August 10, 2012
"While virtues such as compassion, honesty, integrity, altruism, and respect are explicitly valued by the profession, others argue that the medical profession also places a high albeit covert value upon characteristics such as maleness, fierce competitiveness, emotional detachment, aggression, activism and antipathy for weakness. This unresolved tension between objectifying and humanizing forces, or between competence and caring has been described as a feature of medical education and the professional socialization that accompanies it."

Jaye, C., Egan, T & Parker, S. (2006). ‘Do as I say, not as I do’: Medical Education and Foucault’s Normalizing Technologies of Self.Anthropology & MedicineVol. 13, No. 2, August 2006, pp. 141-155. (pp. 143 - 144). (via shrinkrants)

Wow. So I don’t know much about the context this quote came from, but it sounds so interesting that I’m going to go find the article and read it. If you’re interested, here’s the abstract of the paper:

But in the meantime, what do you all think and feel about this? I get the “fierce competitiveness” and “emotional detachment.” But the “maleness” I’m not so sure of, and isn’t “activism and antipathy for weakness” a paradox?

What do you all think?

(P.S. Go follow shrinkrants too, because he always has interesting posts!)

August 3, 2012
Cheryl Mattingly on generosity as an underground practice in medicine


Cheryl Mattingly is an anthropologist who has spent her career studying the culture of occupational therapists who work in large inner city hospitals. This is “exoticizing the domestic” rather than the more traditional cultural anthropology which “domesticates the exotic.” She has a lot to say about the culture of hospitals in general, the politics of class and race in urban hospitals, and the poetics of encounters between professionals and patients. Reading her work gives me hope for the future of medicine. She sees “clinical encounters” as dramas in which each participant is actively and collaboratively making up the lived story of the meaning of what has come before and of what’s possible in the next moment. I am moved by this long paragraph from her book Healing dramas and clinical plots. She is talking about what she has learned in the course of her studies.

“There was more generosity than I was prepared for. I saw small kindnesses rather than life-saving interventions. These went almost unnoticed by the therapists themselves. Generosity and small attentions are not the stuff of the medical chart. Even when something more dramatic (trying to help a despairing person find a reason to stay alive), there is no place to formally record these actions. They are undocumented exchanges, not part of the official purview of the occupational therapist. Therapists personally valued their own kindness and their imaginative capacity to link their interventions to the lives of their patients, but because there is almost no language within biomedical discourse for recognizing and examining exchanges which address the illness experience and because this is not a “reimbursable” part of treatment, the phenomenological aspects of treatment are quite neglected, carried out almost furtively. these attentions to the illness experience constitute an “underground practice” in occupational therapy and doubtless many other health professions. Taking careful note of the narrative structure of clinical interventions reveals “hidden values” within biomedical practice which run counter to the dominant metaphor of body as machine that holds such persuasive force in Western medicine. Put differently, it reveals how some health professionals, some of the time, recognize a physiological body which is inextricable from the imagined and lived body, the body which carries a person through social space and time.”

-Mattingly, Cheryl (1998) Healing dramas and clinical plots: The narrative structure of experience. p 22. Cambridge University Press, New York.

July 24, 2012
"The best way to dehumanize someone while claiming you’re not is to believe you are just the same. You erase their experiences and perspective, their struggles and obstacles, their unique way of having to deal with those things in a world that also erases them. With the words, ‘but humans are humans’ or the bullshit dramatics of ‘we all bleed red’ normal people can simply pretend that if we all did things the way they did, then everything would work out okay. But, yes, we all bleed red but you don’t treat a papercut the same way you treat a gash, you don’t treat an infected wound the same way you treat one that isn’t, you don’t treat a wound to the leg the same way you treat a wound to the gut. You are not acknowledging someone’s personhood when you ignore the very things that make their lives different than yours, and when you refuse to understand that their circumstances have given them their own perspective that is just as valid as yours. More valid in fact – their perspective about their experiences that you haven’t been through is far more valid than anything you could ever think about it."

The danger of worldviews (Speaking when the world sleeps)

(Source: kiriamaya, via shrinkrants)

July 22, 2012


I love Harlene Anderson.

Thanks to Christopher Kinman and Rhizome Network for making and sharing this excellently crafted video of Harlene explaining in clear, plain language one of the foundational principles of Collaborative Language Systems Therapy. In Narrative Therapy, we come at this same territory when we emphasize the importance of noticing (whenever possible) our assumptions and questioning them. We spend more time and effort in trying to unpack and understand the historical, social, cultural influences that support particular assumptions, but both not knowing and questioning our assumptions are stances that have the intention of supporting a non-impositional, client-centered, present-to-future kind of psychotherapy.

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