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In Western societies, human existence and illness are mostly constructed from the perspective of mind-body dualism: body and mind are considered to function independently, and the body/the physical as primary and more real. Research shows, however, that mind-body dualism is no longer tenable, especially in healthcare contexts. This led to the rise the biopsychosocial model, in which bodily experiences, including illness, are seen an interplay of the physical and the psychological, and the social. This model is the current gold standard for treating chronic pain. As these perspectives on the body and illness are potentially conflicting, and discursively constructed, this paper examines whether they are a source of misalignment in interactions between chronic pain patients and their doctors in a pain clinic. The analysis shows these perspectives indeed lead to misalignment, for instance when discussing the relevance of psychotherapy, and lead to intricate uses of argumentative resources to account for the differing perspectives on (the treatment of) pain. [ABSTRACT FROM AUTHOR]

With this study protocol, we present our approach to collaboratively coding metaphors in medical consultations, using the qualitative analysis software package ATLAS.ti. This project came with a number of challenges but also yielded a coded data set that was rich and versatile, and allowed for a wide array of analyses. We therefore believe it can be of interest to share the details of the process, to (1) provide an hands-on approach to qualitative, collaborative (metaphor) coding, and (2) contribute to our understanding and the advancement of qualitative methods in relation to coding metaphors, and coding more generally. The protocol can be of interest for researchers interested in collaborative qualitative coding, of metaphors or other (linguistic) units, using software. We specifically describe how we set up our initial coding system, and how we further developed it inductively; how we dealt with the fuzziness of metaphors; how we approach cleaning between coding rounds; how we divided work over and collaborated as a team of three coders with different but related cultural and linguistic backgrounds; how we structured our documentation and logbook. We then discuss how this set of guidelines complements the theoretical literature and more general guidelines on (metaphor) coding, and on reliability and validity in qualitative research. We will reflect on both a number of logistic and practical issues, as well as methodological and empirical challenges, and advantages and disadvantages of our approach. [ABSTRACT FROM AUTHOR]

This article examines women's magazine journalists' discourses and ideologies of health, agency and science, and how these are shaped by journalists' attitudes to health, and views on the magazine and readership. Health coverage has grown, and impacts behaviour, governmental policy and societal notions of health. Consequently, it is essential to understand how journalists construct notions of health, and how these notions feed into production processes. To examine the journalists' discourses and ideologies on health, eight research interviews were analysed. The analysis shows that journalists construct health as a subjective, dynamic experience of feeling well, in which patients' individual agency is central. This is consolidated by their view on readers as intelligent and independent, who read health content to become more well-informed. This neo-liberal view on health and agency leads to perspectives in which scientific expertise as no longer seen the only source of expertise to self-manage health, but as part of a bigger information landscape which includes pseudo-scientific information. This, in turn, is consolidated by ideas on open-minded journalism: good journalists are non-biased, consider all expertise, and let intelligent readers decide what is relevant knowledge. [ABSTRACT FROM AUTHOR]

In many countries, including Belgium and the Netherlands, dependence on benzodiazepines (BZDs) is a medical and social issue, and, for long-term users who want to taper off, doing so remains a personal challenge. For these users, online contexts such as forums can be a place to discuss this experience and look for practical and moral support among former users and fellow users trying to reduce or stop BZD use. This paper aims to shed light on the discourses of a Dutch-language benzodiazepine withdrawal forum, examining 133 forum threads (41,516 words). We take a corpus-based approach that combines frequency analyses with qualitative discourse analysis. We explore how the users extensively share lived, experiential knowledge of using and reducing medication and, in doing so, engage with domain-specific biomedical jargon. As such they discursively construct specialised expertise and a medical(ised), health professional-like expert identity, both in relation to their own situation, but also in interaction with other forum members, as advisors to each other. The forum thus not only serves as a site for emotional peer support, but also as a site for detailed informational support on tapering, which is traditionally offered by health professionals. This is especially pervasive, as many forum users also express indignation about the medical establishment and its lack of institutional knowledge support in the process of tapering off. [ABSTRACT FROM AUTHOR]

This paper examines pain, illness and medicine metaphors as used in consultations between chronic pain patients and anaesthesiologists, physiotherapists and psychologists in a Belgian pain clinic. As metaphors frame and highlight aspects of understanding and experiences of life events, including illness, they can provide insight in how health professionals and patients construct illness, pain and medicine in interaction. 16 intake consultations (collected in Belgium in April–May 2019) between 6 patients and 4 health professionals were qualitatively coded twice ATLAS. TI by a team of 3 coders, using an adjusted form of the Metaphor Identification Procedure. Each metaphor was labelled for source domain, target domain and speaker. A number of metaphors that have been previously documented in past research were frequent in our data too, such as journey and machine metaphors, although sometimes also used differently, like war metaphors. Our data set also contained many few-used and sometimes more novel metaphors, such as ILLNESS IS A YO-YO. Many metaphors highlight particular aspects of living with and talking about chronic pain, such as its duration and persistent presence, a lack of agency and feelings of powerlessness, and a dualistic perspective on body and mind. The metaphors used by health professionals and patients give insight in the lived experience of having and treating chronic pain. In this way, they can contribute to our understanding of patients' experiences and challenges, how they recur in clinical communication, and how they are related to wider discourses on health, illness and pain. • Metaphors are key in framing illness experiences such as living with chronic pain. • In a Belgian pain clinic, conventional metaphors such as journey metaphors are used. • But also more novel metaphors like ILLNESS IS A YOYO are crucial in consultations. • Metaphors point to the pain's persistence, a lack of agency, and mind-body dualism. • They give insight in the lived experience of chronic pain in clinical settings. [ABSTRACT FROM AUTHOR]