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PubMed2001

Harm reduction - a historical view from the left.

The harm reduction movement formed during a period in which social movements of the working class and the excluded were weak, neo-liberalism ideologically triumphant, and potential opposition movements were viewed as offering "tinkering" with the system rather than a total social alternative. This climate shaped and limited the perspectives, strategies, and tactics of harm reductionists almost everywhere. In many countries, this period was also marked by a "political economy of scapegoating" that often targeted drug users as the cause of social woes. This scapegoating took the form of "divide and rule" political initiatives by business and political leaderships to prevent social unrest in a long period of worldwide economic trends toward lowered profit rates and toward increasing income inequality. However, times have changed. Mass strikes and other labor struggles, opposition to the World Trade Organisation and other agencies of neo-liberalism, community-based protests against belt-tightening, and other forms of social unrest have been increasing in many countries. This opens up the possibility of new allies for the harm reduction movement, but also poses difficult problems for which we need to develop answers. On-the-ground experience in alliance formation needs to be combined with careful discussion of and research about what approaches work to convince other movements to work for and with harm reduction, and which approaches do not. Class differences within the harm reduction movement are likely to become more salient in terms of (a) creating internal tensions, (b) increasingly, opening up new ways in which working class harm reductionists can organize within their own communities and workplaces, and (c) producing different strategic orientations that will need to be discussed and debated. As a movement, we will need to find ways to accommodate and discuss differing perspectives, needs, and assessments of opportunities and threats without paralyzing harm reduction activities.

Journal Article↗
PubMed1998

HIV-related politics in long-term perspective.

Some long-term, large-scale socio-economic changes may affect the politics of HIV and other emerging viruses such as hepatitis C. It is useful to ask why the potential peace dividend of the early 1990s failed to provide adequate resources for HIV-related social and medical service delivery in developed or developing nations. This failure can be understood by looking at long-term global economic trends and the pressures they put on governments and corporations. They have produced a period in which fundamental issues of political and economic structure are at stake and, often, the response is a divide-and-rule politics to promote stability. National politics differ in terms of the extent to which such a 'politics of scapegoating' is institutionalized and in terms of which groups are scapegoated. Groups such as drug injectors, gay and bisexual men and sex traders are particularly likely to be targeted both by the scapegoaters and by HIV. Given this framework, how should public health professionals and activists engaged in HIV-related issues respond? Under what circumstances should we orient efforts upwards towards corporate, political or bureaucratic leaders? Under what circumstances, and how, should we orient towards popular forces? Relatedly, we need to consider an issue we often ignore: What do we have to offer potential allies? That is, in terms of their goals, philosophies and needs, why should they ally with us?

Attitude to Health↗
PubMed1991

Biological impact of social disruption resulting from epidemic disease.

Whereas previous research on the disruptive effects of epidemic disease have focused on the ways in which epidemics affect social structure and function, this study focuses on the biological impact of social disruption. The hypothesis is that social disruption resulting from the occurrence of epidemic disease increases the biological impact of the epidemic, as assessed by disease incidence. This hypothesis is explored in terms of a "level of response" model, borrowed from Slobodkin and Rapoport (Q. Rev. Biol. 49:181-200, 1974). The Human Area Relations File (HRAF) provides ethnographic reports of social responses to epidemics. The most frequently reported response in the HRAF is flight or migration away from the locus of the epidemic, followed in frequency by extraordinary preventive and/or therapeutic measures and scapegoating. The model proposes a continuum of responses beginning with responses that are already part of the indigenous response to disease and proceeding through disruptive processes, including flight and rejection of authority systems. Social disruption increases the biological impact of epidemics by robbing the social group of important participants, dismantling public health programs, or producing general economic hardship. The model proposes a scheme for identification of situations under which particular social group responses are "biologically appropriate."

Adaptation, Biological↗
PubMed1992

The biological impact of social responses to the AIDS epidemic.

This paper examines the extent to which social responses to the AIDS epidemic contribute to the continued transmission of the virus, thereby exacerbating the biological impact of the epidemic. Following the model of McGrath (1991), social responses to AIDS are examined in terms of their impact on potential transmission of HIV. Responses are evaluated using established criteria for decreasing disease transmission: eliminating the source of infection, eliminating contact necessary for infection, decreasing susceptibility of hosts, or decreasing the infectivity of infectious persons. The most frequent responses to AIDS have been scapegoating, resulting in ostracism, stigma, and blame; resignation; use of alternative therapies; political mobilization; and research. With the exception of political mobilization in some communities, the social responses to AIDS have not decreased the biological impact of the epidemic, and, therefore, may not be "biologically appropriate".

Acquired Immunodeficiency Syndrome↗
PubMed1979

A stepfamily in formation.

The increasing incidence of stepparenthood requires that mental health clinicians develop skills for helping members of two families form a viable new family unit. This paper conceptualizes stages in the development of the reconstituted family. Case material describes a scapegoated child as the focus of conflict in one family's progression through these stages.

Adaptation, Psychological↗
PubMed1980

Ethical problems in feeding patients with advanced dementia.

Aged patients with dementia if not stricken by an acute disease sooner or later approach a terminal phase that is distinguished by a failure of spoon feeding. This condition induces great anxiety in the workers who care for these patients. The interaction between patient and care-worker during spoon-feeding failure is described by the psychological model of double-binding. Two serious consequences of double-binding are the distancing of the care-workers from the patient and scapegoating among the care-workers. It is essential that the pressure of double-bindings in the wards should be reduced.

Aged↗
PubMed1976

The role of cognitive and situational variables in aggression toward homosexuals.

The relationship of several antecedents of aggression toward homosexuals was investigated. Attitudes toward homosexuality, perceived similarity to the target homosexual, and type of prior contact with the target homosexual were found to interact in influencing such aggressiveness. The implication of these findings to the "personal threat" and "scapegoating" hypotheses of aggression toward homosexuals is discussed.

Aggression↗
PubMed1999

Psychosocial adversities underestimated in hyperkinetic children.

Abnormal psychosocial factors, assessed both clinically and by raters blind to clinical presentation, were examined in 21 hyperkinetic and 26 conduct disordered children. Blind raters found the frequency of psychosocial adversities to be similar in the two disorders. By contrast the clinical rater, who did know the diagnosis of patients, rated adverse psychosocial situations as much lower in hyperkinetic children than in children with conduct disorder. Logistic regression showed, particularly in the category of abnormal intrafamilial relationships (Lack of warmth in parent child relationship, Hostility or scapegoating of the child, Intrafamilial discord among adults), effects of the interaction between rater and knowledge of diagnosis. Clinical raters should be aware of abnormal psychosocial situations in hyperkinetic children and assess possible adverse effects on parents and children. Researchers should be aware of a possible bias in research interviews.

Adult↗
PubMedDate not supplied

[Suicidal action and sacrificial violence: systemic and anthropological hypothesis].

Studies concerning suicidal behavior show practical limitations of epidemiology and risk factor analysis. Suicidal behaviour is usually considered as a consequence of mental disease, but suicide cannot be studied without addressing the context of the acting-out. Suicide attempt can be interpreted as a thematic relational act, in which the central phenomenon is anger. Using the anthropological hypothesis of scapegoating described by René Girard and a theoretical systemic approach, we propose a vision of suicide attempts in a micro-social context, offering a new interpretation of the acting-out. Application of the hypothesis to the suicidal context shows that suicidal behavior may be considered as a relationship modality. The understanding of rivalry mechanisms and integration of care in a context which takes account of the complexity of suicidal behaviour offers the possibility of developing potentially valuable approaches to prevention.

Acting Out↗