Does understanding individuals require idiographic judgement?

Idiographic understanding has been proposed as a response to concern that criteriological diagnosis cannot capture the nature of human individuality. It can seem that understanding individuals requires, instead, a distinct form of ‘individualised’ judgement and this claim receives endorsement by the inventor of the term ‘idiographic’, Wilhelm Windelband. I argue, however, that none of the options for specifying a model of individualised judgement, to explain what idiographic judgement might be, will work. I suggest, at the end, that narrative, rather than idiographic, understanding is a more promising response to the limitations of criteriological diagnosis

Access, accountability, and the proliferation of psychological therapy:On the introduction of the IAPT initiative and the transformation of mental healthcare

Psychological therapy today plays a key role in UK public mental health. In large part, this has been through the development of the (specifically English) Improving Access to Psychological Therapies (IAPT) programme. Through IAPT, millions of citizens have encountered interventions such as cognitive behaviour therapy, largely for the treatment of depression and anxiety. This article interrogates how this national response to problems of mental ill-health – and the problematization itself – was developed, accounted for, and sustained. By imbricating economic expertise with accounts of mental ill-health and mechanisms of treatment, IAPT has revivified psychological framings of pathology and therapy. However, it has done so in ways that are more familiar within biomedical contexts (e.g. through recourse to randomized controlled trial studies). Today, the initiative is a principal player in relation to which other services are increasingly developed. Indeed, in many respects IAPT has transformed from content to context within UK public mental health (in a process of what I term ‘contextification’). By documenting these developments, this paper contributes to re-centring questions about the place and role of psychology in contemporary healthcare. Doing so helps to complicate assumptions about the dominance of linear forms of (de)biomedicalization in health-systems

Comprehensive or Comprehensible Experience? A Case Study of Religion and Traumatic Bereavement

The first half of this article provides a brief overview of two respective projects concerning traumatic bereavement, in which religious faith appeared to feature amid a constellation of significant coping and sense-making mechanisms for survivors. After presenting some illustrative examples of the kind of data produced in the course of our research, the second half of the article develops a retrospectively critical appraisal of our data collection and corresponding analysis practices. In questioning the extent to which our accounts of our participants’ accounts can be considered adequate representations of social order, we critically explore the relative potential of ‘reflexivity’ for bridging the experiential gap between researchers and participants. Taken together, these reflections prompt a return to the salutary question: what counts as sociologically ‘see-able’

What is psychiatry? Co-producing complexity in mental health

What is psychiatry? Such a question is increasingly important to engage with in light of the development of new diagnostic frameworks that have wide-ranging and international clinical and societal implications. I suggest in this reflective essay that ‘psychiatry' is not a singular entity that enjoins consistent forms of critique along familiar axes; rather, it is a heterogeneous assemblage of interacting material and symbolic elements (some of which endure, and some of which are subject to innovation). In underscoring the diversity of psychiatry, I seek to move towards further sociological purchase on what remains a contested and influential set of discourses and practices. This approach foregrounds the relationships between scientific knowledge, biomedical institutions, social action and subjective experience; these articulations co-produce both psychiatry and each other. One corollary of this emphasis on multiplicity and incoherence within psychiatric theory, research and practice, is that critiques which elide this complexity are rendered problematic. Engagements with psychiatry are, I argue, best furthered by recognising its multifaceted nature

The Talking Cure as Action: Freud's Theory of Ritual Revisited

Freud made creative use of late Victorian theories of ritual as empty modes of behavior, using the idea of seemingly meaningless ritual to offer a compelling comparison with obsessive behavior. However, analytic hours, with their repetitive frame and repetition of unconscious conflicts, have stronger links with rituals than Freud admitted. Recent theories highlight the extensive power of rituals to organize and instantiate models of effective action, especially in terms of the multifunctionality of language. These new theories of ritual offer in turn new tools for understanding the therapeutic action of analytic hours. © 2011 Association for the Advancement of Psychoanalysis