Membership categorization and professional insanity ascription

Abstract

This study, based on three years of research and over 40 hours of videotaped interaction in psychiatry, investigates the issue of insanity ascription/exoneration in psychiatric interviews. Following Sacks's model of membership categorization analysis (MCA), this article analyzes the discursive resources that psychiatrists may draw on to achieve some conclusion regarding their patients' psychopathological status. As it turns out, psychiatrists' invocation of patients' putative membership categories plays a crucial role in the achievement of such a conclusion. I examine some fragments of psychiatric intake interviews (PIIs) and subsequent psychiatric interviews (SPIs). The analysis shows that the process that may lead to insanity ascription/exoneration in psychiatric interviews basically involves the use of mundane, commonsense reasoning.

The History and Landscape of Conversation and Discourse Analysis

“…Specifically, CA is a useful method to explore the language of mental distress and related interactions in this field, as psychiatric categories are produced through and within language (Harper, 1995). The notions of sanity and insanity, normality and abnormality, health and illness are typifications that begin with interaction and observation (Roca-Cuberes, 2008). Importantly, the work from CA has helped to reframe conceptualisations of mental illness and the way in which it is managed by changing the emphasis from biomedical to interpersonal and socio-cultural (Georgaca, 2012).…”

Category attribution as a device for diagnosis: fitting children to the autism spectrum

“…As the reader may note, our analysis has affinities with scholarship that uses membership category analysis (MCA), particularly studies of how categories are predicated of persons (e.g. Hester and Eglin , O'Neill and LeCouteur , Roca‐Cuberes ). Where our approach differs is in its emphasis on the sequential aspects of category attribution: whereas ‘MCA … places more emphasis on interactants’ interpretive procedures than sequential structure’ (Roca‐Cuberes : 549), our approach prioritises sequencing, such that interactants’ interpretations are ascribed on the basis of their sequential location.…”

“…Hester and Eglin , O'Neill and LeCouteur , Roca‐Cuberes ). Where our approach differs is in its emphasis on the sequential aspects of category attribution: whereas ‘MCA … places more emphasis on interactants’ interpretive procedures than sequential structure’ (Roca‐Cuberes : 549), our approach prioritises sequencing, such that interactants’ interpretations are ascribed on the basis of their sequential location. In this respect, our approach is closer to conversation analytic work on category use (Schegloff , Stokoe , Whitehead ).…”

“…As the reader may note, our analysis has affinities with scholarship that uses membership category analysis (MCA), particularly studies of how categories are predicated of persons (e.g. Hester and Eglin 1997, O'Neill and LeCouteur 2014, Roca-Cuberes 2008. Where our approach differs is in its emphasis on the sequential aspects of category attribution: whereas 'MCA .…”

“Having an Ovary This Big Is Not Normal”: Physicians’ Use ofNormalto Assess Wellness and Sickness During Oncology Interviews

“…The diverse and gradated functions of normal throughout diagnosis and treatment, however, have not been systematically investigated and a need exists to reveal how wellness and sickness get interactionally formulated (Greatbatch & Dingwall, 1998; Goetz, 2008). Within several studies of physician-patient interaction, normal appears in the data but has generally remained unaddressed in favor of other important interactional features (See: Frankel, 1984, Excerpt 2; Roca-Cuberes, 2008, p. 555). Thus, crucial aspects of managing wellness and sickness remain unexamined.…”