Critical response. Introduction. Martin Lipscomb BSc (Hons) MSc RN

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1 Blackwell Publishing LtdOxford, UKNUPNursing Philosophy Blackwell Publishing Ltd Critical responsestructuration Theory vs. Realist Social TheoryMartin Lipscomb Rebutting the suggestion that Anthony Giddens s Structuration Theory offers a useful framework for sociological nursing research: a critique based upon Margaret Archer s Realist Social Theory Martin Lipscomb BSc (Hons) MSc RN Senior Lecturer, Hartpury Campus, Gloucester Centre, Faculty of Health and Social Care, University of the West of England, Gloucester, UK Critical response Abstract A recent paper in this journal by Hardcastle et al. in 2005 argued that Anthony Giddens s Structuration Theory (ST) might usefully inform sociological nursing research. In response, a critique of ST based upon the Realist Social Theory of Margaret Archer is presented. Archer maintains that ST is fatally flawed and, in consequence, it has little to offer nursing research. Following an analysis of the concepts epiphenomenalism and elisionism, it is suggested that emergentist Realist Social Theory captures or describes a more coherent explanatory vision of social reality than other perspectives and nurse researchers are advised to consider its potential. Keywords: nursing research, ontology, realism, Realist Social Theory, sociology, Structuration Theory. Introduction Hardcastle et al. (2005) propose that Anthony Giddens s Structuration Theory (ST) (1976, 1991) offers a viable solution to an age old and fundamental sociological conundrum; namely, to what extent do Reply to paper by Hardcastle et al. (2005) Nursing Philosophy 6, Correspondence: Martin Lipscomb, Senior Lecturer, University of the West of England, Faculty of Health and Social Care, Gloucester Centre, Hartpury Campus, Gloucester GL19 3BE, UK. Tel.: ; fax: ; martin.lipscomb@uwe.ac.uk Critical response the voluntary actions of people create and shape society and/or to what extent do socially structured constraints and enablements determine or influence the actions of people? This vexing problem is addressed (wittingly or unwittingly) in all forms of social explanation and the manner of its resolution fixes the ontological basis upon which epistemological and methodological questions are decided. Contra Hardcastle et al. (2005), this paper rejects the idea that ST (an elisionary theory) represents an advance upon earlier individualist and structural (epiphenomenal) approaches. An alternative realist (emergentist) form of social theory is outlined which, it is claimed, better describes social reality. Despite 175

2 176 Martin Lipscomb its relatively low profile, social realism offers greater explanatory power than other sociological perspectives and it should therefore underpin sociologically orientated nursing and healthcare research. Epiphenomenalism in social theory To understand why Giddens is mistaken, it is first necessary to describe the sociological perspectives that ST seeks to supersede. Historically, sociologists tended to adopt or ally themselves with one of two opposing perspectives (they were either individualists or structuralists). And these perspectives have generated radically different and often incommensurable forms of social explanation based on opposing bipolar world views regarding the appropriate forms and objects of social investigation. Bernstein (1979, p. 118), with a nod to Wilfred Sellars, described this ideational conflict as the Scientific vs. the Manifest Image of Man and the alleged partial or incomplete nature of each perspective has incurred the charge that individualism and structuralism are epiphenomenal explanations (Archer, 1996, p. xv). In Realist Social Theory: The Morphogenetic Approach (RST), Margaret Archer (1995) attacks what she calls epiphenomenal social theory. She argues that debates within social science about society and the individual, voluntarism vs. determinism, micro macro levels of analysis or structure and agency can all be understood as re-descriptions of an essentially similar problem, viz: The perennial conflict between individualistic and collectivist theories (RST, p. 7). And this leads her to state that: In the heritage of Individualism it was structure which became the inert and dependent element, whilst Collectivism fostered instead the subordination and neglect of agency. (RST, p. 33) Obvious difficulties attend the collapse of different and nuanced social theories into a simple opposition of individualism vs. collectivism and distortion by simplification is an ever present danger in this type of argument. Nevertheless, differentiating between ideational protagonists in this manner enables Archer to claim that it is an uncritical rooting in empiricism (RST, p. 8) which ultimately grounds, by social realist criteria, the historic failure of each epiphenomenal tradition. Archer asserts that, while UK theorists traditionally discussed the problem of structure and agency and North Americans investigated scope or micro macro-sociology, it is empiricism which bedevils both standpoints (RST, p. 28). Accordingly, empiricism or the perceived need to base explanations in observables (behaviour or speech) provided:... individualists with their trump card (for who could doubt the existence of flesh-and-blood people) and the collectivists with their stumbling block (since how could they validate the existence of any property unless they could translate it into a series of observational statements about people). The American debate was even more unabashed in its positivism, since its defining terms, the micro- and the macro- necessarily dealt only with an observable property, that is size. (RST, p. 8 emphasis in original) Archer suggests that this micro macro distinction (and by analogy the agency structure or individualist structure debate) is more usefully conceptualized in terms of relations rather than bulk. She also claims that the significance of the absence of this dynamic within epiphenomenal reasoning of all sorts cannot be underestimated. Individualist epiphenomenalists Archer argues that individualist social methodological theories (e.g. phenomenology or hermeneutics) fail adequately to address (and therefore underestimate) the enabling and constraining relations that exist between people (agents) and society. Thus, despite protestations to the contrary, theorists with an individualist or idealist orientation inevitably minimalize or ignore the significance of exterior structural (social and/or cultural) factors when describing concrete interactions. Downplaying the true impact of structural factors in social explanation allows agency to assume unwarranted freedoms. This occurs, Archer argues, because individualist theories erroneously privilege the demonstrably objective and empirically verifiable reality of face-to-face interaction between small groups of people. And this leads to an overemphasis upon personal (respondent) understandings in

3 Structuration Theory vs. Realist Social Theory 177 explanation. Indeed, as Archer notes in relation to social realism, her own preferred perspective: there is no isolated micro world no lebsenwelt insulated from the socio-cultural system in the sense of being uncontrolled by it, nor a hermetically sealed domain whose dayto-day doings are guaranteed to be of no systemic import. (RST, p. 10 emphasis in original) Structural epiphenomenalists Structuralists (or collectivists) are chided by Archer for failing to draw the correct ontological conclusion which, she claims, their explanatory success would permit, namely, that a causal criterion of existence is acceptable (RST, p. 23). Archer argues that, historically, theorists such as Mandelbaum (1973) and Gellner (1968) recognized links between causation and ontological veracity as well as the role that emergence plays in this process. However, at the time that they wrote the framework of empiricism (RST, p. 50) presented a brick wall (RST, p. 52) insofar as nonobservables (which collectivists identified as influencing social life) could not be pointed to in the sense in which we can point to material or organic objects, or to their qualities or activities (RST, p. 52) and they therefore failed to meet empirical criteria for existence. Archer claims that what had yet to be discerned was that agreeing to play a purely methodological game according to Humean rules... undermines the Collectivist programme (RST, p. 55) as for most of the time, in open social systems, regularities at the level of events are just what emergent features do not generate (RST, p. 54). Emergentism is a key concept in realist theory. For Archer, the concept describes the manner in which structure and agency (the parts and the people) are both emergent strata of social reality (RST, p. 60). More specifically, emergence captures: the way in which particular combinations of things, processes and practices in social life frequently give rise to new emergent properties. The defining characteristic of emergent properties is their irreducibility. They are more than the sum of their constituents, since they are a product of their combination, and as such are able to modify these constituents. (Carter & New, 2004, p. 7) Elisionism and Giddens Conflict between individualist and collectivist perspectives was, however, (then and now) often cloaked and the unsatisfactory (RST, p. 58) nature of social theory often bypassed researchers who continued in: a state of inarticulate unawareness... at one extreme interpretive sociologists undertook small-scale interactional studies and simply placed a big, etc. after them, implying that the compilation of enough sensitive ethnographies would generate an understanding of society by aggregation. At the other, large scale multivariate analysis pressed on towards some predictive goal without reference to the interactional processes generating such variables. (RST, p. 58) Archer does not explain why this state of inarticulate unawareness had to end. However, in outlining the historical development of elisionism, she proposes that idealist (RST, p. 60) neophenomenological and symbolic interactionists were the first to attempt to surmount or evade the limitations associated with traditional individualist and collectivist approaches by merging structure with agency. Thereafter, mutual constitution (RST, p. 60) or elision developed into a distinctive theoretical orientation (RST, p. 60) when Giddens, the apogee of elisionist thinking for Archer, advanced ST. For Archer, ST illegitimately conjoins structure and agency to preclude examination of their interplay, of the effects of one upon the other and of any statement about their relative contribution to stability and change at any given time (RST, p. 14). Structuration Theory, Archer claims, is grounded upon the mistaken idea that language is a valid metaphor for society and she lambastes Giddens for making this unwarranted association. (Baert, 1998, also notes this linkage of ideas in ST.) Thus, having justifiably noted that many elements of syntax are mutually implicative (RST, p. 95), ST erroneously (in Archer s view) employs the linguistic metaphor to assert that within society every aspect of structure is held to be activity dependent in the present tense and equally open to transformation, and... [thus the] causal efficacy of structure is dependent upon its evocation by agency (RST, p. 60). Structuration Theory is thereby equated

4 178 Martin Lipscomb with the phonological revolution (Archer, 1996, p. 43) which denies the possibility of analytic dualism (see below) insofar as it discounts the separability and relative temporal autonomy of structure and agency. Indeed: Because structure is inseparable from agency then, there is no sense in which it can be either emergent or autonomous or pre-existant or causally influential. (RST, p. 97 emphasis in original) Archer argues that elisionist theories such as ST gained in popularity because their adherents (e.g. Hardcastle et al., 2005) believed they thereby circumvented the now passé old debate (RST, p. 61) of individualism vs. collectivism. However, sociologists and those who wish to use social theory are, she claims, still confronted with a choice between two competing world views, because:... Elision (the term used for those grouping themselves around Structuration theory) and Emergence (those exploring the interface between transcendental realism and social theory) are based upon different ontological conceptions, related to disparate methodological injunctions and thus have quite distinct implications for practical social theorizing. (RST, pp ) Realist Social Theory morphogenetic theory Archer s own work is concerned with the nature of causal reasoning in social explanation and it is this which leads her to begin RST by debunking, from a realist standpoint, the direction and implications of causal argument in alternative forms of social theory (i.e. ephiphenomenalism and elisionist reasoning). Thereafter, Archer develops her own model or theory of social interaction. Archer s theory is presented as a complement (RST, p. 167) to social realism. It combines Lockwood s (1964) concept of analytic dualism with critical realist philosophy to produce an account of structural and agential interaction that is termed (somewhat inelegantly) the morphogenetic/morphostatic model (henceforth simply morphogenetic ). For Archer, morphogenetic theory is the practical methodological embodiment of the realist social ontology (RST, p. 16). Analytic dualism forms the basis of the morphogenetic approach (RST, p. 165). It asserts that cultural and social structures are (1) divisible from each other; and (2) distinguishable from agency. Analytic dualism is used by Archer to argue that sociological explanation describes the interplay of emergent entities (structural and/or agential) without privileging their causal significance on a priori grounds. In contrast to epiphenomenal and elisionist theories, analytic dualism exploits the explanatory power (RST, p. 171) that derives from dealing separately with society s features (the parts and the people, RST, p. 65) and it is proposed that ontological substance or reality accompanies this analytic distinctness (RST, p. 171), i.e. the things described posses discrete essences. The centrality of critical realism and analytic dualism in morphogenetic theory is apparent in its two founding principles; first, that structure necessarily predates the action(s) leading to its reproduction or transformation.... [and second] That structural elaboration necessarily postdates the action sequences which give rise to it (RST, p. 15). It might, at this point, be suggested that recognizing the historical pre-existence of structure inadvertently undercuts the volitional capacity of agency. However, the powers inherent in agential emergence preclude determinism and Archer would not therefore countenance this criticism. In their developed form, these two principles underpin a three-part explanatory cycle i.e. structural conditioning social interaction structural elaboration (RST, p. 16). (Analogues exist for social and cultural structures, as well as primary and corporate forms of agency.) and this cycle generates as its final product, a narrative or analytical history of emergence (RST, p. 91 emphasis in original). Several critical realist and analytic dualist themes are hereby introduced or suggested which enable morphogenetic theory to avoid explanatory conflation while recognizing the stratified, open, and nomic (undetermined) nature of causation in social reality. For example, temporality, which is intrinsic to critical realist philosophy, is incorporated as

5 Structuration Theory vs. Realist Social Theory 179 sequential tracts and phases rather than simply as a medium through which events take place (RST, p. 89). And it is in or through this medium that distinct processes of generative activity and their elaborative emergent consequences (RST, p. 62) occur or function. Similarly, analytic dualism underpins the idea that analytic histories (social, cultural or agential) can be told apart from the entities (social, cultural or agential) with which they interact and overlap. And, in consequence, it is, according to morphogenetic theory, possible to theorize about the differential morphogenesis (change) or morphostasis (non-change) occurring between entities overtime. Another way of putting this is that agential and/or cultural- and/or socio-structural developments need not take place synchronously (i.e. cultural and/or social structural change might precede or lag behind agential change). Emergentist theory This form of causal reasoning can only be accommodated by emergentist theory (it is denied to epiphenomenalists and elisionists). Thus, using Archer s epiphenomenalist nomenclature (1) upward conflationists (those who privilege volitional agency) rebut the suggestion that structure may in some instances be unaffected by, or precede, agential change as structure is, for them, simply an epiphenomenon or reflection of agential activity (structure cannot be granted sui generis status). Alternatively, (2) downward conflationists (those who privilege the enabling and constraining power of social structures over agents) prohibit the idea that agents may be relatively unaffected by structural developments (because agents, as anonymous trager, instantiate and objectify structure). And (3) elisionists (such as Giddens) by definition conjoin structure with agency to deny the possibility that their interplay can be separately investigated or differentially described. Thus, ST prevents investigators from asking of any particular situation: in what ways did structure (social or cultural) influence people and how did the actions of people maintain or change the structure(s) they initially confronted? Social realist theory a promissory note Although social realist theory is becoming increasingly recognized in nursing or health and social care research, it has, in comparison with other theoretical perspectives, yet to achieve widespread recognition. Within the nursing literature, Wainwright (1997, p. 1262) endorses realism as a radically new paradigm for a unified biopsychosocial nursing and somewhat acerbically notes that: Unfortunately, these powerful intellectual currents have not reached the shores of nursing which appears trapped in a timewarped debate about qualitative (constructionist) and quantitative (positivist) approaches. Alternatively, McEvoy & Richards (2003) develop, within a nursing framework, the realist evaluative process originally outlined by Pawson & Tilley (1997). They advance upon simple exhortation by suggesting that realistic evaluation might contribute towards or develop health-associated concepts such as gender, disability, and inequality issues. However, like Pawson & Tilley (1997), who describe an intervention to reduce smoking, McEvoy & Richards (2003) utilize purely hypothetical examples. More ambitiously, Porter (2001, p. 23) has claimed that realism shares similarities with Florence Nightingale s linkage of the knowledge of laws, caring, and the route to social progress. And Porter (2001) further argues that Nightingale s environmentally informed realism trounces positivist excess while embracing (as does realism) fact value interdependence so that: a realist nursing position would reject the model of nursing that regarded nursing action as the disinterested operationalization of scientific insights in order to attain specific goals, favouring instead the adaptation of certain values, such as the emancipatory impulse, through which to filter the facts pertaining to health and illness. (Porter, 2001, p. 22) Less prosaically, Porter & Ryan (1996) suggest that a hiatus exists between sociology s structure agent, micro macro focus and nursing s individualist orientation. To bridge this gap, realism was co-joined with ethnography (mainly through a consideration of health care s economic infrastructure) and this link

6 180 Martin Lipscomb with ethnography is developed by Porter (1998) in one of the few realist inspired health-related research studies. This work introduced open system indeterminacy to explain apparent inconsistencies in racist white nurse attitudes/behaviours to Asian doctors and, to quote from Houston s (2001, p. 852) commentary on this study: By adopting a critical realist perspective Porter was able to show the nuanced, complex nature of racism and how there were other mechanisms curtailing its expression. More recently, Bryne (2004) has investigated the relationship between poor housing and ill-health from a social realist perspective. And Hart et al. (2004) have suggested that power relations between professional health visitors and their clients/patients might best be explored through a realist lens. Conclusion Nurse researchers must interest themselves in theoretical debates, concerning the nature of social reality when they undertake or involve themselves in sociologically orientated research as failure to take theory seriously can lead to the production of conceptually misguided research that has little practical value. Hardcastle et al. (2005) advance a flawed elisionary theory of social explanation and nurses who use this theory are thereby misdirected. Alternatively, Realist Social Theory, though less well-known than ST, offers a more satisfying and nuanced approach to understanding social reality. It is suggested that nursing research should adopt a realist perspective. References Archer M.S. (1995) Realist Social Theory: The Morphogenetic Approach. Cambridge University Press, Cambridge. Archer M.S. (1996) Culture and Agency: The Place of Culture in Social Theory. Revised edition. Cambridge University Press, Cambridge. Baert P. (1998) Social Theory in the Twentieth Century. Policy Press, Cambridge. Bernstein R.J. (1979) The Restructuring of Social and Political Theory. Methuen & Co Ltd, Bryne D. (2004) Complex and contingent causation the implications of complex realism for quantitative modelling: the case of housing and health. In: Making Realism Work: Realist Social Theory and Empirical Research (eds B. Carter & C. New), Critical Realism: Interventions Series, pp Routledge, Carter B. & New C. (eds) (2004) Making Realism Work: Realist Social Theory and Empirical Research. Critical Realism: Interventions Series. Routledge, Gellner E. (1968) Holism versus individualism. In: Readings in the Philosophy of the Social Sciences (ed. M. Brodbeck), pp Macmillan, New York. Giddens A. (1976) New Rules of Sociological Method: A Positive Critique of Interpretive Sociologies. Hutchinson, Giddens A. (1991) Structuration theory: past, present and future. In: Giddens Theory of Structuration: A Critical Appreciation. (eds C. Bryant & D. Jary), pp Routledge, Hardcastle M.A., Usher K.J. & Holmes C.A. (2005) An overview of structuration theory and its usefulness for nursing research. Nursing Philosophy, 6, Hart A., New C. & Freeman M. (2004) Health visitor s and disadvantaged parent-clients: designing realist research. In: Making Realism Work: Realist Social Theory and Empirical Research. (eds B. Carter & C. New), Critical Realism: Interventions Series, pp Routledge, Houston S. (2001) Beyond social constructionism: critical realism and social work. British Journal of Social Work, 31, Lockwood D. (1964) Social integration and system integration. In: Explorations in Social Change (eds G.K. Zollschan & W. Hirsch), pp Routledge and Kegan Paul, McEvoy P. & Richards D. (2003) Critical realism: a way forward for evaluation in nursing? Methodological Issues in Nursing Research. Journal of Advanced Nursing, 43(4), Mandelbaum M. (1973) Societal facts. In: Modes of Individualism and Collectivism (ed. J. O Neill), pp Heinemann, Pawson R. & Tilley N. (1997) Realistic Evaluation. Sage, Porter S. (1998) Social Theory and Nursing Practice, Sociology and Nursing Practice Series. Palgrave, Hampshire. Porter S. (2001) Nightingale s realist philosophy of science. Nursing Philosophy, 2, Porter S. & Ryan S. (1996) Breaking the boundaries between nursing and sociology: a critical realist ethnography of the theory-practice gap. Journal of Advanced Nursing, 24(2), Wainwright S.P. (1997) A new paradigm for nursing: the potential of realism. Journal of Advanced Nursing, 26,