Breaking the silence

: a phenomenological account of epistemic injustice and its role in psychiatry

Abstract

In the introduction to Madness and Civilisation, Foucault sets out his project as follows:
In the serene world of mental illness, modern man no longer communicates with the madman…The language of psychiatry, which is a monologue of reason about madness, has been established on the basis of such a silence. I have not tried to write the history of that language, but the archaeology of that silence (Foucault, 2001: xii).
Through this dissertation, I excavate the archaeology of that silence a little more, uncovering its distinctly epistemic foundation. Drawing on the emerging field of epistemic injustice, I develop an underexplored form of epistemic silencing that I dub ‘hermeneutical silencing’. In a case of hermeneutical silencing, the oppressed individual is silenced by a lack of language to describe their marginalised experiences. I then proceed to demonstrate the true breadth and depth of the harm produced by hermeneutical silencing. The hermeneutically silenced individual not only suffers a cognitive disadvantage due to an inability to articulate their experiences; with recourse to Merleau-Ponty’s phenomenology of speech expression, I argue that they suffer a profound disruption to their embodied experience in the world.
When the concept of ‘hermeneutical silencing’ is applied to the domain of psychiatry, a more complete picture of the ‘archaeology of that silence’ unfolds. Although an experience of alienation from the world is characteristic of psychiatric illness, the concept of hermeneutical silencing demonstrates how this experience can be exacerbated and perpetuated by gaps in the interpretive framework where words to describe the patient’s experience ought to be. If we hope to amplify such marginalised voices in the future, we must first address the unequal hermeneutical practices that stifle them.

Date of Award	11 May 2021
Original language	English
Awarding Institution	University of Bristol
Sponsors	South, West and Wales Doctoral Training Partnership
Supervisor	Havi Hannah Carel (Supervisor) & Lisa El Refaie (Supervisor)