From Skepticism to Competence - (Ethnographic Encounters and Discoveries) by Mariana Craciun (Paperback)

About the Book

"While many doctors can examine the body for cut-and-dry data-a cardiologist can take a scan of the heart, an endocrinologist can measure the hormones in your blood, an oncologist can locate a tumor--psychiatrists are in a unique position: the only way to know someone's mind is through their own account of it. In this ethnography, sociologist Mariana Craciun follows a group of young medical students studying psychiatry as they go through training in psychotherapy. Their instructors, experienced psychotherapists, introduce approaches designed to uncover the inner workings of the mind of each patient, a dramatic departure from the students' earlier focus on the brain's chemical functions and the drugs that treat them. Despite the uncertainty endemic to psychotherapeutic approaches, Craciun shows us how students transform from psychotherapy skeptics into believers. Ultimately, Craciun illuminates widespread conflicts at the intersection of professional authority, uncertainty, and expertise, as we see how professionals come to rethink the goals and purpose of their jobs when they acknowledge the uncertain outcomes of their work"--

Book Synopsis

An examination of how novice psychiatrists come to understand the workings of the mind--and the nature of medical expertise--as they are trained in psychotherapy.

While many medical professionals can physically examine the body to identify and understand its troubles--a cardiologist can take a scan of the heart, an endocrinologist can measure hormone levels, an oncologist can locate a tumor--psychiatrists have a much harder time unlocking the inner workings of the brain or its metaphysical counterpart, the mind.

In From Skepticism to Competence, sociologist Mariana Craciun delves into the radical uncertainty of psychiatric work by following medical residents in the field as they learn about psychotherapeutic methods. Most are skeptical at the start. While they are well equipped to treat brain diseases through prescription drugs, they must set their expectations aside and learn how to navigate their patients' minds. Their instructors, experienced psychotherapists, help the budding psychiatrists navigate this new professional terrain by revealing the inner workings of talk and behavioral interventions and stressing their utility in a world dominated by pharmaceutical treatments. In the process, the residents examine their own doctoring assumptions and develop new competencies in psychotherapy. Exploring the world of contemporary psychiatric training, Craciun illuminates novice physicians' struggles to understand the nature and meaning of mental illness and, with it, their own growing medical expertise.

Review Quotes

"This well-written study is enjoyable to read, providing anecdotal stories, in-depth discussion of different psychotherapeutic interventions, and an insider's understanding of the difficulties facing contemporary psychiatric residents."-- "Choice"

"Mariana Craciun's perceptive ethnography takes us inside psychiatric residency to explore the challenging journey of those learning how to treat mental illness. With vivid observations, Craciun brings the relational dimensions of their training to life, tracing the experience of residents as they watch, listen and practice psychotherapy within a community of instructors and colleagues. She not only offers fascinating details of how residents' skepticism and doubt turn into expanded professional knowledge and identity, but we also see how psychoanalytic instructors work to broaden the legitimate approaches to psychiatry. As a result, From Skepticism to Competence is both a crucial contribution to our understanding of medical socialization and to the sociology of occupations and work."--Beth A. Bechky, University of California, Davis

"Empirically rich, theoretically sophisticated and highly readable, Craciun's book takes readers into the very interstices of psychotherapeutic training, and shows how residents grow from hard-nosed, biomedical skeptics into competent behavioral and psychodynamic therapists. The beauty of Craciun's argument is that she analyzes skepticism not as an obstacle, but as a necessary step in a process of professional socialization that will conclude with competency and trust. In an age of mistrust, skepticism's less disciplined cousin, the lessons that Craciun's book teaches will resonate far beyond the field of psychotherapeutic training." --Gil Eyal, Columbia University

About the Author

Mariana Craciun is assistant professor of sociology at Tulane University.