Women and violence : exploring its construction as a health care issue

• Main Author: Lavis, Victoria
• Published: University of Huddersfield 2004
• Subjects: 362.8292019
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.405182

Adopting a case study approach (Reinharz, 1992; Stake, 1998) this study which was undertaken in collaboration with two Primary Care Trusts (PCTs) explores the health service response to domestic violence. Developed is a feminist Foucauldian discursive approach, enabling an exploration of the impact of the relationship between power, knowledge and language on the provision of services. This approach combines three stands of theory; feminist theory (Flax, 2000; Willot, 1998; Gavey, 1989, 2002; Weedon, 1987), Foucauldian discourse analysis (Willig, 1999; 2001; Parker, 1992) and positioning theory (Davies and Harre, 1990, 2001; Willig, 2000). The study offers a critical consideration of the impact of the discourses through which domestic violence and health are constructed within the health care arena, at a dominant and subjugated level. Considered is the negotiation of these discourses and the practices and subject positions they make available. Thus the approach taken enables a theoretically grounded understanding of the interplay between the experiences of different actors in the health and domestic violence arena. Drawing on feminist research principles the research encompassed two phases of exploration and data collection employing semi-structured (Smith, 1995) and generative 'depth' interviews (Flick, 1998; Wengraf, 20001). The first phase explored the ways in which domestic violence was constructed by policy makers, implementers, advocates and health professionals within the health arena and the implications arising from these constructions.- The second phase aimed to explore further this discursive landscape considering the ways in which women who access services, in relation to their experience of domestic violence, constructed and experienced such responses. A 'unified' approach to analysing discourse (Wetherell, 1998), drawing upon the guidelines developed by Willig (1999), was employed. This approach draws on aspects of both discursive psychology and Foucauldian discourse analysis, which Wetherell, suggests provides 'the most productive basis for discourse work in social psychology (Wetherell, 1998:389). Unlike previous research which has explored domestic violence from what might be termed a 'realist' framework, this research draws upon social constructionist and postmodern thinking. This approach has made possible an alternate way of considering domestic violence. Drawing upon the metaphor of Pandora's Box the research illustrates the impact of the medical discourse upon the District's services, those who respond and women who access services. Brought to the surface are some of the subjugated knowledges of women and health professionals, argued to be constrained by this discourse. These draw attention to the limitations of current discursive practices and make visible possibilities for desirable alternatives (Willig, 1999). A number of key issues arise from the research. Highlighted through the subjugated knowledge of health professionals is their vulnerability and isolation when responding to domestic violence in ways which appear to meet the needs of women service users. Such responding it is suggested requires relational change (Finch and Mason, 2000) and thus positions health professionals outside of the protective mechanisms associated with the medical discourse (Keller, 1985). Highlighted through women's subjugated knowledges is the impact of being able to construct and experience a stronger subjectivity. Such subjectivity is framed by women as crucial in resisting and overcoming domestic violence. A key component of this constructive process appears to be the discursive resources and practices made available to women through the Intercept domestic violence project.