Amina Pizzala, Elena Fogliata, Gian Piero Turchi, Dalila Barbanera Dialogical-self Congress August 2008, Cambridge, UK Università di Padova General Psychology Department THE MENTAL DISEASE AS A DISCURSIVE CONFIGURATION

PARADIGM AND THEORETICAL REFERENCES: NARRATIVISTIC PARADIGM The reality is not something REAL/CONCRETE There are the discursive practices about everything DIALOGICAL IDENTITY THEORY CREATION OF A DISCURSIVE REALITY AS STRONG AS “REAL”

Italian Mental Health Centre (CSM)OBJECTIVE to describe the processes for building the dialogical identity “User of a CSM” METHODOLOGY OF INVESTIGATION M.A.D.I.T: methodology of textual processing data analysis (Turchi et all. 2007) THE GROUP UNDER INVESTIGATION Users: 40 users of a mental institute (CSM) New entry: 40 people at its first interview, entering in the CSM Operator: 40 health operators of CSM Common sense: 40 persons not ‘expert’, interviewed in the street

-- TO USERS TO USERS -- description of oneself in retrospective, current and future perspective -- how the person describes oneself in different phases of its hospitalised career. -- how users anticipated the operators could describe them -- TO OPERATORS TO COMMON SENSE TO THE NEW ENTRY USERS TO OPERATORS -- anticipation about how an user describes oneself -- how the operators themselves describe 'the user of CSM' -- TO COMMON SENSE -- the description of the user before entering -- discursive modality of the common sense about the user ‘new entry’ -- TO THE NEW ENTRY USERS -- the description of an user of the centre during, before and after its stay at the CSM. CONSTRUCTION OF THE AD HOC QUESTIONNAIRE

QUESTIONS: “how do you think that today the operators describe you, thinking to your most important relationships?”, USERS “how do you think that an user describes oneself in reference to its relationships?” OPERATORS USERSOPERATORS Repertoire of the action Repertoire of the disease Repertoire of the characteristics role Repertoire of the normal/abnormal Repertoire of the resolution Repertoire of the evaluation Repertoire of the comparison

QUESTION: “How do you describe the user of the CSM, before entering in?” OPERATORS- COMMON SENSE ”How do you describe yourself before entering in CSM?” USERS OPERATORS COMMON SENSE USERS Repertoire of the disease Repertoire of the characteristics role Repertoire of the risolution The discourses : -OPERATOR -COMMONS SENSE -USERS MHC IDENTITY TYPED ‘MENTAL HILNESS’ COINCIDE

REPERTOIRE OF THE DISEASE AND CHARACTERISTICS OF ROLE TO DESCRIBE THE USER REALITY REPERTOIRES USED BY ALL INTERVIEWED ROLES THE EXPERTS CONSTRUCT THE REALITY IN THE SAME WAY OF THOSE NOT EXPERT the user is always described considering its hospitalization and its illness the hospitalization influences and pervades the life of a person roles involved in the construction of the reality of a patient that use and refer to illness, fixing in this way the identity of the patient and typifying it Operators work and behave using the same references of the common sense, not expert in this field 3. CONSIDERATIONS

QUESTION : “how do you describe yourself at the end of the hospitalization in CSM”? USERS-NEW ENTRY “how do you describe an user at the end of its hospitalization in CSM”? OPERATORS-COMMON SENSE USERSNEW ENTRYOPERATORSCOMMON SENSE Repertoire of the disease Repertoire of the characteristics role Repertoire of the resolution Repertoire of the normal/abnormal

also before the supposed recovery, users, common sense and ALSO OPERATORS think to the patient referring to illness The experts use also here references of the common sense, without refer to scientific basics New entry once became users lost the resolution point of view, assuming that of the disease At the beginning and imagining the end of the therapeutic train there aren’t changes in the description and representation of the patient 4. CONSIDERATIONS

<> <> THE CIRCUIT OF HEALTH PERVADES THE LIFE OF A PERSON IN ITS DISCURSIVE CONSTRUCTION OF IDENTITY AND REALITY <> <> EXPERTS OFFER TO THE USERS A SERVICE UNFOUNDED NOT DIFFERENT BY THAT OF THE STREET <> <> ONCE BECOME USER THE PERSON LOST ITS NORMALIZATION AND RESOLUTION POINT OF VIEW <> <> THE INSTITUTE GENERATE AND MAINTAIN WHAT IT AIMS TO RECOVERY  THE MENTAL DISEASE CONCLUSIONS

THE PROPOSAL 1° HOSPITALISATION TO OFFER SERVICES AND INTERVENTION PINCHED FROM THE COMMON SENSE WAY OF THINKING 2° THE OPERATORS TO ORGANIZE SPECIFIC TRAINING TO GUARANTEE ITS METHODOLOGICAL AND OPERATIONAL RIGOR AND SCIENTIFICITY ALL THE VOICES TO OFFER INTERVENTIONS ON THE DISCOURSES GENERATED BY ALL, PROMOTING THE GENERATION OF DISCOURSES THAT PERMIT TO THE ILL PERSON TO CONSIDER DIFFERENT POSSIBILITIES BY THE MENTAL DISEASE 3°