Abstract:
:This paper reflects upon questions of ontological contingency when the stark, visceral reality of a person's relentless self-destruction unfolds within institutional mechanisms that systematically withhold certain kinds of care. I consider these issues through the lens of "manipulation" as it is elaborated within an American eating disorders treatment center, where the notion of manipulation does particular kinds of affective and pragmatic work. Specifically, it serves to render clients as, paradoxically, both hyper-agentic and "agentically challenged" in ways that legitimate the withholding of their recognition as full subjects and therefore deserving of care. I propose that the ontological perspectives of the treatment center are ill-equipped for accounting for such dynamics and, in fact, carry certain risks when employed in the consideration of psychiatric conditions where they can even become coopted in unintended ways. This carries special importance when working with people whose ontological status is, in a very real (and not just theoretical) sense, teetering on the brink of the void.
journal_name
Transcult Psychiatryjournal_title
Transcultural psychiatryauthors
Lester RJdoi
10.1177/1363461516674874subject
Has Abstractpub_date
2018-08-01 00:00:00pages
516-533issue
4eissn
1363-4615issn
1461-7471pii
1363461516674874journal_volume
55pub_type
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journal_title:Transcultural psychiatry
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