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Biografier från gränslandet - en sociologisk studie om psykiatrins förändrade kontrollmekanismer

Loodin, Henrik LU (2009) In Lund Dissertations in Sociology 88
Abstract (Swedish)
Popular Abstract in Swedish

Under större delen av den moderna psykiatrins historia innebar vården av psykisk sjukdom en förvisning av individer till stora slutna anstalter. Idag har dessa inspärrningsmiljöer reformerats så att vården istället organiseras samhällsbaserat utifrån ledorden: delaktighet, integrering och normalisering.



Den övergripande frågan som ställs i denna avhandling är hur psykiatrins kontrollmekanismer förändras i ett senmodernt samhälle. Verksamheten organiseras inte längre kring disciplineringen av individen utan kring kontrollen av en social miljö. Avhandlingen utforskar hur den moderna psykiatrins förändringsprocess gett upphov till en komplex praktik som innefattar psykiatrisk... (More)
Popular Abstract in Swedish

Under större delen av den moderna psykiatrins historia innebar vården av psykisk sjukdom en förvisning av individer till stora slutna anstalter. Idag har dessa inspärrningsmiljöer reformerats så att vården istället organiseras samhällsbaserat utifrån ledorden: delaktighet, integrering och normalisering.



Den övergripande frågan som ställs i denna avhandling är hur psykiatrins kontrollmekanismer förändras i ett senmodernt samhälle. Verksamheten organiseras inte längre kring disciplineringen av individen utan kring kontrollen av en social miljö. Avhandlingen utforskar hur den moderna psykiatrins förändringsprocess gett upphov till en komplex praktik som innefattar psykiatrisk expertkunskap, psykologisk terapi och samordning av social verksamhet. I fyra delarbeten visas hur psykiatrin har blivit en organisation i vilken medicinsk kunskap, politiska reformer och organisatoriska strukturer konkretiseras biografiskt i människors liv.



Utifrån ett livshistoriskt perspektiv analyseras levnadsberättelser från personer med en psykiatrisk diagnos. Centralt för avhandlingen är också den anpassningsprocess flyktingar med posttraumatisk stress genomgår på vägen till att inkluderas i ett för dem nytt samhälle. I dessa berättelser upptäcks att ett lidande förknippat med en migrationsprocess blir beskrivet som en sjukdomsdiagnos och tillskrivs en medicinsk förklaring som en inomindividuell dysfunktion. En central slutsats är att det mellan den komplexa samhällsbaserade praktiken och den enskildes livssituation uppstår ett spänningsfält – ett gränsland – som innebär en maktförlust i det egna livets fortskridande. En central slutsats är att ett spänningsfält, ett gränsland som innebär en maktförlust i det egna livets fortskridande, uppstår mellan den komplexa samhällsbaserade praktiken och den enskildes livssituation.



Det övergripande syftet med avhandlingen är att förstå hur en psykisk sjukdom inverkar i en människas levnadsförlopp. Avhandlingen består av fyra delarbeten med var sina separata syften. Delarbete ett, analyserar det spänningsfält som skapas då en person får en psykisk sjukdom vilket medför att denna persons levnadsbana påverkas av olika sociala institutioner bortom egen kontroll. Delarbete två, fokuserar på den anpassning flyktingar med posttraumatisk stress genomgår på till att inkluderas i ett för dem nytt samhälle och hur denna anpassning kan upplevas som mer traumatisk än det trauma diagnosen refererar till. Delarbete tre undersöker det spänningsfällt mellan den biografi en person måste utveckla på ett psykiatriskt fält för att få relevant vård och den självbiografiska bild personen som blir diagnostiserad har om sig själv. Delarbete fyra diskuterar hur denna självbiografiska bild kan användas för att utveckla redan existerande teorier om konstruktionen av en sjukroll på ett psykiatriskt fält. (Less)
Abstract
The modern era of psychiatry is predominantly a history of confinement. Individuals suffering from mental disorders were banished to asylums and mental hospitals. During the late twentieth century, however, the Swedish psychiatry was a recurring topic for political debate and the target for numerous reforms. At present it is reorganized around three fundamental principles: participation, normalization and integration. The general question that this doctoral dissertation is concerned with is how the control mechanisms of psychiatry have changed in late modern society. It argues that the new psychiatric sector has shifted focus from the organization around the discipline of individuals to the control of their social environment. The aim is... (More)
The modern era of psychiatry is predominantly a history of confinement. Individuals suffering from mental disorders were banished to asylums and mental hospitals. During the late twentieth century, however, the Swedish psychiatry was a recurring topic for political debate and the target for numerous reforms. At present it is reorganized around three fundamental principles: participation, normalization and integration. The general question that this doctoral dissertation is concerned with is how the control mechanisms of psychiatry have changed in late modern society. It argues that the new psychiatric sector has shifted focus from the organization around the discipline of individuals to the control of their social environment. The aim is to increase societal participation among those with a mental disorder. To this end the dissertation illustrates how the transformation of modern psychiatry – into a new psychiatry – has created a complex organization around persons with a mental illness.



The findings of the research are presented in four articles based on life stories told by persons with a psychiatric diagnosis. The articles deal with how psychiatry is turned into an organization in which medical knowledge, political reforms and organizational structures are concretized biographically in the life of the individual. One central aspect of the analysis is the adaptation phase that refugees with posttraumatic stress disorder go through. The overall aim of the articles is to understand how a psychiatric diagnosis intervenes in a life story. The first article analyses the absurdities that arise when a person contract a mental disorder. The article shows that these absurdities emerge when institutions influence the course of events in a patient’s life. The second article focus upon the adaptation phase that refugees with posttraumatic stress disorder must pass before they are included in a new social context. It is showed that the adaptation phase can be more traumatizing than the actual trauma that has been diagnosed. The third article problematizes the tensions between the autobiography of persons in a marginal position, and their biography as patients positioned on a field structured by psychiatric knowledge. In the fourth article it is discussed how the autobiography created by, what is commonly referred to as marginal experiences, may be used to develop existing theories on the construction of the sick role. A key finding in the four articles is that the discrepancy between the new forms of psychiatry and the patients’ life situations, creates a critical element – a borderland – that involves a loss of agency in how the own life is unfolded. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Professor Börjesson, Mats, Mälardalens högskola
organization
alternative title
Biographies from the borderland - a sociological study about the changing control mechanisms of psychiatry
publishing date
type
Thesis
publication status
published
subject
keywords
Autobiographies, Medical Sociology, Psychiatry, Posttraumatic Stress Disorder, Biography, Migration, Narratives
in
Lund Dissertations in Sociology 88
pages
215 pages
publisher
Lund University
defense location
Stora Ahlgatan 4
defense date
2009-11-27 10:00
ISBN
91-7267-303-6
language
Swedish
LU publication?
yes
id
7ffc344a-aea4-409e-a9a0-e8a4aafd3977 (old id 1502273)
date added to LUP
2009-11-13 13:36:51
date last changed
2016-11-23 09:19:09
@phdthesis{7ffc344a-aea4-409e-a9a0-e8a4aafd3977,
  abstract     = {The modern era of psychiatry is predominantly a history of confinement. Individuals suffering from mental disorders were banished to asylums and mental hospitals. During the late twentieth century, however, the Swedish psychiatry was a recurring topic for political debate and the target for numerous reforms. At present it is reorganized around three fundamental principles: participation, normalization and integration. The general question that this doctoral dissertation is concerned with is how the control mechanisms of psychiatry have changed in late modern society. It argues that the new psychiatric sector has shifted focus from the organization around the discipline of individuals to the control of their social environment. The aim is to increase societal participation among those with a mental disorder. To this end the dissertation illustrates how the transformation of modern psychiatry – into a new psychiatry – has created a complex organization around persons with a mental illness.<br/><br>
<br/><br>
The findings of the research are presented in four articles based on life stories told by persons with a psychiatric diagnosis. The articles deal with how psychiatry is turned into an organization in which medical knowledge, political reforms and organizational structures are concretized biographically in the life of the individual. One central aspect of the analysis is the adaptation phase that refugees with posttraumatic stress disorder go through. The overall aim of the articles is to understand how a psychiatric diagnosis intervenes in a life story. The first article analyses the absurdities that arise when a person contract a mental disorder. The article shows that these absurdities emerge when institutions influence the course of events in a patient’s life. The second article focus upon the adaptation phase that refugees with posttraumatic stress disorder must pass before they are included in a new social context. It is showed that the adaptation phase can be more traumatizing than the actual trauma that has been diagnosed. The third article problematizes the tensions between the autobiography of persons in a marginal position, and their biography as patients positioned on a field structured by psychiatric knowledge. In the fourth article it is discussed how the autobiography created by, what is commonly referred to as marginal experiences, may be used to develop existing theories on the construction of the sick role. A key finding in the four articles is that the discrepancy between the new forms of psychiatry and the patients’ life situations, creates a critical element – a borderland – that involves a loss of agency in how the own life is unfolded.},
  author       = {Loodin, Henrik},
  isbn         = {91-7267-303-6},
  keyword      = {Autobiographies,Medical Sociology,Psychiatry,Posttraumatic Stress Disorder,Biography,Migration,Narratives},
  language     = {swe},
  pages        = {215},
  publisher    = {Lund University},
  school       = {Lund University},
  series       = {Lund Dissertations in Sociology 88},
  title        = {Biografier från gränslandet - en sociologisk studie om psykiatrins förändrade kontrollmekanismer},
  year         = {2009},
}