Reconciling discursive and materialist perspectives on health and illness - A reconstruction of the biopsychosocial approach

This paper examines the feasibility of developing 'material-discursive' approaches suitable for studying the reciprocal interactions between the sociolinguistic and physical aspects of health and illness. The term 'discursive' is used in the broadest possible sense, to refer to a mode of description characterized by awareness of the socially constructed and linguistically mediated nature of human experience. Similarly, the term 'material' is extended to embrace any non-reductionist account of physical being which appears compatible with a discursive outlook. The obstacles to a material-discursive approach are discussed, with particular reference to the debate between researchers who conduct traditional quantitative and experimental research within the 'biopsychosocial' framework and those who advocate a radical anti-realist position and qualitative research. A variety of material-discursive perspectives are explored, ranging from consideration of the physical origins and manifestations of linguistic meaning and socio-cultural processes, to analysis of the consonance between social constructionism, phenomenology and James Gibson's ecological psychology.