Epistemic Injustice and Self-Injury: A Concept with Clinical Implications

Sullivan, Patrick

doi:10.1353/ppp.2019.0049

Cited by 11 publications

(11 citation statements)

References 59 publications

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“…Not just seeing it as a huge failure that they're self-harming. (Inckle, 2011, p. 375) This preliminary acceptability literature provides a compelling case for the clinical and empirical study of HR as a treatment option for NSSI (Sullivan, 2019). In recognition of the need for empirical, quantitative HR research, Hosie and Dickens (2018) developed the first empirical measure to explicitly include HR techniques in assessing practitioner and patient feelings about different approaches to NSSI (Attitudes to Self-Cutting Management Scale [Asc-Me]).…”

Section: Hr As An Nssi Treatmentmentioning

confidence: 99%

“…Many ethical considerations revolve around liability and risk management and the concern of increasing suicidality. Liability and legal concerns lead many clinicians to err more on the side of caution, particularly given the ambiguity of HR interventions (Sullivan, 2019). However, as has been consistently demonstrated in the NSSI-treatment literature, current treatments are often ineffective for people engaged in self-injury, and many people engaged in self-injury express preference and desire for HR interventions; thus, empirical research studies that document the benefits and/or risks of HR strategies are urgently needed to allay or inform clinical risk and liability practices (Sullivan, 2017).…”

Section: Ethical Considerationsmentioning

confidence: 99%

See 1 more Smart Citation

Straight to the Source: e-Communities for Nonsuicidal Self-Injury and the Emerging Case for Harm Reduction in the Treatment of Nonsuicidal Self-Injury

Preston

West

2021

Clinical Psychological Science

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Nonsuicidal self-injury (NSSI) is a prevalent phenomenon, yet no sufficiently effective treatment approach exists, leading researchers to consider how a reconceptualization of NSSI phenomenology may be necessary to optimize treatment. Multiple novel reconceptualizations seem to converge on the idea that NSSI provides certain benefits (e.g., affect regulation) that lead to nonlinear recovery processes in which cessation is not always possible. NSSI e-communities have also become increasingly studied given their popularity among those who self-injure, and they often contain harm-reduction content (e.g., wound care, safe cutting practices). The United Kingdom has approved harm reduction for NSSI treatment; however, its implementation remains uncommon. The current article integrates these novel and growing lines of research and theory and presents converging evidence for the inclusion of harm reduction in NSSI treatment approaches. Future directions and ethical considerations are discussed.

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Section: Hr As An Nssi Treatmentmentioning

confidence: 99%

Section: Ethical Considerationsmentioning

confidence: 99%

Straight to the Source: e-Communities for Nonsuicidal Self-Injury and the Emerging Case for Harm Reduction in the Treatment of Nonsuicidal Self-Injury

Preston

West

2021

Clinical Psychological Science

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“…9 It is worth noting Fricker's characterization of epistemic injustice has gained traction among psychology researchers keen on developing intervention strategies for individuals exhibiting symptoms similar to those described here (Sullivan, 2019;Kyratsous & Sanati, 2016;Kverme, et. al., 2019) 10 "…hermeneutical injustice comes only when the background condition is realized in a more or less doomed attempt…to render an experience intelligible..." (Fricker, 2007, pg.…”

Section: Manifestation Condition and Hermeneutical Marginalizationmentioning

confidence: 99%

Speak No Evil: Understanding Hermeneutical (In)justice

Beverley

2020

Episteme

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Miranda Fricker's original presentation of Hermeneutical Injustice left open theoretical choice points leading to criticisms and subsequent clarifications with the resulting dialectic appearing largely verbal. The absence of perspicuous exposition of hallmarks of Hermeneutical Injustice might suggest scenarios exhibiting some – but not all – such hallmarks are within its purview when they are not. The lack of clear hallmarks of Hermeneutical Injustice, moreover, obscures both the extent to which Fricker's proposed remedy Hermeneutical Justice – roughly, virtuous communicative practices – adequately addresses the injustice, and the accuracy of criticisms suggesting that Hermeneutical Justice is insufficient to the task. In what follows, after briefly defending necessary and sufficient conditions for what I take to be the best candidate interpretation of Hermeneutical Injustice, I build on recent work on moral responsibility to construct and defend a rigorous explication of Hermeneutical Justice.

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“…(Kidd and Carel forthcoming) As some have argued, the risk of encountering this type of EI is even greater in psychiatry because of widespread negative stereotypes associated with mental illness (Crichton et al 2017; see also e.g., Kurs and Grinshpoon 2018;Kyratsous and Sanati 2015;LeBlanc and Kinsella 2016). The application of the conceptual framework of EI has thus made it possible to target various ethical problems related to knowledge production and transmission in psychiatry (e.g., Kyratsous and Sanati 2017;Crichton et al 2017;Kurs and Grinshpoon 2017;Tate 2018;Gosselin 2018;Bueter 2019;Sullivan 2019).…”

Section: Introductionmentioning

confidence: 99%

Wrongful Medicalization and Epistemic Injustice in Psychiatry

Gagné-Julien

2021

EuJAP

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In this paper, my goal is to use an epistemic injustice framework to extend an existing normative analysis of over-medicalization to psychiatry and thus draw attention to overlooked injustices. Kaczmarek (2019) has developed a promising bioethical and pragmatic approach to over-medicalization, which consists of four guiding questions covering issues related to the harms and benefits of medicalization. In a nutshell, if we answer “yes” to all proposed questions, then it is a case of over-medicalization. Building on an epistemic injustice framework, I will argue that Kaczmarek’s proposal lacks guidance concerning the procedures through which we are to answer the four questions, and I will import the conceptual resources of epistemic injustice to guide our thinking on these issues. This will lead me to defend more inclusive decision-making procedures regarding medicalization in the DSM. Kaczmarek’s account complemented with an epistemic injustice framework can help us achieve better forms of medicalization. I will then use a contested case of medicalization, the creation of Premenstrual Dysphoric Disorder (PMDD) in the DSM-5 to illustrate how the epistemic injustice framework can help to shed light on these issues and to show its relevance to distinguish good and bad forms of medicalization.

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Epistemic Injustice and Self-Injury: A Concept with Clinical Implications

Cited by 11 publications

References 59 publications

Straight to the Source: e-Communities for Nonsuicidal Self-Injury and the Emerging Case for Harm Reduction in the Treatment of Nonsuicidal Self-Injury

Straight to the Source: e-Communities for Nonsuicidal Self-Injury and the Emerging Case for Harm Reduction in the Treatment of Nonsuicidal Self-Injury

Speak No Evil: Understanding Hermeneutical (In)justice

Wrongful Medicalization and Epistemic Injustice in Psychiatry

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