Wilkinson S, Kitzinger C
Department of Social Sciences, Loughborough University, UK.
Soc Sci Med. 2000 Mar;50(6):797-811. doi: 10.1016/s0277-9536(99)00337-8.
There is an extensive social science and psycho-oncology literature on coping with cancer which claims that "thinking positive" is correlated with--and, by extension, causally implicated in--individuals' morbidity and mortality rates, and their overall level of mental health. Drawing on our own data, in which groups of women with breast cancer talk about "thinking positive", this paper interrogates the basis of such claims from a discursive perspective, by challenging the data analyses upon which they are based. We show that previous literature overwhelmingly relies on self-report data, which are taken as offering more or less accurate depictions of speakers' psychological states (i.e. their mental adjustment or coping style). A discursive approach, by contrast, explores talk as a form of action designed for its local interactional context, and pays detailed attention to what statements about "thinking positive" actually mean for speakers in the contexts in which they occur. We show that "thinking positive" functions not as an accurate report of a internal cognitive state, but rather as a conversational idiom, characterised by vagueness and generality, and summarising a socially normative moral requirement; we also show that even those breast cancer patients who report "thinking positive" can also actively resist its moral prescriptions. Finally, we sketch out the implications of our analysis for analyses of cancer patients' talk more generally and for future research on coping with cancer.
有大量关于应对癌症的社会科学和心理肿瘤学文献，这些文献声称“积极思考”与个体的发病率和死亡率以及他们的整体心理健康水平相关，甚至在因果关系上有所牵连。本文利用我们自己的数据，即乳腺癌患者群体谈论“积极思考”的数据，从话语角度审视这些说法的依据，对它们所基于的数据分析提出质疑。我们表明，以往的文献绝大多数依赖自我报告数据，这些数据被视为或多或少准确地描绘了说话者的心理状态（即他们的心理调适或应对方式）。相比之下，话语方法将谈话视为一种针对其局部互动情境设计的行动形式，并详细关注关于“积极思考”的陈述在其出现的情境中对说话者实际意味着什么。我们表明，“积极思考”并非作为对内部认知状态的准确报告，而是作为一种会话习语，其特点是模糊性和普遍性，概括了一种社会规范性的道德要求；我们还表明，即使那些报告“积极思考”的乳腺癌患者也可能积极抵制其道德规定。最后，我们概述了我们的分析对更广泛的癌症患者谈话分析以及未来应对癌症研究的意义。
