Psychiatrists’ Accounts of Insight

Abstract

Our main aim was to examine how insight into schizophrenia is discursively represented in psychiatrists’ accounts, how these accounts relate to the current psychiatric literature on insight, and their potential clinical consequences. The article is anchored in the constructionist view of discourse and is based on nine semistructured interviews with specialist psychiatrists. We discuss three dimensions of insight into schizophrenia in the data we collected: a sense of illness, criticism, and readiness to receive treatment. We argue that they are embodiments of the dominant medical perspective in the relations between patients and physicians. Whereas in the former two it is possessing and accepting psychiatric knowledge which constitutes having insight, in the latter it is unquestioning acceptance and trust in whatever treatment the doctor deems fit to administer. We conclude with a discussion of medicalization of experience of mental illness, which appears to be the preferred mode of patient narrative for psychiatrists.