Outlines. Critical Practice Studies

Examining the psychology of practitioners, institutions and structures:

Joanne Hunt — 2022-10-22

‘Medically unexplained symptoms’ (MUS), through the lens of the biopsychosocial model, are understood in mainstream psy disciplines and related literature as a primarily psychosocial phenomenon perpetuated by ‘dysfunctional’ psychology on the part of people labelled with such. Biopsychosocial discourse and practice in this field, underpinned by little empirical foundation and lacking theoretical coherency, are associated with harms sustained by people labelled with MUS. Yet, little attention is paid to the psychology of social actors and institutions whose practice and policy derives from biopsychosocial theorising, or whose vested interests (re)produce such theorising. This article contends that lack of reflexivity among psy practitioners and other social actors on individual, institutional and structural levels furthers biopsychosocial hegemony and contributes to harms. Non-reflexive behaviour on the part of practitioners within clinical and ‘therapeutic’ encounters and on the part of social actors within institutions and broader power structures is examined, and possible psychological underpinnings of non-reflexivity are explored. Notably, the concept of gain, drawn from dominant discourse around MUS, is applied broadly to explore what might be gained from eschewing reflexivity and from adhering to biopsychosocial narratives. Implications for practice, supervision, training and research are discussed, notably highlighting a need for critical reflexivity in all domains.

An assemblage of everyday technologies in the practice of western herbal medicine - a photo essay

Nina Nissen — 2022-10-18

Small, mundane technologies, such as stethoscopes, medicinal bottles, labels, cleaning and dispensing equipment, are integral to the practice of western herbal medicine (WHM) in the UK. A focus on such technologies reveals the dynamic character and porousness of medical systems and allows us to identify cultural interactions. In this photo essay, based on long-term anthropological research, I explore an assemblage of everyday technologies used by WHM practitioners and the ways in which these technologies contribute to shaping diagnostic stories, to performing (bio)medical legitimacy and invoking herbal traditions. The biomedical, herbal and domestic technologies-in-use come into view as vibrant and dynamic objects with highly contingent meanings and identities. Their absorption into this non-biomedical therapy supports the performance of (bio)medical legitimacy, authority, tradition and professionalism, while the use of everyday domestic objects may signal female-coded practices of care. This demonstrates the adaptability of a medical practice situated at the margin of mainstream healthcare and subject to ongoing technological and ideological influence. The strategic integration of this assemblage of everyday technologies into WHM contributes, I suggest, to evoking a competent, trustworthy and time-honoured medical practice, which is simultaneously inscribed with multiple tensions, ambiguities and contestations.

Talking, Listening and Emancipation:

Karl Eriksson — 2022-10-18

This paper adds a phenomenological account to the discussion on what constitutes the favorable prospects of the peer-relation in the context of self-help. By drawing on Heidegger’s lectures on St Paul’s First Thessalonians, and engaging in dialogue with a fictive case, we show that more attention needs to be given to how meaning is enacted, rather than simply adopted, in the peer-relation; that is, away from experiential content towards the process of how experiential knowledge is transferred communicatively. This, we argue, may clarify the underpinnings of the peer-relation and its emancipatory potential. Our findings propose a reconsideration of the role played by communicative activities in self-help. And, whereas storytelling has often been propounded as a way to facilitate agency among self-helpers, also the act of listening should receive more attention. By considering listening as an expression of agency, attention is reversed from self-narration on behalf of the person expected to be helped from it, to participation in another person’s story. The enaction approach to the peer-relation elaborated on in this paper invites the reader to rethink the value of talking and listening in helping relationships.

Research as praxis:

Eduardo Vianna — 2022-10-18