Escaping Psy-Dominance: Ideas from Critical and Community Psychology

One of the four workgroups at the Birmingham conference in Sept 2015 was by Mel Wiseman-Lee and Jonathan Gadsby, titled ‘Escaping Psy-Dominance: Ideas from Critical and Community Psychology’. (Other session summaries will be available soon).

The session aimed to discuss the critical voices within psychology and introduce the network of recent developments there. Also, to generate discussion, particularly around three recent documents (links below) from the Division of Clinical Psychology, part of the British Psychological Society. Dr Mel Wiseman-Lee has strong links with Critical and Community Psychology in the UK, is a clinical psychologist working in the NHS, and has recently written a masters module on critical and community psychology – we were all very grateful for her input.

For the presentation with audio voice-over, approx 20mins, (audio made by Jonathan, after the day for the benefit of those not present), click here (opens Youtube video).

For a simpler and quicker pdf version of the presentation, use the following link: Psy Dominance Presentation, 090915

Please do not use either of these above resources (whole or in part) for teaching purposes without permission.

Three key documents introduced in this presentation are:

The Division of Clinical Psychology Position Statement, please click on this link: DCP-Position-Statement-on-Classification

The British Psychological Society/Division of Clinical Psychology publication: Understanding Psychosis and Schizophrenia, edited by Anne Cooke, 2014. Click on this link: understanding_psychosis_-_final_19th_nov_2014

The British Psychological Society/Division of Clinical Psychology publication: Guidelines on Language in Relation to Functional Psychiatric Diagnosis, 2013. Click on this link: guidelines_on_language_web

From Jonathan Gadsby:

Discussion in the group was limited due to time constraints, but we focussed a little on the BPS Language Guidelines document. Two of the attendees said that they would attempt to adopt the language described for a trial period and then report back to the Network, through this website, about their experiences. This seemed like an excellent idea as part of a process of introducing this document to the Network and beginning to critically engage with it. If others would like to do the same, please let us know. The aim is that within the next few months we form some kind of Network response. Of course, many critical nurses have been aware (and wary) about the language they use throughout their careers, and much of this document is not in that sense original. However, given that it puts it into clear writing and has been produced at a high level within the psychology profession, it offers something tangible to digest, respond to and critique/recommend. What, in your experience, are the advantages and disadvantages of using this kind of less pathologising language? Where would it be most easy to implement, where most difficult?If you are a service-user, what effect do you think it would have if the nurses you came in contact with were choosing this kind of language? And what if this was in conflict to the language used by other professionals?

The other two documents really demand a similar kind of response. Many will be very interested in the Position Statement and perhaps find a lot there they wish to agree with. Were you aware of it? Were the psychologists in your team aware of it? How does its existence contribute to the kinds of discussions you may want to have in your team and with your nursing colleagues? What are the effects of it for you, personally? How might it affect your ability to discuss alternative explanations to what might be called the bio-medical mainstream?

Perhaps of even greater importance is the Understanding Psychosis document. My personal feeling is that reading it seems to make new ways (are they new?) of working and thinking feel more viable and possible, and that is a very good thing. The plain English of the document seems to be a considerable achievement, although the document is not above criticism. What do you feel are its strengths and weaknesses? Does it go far enough to counter the ‘psy-dominance’ described in Mel and Jonathan’s presentation, above? What light does this document shed on the difficulties you experience as a nurse or service-user, and what would a wider adoption of it as a framework achieve? I think we would all be particularly interested in whether anyone feels able to take this document and share it with the team they work with. If you manage this, what responses did you get? What conflicts did it help to resolve and what conflicts might it bring out into the open? Is this document (and the set of three documents) some kind of endorsement from a ‘high up’ and ‘official’ source for some of your own views, and is that empowering? Or do you see it differently? One of the DCP executive recently told me that they feel that psychologists are simply not a large enough group to effect the kinds of cultural change implied by these documents – for that, they are going to need nurses in agreement. We had already decided that we wanted to ask Mel to help us with this session, so it was not a case of us ‘recruiting’ on their behalf!… But is this document the kind of outlook you feel you could be ‘recruited’ into, or not? What are your reservations? Is there a sense that in drawing upon such a document for support nurses are somehow ‘switching allegiance’ from psychiatrists to psychologists? Or is it not really like that? Would it matter if it was? Do nurses have that kind of allegiance to psychiatry, anyway? Is this document broad enough to make it more than simply ‘psychological’, regardless of who wrote it?

Please feel free to see this page as the beginning of a conversation, to which you can contribute via ‘comments’. I have asked some questions, but you may have other ones. I will also ask some of the authors of these documents to read and comment/answer questions you may have. Thank you once again to those who attended this session and contributed so thoughtfully – sorry that time was against us – I hope you will continue to involve yourself here – and that other readers will feel equally welcome.