Moulded of things past
Authors: N. Mays
Journal: BMJ (1990)

MRC and devised in its  sociology unit in the late 1970s. It is concerned with the popular conceptions which elderly Aberdonians use to think about and cope with illness, old age, bereavement, and  and how these practical understandings are bound up with the stock of moral, religiousand economic resources and ideas inherited by Aberdonians both from their own biographical pasts and from the historical past of this city in north east Scotland. A qualitative study of 70 Aberdonians aged 60 and over undertaken in 1978-80 provides the primary source material for the book, but this is supplemented by data drawn from a quantitative random sample survey of 619 Aberdoniails in the same age group. As well as tape recorded interviews, Williams draws on anthropological data froni participant observation of the social Uves of the 70 respondents, half of whom live in a council housing estate and half in the more affluent west end of the city, and who belong to two circles of acquaintances, The first part of the book attempts to enter into the subjective meanings of the 70 Aberdonians and describe their patterns of coping with the range of hazards associated with physical decline and loss. Part two looks at the influences which have shaped these ideas? their assumptions and doctrines about economy, society, and religion (that is, all the ways of making sense of the world open to them)?together with their own personal experiences of illness and the subsequent reactions of their families and friends to their methods of coping. It is not possible in a brief review to do justice to the richness of the material, which Williams handles so skilfully and with such a clear sense of the dynamic nature of his subject matter. His conclusions, however, are worth restating here. Williams concludes that the ways in which contemporary Aberdonians think about medical themes originate not in the  sphere but in their past, especially in their economic history under capitalism and their religious history under Protestantism. This past shapes their present cultural and material resources of coping. It also means that there is no single dominant set of values governing Aberdonian discussions about the universal predicaments of illness, dying, and bereavement. Instead, the process of working out how to cope is marked by contradictions and conflicts both within and between individuals, which reveal the divisions beneath the surface of Aberdonian culture (such as Christianity versus secularism). Thus, for example, Williams uncovers a great variety of ideas about old age. While there seems to be a common view that people should build defences and maintain activity in early old age, optimistic notions of retirement and positive views of old age influenced in part by greater postwar prosperity are found in conflict with older, even preindustrial, schemes of aging which assume a steady process of decline from midlife onwards. Attitudes to dying are similarly diverse. Williams likens them to historical strata laid down by a culture in motion as the dominant pattern of disregarded death contends with newer currents based on older notions of ritual dying.  Although Williams's book is not specifically written to inform  practice, I hope that its complex account of contemporary attitudes to themes intimately bound up with the  task will be quarried successfully by  educators. It is undoubtedly a major addition to knowledge of lay beliefs about health and illness and should undermine any simplistic stereotypes we may have used to explain how ordinary people currently think about these universal human predicaments.