Creating a space for recovery‐focused psychiatric nursing care Within contemporary mental health‐care, power relationships are regularly played out between psychiatric nurses and service users. These power relationships are often imperceptible to the practicing nurse. For instance, in times of distress, service users often turn to or/and ‘construct’ discourses, beliefs and knowledge that are at odds with those which psychiatric nurses rely on to inform them of the mental status of the service user. The psychiatric nurse is in the position to (...) impose knowledge onto service users, usually in concurrence with ‘traditional or bio‐psychiatry’, without realizing or failing to acknowledge that the service user may have an alternative explanation of his/her mental health problems/experiences. In this paper, practice examples, based on the experiences of the four authors (from within and outside of services), are used to illustrate this ‘hidden’ power relationship. The authors use Foucault's ideas about: (i) government; (ii) the knowledge/power nexus and resistance; (iii) and his analytic tool of genealogy to help unravel this paradox within psychiatric nursing practice. The authors also use the emerging discourse of recovery as an alternative (and challenge) to ‘traditional bio‐psychiatry’ and consider the implications for psychiatric nursing practice. (shrink)

This article argues that a new diagram is emerging in the criminal justice system as it encounters developments in the neurosciences. This does not take the form that concerns many ‘neuroethicists’ — it does not entail a challenge to doctrines of free will and the notion of the autonomous legal subject — but is developing around the themes of susceptibility, risk, pre-emption and precaution. I term this diagram ‘screen and intervene’ and in this article I attempt to trace out this (...) new configuration and consider some of the consequences. (shrink)

This essay considers the structure of risk in health campaign formation and design by examining an early 20th century federal campaign to reduce infant mortality. Health campaigns navigate the gap between study and practice, translating quantitative findings into prescriptive responses for individual consumers of the text. By focusing specifically on the visual rhetoric of risk, this campaign serves as a case study to examine how the public was taught to see and understand risk and preventive health at a critical point (...) in the development of public health in the United States. (shrink)

Although histories of cognitive behaviour therapy have begun to appear, their use with people with psychosis diagnoses has received relatively little attention. In this article, we elucidate the conditions of possibility for the emergence of cognitive behaviour therapy for psychosis (CBTp) in England between 1982 and 2002. We present an analysis of policy documents, research publications and books, participant observation, and interviews with a group of leading researchers and senior policy actors. Informed by Derksen and Beaulieu’s articulation of social technologies, (...) we show how CBTp was developed and stabilised through the work of a variety of overlapping informal, academic, clinical, professional, and policy networks. The profession of clinical psychology played a key role in this development, successfully challenging the traditional ‘division of labour’ where psychologists focused on ‘neurosis’ and left ‘psychosis’ to psychiatry. Following Abbott's systems approach to professions, we identify a number of historical factors that created a jurisdictional vulnerability for psychiatry while strengthening the jurisdictional legitimacy of clinical psychology in providing psychological therapies to service users with psychosis diagnoses. The National Institute for Health and Clinical Excellence played a significant role in adjudicating jurisdictional legitimacy, and its 2002 schizophrenia guidelines, recommending the use of psychological therapies, marked a radical departure from the psychiatric consensus. Our analysis may be of wider interest in its focus on social technologies in a context of jurisdictional contestation. We discuss the implications of our study for the field of mental health and for the relationship between clinical psychology and psychiatry. (shrink)

The paper contrasts understandings of knowledge grounded in Enlightenment norms with the departures from those norms taken by some strands of feminism and hermeneutics, as well as the contributions made by the writing of Michel Foucault. A reading of Foucault's writings on knowledge, power and the discursive constitution of self and world is offered as a potentially useful frame within which to raise questions about nursing, nurses and knowledge.

The existence of ‘postnatal’ or maternal depression (PND) is contested, and subject to various medico-legal and cultural definitions. Mothers remain subject to complex systems of scrutiny and regulation. In medico-legal discourse, postnatal distress is portrayed as a tragic pathology of mysterious (but probably hormonal) origin. A PND diagnosis denotes ‘imbalance’ in the immediate postnatal period, although women experience increased incidence of depression throughout maternity. Current treatment patterns emphasise medication and tend to elide the perspective of the individual sufferer in favour (...) of a blanket disease model. I emphasise the need for a feminist reassessment of maternal distress and the means available to ‘testify’ to its forms, and argue for PND to be analysed in biopolitical terms, perhaps as a ‘habitus’ materialising the low status and pervasive privatisation of Western mothers. (shrink)

How and from where can power be criticized and resisted? The advent of new managerial forms of power has brought the question once more to the fore. One of the salient issues is whether the ubiquity and apparent omnipotence of contemporary forms of managerial power renders critique and resistance difficult. This article compares the critical potential of French pragmatic sociology and Foucauldian-inspired genealogy. We argue that both approaches offer viable critiques of contemporary forms of power. Yet, whereas the critique of (...) pragmatic sociology hinges on the position of those who exercise critique and/or resist, genealogical critique depends on the concrete form of power that is being scrutinized. We argue that even though we see critique as modus as more convincing than critique as locus, the two approaches can inspire each other in order to advance effective critique. (shrink)