Towards ‘a postmodernism-informed critical perspective’ and its implications for this study

The different theoretic perspectives described above bring some implications for my research on music therapy within compulsory mental healthcare. Although the men-tioned perspectives differ in many ways, I find them valuable for my interpretation of user accounts and for my understanding of the status of compulsory mental healthcare.

I will in the following describe my eclectic philosophical position as ‘a postmodern-ism-informed critical perspective’.

Hermeneutical thinking teaches us cautiousness when interpreting phenomena in our culture, and reminds us that as human beings we cannot make neutral observations from a distance; we are always already part of the world we are observing. All research is coloured by the researcher and the researcher’s interests, but the subjectivity of the researcher is an even more problematic when human beings investigate human beings.

When interpreting the meaning of a ‘text’, in a broad sense, we need to take into account the circumstances of the meaning making, as well as the prejudgments of the interpreter.

We need to accept that we can never really understand the true meaning of an account, as the horizons of both sender and receiver melt together and possibly make up new meanings. All this considered, we can still make use of insights that derive from the interpretation, regardless of the potential gap between interpreted meaning and the original thoughts behind the text.

The text will sometimes carry meaning that was not necessarily part of the initial idea behind the text. There is always already a culture in prior of the text. The culture is a great part of the language that is used, and whether or not intended, the text brings with it specific traditions and ways of thinking. And as long as the same language is being used,

the culture will continuously renew and legitimate itself. But as suggested by critical theorists, unfortunately the culture does not provide the best frames for everybody to flourish, rather there are privileged people on the top who benefit from keeping the culture unbalanced. We learn from critical theory to look for, and to reveal, iniquities in society. And according to voices within critical theory, I support that research within the social sciences and within the humanities should stress being part of an emancipat-ing project, which seeks to make society a little more just. From critical theory I also bring with me the belief that a researcher, at least within social sciences, can never stay neutral: either I accept iniquities, or I criticize inequities. I also very much support music therapist Brynjulf Stige (2003) when he writes about music therapists’ responsibilities for supporting marginalized groups in society:

While working directly with the individual and/or group, crucial interven-tions in the process may also be directed toward the community itself, for instance in order to work with attitudes and traditions that create barriers in the community. Very often, lack of economic priorities given by the muni-cipality or other funding agencies limit client’s possibilities for growth and development. The work of the music therapists therefore also has a political dimension to it. Therapists cannot be indifferent about the political discussion of education, health, and culture. (Stige, 2003, s. 264)

Critical theory brings me closer to a position in which I, as a researcher, am more aware of the iniquities of marginalized groups in society. Critical theory also makes me believe that it is important that I write about repression when revealed. I believe that it is in line with critical theory that I include notions from The Convention on the Rights of Persons with Disabilities in the study, and consequentely take an active stance in rejecting the

‘treatment criterion’ as a valid argument for coercive options.

Postmodernist ideas affect my worldview to a great extent, and are thus relevant for my engagement with the field of compulsory mental healthcare. Through postmodernism I am reminded that what we think is limited to the language we use, and that the inter-pretation of phenomena around us are affected by the words we use to describe them.

Through postmodernism I have come to believe that researchers cannot merely accept modern institutions in society as results of natural or flawless evolutions, rather they are constructed and maintained through webs of discoursive rules. This means that I cannot take for granted that mental healthcare in its current form is necessarily formed to serve the service users as best as possible. The mental healthcare has been socially constructed over time through ruling discourses, and a multiple-layered collective men-tality have helped to maintain a patriarchal mental healthcare since the beginning of the

modern age, in which experts have had the power to define people’s health challenges with few attempts of creating the necessary dialogue with the service users.

Dis/ability studies make up a compound theoretical field that includes postmodernist perspectives. One central part of dis/ability studies is the relationship between the terms disability and ability, and how the terms are comprehended in cultures that significally value ableism. Through the deconstruction (or rather co-construction) of the term dis/ability, it becomes clearer that we need to provide new understandings of disabilities; it is not disabilities that limit persons, as much as the elevated view on ableism in neoliberal cultures, and the scarce accommodation to include different persons despite their individual variation.

Randi Rolvsjord (2014) describes two different and important perspectives regarding her engagement with disability studies: 1) the feminist perspective connects with perspectives on gender, race, class and disability, and 2) a critical perspective towards the medical model includes thoughts from ‘positive psychology, empowerment philos-ophy, contextual models in psychotherapy, and recovery models’ (Rolvsjord, 2014, p.

2). Rolvsjord stresses the similarities between disability studies and a critical approach to modern mental healthcare:

In my understanding, there are clear similarities between these perspectives and disability studies with regard to the critique of the medical model, the focus on human rights and anti-oppressive practice, the focus on strengths and participation, and the critique of individualist models. (Rolvsjord, 2014, p. 2) Music therapy as an academic discipline needs to be critical to the society we are part of, and to not take for granted the present medicalised and individual understanding of mental health. Disability, challenges, stigmas, and exclusion do not happen in a vacuum;

rather, the challenges for the client group in this study occur within cultural discourses.

I agree with Rolvsjord in that it seems relevant to combine the two: 1) dis/ability studies, inspired by postmodernist ideas, and 2) critical perspectives. In the quote above Rolvsjord mentions both a critique of the medical model and the focus on human rights. Below I will include perspectives from both critical psychiatry/post-psychiatry and The Convention on the Rights of Persons with Disabilities. I find that both of these perspectives also fit with the combination of postmodernist ideas of representation and a critical perspective that call for emancipation. I believe that discourses make up the Norwegian mental health institutions the way we see it today; different understandings, beliefs, and local truths about compulsory mental healthcare will occur, depending on the discourses from which people perceive the institutions. I believe that the idea of

compulsory mental healthcare is made up of multiple discourses, from the political and governmental level all the way down to everyday life inside the institutions. The assorted work staff, the service users, and the politicians speak differently about com-pulsory mental healthcare, and they understand coercive measures differently. I also believe that it is the researcher’s task to look for injustice, and to speak it out loud if injustice is revealed. Thus, I find my self in the crossing between different traditions.

And for the reasons mentioned above I will name my eclectic philosophical stance ‘a postmodernism-informed critical perspective’.

The philosophical stance that I have outlined in this chapter presupposes ontological challenges, particularly regarding the representation of user perspectives. A postmod-ernist approach is not self-evident when trying to understand the actual world through

‘empirical investigations’, such as interviews. Discourse analysis or a proper deconstruc-tion may seem to hold a more immediate relevance to postmodernism. When I choose to interview music therapy participants in this study, it is performed with an awareness of the limitations of mediated information. I believe that I can never acquire first hand knowledge about the participants’ experiences. At best I can interpret their stories of the experience, constructed through language and discourses. Hence, the findings that I refer to in the dissertation can never be held as true, or at least not as the one truth.

It should be made clear that the themes that ‘appear’ through a thematic analysis of the interview scripts are really constructed areas of interests, and a means to answer semi-specific research questions. At the same time I need to be aware of, and to clarify as much as possible, the traditions that I am part of, in order to make transparent the ruling discourses that lay the foundation for my interests, for the area of investigation, and for the construction of the research as a whole.

As a researcher I also need to be aware of the relationship between power and knowl-edge, for with power follows ethical dilemmas. I write my thesis from within certain discourses, as a researcher but with a music therapist identity, and I speak to readers within certain discourses. When writing this thesis I do not firstly speak to the service users whose lives and recovery processes I define throughout the research process. It is crucial that I scrutinize my own works, and make sure that I make use of the power in a way that is advantageous for the ones I seek to aid. I believe that it is my duty, as an academic of a health profession, to take part in both political and professional debates, and to take sides with marginalized groups that are often suppressed and disabled in our neoliberal culture, including people within compulsory mental healthcare. I will not take for granted the current medicalised mental health institution as a natural and final end of a teleological development. Until we truly have tried other alternatives to coercive means, we need to be critical of the ruling discourses that make up the master narrative of compulsory mental healthcare.

2.4 The Convention on the Rights