity is crucial here. Laura suggests that we can reflect on the specific parts of our body-self that are relevant in our research, to consider what our body has learned, how our senses have changed over course of the fieldwork, and how we come to recognise discourses circulating through our body and those of our participants.

In the course of planning and conducting interviews, focus groups, or any other form of communicative interaction, Laura suggests planning questions that explicitly encourage participants to reflect on touch, taste, smell, texture, temperature and movement. When conducting ethnographic fieldwork, she advises us to spend time focusing on and describing one specific sense. It is also essential for us to enhance our note-taking practice; getting in the habit of making notes about a range of sensations and emotions during important moments of understanding and connection. By jotting down more visceral, messy and sensorially rich notes, this will hopefully help spark our imagination and reflections when we return to (re)analyse the data at a later date.

To succinctly illustrate the benefits of this approach, at the beginning of each chapter, Laura provides eloquent examples where she creatively writes her own and others’ bodies into her research. Reading these descriptively rich and flowing sections of prose, I felt like I was getting to know Laura, her passion for research, her attention to specific details in the field, her quirky way of reflecting on her own disability, and her strange hankering for sugar-free fizzy pop. If only I could write in such an evocative and engaging way. As an early career researcher, I’m still struggling to get to grips with what I see as the staid academic style. But this embodied style is so much more gripping and reader friendly.

Ultimately, reading this text has helped me recognise that I need to experiment with my research practice and writing style, specifically, enriching my vocabulary, getting in the habit of describing single events in more holistic sensory ways, and experimenting with more imaginative, figurative and poetic language. No doubt, this will not be an easy task. But, if we take Laura’s advice that our progress will be as much a result of our mistakes and accidents as our plans and successes, we need only try.

Introducing ISCHP’s Podcast: The Operative Word

Brett Scholz (University of Canberra), Britta Wigginton (University of Queensland), and Ally Gibson (UNSW Sydney)

At ISCHP (the International Society of Critical Health Psychology) conferences, conversations inevitably circulate around how to break down existing paywalls, geographical boundaries, and the institutional privileges that disallow or constrain access to academic knowledge. Indeed, flattening academic power structures and promoting fairness are some of the values that characterise ISCHP as an academic community. As critical scholars, we are all too aware of the power relations imbued in the knowledge production and dissemination process(es) of the academy. The creation of a podcast series for ISCHP, entitled The Operative Word, therefore represents our attempt to join digital media platforms, in an effort to freely disseminate and share critical perspectives and knowledge, and to inspire conversations amongst critical scholars around the world – wherever their location.

Inspiration

The idea for this podcast arose during our last conference in Loughborough (UK) in July 2017.  The three of us were having an impromptu conversation about our favourite podcasts, and we were commenting on how few academic podcasts were available, particularly those that took a critical lens to health and other social phenomena. At the same conference, our ISCHP colleagues, Dr Glen Jankowski and Dr Neda Mahmoodi, also happened to run a workshop on using podcasts to disseminate academic work. We therefore thought that perhaps it was time for ISCHP to have its own podcast.

We’re hoping that this can be a resource for students new to critical psychology. In addition, we hope that those who are involved in teaching and research will be able to draw on this for their own interests and be able to use it in the classroom. And because of the eclectic community that makes up ISCHP, we anticipate that listeners both within and beyond psychology will be interested in our content. We also hope that this podcast bridges the geographical and socio-economic barriers to attending the conference in person and in being able to participate in the community between conferences. In keeping with (some) academic tradition, the podcast takes the format of a journal – our first volume for 2018 consists of six issues, which all build on content from the 2017 conference.

What’s in Store: Volume 1 of The Operative Word

A fairly recent addition to the ISCHP conference programme is the invited ‘5-Minute Challenge’. Speakers are asked to present a thought-provoking or challenging argument that cannot focus on a specific research study but must rather have relevance for a broader audience. The trick is to keep to the strict 5-Minute time limit and speak to pre-timed slides using only use images chosen by the speaker. With no question time for the audience afterwards, this snappy format makes for an entertaining, sometimes slightly frantic, and always thought-provoking segment of the conference.

For Volume 1 of The Operative Word, all 5-Minute Challengers from the 2017 ISCHP Conference were invited to be interviewed for a podcast Issue dedicated to airing their challenge, and then discussing it in more depth. To spice things up, we also invited Prof Antonia Lyons (Victoria University of Wellington) to revisit her keynote presentation from the conference (Issue 4). In each Issue, or episode, of this volume, we will feature one of these interviews. In keeping with the podcast name, each Issue has been titled with one word that encapsulates the spirit of the argument – namely, ‘the operative word’.

Thanks to their creative responses to the 5-Minute Challenge, we interviewed ISCHP community members on a range of topics. Not only did these topics stimulate rich discussions but, in many ways, they resonated with our own experiences in academia and – unexpectedly – in constructing this podcast.

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A Transparent Reflection…

In creating this podcast, we have ended up reflecting on our own intentions for embarking on this alternative project and realised the need (especially as qualitative researchers) to locate ourselves, in the spirit of being transparent and reflexive.

To briefly introduce ourselves, we are three early career researchers (and friends) all working in Australian universities, and have held positions in various disciplines (psychology, nursing, public health, sociology). Our energy and drive to create this podcast stems from our collective passion to challenge dominant knowledge production and dissemination processes – or put another way, to go beyond the journal article. More broadly, we are motivated to use alternative platforms for dissemination of research and teaching content, in an effort to increase accessibility and stimulate connections and inspiration amongst our colleagues between the ISCHP conferences, which are held every two years. Accessibility is important to us but, at the same time, in being transparent about the context in which we work, we are increasingly aware of mounting pressures on academics to go beyond conventional publication methods. In Australia, we are expected to attend to, what are termed, ‘alternative metrics’ (altmetrics, for short), based on our social media impact. Essentially, how we are speaking to wider audiences – whether in other disciplines, in industry, or in the communities we research.

So, in some ways we recognise how our own practices and (precarious) employment positions represent or embody the neoliberal culture of current academia – the short-term employment we face, the unpaid labour we are expected to provide in the name of ‘service’ or ‘passion’, the ever-increasing demands we face in improving our research ‘track records’, what we have to sign up for in order to survive, and so on. Indeed, as critical scholars, we are all too aware of the power structures in which we operate and the practices that can often obscure the problematic and even destructive elements of working in Higher Education. But, as many can relate, taking a critical stance also means thinking productively, of trying to think of new ways of working within a system, of subtly pushing back the boundaries when we can. One of the elements that all three of us have experienced from being a part of ISCHP, for example, is the deep sense of engagement and genuine support that flows between members – how we as junior academics have been able to be guided, challenged, and encouraged from our senior colleagues. We believe that this continues to be a unique aspect of the ISCHP community, and we hope that that spirit comes out in our podcast.

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Similarly, in being open about our journey through this editorial process, we have admittedly faced a few challenges along the way. One concern that was raised by our community when we initially suggested creating this podcast was the fact that it would be produced in English, thereby reproducing the ongoing dominance of English in academic spaces and dissemination processes. We would therefore welcome non-English language community members to volunteer to produce and edit future Issues of The Operative Word, to make this possible since we were unable to do so. We would also hope that as this podcast develops, we could attract the funds or find volunteers to transcribe the Issues, allowing them to be accessible to d/Deaf or non-English speaking audiences. We’ve also faced the challenges of being podcasting ‘newbies’, having to teach ourselves how to navigate the world of podcasting and editing software, losing episodes, and even having to re-do them!

The Final Word

Yet, in saying all of that, we really believe in the purpose and possibilities of this podcast. Indeed, we have experienced designing, constructing, and editing this podcast as a lesson in hope. As the co-editors of this podcast, we are attempting to find room to do things differently, to enact the values that make up and sustain the ISCHP community, and hope to create new de-neoliberalised spaces and conversations.

Through The Operative Word we therefore aim to build up new and existing connections between members of the ISCHP community. Given the shared vision for social change, such connections within ISCHP and beyond are absolutely vital. After each ISCHP conference, we always go home and feel energised to continue fighting for social justice. We hope that this podcast acts as an extension of the ISCHP conference, and that it re-energises listeners’ resolve to work within their own contexts, knowing that their ISCHP connections are sharing similar struggles in different parts of the world.

Listening Guide

Volume 1 promises to be an exciting series, with discussion about issues that speak to the core of critical research in the social sciences. A taster episode is now available! And Issue 1 will be released at the beginning of July.

To listen to The Operative Word, please go to https://anchor.fm/theoperativeword and please don’t forget to subscribe!

Also keep the conversation going with our hashtag #TheOW and/or tag @crithealthpsych

 

As a health coach, my fat is my greatest asset –– not a challenge to be overcome

By Tiana Dodson
As a fat person, you’re constantly browbeaten with the idea that your health has been
somehow damaged, ruined, or compromised and that it’s imperative that you reclaim it
by figuring out some way to make your body thin. So we look for people who model what we’re supposed to be. We look for the yoga teacher with the tightest butt, the deadlifter with the biggest pecs, the marathoner who makes the 26.2 look effortless, and the lithe, glowing health guru smiling around the straw of a green juice.
It might seem logical –– imitate that which you want to become –– but what people don’t
know is that it’s more than a lifestyle that got those people there. It’s their job. So unless
you’re trying to make fitness your career, you’re more than likely going to be trying to
squeeze fitness into a life where time, energy, and resources are already at a premium.
Trying to emulate these people almost always falls short… and that’s without starting
from absolute fatness.
If you’ve got an extra 20 pounds or so, then yeah, that 21-day cleanse might put you out
the other side with washboard abs. But if you’re in a situation where losing 20 pounds
would be unnoticeable because your body is very large at the outset, any advice these
health gurus give is just not helping. In fact, it’s much more likely to throw you into a
shame spiral, because if you can’t succeed with the 7 simple steps that anybody can
do, then you’ve failed, and it’s all your fault.
This is why fat people need their own health and wellness gurus –– and that’s
where I come in.
When it comes to overcoming body hatred, yo-yo dieting, and the difficulties of
navigating a fat phobic culture, I’ve been there and my work is based in my own journey.
So when a person tells me how hard it is for them to even be at the gym because of
how other people look at them, I get it. I get it when someone says that they really want to order dessert at a restaurant, but they’re deterred by the thought of the dreaded eyebrow raise –– because even if it’s the only dessert they’ve ordered all month, it still looks like all they eat is dessert. I get it when they say that they’re dreading going home for Thanksgiving because they’ve had to buy pants in a larger size. I get it because I’m fat, too.

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I’m also a certified health coach, which means that I have both the intellectual and
experiential knowledge of how bodies work. So when a client comes to me looking for
guidance on how to improve their health, I can easily put myself in their shoes because
their experiences are so familiar to me. And experiential knowledge can never be
outpaced by theoretical knowledge, no matter how many fat people a skinny health
coach has worked with. I’ve done –– and am still doing –– the work personally, so I know what it’s like to go through these steps, to experience the backslides, and to overcome the hurdles again and again.
The most well-intentioned ally can never be more than just that –– an ally.
But when your health’s on the line, you don’t just need an ally. You need a peer.
You need a partner. Not just because it’s nice. But because research indicates that
shared identity is foundational to forming a more effective partnership with a healthcare
provider (Street et al, 2008) . My compassion and my empathy comes from the fact that I have been there at
the lowest lows, and I’ve climbed up to the highest highs –– and I know how to help
other people do that too.

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Health is more than numbers on pieces of paper, health is all-encompassing and
holistic. And to get there, you need to be able to work with someone who can get
all of your life, not just the theoretical experience of it. When you’re talking about wanting someone to be healthy, you also need to be talking about all of them, all the things that make their life uniquely theirs. This includes the intersections of their identity and the social determinants of health (The World Health Organisation., 2010), because fatness never happens in a vacuum. It’s related to race, class, gender, sexuality, geography, and genetics, among many other things.
When you’re assessing the potential for health improvement, you have to be able to
understand how these things affect the probability and achievability of real health
improvement. Because not everybody can just get up and walk, not everybody has
equal access to healthcare providers. You have to take into consideration where a
person is starting from, what they’re capable of in their reality before you can start
prescribing things to improve their health. There’s just something about experiential knowledge that makes the difference between okay healthcare and life-changing healthcare.

So when I introduce myself as a fat health coach and you find yourself wondering how
that can even be possible, understand this: the “fat” part is the part that makes me really
damn good at what I do. It’s the same reason why welcoming, centering, promoting, and
employing people with marginalized identities does nothing but enrich a space. There is
so much to learn from those who are different from us, and embracing these differences
helps us all move forward.

References:
Street Jr., R., O’Malley, K., Cooper, L., & Haidet, P. (2008). Understanding
Concordance in Patient-Physician Relationships: Personal and Ethnic Dimensions of
Shared Identity. Annals of Family Medicine 6:3 , 198-205. Available as Open Access:
http://www.annfammed.org/content/6/3/198.long

The World Health Organization. (2010). A Conceptual Framework for Action on the
Social Determinants of Health. Social Determinants of Health Discussion Paper 2 . p. 6.
Available as Open Access:
http://apps.who.int/iris/bitstream/handle/10665/44489/9789241500852_eng.pdf;jsessioni
d=261C719F5A7315644BA8CE914440C62E?sequence=1

Are We Well Enough Yet?

By Annie Belcher

I’ve been away from Melbourne for the past month. Having a break from yoga and teaching has provided me space to think through and distill some thoughts I’ve been having about yoga – it’s downfalls and some parts I think we (those in the yoga industry in the Western World) could be doing better.

There are many aspects of yoga which I think need further thought and interrogation; issues of cultural appropriation, yoga’s limited engagement with structural issues, yoga’s focus on the individual. In this instance however, I’m speaking to the implications of commodification. Exploring what happens when yoga is simultaneously “health and wellness” and a commodified product.

I’m concerned that there’s no regulatory body that actively intervenes to ensure the consumers of yoga aren’t mistreated. Whether that’s through marketing yoga, in classes or in conversations.

There are many reasons why I love yoga and there is a reason why I have spent a lot of time learning about it, practicing it and teaching it. However, despite the many aspects of yoga I enjoy, I often question why I teach it. I question why so many of the associations that come with yoga make me cringe? Why I feel deeply uncomfortable in places that are bustling with yoga tourism? Why, in social situations I often omit the fact that I teach yoga? Why when I see images of bikini-clad women and oiled up men doing “yoga” I feel a desire to distance myself from the industry?

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I think the problem doesn’t actually lie with yoga, but with processes of commodification and how this has made people in the yoga industry behave. I’m concerned with the messages that are communicated to consumers when there is a need for yoga to create a monetary return.

I wonder why there are so many people doing yoga. Why there are 35 people wanting to “Balance their Chakras” on a Saturday afternoon. Why the amount of people doing yoga teacher trainings continues to rise. If it’s because people enjoy doing yoga then great, but I’m worried the amount of people doing yoga is because of a very clever marketing campaign rather than yoga itself. Because I don’t think what a lot of us gain from yoga is exclusive to yoga.

There are other platforms to inquire about the human experience: Buddhism, western science, Taoism, indigenous knowledge, being in nature, reading a book. We could move in other ways other than asana. Yoga can make you feel strong and calm, it can provide a sense of ease, connection and freedom, so I understand why so many people enjoy it.

I think yoga can be very beneficial for people but I do not think it is necessary. I also don’t think it is necessarily the best way to ‘help’ people. I believe thinking we need to ‘help’ people is problematic in itself. Let alone helping them by selling them yoga. Maybe I’m just being cynical and the way to solve the world’s problems is for everyone to become a yoga teacher and do yoga. I’m just not that optimistic though. I’m worried the yoga industry has created a market; similar to how the beauty industry has created a market.

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The beauty industry could be harmless – people using products to express themselves and to make themselves feel good. But the beauty industry has also created its own market by constantly telling people they aren’t thin enough, hairless enough, that their skin isn’t smooth enough. Because, to sell beauty products we need to work from the premise that people aren’t already beautiful as they are.

Let me be clear, I don’t think make-up is necessarily bad. In fact it can be great. But when people are told they need it just so the company can increase profits it gets ugly. The marketing that accompanies yoga, like the beauty industry, often works from the premise that people as they are aren’t enough. There’s a big flaw inherent in selling health and wellness. To sell someone health and wellness one needs to work from the premise that they don’t already have it. That people aren’t well enough, healthy enough, flexible enough, spiritual enough, strong enough, self aware enough, eating well enough, following self-care rituals enough, that people just aren’t enough as they are. And yoga is the perfect commodity to sell. You need to buy it many times a week to maintain the benefits. You can stop buying it when you reach the elusive and esoteric ‘enlightenment’ (so most of us are in it for a lifetime I imagine).

Phrases such as “Discover your best self” and “Fulfill possibility” can be said harmlessly, benevolently in fact. But what these phrases infer is that one isn’t already their best self, one hasn’t already fulfilled their potential unless they come to your yoga class, your workshop or your retreat. I think a lot about social impact and while yoga can be great for people, I think culturally and socially, the yoga industry can also be harmful.

My concern is that there is no (active) regulatory body that has the consumers’ best interests first and foremost. Yoga is not held to the same standards that other health and wellness providers are. As Bessel Van De Kolk articulated so well “you don’t know you’re being negligent until you know”. By telling people what they do and don’t need to feel good are we accidently being negligent? Can we abuse our power as “teacher”? Matthew Remski thinks so, highlighting the damage yoga instructors can do on participants’ bodies because of what the teacher believes is “right”, is “necessary” to get “better” at yoga.

I look at people selling things (for example supplements) whole heartedly believing the consumer needs them, telling them to spend a lot of money because they believe it will work. But is their belief enough? Or is it an abuse of their position of power? Are good intentions enough?

If yoga is going to continue to be commodified, it should at the very least be subject to market protections and regulations. I’m worried we easily lose sight of our initial reasons for teaching yoga when creating a monetary return also becomes a goal. I feel uncomfortable having to make money from yoga, I feel uncomfortable competing for business and I’m uncomfortable telling people they need yoga even if I do that implicitly by simply communicating what I’m selling.

It’s not yoga itself, it’s the commodification of yoga and what that has done to yoga and therefore, has made people teaching/selling yoga have to do and the effect that is having on consumers. It’s the message of advertising of not being good enough without yoga and that to be happy one must do yoga. Yogic philosophy poses an inherent contradiction to a market centered on need and insufficiency; that practitioners are told they are enough at the same time that they exist as consumers being told that they need more yoga. So if it makes you feel good, keep doing yoga, I’m going to. But can we use yoga to challenge ideas of insufficiency, scarcity, competition, and spread ideas of sufficiency and abundance? And if no one else is going to hold us to account, can those of us teaching/selling yoga hold ourselves accountable for our intended and unintended impacts on society?

the HAES files: Why I Don’t Care about Health

Cat Pausé in this blog post reflects upon her experiences and the conversations around health and fat stigma.

As a Fat Studies scholar and fat activist, the issue of health is forever looming around me. In the background; in the foreground; off in the wings; waiting to pounce. Much of my scholarship has focused on fat identity and how it is managed in social media; much of my activism has focused on securing equal rights protection for fat individuals. And yet, when speaking to the media about weight discrimination in the workplace, or submitting an academic manuscript to a humanities journal, it is almost a guarantee that a reviewer or reporter will ask questions about fatness and health. “What about their health?” they’ll query, as though it has any relevance on whether fat people should be paid the same as non-fat people for work of equal value. “But isn’t fat unhealthy”, they’ll ask, as though someone’s health status has any bearing on whether they deserve to have a Facebook or Tumblr account.

Questions around health are always present in my work on/for fatness. Because health is one of the few lenses through which we, as a society, are capable of viewing fatness.

I spent much of my doctorate degree waging yet another war against my body. Even though I had been fat my whole life, and had a sneaking suspicion that there wasn’t anything wrong with me, I still went to war with my body regularly. I had all the tools – the scales, the points, the counting, the gym membership, the calendar on which I would check each day where I achieved at least 30 minutes of exercise. At the same time I was waging this latest battle, I was researching how very fat women constructed, maintained, and revised their weight identity. All of the women in my work had similar stories to my own; lifelong fatness, lifelong dieting; lives spent chasing that elusive fantasy of being thin. One of the women I interviewed was different from the rest; she wasn’t ashamed, wasn’t afraid, and didn’t believe that her weight was holding her back from anything, including health. At the end of our interview, she casually suggested I read Paul Campos’ The Obesity Myth. It was my first exposure to work that was critical of obesity studies. And from there it began; like many scholars, I fell down this new rabbit hole and read everything I could.

Friend of Marilyn v2.2

When I began, I was most drawn to understanding how tenable the links between weight and health really were. I spent a great deal of time reading empirical studies that disproved that weight was a reliable predictor of health, or that permanent weight loss was possible, even while concluding that weight loss should still be pursued by those who fell outside the desirable range. (This was before Health at Every Size; before scholars like Bacon, Aphramor, and Burgard, began revolutionising understandings of health and illuminating that keeping the definition of health as thin as it was ensured that many people of all sizes were excluded). This science, that never seemed to be at the fore of people’s minds when they casually dismissed fat politics, seemed to me to be the answer.

If I could just convince enough people that being fat isn’t automatically unhealthy, then things would change! They wouldn’t make assumptions about people based on their body sizes. They wouldn’t judge a fat person for eating at McDonalds while they themselves consumed the same food themselves. They would acknowledge that fat people deserved the same rights and dignity as non-fat people! I set to work doing just that: I facilitated workshops for healthcare providers, I wrote about the relationship between weight and health, I shared evidence through social media.

In 2012, I agreed to do a segment for 20/20 in New Zealand. By this time, my understanding of health as a social construct and a social contract had developed. When the interviewer asked me whether I was healthy, I first spoke to the varying definitions of health. Who’s health? Who gets to define health?  Who is excluded from these definitions? Then I moved into speaking specifically about my personal health. Was I metabolically healthy? Yes. Did I engage in health seeking behaviours? Yes. Did my BMI fall within what was believed to be healthy range? No. I then went on to speak on whether it should matter – did my worth of being a person with dignity and respect depend on my health status? Most of my response was edited down, and I cringed when the Me on TV began talking about my health behaviours. In my earlier work as a fat activist, I was willing to speak about my health, and the relationship between weight and health as demonstrated in the literature as I understood it. I kept thinking, one more time for the camera, and things will change. (I probably don’t have to tell you that they never have).

fat studies

I no longer participate in this form of respectability politics, a term coined by Evelyn Brooks Higginbotham to explain the efforts made by black women to demonstrate they were good enough for white society to overlook their flaw of being black (and women). In fat activism, respectability politics is often expressed in the performance of the good fatty; the fat person who apologises for their body, who demonstrates their efforts to seek health despite their size, who performs their fatness in ways that are most tolerable for the fat hating world they live in.

As a scholar and an activist, I’ve come to recognise that any conversation about health and fatness will be centred on physical health, and the ways that fatness impedes the achievement of health. And while increasingly conversations will include acknowledgement of the role of environments on health acquisition (the dreaded obesogenic environment), rarely does the conversation include a consideration of the impact of fat stigma and hate on the health and well-being of fat people. And for me, that’s the only interest of health that lives on in my scholarship and activism.

I am incredibly fat; death fat, as we like to say in the Fatosphere. In this way, I may have learned earlier than others that engaging in respectability politics wasn’t going to get me anywhere. It doesn’t matter how much I exercise or am seen eating a salad, the world will perceive me as incredibly unhealthy and incredibly unworthy. It doesn’t matter what my health status is, everyone, including healthcare providers, will treat me like a ticking time bomb that will, one day, implode and double-stomachedly take down public health care systems.

Health is the latest form of respectability politics for fat people. And I want no part of it.

More details about the authors:

Cat Pausé (Institute of Education, Massey University, New Zealand)

Through a different lens: Using photovoice to reframe understandings of sexuality and disability in South Africa

By Poul Rohleder, Xanthe Hunt and Leslie Swartz

Poul post March 2018 - upfront extra pic

When we interviewed Edward (not his real name), for a research project on disability and sexuality, we talked in his office at a large, maximum-security prison near a large city in South Africa. He spoke of a car accident that had left him paralysed and needing to use a wheelchair, and the impact that this incident five and a half years ago had on his life and sense of identity.

He told us: “I’ve struggled, because if you were born and you were active and now suddenly there’s a change, so you need to accept first that there is this change now.  And my movement is limited now and all those things,” he pauses, sucks air in between his teeth, and then adds, “The main thing with a spinal cord injury… you’re going to have a problem with your sexual life because now there’s nothing that is normal at all.”

His comment cuts to the core of an issue for many people with disabilities. What Edward alludes to is not just that “nothing is normal” in physical terms, but, more importantly, in terms of societal perceptions and expectations about sex and bodies. This has been a focus of study conducted by ourselves and a team of colleagues from the University of East London (UK), the Southern African Federation of the Disabled (SAFOD), SINTEF Technology and Society (Norway), and Stellenbosch University (South Africa). The study was concerned with exploring and challenging the misconceptions about disability, sex and sexuality for people with physical disabilities in South Africa.

Edward is one of our participants.

Many people do not consider issues of sexuality – sex, desire and attractiveness – with disability. Many may perceive disability as rendering one damaged, passive and ‘sick’ (not things many associate with sexuality), and we see sexuality as being most often something active, healthy and attractive (not things many associate with disability).

In general, research suggests that many non-disabled people tend to make assumptions about the sexuality of people with disabilities and hold many misconceptions: very often they see people with disabilities as non-sexual (for a review of the literature concerning physical disability and sexuality see Carew et al., 2016). Additionally, what research is conducted on the sexual and reproductive health of people with disabilities tends to be in richer countries of north America and western Europe with much less research conducted in low and middle-income countries (Carew et al., 2017). However, the majority of people with disabilities in the world live in low- and middle- income countries.

During the research interview with Edward, he tells us about the men he works with, ‘the guys’. Working at a prison, and living in the prison compound, the guys are his family and friends, his people and his pack. The camaraderie does not stop them from stripping Edward of his sexuality with their blunt assumptions. He said: “The guys I work with, when they saw my girlfriend had a baby, they asked, ‘Are you sure this is your baby?  Maybe someone made this baby for you?’”. They assumed he wouldn’t be able to have a girlfriend, let alone do what is required to make a baby.

Edward’s feeling that nothing is “normal” when it comes to his post-accident sexuality, and his friends’ assumption that he is no longer sexual, are not unusual experiences for people with physical disabilities. However, until recently, little was known, in South Africa at least, about the sexuality of people with disabilities: what sorts of attitudes do they encounter from non-disabled people when it comes to romance, and accessing sexual and reproductive healthcare? how do they experience themselves as sexual beings?

Both of these questions are important: Sexuality is a two-sided coin: part of our experience of it is “in here” – how we think and feel about ourselves as sexual beings, what we think about our gender and how we feel about sex. But another part of our sexuality is very much “out there” – what others’ behaviour tells us about our attractiveness, what their actions lead us to believe about what is ‘normal’ and what is sexual. Others’ attitudes create barriers for people with disabilities having sexual and reproductive health rights and access to care.

As part of our project, we wanted to find out about the attitudes of non-disabled people, towards the sexuality of people with physical disabilities. We conducted a survey measuring respondents’ attitudes towards dating, attractiveness, sexuality, sexual rights, and need for sexual and reproductive health care of people with physical disabilities. We advertised the survey widely through social media, major newspapers, student email lists, and through field researchers. We obtained 1990 respondents in total, of which 1865 reported being non-disabled.

In the survey, we asked respondents about their perception as to the need for sexual and reproductive health care for people with disabilities as well as the perceived needs for non-disabled people.

What we found was not surprising, but it was worrying: the respondents tended to believe that disabled people had fewer sexual and reproductive rights, and had less need for sexual and reproductive health services, than non-disabled people (Hunt et al., 2017). The survey also contained story completion tasks, which revealed mostly negative, stereotyped views about dating people with physical disabilities, and about their sexuality (Hunt et al., 2018).

Taken together, both sets of information suggest that non-disabled South Africans tend to desexualise physically disabled people, seeing them as less sexual than non-disabled people, and feeling disinclined to view them romantically. The ‘out there’ side of the coin, it would seem, is unfavourable.

Finding out about the ‘in here’ side, on the other hand, is a little more complicated: what are the experiences of sexuality amongst people with physical disabilities in South Africa?

It is complicated because talking about sexuality (which includes gender, sexual orientation, sexual activity, reproduction and related activities and identities) is – often – a taboo. It is deeply private, but also highly political. Further, it is not a subject for which yes or no questions, or even scales can tell us enough. We found a fruitful method of inquiry was to use photovoice as a method to elicit personal stories and narratives in qualitative interviews with 13 participants with physical disabilities, one of whom is Edward.

Given the silences and awkwardness which may characterise interviewing people about their sexuality, this method was ideally suited to this study. It also allowed our participants to take a more active role in the project – rather than being passive subjects who ‘gave’ us information to make a story out of. We worked collaboratively on creating images as well as a documentary film that depicted some of their views and experiences. All participants happened to identify as heterosexual, and so the focus was on heterosexual sexual relationships.

As one of the participants, Edward, explains: “You see this ramp?  If you look at it, it must look like this.  You can see it was specially made as well, the ramp.  There was no ramp.  It was just the step”.

Poul post March 2018 - pic1

Like many of our photographer-participants, Edward chose to take photos which seem to have less to do with disability, and more to do with access. In fact, many of them seem to bear little resemblance to the kinds of images which many of us would be used to associating with sexuality. But, as the participants speak around the images, a picture of their relevance grows: the ramps, doors or inaccessible spaces represented in their photos are standing in for the sexual access and social acceptance which they desire.

A female participant, Mary, draws a no-entry sign, and says how this represents a feeling she has carried inside for most of her life when it comes to relationships. She explains: “I come from a conservative background, a conservative Christian background, so for me, as I was growing up, the whole thing of sexuality and even marrying was very closely tied to having children.  And everybody just took for granted, because I couldn’t have children, I wouldn’t marry”.

Poul post March 2018 - pic2

This sentiment is brought into sharp relief by the findings from the survey part of our study: that non-disabled people seem reticent to grant the kinds of access and acceptance which people with physical disabilities desire (and have the right to).

Our survey responses teach us something about the kinds of attitudes which people with physical disabilities might encounter in their daily lives: the survey gave us an impression of non-disabled respondents’ discomfort with the sexuality of disabled people. The photographs taken by the interview participants bring life to the impact of this discomfort.

But the photographs, and the photovoice project, also opened up a space for thinking about the sexuality of people with physical disabilities in South Africa. Together with some of the participants, we created a short documentary video revealing the experiences of 2 men and 2 women with physical disabilities in South Africa. The video and some of the photographs and personal stories of participants are all available on our project website: www.disabilityandsexualityproject.com. We hope that the website might be used as a resource for raising awareness and facilitating education about disability and sexuality at schools and other forums. Such work, as well as the sustained activism of disability organisations and individuals with disabilities, will be necessary if the goals outlined in the United Nations’ Convention on the Rights of Persons with Disabilities is to be realised, full inclusion, participation, and sexual citizenship for people with disabilities to be achieved.

References:

Carew, M., Rohleder, P., Chiwaula, M., Braathen, S. H., Hunt, X., & Swartz, L. (2016). The myth of asexuality? Disability stigma as a barrier to sexual relationships in South Africa: Literature review. Literature review prepared for the Federation of Applied Disability Research. (http://www.firah.org/centre-ressources/upload/publications/rl/asexualite/rl-axesuality-en.pdf).

Carew, M., Braathen, S., Swartz, L., Hunt, X., & Rohleder, P. (2017). The sexual lives of people with disabilities within low- and middle-income countries: A scoping study of studies published in English. Global Health Action, 10:1, 1337342. Available as Open Access: http://www.tandfonline.com/doi/abs/10.1080/16549716.2017.1337342

Hunt, X., Carew, M., Braathen, S.H., Swartz, L., Chiwaula, M., & Rohleder, P. (2017). The sexual and reproductive rights and benefit derived from sexual and reproductive health services of people with physical disabilities in South Africa: beliefs of non-disabled people. Reproductive Health Matters 25:50, 66-79. Available as Open Access: http://www.tandfonline.com/doi/full/10.1080/09688080.2017.1332949?src=recsys

Hunt, X., Swartz, L., Carew, M., Braathen, S., Chiwaula, M., & Rohleder, P. (2018). Dating persons with physical disabilities: the perceptions of South Africans without disabilities.  Culture, Health & Sexuality, 20(2), 141-155.

 

More details about the authors:

Poul Rohleder (University of East London, UK)

Xantha Hunt (Stellenbosch University)

Leslie Swartz (Stellenbosch University)

How do men’s magazine talk about penises?

As February begins we in the ISCHP website editing office, look to our next interesting article. The following was produced by Craig Owen and Christine Campbell following a pecha kucha presented at ISCHP’s 2017 conference. Dee and Neda.

In this blog post, Craig Owen and Christine Campbell showcase their recently published research which won the prize for best Pecha Kucha presentation at the 2017 ISCHP conference (1).

This is an adaptation of the paper presented and that can be readily viewed on You Tube.

Constructions of masculinity have shifted and changed but the central role of the penis has remained firm. Indeed, the very word ‘manhood’ is synonymous with both masculinity and the penis.

Twenty years ago most traditional men were comfortable not talking about the penis, but since then there has been an explosion of media representations of penises. In turn, research suggests men’s fears about their penises are constantly expanding. Where once size was the only salient factor, men are increasingly being directed to concern themselves with the aesthetics of their genitals: shape, proportions, and pubic hair topiary. Men’s magazines play a crucial role here, acting as cultural signposts, telling men how they should feel about their penises and their masculinity.

In a recent article published in the Journal of Health Psychology, we analysed the representations of penises in four of the most popular UK men’s magazines – GQ, Loaded, Attitude and Men’s Health. We found two prominent discourses across the four publications which we termed ‘laddish’ and ‘medicalised’. Laddish discourses built the penis up by celebrating and giggling at large and detailed phallic images and worshiping at the altar of well endowed ‘celebrity swordsmen’. Medicalised discourses seemed to offer a critique of laddish standards, promoting a more serious ‘scientific’ approach that challenged the ideal of a big penis. But this was not as radical as it first appeared. The aspirational goal of having a large penis was replaced by the ideal of a beautiful one. Both discourses increase fears by putting pressure on men to meet particular standards and by highlighting extreme examples of traumatised, mutilated and non-functioning penises.

Ultimate, then, men’s magazines continue to reproduce age-old fears that men’s masculinities are bound up with the achievements and failures of their penises, but present these fears in new, repackaged ways. For sexual health practitioners and health psychologists working closely with boys and men, an understanding of the dominant media representations that males are exposed to in these mainstream media publications will be valuable when structuring interventions, therapies and sex-education classes.

Notes

(1) The original pecha kucha that was presented at ISCHP’s conference in 2017 can be viewed at https://www.youtube.com/watch?v=Ad3YLBvpbDw&t=

How sport and exercise helps veterans heal – and how it can do it better

To open 2018 we have a critical piece exploring research, interventions and mainstream narratives within Western cultures surrounding sport, exercise and war veterans. UK-based Nick Caddick critiques and overviews the current state of knowledge and approach to treatment of veterans, and follows this up with some innovative suggestions on how to move things forward at an individual and societal level in order to facilitate veterans’ healing and wellbeing. Thanks for reading and happy new year. (Dee Lister and Neda Mahmoodi, your ISCHP Website and Blog Editors)

 

By Nick Caddick (nick.caddick@anglia.ac.uk)

There’s a new story unfolding about how veterans are healing from the physical and psychological damage of war. Or rather, a new chapter in an older story. The birth of Paralympic sport over 60 years ago was stimulated by the need to rehabilitate wounded Servicemen. And the evidence suggests it had many rehabilitative benefits. Today, the use of sporting and other pursuits – surfing, sailing, fishing, skiing, archaeology, and the recent Invictus phenomenon, to name but a few – is expanding as a means of supporting veterans.

These activities have started to take hold as an approach to helping veterans deal with “PTSD”; the medicalised, disorder-focused label by which we denote what can be more simply understood as the psychological turmoil that sometimes follows encounters with deeply scarring and frightful situations. Healing for physical injuries – most notably in the case of war amputation – also increasingly follows a sports-based model of recovery.

A large network of military charities has been at the forefront of this ‘alternative’ approach to helping veterans. These charities have been well-funded – at least during the wars in Iraq and Afghanistan – and have supplied the British public with no shortage of stories about veterans overcoming their disabilities through medal-winning competition, or battling the demons that haunt them.

One question to pose is why some veterans are turning to sport and exercise – and other ‘non-medical’ approaches – to help them deal with the traumas of war? And, similarly, what are they finding in such approaches that they do not get from the clinical therapies often favoured as the ‘gold standard’ treatments?

I recently reviewed a mounting body of evidence regarding the impact of sport and exercise-based approaches to helping veterans. This included benefits that were integral to the activities, such as the restorative psychological benefits of being active in nature, and those that were more incidental, such as the powerful dynamics of peer support and challenging mental health stigma through a ‘positive’ and ‘proactive’ method of dealing with issues. The benefits are real, wide-ranging, and call out to be acknowledged.

Contestation and control

Yet, in what Herman and Yarwood1 refer to as the “politicised terrain of post-transition welfare”, such findings are sometimes contested. Psychiatry, for example, tells a different story; that only the NICE-approved clinical therapies are fully supported by evidence and should be used to help veterans, particularly with regard to mental ill-health. This is a powerful story – with the weight of medical scientific discourse behind it – and it tends to push other voices to the margins. And being marginalised hurts the pockets of the smaller charities providing these ‘alternative’ approaches to supporting veterans.

So, we have arrived at a situation whereby it is in the interests of charities to shout loudest that ‘their’ approach works best or has the best outcomes. The clinical approaches do, of course, work for some, but even here the evidence is sometimes overstated. In the crowded space of the military third sector, with strong competition for control of resources and authority, overstatement of evidence is a problem which sometimes leads on to proselytizing and to over-dramatized stories of veterans’ heroic transformations. A more sober assessment of evidence, without the inflated patriotism, heroism, and ubiquitous ‘inspiration’ is certainly needed.

Doing things better

The evidence does suggest that sport, exercise and a range of other pursuits can be meaningfully beneficial to veterans in dealing with physical injury and psychological suffering. I wish to suggest three ways in which this can be done better.

A balanced assessment

Just like the clinical approaches, sports and other activities are no panacea for recovery in mental ill-health or for transformational physical rehabilitation. Each approach has its benefits and its limitations, and these need to be acknowledged. For instance, when someone is in the darkest depths of depression, it can take an enormous effort of the will simply to rouse the energy to face the day, let alone force oneself into a freezing wetsuit and go surfing. Yet, for the veterans with whom I worked at charity Surf Action, surfing was something that made life worth living in the aftermath of war. That’s a powerful story, and it calls out for our attention and respect. But we must also be mindful not to oversell the message. Further research is needed to broaden the evidence base for a range of activities; a case I set out in detail in my recent article.

Drop the populism

The messages surrounding veterans’ participation in sports events and other activities often promote uncritically a populist discourse of military heroism. The message, amplified by the media, is that of ‘our’ brave and heroic soldiers inspiring the nation by continuing a personal fight away from the battlefield. Similar to how the ‘support the troops’ discourse worked during Iraq and Afghanistan to obfuscate criticism of these wars, the populist message can be seen as one way of excusing governments of responsibility for veterans’ injuries and illnesses by focusing instead on their triumph and redemption. Moreover, the populist discourse too easily traps veterans in a story of dramatically ‘overcoming’ illness and injury. The danger is that this doesn’t allow veterans to become civilians, or even just ordinary people, in the same way Paralympic sport sometimes positions athletes in the exclusionary identity of ‘super-crips’. We need to promote the benefits of sporting and other pursuits without the ‘inspirational’ populist messages. Doing so might better enable the charities to focus on a common purpose of supporting veterans in transitioning to healthy and productive civilian lives.

Take the long view

Sport can be a powerful tool for recovery, as Prince Harry has argued in relation to Invictus. But we also need to look well beyond the initial ‘post-transition’ phase of rehabilitation and support. Veterans’ long-term future in civilian life may well be served better by funnelling resources into their education and career development, for instance. My latest research with colleagues from Northumbria University explores the narratives of older limbless veterans in relation to the challenges of ageing with limb-loss. For these veterans, years of wear and tear on their remaining limbs – along with comorbidities such as arthritis and low back pain – create an ongoing struggle to maintain a sense of independence. As well as a ‘get on with it’ approach to dealing with pain and hardship, these veterans stressed the need for more mundane yet purposeful activity – photography was a popular one – to keep them engaged and provide structure to their daily lives. Also highlighted was the importance of a telling a positive career story post-injury; something that brought a sense of continuity to their post-injury lives. There are, therefore, other things besides glamorous and well-publicised sporting opportunities to consider in terms of rehabilitation and recovery.

There are finite resources – shrinking resources, now there is no war on – for supporting veteran communities. It matters how we use them. Sport, exercise, and various other pursuits clearly have a role to play. It’s time to consider how we can make that sustainable.

1Herman, A., & Yarwood, R. (2015; p. 2640). From warfare to welfare: veterans, military charities and the blurred spatiality of post-service welfare in the United Kingdom. Environment and Planning A, 47,

Causing stigma by highlighting stigma? A lesson from Twitter

Russell Delderfield in the following blog post explores and problematises the issue of stigma and eating disorders, within the context of exchanges he had on the social media site Twitter. 

Russell D pic

Image by frankieleon (Creative Commons License) 

I have recently had the wind knocked out of my post-PhD prideful sails. I studied male eating disorders using qualitative approaches for my doctorate.

The issue of stigma arises constantly in the research I read and conduct. It feels as if there is no avoiding it. It is pervasive and un-ignorable. I cannot possibly ‘choose’ to set it aside and not engage with it. Yet, when it appears in psychological publications, the treatment of it (within my field, at least) is dissatisfying. The inferences seem to start from a hefty assumption: that ‘stigma’ is a coherent, unified ‘thing’. And more importantly, that it either exists – or doesn’t. In addition, there is a kind of unwritten imperative that I experience. This asserts that mining the data for its evidence about stigma and presenting this to the world is a good thing; it helps to hold it up to the light for further keen observation. And this is where our dilemma begins.

Let me backtrack and fill in some gaps at this point. Whilst I qualitatively explore  men’s experiences with eating disorder, I’m not entirely alone. There are other clinicians, psychologists and psychiatrists who investigate  male disordered eating. A small number of studies have been published that try to improve our understanding using qualitative methods (I count 6 in my collection, thus far). Although I do not profess to specifically examine stigma in male eating disorders (my interest is broader than this alone), some of my participants share stigma they encounter.

During my PhD, I wanted to address the cursory and superficial coverage of stigma that I perceived in other work. So, I did something that no other person has done (at least to my knowledge) within my field. I did not simply report on the existence of stigma and select some careful quotes from the data to illuminate what men had been through, I took the study of a couple of men’s experiences back to its ‘roots’, with a Bordo-esque exploration of what this stigma meant to these men. I explored stigma through the lens of spoiled identity. I asked, ‘What does it mean to the man to live with stigma?’, ‘What does the experience of stigma mean for a man’s masculine identity?’, and ‘What does the avoidance of stigma mean for a man’s masculine identity?’

This, for me, emulated the ethos of feminist eating disorder work where there is an established history of women and researchers sharing their stories of ‘spoiled’ identity, objectified womanhood and the meanings of what it is to be an anorexic, bulimic or binge-eating woman. I formulated a useful exposition of what spoiled masculinities mean and feel like for men living with an eating disorder. This went beyond simply saying ‘men report they experience stigma and here’s an example of the stigma they had to deal with.’ Finally, I was satisfied. This laudable and novel achievement was a source of pride. Job done (at least for now, I’m not naïve enough to believe that qualitative work is finite).

Well that was then, and this is now. Over the summer a fellow researcher tweeted about a BBC News report that asked why men who have eating disorders keep it a secret. I was straight on the case. I retweeted with my usual ‘awareness-raising-challenge-the-stigma’ gusto. In a painfully cropped 140 words, I said that stigma is one reason that men do not speak out. I tweeted that I knew this due to my qualitative research with the men themselves. I encouraged others to face-down this stigma that can be so debilitating.

And I was challenged in turn. One of the men who has an eating disorder, who follows my research on Twitter, contacted me to raise something that I had not thought of before. In my positively proselytising mission to campaign against the damaging effects of stigma (important as I still believe it is), I had overlooked something. One tweet was all it took:

twitter“I sometimes wonder if (only) talking about how men with EDs feel stigmatised teaches men with EDs that they should feel stigmatised…”

I was floored – both as a man with an eating disorder and a researcher.

I wonder how many men feel similarly? I wonder if it is true that holding a mirror to the nature and effects of stigma simply serves to perpetuate it? In my empowered role as researcher I had overlooked something that, once said, seems so obvious. How could I not have thought about this before? Am I part of the problem, instead of being one among many cogs of the solution?

I didn’t despair for long. My interlocutor and I had a thought-provoking exchange of views. I learnt something extremely valuable. This is the very substance of what critical psychology embraces: it acknowledges the fallibility of research because it is carried out by humans about humans for humans. It challenges the monadic perspective of psychology and the monolithic nature of published research studies.   In many ways, the fact that people actually respond to my research on Twitter, rather than just passively consuming it, means that my work finds meaning somewhere. Talking about my research findings with the public leads to dialogue and a shared understanding of my single researcher experience.

However, I’m still left with a dilemma. I accept the proposition in the tweet but I do not have an answer as to how do we erode the deleterious effects of stigma, if we do not highlight the concept and the role it purportedly plays in preventing men from getting help. As a researcher, I must make sense of the potential consequences of my findings. Is uncomplicated campaigning for improvement unequivocally beneficent? I thought so, but I don’t anymore. I set out to redress the lack of complexity in male eating disorders research when it comes to stigma (amongst many other things). In turn, this bred further complexity because it created an unforeseen conversation.

Unforeseen, but not unwelcome: it’s a lesson that I appreciated learning.

Dr Russell Delderfield
University of Bradford
@MaleEDResearch

‘You are enough’

Andrea La Marre in this blog post reflects upon her experiences of speaking in a community setting to a group of young people on the topic of bodies and body image. 

I go to a lot of conferences. This summer I did the grueling three-conference circuit including QMiP, ISCHP, and POWs. Over the course of nine days, I spoke to some brilliant academics about my work, and learned a lot. I love going to conferences; oddly, I’ve come to love public speaking.
As much as I love conferences, however, I have been trying to break away from speaking only or primarily in academic settings. My focus is turning to ways to speak to people who I might never otherwise interact with.

 

Like, say… a group of Girl Guide Pathfinders.

 

A few weeks ago, I delivered a talk about growing up in a body-obsessed world to a group of community members. I had no idea that the audience would be mostly teenage girls, but I couldn’t have chosen a better crowd. It suddenly no longer mattered that my methods were verging on post-qualitative; my deep dives into Deleuze during the course of my dissertation seemed inconsequential in the face of a call to speak on a different level.

 

While I’m fairly new to the world of escaping academic-speak, I’m sure many of you are well familiar with this flip. With the need to distill messages that we’ve spent years crafting into elegant turns of theoretical phrase into digestible morsels. Not to dumb things down, but to make sure that our messages land.

 

So, what does one say to a group of teenagers who are, at this precise moment, growing up in a world that makes sure that many bodies don’t, and will never, fit? In a society that is racist, classist, ableist, ageist, and still—somehow, still—sexist?

 

I tried to make the message about more than aesthetic ideals, because the feeling of not fitting runs so much deeper than that. We don’t dislike our bodies only because we don’t think they are beautiful—though we often don’t. We dislike our bodies because we are also told they are not doing enough; that they are wrong and unwelcome. We are simultaneously made to feel like not enough and too much in this world. We are told that we need to continually strive for productivity. If we fail in our pursuit, we are not worthy citizens.

 

These messages seep in, and of course they land on our bodies. The world wants big things from us, while it simultaneously wants to keep us small. Reconciling those tensions is challenging when living in a world that keeps the surface level interest in the aesthetic value of bodies, the struggle for voice and representation materialize corporeally.

 

It felt important to me to talk about how systemic oppressions, like racism, classism, ableism, sexism, heterosexism all impact how we feel about our bodies with this group in particular because conversations about bodies with teens too often remain stuck at the level of media literacy debunking the thin ideal. And while debunking the thin ideal—and, increasingly, the fit ideal—is a worthy endeavor, media literacy is not immunity. I tried to highlight how even when we know we should not be swayed by the pull of aesthetic ideals, we may still feel crummy about ourselves at times.

 

Normalizing this experience is not about accepting the status quo—far from it. It is about recognizing that this sense of being ill at ease in one’s body does not stem only from not being a supermodel, but also from living in a world that constantly demands perfection and productivity, gives some people more than others, and then tells us it is our fault if we don’t succeed.

 

During this talk, it didn’t matter how I had analyzed my data; the teens didn’t care about methodological rigour or sample sizes. They cared about stories, and ways to move forward. One of the most poignant questions I was asked echoed a question I ask my participants in each interview: if you could go back and tell yourself something when you were struggling, what would you say?

 

I found this question really hard to answer; after all, who’s to say I’d have listened to the dorky grad student standing up at the front of the room? I chose a simple answer, which is much harder to feel: “You are enough, exactly as you are. You are not measured by how productive you are, how thin you are, or how health conscious. You are enough.”

 

I chose this not because I believe in some Polyanna-esque version of complete body peace or think that we can realize a society untethered from productivity discourses tomorrow, but because I believe it’s important that we start by believing that we are, truly, enough (and not too much). I chose it because whether or not I would have believed it is irrelevant. I chose it because I hope that it resonates with the audience—now, or 10 years from now. And I hope it is enough.

Harnessing the power of new technologies – meme workshop at ISCHP 2017’s conference

In this blog post, Neda Mahmoodi adds a commentary following a workshop held by Neda and Glen Jankowski at the ISCHP conference this year in Loughborough, UK. This is an adaptation of the abstract submitted for the ISCHP conference. From this it is possible to get a taste of the workshop’s aims to illustrate the promise of doing research in engaging ways that use audio-visual textual forms. 

Meme 1

(Meme 1)

Time constraints, increasing job precarity, and a ‘publish or perish’ culture can lead many of us frustrated with the impact our research has. Traditionally, research and theoretical studies have been disseminated through articles published in journals, or via conferences presentations. Disturbingly, around 1.8 million journal articles were published in 2015 alone and yet it is estimated that only half of these were actually read (1). However, the rise of the internet, particularly social media, has broadened opportunities. In this year’s workshop sessions during the 10th Biennial ISCHP conference, Glen Jankowski and Neda Mahmoodi discussed some of the free and easy methods to disseminate research beyond traditional academic outputs, including the use of memes. A meme is a virally-transmitted cultural symbol, social idea or concept expressed in some form of content. It can be a photo, a video, a person, a fictional character, an event, a song, a belief, an action, a word or anything else. It’s social phenomenon of mass online sharing makes them ideal for a rapid dissemination of ideas in an open access way, and therefore one small step to putting our ‘work to work’.

img_3643.jpg

(Meme 2)

During the conference workshop, attendees took part in a fun activity to ‘make a critical psychology related meme’ by captioning presented images. Examples created by workshop attendees includes Mariam Mousa’s (Auckland University of Technology) word art meme of the apple (meme 1) that taps into the theme of mental health and social media. Elizabeth Peel’s (Loughborough University) meme (meme 2) of the two wooden men explored the theme of taking a ‘hard’ line  when ‘processing’ knowledge in psychological and scientific research and theory.

 

The workshop also provided training in ‘how to make a podcast’. In pairs, attendees were given the opportunity to create a podcast by drafting their own interview questions and recording one another. This activity was described by attendees to be enjoyable and valued, with attendees stating that the activity showed how quick and simple it is to make and share a podcast, or a meme. Engaging in the activity gave attendees the confidence and skills to deviate from traditional methods of research outputs.

Notes:

http://www.smithsonianmag.com/smart-news/half-academic-studies-are-never-read-more-three-people-180950222/?no-ist

 

Earrings – and what they tell us about medicalisation

In this moving and personal blog post, Wendy Stainton-Rogers explores her experiences of the meaningful everyday practice of getting her ears pierced. Wendy connects this with her experience becoming, and remaining, the medical subject and object due to serious illness and disability.

Wendy for blog post pic (cropped) (1)

Three weeks ago I went into a jeweller’s shop in a busy shopping mall and got my ears pierced. It was on my ‘day out’ to celebrate my 71st birthday. Possibly a bit of a weird thing to do at my age, but not that big a deal surely? Actually, for me it was a very big deal. It was the first time in years that I had got something done to my body for a frivolous reason rather than for a medical one.

In 2011 during a biopsy to see if I had cancer, my bowel was accidently punctured and, a day or so later, I felt dreadful and my temperature skyrocketed, the alarm was called and I needed to have many hours of emergency surgery to deal with the septicaemia that had ensued. From that point on my life changed dramatically and I became highly medicalised. I was incredibly compromised, ill and weak and totally dependent. For several years after that, surgical catastrophes followed, one after another and my life became completely dominated by medical procedures. These ranged from the minor ones – such as regular ‘obs’ (observations – the taking of my temperature, blood pressure and pulse throughout the day and sometimes all night too), through constantly having routine cannulas fitted and being sent for all manner of Scans, X-Rays and Ultrasounds, to very invasive procedures, such as having a Hickman line fitted (more on this later). This powerful medicalisation of my body, my life and my consciousness was intensified in the weeks and days following  two further lengthy surgical procedures attempting to get rid of the cancer.  Each time I ended up in intensive and then critical care, linked up to a barrage of machines, with a dedicated nurse constantly looking after me.

As a health psychologist, ‘medicalisation’ is a word I had certainly read about and even written about, but it signified little to me of the enormous impact of what it can do to a person – that is, until I experienced it for myself. The days of horror are over (I hope!) but I am left disabled in some interesting ways, so my life is still dominated by medicalisation. The outcome of all that went wrong with my body is that my gut was destroyed and I have a condition called ‘total intestinal failure’. This means I have to have artificial food supplied through the Hickman Line – a tube that enters my body just at the top of my left breast and goes into my bloodstream near my heart.

Every night my line has to be ‘put up’; that is, attached to a ‘giving set’ (another tube that is joined up to a 3 litre bag of liquid food) via a pump, so that the food I need to keep me alive can be pumped into my body. The pumping takes about eleven hours. ‘Putting me up’ is a fine-tuned procedure that Robin (my husband and my carer) and I do together, following strict instructions to keep the line sterile (it took us three weeks in hospital to be trained to do this). An infection in the line is potentially lethal, and leads to immediate hospitalisation and what my GP calls ‘scary antibiotics’, so we are very vigilant to make sure we get it right.

These hours of food pumping rather mucks up your day! The eleven and a half hours of ‘putting up’, pumping and ‘taking down’ is an invariable constant that has to be built into my life. At first I spent all of the time in bed, but it’s much easier now that I have a smaller stand that is easier to manipulate. I can have my food pumped into me anywhere I can get it to so I don’t have to be in bed. At one conference I wheeled it into the bar, making life much more sociable.

This kind of intrusion into one’s time is one of the strongest downsides of being medicalised. It’s all too easy to talk blithely about people having procedures like, say, chemotherapy or renal dialysis and to not to properly realise the enormous impact the way in which it devours time for the person concerned. It is totally life-limiting and intrusive.

Medicalisation has many, many facets in addition to eating into time. Another is what it does to your identity. So – back to the earrings. They used, in the past, to be very much part of my ‘style’. I have a gargantuan collection of earrings – elegant ones to wear to job interviews, flamboyant ones for parties and dancing, deeply emotionally meaningful ones that I had been given to mark special days – the list goes on and on. But through all the horrors and tribulations of hospital treatment earrings were clearly not something I could wear, and even when I got home, for a long time I was just too weak and clumsy to get them in. So my piercings closed up, and for a long while I was so sensitised to the need to be sterile that I couldn’t contemplate having my ears pierced again for fear of infection. So my ‘birthday treat’ was, indeed, a really, extremely, fabulously and magnificently big deal. And now only a few more weeks to go and I can be as frivolous with my ears as I want. Hallelujah!
Notes

1 Picture kindly provided by Wendy Stainton-Rogers to accompany this blog post.

Sun, strawberries, and social representations theory: ISCHP 2017

ISCHP has been kindly granted permission by Katie Bevans-Wright to re-post a piece of writing posted on July 16th 2017 after Katie attended this year’s ISCHP conference in Loughborough, UK. The original article can be found at https://drkatiewright-bevans.com/2017/07/16/sun-strawberries-and-social-representations-theory-ischp-2017/.

Katie blog post pic(1)

This week I attended my second International Society of Critical Health Psychology Conference – a good time for a first blog post!

It had been four years since my last ISCHP. Back then I was in the early days of my PhD research and the Bradford conference opened my eyes to a world of passionate critical health psychologists. I was very much looking forward to Loughborough 2017 and it certainly didn’t disappoint. From arriving on a sunny Sunday afternoon to a reception of bangers and mash, and strawberries and cream, to the final (and very inspirational) keynote on the Wednesday by Dave Harper the whole 3 days were just fantastic. Unlike many other conferences where I feel very much on the margins as a critical social psychologist, I feel at home at ISCHP. My impression of ISCHP is that it is a critical space through and through, embracing scholars from many different theoretical and methodologically orientations and addressing a HUGE range of social and health concerns. There appears to be an understanding across the board that the most popular way of doing things is not necessarily the best or most effective one.

Scanning through the conference programme was not a case of locating where ‘my kind of talks’ were on and when but instead (refreshingly) having to face tricky decisions about what to attend and what to miss out on. Two of this events themes (‘diversity and inclusivity’ and ‘ageing’) summed up much of my research and interests, adding to dilemmas over which talks to attend. I thoroughly enjoyed talks on ageing and issues such as social inclusion, physical activity and sexual health. Many of the diversity and inclusivity talks touched upon the challenges of conducting good quality, ethical co-produced research with ‘disadvantaged’ or marginalised communities – these were most definitely relatable.

Presenting in one of two symposia on the theory of social representations was a personal highlight. For me this was an opportunity to position my work in the context of this fascinating and evolving theoretical framework. Between the two symposia, eight scholars (including colleagues at Keele: Michael Murray and Jenny Taylor) presented research on innovations in theory and methodology. It was inspiring to see SRT used to underpin novel methodologies such as film analysis and also to see people exploring different theoretical combinations to better understand social issues.

I came away from ISCHP 2017 feeling inspired, energised and motivated to crack on with the paper I’m currently working on! On top of that I met many friendly like-minded academics who I hope to cross paths with in the future. Already looking forward to ISCHP 2019!


Notes

1 Katie Wright-Bevans kindly gave permission for the picture to be republished on ISCHP’s website to accompany this blog post.

For more information about ISCHP 2017’s successful conference in the UK the reader may wish to see the ‘Past conferences’ page of this website.