Cutcliffe John, Happell Brenda
University of Texas (Tyler), Texas, USA.
Int J Ment Health Nurs. 2009 Apr;18(2):116-25. doi: 10.1111/j.1447-0349.2008.00591.x.
Interpersonal relationships, although considered to be the cornerstone of therapeutic engagement, are replete with issues of power; yet, the concept of 'invisible power' within such formal mental health care relationships is seldom explored and/or critiqued in the literature. This paper involves an examination of power in the interpersonal relationship between the mental health nurse and the consumer. Issues of power are emphasized by drawing on examples from clinical experiences, each of which is then deconstructed as an analytical means to uncover the different layers of power. This examination highlights the existence of both obscure and seldomly acknowledged invisible manifestations of power that are inherent in psychiatry and interpersonal mental health nursing. It also identifies that there is an orthodoxy of formal mental health care that perhaps is best described as 'biopsychiatry' (or 'traditional psychiatry'). Within this are numerous serious speech acts and these provide the power for mental health practitioners to act in particular ways, to exercise control. The authors challenge this convention as the only viable discourse: a potentially viable alternative to the current of formal mental health care does exist and, most importantly, this alternative is less tied to the use of invisible power.
人际关系虽被视为治疗性互动的基石,却充斥着权力问题;然而,在这类正式心理健康护理关系中,“无形权力”的概念在文献中很少被探讨和/或批判。本文探讨了心理健康护士与服务对象人际关系中的权力问题。通过引用临床经验中的例子来强调权力问题,然后对每个例子进行解构,作为揭示权力不同层面的分析手段。这种探讨突出了精神病学和人际心理健康护理中存在的既模糊又很少被承认的无形权力表现形式。它还指出,正式心理健康护理存在一种正统观念,或许最好将其描述为“生物精神病学”(或“传统精神病学”)。其中有许多严重的言语行为,这些为心理健康从业者以特定方式行事、实施控制提供了权力。作者质疑这种作为唯一可行话语的传统观念:一种可能替代当前正式心理健康护理潮流的可行选择确实存在,而且最重要的是,这种替代选择与无形权力的使用联系较少。