Deconstructing the Language of Psychotherapy Documentation

Abstract

In this paper, the author examines the role that psychotherapy documentation plays in community mental health: documentation’s bureaucratic/administrative functions, its foundation in the science of psychiatry, and the impact it has on the clinical situation. His critique of documentation language uses ideas drawn from Samuel Beckett’s 1951 novel Molloy, which deals with the weakness and absurdity of language as a means to express what is often unnamable. Likewise, he draws on Hanna Segal’s idea of symbol formation to offer a psychodynamic explanation for the way language is employed in documenting treatment in community settings, especially the treatment of those with severe mental illness. The author argues that the essence of psychotherapy and what it addresses cannot be captured by the style of documentation imposed on medical/agency settings. He uses his own personal story and a case study to show how the documentation requirements became a source of distress and negatively impacted the treatment.