Psychiatry and Subjectivity. Experiences of Patients in West German Psychiatric Institutions from the 1960s to the Present.

精神病学的经历挑战了患者的自我认知。但在精神疾病形象和精神病院改革的背景下，这种自我认知发生了变化，有时是戏剧性的。这项研究项目探索了心理健康消费者的自我认知，因为从20世纪60年代到现在，制度的变化改变了精神病学的实践。我们描述了(前)患者的主观化，即他们重新获得机构和自主性的形式和策略，这些形式和策略曾受到他们的精神病学经验的质疑。这一探索既涉及当前精神病学领域关于患者自主与约束的争论，也涉及公共卫生政策中的新范式，包括患者的主动性和预防。我们拓宽和解释了现有的对精神卫生机构消费者的叙述性访谈数据，并将我们的结果与精神病学转型的历史研究相联系。因此，我们描述了(前)患者的主观化，并将他们放在精神病学实践的变化的背景下。通过这些方法，我们提供了一种解释病人的主体状态--精神化的自我--模式的类型。这一结果与社会学的基础研究相关，并揭示了精神病学改革对患者自我感知的意义。

The experience of psychiatry challenges patients' self-perceptions. But this self-perception changes, sometimes dramatically, against the background of transformations in both the images of mental illness and reforms in psychiatric institutions. This research project explores the self-perceptions of mental-health consumers in view of the institutional changes that have transformed the practice of psychiatry from the 1960s to the present. We describe the subjectifications of (former) patients, i.e. their forms and strategies of regaining the agency and autonomy which had been questioned by their experiences of psychiatry. This exploration refers both to current debates in the psychiatric field about patient autonomy versus restraint as well as to new paradigms in public health policy, including proactivity of patients and prevention.We broaden and interpret the existing data of narrative interviews with consumers of mental health institutions, and place our results in relation to historical research on the transition of psychiatry. Thereby we describe subjectifications of (former) patients and put them in context of changes in psychiatric practice. By these means we offer a typology of interpretation patterns of the patient's subject status, the psychatrized self. This result bears relevance for basic research in sociology and sheds light on the significance of psychiatric reforms for the self-perception of patients.