Mental health from post-structuralist paradigm

Poststructuralist ideas entail a de-centered position and bring the focus back on the individual.

I have been practicing as Mental Health Professional for the past several years, mainly in private practice and in community mental health settings. In my practice, I have been routinely seeing people facing severe mental health challenges and helped them overcome these issues in these settings. Over the years, I have drawn inspiration from a wide range of psychotherapeutic ideas and practices but post-structuralist ideas and practices take special attention and remain central to my work.

I work in collaboration with psychiatrists and other mental health professionals and people who are referred to me and who choose to consult me primarily want to overcome the mental health challenges that they are facing, the problem descriptions and narratives, that are bothering them, which are largely situated in a medical model, namely, depressive disorders, anxiety disorders, obsessive-compulsive disorders, eating disorders, personality disorders, relationship issues, suicidal thoughts, self-harm, insomnia, psychotic symptoms like delusions and hallucinations, and so on.

For the past few years, I have been working on this format to align it with post-structuralist ideas and framework and situate the problem in the psycho-socio-cultural-historical-political-biological landscape rather than in the person.

Using my years of experience, I have developed a particular working format and a knowledge framework, which have resulted primarily in an effective way for me to work and help my clients overcome these issues. When a patient seeks help from me, they have to fill a detailed intake-form, then they have to go through an intake consultation session and post which particular assessments are administered to come to a better understanding of the problem, which also helps in setting baselines and in making a provisional diagnosis before we begin the therapeutic work. Many of these processes unknowingly reinforced problem saturated narratives and made negative identity conclusions.

For the past few years, I have been working on this format to align it with post-structuralist ideas and framework and situate the problem in the psycho-socio-cultural-historical-political-biological landscape rather than in the person. After giving a deep thought to these processes, I have worked extensively to overhaul these processes, now, the primary aim of the consultation session is to largely externalize ‘the internalized problem narrative’ by exploring the nature of the problem and come to a common understanding about what influenced these problems and how it limits the person; re-authoring the problem story by exploring the person’s skills, resources and the implicit values in resisting the problems and efforts in preferred living; and lastly setting goals leading to preferred ways of being.

Instead of focusing on classical ‘history of present illness’, I focus on gathering a full, rich, detailed, emotionally meaningful ‘history of resistance’ to the dominant discourses which underscore the presenting problems

The result of the shift in these processes, from exploring ‘problem saturated stories’ to the ‘preferred alternative stories’ is quite apparent in the way the person responds to this process. Rather than privileging singular structuralist stories of loss and failure, helplessness and hopelessness, suffering and conflict, neglect or abuse, the effort is to develop a rich multi-storied post-structuralist narrative of hope, values, dreams, aspirations, joy, connection, intimacy, and successes. The stories of their efforts of resistance which are often invisible come to the fore and are affirmed.

Poststructuralist ideas entail a de-centered position and bring the focus back on the individual. Meaning is created considering the individual in the center and multiple interpretations and sources are considered in meaning-making rather than a singular identity narrative, which is largely a fictitious construct. The client’s culture and society, the dominant discourse, share a significant part in the existence of the problem narrative. Instead of focusing on classical ‘history of present illness’, I focus on gathering a full, rich, detailed, emotionally meaningful ‘history of resistance’ to the dominant discourses which underscore the presenting problems, basically, a re-authoring conversation in which a new story of meaning and identity can emerge.

We offer Narrative Therapy in Mumbai, India, and Online over Zoom. Would you like to explore these dominant stories which lead to the current presenting problems and symptoms?

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