Patient initiatives in psychiatric care concerning shame in the discussion in co‐operative team meetings

Abstract

The aim of this paper is to describe patients' experiences of shame and the way in which this experience is discussed in co-operative team meetings in acute psychiatric care. As an experience, shame is described as a painful and ugly feeling, which results in personal devaluation, isolation and a feeling of inferiority compared to others. This paper is based on 11 videotaped episodes of co-operative team meetings in two psychiatric units. The study approach was narrative. Shame was found to be the core narrative. The narrative of shame was laid out as an experience, and shame caused difficulties in the patients' daily lives and finally led to feelings of difference and loneliness. When the psychiatric patients and significant others tried to speak about the experience of shame with the professionals, the professionals either did not respond or changed the topic of discussion by asking questions about the patient's daily life and rationalizing the experience of shame. The participants did not share a common objective in the co-operative team meetings. Further research is needed to find new ways of co-operative team discussion and to develop the co-operative team meetings towards a patient-orientated model.

Patient Experiences of Loneliness

“…16 Shame itself caused avoidance behavior and resulted in separation, isolation, and diminished interaction with other people. 16,17 These factors together caused a sense of loneliness. Feelings of being different were also reported by patients who found that nobody understood them when they needed help.…”

Health Professionals' Perspectives of Suicide in Taiwan

“…If these behaviors weren't observed, the patient's attempt was not taken seriously, he or she was diagnosed as having a "personality disorder," and/or stigmatized with negative such labels as "a difficult patient," "crying for attention," or making "a suicide gesture." This process of placing judgment on suicidal patients confirms that they "deserve" the stigmatized label (Raingruber, 2002;Vuokila-Oikkonen, Janhonen, & Nikkonen, 2002). It also encourages patients to perceive that health professionals are not willing to talk to them, and do not respect them (Fletcher, 1999;Samuelsson, Wiklander, Asberg, & Saveman, 2000), do not regard their individual needs (Duffy, 1995;Pallikkathayil & McBride, 1986), but rather confine them (Cardell & Pitula, 1999) and judge them (Jones, Ward, Wellman, Hall, & Lowe, 2000).…”

Social Worker Shame in Child and Family Social Work: Inadequacy, Failure, and the Struggle to Practise Humanely

“…Shame is an emotion that is often unacknowledged by individuals and even where feelings of shame are explicit, it is more likely to be misnamed with individuals referring to shame in disguised terms, e.g. feeling foolish, stupid, inadequate, defective or incompetent (Lewis, 1971;Scheff, 1988;Retzinger, 1989;Vuokila-Oikkonen et al, 2002).…”