- Hermeneutic Haunting: The Interpretation of Violence and the Violence of Interpretation
It is a pleasure to respond to these thought-provoking commentaries by Laurence J. Kirmayer and Nancy Nyquist Potter. Rather than addressing their comments one-by-one—and rather than entering into the same meditative attitude that produced my original essay, an unusual and exploratory text—I will take the liberty of responding to a theme that appears in both commentaries: the potential epistemic violence done by interpretation. It is perhaps no mistake that interpretative violence is thematized in commentaries on the topic of haunting—the haunting of texts and of experience. In responding to this theme, I will offer some reflections on the role of psychotherapy in producing interpretations.
Kirmayer’s commentary draws attention to the ways in which heard voices and ghostwritten texts are both haunted by structures of social inequality—structures that lead to emotional distress, as in heard voices (of the critical sort), and to questionable scholarly-cum-business practices, as in ghostwriting. Reminding us of the research literature on cultural differences in voice hearing (e.g., Luhrmann, Ramachandran, & Tharoor, 2015), he elegantly posits that voices heard in the United States can be seen as “the kind of self-critiques of failure, dejection and marginalization that characterize the social position of the psychotically disabled person in an economy that demands consistent consumption, performance and productivity.” We might note that recognition of unifying social meanings here negates these very meanings, namely isolation and alienation, as the voices (or other forms of distress that result, as Kirmayer points out, from the same problematic structures) belie belongingness to the same broken, inhospitable society.
Here I will focus on one of Kirmayer’s claims— in part because it fascinates me as a clinician. He writes: [End Page 277]
Imputing agency or communicative intent to symptoms when people feel out of control and, indeed, when their suffering is directly related to that sense of loss of control, does a kind of epistemic violence (Kirmayer & Gomez-Carrillo, 2019). In effect, it appropriates the experience of the sufferer to launch a critique of structures of inequity in society. This may be good politics but bad therapeutics, unless it results in increased agency on the part of the sufferer.
Much has been written, of course, about the act of interpretation—both as a mechanism of revealing experience (e.g., in psychoanalytic psychotherapy) and as a means of structuring or even introducing experience (e.g., in postmodern and narrative approaches). Kirmayer’s point conjures a set of epistemological and ethical questions about psychotherapy as an enterprise: Does the therapist hold any special kind of knowledge? If so, should they share it with the client, and how? What happens when the therapist’s understanding differs from that of the client? Do the therapist’s interpretations exact epistemic violence on those already in a vulnerable place? Is it iatrogenically risky to conceptualize a symptom in a way that its sufferer does not? Finally, does naming structural violence as a source of suffering amount to a form of epistemic violence?
These questions—the answers to which are far beyond the scope of this brief response—lay bare the basic assumption that psychotherapy is an epistemic tool for knowing about human experience. Psychotherapy is predicated, after all, on the possibility of enhanced understanding, even revelation. But whose? Kirmayer suggests that rather than attributing the voices to the effects of social marginalization, voice hearers often feel a loss of control—and thus any understanding of the voices as having coherent social meanings invalidates the essentially chaotic nature of their experience. This is what he calls “good politics but bad therapeutics.” In this admonishment, Kirmayer appears to call for conservative exegesis, a radically faithful depiction of experience on and in the person’s own terms.
Most clinicians are familiar with deliberations about whether to withhold interpretation when the client’s repudiation of it is all-but-inevitable. Is it best, from the lens of clinical ethics and social justice, to stick with a radically descriptive approach that mirrors the individual’s own expressions of distress? Here we might turn to the realm of qualitative research methodology...