ABSTRACT

Narratives within mainstream psy disciplines around ‘medically unexplained symptoms’ (MUS), as constructed through (bio)psychosocial theorising, have been charged with promoting victim blaming. Psychosocial discourse and practice within this field are also critiqued on grounds of inadequate empirical support and associated with patient harms, yet (bio)psychosocial hegemony persists. Understanding what drives current practice and attendant victim blaming in the field of MUS is therefore important in challenging dominant discourse and changing psychotherapy practice, thus precluding patient harm. In this article, practitioner psychology is explored through a critical lens, locating this within a context of organisational and biopolitical influences which likely reinforce mainstream theory and practice. It is argued that victim blaming tendencies within dominant discourse around MUS may serve relational, existential and epistemic needs for practitioners and social actors more broadly, alongside fulfilling a need to assert moral value in the face of social injustices that threaten the neoliberal ‘just world’ view. In other words, (bio)psychosocial constructions of MUS satisfy society’s need to create and ascribe to a shared reality, dominated by a belief in a just, meaningful and relatively predictable world that justifies the status quo. Critical reflexivity is emphasised as a starting point for transforming practice.

摘要

主流心理学学科中围绕“医学上无法解释的症状”（MUS）的叙述，通过（生物）心理社会理论构建，被指控助长了对受害者的指责。该领域的心理社会话语和实践也因经验支持不足和与患者伤害相关而受到批评，但（生物）心理社会霸权仍然存在。因此，了解 MUS 领域当前实践的驱动因素以及随之而来的受害者指责对于挑战主流话语和改变心理治疗实践非常重要，从而防止患者受到伤害。在本文中，从业者心理学通过批判性的视角进行探讨，将其置于组织和生命政治影响的背景下，这可能会强化主流理论和实践。有人认为，围绕 MUS 的主流话语中的受害者指责倾向可能会更广泛地满足从业者和社会参与者的关系、存在和认知需求，同时满足在面对威胁新自由主义“公正世界”的社会不公正时维护道德价值的需要。看法。换句话说，MUS 的（生物）心理社会结构满足了社会创造和归因于共同现实的需要，这种现实以对公正、有意义和相对可预测的世界的信念为主导，该世界证明了现状的合理性。强调批判性反思性作为转变实践的起点。同时满足在面对威胁新自由主义“公正世界”观的社会不公正时维护道德价值的需要。换句话说，MUS 的（生物）心理社会结构满足了社会创造和归因于共同现实的需要，这种现实以对公正、有意义和相对可预测的世界的信念为主导，该世界证明了现状的合理性。强调批判性反思性作为转变实践的起点。同时满足在面对威胁新自由主义“公正世界”观的社会不公正时维护道德价值的需要。换句话说，MUS 的（生物）心理社会结构满足了社会创造和归因于共同现实的需要，这种现实以对公正、有意义和相对可预测的世界的信念为主导，该世界证明了现状的合理性。强调批判性反思性作为转变实践的起点。