‘These psychiatrists rate themselves as gods’: Disengagement and engagement discourses of people living with severe mental illness

Authors

  • Mike Chase University of Portsmouth, Portsmouth, UK
  • Jörg Zinken University of Portsmouth, Portsmouth, UK
  • Alan Costall University of Portsmouth, Portsmouth, UK
  • Jay Watts City University, London, UK
  • Stefan Priebe Newham Centre for Mental Health, London, UK

DOI:

https://doi.org/10.1558/cam.v7i1.43

Keywords:

mental illness, disengagement, mental health services, discourse analysis, positioning analysis, identity

Abstract

Positioning analysis, a variant of discourse analysis, was used to explore the narratives of 40 psychiatric patients (11 females and 29 males; mean age = 40 years) who had manifest difficulties with engagement with statutory mental health services. Positioning analysis is a qualitative method that captures how people linguistically position the roles and identities of themselves and others in their day-to-day lives and narratives. The language of disengagement incorporated the passive positioning of self in relation to their lives and treatment through the use of metaphor, the passive voice and them and us attribution, while the discourse of engagement incorporated more active positioning of self, achieved through the use of the personal pronoun we and metaphoric references to balanced relationships. The findings corroborate previous thematic analysis that highlighted the importance of identity and agency in the ‘making or breaking’ of therapeutic relationships (Priebe et al. 2005). Implications are discussed in relation to how positioning analysis may help signal and emphasize important life and therapeutic experiences in spoken narratives as well as clinical consultations.

Author Biographies

  • Mike Chase, University of Portsmouth, Portsmouth, UK
    University of Portsmouth, Portsmouth, UK
  • Jörg Zinken, University of Portsmouth, Portsmouth, UK
    University of Portsmouth, Portsmouth, UK
  • Alan Costall, University of Portsmouth, Portsmouth, UK
    University of Portsmouth, Portsmouth, UK
  • Jay Watts, City University, London, UK
    City University, London, UK
  • Stefan Priebe, Newham Centre for Mental Health, London, UK
    Newham Centre for Mental Health, London, UK

Published

2010-10-23

Issue

Section

Articles

How to Cite

Chase, M., Zinken, J., Costall, A., Watts, J., & Priebe, S. (2010). ‘These psychiatrists rate themselves as gods’: Disengagement and engagement discourses of people living with severe mental illness. Communication and Medicine, 7(1), 43-53. https://doi.org/10.1558/cam.v7i1.43

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