diagnosis dialogical space
TRANSCRIPT
10/03/2013
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AboutAbout howhow a diagnosis a diagnosis
cancan open up a open up a dialogicaldialogical spacespace
Thomas Fondelli
Thomas Fondelli
Background?Background?
Thomas Fondelli
• Psychiatric disorder
• Triad of impairments:
• Qualitative impairment in social interaction
• Qualitative impairment in communication
• Restricted repetitive and stereotyped patterns of
behavior, interests and activities
WhatWhat is is autismautism??
Thomas Fondelli
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• Psychiatric disorder
• Triad of impairments
• Neurodevelopmental – neurocognitive disorder
WhatWhat is is autismautism??
Thomas Fondelli
A personal struggle
Psychiatric diagnosis
• Focus on the individual
• Focus on difficulties and limitations
• Often an outsider perspective
• Therapy often defined as learning
Systemic psychotherapy
• People as knots in a network
of relationships
• Focus on commitment
• Focus on ‘lived realities’
• Therapy defined as reflection
Thomas Fondelli
How to be a good therapist and an expert on autismat the same time?
• How to know and not know at the same time?
• How to respond to questions clients have and still be faithfull to the systemictheory?
• How to focus on relations while ‘someone’ is the problem?
• What to think of myself when all of a sudden a caught myself seeing someoneas autistic?
• …
A A personalpersonal strugglestruggle
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TWO THEORETICAL ANCHORS
Thomas Fondelli
• The denomination …
• … of a unity, a coherence, …
• … observed from a specific point of view
1. 1. WhatWhat is a diagnosis?is a diagnosis?
Thomas Fondelli
At the psychiatrist:
Autism
At the supermarket:Spoiled kid
On the playground:Loser!
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At the neuropsychologist:
NLD
At the occupational therapist:
SID
At the psychotherapist:HS
Thomas Fondelli
• Perspectival relativity
‘… the identity of any given state of affaires is contingent upon the
position from which it is viewed’ (Rommetveit, 1991)
• Perspectival obliviousness
WhatWhat is a diagnosis?is a diagnosis?
Thomas Fondelli
• There are many ways to think and talk about people
• There are many ways to think and talk about problems
• There are many ways to think and talk about autism
PerspectivalPerspectival relativityrelativity??
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2. 2. DialogicalDialogical rationalityrationality((MarkováMarková, 2003), 2003)
Thomas Fondelli
• An effect-approach in psychotherapy
• Developping playfulness in relation to
psychiatric diagnoses
DialogicalDialogical rationalityrationality
Thomas Fondelli
SOME PRACTICAL ANCHORS
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• Framing what you do? What you can do?
• But not being to rigid
1. 1. FramingFraming
Thomas Fondelli
• Jumping from one perspective to another
• Shifting from ‘wanting to understand’ to
‘being sensitive to the effect’
• Can I understand it otherwise?
2. 2. AwarenessAwareness to to perspectivalperspectival relativityrelativity
Thomas Fondelli
• Every behavior could be interpreted as a
commitment:
• Unfortunately not everybody sees it that way
• Unfortunately it doesn’t always work out as you would
like to
3. 3. BehaviorBehavior as as commitmentcommitment
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• Sometimes people want you to stay within the
limits of the diagnosis
4. 4. PlayfulnessPlayfulness fromfrom withinwithin
Thomas Fondelli
• Keeping an open mind to different ways of understanding or talking about autism:
• Autism as an extrem mail brain
• Autism as needing subtitles
• Autism as having country roads instead of highways
• Autism as thinking in pictures
• Autism as …
• Not the correctness but the effect counts!
Thomas Fondelli
• Not because someone is autistic, but just becauseit seems to work:
• Temporising
• Visualising
• Working with metaphors
• Giving subtitles to your questions
• Exploring bottom up
• Mathematising
• …
5. 5. DeveloppingDevelopping creativitycreativity in in waysways of of
workingworking
Thomas Fondelli
