Skip to main content
Log in

Clinical writing and the documentary construction of schizophrenia

  • Published:
Culture, Medicine and Psychiatry Aims and scope Submit manuscript

Abstract

Psychiatric practice involves writing as much as it involves talking. This study examines the interpretive processes of reading, writing and interviewing which are central to the clinical interaction. It is part of a broader ethnographic study of an Australian psychiatric hospital (which specializes in the treatment of patients with a diagnosis of schizophrenia). The paper examines two major types of written assessment of patients — the admission assessment and the ‘complete work-up.’ Writing is analyzed as performance, thereby focusing on the transformations that are effected in patients, their perceptions of their schizophrenia, and their total identity. One crucial transformation is from ‘person suffering from schizophrenia’ to ‘schizophrenic.’ The paper aims to show that as much as psychiatry is a ‘talking cure’ it is also a ‘writing cure.’

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Austin, J. L. 1962 How to Do Things with Words. London: Oxford University Press.

    Google Scholar 

  • Bosk, Charles 1979 Forgive and Remember: Managing Medical Failure. Chicago: University of Chicago Press.

    Google Scholar 

  • Burke, Kenneth 1969 A Rhetoric of Motives. Berkeley: University of California Press.

    Google Scholar 

  • Chafe, Wallace L. 1982 Integration and Involvement in Speaking, Writing and Oral Literature. In Deborah Tannen, ed., pp. 35–54. Norwood, New Jersey: Ablex.

    Google Scholar 

  • Chapman, J. 1966 The Early Symptoms of Schizophrenia. British Journal of Psychiatry 112: 225–251.

    Google Scholar 

  • Cicourel, Aaron V. 1968 The Social Organization of Juvenile Justice. New York: John Wiley and Sons.

    Google Scholar 

  • Cicourel, Aaron V. 1974 Interviewing and Memory. In Pragmatic Aspects of Human Communication. C. Cherry, ed., pp. 51–82. Dordrecht: Reidel.

    Google Scholar 

  • Daniels, Arlene Kaplan 1975 Professionalism in Formal Organizations. In Processing People: Cases in Organizational Behaviour. John B. McKinley, ed., pp. 303–338. London: Holt, Rinehart and Winston.

    Google Scholar 

  • Dreyfus, Hubert L. and Paul Rabinow 1982 Michel Foucault: Beyond Structuralism and Hermeneutics. Sussex: The Harvester Press.

    Google Scholar 

  • Erikson, Kai T. and Daniel E. Gilbertson 1969 Case Records in the Mental Hospital. In Stanton Wheeler, ed., pp. 389–412.

  • Foucault, Michel 1973 The Birth of the Clinic: An Archeology of Medical Perception. London: Tavistock.

    Google Scholar 

  • Foucault, Michel 1977 Discipline and Punish: The Birth of the Prison. Harmondsworth: Penguin Books.

    Google Scholar 

  • Frank, Gelya 1979 Finding the Common Denominator: A Phenomenological Critique of the Life History Method. Ethos 7: 68–94.

    Google Scholar 

  • Frankel, Richard M. 1984 From Sentence to Sequence: Understanding the Medical Encounter through Microinteractional Analysis. Discourse Processes 7: 135–170.

    Google Scholar 

  • Freidson, Eliot 1970 Profession of Medicine: A Study in the Sociology of Applied Knowledge. New York: Harper and Row.

    Google Scholar 

  • Garfinkel, Harold 1956 Conditions of Successful Degradation Ceremonies. American Journal of Sociology 61: 420–424.

    Google Scholar 

  • Garfinkel, Harold 1974 ‘Good’ Organizational Reasons for ‘Bad’ Clinic Records. In Ethnomethodology: Selected Readings. Roy Turner, ed., pp. 109–127. Harmondsworth: Penguin Books.

    Google Scholar 

  • Gilbert, Nigel and Michael Mulkay 1980 Contexts of Scientific Discourse: Social Accounting in Experimental Papers. In The Social Process of Scientific Investigation, Sociology of the Sciences, Vol. IV. Karin D. Knorr, Roger Krohn and Richard Whitley, eds., pp. 269–294. Dordrecht: Reidel.

    Google Scholar 

  • Goffman, Erving 1968 Asylums: Essays on the Social Situation of Mental Patients and Other Inmates. Harmondsworth: Penguin Books.

    Google Scholar 

  • Goody, Jack 1977 The Domestication of the Savage Mind. Cambridge: Cambridge University Press.

    Google Scholar 

  • Handelman, Don 1978 Bureaucratic Interpretation: The Perception of Child Abuse in Urban Newfoundland. In Bureaucracy and World View: Studies in the Logic of Official Interpretation. Social and Economic Studies, No. 22. Institute of Social and Economic Research. Memorial University of Newfoundland. Pp. 15–68. Toronto: University of Toronto Press.

    Google Scholar 

  • Heath, Christian 1982 Preserving the Consultation: Medical Record Cards and Professional Conduct. Sociology of Health and Illness 4(1): 56–74.

    Google Scholar 

  • Heath, Shirley Brice 1982 Protean Shapes in Literacy Events: Ever-Shifting Oral and Literate Traditions. In Deborah Tannen, ed., pp. 91–118. Norwood, New Jersey: Ablex.

    Google Scholar 

  • Hymes, Dell 1972 Models of the Interaction of Language and Social Life. In Directions in Sociolinguistics: The Ethnography of Communication. John J. Gumperz and Dell Hymes, eds., pp. 35–71. New York: Holt, Rinehart and Winston.

    Google Scholar 

  • Kleinman, Arthur 1982 Neurasthenia and Depression: A Study of Somatization and Culture in China. Culture, Medicine and Psychiatry 6: 117–190.

    Google Scholar 

  • Labov, William and David Fanshel 1977 Therapeutic Discourse: Psychotherapy as Conversation. New York: Academic Press.

    Google Scholar 

  • Leder, Drew 1984 Medicine and the Paradigms of Embodiment, Journal of Medicine and Philosophy 9: 29–43.

    Google Scholar 

  • MacCarthy, Mary 1951 The Groves of Academe. New York: Avon Books.

    Google Scholar 

  • MacKinnon, Roger A. 1980 Diagnosis and Psychiatry: Examination of the Psychiatric Patient: Psychiatric Interview. In Comprehensive Textbook of Psychiatry, III(1). Harold I. Kaplan, Alfred M. Freedman and Benjamin J. Sadock, eds., pp. 895–905. Baltimore: Williams and Wilkins.

    Google Scholar 

  • Millman, Marcia 1977 The Unkindest Cut: Life in the Backrooms of Medicine. New York: William Morrow.

    Google Scholar 

  • Mishler, Eliot G. 1979 Meaning in Context: Is There Any Other Kind? Harvard Educational Review 49(1): 1–19.

    Google Scholar 

  • Mishler, Eliot G. 1984 The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, New Jersey: Ablex.

    Google Scholar 

  • Movahedi, Siamak 1975 Loading the Dice in Favour of Madness. Journal of Health and Social Behaviour 16(2): 192–197.

    Google Scholar 

  • Pittenger, Robert E., Charles F. Hockett and John J. Danehy 1960 The First Five Minutes: A Sample of Microscopic Interview Analysis. New York: Paul Martineau.

    Google Scholar 

  • Raffel, Stanley 1979 Matters of Fact: A Sociological Inquiry. London: Routledge and Kegan Paul.

    Google Scholar 

  • Ricoeur, Paul 1979 The Model of the Text: Meaningful Action Considered as a Text. In Interpretive Social Science: A. Reader. P. Rabinow and W. M. Sullivan, eds., pp. 73–101. Berkeley: University of California Press.

    Google Scholar 

  • Ricoeur, Paul 1981 Hermeneutics and the Human Sciences: Essays on Language, Action and Interpretation. Cambridge: Cambridge University Press.

    Google Scholar 

  • Rosenhan, David L. 1973 On Being Sane in Insane Places. Science 179: 250–258.

    Google Scholar 

  • Rosenhan, Paul 1981 The Contextual Nature of Psychiatric Diagnosis. In The Sociology of Mental Illness: Basic Studies. Oscar Grusky and Melvin Pollner, eds., pp. 319–329. New York: Holt, Rinehart and Winston.

    Google Scholar 

  • Schneider, Kurt 1974 Primary and Secondary Symptoms in Schizophrenia. In Themes and Variations in European Psychiatry. Steven R. Hirsch, Michael Shepherd and Lothar Kalinowsky, eds., pp. 40–44. Charlottesville: University Press of Virginia.

    Google Scholar 

  • Schutz, Alfred 1962 Scheler's Theory of Intersubjectivity and the General Thesis of the Alter Ego. In Collected Papers, I: The Problem of Social Reality. Maurice Natanson, ed., pp. 150–179. The Hague: Martinus Nijhoff.

    Google Scholar 

  • Schutz, Alfred 1967 The Phenomenology of the Social World. London: Heinemann Educational Books.

    Google Scholar 

  • Schutz, Alfred and Thomas Luckman 1973 The Structures of the Life-World. Evanston: Northwestern University Press.

    Google Scholar 

  • Scott, Marvin B. And Stanford M. Lyman 1968 Accounts. American Sociological Review 33(1): 47–62.

    Google Scholar 

  • Sharrock, W.W. and Roy Turner 1978 On a Conversational Environment for Equivocality. In Studies in the Organization of Conversational Interaction. Jim Schenkein, ed., pp. 173–197. New York: Academic Press.

    Google Scholar 

  • Silverman, David 1975 Accounts of Organizations — Organizational ‘Structures’ and the Accounting Process. In Processing People: Cases in Organizational Behaviour. John B. McKinley, ed., pp. 269–302. London: Holt, Rinehart and Winston.

    Google Scholar 

  • Smith, Dorothy E. 1974 The Social Construction of Documentary Reality. Sociological Inquiry 44(4): 257–268.

    Google Scholar 

  • Strauss, Anselm and Rue Bucher 1975 Professions in Process. In Professions, Work and Careers. Anselm Strauss, ed., pp. 9–23. New Brunswick, New Jersey: Transaction Books.

    Google Scholar 

  • Strauss, J. S. 1969 Hallucinations and Delusions as Points on Continua Function, Archives of General Psychiatry 21: 581–586.

    Google Scholar 

  • Sullivan, Harry Stack 1954 The Psychiatric Interview. New York: W.W. Norton.

    Google Scholar 

  • Tannen, Deborah 1982 Spoken and Written Language: Exploring Orality and Literacy. Norwood, New Jersey: Ablex.

    Google Scholar 

  • Turner, Bryan 1984 The Body and Society: Explorations in Social Theory. Oxford: Basil Blackwell.

    Google Scholar 

  • Vaughn, Christine E. and Julian P. Leff 1981 Patterns of Emotional Response in Relatives of Schizophrenic Patients. Schizophrenia Bulletin 7(1): 43–44.

    Google Scholar 

  • Weber, Max 1970 Bureaucracy. In From Max Weber: Essays in Sociology. H. H. Gerth and C. Wright Mills, eds., pp. 196–244. London: Routledge and Kegan Paul.

    Google Scholar 

  • Wheeler, Stanton 1969 On Record: Files and Dossiers in American Life. New York: Russel Sage Foundation.

    Google Scholar 

  • Woolgar, Steve 1980 Discovery, Logic and Sequence in a Scientific Text. In The Social Process of Scientific Investigation, Sociology of the Sciences, Vol. IV. Karin D. Knorr, Roger Krohn and Richard Whitley, eds., pp. 239–268. Dordrecht: Reidel.

    Google Scholar 

  • World Health Organization 1978 International Classification of Diseases: Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death. Geneva: World Health Organization.

    Google Scholar 

  • Zimmerman, Don H. 1979 Record-Keeping and the Intake Process in a Public Welfare Agency. In Stanton Wheeler, ed., pp. 319–354.

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Barrett, R.J. Clinical writing and the documentary construction of schizophrenia. Cult Med Psych 12, 265–299 (1988). https://doi.org/10.1007/BF00051971

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00051971

Keywords

Navigation