Department of Sociology, Durham University, 32 Old Elvet, Durham, DH1 3HN, UK.
Cult Med Psychiatry. 2023 Dec;47(4):961-981. doi: 10.1007/s11013-023-09820-w. Epub 2023 Apr 6.
A key tenet of critical health research is that individual symptoms must be considered in light of the social and political contexts that shape or, in some cases, produce them. Precisely how oppressive social forces give rise to individual symptoms, however, remains challenging to theorize. This article contributes to debates over the interpretation of symptoms through a close reading of the case of Leon, an African American man struggling with an addiction to crack cocaine. Leon presented a complex illness narrative in which his addiction was clearly a product of structural racism, but also the result of dynamics within his family. Drawing on critical reevaluations of Freud's concept of the dreamwork, I call attention to the surface elements of Leon's narrative-what I term the surface of the symptom-and to the formal mechanisms by which latent contents (such as the social, the political, and the personal) are transformed into the manifest form of his symptom. This formal mode of reading offers a productive way of approaching questions of demystification and interpretation, one that holds in tension the register of social causation with the singularities of individuals and their symptoms.
关键健康研究的一个基本原则是，必须根据塑造或在某些情况下产生个体症状的社会和政治背景来考虑个体症状。然而，压迫性的社会力量究竟是如何引发个体症状的，这仍然难以理论化。本文通过对非洲裔美国人利昂案例的细读，为关于症状解释的争论做出了贡献，他因吸食强效可卡因而成瘾。利昂呈现了一个复杂的疾病叙述，其中他的成瘾显然是结构种族主义的产物，但也是他家庭内部动态的结果。借鉴对弗洛伊德的梦境工作概念的批判性重新评估，我提请注意利昂叙述的表面元素——我称之为症状的表面——以及将潜在内容（如社会、政治和个人）转化为他症状的明显形式的形式机制。这种形式化的阅读模式为解决去神秘化和解释的问题提供了一种富有成效的方法，它在社会因果关系的记录与个人及其症状的特殊性之间保持紧张关系。
