Examining privilege, puzzlement and the problematic positioning of the ‘psychologist’ as internal consultant in psychologically-informed environments

Abstract

Deliberate self-harm and the attribution of intentionality – that sufferers are choosing to harm themselves – have become dominant constructs within mainstream Western mental health care. The aim of this paper is to explore the author’s privileged positioning as internal consultant, whereby psychological knowledge was used to explain why a chronically excluded homeless adult refused an invitation to reside inside. The attribution of intention to an individual perceived as engaging in deliberate self-harm is explored over three psychological case discussions with staff. A critique is offered that psychologised attributions merely add to patients’ existing predicaments and psychosocial dismemberment. Scanlon and Adlam’s seminal work on reciprocal violence is referenced as a critique, that instead of choosing to harm oneself, subjects are communicating to carers their internalised experiences of interpersonal violation and neglect which have in turn given rise to violent states of mind. The paper could be used as a reflective aid to facilitate clinicians and scholars to consider how to digest violent and unthinkable material, and consider one’s own personal obstacles to thinking about unhoused minds and psychosocial dismemberment.