Silence

This post is by Dan Degerman, Leverhulme Early Career Research Fellow at the University of Bristol. Dan is soon to join project EPIC. 

Some members of team EPIC: Matthew Broome, Ian Kidd, 
Dan Degerman, Havi Carel, Kathleen Murphy-Hollies, and Fred Cooper.

Silence is an important phenomenon in mental health. But while philosophers have had much to say about the social silencing of people with psychiatric diagnoses, other ways in which silence can feature in psychopathology have been underexplored. In a recent workshop at the University of Bristol, generously funded by the Leverhulme Trust, we sought to begin to address this neglect by exploring the different faces of silence in psychopathology.

Ian Kidd opened the workshop with a talk that explored painful silences common in bereavement grief. In particular, he focused on four silences, each characterised by a loss of communicative possibilities that follows the death of a loved one. This included, for example, silence as the loss of the distinctive communicative style of the deceased and silence as the permanent absence of narrative closure. For the person subject to these silences, they are painful for three reasons, Ian explained. Firstly, these silences cannot be filled. Secondly, they involve the awareness that the ways of being in the world the relationship with the deceased made possible are now impossible. Thirdly, they involve the awareness that one can no longer be the same person that one was with the deceased.

Ian Kidd

The second speaker, Richard Stupart, drew on accounts of investigative journalists working in South Sudan to shed light on some of the mental dangers of being silent. He argued that journalists are at a heightened risk of moral injury, referring to the negative psychological impact a person experiences when they are unable to respond to a situation in what they consider a morally appropriate way. Journalists in conflict and crisis situations are particularly vulnerable to such injury because they often find themselves subject to structural pressures that may prevent them from communicating their knowledge about morally charged stories.

Richard Stupart

Inner speech in mental disorders was the subject of the next talk by Sam Wilkinson. He defended what he called a strong dialogical account of inner speech, which entails that all inner speech is directed at a recipient, namely, ourselves. This account also suggests, among other things, that inner speech plays a central role in shaping our identity. Sam then outlined some ways this account can help clarify the implications of inner speech and its absence in different mental disorders. For example, the strong dialogical account indicates that negative inner speech in anxiety and depression is not just an epiphenomenon of pre-existing a person’s feelings but that it can create a downward spiral of those feelings.

 

Sam Wilkinson

The fourth talk by Anna Bortolan examined experiences of silence in social anxiety. Drawing on some distinctions proposed in a recent paper on silence in mood disorders, Anna showed that these capture experiences described by people with social anxiety as well. She then went beyond that account to argue that a further two experiences of silence can be discerned in accounts of social anxiety. The first is characterised by a perceived inability to fill certain silences when one wants to do so, and the second is accompanied by a diminished sense of agency over how silences are filled.

Anna Bortolan

Finally, in my talk, I argued for the importance of attending to first-person experiences of silence in psychopathology through a case study drawn from accounts of depression. Using a phenomenological framework inspired by the work of Merleau-Ponty, I described an experience common in first-person accounts of depression that I termed empty silence. This is an unpleasant experience that involves a solicitation to speak and a breakdown in a person’s habitual relationship with words, which confronts them with their own outward and inner silence. I proceeded to argue that if lived repeatedly, it may give rise to bodily doubt in one’s ability to speak.

Dan Degerman

If you are interested in learning more about the talks, presentation materials from most of them can be found here. The talks were followed by wonderful discussions with the interdisciplinary audience that was in attendance in the room and online, and I want to extend heartfelt thanks to all those who participated.

The workshop was the capstone event for my Leverhulme Early Career Fellowship. However, it also served as an informal launch event for the EPIC project, with many of its team members in attendance, including Ian Kidd, Havi Carel, Matthew Broome, Fred Cooper, Kathleen Murphy-Hollies, and myself. The conversations and explorations that began during this workshop on silence and psychopathology will continue as part of the project, and if you are interested in contributing or participating in some way, please do get in touch.

Fred Cooper joins EPIC

More good news for project EPIC! Fred Cooper, currently a Research Fellow at the University of Exeter, will join EPIC as a Senior Research Fellow based in the Law School at the University of Bristol. We asked Fred a few questions about current interests and future plans.

Fred Cooper

Hi Fred! What is your main research interest?

Most of my work to date has been about attempting to understand the historical, political, and experiential dimensions of loneliness, although this has led me to spend substantial amounts of time with other problems, particularly shame, which share a porous border. As a historian of medicine, I’m interested in how the idea of loneliness that we work from today has been assembled over time, in different processes and contexts and by individuals and groups with different claims to expertise. 

I have an upcoming article, for example, on loneliness, shame, and personality, which uses historical methodologies to unpick some of the ways that loneliness has been (and continues to be) framed as a matter of personal failure. Maybe predictably given my disciplinary training, I’m also interested in temporal representations of loneliness (i.e., as a crisis or epidemic linked to the present or the very recent past); I’ve written recently on the history of this strain of thinking and why I think it constrains the kinds of questions we need to ask.

Threaded through this work has been a series of important questions over how knowledge is built and by who. Focusing primarily on loneliness, my case study at EPIC will tack between historical, philosophical, and engaged research methods to think critically about how epistemic injustices are produced and perpetuated over (relatively) long periods of time, and the impact this has on opportunities for epistemic, experiential, and structural redress.

Why do you think it is important to study epistemic injustice in healthcare?

I strongly suspect that a significant number of people working in the medical humanities, social sciences, and other kinds of health research – particularly where that work involves co-production, engaged research, or other kinds of participatory methods – are fundamentally concerned with epistemic injustice, even when they don’t use that precise framing. 

Just the other day, I spoke at a knowledge exchange symposium between the University of Exeter’s Wellcome Centre for Cultures and Environments of Health (my workplace for the past six years), and the Copenhagen Centre for Health Research in the Humanities; in almost every talk or discussion, problems of service user testimony being discarded or derided were addressed, or of complex systems of knowledge being created around – but not necessarily with or for – the people concerned. 

As well as opening up new lines of research and new ways of identifying and ameliorating harm, epistemic injustice is a vastly useful conceptual tool for better articulating and understanding many of the phenomena that researchers are already substantively engaged with. In the ethical imperative to work on epistemic injustice in ways that don’t unwittingly reproduce hierarchical or extractive epistemic processes, it can also inform and improve our engagements with different partners and publics.

What are you working on right now?

I’m currently working on a resource which draws out insights from historical research on loneliness for a wider, non-humanities audience. Co-authored with 15 other scholars, it’s an overture to other disciplines - and health policymakers too - to work in closer dialogue with historical questions, findings, methods, and researchers. One of many reasons I’m excited about joining EPIC is the chance to show what historical practice can do in this kind of outward-looking interdisciplinary space, particularly as historical contributions to the existing literature on epistemic injustice have been relatively few. 

I’m also working on several talks: my first Keynote, for a symposium on loneliness and shame at the University of Bristol, and a paper on loneliness and culture for a seminar with the European Commission’s Joint Research Centre. Ahead of starting work at EPIC in the new year, I’m beginning to sketch out how my case study will work in practice, thinking about sources and archives, and putting together thoughts on possible collaborations with the rest of the team.