A Systems Theory Approach to Phenomena in Psychiatric Institutions

• In Event: 343 - Section on Medical Sociology Roundtables (one-hour)
  In Refereed Roundtable: Table 06. Mental and Behavioral Health

Abstract

Abstract
I want to examine the usefulness of certain concepts from sociological systems theory for analyzing the behavior patients present in psychiatric institutions. I will first present the empirical material, from which I take the examples. It includes three years of overt participant observation in two centers of community psychiatry. The major difference between the medical and the psychiatric system is that the medical system focuses on the body, but in psychiatry language and with it meaning and communication are central. I select Talcott Parsons’ definition of mental illness as an “incapacity to meet the expectations of social roles” as a point of departure. The Daycare Centers functioned very differently for the two groups involved, the staff and the patients. In this article I focus mainly on the patients in Center A. The patients had the privilege of reacting spontaneously according to their present state. I will interpret the behavior of the psychiatric patients applying a systems theory approach to communication, the function of the theme of interaction systems, synchronicity, self- and other-reference, and attributions. Taking point of departure in T. Scheff’s “residual rules” I develop a concept of “basic expectations” and show that persons descending into psychosis violate them. Simultaneously they give up distinguishing between normative and cognitive expectations, which is the layer that processes differential disappointment strategies. I hope to show that with a precise theory you can conceptualize major phenomena in psychiatry in sociological terms.

Author

• Vibeke Klitgaard, University of Lund, Sweden