Hermeneutic Photography: An Innovative Intervention in Psychiatric Rehabilitation Founded on Concepts From Ricoeur (original) (raw)
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Acknowledgements: there were no industrial links or affiliations. For building an exhibition we were funded by funds, one public and one related to health insurance companies, but this was limited to the exhibition and did not concern the research and development of the intervention. The research was done as part of our job as researcher and innovation staff member in the service of GGnet. Disclosure of interests: there is no conflict of interest. Abstract Our aim was to develop and evaluate an intervention that can be used in recovery oriented care to promote recovery processes and goals as found in the CHIME framework [1]. Using the Appreciative cycle and principles from the MRC-Framework for the development and Evaluation of complex interventions an intervention with photography has been designed and tested on 3 long stay wards of a mental health care hospital. 15 Service users participated and were photographed during 4 sessions. The intervention built on the expertise that already existed about rehabilitation approaches, especially the Strengths approach [2] and the findings from earlier studies into hermeneutic photography by the author. The intervention proved to inspire hope and meaning giving in service users and contributed to a transformation of relationships between service users and their mentor nurses. These relationships became more reciprocal and equal. The intervention yielded opportunities for service users to express their wishes and values in life. In this way they made a representation of the persons who they are. The photographs probably contribute to a greater self-esteem of the service users and may inspire them to use the action and what it meant to them for further recovery. The intervention put the service user in the lead and contributed to more mutuality in the relationship with the mentor nurse.
Photo Stories, Ricoeur, and Experiences from Practice.
The purpose of this article is to demonstrate how a particular narrative approach in nursing, namely the photo instrument can be connected with Ricoeur’s hermeneutic philosophy. Ricoeur’s concept of mimesis, when supplemented with the concept of performance, is shown relevant for understanding how patients construct and reformulate meaning in illness experiences. A single-case study is presented for a tentative exploration of how the key concepts of mimesis and performance can broaden our understanding of practice. More specifically it concerned the use of photographs in a group with psychiatric patients.
Nursing Philosophy, 2020
This article is about the therapeutic use of photography in mental health care. We will first describe the intelligent nature of perception as we understand on the basis of neurobiological research findings. We will link our interpretation of visual perception with the phenomenology of perception from the theory of Merleau-Ponty.. Then we will discuss how patients in mental health care with mental health problems may profit by an experiential approach that is concomitant with the existential reality described by Merleau-Ponty. The experiential approach we go into more detail is Focusing. We will demonstrate the limitations and feasibility of Focusing in the procedures of working with photography as a therapeutic medium.
Community Mental Health Journal, 2020
Personal recovery has become a guiding paradigm in mental health services. Most research on recovery is based on the exploration of personal stories of service users through verbal methods. As not everyone with psychiatric problems is able to verbally formulate a recovery narrative, the current study assesses personal recovery through PhotoVoice, with emphasis on visualisation, small stories and participation. Two ten-week groups were conducted with 18 participants living with severe mental illnesses. They participated in both the collection and analysis of visual narratives. Across the images produced by participants, four main recovery themes were found : People, Places, Activities and Finding Meaning. Compared to other frameworks, the emphasis participants put on the theme Places adds value to the understanding of recovery processes. Furthermore, participants showed that recovery is about dealing with vulnerabilities as well as aspiring a meaningful life. This study demonstrates that exploring visual narratives is powerful within recovery oriented mental health.
Facades of Suffering: Clients' Photo Stories about Mental Illness
In this article, photo stories are examined that were the result of working with photography as a therapeutic instrument dealing with suffering in mental health care settings. The purpose is to describe the role of facades in the process of suffering and acceptance. Clients took photographs, talked about them in group meetings, and exhibited them to a broader audience. Their photo stories were analyzed using a mixed-methods model. Data from two narrative approaches (semiotics and hermeneutics) were compared with information from other informants and official records to find discrepancies between the photo story and the real life context. Although facades are usually perceived as an obstacle for personal growth, the visual narratives revealed that facades can function as an alternative to common acceptance strategies, such as facing one’s losses and reconciliation. Facades can create a distance between the person and the suffering. We conclude that visual narratives can reveal and foster agency in clients.
New roads paved on losses: photovoice perspectives about recovery from mental illness
Qualitative health research, 2014
People with serious mental illness face stigma that interferes with recovery. Photovoice is a method that integrates photography and writing, providing a valuable means for capturing the narratives of people with mental illness whose voices are often marginalized. The purpose of the present article is to explore the meaning of recovery for individuals with serious mental illness based on a qualitative analysis of a new photovoice-based intervention, Recovery Narrative Photovoice. This intervention focuses on promoting the process of recovery and sense of identity through the creation of empowering visual images and narratives of recovery for individuals with serious mental illness. In this article, we present iconographic and thematic analysis for the 23 photovoice works from two pilots of the Recovery Narrative Photovoice intervention. Results reveal several themes, including metaphors for mental illness, associated losses, recovery strategies, and recovery outcomes. A final theme ...
Royal Institute of Philosophy Supplements , Volume 94: Lived Experience and Co-Production in Philosophy and Mental Health , Cambridge University Press, 2023
The co-production of meaning' is a phrase that has become entrenched in the field of public mental health, adopted almost as a slogan within the literature. But what does it actually mean? Current definitions gesture toward the very broad idea that co-production involves a collaboration between 'service users' and healthcare professionals, each contributing their knowledge to better understand and treat mental health problems. Yet, terms such as 'equal' 'reciprocal', and 'partnership' fail to clarify the nature of this 'co-production', and how it can be achieved. To better understand the co-production of meaning, we shall attempt to develop an account of co-production through phenomenological psychopathology. Through Hans Georg Gadamer's remarks on 'the hermeneutic problem of psychiatry' two key obstacles to 'co-production' emerge: 1) contingent problems, and 2) intrinsic problems. In calling attention to these obstacles, we problematise the concept of 'co-production' in public mental health, revealing it to be more complex than originally thought. We conclude by arguing that new developments in phenomenological psychopathology can be used to overcome the limitations of 'co-production'.
An Approach Using Photographs As Part Of The Therapeutic Process For The Mentally Ill
- The research explores one approach using photographs as part of a therapeutic process for mental patients in Malaysia. The process described might be utilized in different ways by different actors. In that case, this could be classified as an photo therapy approach. Because the researcher is not a mental health professional and is therefore not qualified to judge the therapeutic value of a particular methodology, this research and its conclusions are confined to this second approach. The approach is as follows: five institutionalized, non-violent patients were selected under the supervision of a doctor aware of the patients’ mental health history. Patients were picked who often exhibited difficultly socializing or communicating or who had difficulty focusing on a particular subject. The researcher presented each patient with 200 photographs of near random images, and the patient was asked to pick one. From that image, patient produced his own artwork using colored pencils. A video recording was made of each patient, including an interview process designed to ascertain the patients frame of mind before and after the drawing process. The medical professional responsible for the patients was presented with information the patient expressed in these interviews and was asked if this behavior was typical or atypical for each patient. The majority of patients who went through this process gave qualitative feedback that indicated perceived improvements in their general mental health state. The most significant observations were that patients appeared: more sociable, more relaxed, more in control and better able to reflect on experiences. Author Keywords :- Photograph, Therapy, Mental Patient
The Photography Use as A Therapeutic Resource
International Journal of Psychological Research and Reviews, 2020
To report the experience of three students who performed an intervention that used photography as a therapeutic resource with users of a CAPS Disorder. Methodology: The intervention was the product of the Workshop on Mental Health of the 6th semester of the psychology course of the Faculdade Pernambucana de Saúde. During the Workshop, the students were able to build knowledge through their experiences and their interactions with the field studied. The experience was divided into three moments. Initially, a photography workshop and a collage activity were held. Afterwards, users went to Engenho Massangana to practice photography. Finally, they organized a photographic exhibition for their families and service staff. Results and discussion: During the activities, seventeen users participated voluntarily. Through artistic experimentation, it was realized that the intervention could favor psychosocial rehabilitation through protagonism, leisure and art. Users were able to explore the place and interact with others, developing a new socializing environment beyond the limits of CAPS. In addition, through the photographic gaze, they created narratives and ways of expressing subjectivity. Conclusion: The intervention allowed the exercise of autonomy and citizenship of service users. Thus, it is extremely important that mental health services promote recreational and leisure social activities, contributing to the social reintegration of individuals who have long been excluded from their families andcom munities.
Psychiatric Truth and Narrative Hermeneutics
What is psychiatric truth? How do psychiatrists understand it? How do they use and abuse it? ese questions preoccupy this chapter, and I will give my perspective from the start. I see psychiatry as a philosophical and narrative hermeneutic practice (Lewis, 2011). is means that "psychiatric truth" always involve questions of interpretation and meaning-making. In keeping with some of the central principles of philosophical hermeneutics, I see humans as meaning-making creatures, or, as Charles Taylor so memorably put it, "self-interpreting animals"-constituted by the way we interpret ourselves and our worlds (Taylor, 1985, p. 96). I appreciate Hans-George Gadamer's foundational insight that interpretation is not "an isolated activity of human beings but a basic structure of our experience of life. We are always taking something as something. at is the givenness of our world orientation, and we cannot reduce it to anything simpler or more immediate" (Gadamer, 1970, p. 87). Or, as John Caputo puts it, philosophical hermeneutics means that interpretation is unsurpassable and that, when we encounter the world, both inner and outer, it's interpretation "all the way down" (Caputo, 2018, p. 4). Narrative hermeneutics adds to philosophical hermeneutics by layering in narrative meaning-making as part of the larger process of human meaning-making (Brockmeier & Meretoja, 2014; Freeman, 2017; Ricoeur, 1991, 1992). is narrative addition is particularly relevant for interpreting ideas of self, identity, and di erence and how we tell the stories of our lives (Lewis, 2011, 2017). From this perspective, psychiatric practice is a subset of philosophical and narrative hermeneutics. Psychiatry, in other words, is a dialogic practice of working with people to make meaningful interpretations of their selves, their worlds, their su ering, their joys, and their psychic di erences (the ways that mental states vary and "normal" mental states only scratch the surface of psychic possibility).