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Mad science: discourses of 'schizophrenia'and 'therapy' for hearing voices

Wise, Michael (2004) Mad science: discourses of 'schizophrenia'and 'therapy' for hearing voices. PhD thesis, Murdoch University.

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      Abstract

      People who are diagnosed with 'severe mental illness' experience some of the most extreme and pervasive prejudice of all groups in Western society. How can this still be so? Although the term 'mental illness' is typically reserved for the most 'serious' of 'cases', psychiatry's medical model is expanding into increasingly everyday realms. Thus, in concert with efforts to reduce social stigma, 'mental illness' is becoming 'normal'. Nevertheless, 'abnormality' is a requirement of biopsychiatry and its offshoots; professionals require some 'thing' to remedy. How do 'clinical' professionals manage these tensions? And what alternatives are there to the pathologizing of such phenomena?

      Such concerns are considered in relation to my main thesis question: How do professionals represent 'schizophrenia' and hearing voices in theoretical texts, and how is that played out in the minutiae of therapy practices? Drawing on discourse analysis and conversation analysis, I critique professional categorizations of what are typically known as 'schizophrenia', 'mental illness', 'patients', 'clients', and 'therapists'. My case in point is the experience of hearing voices - pathologically known as 'auditory hallucinations'. 'Delusional' beliefs are also considered.

      In Part 1, accounts of voices as supernatural or ordinary phenomena, or as a 'symptom' of 'severe mental illness', are considered. Mainstream psychiatric and psychological texts are analyzed and critical alternatives are summarized.

      In Part 2, a selection of studies of interactions involving 'severe mental illness' are reviewed and ongoing analytic/methodological debates are discussed. A cognitivebehavioural therapy group for hearing distressing voices then provides data from 'clinical' talk-in-interaction for analysis. I focus on negotiations of 'reality' (the ordinary versus the psychiatric) and on what I take to be sanist prejudice-in-action.

      Part 3 relates findings from Part 2 to the context and findings of Part 1. There is also discussion of the positive implications of a more social and dialogical approach to understanding and otherwise dealing with the phenomena in question; for voice hearers, 'schizophrenics', and society at large.

      Publication Type: Thesis (PhD)
      Murdoch Affiliation: School of Psychology
      Supervisor: Rapley, Mark
      URI: http://researchrepository.murdoch.edu.au/id/eprint/411
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