Evans Alicia M
Int J Ment Health Nurs. 2005 Dec;14(4):285-9. doi: 10.1111/j.1440-0979.2005.00395.x.
Information is given a privileged place in the psychiatric clinic, as illustrated by the prevalence and volume of data to be collected and forms to be completed by psychiatric nurses. Information though is different to knowledge. The present paper argues that information is part of a managerial discourse that implies commodification whereas knowledge is part of a clinical discourse that allows room for the suffering of the patient. Information belongs to the discourse of managerialism, one that positions the patient as customer/consumer and in doing so renders them unsuffering. The patient's suffering is silenced by their construction as a consumer. The discourse of managerialism seeks a complete data set of information. By way of contrast, another discourse, that of psychoanalysis offers the institution the idea that there are always holes, gaps, and uncertainty. The idea of uncertainty, gaps, things remaining unknown and a limit sits uncomfortably with the dominant discourse of managerialism; one that demands no limits, complete data sets, and many satisfied customers. This market model of managerialism denies the potential of the therapeutic relationship; that something curative might be produced via the transference. In addition, the managerialist discourse potentially positions the patient as both illegitimate and unsuffering.
在精神科诊所中，信息占据着特殊地位，这体现在精神科护士要收集的数据之多、要填写的表格之繁杂。然而，信息与知识不同。本文认为，信息是管理性话语的一部分，这意味着商品化，而知识是临床话语的一部分，它为患者的痛苦留出了空间。信息属于管理主义话语，这种话语将患者定位为客户/消费者，从而使他们显得没有痛苦。患者的痛苦因被建构为消费者而被压制。管理主义话语追求完整的信息数据集。相比之下，另一种话语，即精神分析话语，给该机构带来了这样一种观念，即总是存在漏洞、缺口和不确定性。不确定性、缺口、未知事物和极限的观念与管理主义的主导话语格格不入；后者要求没有极限、完整的数据集和众多满意的客户。这种管理主义的市场模式否认了治疗关系的潜力；即通过移情可能产生某种治愈效果。此外，管理主义话语可能将患者定位为既不合法又没有痛苦的人。
