Mind and body in the discursive construction of M.E.: a struggle for authorship of an illness
This thesis is an analysis of the discursive construction of a controversial medical condition (Myalgic Encephalomyelitis) and how it has been made sense of, in and through the discourse of medical scientists, general practitioners, and M E sufferers. Various kinds of text and talk are analysed from the perspective of discursive psychology, arguing that versions of reality are a product of participants' constructive and dialogical practices. (I include my own text as an example of this.) The analysis of scientific texts, illness narratives, diagnostic narratives, and M E self-help group discussions, show how explanations about the status of M E and its causes are embedded in accounts of the identity of sufferers, the nature and status of medical explanation, and the competencies of medical practitioners. There is a sense in which the controversial topic of this thesis provides an ideal forum for examining both lay and professional reasoning practices about illness, in a context where the 'objective' world of 'medical facts' threatens to disintegrate into merely subjective points of view. One of my concerns has been to show how the participants themselves orient to, and manage this 'reality disjuncture' by means of a variety of discursive devices. The main body of the thesis addresses this problem through issues such as: the significance of diagnostic labels, different models of medicine, and the relevance of mind and body in explanations for illness. Finally, there is an analysis of the narrative constructions of M E sufferers and GPs, to show how psychosocial 'evidence' is used to warrant the speaker's interpretation of illness as either a mental or physical phenomenon.