‘I don’t know what I’m doing. How about you?’: Discourse and identity in practitioners dealing with the survivors of childhood sexual abuse.

Abstract

This research is based on interviews conducted with a voluntary group of health practitioners who care for the adult survivors of childhood sexual abuse in one area of Scotland. This project takes a broadly interpretive approach to the interviews, and examines the processes of sense-making apparent in the scripts of the doctors, community nurse and counsellors who comprise this voluntary Forum. Those interviewed were highly sceptical of traditional medical approaches to dealing with survivors of such abuse, and they all questioned the effectiveness of expert professional knowledge. The research highlights the role of patient disclosure as a key mechanism in the process of their treatment, which is akin to the confessional technology discussed in detail in the work of Michel Foucault. Combined with other medical technologies patient disclosure is revealed as a technique of normalization. In this particular case the experts themselves were engaged in unravelling this process in search of alternative approaches to caring for their patients, which were based on a relationship of equal partnership rather than of expert authority. This research thus begins to illustrate the processes of sense-making and identity formation which exist between professional health care workers and the victims of abuse for whom they care.