- Convenor:
-
Huiyan Fu
(University of Essex)
Send message to Convenor
- Discussant:
-
Roger Goodman
(University of Oxford)
- Format:
- Panel
- Section:
- Anthropology and Sociology
Short Abstract
Despite its popularity in modern healthcare, the BioPsychoSocial (BPS) model has been insufficiently understood. By focusing on food allergy, drug overdose and compulsive gambling in Japan, this panel aims to reassert the importance of the social and its relationship with the individual/body.
Long Abstract
Despite its popularity in modern healthcare, the BioPsychoSocial (BPS) approach has been insufficiently understood or ill defined. It has been in practice eclipsed by the long-dominant Biomedical mode that situates illness and wellbeing within the individual and the body. By addressing issues surrounding food allergy, drug overdose and compulsive gambling, this panel brings to the fore the importance of the social in conditioning, mediating and shaping individual perceptions and experiences of ‘disorder’ (shōgai) in Japan.
Drawing on ethnographic fieldwork and other qualitative methods, the panel’s three papers set out to unpack the lived, diverse and oft-hidden realities of tōjisha, particularly those from marginalised and discriminated groups, which often defy powerful discourses and authoritative statistical representations. Special attention is paid to how social inequalities and power dynamics, combined with cultural assumptions, help to grapple with agential constraints and opportunities in everyday life. By closely and critically examining the meaning of the social in the Japanese context, the panel aims to contribute to a better understanding of the BPS model, with a view to generating insights and lessons that might inform public health elsewhere.
| Abstract in Japanese (if needed) | 生物-心理-社会（BPS）アプローチは現代医療において広く普及しているにもかかわらず、十分に理解されておらず、定義も曖昧なままである。これは主に、生物医学的モデルが病気と健康を個人と身体の中に位置づけ、長らく支配的な影響力を行使しているためである。本パネルは、食物アレルギー、薬物過剰摂取、ギャンブル依存をめぐる問題を取り上げ、日本における「障害」の認識と経験の形成・媒介・変容における社会的な重要性を浮き彫りにする。 本パネルは、民族誌的調査やその他の質的手法を通じて、周縁化・差別化される当事者たちのリアルな日常に迫り、権威ある言説や統計的表象で隠されがちな彼らの多様な認識と経験を深く掘り下げることを試みる。特に注目されるのは、社会的不平等と権力関係が文化的な規範や価値観と結びつき、日常生活における当事者の主体性の制約と機会をいかに形成・影響するかである。本パネルは、日本を舞台にする「社会的」の意味を緻密かつ批判的に検証することで、BPSモデルの理解深化へ貢献し、他の国の公衆衛生に応用できる洞察と教訓を生み出すことを目指している。 |
Accepted papers
Paper short abstract
Based on an ethnographic study of mental health self-help groups, this paper explores a rising overdose or OD crisis involving everyday drugs among women and young people in Japan. Special emphasis is placed on the importance of gendered inequality in grappling with ikizurasa or 'pain of living'.
Paper long abstract
Based on an ethnographic study of more than 100 meetings in mental health peer-support or self-help groups (SHGs), this paper explores Japan’s everyday drug issues from a gender-centred stratification perspective, with a view to highlighting inequality as a fundamental and complex driver of social suffering. I will begin with a broad analysis of the Japanese political economy of everyday drugs where a nexus of key institutions including businesses, the state and psychiatry forms the backbone of Japan’s mental health landscape. This is followed by a detailed empirical examination of individual perceptions and experiences of drug consumption in everyday life. Special emphasis is placed on how uneven power distribution, combined with cultural assumptions surrounding gender roles and personhood, in grappling with agential constrains and opportunities, as well as ikizurasa or 'pain of living'. By bringing lived realities back to structural scrutiny, the paper aims to generate insights and lessons that might inform drug policies and mental health care elsewhere.
Paper short abstract
Chronic illness fundamentally shapes one’s experience of the world, and different relationships to illness shape both the perception and experience of it. In this paper I analyze the experiences of food allergy tōjisha and the diverse understandings of food allergy that emerge in their accounts.
Paper long abstract
Chronic illness fundamentally shapes one’s experience of the world, and different positionalities and relationships to illness shape both the perceptions and experience of it. In this paper I explore the experiences of food allergy tōjisha, specifically adults with food allergies and parents whose children have food allergies, and the diverse understandings of food allergy that emerge in their accounts. For some it is an illness, for others a disability, and for still others it entails a part of their individuality and a ‘being with’ that they have learned to live with. These understandings are not, however, fixed but may shift depending on what is happening within the body at different times, and what is happening socially or institutionally. How they relate and understand their condition is shaped by the ways they feel food allergy interfere with daily life, the accommodations that are necessary, how treatment options shape their understandings and experiences, as well as diverse conceptualizations of identity and individuality. This paper consequently analyses the different positionalities and changing relationships tōjisha have with the categorization and experience of food allergy in Japan and argues that experiences of chronic disease are relational and changeable over the life course, not only shaped by social interactions with others but through their bodily experiences and how they relate to it.
Paper short abstract
Japan has a serious gambling problem and now has a national network of support facilities. The pioneer was One Day Port, a Yokohama NPO providing residential care for compulsive gamblers, launched in 2000. This paper traces the developing approach taken by its founder, Nakamura Tsutomu.
Paper long abstract
Japanese people have one of the world’s highest per-capita spend on gambling, partly because Japanese attitudes to gambling, as with drinking, have tended to be relatively tolerant. Behavior that would be viewed as pathological in many other societies has tended to be shrugged off as a personal foible. That started to change in 1989, when the first chapter of Gamblers Anonymous was opened in Japan; nowadays there are chapters in all 47 prefectures. Another landmark came in 2017, with the establishment of a network of Gambling Addiction Prevention and Recovery Support Centres (Gyanburu Izonshō Yobō Kaifuku Shien Sentā), with ten locations in major cities providing private consultations and 24/7 telephone counselling. But while the Japanese state has slowly moved from denial to recognition of the problem of gambling, one man has been making his own journey of discovery. I refer to Nakamura Tsutomu , who founded his semi-residential support centre for gamblers, One Day Port, in a couple of rented rooms in an unfashionable suburb of Yokohama back in April, 2000. A quarter of a century working with gamblers has given Nakamura -- himself a recovered compulsive gambler -- a unique perspective on this phenomenon. I will explain how that perspective has developed and changed over the years. One thing that has not changed is Nakamura's core belief that gambling should be treated not as a disorder but as a symptom of a deeper-lying social malaise.
| Abstract in Japanese (if needed): | 日本人は、一人当たりのギャンブル支出額が世界でも最も高い水準にあるとされている。その背景には、飲酒に対する態度と同様、ギャンブルに対して比較的寛容な社会的意識がある。多くの社会では病理的とみなされるような行動であっても、日本では個人的な癖や性分として軽く受け流されてきた傾向があった。こうした状況が変わり始めたのは1989年、日本で最初のギャンブラーズ・アノニマス（GA）の支部が設立されてからである。現在では、47都道府県すべてに支部が存在している。 さらに2017年には、「ギャンブル依存症予防回復支援センター（Gyanburu Izonshō Yobō Kaifuku Shien Sentā）」の全国ネットワークが設立され、主要都市10か所での対面相談や、24時間体制の電話相談が提供されるようになった。こうして日本国家は、ギャンブル問題を否認する段階から、徐々にその存在を認識する段階へと移行してきた。 しかしその一方で、独自の探求の道を歩んできた人物がいる。2000年4月、横浜の場末の住宅地にある借り部屋数室で、半居住型のギャンブラー支援センター「ワンデイ・ポート」を立ち上げた中村勉である。四半世紀にわたりギャンブラーと向き合ってきた経験は、回復した強迫的ギャンブラーでもある中村に、この現象についての独自の視座を与えてきた。本稿では、その視点が年月とともにどのように形成され、変化してきたのかを明らかにする。変わらず貫かれてきたのは、ギャンブルを障害としてではなく、より深層にある社会的病理の症状として捉えるべきだという中村の中核的信念である。 |