Mapping the discursive spaces of trauma and healing in mental health: The institutional unconscious

This research maps discursive spaces, or linguistic exchanges, that are manifested in the socio-spatial practices, based on the notions of trauma and healing within five participant mental health sites at Vancouver Coastal Health. I conducted 20 semi-structured interviews and a focus group to explore the understandings of trauma and recovery practices among both the users and the providers of mental health and addictions services within VCH. I employed qualitative methods such as ethnography, participant observation, Lacanian Discourse Analysis (LDA) and thematic analysis to explore the various perspectives behind trauma-specific services (TSS). Theoretically and methodologically this dissertation puts in dialogue three paradigms: Psychoanalytic geography, which explores the specific socio-spatial practice around trauma and healing in the institution; clinical psychoanalysis, which explores how those exchanges are informed by unconscious mechanisms, based on language, that affect the subject's body and psyche; and the mental health field, which explores how the socio-spatial exchanges affect physical spaces, practices and interpretative frames in mental health service provision. My conceptual approach relies on a consistent shift of focus between the psychic (individual subject) and inter-subjective (social discursive) scales. I also locate two bodies of enjoyment —the subject's private body of jouissance and the social public body politic—, whose concerns are of different and often divergent nature. And finally, I rely on the Lacanian ternary of the Imaginary, Symbolic and Real registers of human experience to sustain my discussion. The research proposes two main topologies of trauma, explores various forms of trauma discourses and their social bonding, and discusses challenges from imaginary, symbolic and real nature in the provision of trauma services. I claim that Lacan's university discourse or know-it-all is the privileged social bonding in the institution, based on the master signifier "mental health evidence-based practice" (MHEBP), which functions as a hegemonic fetish that resists the complexity of traumatic suffering and simultaneously covers the anxiety of not knowing how to deal with the roots of such difficulty. By relying exclusively on biomedical and emotional literacy treatments for trauma, the institution also reduces costs in their response to the overwhelming demand for mental health services.