- 學位論文
為什麼人們願意住進精神病院？一個基進權力取徑的分析
Why Would People Be Willing to Enter Psychiatric Hospitals? An Analysis in a Radical Approach to Power
摘要
Erving Goffman在《精神病院》中指出，人會被送進精神病院只是基於一些偶然的因素，所以在院內並不意味著有精神疾病。然而，在精神醫學日益擴張、人們所思所行愈來愈被精神醫學凝視的今日，被賦予精神病患角色的人們開始肯定存於自身的疾病實體，合理化施加在自身的醫療處置。反覆入院的人們有著「自願住院」的經驗。 為什麼人們會願意住進精神病院受其支配？本文運用訪談、田野調查、自我敘事、畫作詮釋、時空分析等方法，指出人們在原本的社會處境中的自我遭逢困境，而醫院滿足了人們對肉身形式、轉換場域、社會關係、集體社會安排、訊息傳遞與維生手段的自我「原初需求」，使自我有繼續在社會生活的基礎。不過，通過 Steven Lukes對於「權力」的基進觀點，本文主張，住院選擇同時也是精神醫學權力流域以知識系統化、中介者化、個人史化與制度化的多元型態發揮引導作用的結果，在病房的運作邏輯底下終究不利於人們作為具有發展性與創造性主體的互助共生。願意住院並非個人偏好，而是自我心理動力與精神醫學權力共構的一個社會行動。
並列摘要
In “Asylums”, Erving Goffman points out that it is because of some contingent factors that people are sent into asylums, so being in asylums doesn’t imply mental disorders. Yet, in the age of expanding psychiatry and thoughts and behaviors being gazed more, those who are attributed the role of “psychiatric patient” have begun to legitimize the medical treatment imposed on themselves. People who repeatedly enter psychiatric hospitals do so willingly. Why would people be willing to enter psychiatric hospitals and render themselves dominated? With interviews, field work, self narratives, painting interpretation, and analysis of space and time, I argue that the selves of people encounter predicaments, and hospitals satisfy their “primary needs” of form of body, field change, social relationship, collective social arrangement, message delivery and way of sustenance, which forges a basis on which their selves can remain in society. Nevertheless, with Steven Luke’s radical perspective of power, I contend that choices to enter hospitals are the results of the channeling of “the basin of psychiatry” through knowledge systematization, mediatorization, personal-historicization and diverse forms of institutionalization, which after all impede the mutualism of people as prospective and creative subjects. Willingness to enter hospitals is not an individual preference, but a social action co-constructed by mental dynamics of selves and psychiatric power.