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What Ideas Do Viewers Have About A Discursive Thematic Analysis of Audience Response Towards the Portrayal of Mental Distress in United Kingdom Soap Operas EDWARD SMITH A thesis submitted in partial fulfillment of the requirements of the University of East London for the doctoral degree in Clinical Psychology July 2012 ABSTRACT The potential for stigmatising public attitudes to have a negative impact on the wellbeing of individuals identified as experiencing mental distress has been widely documented. The contribution of the mass media towards public attitudes surrounding mental distress has attracted particular interest, particularly that of television portrayals. Research into the influence of the media towards public attitudes has focused on a ‘strong media’ model that assumes a direct influence of the content on viewer attitudes. Recent theory has suggested an ‘audience response’ model whereby audience attitudes towards the subject matter, genre and purpose of viewing can influence their understanding of the content; however this approach is under-represented in research. In the United Kingdom the soap opera genre in particular is positioned to have a potential role in influencing public attitudes towards mental distress, frequently depicting mental distress within a realist frame and being presented as having a public service function. This thesis aims to explore the ideas that viewers take from soap opera portrayals of mental distress within an audience response approach. Soap opera viewers were interviewed about the ideas of mental distress they developed from storylines they had watched, and these interviews were analysed using a discursive thematic analysis, taking into account their beliefs about mental distress, the soap opera genre and their viewing purposes. These constructions drew attention to the presentation of mental distress as socially undesirable and incomprehensible, the validation of mental distress storylines as socially responsible by programme makers and viewers, and the purpose of these storylines as cautionary tales against dissent from professional opinion. This research supports calls for greater diversity in television representations of mental distress; in particular a stronger representation of positive or heroic qualities in characters portrayed with mental distress, and a greater role for psycho-social explanations of their distress. This research also questions whether positive representations of mental distress are best served through explicit ‘anti-stigma’ campaigns. i TABLE OF CONTENTS ABSTRACT ....................................................................................................................... i TABLE OF CONTENTS .................................................................................................. ii ACKNOWLEDGEMENTS ............................................................................................. vi INTRODUCTION............................................................................................................. 1 1.1 Preface ............................................................................................................... 1 1.2 The Effects of Stigma on People Experiencing Mental Distress ...................... 2 1.2.1 Public Attitudes towards Mental Health ..................................................... 2 1.2.2 The Effects of Stigmatising Attitudes towards Mental Health Difficulties 3 1.2.2.1 Direct effects ........................................................................................ 4 1.2.2.2 The effects of internalising negative social attitudes ........................... 5 1.2.2.3 The effects of government and institutional policy ............................. 5 1.3 The Role of the Mass Media in Forming Public Attitudes ............................... 6 1.3.1 The portrayal of mental health difficulties in television programming ...... 6 1.3.2 The Direct Effects of Dramatized Television Portrayals of Mental Health Difficulties on Viewer Attitudes ............................................................................... 9 1.3.3 The Relationship between Dramatic Media, the News Medium and Public Attitudes .................................................................................................................. 10 1.3.4 Ideology and Agenda in the Portrayal of Mental Distress in the Media ... 11 1.4 Soap Operas as a Form of Dramatic Media .................................................... 12 1.4.1 Viewing Figures and Demographics ......................................................... 13 1.4.2 Overview of British Soap Operas and Storylines Related To Mental Health Difficulties ................................................................................................... 16 1.4.2.1 Eastenders .......................................................................................... 16 1.4.2.2 Coronation Street ............................................................................... 17 1.4.2.2 Emmerdale ......................................................................................... 18 1.4.2.3 Hollyoaks ........................................................................................... 18 1.5 The Role of the Viewer in Making Meaning from Media .............................. 19 1.5.1 The relationship between the audience and the text.................................. 21 1.5.2 The use of the media by the viewer .......................................................... 23 1.5.3 Markers of ‘reality’ in the media .............................................................. 24 1.5.4 Public attitudes towards the soap opera genre .......................................... 26 1.5.5 Issues in audience activity within realist media ........................................ 27 1.6 Research into Audience Activity with Media Portrayals of Mental Health Difficulties................................................................................................................... 28 ii 1.7 Summary and Development of Research Questions ....................................... 30 1.7.1 Summary ................................................................................................... 30 1.7.2 Relevance to Clinical Psychology ............................................................. 31 1.7.3 Research Questions ................................................................................... 33 METHODOLOGY .......................................................................................................... 34 2.1 Qualitative Design ........................................................................................... 34 2.2 Epistemology................................................................................................... 35 2.3 Discursive Thematic Analysis......................................................................... 37 2.4 Interview Schedule .......................................................................................... 39 2.5 Permission and Ethics ..................................................................................... 40 2.5.1 Informed Consent ...................................................................................... 41 2.5.2 Confidentiality........................................................................................... 42 2.6 Participants ...................................................................................................... 42 2.6.1 Selection Criteria ....................................................................................... 42 2.6.2 Recruitment ............................................................................................... 43 2.6.3 Payment ..................................................................................................... 44 2.6.4 Participant Profile...................................................................................... 44 2.7 Data Collection................................................................................................ 46 2.7.1 Transcription ............................................................................................. 47 2.8 Analysis ........................................................................................................... 47 2.9 Evaluative Criteria .......................................................................................... 48 2.9.1 Reflexivity ................................................................................................. 49 ANALYSIS ..................................................................................................................... 51 3.1 Overview of Characters and Storylines Referred To During the Interviews .. 51 3.1.1 Eastenders: Jean and Stacey Slater ........................................................... 51 3.1.2 Emmerdale: Aaron Livesy ....................................................................... 52 3.1.3 Eastenders: Joe Wicks .............................................................................. 52 3.1.4 Doctors: Ruth Pearce ................................................................................ 52 3.1.5 Coronation Street: John Stape .................................................................. 53 3.1.6 Hollyoaks: Newt ........................................................................................ 53 3.2 Analysis ........................................................................................................... 54 3.2.1 Cues Identifying the Character as Experiencing Mental
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