Social and Cultural Lives of Immune Systems (Theory and Practice in Medical Anthropology and International Health)

329 Pages·2003·2.1 MB·English

by  James M. Wilce Jr.

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Social and Cultural Lives
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13111 Social and Cultural Lives of Immune Systems introduces a provocative new
4 hypothesis in medico-social theory – the theory that immunity and disease
5 are in part socially constituted, and that immune systems function not just
6 as biological entities but also as symbolic concepts charged with political
7 significance. Bridging elements of psychology, sociology, body theory,
immunology, and medical anthropology, twelve papers from leading inter-
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national scholars explicate some of the health-hazards of emotional and social
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pressure, whilst analyzing the semiotic and social responses to immunity and
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to imagery associated with it. Is it possible, as some experts now claim, that
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the terminology of immunity, dependent upon the defense of the self from
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invasion by an alien other, has entered modern consciousness to a point where
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it serves as a metaphor and indicator of wider political realities? If one’s
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social status affects one’s immune competence, can health interventions
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avoid taking poverty and discrimination into account? Can immunological
6 rhetoric genuinely be shown to affect operations as diverse as military action,
7 crime policy, and international food distribution? If this is the case, what
8 conclusions can be drawn from the fact that tactics of disclosure, emotional
9 openness, and inclusion are clinically proven to boost immunity, whereas
30111 division, denial, and containment – apparently modeled on the activities of
1 immune cells – ironically raise susceptibility to disease?
2 Social and Cultural Lives of Immune Systems features contributions from
3 David Napier, Emily Martin, Daniel E. Moerman, and others alongside criti-
4 cal data from trauma-writing interventions in the US and New Zealand,
5 European drug trials, US clinical practice, and global fieldwork on stress,
6 status, and cultural capital. Possibly the first cultural analysis of embodiment
7 to give close attention to immune function, and certainly one of the first stud-
8 ies of immunology, disease, and healing to look seriously at concepts of the
social self, it offers a comprehensive framework for future study in an excit-
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ing new area.
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1 James M. Wilce Jr is Associate Professor of Anthropology at Northern
2 Arizona University. He specializes in sociocultural perspectives on language,
3 illness, and healing, and is author of Eloquence in Trouble: Poetics and
44111 Politics of Complaint in Rural Bangladesh (1998).
Theory and Practice in Medical Anthropology and
International Health
A series edited by Susan M. DiGiacomo
University of Massachusetts, Amherst
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H. Kris Heggenhougen, Harvard University, Cambridge, Massachusetts
Daniel E. Moerman, University of Michigan, Dearborn
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Against Death: The Practice of Social and Cultural Lives of
Living with AIDS Immune Systems
Robert M. Ariss Edited by James M. Wilce Jr
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Edited by James M. Wilce Jr
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First published 2003
by Routledge
11 New Fetter Lane, London EC4P 4EE
Simultaneously published in the USA and Canada
by Routledge
29 West 35th Street, New York, NY 10001
Routledge is an imprint of the Taylor & Francis Group
This edition published in the Taylor & Francis e-Library, 2003.
© 2003 James M. Wilce Jr for selection and editorial material;
individual chapters, the contributors
All rights reserved. No part of this book may be reprinted
or reproduced or utilised in any form or by any electronic,
mechanical, or other means, now known or hereafter invented,
including photocopying and recording, or in any information
storage or retrieval system, without permission in writing
from the publishers.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the
British Library
Library of Congress Cataloging in Publication Data
Social and cultural lives of immune systems / edited by
James M. Wilce, Jnr.
p. cm. – (Theory and practice in medical anthropology
and international health)
Includes bibliographical references and index.
1. Medical anthropology. 2. Immune system. 3. Culture –
semiotic models. 4. Body, Human – Social aspects. 5. Body,
Human – Symbolic aspects. I. Wilce, James MacLynn, 1953– .
II. Series.
GN296.S613 2003
306.4′61 – dc21 2002031935
ISBN 0-203-40451-3 Master e-book ISBN
ISBN 0-203-34183-X (Adobe eReader Format)
ISBN 0–415–31004–0 (hbk)
ISBN 0–415–31005–9 (pbk)
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Contents
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13111 List of illustrations vii
4 List of contributors ix
5 Acknowledgements x
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1 Introduction: social and cultural lives of immune systems
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in a semiotic universe 1
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J A M E S M . W I L C E J R
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PART I
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Theoretical perspectives 17
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2 Telling stories: the health benefits of disclosure 19
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J A M E S W . P E N N E B A K E R
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7 3Relating to our worlds in a psychobiological context:
8 the impact of disclosure on self-generation and immunity 36
9 R O G E R J . B O O T H A N D K A T H R Y N P . D A V I S O N
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1 4 Metaphors our bodyminds live by 50
2 J A M E S M . W I L C E J R A N D L A U R I E J . P R I C E
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4 5 “Immune” to emotion: the relative absence of emotion
5 in PNI, and its centrality to everything else 82
6 M A R G O T L Y O N
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8 PART II
9 PNI in the wild: anthropological fieldwork using
40111 endocrine and immune variables 103
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2 6 Childhood stress: endocrine and immune responses to
3 psychosocial events 105
44111 M A R K V . F L I N N A N D B A R R Y G . E N G L A N D
vi Contents
7 Cultural congruity and the cortisol stress response among
Dominican men 147
S E A M U S A . D E C K E R , M A R K V . F L I N N , B A R R Y G . E N G L A N D ,
A N D C A R O L M . W O R T H M A N
8 Life event stress and immune function in Samoan adolescents:
toward a cross-cultural psychoneuroimmunology 170
T H O M A S W . M C D A D E
PART III
Civilization and its stressed discontents: from
individual stress to cross-national comparisons 189
9 The enigma of hypertension and psychosomatic illness:
lessons for psychoneuroimmunology from beyond the
conscious mind 191
S A M U E L J . M A N N
10 Cultural variations in the placebo effect: ulcers, anxiety,
and blood pressure 206
D A N I E L E . M O E R M A N
11 Corporeal flows: the immune system, global economies of
food, and new implications for health 232
R I C H A R D C O N E A N D E M I L Y M A R T I N
PART IV
Critical retrospectives 267
12 Stressful encounters of an immunological kind: the social
dimensions of psychoneuroimmunology 269
D A V I D N A P I E R
13Reflections on embodiment 282
L A U R E N C E J . K I R M A Y E R
Index 303
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Illustrations
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Figures
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5 3.1 Word use analysis of emotional writing 44
6 6.1 Longitudinal monitoring of cortisol levels as a tool for
7 investigating stress response among children in a
8 Caribbean village 108
9 6.2 Household composition and cortisol 117
20111 6.3 Average (mean) cortisol levels of step and genetic children
1 residing in the same household 118
2 6.4 Morning and afternoon cortisol levels of “Jenny” during
3 summer 1994 119
4 6.5 Marital conflict and cortisol levels in the “Franklin” family 120
5 6.6 Household composition and cortisol during “non-stressful”
6 periods 122
7 6.7 Chronic stress, cortisol levels, and frequency of illness 124
8 6.8 Temporal association between naturally occurring stress
9 events and frequency of illness 125
30111 6.9 Temporal changes in salivary cortisol, neopterin, interleukin-8
1 and s-immunoglobulin A levels of a 12-year-old male over
2 a five-day period 127
3 6.10 Cortisol and s-IgA levels 127
4 6.11 Neopterin and stress 128
5 6.12 Interleukin-8 response to illness and chronic stress 128
6 6.13 Temporal changes in immune measures during illness 129
7 6.14 Temporal changes in immune measures during illness
8 for chronically stressed children 129
9 7.1 Salivary cortisol by time of day 153
40111 7.2 Partial regression residual plot of subjects’ mean cortisol
1 residuals and frequency of distressed mood 155
2 7.3 Partial regression of residual plot of cortisol and mean
3 peer rating 156
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viii Illustrations
7.4 Least squares means and standard errors of subjects’ mean
cortisol residuals 157
7.5 Least squares means and standard errors of subjects’ mean
cortisol residuals 157
8.1 Interaction between life events and socioeconomic status
in predicting EBV antibody level 179
8.2 Interaction between life events and social orientation in
predicting EBV antibody level 180
10.1 Variations in placebo healing rates 214
10.2 Relationship between placebo healing rates and the drug
healing rates in duodenal and gastric ulcer using cimetidine
and ranitidine 215
Plates
4.1 A Bangladeshi girl is protected from the harm of nazar
(the evil eye) by a beauty mark intentionally applied
off-center so as to divert nazar 62
4.2 Maintaining a bright face despite one’s inner state helps
guard against threats such as sorcery in Indonesia 63
6.1 Children from the study village playing in a tree 106
6.2 General oral examination and a check for throat infection
conducted for this study 112
8.1 Drinking kava on the island of Savai’i 172
Tables
6.1 Associations between measures of immune function, stress,
and illness conditions among children in a Caribbean village 126
7.1 Four-item peer-rating of social status scale 152
7.2 Two dichotomous measures of childhood developmental
environment and social role 154
7.3 Final ANOVA table for a backwards stepwise multivariate
linear regression model of mean cortisol with nine
psychosocial variables 155
8.1 Distribution of participants across region, as well as mean
(standard deviation) values of selected variables 177
8.2 Linear model results indicating the effects of life events, SES,
and social orientation on log-transformed EBV antibody levels 180
9.1 Common largely unexplained medical conditions believed
to be at least partly emotion-related 192
9.2 Blood pressure recordings and plasma catecholamine values
during a hypertensive crisis in three patients with paroxysmal
hypertension 196
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Contributors
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13111 James M. Wilce Jr is Associate Professor of Anthropology at Northern
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6 Roger J. Booth is Professor of Molecular Medicine and Pathology at The
7 University of Auckland.
8 Richard Cone is Adjunct Professor of Biology at Johns Hopkins University.
9 Kathryn P. Davison works with Tonic Capital, 594 Broadway, Suite 309,
20111 New York 10012.
1 Seamus A. Decker is Visiting Lecturer in Anthropology at Yale University.
2 Barry G. England is Professor of Pathology, University of Michigan
3 Hospitals, Ann Arbor.
4 Mark V. Flinn is Professor of Anthropology at University of Missouri,
5 Columbia.
6 Laurence J. Kirmayer is Professor and Director of the Division of Social
7 and Transcultural Psychiatry at McGill University.
8 Margot Lyon is Senior Lecturer in Anthropology at The Australian National
9 University.
30111 Samuel J. Mann is Associate Attending Physician and Associate Professor
1 of Clinical Medicine at the Weil Medical College of Cornell University.
2 Emily Martin is Professor of Anthropology at New York University.
3 Thomas W. McDade is Assistant Professor of Anthropology at Northwestern
4 University.
5 Daniel E. Moerman is Professor of Anthropology at the University of
6 Michigan, Dearborn.
7 David Napier is Professor and Dana Faculty Fellow in Anthropology and
8 Art at Middlebury College.
9 James W. Pennebaker is Professor of Psychology, University of Texas,
40111 Austin.
1 Laurie J. Price is Associate Professor and Chair of Anthropology at
2 California State University, Hayward.
3 Carol M. Worthman is Professor and Chair of Anthropology at Emory
44111 University.