Overcoming Hermeneutical Injustice in Mental Health: A Role for Critical Phenomenology

Adopting a critical phenomenological stance in psychiatric practice can address instances of hermeneutical injustice that arise when clinicians dismiss the communication of patients with psychosis as meaningless or unintelligible. The author argues that shifting from individualistic to interactionist views of understanding, which account for contextual, historical, and relational backgrounds of meaning co-constitution, can remedy such unintelligibility. A proposed corrective involves attentiveness to the person's subjectivity, sensitivity to contingent meaning-generating structures, and hermeneutical flexibility as an openness to alternative horizons of possibility.

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Abstract

ABSTRACT The significance of critical phenomenology for psychiatric praxis has yet to be expounded. In this paper, I argue that the adoption of a critical phenomenological stance can remedy localised instances of hermeneutical injustice, which may arise in the encounter between clinicians and patients with psychosis. In this context, what is communicated is often deemed to lack meaning or to be difficult to understand. While a degree of un-shareability is inherent to subjective life, I argue that issues of unintelligibility can be addressed by shifting from individualistic conceptions of understanding to an interactionist view. This takes into account the contextual, historical and relational background within which meaning is co-constituted. I conclude by providing a corrective for hermeneutical injustice, which entails a specific attentiveness towards the person’s subjectivity, a careful sensitivity to contingent meaning-generating structures, and a degree of hermeneutical flexibility as an attitude of openness towards alternative horizons of possibility.