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Voz y discurso en salud mental: esquemas diagnósticos en conflicto en un análisis de caso
(Servicio de Publicaciones de la Universidad de Navarra, 2022) Bonnin, J.E. (Juan Eduardo)
In this article we present a case of misdiagnosis in mental health that started in the admission interview and lasted for a year of treatment. To interpret the causes of this error, and based on a collaborative process with the mental health team, we use two theoretical categories: “discourse” (understood as the set of semiotic and semantic regularities that correspond to a social field, as in “medical discourse”, etc.) and “voice” (understood as the singular product of the articulation between multiple discourses throughout the biographical trajectory of a person). Methodologically, we use the descriptive tools of conversation analysis in a heterogeneous corpus that goes through the different stages of diagnosis and treatment. The analysis shows the effect of psychoanalytic discourse, which selects some aspects of the patient’s voice while ignoring others, arriving at a diagnosis of conversion disorder (“hysteria”) and preventing another, of progressive aphasia. In the end, the potential of interaction studies for the diagnostic process and some implications of the case for the field of discourse analysis are discussed.