Working In Controlled Environments: Ideas and Reflections On A Phenomenological Stance For Mental Health-Care Professionals

Abstract

This paper aims to show some important themes linked to the very important clinical core of ‘distance’ and ‘stance’ in the clinical work of high intensity psychiatric institutions. In particular this paper concerns patients who have clearly visible symptoms of de-personalisation, de-realisation, hallucinations or other connected phenomena – for their proximity, assonance or clear expression – to schizophrenia or psychosis. In psychiatry, we often find ourselves having difficulties with the concept of ‘distance’ in observational situations as well as when operating in more active roles like proper psychotherapy. With a view to acknowledging and at the same time tackling these difficulties directly, I have tried to design and hence to describe a phenomenological stance that I metaphorically called ‘erranza’.