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- Ekendahl, Mats, 1971-, et al.
(författare)
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Self‐interpellation in narratives about craving : Multiple and unitary selves
- 2022
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Ingår i: Sociology of Health and Illness. - : Wiley. - 0141-9889 .- 1467-9566. ; 44:9, s. 1391-1407
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Tidskriftsartikel (refereegranskat)abstract
- The concept of addiction seeks to explain why people actcontrary to their own best interest. At the centre stageof addiction discourse is craving, conceptualised as astrong urge to use substances. This article analyses howtalk therapies such as relapse prevention and self-helpgroups shape identity constructions and understandingsof craving among clients. Drawing upon interviewswith individuals who have engaged in talk therapies inSweden, we analyse how craving is made up through‘self-interpellation’, that is, personal narratives aboutpast, present or future thoughts, feelings and actions.The main ‘self-interpellation’ included multiple selves,where craving was elided by the true self and only feltby the inauthentic self. Less dominant were narrativeswhich drew on a unitary self that remained stable overtime and had to fight craving. The notion of multipleselves appeared as a master narrative that the participantswere positioned by in their identity constructions.We conclude that this multiplicity seems ontologicallydemanding for people who try to recover from substanceuse problems. A demystification of craving, in whichneither substance effects nor malfunctioning brains areblamed for seemingly irrational thoughts and actions, may reduce the stigmatisation of those who have developedhabitual substance use.
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| 2. |
- Heimdahl, Karin, 1983-
(författare)
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Barndomsminnen av alkohol och vuxna : Ur skrivaruppropet "Alkoholen i mitt liv" besvarat av personer födda mellan 1926 och 1990
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Studiens syfte var att studera barndomsminnen av alkohol såsom de återberättades i skriftliga självbiografier. Frågeställningarna rörde vilka värderingar kring barndom och alkohol som förmedlades via berättelserna, hur dessa värderingar samspelade med varandra samt hur de kunde förstås genom att relateras till ett bredare historiskt och socialt sammanhang. Materialet bestod av självbiografier som samlats in via det allmänna skrivaruppropet ”Alkoholen i mitt liv” och var skrivna av personer födda mellan 1926 och 1990. Detta material analyserades utifrån en socialkonstruktionistisk syn på berättande med hjälp av Labovs metod för berättelseanalys. Resultaten visade att skribenterna i sitt berättande förhöll sig till föränderliga normer, värderingar och föreställningar kring såväl alkohol som barndom och föräldraskap. I de äldre skribenternas berättelser avspeglades tydligt det nykterhetsideal som präglade den tid då de återberättade erfarenheterna upplevdes, medan yngre skribenters berättande istället förhöll sig till ett måttlighetsideal för alkohol och drickande. Resultaten visade även hur en föränderlig syn på barn och barndom, och därmed även föräldraskap, fick genomslag i skribenternas berättande och samspelade med värderingar kring alkohol. Beroende på ålder relaterade skribenterna i sitt berättande till skiftande ideal kring hur en förälder bör vara och bete sig. Den största skillnaden mellan äldre och yngre skribenters berättande stod här att finna i hur förväntningarna på pappor växlat under 1900-talet. Detta tog sig bland annat uttryck i att äldre skribenter relaterade pappors drickande till praktiska och materiella konsekvenser medan yngre skribenter i högre utsträckning beskrev och värderade den känslomässiga upplevelsen av pappors berusning.
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| 3. |
- Heimdahl, Karin, 1983-, et al.
(författare)
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Psychosocial interventions for substance-abusing parents and their young children : A scoping review
- 2016
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Ingår i: Addiction Research and Theory. - : Informa UK Limited. - 1058-6989 .- 1606-6359 .- 1476-7392. ; 24:3, s. 236-247
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Forskningsöversikt (refereegranskat)abstract
- The aim of this scoping review was to give an overview of efficacy research on psychosocial interventions aimed at substance-abusing parents with children of up to the age of three. Throughout the overview, there was a focus on underlying assumptions and how the problem descriptions motivating the interventions corresponded with the solutions, i.e. the interventions in question. The data consisted of peer reviewed intervention studies (n = 22) identified through literature searches in online databases. Randomised controlled trial studies as well as quasi-experimental and pre-post studies were included. The results showed that all the studies included bar one focused exclusively on women as parents. Moreover, while the problem descriptions in the studies tended to be quite broad, framing parental substance abuse as a problem influenced by social and structural conditions, the solutions presented in the form of interventions generally had a narrower focus, addressing the individual parent from a psychological perspective only. In conclusion, the review points out the need for developing and evaluating interventions aimed at substance-abusing fathers as well as mothers, and also underscores the importance of these interventions being focused on a broader range of factors rather than just addressing deficits at the level of the individual.
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| 5. |
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| 6. |
- Heimdahl, Karin, 1983-, et al.
(författare)
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Riktade psykosociala insatser till gravida och småbarnsföräldrar med psykisk ohälsa : en litteraturstudie
- 2013
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I rapporten beskrivs resultaten från en litteraturstudie om riktade psykosociala insatser till gravida och småbarnsföräldrar (med barn upp till 3 år) som har ett så kallat problematiskt bruk av alkohol och/eller narkotika. Ovanstående grupper är viktiga att uppmärksamma, dels för den inverkan det problematiska bruket kan ha på föräldrarna själva, men framförallt på grund av de negativa effekter detta kan få för föräldra-barnrelationen samt barnets psykiska hälsa och utveckling. Syftet med litteraturstiden har varit att identifiera, sammanfatta och värdera den internationella interventionsforskningen på området. Via sökningar i databaser återfanns 53 relevanta primärstudier. Av dessa undersökte 27 studier interventioner riktade till gravida, 14 studier fokuserade på insatser till småbarnsföräldrar, medan 12 studier beskrev effekter av interventioner som påbörjats under graviditet och avslutats en tid efter barnets födelse. Sammantaget undersökte dessa studier ett flertal olika typer av interventioner. Till de interventioner som studerades mest frekvent hörde bland annat hembesök, behandlingsinsatser samordnade med mödravård samt insatser fokuserade på föräldraträning/föräldraförmågor. De aktuella studiernas sammanvägda resultat pekar dock mot att det råder stor osäkerhet kring de olika insatstypernas effekter. Avsaknaden av enhetligt vetenskapligt stöd innebär dock inte att stöd saknas helt; snarare drar de olika studierna skilda slutsatser kring respektive insats. Därtill är många av studierna alltför metodologiskt svaga för att det ska vara möjligt att uttala sig om effekter, samt i vilken utsträckning dessa eventuellt kan vara bestående. En slutsats som kan dras är därmed att det behövs fler experimentella studier med längre uppföljningstider på området. Ur ett svenskt perspektiv är det även angeläget med studier genomförda i en svensk/nordisk kontext, då skillnaderna mellan länderna avseende tillgång till mödra- och barnhälsovård begränsar möjligheterna att överföra resultat från exempelvis amerikanska studier till svenska förhållanden.
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| 8. |
- Heimdahl Vepsä, Karin, 1983-
(författare)
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Is it FASD? And does it matter? Swedish perspectives on diagnosing Fetal Alcohol Spectrum Disorders
- 2021
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Ingår i: Drugs. - : Informa UK Limited. - 0968-7637 .- 1465-3370. ; 28:6, s. 547-557
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Tidskriftsartikel (refereegranskat)abstract
- Fetal alcohol spectrum disorders (FASD) is an umbrella term covering a range of conditions related to prenatal alcohol exposure. In Sweden, only the most severe of these conditions, Fetal alcohol syndrome (FAS), is used as a medical diagnosis. The aim of this study was to analyze the Swedish discussion on whether or not FASD conditions (other than FAS) should be actively diagnosed/identified. The data consisted of a webpage material from a FASD interest organization and a report from a Swedish authority. The analysis was informed by Fairclough’s critical discourse analysis and strived to pay attention to which discourses that were drawn upon, and how these discourses related to each other, and to a broader social context. The discussions on whether or not FASD should be actively diagnosed/identified were structured by three main discourses. These were: a scientific discourse, a pragmatic discourse, and an ethical discourse, with the scientific discourse taking a special position, often being present also when other discourses were drawn upon. Taken together, there is not yet any consensus around what the status of the FASD conditions should be in Sweden, neither regarding the usefulness of diagnosing/identifying, nor regarding the causality between prenatal alcohol exposure and FASD.
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| 9. |
- Heimdahl Vepsä, Karin, 1983-, et al.
(författare)
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Polyphonic narratives : The mixing of Alcoholics Anonymous and relapse prevention in stories about recovery and relapse
- 2024
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Ingår i: Nordic Studies on Alcohol and Drugs. - 1455-0725 .- 1458-6126.
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This exploratory study analyses the interplay between the treatment philosophies of Alcoholics Anonymous (AA) and Relapse Prevention (RP) in personal stories of addiction. While the basic ideas of AA and RP are compatible in many ways, they also carry some fundamental differences.Methods: The data consisted of interviews with 12 individuals recovering from substance use problems, who had experience of both AA and RP. The analysis drew on a dialogical narrative perspective, and the concept polyphony was used to shed light on the interplay between different treatment philosophies in personal stories of relapse.Findings: Although sometimes resulting in incoherence, the treatment philosophies were combined idiosyncratically, in ways that appeared productive for the participants’ self-images and recovery journeys.Conclusion: The combination of AA and RP philosophies in narratives of relapse and recovery may reflect a new treatment discourse where individualisation and responsibilisation stand in a complicated relationship with collectivism and surrendering to so-called addicting processes.
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| 10. |
- Heimdahl Vepsä, Karin, 1983-
(författare)
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Substance use, pregnancy, and parenthood : A study on problematizations and solutions
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- With the starting point in the view that how we interpret a problem is decisive for how we think this problem should be dealt with, the overall aim of this dissertation is to explore problematizations of substance use in relation to pregnancy and parenthood within different settings. The dissertation consists of four studies, based on different empirical materials, that analyze problematizations of substance use, pregnancy, and parenthood from different perspectives. Elucidating how these constructions are made in social work related settings can in the long run contribute to improve the ways that pregnant women and parents with substance use problems are approached.Study I analyzes the Swedish discussion on the diagnosing of Fetal alcohol spectrum disorders (FASD). The data consists of a report from a Swedish authority and webpage material from an FASD interest organization. The results show that the interest organization and the authority have different views on whether FASD diagnoses should be used. The analysis suggests that the discussion on FASD is structured by three main discourses; a scientific discourse, a pragmatic discourse, and an ethical discourse.Study II analyzes professional accounts of substance-using pregnant women’s transitions into parenthood. Professionals within maternity care were interviewed in focus groups. The results show that the professionals related to two, sometimes contradictory, ideals of, on the one hand, “believing in the patient” and on the other hand “being realistic” when reflecting on the patients’ prospects to function well as parents.Study III is carried out as a scoping review aimed to give an overview of research on psychosocial interventions targeting parents with substance use problems. It has a focus on underlying assumptions motivating these interventions. The results show that all studies but one focused on women as parents. Most of the interventions were primarily concerned with the psychological deficits of these mothers, while only seldom addressing broader social and structural factors.Study IV aims to explore how parents with previous substance use problems narrated their experiences of becoming and being parents. The study participants were all active in the 12-step movement. The results show that the way they narrated their experiences of substance use problems, recovery, and parenthood was structured by a classic 12-step storyline. The participants described how their recovery processes had made them more emotionally present and skilled in handling their own feelings – competences they described as important resources for them as parents. The four studies, taken together, show some patterns in how substance use, pregnancy, and parenthood were problematized in relation to each other. The problematizations tended to portray parents, and especially mothers, with substance use problems as posing risks towards their children’s psychological and physical wellbeing. Furthermore, there was a tendency to define these parents solely based on their substance use problems, without acknowledging potential individual variation in parenting capacity. Finally, the solutions presented had a clear individualistic focus, emphasizing, for example, the importance of individual motivation and the willingness to comply with treatment, but only occasionally taking contextual and structural factors into account.
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