Paper short abstract:

Mental health patients' accounts of bodily distress are often challenged by clinicians. This paper explores an unexpected counter-challenge that substantiates patient claims. What is the role of the ethnographer in documenting the experiential truths that lie outside of authorised knowledge?

Paper long abstract:

‘That’s just their anxiety.’ While conducting ethnographic fieldwork in mental health settings in Alberta, Canada (2016-2019), I often heard clinicians voice this ‘just anxiety’ interpretation of patients’ physical distress. Patients, clinicians continued, needed psychiatric medication or psychotherapy—interventions targeting their anxious minds, not their sick bodies.

My doctoral research investigates the challenges of individuals who experience what I call ‘strange transformations’—pathological changes in individuals’ bodies that impact their minds. Although an individual may require medication for tuberculosis, surgery for a brain tumour, or hormones for thyroid dysfunction, the psychological disturbances accompanying these conditions may garner excessive attention from clinicians. Misinterpretation of the psychological traits of physical conditions as mental disorders (often classified as anxiety) has been shown to have dire consequences, as it interferes with access to appropriate services and contributes to disproportionately high rates of premature death.

Nonetheless, patients' accounts of the prominence of their physical symptoms are frequently contested by clinicians. Epistemic clashes arise not only along emic-etic power gradients, but also between contrasting authoritative interpretations of disease etiology and health outcomes. This paper follows my deeper ethnographic exploration into how some patients may be investigated for ‘strange transformations’ (referred to as ‘physical cause’ in the F06 block of classifications in the ICD-10; as ‘another medical condition’ in the DSM-5). I highlight the role of the ethnographer in documenting the experiential truths that lie outside of authorised knowledge (Geissler 2013).