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为无效知识正名:对第一人称幻听体验报告的话语分析。

Towards validating invalidated knowledge: a discourse analysis of firsthand accounts of hearing voices.

机构信息

Department of Health Promotion and Development, The Faculty of Psychology, University of Bergen, Bergen, Norway.

出版信息

BMC Psychol. 2024 Oct 2;12(1):527. doi: 10.1186/s40359-024-02023-x.

Abstract

BACKGROUND

As Foucault historically traced, dialogs about madness were silenced with the emergence of biomedical psychiatry. The silence entailed the epistemic violence of invalidating persons who hear voices as knowers, arguably leaving them without validating sensemaking languages for firsthand experiences. This article analyzes five Norwegian firsthand accounts of hearing voices, and how they differed from the predominating biomedical psychiatry discourse, in search of validating languages and knowledge that may facilitate making sense of voice-hearing for persons who hear voices.

METHODS

The text material consisted of four sets of blogs authored by four young women and a short interview with a man, all of whom had firsthand experiences of voice-hearing in a Norwegian context. Ian Parker's version of Foucauldian discourse analysis was used to analyze the material.

RESULTS

Six discourses were identified: biomedical psychiatry-discourse, discourse of reason, psychodynamic discourse, discourse of personal characteristics, spiritual discourse and discourse of personal relationships between hearer and voices. Within the discourses of biomedical psychiatry and reason, voice-hearing was rendered as hallucinations, unreason, and as a problem to be solved, preferably by professionals, thus silencing the person who hears voices. In contrast, within the discourses of psychodynamics, personal characteristics, spirituality, and personal relationships between hearer and voices, voice-hearing has diverse meanings, and they grant voice hearers greater freedom concerning voice-hearing. The psychodynamic discourse nonetheless aligns with the discourses of reason and biomedical psychiatry in allowing professionals the prerogative of determining the meaning of voice-hearing. The remaining three discourses appear to facilitate more space for voice-hearers to narrate and engage with their voice-hearing at their discretion, with little to no professional impingement.

CONCLUSIONS

Discursive complexity notwithstanding, I consider that particularly the discourses of personal characteristics, spirituality, and personal relationships facilitate languages that may enable a person to narrate their own experiences and actions at their own discretion, without needing an expert commentator on the side. To have such languages available is argued to entail clear strides towards more empowered positions in one's life.

摘要

背景

正如福柯在历史上所追溯的那样,随着生物医学精神病学的出现,关于疯狂的对话被沉默了。这种沉默带来了无效化那些听到声音的人的知识暴力,可以说,这使得他们失去了可以理解第一手经验的有效意义的语言。本文分析了挪威的五个第一手声音体验,以及它们与占主导地位的生物医学精神病学话语的不同之处,旨在寻找可以帮助那些听到声音的人理解声音体验的有效语言和知识。

方法

文本材料包括四位年轻女性撰写的四组博客和一位男性的简短访谈,他们都在挪威背景下有过声音体验。本文使用了伊恩·帕克(Ian Parker)的福柯话语分析版本来分析材料。

结果

确定了六个话语:生物医学精神病学话语、理性话语、心理动力学话语、个人特征话语、精神话语和听者与声音之间的个人关系话语。在生物医学精神病学和理性话语中,声音体验被描述为幻觉、不合理和需要解决的问题,最好由专业人员来解决,从而使听到声音的人沉默。相比之下,在心理动力学、个人特征、精神和听者与声音之间的个人关系话语中,声音体验具有多种含义,它们给予声音体验者更大的自由来对待声音体验。然而,心理动力学话语与理性和生物医学精神病学话语一致,允许专业人员享有确定声音体验意义的特权。剩下的三个话语似乎为声音体验者提供了更多的空间,让他们自主地叙述和参与自己的声音体验,几乎没有专业人员的干扰。

结论

尽管话语具有复杂性,但我认为个人特征、精神和个人关系话语尤其为个人提供了可以自主叙述自己经验和行动的语言,而不需要专家在旁边评论。拥有这样的语言被认为是朝着更赋权的生活地位迈出了明确的步伐。

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