In a new article, Svetlana Sholokhova explores the tradition of “objectivity” in the training of mental health clinicians. She suggests that incorporating the lived, embodied experience of both clinician and client (“phenomenology”) could lead away from objectifying clients as a set of disorders to be treated, and toward experiencing them as human beings.
“In order to dismantle the view of the patient as the object of examination and treatment, and to see her as a subject, it is necessary to deny the psychiatrist (the subject of study) the position of the invisible and omnipotent eye. Phenomenology offers psychiatrists the tools to reach this awareness and actively engage in the transformation of the psychiatric theory and practice,” writes Sholokhova.
Sholokhova is a teaching associate in the department of Psychology and Educational Sciences at the Catholic University of Louvain in Belgium. The article was published in the journal Philosophy, Psychiatry & Psychology.
Throughout the years, advocates have worked toward person-centered approaches in psychiatry (in which the client is considered the expert of their own experiences). However, the status quo in mainstream psychiatry still regards the psychiatrist as an expert who dictates the care of the client. Even within a person-centered perspective, the subjectivity of the medical professional is mistrusted out of fear of malpractice or undue influence. Although such concerns may be valid in some circumstances, ignorance of clinician subjectivity is problematic as it continues to maintain the idea that knowledge can only be gained through a subject-less, detached observer.
From the perspective of phenomenological psychology, the therapist is not a detached expert, but rather an active participant in the therapeutic process. From this perspective, attending to the therapist’s emotional experiences is also an essential part of therapy.
Key to phenomenological practice is a task called “performing the epoché.” To do this, the therapist must attempt to suspend prior assumptions, beliefs, and prejudices about themselves, others, and the world, in the service of more completely understanding the experience of the client. This task is a dynamic, aspirational process that is never fully completed. This continuous process allows for the therapist to keep learning more about themselves, others, and the world, which is crucial to the process of psychotherapy. When applied to the clinical encounter, such a stance is theorized to enable the clinician to suspend their prior beliefs and allow them to pay more attention to the lived experience of the client.
Sholokhova argues that coupling phenomenology with psychiatry could allow for a more comprehensive understanding of mental illness. The phenomenological perspective could serve as a critical lens, both challenging and helping to balance the objectifying view of psychiatry. She suggests that phenomenology could allow for a more relational experience of the therapeutic encounter, rather than one that is grounded in seeing client as object. According to Sholokhova, this could open up possibilities for profound transformation in the field of psychiatry.
Sholokhova, S. (2019). Benefits and challenges of the phenomenological approach to the psychiatrist’s subjective experience: Impassivity, neutrality, and embodied awareness in the clinical encounter. Philosophy, Psychiatry & Psychology, 26(4), p. E-83-E-96. (Abstract)