Postmodernism

The previous discussion on the meanings and utilisation of modernism has laid the foundations for understanding postmodernism. There have been a multitude of articles and books published on postmodernism since the late 1950s, however it was not until the 1980s that it began to gain significant prominence in philosophical texts (Rolfe, 2000). Postmodernism is a philosophical current critical of the promise of enlightenment inherent in modernist philosophies and their assumptions, as discussed in the previous sections 2.3, 2.3.1 and 2.3.2.

Postmodernism has been described as an exasperating term due to its application to a multitude of phenomena and objects that sit within the realm of reality (Bertens, 1995). It is possible that there are as many constructions of postmodernism as there are postmodernists, if in fact there is such as thing as a postmodernist. However one thing is certain, there is no single unified position related to postmodernism, except that all variants participate in the critique and challenge of foundationalism, the view that science is built on a firm base of observable facts. Rue (1994) agrees and describes postmodernism as the rejection of the dominant foundational programme associated with western tradition when he claims:

There are no absolute truths and no objective values. There may be local truths and values around, but none of them has the endorsement of things as they really are … As for reality itself, it does not speak to us, does not tell us what is true or good or beautiful. The universe is not itself any of these things, it does not interpret. Only we do, variously (p.272-273).

Postmodernism is an intellectual movement that is frequently aligned to architecture, literature and the arts (Burr, 1995). In the literal sense the ‘post’ in postmodernism may be seen by some as meaning coming after the period of modernism. This interpretation is problematic in the sense that it “defines a period in time rather than an intellectual or artistic movement” (Rolfe, 2000, p.29). The era of postmodernism should not be misunderstood as being anti modernist either. The term ‘post’, as in postmodernism, should be taken as signifying continuity as well as critique. Both eras can and do co-exist with

modernism merely being displaced (Lupton, 1998). Several commentators regard modernism as being very much alive and well (Giddens, 1991; Rolfe, 2000). Regardless of the multitude of definitions surrounding postmodernism its major function is to critique the assumptions inherent in the Enlightenment and modernist projects, and challenge the links between science and truth. Lyotard (1992) identifies that the utilisation of postmodernism in this way enables the rewriting of some of the features modernity had tried or pretended to gain, particularly in founding its legitimation upon the purpose of the general emancipation of humankind.

As previously suggested, a key aspect associated with a postmodernist perspective is the rejection of the notion that the world can be understood through explanations provided by grand theories or narratives. Some examples of grand theories are capitalism, existentialism and marxism (Natoli, 1997). Postmodernists instead argue for an emphasis on multiple ways of being and knowing, with a key focus on the favouring of situated accounts. Situated accounts take the form of mini narratives (Rolfe, 2000), multiple perspectives and/or truths that occur on a micro level. Postmodernism has been described as a form of cultural representation that:

… leaves us free to acknowledge an irreducible heterogeneity. The monologue of a totalising theory, is replaced by a continual dialogue across the “hard surfaces” and “local knowledges” of these differences, where analysis does not represent the closure of the truth, but an attempted exchange conducted in good faith and with a certain scepticism towards its own language and position (Chambers, 1990, p.10).

As discussed so far, the grand narratives to which postmodernism reacts are largely representative of scientific knowledge, which postmodernism rejects as the only form of knowledge or truth available on a given subject. Lyotard (1984) identifies the metanarrative of scientific knowledge as being in continual conflict with narrative, or personal knowledge. Jameson (1982) believes narrative, also referred to as story, to be a theoretical category which presents and represents the world. For example, the narrative of medicine applies the rules of science (the maintenance of objectivity and ensuring scientific progress is made) to ensure that only one truth, or knowledge about a certain condition (such as

delirium) can be retained, at the exclusion of all others. While scientific knowledge requires scientific proof regarding its validity, personal narratives do not (Lyotard, 1984). Personal narratives are localised, contextual and imbued with social and historical meaning. It is this conceptual understanding of narrative that underpins the use of the word in this thesis.

When placed in the context of health care, and in particular delirium, postmodern thought challenges the pervasive health sector environment where all health professionals work together to ensure the best health outcome for the older person who is, or has been delirious, as well as their families. Postmodernism critiques the modernist view of scientific progress within the discourse of delirium, and indeed would challenge whether the advances identified in the delirium literature are progressive. By assuming a postmodern position for this research I am not intent on uncovering the truth. If that were the case then doing so “…implies that there is something there waiting to be uncovered. Instead, they would see truth as something that is constructed, and there can be as many constructions of the truth as there are people in the world to construct it” (Rolfe, 2000, p.3).

Davis and Glass (1999) advocate for nursing to embrace postmodernism as a philosophical lens to advance nursing practice to encompass those who are marginalised. This claim is aligned to the key assumptions associated with this research, as outlined in the previous chapter. A postmodern perspective encourages nurses to foster a respect for older people who have been delirious through opposing the search for coherence and the ultimate truth, to the promotion and celebration of difference, partiality and multiplicity of knowledge (Davis & Glass, 1999; Strickland, 1994).

Several authors view the term postmodernism as a theory of society and culture that is often used interchangeably with poststructuralism, a theory of knowledge and language (Cheek, Shoebridge, Willis & Zadoroznyij, 1998; Rafael, 1997). The separation of the two positions is difficult, as culture and language are so intricately linked (Gribich, 1999). Even though the terms used to describe the two positions are referred to interchangeably in the literature, they are not identical concepts. For example Agger (1991) proposes that postmodernism focuses on the broader theorisation about culture, history and society, while

poststructuralism is concerned with theories regarding language and knowledge. Lupton (1998) suggests the difference between postmodernism and postructuralism needs to be highlighted, as people who embrace a poststructuralist theory may not consider themselves to be postmodern and vice versa. The following section of this chapter overviews the central tenets of poststructuralism.