Words are flowing out like endless rain into a paper cup, They slither while they pass, they slip away across the universe Pools of sorrow, waves of joy are drifting through my open mind, Possessing and caressing me
Excerpt from Across the Universe by The Beatles (Lennon & McCartney, 1970) In this chapter I will outline my view on the construction of knowledge, which is inspired by both critical theory and postmodernist ideas. These ideas affect both the way I research, and the way I interpret previous knowledge. Also, this worldview is defining for how I perceive the modern psychiatric institution and the use of coercive means for people with mental health challenges. Hence, this worldview is important for my research project on music therapy as a voluntary based part of coercive mental healthcare. I will try to clarify how I come to think of my philosophical stance as a ‘postmodernism-in-formed critical perspective’.
As an introduction to this chapter I will describe how I understand the terms episte-mology, ontology and axiology, and the relationships between these concepts. Then I will portray my understanding of critical theory, before describing postmodernism as an umbrella term, which is strongly influenced by the scholar Mats Alvesson (2002).
Two postmodernist ideas are especially are important for my current worldview, and I will investigate these more profoundly: the idea of discourses as understood by Michel Foucault (2002, 2009a), and the idea of deconstruction as presented by Jacques Derrida (1997, 2004a, 2004b). Later on I will give a short introduction to the field of disability studies, as I see this approach as relevant for both my postmodernist worldview and my role as a health researcher. Further, I will present notions from the Convention on the Rights of Persons with Disabilities (CRPD), from critical pshyciatry, and from ideas about freedom, as part of the ethical-philosophical foundation for this study.
2.1 Methodology
The concept of truth is dependently related to our understanding of knowledge and to our view on being in the world. The history of science shows that different views on knowledge affect the research; methods used, language used to present findings, and objects of research, all is dependent on the researcher’s understanding of knowledge (Thornquist, 2003). And vice versa; the researcher’s choices can indirectly tell us a great deal about the researcher’s view on important fields, her favourite area of investigation, the research traditions she is a part of, and of what she wants to find out, through the methods she believes will give adequate answers to the research questions.
With the term methodology I refer to the underlying attitudes, expectations, values and beliefs that make the foundation for academic work; there are reasons for what we do and how we do it. In order to understand better the choices I make as a researcher, it is vital that I also make transparent my view on the construction of knowledge. I will start by introducing my fundamental view on the metaphysics, and describe how knowledge, understanding and ethics are highly connected with each other.
2.1.1 Epistemology, ontology, and axiology
As we embark the ship of philosophy, and leave the steady ground for a while, I will start by introducing three terms as a matter of precaution: epistemology, ontology and axiology. Whenever the shores feel too unsteady, these terms may guide the way back to safety, knowing that every obscure or farfetched theory can always be reduced down to these three ideas.
Epistemology is the matter of what we can know and what we cannot (Ruud, 2005).
Although the concept of metaphysics has been mused upon for ages within the human-ities, and is still an important part of certain academic circles, the same cannot be said to be true for all academic environments. There are theories in our culture that are held to be truer than others. Within certain scientific milieus there are also methods that are claimed to reveal unshakeable facts about our nature of existence. I do not support the idea that knowledge is a neutral concept or some sort of bottomless source of truth, from which we may acquire useful information whenever we want. I do not believe that the perfect methodological approach reveals the truth. Later in this chapter I will present my understanding of how Michel Foucault (2002) challenges thoughts on knowledge through the idea of discourse; he argues that a deep network of discourses within a given institution provide rules for how we think and what we know. It is a matter of epistemological doubt when researchers question the positivistic definition of truth, and
when people criticize the ‘evidence’ developed by leading pharmacological corporations.
Also, it is a question of epistemology when I believe that I cannot possibly know what the research participants of this study think or experience; I can never know more than my interpretation of their narratives.
Ontology is the concept of being (Ruud, 2005), of what is and what is not. Or perhaps we should pay more attention to what it is. Questions pertaining to ontology scrutinize what we think about everything around us, either abstracts or concretes, and potentially criticizes the beliefs taken for granted that define our understanding. When I research on human experiences about music therapy as a voluntary part of treatment in coercive mental healthcare, there are several questions that could be raised regarding the nature of my research theme. When the French-Algerian3 linguist and scholar Jacques Derrida (2004a, 2006) speaks of deconstruction, as will be presented later in this chapter, he occupies a critical attitude towards terms that are taken for granted, and stresses that we fail to understand this specific signifier if we do not view it in relation to its opposites, or that which is left behind. Deconstruction is a way to think critically about ontology.
Axiology refers to ‘the study of values’ (Oxfordreference.com, 2016), and is a relevant term whenever we want to investigate the hierarchy of importance, or in which order we organize what we believe is right. When I say that people should have the same opportunities in life, regardless of ethnicity, religious background or sexuality, this is in line with my values. This point of view is no truer than any right-wing populist’s belief that we must protect our national heritage, - keep it as clean as possible, and get rid of all abominations that hold a threat to our beautiful kingdom. The latter view is possibly further away from the basic human rights declared by the United Nations (1948), which values every person equally, but these declarations are also a matter of axiological questions. It is a matter of axiological questions when we try to find the
‘right’ balance between self-determination and protection of both service users and health professionals in compulsory mental healthcare.
Sometimes it may seem artificial to distinguish between the three; epistemology, ontol-ogy and axiolontol-ogy. To me, the question of knowledge and reflection is overarching; how we perceive the world will determine what we think is right. And vice versa, what we believe is right will decide how we understand the world. My wish to be part of a culture that supports equality and dignity is a matter of axiology. This is tied to how I under-stand human health and well-being, which is a question of ontology. My critical view on mental healthcare, together with my investigation of voluntariness in compulsory mental healthcare, is connected with both axiology and ontology. The fact that I am
3 Jacques Derrida was born and raised in Algeria but lived most of his academic grown-up life in Europe and in The United States of America.
often critical towards economic reports and quantified data saying something truthful about human nature comes from my epistemological view: what we think we know about human needs, mental health, and the proper treatment of people using medica-tion and coercion, are all part of the ruling discourses within different cultures. What I think is right does not appear in a vacuum; rather, it is a result of how I understand human culture and the construction of different realities.