In this article, we use the intersubjective ethics of Bakhtin and Levinas and a case illustration to explore change in therapy as an ethical phenomenon. We follow Lakoff and Johnson in their emphasis on the way our conceptions of change seem permeated by metaphors. Bakhtin and Levinas both suggest through a language in which metaphors play a crucial role, that human existence—the consciousness and the subject—emerge within the dialogue of the encounter. They both describe the dynamics of human existence as ethical in their origin. Following this, we argue that change may be seen as an ongoing ethical event and that the dynamics of change are found in the ways we constantly become in this event. We investigate the ethical dynamics of this ongoing event through three themes illuminating the contributions of both Bakhtin and Levinas: (1) we become as responsible, (2) we become in speaking, (3) we become in answering the unknown. We explore these themes through a case illustration. Finally, we briefly point out some possible implications for mental health practice.
This article explores how professional relationships may be helpful from the perspective of residents in community-based staffed supportive housing for individuals with severe mental illness (SMI) and/or drug abuse. Residents were individually interviewed about a relationship with a self-chosen staff member, the content of the help provided by this staff member and how this help influenced their lives. Using thematic analysis, we found that the residents described mutual relationships that resembled friendships and helpful staff members who carried out a variety of doings. Four domains of doings were identified: small human gestures, filling the hours with 'friendship', enabling the residents to take care of their own needs and fighting on behalf of the residents to ensure rights and benefits. To some of the residents, these doings had life-changing impact. We propose that mental health service management should facilitate friendship resemblance when matching professionals and service users, and we warn against a pitfall were present 'recovery ideals', such as independency, contradict the idea of helping by doing.
Studies exploring the experiences of recovering from mental health difficulties show the significance of social and relational aspects. Dialogical practices operate within the realm of social relations; individual perspectives are not the primary focus of attention. The present study is part of a series of qualitative studies from southern Norway, exploring dialogical practices and change from the perspective of lived experience and in relationship with network meetings. Two co-researchers, who themselves had experienced mental health difficulties, were part of the research team. Material from qualitative interviews was analysed through a dialogical hermeneutical process where ideas from Emmanuel L evinas and Mikhail Bakhtin were used as analytical lenses. Six interdependent dimensions emerged from our interpretative analysis, comprising three temporal dimensions (1. Dialogues open the moment, 2. Dialogues open the past, and 3. Dialogues open the future) and three dimensions of speaking, which operated across the three temporal dimensions (4. Ethical: Dialogues open through inviting attentiveness and valuing, 5. Expressive: Dialogues open for new vitality, and 6. Hermeneutical: Dialogues open for new meaning). These dimensions were incorporated into one main theme: Dialoguesbeginning by others being invitingly attentiveopen for moving and living. The way the findings point to change events as an opening for movement -'moving in' as if from the outside, and 'moving on' as opposed to being stuckare discussed in relation to other studies.We conclude by suggesting that the salient point of change-generating conversations is in the ethics of being invitingly attentive, and such conversations should take into account multidimensionality, that relates to the past and the future.
Within mental health research, the promise of exploring the lived experience of those affected is increasingly acknowledged. This research points to the significance of social aspects. The present study is part of a series of qualitative studies exploring network-oriented practices in southern Norway. The aim of this study was to explore the social dynamics of change related to adolescents in psychosocial crises. From the perspective of lived experience the study focused changes related to the ado-
Accessible Summary What is known on the subject? Recovery‐oriented studies show that the quality of the professional relationship plays an essential role in the recovery from mental illness. Within mental health care in general, previous studies show that helpful professional relationships are characterized by several reciprocal aspects, such as friendship resemblance and self‐disclosure. The literature is scarce on in‐depth explorations of professional relationships within the often long‐lasting and intimate help context of institutional supportive housing. Explorations of staff members’ experiences are absent. The scientific rationale of this study was to expand the current knowledge about professional relationships in mental health care by exploring staff members’ descriptions of helpful professional relationships in supportive housing institutions. What this paper adds to existing knowledge The study shows that helpful relationships may involve staff experiences of reciprocity in terms of both a two‐way influence between staff and residents and a reciprocal gain from being part of the helpful relationships. A conceptualization of reciprocity that complements existing concepts is suggested and connected to a “good match” between staff and residents. What are the implications for practice? When support and care are intended to be provided within a dyadic relationship, both parties’ preferences should be considered when pairing service users and professionals. Practitioners should get involved in ways that open up for being influenced and inspired by the service user’s characteristics, such as personality and attitude. Furthermore, they should dare to enjoy and make use of the company of the service user in ways that promote multifaceted reciprocity. Abstract IntroductionIn the aftermath of the deinstitutionalization in western countries, new community‐based mental health services have been established. An essential object of studies in this new institutional landscape has been helpful professional relationships, but we still lack knowledge about helpful relationships in community‐based institutional supportive housing. AimTo explore how staff members describe their relationships with residents who have identified them as helpful. MethodsQualitative interviews with nine staff members were analysed using thematic analysis. Results“Reciprocity” was identified as the main theme, and two subthemes were developed: “Something influential about the resident” and “Value for the staff member.” DiscussionThe findings are discussed and related to existing conceptualizations of reciprocity in professional relationships, and an additional conceptualization is suggested. Implications for practiceTo promote reciprocity, managers should consider both parties’ personal preferences when matching professionals and service users. Further, professionals should get involved in ways that open up for being influenced and inspired by several of the service user’s characteristics. They should allow themselves to enjoy the com...
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