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Principles of psychiatric interview: How to examine and assess personal experiences
Published online by Cambridge University Press: 16 April 2020
Abstract
The aims of this Course can be summed up as follows: (1) improve the epistemological awareness of mental health professionals concerning the crucial situation of the interview, (2) provide methodological guidelines for clinicians while performing the interview, (3) provide criteria for clinicians and researchers to test the results of their interviews.
I will first shortly revise the basic tenets of the mainstream tradition, i.e. the "technical" approach to psychiatric interview, and then pass to scrutinize the large repertoire of problematic issues concerning the situation of the psychiatric interview in general, and the procedures of structured interviews in particular. The second part of the Course will be devoted to the problems arising in assessing first-personal experiences (with a special focus on psychotic experiences). Very little effort has been made until now to bring to the foreground the problem which arise in examining the psychiatric patients' subjectivity. The following are crucial questions: "Can subjectivity be made accessible for direct theoretical examination? Does each examination necessarily imply an objectivation and consequently a falsification? Which degree of falsification is acceptable?". The last part of the Course will address the issue of alternative (with respect to standard techniques) approaches to the psychiatric interview as a way to illuminate the quality of subjective experiences and behaviours, their meanings, and the pattern in which they are situated as parts of a significant whole. I will sketch a concurrent, phenomenologically-oriented epistemological framework for the psychiatric interview, and provide evaluative criteria.
The dispute about the family of instruments psychiatrists use or should use for assessment largely coincides with the debate about the scientific status of psychiatry. Is psychiatry in fact to be a science of the mind, or a science of something else, such as the brain or behaviour? Is it to be "science by analogy" or "physical science proper"? I will argue that the kind of science we dearly need is called phenomenology and its contribution is to complement mainstream psychopathology characterized by objectivism, emphasis on symptoms of behaviour and expression, focused on implicit biological causation and socially decontextualized symptoms. Especially the issue of contextualism is becoming particularly relevant, i.e. the role of context (cultural and historical) in knowledge, understanding, meaning and finally in assessment and classification. The phenomenological perspective, and specially the second person mode, advocates that the context of the clinical encounter should be one of co-presence (and not of dominance) whose aim is understanding (and not labelling), that is negotiating intersubjective constructs, and looking for meaningfulness through the bridging of two different horizons of meanings. This approach is relevant not only to develop the patients' self-perception, but also to rescue fringe abnormal phenomena that are usually not covered by standard assessment procedures.
- Type
- Courses
- Information
- European Psychiatry , Volume 22 , Issue S1: 15th AEP Congress - Abstract book - 15th AEP Congress , March 2007 , pp. S99 - S100
- Copyright
- Copyright © European Psychiatric Association 2007
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