Semptom bazlı sınıflamanın ötesinde: Obsesif kompulsif bozukluk tanısı alan kişilerin öznelliğinin Lacanyen Söylem Analizi perspektifiyle incelenmesi

Year 2024, Volume: 8 Issue: 1, 114 - 124, 25.04.2024

Sinem Baltacı Sevda Sarı Tülin Gençöz

https://doi.org/10.57127/kpd.26024438m0000111

Cited By: 1

Abstract

İstenmeyen düşünce ve tekrarlı davranışlar oldukça farklı görünümlere sahiptir; ancak semptom bazlı sınıflama sisteminde bu denli farklı belirtilere sahip kişilerin tamamı obsesif-kompulsif bozukluk (OKB) tanısı altında sınıflandırılmaktadır. Psikoterapi araştırmaları üzerinde etkisi giderek artan sosyal inşacı bakış açısı, psikoterapi alanının birebir çalışma alanı olması nedeniyle bireylerin öznelliğine vurgu yapmaktadır. Öte yandan, psikoterapi ve dilin kullanımı üzerine yapılan çalışmalar artsa da özellikle obsesif-kompulsif bozukluk ile etiketlenen kişilerin öznelliği henüz söylemsel, eleştirel ve dil temelli bir bakış açısının kombinasyonu içinde incelenmemiştir. Bu araştırmanın temel amacı, insanların öznelliğine ve söylemsel pratiklerine özel bir vurgu yaparak, terapötik süreçte semptom temelli tanıyı eleştirel bir bakış açısı içinde incelemektir. Bu amaçla, amaçlı örnekleme yöntemiyle seçilen ve OKB tanısı almış olan altı katılımcı ile görüşmeler yürütülmüştür. Nitel analiz çerçevesi içinde, eleştirel ve Lacanyen Söylem Analizi perspektiflerinden yararlanılmıştır. Bu yaklaşımın kavramları göz önüne alınarak yürütülen analiz sonuçlarına göre tüm katılımcılar, OKB ismi altında aynı teşhis ile sınıflandırılmış olmalarına rağmen, temel gösterenleri, konumları ve Başka ile ilişkileri oldukça farklılaşmıştır. Ayrıca kişilerin farklılaşan (öznel) söylemleri ve cinsiyet farklılıkları Lacanyen psikanalitik alanyazın ışığında tartışılan diğer önemli konular olarak belirmiştir. Bulgular, bireylerin semptomlarının benzerliklerine göre kategorize edilmelerinin yerine, öznellikleri ve psikolojik yapıları içinde dikkatle dinlenmeleri gerektiğini ortaya koymaktadır. Mevcut çalışma tanısal bir tartışma ve klinik çıkarımlara ilişkin öneriler sunmaktadır.

Keywords

öznellik, OKB, obsesyonel nevroz, tanı tartışması, Lacanyen söylem, söylem analizi, eleştirel söylem analizi

Beyond symptom classification: Analyzing subjectivity of people diagnosed with obsessive compulsive disorder through Lacanian Discourse Analysis perspective

Abstract

Intrusive thoughts and repetitive behaviors are manifested in numerous forms, however regarding the symptom-based system, people with such diverse forms of symptoms are diagnosed under the same category, named obsessive-compulsive disorder (OCD). The social constructivist approach, that have an increasingly substantial impact on psychotherapy research, emphasizes the subjectivity of individuals since the therapeutic field focuses on one-to-one work. Although studies on psychotherapy and the use of language are expanding, to the best knowledge of authors the subjectivity of people diagnosed with obsessive-compulsive disorder has not yet been studied using a combination of qualitative, discursive, critical, and language-based perspectives. The main purpose of this study was to critically evaluate the symptom-based diagnosis in the therapeutic process, with a particular emphasis on the subjectivity of people with OCD symptoms and their discursive practices. For this aim, interviews were conducted with six participants who were diagnosed with OCD and selected via the purposive sampling method. As for the qualitative analysis, critical and Lacanian Discourse Analysis perspectives were utilized. Considering the concepts of this perspective, the analysis revealed that though all participants were diagnosed under the same category, namely OCD, their basic signifiers, positioning, and relationships with the Other were quite distinct. Furthermore, differentiated patient discourses and gender differences emerged as crucial issues that were discussed in the light of Lacanian psychoanalytic literature. These findings suggested that individuals should be carefully listened to within their own subjectivity and psychological structures instead of being broadly categorized on the basis of symptom similarity. Based on the findings, the current study presents a diagnostic debate and key clinical implications.

Keywords

subjectivity, OCD, obsessional neurosis, diagnostic discussion, Lacanian discourse, discourse analysis, critical discourse analysis

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