A recent study in Philosophical Psychology examined the dynamics between psychiatrists and their patients in closed psychiatric units. Led by Bram Salman from UMC Utrecht, researchers observed clinical interactions and documents to uncover how narratives about patientsā conditions are formed and negotiated between psychiatrists and patients.
The researchers explored how psychiatrists and patients negotiate narratives during psychiatric assessments and treatments. By describing how psychiatric discourse typically plays out in clinical encounters, these findings can help mental health professionals identify and understand these patterns and learn more effective approaches to epistemic negotiations with service users. As the researchers explained:
āThe patientās condition may be interpreted differently by both patients and psychiatrists. Especially on a closed psychiatric ward, these differences may involve tension and conflict. In his book A Philosophy of Madness, philosopher and expert by experience Wouter Kusters arguesā¦his psychotic experiences were seen by his psychiatrists as meaningless symptoms of an underlying disease, whilst he himself interpreted them as experiences of āecstasyā and ārevelationā. In cases like this, where different interpretations appear to be irreconcilable, this may result in the patientās interpretation to be neglected or overruled. It is a complaint that has been made more often by (ex-)psychiatric patients, namely that their own interpretation is insufficiently done justice to. This tension poses a challenge for contemporary ideals such as shared decision making, patient participation, and power-free communication.ā
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This study had allot of potential in terms of what it investigates – the duality and the conflict between the patient and psychiatrists narratives – but this potential cannot be realized by a socially conditioned, academic approach. It can only be realized in the way all the best philosophy and psychology of enlightenment and post-enlightenment Western thought came about – by investigating the actual terrain afresh as someone like Nietzsche or Hegel or Marx or Jung or Laing or whoever else did. Then they are investigating reality and using words to convey it. Now we just examine reality through socially conditioend, nechanical, ossified conceptual frameworks that merely make out of reality what it put there conceptually in the first place. This is why there will be no true insight in these studies but let the researchers be free and unprejudiced and they will more easily produce a study and that study would be brilliant, inevitably. It’s that simple.
Now you will make me laugh by asking which is the true account – that of the patient or the psychiatrist. The psychiatrist is obviously the more distant, more prejudiced, and more socially conditioned interpretation, so we can leave that aside. But the patient’s interpretation is all too often exactly the same, socially conditioned, and using the concerns only of psychiatry, which is medication and behaviour, not the underlying condition at all. But quite often the patient does observe and understand their condition and produce deep, non-ordinary insight into psychological depths and psychological phenomena that elude the social consciousness of humanity entirely. Very often at best you’ll say they are interesting and weird. Well you’re reality is boring and weird and is made entirely of words. This isn’t reality at all.
And the only true reality is neither the patient’s interpretation or anyone elses. It’s the actual silent perception of the actual phenomena, leading to clarity about the phenomena. This produces what we call understanding rather then knowledge of the phenomena. Understanding means understanding it’s movements and structure and process, understanding the whole thing. Rarely does a patient allow themselves this simple freedom to observe and understand their own psychological phenomena because they are viewing it instead as a problem that needs to be labelled or solved, setting into motion mental processes that destroy this simple capacity to observe the phenomena quietly and if there is any awareness at all to the extent interpretation and machination go on it will pervert, confounds or destroys the understanding of the phenomena. And this is all the plain truth guys. There is a plain truth beyond all thoughts and words. It is only thoughts and words that think this is arrogant because they argue over the truth, proving their utter separateness from the truth. Awareness of what is is the truth until you label it.
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Brilliant comment- thank you- very inspiring-have you written more about this- the term tyranny of conditioned language comes to mind
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“Tyranny of conditioned language” – quite so! You read my mind. I do write about this in comments here but nowhere else really. You catch my drift though! š
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