Arnout De Cleene
TELL THE TRUTH
Power and Language in Psychiatry
Between solitary confinement and assisted living there is a spec trum of power dynamics. The conceptual pair ‘power and power lessness’ run through the history of psychiatry up to and including its practice today: from powerlessness in respect of one’s thoughts or delusions, compulsive behaviour or offering appropriate help to a loved one, to the relationships between pharmaceutical com panies and the scientific agenda, or deciding where the couch and chair go in the psychiatrist’s consulting room. There are measures that restrict freedom of movement. There are institutions you can’t just enter and leave. Psychiatric power and powerlessness were and are most visible in the form of confinement, when chains and shackles are used, when patients wear a gown or straitjacket, receive orders, have to be silent, or scream in isolation. But there are also less visible forms of power, such as authoritative theories and current therapies and diagnoses. Power dynamics are intrinsic in the way psychiatry works. In many respects, the history of psychiatry and the issues it has to deal with today have to do with speaking, with the discourse in which psychiatry functions. What meaning is given to words? To what diagnoses do they lead? Is someone who is quiet calm, or is he or she suffering from aphasia? Do we talk about psychiatric illness or psychic vulnerability? Are those who had ‘weak nerves’ in the early twentieth century people who are now ‘hypersensi tive’? How trustworthy is what someone says if he or she has been diagnosed as non compos mentis? How do you deal with a request for euthanasia from someone who suffers from depression? In those sometimes deafening, sometimes whispered words, the tension between power and powerlessness is revealed. Where do we find the traces of those words, fresh or faded, and what signi ficance do we dare give to them?
T E L L T H E T R U T H — 211
