Paradigms underlying the study of nerves as a popular illness term in eastern Kentucky

Theoretical paradigms underlying the study of nerves as a popular illness term in eastern Kentucky are examined in light of the three knowledge-constitutive interests identified by Habermas (1965). A positivist biomedical approach to popular illness categories that focuses on the nosological features of the term fails to recognize the social relations communicated by the complaint. A hermeneutic approach to illness terms that focuses on the individual communication of distress may also conceal the social relations that shape the health of those who express their distress in popular illness terms. A study of nerves in eastern Kentucky, informed by a critical perspective, suggests that a broad range of general symptoms is linked to social relations through the popular illness category of nerves. The daily lives of individuals who complain of nerves are characterized by continuous struggles to cope with the responsibilities of family life in an Appalachian context of poverty, restricted opportunities for employment, and limited sources of emotional and social support. Experiences of distress that result from this struggle are interpreted, but the informants, as symptoms of nerves.