Current Online First Articles: A Digest

Following previous digests published here the articles are drawn from ‘Articles in Press’ on the Social Science and Medicine (SSM) website; ‘Early View’ on the Sociology of Health and Illness (SHI) website and ‘Online First ’ on the Health website. Similar to the previous digest (Cavaye 2013) the scene for my selection emerged from the re-occurrence of articles relating to contemporary problems of eating, diet, weight and managing healthy lifestyles. From Health, Kristensen and Koster (2014) present an interesting investigation into ‘Contextualising eating problems in individual diet counselling’. This article starts from the assumption that individualistic, bio-psycho interventions such as health coaching, diet counselling, and motivational interviewing, do not fully respond to the complex, contextual qualities of eating problems. This position is not unexpected as one of the authors is a narrative therapist and the other an anthropologist working in the sociology of food. Both authors examine narrative practice (White and Epston 1990, White 2007) as a means to contextualise eating problems: "In our work with eating problems, we engage in collaborative mapping of how the client’s problem is continually constituted through social interaction and historical context" (Kristensen and Koster 2014 p:4/5). A storytelling strategy, ‘externalisation’ is used to identify the problems experienced as an external entity, existing outside, independent of the person. This external ‘problem’ is then articulated, reflected on and analysed. This reflective analytical stage is called ‘co-researching’ the problem in the person’s ‘life world’. The authors argue this narrative practice allows the client and the therapist to explore social obligations, relationships, structures and discourses that shape the eating practices and each individual's response. This permits the complex and contextual qualities of an eating disorder to be observed and addressed. The authors do not claim that narrative practice enables the client to challenge the social structures and discourses that shape them. This narrative practice works to change the way the story is told and consequently is seen to offer new opportunities to respond differently to the problem. The authors present their argument systematically, initially discussing the philosophical and psychotherapeutic underpinnings of narrative practice, and then followed by a series of analytical case studies from the clinical setting. This analysis identifies three key contextual themes that frequently frame the person’s story. The first theme, ‘logistic eating problems’, shows how the problem is located within schedules, organisations and social practices of preparing food, and eating food. The second theme ‘social eating problems’ emphasise social relationships where issues of intimacy and trust are contextualised through the mediums of eating and types of food. The last theme focuses on ‘discursive eating problems’ when people locate their self-identities within ideal discourses of gender, body, health and diets. Research evidence from this psychotherapeutic setting depends upon the coherent and robust analysis of case studies. Here the authors present a persuasive and interesting point of view on the success of this phenomenological therapeutic practice, one that fits well with those who seek to prioritise the social within the complexities of health and illness. The next article from SHI ‘The pursuit of preventative care for chronic illness: turning healthy people into chronic patients close’ (Kreiner and Hunt 2013), explores doctor/patient interaction and the micro processes involved in the medicalization thesis. The