Medicalized Psychiatry and the Talking Cure: A Hermeneutic Intervention

Abstract

The dominance of the medical-model in American psychiatry over the last 30 years has resulted in the subsequent decline of the ''talking cure''. In this paper, we identify a number of problems associated with medicalized psychiatry, focusing primarily on how it conceptualizes the self as a de-contextualized set of symptoms. Drawing on the tradition of hermeneutic phenomenology, we argue that medicalized psychiatry invariably overlooks the fact that our identities, and the meanings and values that matter to us, are created and constituted by our dialogical relations with others. While acknowledging the importance of medical and pharmaceutical interventions, we suggest that it is only by means of the dialogical interplay of the talking cure that the client can both recognize unhealthy and selfdefeating ways of being and be opened up to the possibility of new meanings and self-interpretations.

Hermeneutical injustice and unworlding in Psychopathology

“…A Gadamerian approach to psychiatry promotes “the art of healing”: using doctor-patient dialogue to grasp the disturbance in the patient’s life-world and thereby work toward bridging the gap between the patient and the outside world (Gadamer, 1996 , p. 163). In discussing the benefits of “the talking cure” Aho and Guigon observe that “the dialogical interplay in which two people engage in bringing to light what is initially inchoate and confused can be seen as a creative act in which new possibilities of understanding and self-formulation are allowed to emerge into the light” (Aho & Guignon, 2011 , p. 305). According to Messas et al, a phenomenological approach to therapeutic interview can “help the patient to recalibrate his miscarried position-taking and, finally, to recover his sense of responsibility and agency” (Messas et al, 2018 , p.4).…”

Theorizing the Deep Parallel between Goffman and Freud: Goffman's Interaction Order as a Social-structural Underpinning of Psychoanalytic Concepts of the Self

“…The neurosis-generating process that Freud called "repression" can itself be seen as in part a product of over-regulation (as he suggests in his fable of the "over-regulated" little bourgeois girl whom he contrasts to her less regulated workingclass playmate). A shift from a bio-somatic (or bio-medical) model of neurosis to an interactive model is necessary in order for free association and transference to make sense as treatment (Aho and Guignon 2011). 10 Otherwise the psychoanalyst is left without an explanation why a "talk-9.…”

“…10. For a detailed phenomenological reading of the talking cure, see Aho and Guignon (2011). ing cure" in which the patient "transfers" past relationships into the analysis could possibly be effective.…”