Chapter 8 in:
Hope and Despair in Narrative and Family Therapy: Adversity, Forgiveness and
Reconciliation, Flaskas C., McCarthy I., and Sheehan J. (eds.). Hove: Brunner-
Anticipating hope within written and naming domains of despair
By Stephen Madigan
In his paper Madigan advocates for a shift away from institutional labelling “pathologizing” and “pathology oriented” thinking inherent in the “relational politics of dominant norms” in clinical psychology. To the layman, this relates to the suite of around 400 potential and institutionally described dysfunctional states of the human mind, into which clinicians are seemingly keen to funnel each presentation of (so-called) abnormality. Madigan describes the “post structural dialogic view of self” as the mode by which narrative recoding is able circumnavigate the constraints of dialectic thinking (where supremacy of the dominant mode is established and adhered to). Madigan describes the rigidity of pathologized identity as a mechanism whereby the dysfunctional person is appropriated into preconditioned labels, which in turn serves to decontextualize the reality of their experience. In this mode of preconditioning, Madigan believes that any anticipation of hope is extinguished once the institutional label is applied to the person, and argues that “the client is instructed to anticipate the limits of their life course in a particular & non hopeful way” (page 177).
Institutional labelling serves to bind the person with their problem when the goal is to detach the sufferer from their suffering and prove that they can potentially become free from these imposed states of being. Lived experience reveals the constant state of self-binding activity inherent in the narrative of person and problem. Carrying a label of “ACOA”, or GAD sufferer is possibly self-fulfilling in this sense in terms of performing the pathologizing role on behalf of the institutionalised practitioner. Madigan therefore speaks of the limitations in the discreet taxonomy of dominant knowledge, that “problem identity”, however externally derived or classified, is manifestly misrepresentative or decontextualized from individual identity (page 181).
Madigan reflects upon the limitations of therapeutic interview models, suggesting alternative and more critical “counter viewing” approaches that seek to establish greater contextual truth around individual problems that allow for opportunities to apprehend the possibility of alternative (and more hopeful) outcomes. His approach is to create “spaces of resistance” in order to dispel the often seemingly hopeless dominant narrative.