Paper to the workshop in Ethnographies of Knowledge - from Cognition to
Fieldwork
Abstract
Knowledge as cultural practice, as situated and socially distributed is the way
anthropology usually talks about knowledge, but how do we understand the concept
of knowledge and the way of acting upon knowledge, when different kinds of
knowledge seem to be on stage?
In my fieldwork I studied a group of pregnant smoking women and their way
of knowing. Pregnant women are presumed to be highly motivated to stop smoking
and to be prone to behaviour changes. I found, however, that their motivation was
extremely contingent and based on their social situations rather than on knowledge. I
also found that they were overall sceptical towards the ambiguity of the health
promotion messages, they had a feeling on being on their own and, eventually, they
ended up acting and reasoning in a practical way and producing their own style of
knowledge.
In this paper I shall argue that what is usually presented to us as explicit
factual knowledge, e.g. epidemiology and health promotion, is being contested,
negotiated and transformed into other knowledge processes. These processes are
defined as a pragmatic and practical reasoning which is particular, situated,
experience-based and seeking to equilibrate the practices of everyday life.
Mette Bech Risør
M.A., Ph.d.-student
Department of Ethnography and Social Anthropology
Moesgård
8270 Højbjerg
e-mail: etnombr@hum.au.dk
telephone: +45 89 42 46 78
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PAPER
Practical reasoning – knowledge in between health promotion and everyday life
of pregnant women
(not to be quoted)
In this paper I shall talk about the production of knowledge in everyday life and the
relationship between this knowledge and the knowledge tradition found in health
promotion, seen as predominantly being based on epidemiological knowledge. My
focus of analysis was the smoking habits of pregnant women in Arhus county in
Denmark and it is their daily life that gave me empirical data on how to perceive the
knowledge production in everyday practice. Originally I set out trying to understand
the seemingly irrational relationship between pregnant women knowing about the
risks of smoking during pregnancy and not stopping to smoke despite this knowledge
and from there I was led into another universe of knowing and reasoning.
Within the anthropological discussions on fieldwork in general and the relationship
between theory and empirical data, there is an ongoing discussion about how data is
produced in the light of a certain epistemology and theory. I also see another
discussion hidden, on another level perhaps, which is a discussion on the relationship
between knowledge and practice, a discussion which tries to encompass the field and
the concrete actions going on in a much more direct way than just reflecting upon
one’s own scientific tradition and knowledge production. This field, the relationship
between knowledge and practice, is often commented upon by different researchers,
but not so often made the explicit topic of research. However, there are exceptions
and more are coming I think. I see some of these exceptions in analyses of local
knowledge, for example within the context of development aid, where there is a
tendency to analyse conflicts in aid programmes as a conflict of local knowledge
versus expert knowledge, local knowledge being more about how to do things,
practical and differentiated knowledge. I also see this tendency in the health sector
not only in developing countries but also ‘at home’, where the conflict is mainly
formulated as a discussion on the relationship between expert and lay knowledge. In
these discussions anthropology has until recently focused on mainly the local or lay
knowledge, trying to define its content, performance and position. In such efforts
concepts as embodied knowledge, experience-based knowledge, tacit knowledge and
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so on have been introduced and explored and have given much input to the
understanding of certain knowledge traditions. I see this as an extremely important
object for anthropology, but also miss a more thoroughgoing approach to the
definition of knowledge not only seen as a certain tradition, but also as a relationship
between different knowledge systems/traditions and furthermore I miss the position of
practice in this context, because I believe it is a central field in the understanding of
any knowledge production, not only in science but in knowledge in general. Practice
or knowledge is not just lay or local or expert, but is a fluid field connected to and
influenced by different positioned actors and cultural structures.
One of the contributors I find fruitful to further discussions of knowledge and
practice are Holy and Stuchlick in their book Actions, Norms and Representations
from 1984?. The two authors argue that in anthropology and anthropological
fieldwork there is an ongoing problem which consists in the fact that ideas and
concepts are not always being clearly discerned from observed, empirical facts, that is
for example actions. This overlap between ideas and observed facts tend in much
anthropological fieldwork data to make them refer to each other and to let them be
interpreted as two phenomena containing information about the same phenomena and
being a part of the same social reality. That is, what people tell you is interpreted in
the same way as what people do and seen as the same kind of cultural information or
knowledge. Such an overlap is however denied in almost every empirical
investigation simply because there is a difference between what people say and what
they actually do. Hereby we have a difference between verbal data and actions and
seen from another analytical level, between explicit knowledge and ordinary maybe
habitual practice.
However, Holy and Stuchlick further argue that anthropology must try to
combine these two phenomena in any analysis and not only concern itself about one
of the possibilities to obtain data and to start an analysis from. Both should be
intertwined and made explicit in an analysis. Both phenomenae influence each other,
they are not identical, but they are also not strictly different. So it is the relationship
between them which counts.
But what is knowledge and what is practice? How are we to understand
knowledge, especially when you also have to account for practice at the same time?
Some of the attempts in anthropology talk about knowledge in general, also scientific
knowledge, as being understood as a proces, as a culturally defined practice. In this
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process the positioned actor, the individual person, plays a central part as a creative
person, producing meaning in the world and knowledge about the world in a daily
practice, activity and process. In this sense knowledge is not exclusively a
representation or a model of reality but an action which is shaping and
producing/making knowledge in itself. And producing social reality. This concept of
knowledge tries to link the relation between knowledge and practice by turning
knowledge into practice, so to speak, and transcending the traditionally reduced
concept of knowledge: knowledge as a mental concept.
In the same way I also see a relevance of Barth’s contribution to the
redefinition of the culture concept. Culture is in his understanding interaction and
practice and what constitutes and gives shape to this practice becomes in Barth’s
words a knowledge tradition – dependent on use, life and consistency. Using the
concept of knowledge tradition is however more a way of turning practice into
knowledge and there by also redefining knowledge as a tradition based on practice.
This gives us the possibility to think variations, positions, practice, exchange,
reproduction, change and creativity into an analysis of culture, because practice is in
itself fluctuating and process-oriented.
So the concept of knowledge is not left out of discussions as is neither the
concept of practice and actions, but there are different agendas for the discussion and
they bring on different possibilities. An approach I also see as fruitful is the
anthropologist Lucy Suchman and her theory on the relationship between plan and
action in the use of computers. Here she argues that a plan is not a prescription or a
model for action but is just as procedural and situational as action itself. It is only
given the status of a model in certain knowledge traditions. Action is in her approach
a part of practice in general and action is the basis and the source for plans and
knowledge, which makes knowledge ad hoc and situational in the same way as
practice is mainly understood. Suchman finally uses her analysis to emphasize that we
start our analyses in practice and not in abstract or decontextualised fields of
knowledge.
I see the above not as an overlap of what Holy and Stucklick would call verbal
data and action but as an attempt to redefine knowledge and theory into an
understanding which gives us an opportunity 1) to talk about practice and not mainly
only about knowledge and 2) to talk about knowledge as being part and parcel of
practice and viceversa.
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This short presentation of the concepts of knowledge and practice and the
anthropological contributions and problems surrounding are my starting points in my
own analysis of different knowledge traditions and their inherent practice forms.
Furthermore I found inspiration in three philosophical theories which all emphasize
the aspect of daily life, daily practice, ordinary practice, routine practice as a main
object of science. Phenomenology is concerned with our being in the world and the
experiences we create while living the lived life. These experiences are basic to our
understanding and they are all important to the social life world (Schutz) which is a
concept I work with to grasp the aspect of everyday life, the immediate social actions
and the practical activity. American pragmatism is another inspiration, especially as it
is formulated by William James and John Dewey. They take their starting point in
human action and see human beings as socially formed and part of a social reality at
the same time. How do people think, act and obtain knowledge, they seem to ask. And
the answer lies in experiencing the world, acting actively upon the world and
understanding this experience as a process of knowledge production which is having
the same validity as any other knowledge. In ethnomethodology I also find similar
thoughts which see social practical activities as containing itself a methodology and
accountability and which makes it a virtue not to distinguish between lay and
professional knowledge – an approach which questions the hierarchy of knowledge
and which sees social practice as the main object of science.
So where are we with this load of theoretical inspiration? What I am trying to
argue is that the traditional way of seeing the relationship between knowledge and
practice (as two distinct and hierarchical phenomena, a hierarchy telling us that
knowledge leads to and determines practice) should be turned up side down, because
it is empirically invalid and because practice could be seen as a primary and
fundamental element in the understanding of what knowledge is. This also means that
I want to argue that to look at peoples ordinary actions and practice is to account for
the many ways of transforming and reshaping, (experiencing and living creatively),
the knowledge or discourse which is normally accepted as established science.
This perspective was born out of a project concerning pregnant women and
their practice in relation to smoking habits. In Denmark in general health information
or health campaigns have not had substantial prophylactic results when it comes to
smoking during pregnancy. There has been a decrease in the number of pregnant
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smokers but the decrease is mainly due to a decrease in the number of women
smoking before pregnancy and an increase in the number of women stopping before
or in the beginning of pregnancy. However, there is not much knowledge about the
motivations and reasons behind smoking cessation and a large number still continues
to smoke throughout pregnancy. In this I see a problem related to the understanding of
the relationship between knowledge and practice: pregnant women are informed in
one way or another by the health authorities of the risks of smoking and their
behaviour doesn’t seem to change as wished for. To grasp this problem I start with
the argument that we can talk of a distinction between knowledge and practice in the
field of health promotion and in other words (in the light of the above mentioned
theories of knowledge) of a distinction between different kinds of knowledge,
different knowledge traditions. These knowledge traditions or knowledge forms are
more explicitly understood as epidemiology on the one hand and daily practice on the
other.
In my project I set out to examine and analyse the practice and attitudes of the
pregnant women seen in relation to health promotion/epidemiology, exemplified by a
smoking cessation course. It became clear to me, that the pregnant women who
smoke, of whom some try to stop, some don’t, some cut down the number of
cigarettes, have a way of reasoning and acting which is not determined by the explicit
or exact knowledge from epidemiology. (I will just you show a few examples of their
practical reasoning in a minute). For example their motivation to join the cessation
course is highly contingent, they gather information from their own daily world,
personal sources, others’ experiences, being in a way lay epidemiologists, and they
act according to the practical and social situations - actions which can be ad hoc and
unplanned in a very pragmatic way and they tend to weigh arguments and information
comparing them to the every day life frame and their own understanding of health.
Their everyday life is filled up with efforts to cope with economy, daily practical
routines like bringing children to school, cleaning, cooking etc. They rush and run to
make things fit together, to make the family work, and they prioritise smoking
cessation on a much lower level than a few minutes of peace, a break with a few
cigarettes. They hear and learn about health promotion but rely on many years of
experience with health information which makes them sceptical and gives them a
feeling of being left to themselves – what shall they believe in? They have to draw
their own conclusions and they have to make a decision which they can live with. A
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decision which can be seen as very responsible although they continue to smoke,
because smoking is outweighed with other unhealthy life style factors or seen in the
light of a balanced way of thinking – the golden mean is a characteristic of their daily
practice. They draw from their life world, their experiences, their concerns and their
feelings and only partly from the explicit knowledge coming from epidemiology and
health promotion. They transform and convert this knowledge into another context
and another kind of knowledge which resonates with their former experiences and
concerns.
Overheads
Conclusion
These examples of decision-making, of moral judgments, of attitudes and
actions are as I see them examples of practical reasoning and situational knowledge
which is a knowledge form that is based on pragmatics, experiences and social
situations. And it is a knowledge form which has contested, negotiated and
transformed scientific health knowledge into other knowledge processes as illustrated
by the examples. It is perhaps not a distinct knowledge tradition in Barth’s sense of
the word but it represents to me a way of knowing, a way of creating knowledge
useful in a certain context and closely linked to practice – that is based on practice or
even more radically, it shows that practice is knowledge, because action is knowledge
with the words of John Dewey.
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