Inden for rammerne af tvang: En systemteoretisk analyse af ligeværd som medicin i psykiatrisk behandling

Thurøe Nielsen Anne Mette & Iburg Anne

Student thesis: Master thesis


This thesis sets out to investigate how equality (ligeværd) as a communicative construct has become a kind of drug, challenging the use of coercion, and paving the way for a new approach to managing psychiatric patients. Our interest in equality is driven by the seemingly opposite directed nature of the drug, aiming for the freedom of the psychiatric patient while recognizing coercion as a potential necessary means. With a systems theoretical approach we investigate the semantics of coercion and equality respectively, and show how coercion over time has become a problem rather than a matter of course in psychiatric treatment. Equality, on the other hand, has become a new treatment solution since it is capable of addressing both psychiatric illness and the need for reducing coercion. The solution lies within the observation that equality does not claim to be either freedom or coercion, but a paradoxical mix of the two. As such, equality seems to be more than a conventional drug. Moreover, it has come to play a part in the very operation of the medical system, distinguishing between ill and not ill, and given the ambiguity of the drug - the observation of freedom in the frames of coercion - the medical system thereby puts itself at stake. Equality as a drug is prescribed regardless of a diagnosis and without reference to a given standard.It is prescribed to both patient and practitioner, and the right dosage is never ascertained. The ground rules of the relation between patient and practitioner have perished, as the practitioner’s way of reasoning has come to encompass the unreasonableness of the patient. As such, equality questions every aspect of psychiatric treatment, but has nevertheless become paramount to the medical system and is no longer a mere matter of alternative treatment. This new medicine thus installs a considerable uncertainty within psychiatric treatment. Our exploratory study of patient management in three psychiatric hospitals shows that equality calls for a hybrid reflexivity among the practitioners, striving towards the freedom of the patient while recognizing the potential of coercion.

EducationsMSocSc in Political Communication and Managment, (Graduate Programme) Final Thesis
Publication date2016
Number of pages125