Handle with Care

Abstract

This thesis is drawn from an empirical project that sought to better understand the work of clinician-patient relationships in psychiatry in a contemporary, mainstream Western societal context. The project was carried out over two years in New Zealand and was then written up over two more. It took a phenomenological, hermeneutic approach that shaped itself as it went. There was no hypothesis that the project sought to prove or disprove. Instead, the aim was just to try and understand in as open and honest a way as possible what was going on in these therapeutic relationships, and what it meant to those concerned. This task involved getting to know two community mental health teams, how they worked and what they did. I got to know these teams as communities in their own right – communities who, in turn, were situated within a wider community that was situated within wider society, each affecting the other in all directions. Within this context, I got to know nine people individually through a series of open-ended, one-to-one interviews. In these conversations, five people spoke as patients and four spoke as clinicians. Each person guided me into their lives, hosted me there, and then shared their world as they did so. From here, they each articulated their understanding of the clinician-patient relationship, its work, and what it meant to them. In the end, the story that is told in this thesis is about understanding what it means to see and to hear another person … what it means to be present in the world as a human-kind-of-creature, and to light it up in meaning. Ultimately, it’s about learning to hear beyond categories … learning to hear with ‘open ears’, the right kind of ears … so that, finally, I can say to this person who stands before me, “I hear you, now”, so that we can go from there.