‘But this is a wizardry something that has to be removed first’
Relational negotiation of diagnoses and experiences of schizophrenia in Nigerian mental health clinics
DOI:
https://doi.org/10.1558/cam.24273Keywords:
schizophrenia, common ground, communicating and relating, conjoint co-constitution, diagnoses, mental health clinics, NigeriaAbstract
In Nigeria, diagnoses of schizophrenia and descriptions of its symptoms and experiences are shaped by numerous biomedical and sociocultural perspectives. However, although many studies have focused on the social realities and public attitudes towards the disorder, the interactional means of how its diagnoses and experiences are constituted in psychiatric interviews have not hitherto received close attention from linguists in Nigeria. This paper thus examines a corpus of 56 audio recorded interviews in mental health clinics in southwestern Nigeria, using insights from Arundale’s concept of communicating and relating and Stalnaker’s notion of common ground. It observes that diagnoses of the disorder do not subscribe to any rigid diagnostic pathways, but evolve from the relational, provisional and operative interpretation of the design of its experiences and other shared contextual situations that collectively instantiate the knowledge of mental illness in Nigeria.
References
Adelekan, Moruf, Alfred Bamiso Makanjuola and Roy Ndom (2001) Traditional mental health practitioners in Kwara State, Nigeria. East Africa Medical Journal 78 (4): 190–196. https://doi.org/10.4314/eamj.v78i4.9061
Adewuya, Abiodun and Roger Makanjuola (2009) Preferred treatment for mental illness among southwestern Nigerians. Psychiatric Services 60 (1): 121–124. https://doi.org/10.1176/ps.2009.60.1.121
Antaki, Charles (2008) Formulations in psychotherapy. In Anssi Peräkylä, Charles Antaki, Sanna Vehviläinen and Ivan Leudar (eds) Conversation Analysis and Psychotherapy, 26–42. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9780511490002.003
Arundale, Robert B. (2010) Constituting face in conversation: Face, facework and interactional achievement. Journal of Pragmatics 42 (8): 2078–2105. https://doi.org/10.1016/j.pragma.2009.12.021
Arundale, Robert B. (2020) Communicating & Relating: Constituting Face in Everyday Interacting. Oxford: Oxford University Press. https://doi.org/10.1093/oso/9780190210199.001.0001
Atilola, Olayinka and Funmilayo Olayiwola (2013) Frames of mental illness in the Yoruba genre of Nigerian movies: Implications for orthodox mental health care. Transcultural Psychiatry 50 (3): 442–454. https://doi.org/10.1177/1363461512443998
Barrett, Robert John (2004) Kurt Schneider in Borneo: Do first rank symptoms apply to the Iban? In Robert John Barrett and Janis Hunter Jenkins (eds) Schizophrenia, Culture and Subjectivity: The Edge of Experience, 87–110. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9780511616297.006
Bergmann, Jörg R. (1992) Veiled morality: Notes on discretion in psychiatry. In Paul Drew and John Heritage (eds) Talk at Work: Interaction in Institutional Settings, 137–162. Cambridge: Cambridge University Press.
Bergmann, Jörg R. (2016) Making mental disorders visible: Proto-morality as diagnostic resource in psychiatric exploration. In Micelle O’Reilly and Jessica Nina Lester (eds) The Palgrave Handbook of Adult Mental Health, 247–268. Basingstoke, UK: Palgrave Macmillan. https://doi.org/10.1057/9781137496850_14
Bolden, Galina B. and Beth Angell (2017) The organization of the treatment recommendation phase in routine psychiatric visits. Research on Language and Social Interaction 50 (2): 151–170. https://doi.org/10.1080/08351813.2017.1301299
Clark, Herbert (1985) Language use and language users. In Lindzey Gardner and Aronson Elliot (eds) Handbook of Social Psychology, 179–231. New York: Harper and Row.
Davis, Kathy (1986) The process of problem (re) formulation in psychotherapy. Sociology of Health & Illness 8 (1): 44–74. https://doi.org/10.1111/1467-9566.ep11346469
Falk, Jane (1979) The Conversational Duet. Unpublished doctoral dissertation, Princeton University, Princeton, NJ.
Ferrara, Kathleen Warden (1994) Therapeutic Ways with Words. Oxford: Oxford University Press. https://doi.org/10.1093/oso/9780195083378.001.0001
Goffman, Erving (1955) On face-work: An analysis of ritual elements in social interaction. Psychiatry 18 (3): 213–231. https://doi.org/10.1080/00332747.1955.11023008
Gureje, Oye, Victor O. Lasebikan, Olusola Ephraim-Oluwanuga, Benjamin O. Olley and Lola Kola (2005) Community study of knowledge of and attitude to mental illness in Nigeria. British Journal of Psychiatry 186 (5): 436–441. https://doi.org/10.1192/bjp.186.5.436
Hyden, Lars-Christer (1995) The rhetoric of recovery and change. Culture, Medicine and Psychiatry 19: 73–90. https://doi.org/10.1007/BF01388249
Jegede, Ayodele Samuel (2005) The notion of ‘were’ in Yoruba conception of mental illness. Nordic Journal of African Studies 14 (1): 117–126.
Mac Martin, Clare (2008) Resisting optimistic questions in narrative and solution-focused therapies. In Anssi Peräkylä, Charles Antaki, Sanna Vehviläinen and Ivan Leudar (eds) Conversation and Psychotherapy, 80–99. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9780511490002.006
Maynard, Douglas W. (1997) The news delivery sequence: Bad news and good news in conversational interaction. Research on Language and Social Interaction 30 (2): 93–130. https://doi.org/10.1207/s15327973rlsi3002_1
McCabe, Rosemarie, Christian Heath, Tom Burns and Stefan Priebe (2002) Engagement of patients with psychosis in the consultation: Conversation analytic study. British Medical Journal 325 (7373): 1148–1151. https://doi.org/10.1136/bmj.325.7373.1148
McCabe, Rose, Imren Sterno, Stefan Priebe, Rebecca Barnes and Richard Byng (2017) How do healthcare professionals interview patients to assess suicide risk? BMC Psychiatry 17: Article 122. https://doi.org/10.1186/s12888-017-1212-7
Monzoni, Chiara M. and Markus Reuber (2016) Psychogenic non-epileptic seizures: How doctors use medical labels when they communicate and explain the diagnosis. In Michelle O’Reilly and Jessica Nina Lester (eds) The Palgrave Handbook of Adult Mental Health, 577–596. Basingstoke, UK: Palgrave Macmillan. https://doi.org/10.1057/9781137496850_12
Labov, William and David Fanshel (1977) Therapeutic Discourse: Psychotherapy as Conversation. Orlando, FL: Academic Press.
Lisboa, Milena Silva and Mary Jane Paris Spink (2016) The process of social labelling of mental illness: An analysis of family conversations. In Michelle O’Reilly and Jessica Nina Lester (eds) The Palgrave Handbook of Adult Mental Health, 227–246. Basingstoke, UK: Palgrave Macmillan. https://doi.org/10.1057/9781137496850_13
Oguejiofor, Whitneyhope (2017) Perceptions of Mental Illness in Nigerian Communities: A Literature Review. Unpublished master’s dissertation, Adler Graduate School, University of Richfield, Richfield, MN.
Peräkylä, Anssi (2004) Making links in psychoanalytic interpretations: A conversation analytic view. Psychotherapy Research 14 (3): 289–307. https://doi.org/10.1093/ptr/kph026
Peräkylä, Anssi (2005) Patients’ responses to interpretations: A dialogue between conversation analysis and psychoanalytic theory. Communication & Medicine 2 (2): 163–176. https://doi.org/10.1515/come.2005.2.2.163
Peräkylä, Anssi (2019) Conversation analysis and psychotherapy: Identifying transformative sequences. Research on Language and Social Interaction 52 (3): 257–280. https://doi.org/10.1080/08351813.2019.1631044
Peräkyla, Ansi, Charles Antaki, Sanna Vehviläinen and Ivan Leudar (2008) Analysing psychotherapy in practice. In Anssi Peräkyla, Charles Antaki, Sanna Vehviläinen and Ivan Leudar (eds) Conversation Analysis and Psychotherapy, 1–25. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9780511490002.002
Pittenger, Robert F., Charles F. Hockett and John J. Danehy (1960) The First Five Minutes: A Sample of Microscopic Interview Analysis. Ithaca, NY: Paul Martineau.
Quirk, Alan, Rob Chaplin, Paul Lelliott and Clive Seale (2012) How pressure is applied in shared decisions about antipsychotic medication: A conversation analytic study of psychiatric outpatient consultations. Sociology of Health & Illness 34 (1): 95–113. https://doi.org/10.1111/j.1467-9566.2011.01363.x
Ribeiro, Branca Telles (1994) Coherence in Psychotic Discourse. Oxford: Oxford University Press. https://doi.org/10.1093/oso/9780195065978.001.0001
Roca-Cuberes, Charles (2011) Making psychotherapy visible: A conversation analytic study of some interactional devices employed in psychiatric interviews. Text & Talk 31 (2): 221–245. https://doi.org/10.1515/text.2011.010
Roca-Cuberes, Charles (2016) Diagnosing as an interactional achievement in psychiatric interviews. In Michelle O’Reilly and Jessica Nina Lester (eds) The Palgrave Handbook of Adult Mental Health, 577–596. Basingstoke, UK: Palgrave Macmillan. https://doi.org/10.1057/9781137496850_11
Scheflen, Albert (1973) Communicational Structure: Analysis of a Psychotherapy Transaction. Bloomington: Indiana University Press.
Stalnaker, Robert (1973) Presuppositions. Journal of Philosophical Logic 2 (4): 447–457. https://doi.org/10.1007/BF00262951
Stalnaker, Robert (2002) Common ground. Linguistics and Philosophy 25 (5–6): 701–721. https://link.springer.com/article/10.1023/A:1020867916902
Thatcher, Mathew S. (2016) The role of self-disclosure in the social construction of understandings of alcoholism and mental health within talk between members of Alcoholics Anonymous. In Michelle O’Reilly and Jessica Nina Lester (eds) The Palgrave Handbook of Adult Mental Health, 269–286. Basingstoke, UK: Palgrave Macmillan. https://doi.org/10.1057/9781137496850_15
Thompson, Laura and Rose McCabe (2018) How psychiatrists recommend treatment and its relationship with patient uptake. Health Communication 33 (11): 1345–1354. https://doi.org/10.1080/10410236.2017.1350916
Vehviläinen, Sanna (2003) Topicalizing the patient’s emotion in psychoanalytic interaction. Paper presented at the Communication, Medicine & Ethics (COMET) Conference, University of Cardiff, 26–28 June 2003.
Wilce, James M. (1995) ‘I can’t tell you all my troubles’: Conflict, resistance, and metacommunication in Bangladeshi illness interactions. American Ethnologist 22 (4): 927–952. https://doi.org/10.1525/ae.1995.22.4.02a00140
Wilce, James M. (1997) Discourse, power, and the diagnosis of weakness: Encountering practitioners in Bangladesh. Medical Anthropology Quarterly 11 (3): 352–374. https://doi.org/10.1525/maq.1997.11.3.352
Wynn, Rolf (2000) Incomprehensible language in psychiatric doctor-patient interaction. 7th International Pragmatics Conference, Budapest, 9–14 July 2000.
Wynn, Rolf, Svein Bergvik and Brita Elvevag (2009) Exaggerations in consultations between psychiatrists and patients suffering from psychotic disorders. Communication & Medicine 6 (1): 95–105. https://doi.org/10.1558/cam.v6i1.95
Wynn, Rolf and Michael Wynn (2006) Empathy as an interactionally achieved phenomenon in psychiatric interactions: Some conversational resources. Journal of Pragmatics 38 (9): 1385–1397. https://doi.org/10.1016/j.pragma.2005.09.008
Published
Issue
Section
License
copyright Equinox Publishing Ltd.