“I wouldn’t tell my psychiatrist any of this” – why we need independent phenomenological research to understand the experience of those acquiring a psychiatric diagnosis.

I am currently undertaking a small phenomenological study of those experiencing delusion. Whilst I am not specifically investigating how and what patients communicate to healthcare professionals I have gathered some evidence highlighting some of the problems people encounter in this regard. Psychiatrists, under pressure to diagnose and treat, are not encouraged to get to know their patients. Diagnosis has been simplified but the meaningfulness of the diagnosis might be lost if we are working with narrow constructs. We might also exclude or deny other features of experience that are outside diagnostic limits (Andreasen, 2007). Some have called for a return to phenomenology highlighting the ‘mixed’ nature of various disorders and citing the use of checklists as contributing to over simplification (Ghaemi, 2007). Diagnosis by diagnostic schema may be impeding the evolution of psychiatric knowledge. A structured diagnostic interview might fragment personal experience, assume shared meanings between interviewer and interviewee and suppress the interviewee’s narrative (Stanghellini, 2013). I examine the problem as described by patients as well as the potential consequences of losing valuable information about mental health disorders.

References:
Andreasen, N.C. (2007) DSM and the Death of Phenomenology in America: An Example of Unintended Consequences. Schizophrenia Bulletin, 33 (1): 108–112
Ghaemi, S.N. (2007) Feeling and Time: The Phenomenology of Mood Disorders, Depressive Realism, and Existential Psychotherapy. Schizophrenia Bulletin, 33 (1): 122–130
Stanghellini, G. (2013) “Philosophical Resources for the Psychiatric Interview.” In Fulford, K.W.M., Davies, M., Gipps, R.G.T., et al. (eds.) The Oxford handbook of philosophy and psychiatry. Oxford: Oxford University Press. pp. 321–356