Research interests
Research interests focus on two main areas. Firstly, this has been around the concept of insight in patients with mental disorders. Questions around whether it is possible for patients with mental disorders to have insight into their conditions, and/or to what extent this might be the case, whether this relates to the specific mental disorder itself or to other psychosocial factors and whether this is associated with prognosis, have concerned clinicians and researchers for many years. Her research in this area, both theoretical and empirical, has helped to highlight the relational structure of insight, the necessarily heterogeneous phenomena of insight that are invoked in relation to various mental disorders, the consequent different contribution of organic and non-organic factors into their constitution and the implications this carries for our understanding of insight and its research. One aspect of this work involved the development of an ‘insight in psychoses’ scale.
Secondly, her research focuses on the epistemology of psychiatry. This research is essential for the understanding of psychiatry as a discipline and for the understanding of the nature of mental symptoms and mental disorders. Epistemology of psychiatry refers to the theory of the grounds of psychiatric knowledge and deals with questions around the nature, origin and stability of psychiatric knowledge. In particular, this work in collaboration with colleagues, has highlighted the deeply hybrid structure of mental symptoms and mental disorders. This means that mental symptoms and mental disorders are constituted not only by neurobiological elements but also by elements of a different order, ones that are unique to the individual. These latter elements are the products of multitudinous factors including the personal (individual experiences, intellect, education, language, personality, etc.), socio-cultural (e.g. family, peers, wider outside influences and contexts) and the interactional (with others and environment). These elements can be called ‘semantic’ in a very broad sense. What is crucial here is that these ‘semantic’ elements together with the neurobiological elements constitute symptoms and disorders. It is this inherently double nature or constitution of mental symptoms and disorders (not to be confused with the biopsychosocial model) that makes for a fundamentally different epistemological position underlying psychiatry from that which underlies medicine. To date, empirical research in psychiatry has tended to follow the empirical methods used in medicine, in turn based on the natural sciences. This research however shows that for empirical research in psychiatry to be valid, it needs to take into account the relative contribution to psychopathology, of the neurobiological and the ‘semantic’ elements, i.e. those complexes of individually and socio-culturally derived meanings. ‘Semantic’ elements are not reducible to the neurobiology of an individual but make up the meaning that is unique to the individual and their socio-cultural environment. As such, they demand a research methodology that draws on a different and wider approach, one that encompasses the exploration and capture of a range of psychological, socio-cultural and interactional factors.