'His brain is totally different': an analysis of care-staff explanations of aggressive challenging behaviour and the impact of gendered discourses.
Using a discourse analysis on the texts of 10 interviews with care staff, this research explored the discourses used by care staff in constructing the aggressive challenging behaviours of men and women with learning disabilities. The research also explored discourses used differentially to understand the aggressive challenging behaviour of one gender. The analysis demonstrated the use of two main discourses, an individual pathology discourse which constructed the behaviour as originating in factors stable and internal to the client, and a context discourse which constructed the behaviour as a response to the client's circumstances. Participants used these accounts flexibly within their talk, and also used a mixed discourse which constructed the behaviour as due to both individual pathology and context. Despite the staff presenting their understandings as not being affected by the client's gender, the presence of two gendered individualizing discourses within the interviews was also demonstrated. Women's behaviour, unlike men's, was constructed with the use of discourses about their menstrual cycle or character flaws. The consequences of the use of these different discourses are discussed, as are the subject positions which they afford for both staff and clients. It is argued that clients are disempowered by the individual pathology discourse; that consideration of the broad contexts within which care-staff actions are situated may allow them to manage blame whilst reflecting on their practice, and that the impact of gender stereotypes on the understandings staff have of a client's behaviour should be a legitimate area for consideration in clinical practice.
Wilcox
Esther
E
West Sussex Health and Social Care NHS Trust, UK. esther.wilcox@wshs.nhs.uk
Finlay
W M
WM
Edmonds
Jane
J
D000328:Adult; D000374:Aggression / Q000523:psychology*; D003142:Communication; D005260:Female; D006282:Health Personnel; D006801:Humans; D007407:Interviews as Topic; D007859:Learning Disabilities; D008297:Male; D008875:Middle Aged; D011369:Professional-Patient Relations; D006113:United Kingdom