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Narrative reconstruction of mental illness as a work-stress-induced disorder: Processes, consequences and implications
Sociology of Health & Illness ( IF 2.7 ) Pub Date : 2021-05-20 , DOI: 10.1111/1467-9566.13288
Hiroto Shimizu 1
Affiliation  

Stress-induced mental illnesses have become the focus of increasing international attention, particularly in Japan since the 1990s, where judiciary cases and welfare-state initiatives established causal links between work stress and mental illness. However, how individuals retrospectively construct this causality remains a marginal topic in the literature. This ethnographic article explores the ways in which male workers seeking compensation for their condition (depression and adjustment disorder) reconstruct aetiology narratives and to what avail. This paper demonstrates two themes: (1) how objectivising stress (related to specific formats of worker compensation), no-faulting (dispensing with individual blame to view stress as pervasive in the workplace) and negotiating blame (seeking explanation in terms of individual psychology) construct a case, and (2) how narrative reconstruction functions as both a barrier to recovery and way of working towards recovery and collective function. It is argued that the narrative reconstructions of workers, who become unwell and seek recognition, suggest uncertain self-victimisation despite the broader understanding of mental illness in contemporary Japan. The findings imply the heuristic potential of relativising causality and treating analytical dichotomies, including causality–narrative, victimhood–agency and fact–fiction, not as contradictory alternatives, but as different analysis levels, to better understand ambiguous illness narratives.

中文翻译:

精神疾病作为工作压力引起的障碍的叙事重建:过程、后果和影响

压力引起的精神疾病已成为越来越受到国际关注的焦点,特别是自 1990 年代以来的日本,司法案件和福利国家举措在工作压力和精神疾病之间建立了因果关系。然而,个人如何回顾性地构建这种因果关系仍然是文献中的一个边缘话题。这篇民族志文章探讨了男性工人为他们的状况(抑郁症和适应障碍)寻求补偿的方式,重建病因叙述以及有什么用。本文展示了两个主题:(1)如何客观化压力(与工人薪酬的特定形式相关),无过错(免除个人责备以将压力视为工作场所普遍存在的压力)和谈判责备(从个人心理寻求解释)构建案例,以及(2)叙事重建如何既作为恢复的障碍又作为恢复的方式发挥作用致力于恢复和集体功能。有人认为,尽管对当代日本的精神疾病有更广泛的了解,但对身体不适并寻求认可的工人的叙事重建表明了不确定的自我伤害。这些发现暗示了因果关系相对化和治疗分析二分法的启发式潜力,包括因果关系-叙事、受害者-机构和事实-虚构,不是作为相互矛盾的替代方案,而是作为不同的分析层次,以更好地理解模棱两可的疾病叙述。(2) 叙事重建如何既是恢复的障碍又是恢复和集体功能的工作方式。有人认为,尽管对当代日本的精神疾病有更广泛的了解,但对身体不适并寻求认可的工人的叙事重建表明了不确定的自我伤害。这些发现暗示了因果关系相对化和治疗分析二分法的启发式潜力,包括因果关系-叙事、受害者-机构和事实-虚构,不是作为相互矛盾的替代方案,而是作为不同的分析层次,以更好地理解模棱两可的疾病叙述。(2) 叙事重建如何既是恢复的障碍又是恢复和集体功能的工作方式。有人认为,尽管对当代日本的精神疾病有更广泛的了解,但对身体不适并寻求认可的工人的叙事重建表明了不确定的自我伤害。这些发现暗示了因果关系相对化和治疗分析二分法的启发式潜力,包括因果关系-叙事、受害者-机构和事实-虚构,不是作为相互矛盾的替代方案,而是作为不同的分析层次,以更好地理解模棱两可的疾病叙述。尽管当代日本对精神疾病有更广泛的了解,但这表明不确定的自我伤害。这些发现暗示了因果关系相对化和治疗分析二分法的启发式潜力,包括因果关系-叙事、受害者-机构和事实-虚构,不是作为相互矛盾的替代方案,而是作为不同的分析层次,以更好地理解模棱两可的疾病叙述。尽管当代日本对精神疾病有更广泛的了解,但表明不确定的自我伤害。这些发现暗示了因果关系相对化和治疗分析二分法的启发式潜力,包括因果关系-叙事、受害者-机构和事实-虚构,不是作为相互矛盾的替代方案,而是作为不同的分析层次,以更好地理解模棱两可的疾病叙述。
更新日期:2021-07-14
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