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Negotiating the limits of therapy. Patients’, families’ and nurses’ perspectives on therapeutic failure in the aftermath of the psychiatric revolution,1970s–1980s

Abstract : To a large extent, the history of psychiatric therapy is the history of incomplete cures, defeated hopes, and ever enduring chronicity. Yet while the historiography of psychiatry has paid much attention to the therapeutic successes claimed by psychiatrists, it has had only little to say about its failures. This article offers both a framework for analyzing therapeutic failure in the aftermath of the mid-twentieth century psychiatric revolution and an exploration of the ways in which it has been problematized in three corpuses of publications from families of people with mental illness, psychiatric survivors, and nurses, respectively. I suggest that failure should be understood as a situated concept that emerged, historically, from the complex set of transactions among psychiatrists, their clients, and the wider society. Specifically, I highlight three levels of analysis when addressing therapeutic failure. The first relates to the broader system of expectations surrounding medical practices. At the second level, failure emerges in the course of the administration of a given treatment from the observation that a cure or at least some relief has not been obtained for a given patient. At the third and last level, failure refers to the inability of a clinician to perform his prescribed role. The changing dynamics of treatment administration in the wake of the neuroleptic revolution, the evolving dangers of therapy, and the transformations in the relationship between therapists and patients is then highlighted to offer a broad understanding of failure as an experience and a concept for the various protagonists of the psychiatric drama.
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https://hal.archives-ouvertes.fr/hal-03179019
Contributeur : Nicolas Henckes <>
Soumis le : vendredi 26 mars 2021 - 09:25:33
Dernière modification le : mardi 8 juin 2021 - 17:59:08
Archivage à long terme le : : dimanche 27 juin 2021 - 18:04:40

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Nicolas Henckes. Negotiating the limits of therapy. Patients’, families’ and nurses’ perspectives on therapeutic failure in the aftermath of the psychiatric revolution,1970s–1980s. Medizinhistorisches Journal, 2021, 56 (1-2), pp.79-102. ⟨10.25162/mhj-2021-0004⟩. ⟨hal-03179019⟩

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