David A. Karp

Mental Illness, Caregiving, and Emotion Management:

Based on 50 in-depth interviews, this article considers how caregivers to a spouse, parent, child, or sibling suffering from depression, manic-depression, or schizophrenia manage their emotions over time. By considering the turning points in the joint career of caregivers and ill family members, our analysis moves beyond studies that link emotions to particular incidences, momentary encounters, or discreet events. Four interpretive junctures in the caregiver-patient relationship are identified. Before diagnosis, respondents experience emotional anomie. Diagnosis provides a medical frame that provokes feelings of hope, compassion, and sympathy. Realization that mental illness may be a permanent condition ushers in the more negative emotions of anger and resentment. Caregivers’ eventual recognition that they cannot control their family member’s illness allows them to decrease involvement without guilt. The article concludes with a call for research that understands that emotions in groups, settings, or organizations are linked to their distinctive histories.

Taking Anti-Depressant Medications: Resistance, Trial Commitment, Conversion, Disenchantment

This paper documents the meanings attached to taking anti-depressant medications. Indepth interview materials from a sample of persons diagnosed and treated for depression suggest that taking doctor-prescribed drugs involves an extensive interpretive process about the meanings of having an emotional “illness.” The data and analysis extend previous studies on the meanings of taking psychotropic drugs by showing how those meanings change over the course of the depression “career.” An individuals changing responses to psychiatric medications can be described as a socialization process having radical implications for self definition. The four stages constituting this socialization process and central to the analysis in the paper are: resistance, trial commitment, conversion, and disenchantment. Each of these stages is discussed in terms of its impact on personal identity. The implications of the presented data for challenges to the medical model are discussed.

Hiding in Pornographic Bookstores: A Reconsideration of the Nature of Urban Anonymity

THERE EXISTS IN THE TIMES SQUARE AREA of New York a distinct sexual community or subculture composed of those persons who provide sexual goods or services and their &dquo;clientele.&dquo; Such persons or organizations of persons include pornographic bookstores, pornographic movie theatres, peepshow establishments, burlesque houses, topless bars, live sex show productions, homosexuals, hustlers, and prostitutes. The research reported in this paper documents the &dquo;hiding, shielding, or concealing&dquo; behavior of persons involved in pornographic bookstores in the area.’ Very importantly, Times Square epitomizes the anonymous inner city. As such, it is a good testing ground for a number of assumptions, found in the urban literature, about urban interpersonal relations or more

Sport and Urban Life

The paper draws together historical and sociological literatures on sport with the purpose of more firmly introducing the role of sport into scholarly dialogue about city life. A central thesis of the paper is that there was a mutually transformative relationship between sport and the growth and development of American cities during the nineteenth and early twentieth centuries. Discussed in this regard is the role of sport and games in socializing and controlling immigrants. On a more social psychological level, the significance of sport in providing urbanites with a subjective sense of community identification is examined. The last section of the paper considers how participation in urban playground sports may provide a forum for the expression of self, identity, and individualism in an otherwise anonymous urban world.

Work, careers, and aging

This article relates the literature on work and profession to that on aging as a life-long process. The authors maintain that meanings attached to chronological age arise, in large measure, out of the work experience. An individuals career frames expectations about what he/she should be doing at different ages and thus serves as a yardstick against which to measure life process. Five stages of the work career are identified: (1) preparation and exploration, (2) learning the ropes, (3) coming to grips, (4) settling in, and (5) exiting.

Academics beyond Midlife: Some Observations on Changing Consciousness in the Fifty to Sixty Year Decade

This article draws on in-depth interview data collected from forty-seven professors between the ages of fifty and sixty. The central focus is on the twenty-three interviews done with the men. A review of the literature suggests that professionals in the fifty to sixty year decade are actively assessing how to divide their energies at work and between work and other life spheres. After describing how aging is experienced in the fifties by both men and women, the article describes a set of related patterns of consciousness change among the male professors interviewed. As male professors approach sixty, they express a number of interconnected feelings and concerns that distinguishes them from younger colleagues. First, they stress the need to exercise greater selectivity in the allocation of their time. They recognize that a limited amount of time lies ahead in their careers and that they must make qualitatively good decisions about the work they do. Second, the men in our sample evidence a decreased intensity toward research work. Third, many men express a growing humanism; a concern with getting beyond the objective boundaries of their respective disciplines. Last, professors begin to develop an exiting consciousness as they approach sixty.

Gender, academic careers, and the social psychology of aging

Because of cultural, historical and other social structural factors, men and women with the same chronological age have had quite different career trajectories. This paper examines how the different career-paths of men and women academics create differences in their images of aging, self and work. In-depth interviews (N=47) were conducted with a sample of male and female professors, currently between fifty and sixty years of age. Male respondents nearly uniformly followed continuous, linear careers while the womens careers were, with equal uniformity, discontinuous. Data suggest that this difference in career routes fashions different “gender timeclocks,” i.e., different experiences of aging.

Listening to Voices: Patient Experience and the Meanings of Mental Illness

This chapter proceeds from the observation that the voices of the mentally ill have been inappropriately neglected both by social scientists and mental health practitioners. After tracing how the triumph of biological psychiatry in recent decades has led to a disproportionate focus on patients’ symptoms rather than stories, we consider the political significance of listening well to individual accounts. We draw inspiration from feminist, critical race, and disability theories to illustrate how patients’ stories illuminate the nature of personal suffering as well as the social structures that can cause or amplify such suffering. While personal memoirs can be a valuable source for understanding the subjective experience of mental illness, we maintain that sociological writing based on a range of voices uncovers broader regularities in the evolution of illness experiences. To illustrate this point, we consider how qualitative research can powerfully articulate the connection between illness careers and patterned identity transformations. The chapter closes with a call for more studies on how different intersections of multiple social locations shape diverse mental illness experiences and associated meanings.

The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder

and social critics were edgily attuned to the complexities of wielding the authority to declare someone mentally ill. Behavioral scientists bemoaned the lack of a systematic method for designating people mentally ill. Physicians who cared for the seriously mentally ill were fed up with the uselessness of talk therapy. And private insurers complained about the cost of long-term psychotherapy, sometimes lasting for years, for neurotics who had no obvious mental illness. Large-scale evidence pointed to diagnostic disarray. In 1971 a seminal study found that the definition of schizophrenia employed by American psychiatrists led them to diagnose the condition several times as often as their counterparts in Great Britain. American doctors were using an overly broad description that led them to misidentify people in the excited phase of manic-depressive disorder as having schizophrenia. !e error was especially significant because the Food and Drug Administration had just approved lithium carbonate as a treatment for mania. If a patient were misdiagnosed, he would not be properly treated. In 1973, in Science magazine, a smaller but no less powerful study by the Stanford University psychologist David L. Rosenhan, called “On Being Sane in Insane Places,” described how eight normal people got themselves admitted to a psychiatric hospital by simply claiming they were hearing voices that said “empty,” “hollow,” and “thud.” !ough these pseudo-patients said their symptoms disappeared upon admission, it still took an average of three weeks before they were considered well enough for discharge. Damning stuff. If the integrity of a medical specialty turns on its ability to make meaningful diagnoses and to distinguish THE LOSS OF SADNESS:

The Research Imagination: COMPARATIVE RESEARCH METHODS

INTRODUCTION In contrast to the chapters on survey research, experimentation, or content analysis that described a distinct set of skills, in this chapter, a variety of comparative research techniques are discussed. What makes a study comparative is not the particular techniques employed but the theoretical orientation and the sources of data. All the tools of the social scientist, including historical analysis, fieldwork, surveys, and aggregate data analysis, can be used to achieve the goals of comparative research. So, there is plenty of room for the research imagination in the choice of data collection strategies. There is a wide divide between quantitative and qualitative approaches in comparative work. Most studies are either exclusively qualitative (e.g., individual case studies of a small number of countries) or exclusively quantitative, most often using many cases and a cross-national focus (Ragin, 1991:7). Ideally, increasing numbers of studies in the future will use both traditions, as the skills, tools, and quality of data in comparative research continue to improve. In almost all social research, we look at how social processes vary and are experienced in different settings to develop our knowledge of the causes and effects of human behavior. This holds true if we are trying to explain the behavior of nations or individuals. So, it may then seem redundant to include a chapter in this book specifically dedicated to comparative research methods when all the other methods discussed are ultimately comparative.