Professor Arthur Kleinman
Department of Anthropology Wm. James Hall 330 Harvard University CAMBRIDGE,
MA 02138 USA February 1997
Re Ideology and Aetiology: RSI, an Epidemic of Craft Palsy
This is a scholarly dissertation, written with great clarity and including
an impressive review of several literatures: RSI, writers' block, somatization,
etc. The last is about as well reviewed as I could have hoped. The central
argument is advanced with considerable empirical support from the research
literature. It is an argument for the role of cultural and social research
in clinical and policy settings as much as for psychiatry's role in assessing
an epidemic of functional complaints. The idea of collective experience
of functional symptoms receives a good deal of support in the dissertation.
This is an important advance over the great emphasis routinely given the
individual level of analysis. The author reviews this as well as linguistic,
gender, and political aspects of expressing the problem. The issue at hand
is the iatrogenic creation of moral pain and shared illness complaints owing
to medical, union, and other social activities. This social genesis not
only explains this case study but a number of other instances of collective
sickness as well. It is nicely grounded in anthro studies.
The thesis builds very effectively from classical medical sociological
accounts to the ideas of medical history, and clinical and social science
assessment. The fact that the author is herself a protagonist in the Australian
epidemic lends a poignancy to the dissertation.
The critical review and analysis impresses me as original, scholarly
and compelling. I have no problem whatsoever with the methodology or findings.
The interpretation for my interests is perhaps too focused on political
economic issues and cultural matters. In fact, what is most impressive about
this account is the attempt to relate RSI to larger contextual social forces.
It is surprising in this regard not to read much mention of the role of
the 'state'.
I think this thesis would be accepted in most Departments of Anthropology
and Social Medicine in the U.S., indeed it should be published as a monograph.
I give it a high recommendation. The analysis is critical, balanced, and
focused on the key questions. This thesis should be published.
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