Читать книгу Health Psychology - Michael Murray - Страница 85

We are cultural beings, and an understanding of health beliefs and practices requires an understanding of the historical and socio-cultural context that gives human lives meaning.

Culture has been viewed principally in two different ways: (1) as a fixed system of beliefs, meanings and symbols that belong to a group of people who speak a common language and may also adhere to a common religion and system of medicine; (2) as a developmental and dynamic system of signs that exists in continuously changing narratives or stories. People’s reactions to illness are driven by a constant struggle for meaning in light of beliefs that are evolving across space and time. These two approaches yield very different kinds of psychological investigation.

Within psychology, the study of culture that uses the first approach is that of cross-cultural psychology. Samples of populations said to be from different cultures are compared in terms of attitudes, beliefs, values and behaviours that are viewed as stable and essential characteristics of particular cultures. This approach is illustrated by research on individualism versus collectivism by Triandis (1995) and Hofstede and Bond (1988). The study of culture that uses the second approach is that of cultural psychology and is illustrated by the work of Valsiner (2013), who views cultural psychology as:

a science of human conduct mediated through signs from beginning to end, and from one time moment to the next in irreversible time. … All phenomena of manifest kind – usually subsumed under the blanket term behavior – are subordinate to that cultural process of irresistible meaning-making (and re-making). Behavior is not objective, but subjective – through the meanings linked with it. … Human psychology is the science of human conduct and not of behavior, or of cognition. (2013: 25)

The concept of belief is a core concept in health psychology but rarely is it defined. Beliefs are viewed as:

durable and implicit; as associated with practices, choices and activities; and as bearing personal significance and import. … Belief tends to reproduce cultural norms, the precepts, expectations and values of particular times and places. … Simultaneously, within such broad cultural patternings, the belief of any given individual is produced through the mediation of that person’s particular history of social relations – with parents, carers, teachers, significant others – with which these acquired norms get inflected. (Cromby, 2012: 944–6)

Belief is viewed in social cognition models such as the theory of planned behaviour (TPB; Ajzen, 1985) as a fundamental theoretical construct, with each of the TPB’s three core constructs – attitude, subjective norm and perceived behaviour control – being underpinned by belief, an enduring, cognitive entity employed in rational thought and detached from feelings. It is often constructed and expressed as a part of discourse and narrative when asked for an account of one’s views about a topic in conversation. Beliefs are therefore constructed ‘on the hoof’ as much as they are a fixed piece of dogma that underlies decisions and actions.

Yet, as we argue elsewhere in this book, beliefs are almost always associated with affect. This is the view of Cromby (2012: 954), who states:

Belief arises when social practice works up structures of feeling in contingent association with discourse and narrative. … Believing is not merely information- processing activity, and belief is not an individual cognitive entity. Belief is the somewhat contingent, socially co-constituted outcome of repeated articulations between activities, discourses, narratives and socialized structures of feeling.

Beliefs are at the core of what we mean when we talk of culture.