Part Two: Approaches to understanding health and illness

Part Two explores the complex journey from the recognition of bodily signs to the nuanced dynamics of interacting with healthcare providers. In this section, we trace the process by which individuals interpret changes in their bodies, communicate these experiences as symptoms, and ultimately engage with healthcare systems through diagnosis and in patient-practitioner relationships.

We take a holistic approach to health, considering both physical and mental health, which are deeply interconnected in people’s lives. This departs from traditional distinctions within health psychology, which historically separated physical and mental health to mark health psychology as distinct from clinical psychology. From a critical perspective, such divisions can obscure the complex ways social, political, and cultural forces shape all aspects of health and illness.

Part Two offers a critical and holistic view of how health and illness are understood, experienced, and managed. Ultimately, it points to the importance of more equitable, culturally responsive, and contextually grounded approaches to care. Questioning the taken-for-granted assumptions of dominant medical paradigms, the chapters in this section explore how these broader forces shape bodily experiences, symptom interpretation, help-seeking, social reception, and the care people receive. Readers will gain insight into how:

• health is constructed across different cultural and historical contexts;
• bodily experiences are interpreted and validated (or not);
• the socio-political nature of diagnosis as a practice;
• diagnostic categories carry both benefits and risks; and
• power is negotiated in healthcare relationships.

We wish to encourage curiosity about how health and illness are understood across cultural contexts. In doing so, we include a range of cultural perspectives on health and wellbeing, drawing on examples from both Aotearoa New Zealand and other parts of the world. Our location in Aotearoa New Zealand shapes the examples and scholarship we draw on, particularly our engagement with Māori models and understandings of health. We use the term Indigenous to refer broadly to the first peoples of any land, and Māori when referring specifically to the Indigenous people of Aotearoa. While Part One focuses more closely on the Aotearoa context—including a dedicated chapter on Māori health (Chapter 1.1)—Part Two aims to complement this with a broader range of cultural and global perspectives.

Some of the concepts explored in this section—like social constructionism, cultural understandings of health, and critiques of the biomedical model—will be familiar from Part One. However, we build on those foundations by looking more closely at how these ideas play out in practice. While Part One focused on introducing key frameworks and perspectives, Part Two applies them to everyday experiences of health and illness: how people make sense of bodily changes, how diagnoses are made, and how care is provided. The aim is to take you deeper into the ideas you have already encountered, showing how they help us critically understand real-world health contexts.

We include Indigenous and non-Western scholarship where possible, and refer to Māori examples where directly relevant, while being mindful not to speak on behalf of Māori scholars or communities. Our aim is to support the decolonisation of psychology by making space for multiple ways of understanding health that are often marginalised in mainstream texts, without collapsing distinct worldviews into a single category.

Chapter 2.1., “Perspectives on health and illness”, encourages readers to think critically about how different societies construct ideas of health and illness, and what that means for both individuals and health systems. It challenges the conventional biomedical model, which treats health as a neutral, objective state, and instead shows how definitions of wellness and sickness are shaped by cultural values, historical contexts, and social norms. By comparing biomedical approaches with alternative frameworks—including Indigenous and community-based models—Tracy Morison and Alexandra Gibson show how dominant definitions of health can marginalise other ways of knowing, and why it matters who gets to define what counts as healthy or ill.

Building on these foundational ideas, Chapter 2.2., “Making sense of bodily experiences”, explores how people make sense of changes in their bodies, showing that bodily sensations are not interpreted in a vacuum but within social and cultural contexts. It highlights that bodily experiences are not just biological signals—they also carry meaning shaped by norms, expectations, and interactions with others. Tracy Morison and Alexandra Gibson examine how individuals decide whether symptoms are serious and whether to seek care, emphasising that symptom interpretation is both a personal and social process. By drawing attention to these dynamics, the chapter reveals how embodiment and culture intersect in shaping health experiences.

Delving deeper into others’ responses to reported symptoms, the next chapter, Chapter 2.3., “Diagnosis as a social and political practice”, considers how symptoms are interpreted in the process of diagnosis. Tracy Morison and Clifford van Ommen invite readers to understand diagnosis not as a neutral act of naming illness, but as a powerful social and political practice. They examine how diagnoses are shaped by values, norms, and institutional power, showing they can open up access to care while also potentially stigmatising or reducing complex experiences to narrow categories. They also explore the implications of diagnostic labels and the role of medicalisation in framing everyday experiences as medical problems. Through this critical lens, the chapter encourages reflection on whose voices are heard, whose bodies are recognised, and whose suffering is legitimised.

Finally, Chapter 2.4., “Healthcare interactions: patient–practitioner relationships“, homes in on the dynamics of care once a diagnosis is made. Alexandra Gibson examines what happens when people seek care and interact with healthcare professionals, highlighting how power, identity, and system-level factors shape these encounters. She traces the shift from traditional, top-down models of care—where patients are passive recipients of treatment—to more collaborative, patient-centred approaches that emphasise shared decision making. She explores the different roles that healthcare professionals play and how these roles can support or constrain patient agency, using case studies to illustrate how clinical interactions are deeply affected by social identities, institutional contexts, and histories of marginalisation.

These chapters invite readers to reconsider established assumptions and to reflect on the social, cultural, and political forces that shape people’s experiences of the body, care, and health systems. The aim is not only to deepen understanding of what it means to be healthy or ill, but also to highlight how practices like symptom interpretation, diagnosis, and healthcare interactions are embedded in broader structures of power and what that means for different people and groups.