Nissim Mizrachi

Entering the well-guarded fortress: alternative practitioners in hospital settings

There is a growing evidence that alternative health care practitioners and physicians are working together in collaborative patterns. The paper examines these collaborative patterns in hospital settings in Israel. On the theoretical level, the specific issues relate to theories concerning relationships between dominant institutional structures which enjoy the benefits of epistemological legitimacy as well as extensive, supportive social structures and groups of non-conformists who seek to attain many of the same goals by utilizing different methods based on other epistemologies. In the most general sense, the issues involved concern processes of accommodation and social change. Data were collected by means of semi-structured, qualitative interviews in four general hospitals in Jerusalem during 2000. Nineteen persons were interviewed including 10 alternative practitioners working in a variety of fields and nine biomedical practitioners who worked with them (six physicians and three nurses). Interviews focused on background and training, reasons for entry into the hospital, length of practice, status in the hospital system, mode of remuneration, content of work, modes of interaction with others in the hospital and problems encountered. The findings suggest a dual process of simultaneous acceptance and marginalization of alternative practitioners. While small numbers of alternative practitioners were found to be practicing in a wide variety of hospital departments and in a broad spectrum of specialties, they were in no way accepted as regular staff members and their marginality was made clear by a variety of visible structural, symbolic and geographical cues. There is a division of labour expressed by focusing on the biomedical practitioners on the diagnosis and treatment of specific disease entities, while the alternative practitioners work in the illness context, concentrating of feelings and affective states involving the alleviation of pain, suffering and efforts to improve the quality of life.

Ordinary people doing extraordinary things: responses to stigmatization in comparative perspective

Abstract This special issue offers a first systematic qualitative cross-national exploration of how diverse minority groups respond to stigmatization in a wide variety of contexts. This research is the culmination of a coordinated study of stigmatized groups in Brazil, Israel and the USA, as well as of connected research projects conducted in Canada, France, South Africa and Sweden. The issue sheds light on the range of destigmatization strategies ordinary people adopt in the course of their daily life. Articles analyse the cultural frames they mobilize to make sense of their experiences and to determine how to respond; how they negotiate and transform social and symbolic boundaries; and how responses are enabled and constrained by institutions, national ideologies, cultural repertoires and contexts. The similarities and differences across sites provide points of departure for further systematic research, which is particularly needed in light of the challenges for liberal democracy raised by multiculturalism.

Participatory destigmatization strategies among Palestinian citizens, Ethiopian Jews and Mizrahi Jews in Israel

Abstract This study examines how members of minority groups in Israel cope with stigmatization in everyday life. It focuses on working-class members of three minority groups: Palestinian Arabs or Palestinian citizens of Israel, Mizrahim (Jews of Middle Eastern and North African origin) and Ethiopian Jews. It reveals the use of racial, ethnic and national markers in daily processes of social inclusion and exclusion in one sociopolitical context. Palestinians, a group with a fixed external identity and a limited sphere of participation, were found to use the language of race and racism when describing stigmatizing encounters. Ethiopian Jews, the most phenotypically marked group, strictly avoided this language. For their part, Mizrahi Jews perceived the very discussion of stigmatization as stigmatizing, while often using ‘contingent detachment’ to distance themselves from negative group identities. Despite differences between the communities and the powerful role of the state in establishing symbolic and social boundaries, members of all three groups expressed their intention to achieve or retain avenues for participation in the larger society.

Changing Boundaries: Modes of Coexistence of Alternative and Biomedicine

In this article, the authors address the boundaries of institutional structures, the dynamics of their configuration, and the nature of their permeability. The authors explored these issues in Israel, where the changing relationship of bio and alternative medicine elucidates recent processes of professional boundary redefinition. They used qualitative methods to analyze in-depth interviews in clinics and hospitals where alternative and biomedical practitioners work under the formal auspices of publicly sponsored biomedical organizations. The findings show an incursion by alternative practitioners into territories viewed until fairly recently as the exclusive domain of biomedicine. However, the “alternatives” are not defined as regular staff members, and their marginality is elucidated by a variety of visible structural, symbolic, and geographical cues. The authors used decoupling theory in interpreting the findings. Changed boundary contours signal underlying processes of social change that could have meaningful implications in defining membership criteria in the biomedical community.

‘From badness to sickness’:1 the role of ethnopsychology in shaping ethnic hierarchies in Israel

This article explores the role of the psychological sciences in depoliticising processes of ethnic demarcation and marginalisation within the Jewish population in Israel. It shows how the psychological sciences have provided the scientific foundation by which cultural domination and subordination have been essentialised. The study traces the ways in which ethnopsychological discourse has changed its contours over time. Early ethnopsychological discourse provided an overt link between the ‘cultural backwardness’ and ‘psychological impairment’ of the Mizrahi Jew. In light of broad social and political transformations, in the more recent model the overt ethnic signifier was silenced, and the Mizrahi ‘impaired mind’ appeared to be detached from its ethnic roots while being attributed to the same ethnic population. Both ethnopsychological forms have focused on the individuals ‘special needs’ and ‘inherent psychological impairment’, obscuring the role of social and political forces in shaping social gaps in Israeli society and reinforcing the hegemonic discourse of nurture. The latter has provided a negative mirror image of the modern Ashkenazi secular Israeli Jew following Western cultural models of self‐control as the universal index of health and progress. This study is based on both primary and secondary sources as well as on my in situ observations.

‘I don't want to see it’: decoupling ethnicity and class from social structure in Jewish Israeli high schools

Abstract Social inequality in Israels education system has often been analysed with top-down structural models. This study inquires, instead, how students understand their position in the stratified structure of opportunities at school. Our quantitative and qualitative data, gathered in Jewish high schools in Israel, indicate that, despite clear ethno-class distribution in academic tracking, students reject the logic of identity politics and consider ‘free will’ to be the main factor determining tracking. In light of the Jewish-Israeli national identity, which rejects class and ethnic divides, the reference point for the system of classification at school shifts to the autonomous individual. Our findings show that students use consumerist and psychological discourses to dismantle ethno-class identities and depoliticize the classification system at school.

Between global racial and bounded identity: choice of destigmatization strategies among Ethiopian Jews in Israel

Abstract Our research explores how Ethiopian Jews in Israel apply local and global cultural resources when forming their reactive strategies to stigmatization. Drawing on 40 in-depth interviews with adult men and women, we examine class variations in the destigmatization strategies of working-class and middle-class Ethiopian Jews. Working-class Ethiopian Jews rely on their local bounded identity, that of Jews, rather than identity politics, which stresses phenotype in formulating destigmatization strategies. The former provide is Ethiopians of all classes with the network of meaning necessary for active participation in the broader society, whereas the latter is primarily the province of a small number of highly educated middle-class individuals, those who had access to social networks of highly educated liberals and could mobilize valued global black cultural resources (e.g. music, art) to their advantage in the local context.

Epistemology and legitimacy in the production of anorexia nervosa in the journal Psychosomatic medicine 1939-1979

Abstract This study examines the role of the interplay between epistemology and legitimacy in shaping the conceptualisation of anorexia. It focuses on the process of knowledge production within a particular medical setting – the journal, Psychosomatic Medicine. The journal was founded as part of the first psychosomatic movement in the history of the US seeking to undermine the epistemological foundation of biomedicine: the mind-body division in medical theory and practice. From its inception, the movement was haunted by an ongoing identity problem, institutional uncertainty and scientific ambiguity. The study relies on four separate data sets – articles appearing on anorexia in Medline, archival sources and editorial board minutes of Psychosomatic Medicine, the journal’s referees and their decisions and the articles on anorexia which appeared in Psychosomatic Medicine. The study shows how in the course of its knowledge production, the journal managed to increase the level of consistency while evaluating papers submitted. At the same time it moved towards the dominant biomedical discourse, either through shifting the psychosomatic focus on anorexia from the mind-body interaction to the ‘anorexic body’ only, or alternatively through reducing the methodological model from causal to correlational. This transition in reasoning in the case of anorexia represents an intriguing trade-off between the scope and the reliability of ambiguous medical knowledge in the face of the overriding need to gain legitimacy within the existing dominant biomedical domain.

Translating Disability in a Muslim Community: A Case of Modular Translation

This study examines how Muslim religious leaders (imams) introduce the liberal notion of disability to their communities in Israel. The project described, initiated and supported by an American NGO, provides a case for exploring how the secular notion of disability rights is cast and recast in a Muslim world of meaning. It focuses on the mediation strategy that I call modular translation, employed by imams in sermons delivered for the purpose of altering or improving the status and conditions of people with disabilities. This strategy, as it emerged from the analysis, entails decoupling norms of conduct from their underlying justifications. It thus suggests that norms of conduct are open to change so long as the believers’ cosmology remains intact. As such, this turn may offer new avenues of thinking and acting about globalizing human rights within the arena of health and disability.

From the study of racism to destigmatization and the transformation of group boundaries

From the study of racism to destigmatization and the transformation of group boundaries Michèle Lamont and Jessica Welburn Department of Sociology, Harvard University, Cambridge, USA; Department of African and African American Studies, Harvard University, Cambridge, USA; Department of Sociology, University of Iowa, Iowa City, USA; Department of African American Studies, University of Iowa, Iowa City, USA