15041611Voices: A World Forum for Music Therapy1504-1611GAMUT - Grieg Academy Music Therapy Research Centre (NORCE &
University of Bergen)10.15845/voices.v19i3.2834EssayWhose Knowledge?Epistemic Injustice and Challenges in Attending to Children's
VoicesKlyveGuro Parrguro.klyve@uib.noThe Grieg Academy – Department of Music, University of BergenBainCandiceGumbleMaevonHadleySusan111201919331320198102019Copyright: 2019 The Author(s)2019This is an open-access article distributed under the terms of the
http://creativecommons.org/licenses/by/4.0/, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited.https://voices.no/index.php/voices/article/view/2834
In this essay, I will discuss the importance of having an awareness about epistemic
justice, epistemic ignorance and epistemic injustice, and why this awareness is
important in connection to children and patients in mental health care. I also
suggest ways to avoid epistemic injustice when working with, and doing research with,
children in mental health care. In doing so, I tie this to feminist epistemology
where conceptions such as knowledge, knowers and objectivity are questioned, and
dominant conceptions and practices of knowledge production are perceived as a
systematic disadvantage of women and other subordinated groups (Anderson, 2017). I am as well linking this to queer
epistemology which differs from feminist standpoint epistemology in the idea of the
identity being “a point of departure for shared consciousness” (Hall, 2017, p. 163).
Drawing on both queer theory and feminist theory in this essay, I will explore epistemic
injustice and the challenges faced when attending to children’s voices in mental health
care.
Philosopher and feminist, Miranda Fricker (2007), defined “epistemic injustice” as “a wrong done to someone specifically
in their capacity as a knower” (p. 1). Informed by this understanding, I am discussing
how both children and patients in mental health care have been subjected to epistemic
injustice, and how children in mental health care in this sense might experience a
double epistemic injustice.
What are the challenges when considering epistemic justice in interviewing
children in mental health care?
Fricker`s (2007) perspectives on
epistemic injustice and ignorance are framed in a feministic epistemology.
Discussions about objectivity in feminist epistemology are concerned with “limited
location and situated knowledge” (Haraway, 1988, p.
583) and focused on how the knowers` social location affects “what and how
she[/he/they] 1knows” (Anderson, 2017). In relation
to these discussions, Fricker (2007)
argues that people should be conceived “as operating as social types who stand in
relations of power to one another” (p. 3).
In queer epistemology, one is instead focusing on an affectively attuned knowing, “a
sensibility of something other than shared understanding” (Hall, 2017, p. 163). Queer theorists acknowledge other forms of
epistemic injustices, such as epistemic violence (Hall, 2017) and “willful hermeneutical ignorance” (Pohlhaus, 2012), focusing on “the dialectical relation between
interdependence and situatedness” (p. 720).
I perceive both feminism and queer theory as part of a broad discourse on gender.
Through a discussion on epistemic injustice and ignorance, I will connect these two
perspectives, focusing on two identity markers which seldom are discussed in the
intersectionality debate on gender, namely children and patients in mental health
care.
I am currently working on a Ph.D. project where the purpose is to gain more knowledge
about how children experience music therapy during hospital admission in mental
health care. The project is a qualitative study, and the problem statement is
explored through a multiple case study design with 8 cases. I am conducting separate
interviews with the children, as well as their parents, and several of the staff at
the hospital will participate in focus group interviews. What is explored in this
essay will be of importance when arguing for interviewing children in mental health
care despite the challenges and critical issues this might imply (Einarsdóttir, 2007). It will also be important
in interpreting and understanding the children’s voices.
Even though my focus in this text is on children in mental health care, I do think
there are examples that will be transferable to other identity markers.
The child as a social competent actor
What is a child? When working and doing research with children, this is an important
question to ask. One could argue that it is an easy question to answer, emphasising age
and development. It is, however, as much a question about how we (adults) perceive
children, what their role and impact are in our society. All interaction with others is
“predicated on the categories in which we spontaneously place them” (Gilbert, 2009, p. 93), and the binary opposition
child/adult places children linguistically less valued than adults and dependent on
them. Fixed categories, such as children and adults, gender and sex, are strongly
criticized and questioned in queer theory, and binary oppositions such as
feminine/masculine, woman/man, female/male are under constant deconstruction (Butler, 2006).
The “otherness” of children “somehow represents the very things which make children
children” (Jones, 2001, p. 173). How we
perceive this “otherness” and deal with it is a key issue in the relations between
adulthood and childhood, as well as in research related to childhood. From an adult’s
position, the child seems to be more “other” the younger they are, Jones suggested,
acknowledging how the inner worlds of young children are mysterious and distant to
adults. At the same time, Jones referred to the infant research conducted by the
biologist Trevarthen (1993), among others,
which showed infants` capabilities for emotionality and communicating. This
“communicative musicality” (Trevarthen & Malloch,
2000) provides a basis for mutual understanding between people.
To communicate about “children” as a fixed category and a unified group of people might,
however, simplify the complexity of the group. There is, nevertheless, something that
apparently forms them as a group, including their youngness, newness, and “lack of
accumulative experience and knowledge which make adults adults” (Jones, 2001, p. 175). This implies that children are defined as
the binary opposite, the negative of adult, but, as Jones emphasises, it is important to
realise that children “are not less than adult; they are different to
adults” (p. 175, emphasis in original).
The children`s rights, defined by the UN Child Convention (UN, 2006), and a growing influence of the consumer have had a
great influence on how childhood is viewed in society. What has changed has been an
increasing understanding of the child as a competent social actor and children`s
involvement in research (Powell & Smith,
2009; Sinclair, 2004). Children are
now not merely objects of inquiry but can be active participants in the research
process. This development demands specific attention and capabilities in the researcher,
as their methodological and ethical choices impact children`s participation in research
(Powell & Smith, 2009). Given the
diversity of contexts and research problems, a child-centred perspective is suggested
(Grover, 2004).
Epistemic injustice
Two of our most basic everyday epistemic practices are “conveying knowledge to others by
telling them” and “making sense of our own social experiences” (Fricker, 2007, p. 1). Fricker brought to light certain ethical
aspects of these practices by defining a distinctively epistemic kind of injustice,
dividing it into two forms: testimonial injustice and
hermeneutical injustice. In both, it is the subject that “suffers
from one or another sort of prejudice against them qua social type” (p.
155). In testimonial injustice, “a hearer wrongs a speaker in
his[/her/their] capacity as a giver of knowledge, as an informant” (p. 5), while in
hermeneutical injustice it is “some significant area of one´s social
experience” that is “obscured from collective understanding owing to a structural
identity prejudice in the collective hermeneutical resource” (p. 155).
Testimonial injustice
When the speaker is wronged in their capacity as a subject of knowledge, they are
wronged in a capacity which is essential to human value (Fricker, 2007). This is a matter of credibility deficit, where
someone receives lower credibility than they deserve. Fricker argued that various
degrees of this happen all the time, referring to Shklar (1990) who pointed at injustice as something that is not a
surprising abnormality, but rather a normal social baseline.
Social power is central in testimonial injustice, especially the particular kind of
social power called identity power. Identity power is at work where
there is an operation of power depending upon “shared imaginative conceptions of
social identity” (Fricker, 2007, p. 14), and
one example of this is gender. For example, gender identity power is active when a
cis man influences a cis woman`s action by making use of the identity as a cis man.
One of Fricker’s main example was from Minghella`s (2000) movie, The Talented Mr. Ripley, where
Herbert Greenleaf wrongs Marge Sherwood’s capacity as a knower in relation to the
disappearance of their fiancé, Dickie Greenleaf. Marge is convinced (rightly) that
Dickie´s friend, Tom Ripley, has killed Dickie, but Herbert Greenleaf disregards
Marge`s beliefs. “Marge, there´s female intuition, and then there are facts” (Minghella, 2000, in Fricker, 2007, p. 88). Herbert Greenleaf thus fails to see
Marge as a source of knowledge, and one might claim that there is a clear identity
prejudice at work in this situation.
The primary harm of testimonial injustice is about exclusion from knowledge owing to
“identity prejudice on the part of the hearer” (Fricker, 2007 p. 162). Identity prejudice is related to social identity,
and the influence of this prejudice in the credibility judgement of a hearer is an
“operation of identity power” (p. 28). Identity power can control our actions even
despite our beliefs, as it is at “the level of the collective social imagination” (p.
15). Our responses to the testimony of others are learned through epistemic
socialization and “our normal unreflective reception of what people tell us is
conditioned by a great range of collateral experience” (Fricker, 2003, p. 161).
Hermeneutical injustice
The primary harm of hermeneutical injustice is about exclusion from knowledge owing
to “structural identity prejudice in the collective hermeneutical resource” (Fricker, 2007, p. 162). This harm is in deep
connection with the primary harm of testimonial injustice, but, according to Fricker,
in hermeneutical injustice and in contrast to testimonial injustice, there is no
culprit it is purely structural. Hermeneutical injustice happens when an individual
is unable to understand their own experience because of a cognitive disadvantage
stemming from a “gap in collective hermeneutical resources” (p. 6).
Fricker (2007) exemplified hermeneutical
injustice with the story of Carmita Wood, a woman in the late 1960s, who experienced
sexual harassment at the workplace. At that time, there were no words in the
hermeneutical resources that could explain what happened, to neither Wood nor the
male professor at work who sexually approached Wood. Wood developed chronic back pain
and quit their job. Applying for unemployment insurance, Wood had a hard time
explaining what had happened, and their application was denied. Wood joined a
feminist group discovering that everyone in the group had had similar experiences,
and they started to speak out about this “sexual intimidation,” and “sexual coercion”
(Brownmiller, 1990, in Fricker, 2007, p. 150), coming up with the word “sexual
harassment.”
When some groups are excluded from practices where social meaning is generated,
“collective hermeneutical resources” (p. 6) inadequate to the experiences of
marginalized social groups are produced. Collective impoverishment becomes unjustly
and particularly disadvantageous to some groups of people, but not others, in
concrete social situations, such as in the example of Carmita Wood. Hence, according
to Fricker (2007), hermeneutical
injustice is fundamentally “a kind of structural discrimination” (p. 161).
Epistemic violence, epistemic ignorance and willful hermeneutic ignorance
Queer epistemology brings another form of testimonial injustice into focus, namely “the
epistemic violence” (Hall, 2017, p. 158) of
mandatory testimony about one`s gender and sexuality. Testimonial injustice in queer
epistemology is thus not only about the silencing of those who are marginally situated,
but also about the epistemic violence maintained by the pressure to inhabit an identity
category, “to understand oneself as a certain kind of person because of one’s desires
and actions” (p. 159).
Mason (2011) was critical of Fricker`s
central argument of hermeneutical injustice, claiming that Fricker`s analysis might
contribute to the disempowerment and marginalization of non-dominant subjects. Mason
argued that Fricker failed to see the possibility that subjects in marginalized groups
might possess “non-dominant interpretive resources from which they can draw to
understand and describe their experiences” (p. 295). According to Mason, marginalized
subjects will hence not necessarily experience hermeneutical injustice, and even though
Fricker (2007) emphasized that hermeneutical
injustice is “not a subjective failing” (p. 169), I do, to a certain degree, agree with
Mason. For instance, in Wood`s example, Mason argued that the women understood that
their experiences of sexual harassment were wrong even though they didn’t have any name
for it. It is not the socially recognized name that prevents groups from understanding.
Mason (2011) suggested an “alternative kind
of unknowing” (p. 298), which is at play when hermeneutical resources are insufficient
with the experiences of someone in the community. This is hermeneutical injustice and
“epistemically and ethically blameworthy ignorance” (p. 301). Mason here referred to
Mills (1997) who focused on ignorance rather
than knowledge, reflecting on how those with power can fail to understand, rather than
marginalized groups, due to “epistemically irresponsible and ethically reprehensible
practices of misinterpretation, misrepresentation evasion, and self-deception” (p. 303).
In the context of epistemic ignorance, the comprehensibility of marginalized groups to
dominant groups is prevented by “epistemic practices infected by ignorance, not by their
own inability to understand their experiences” (Mason,
2011, p. 304).
Following up on Mills` notion of epistemic ignorance, Pohlhaus (2012) paid attention to the relationship between
interdependence and situatedness as an account of how it is possible to actively
maintain such systemic ignorance. Pohlhaus critiqued Fricker (2007) and the limitations of hermeneutical injustice, pointing
to the argument regarding willful hermeneutical ignorance. Marginally situated knowers
may be epistemically disadvantaged, Pohlhaus (2012) argued, but those who are dominantly situated are also situated to know
that their dominant epistemic resources are not very suitable in whole parts of the
world. Willful hermeneutic ignorance describes how marginally situated knowers resist
epistemic dominance actively through interacting with other marginally situated groups.
At the same time, dominantly situated knowers continue to misinterpret and misunderstand
the world. A dominantly situated group may maintain their ignorance “by refusing to
recognize and by actively undermining any newly generated epistemic resource that
attends to those parts of the world that they are vested in ignoring” (p. 728). One way
this kind of ignorance appears might be through the maintenance of binary pronouns. I
find these perspectives both relevant and interesting, and I will discuss them further
in relation to children.
Epistemic injustice and children
Considering my above discussion of children`s “otherness” in society, prejudices against
children and childhood are clearly present. The epistemic prejudices are related to the
prejudices and assumptions adults have, implicitly and explicitly, about children (Murris, 2013). Do these prejudices make children
more vulnerable to epistemic injustice (Carela &
Györffyb, 2014)? Fricker (2007)
claimed that “wherever there are identity prejudices in the discursive environment,
there is a risk of testimonial injustice” (p. 86). Identity prejudice, which is produced
by binary discourses, operates as a “widely held disparaging association between a
social group and one or more attributes” (p. 35), and talking about children as a fixed
category might emphasize prejudices in this context. As earlier mentioned, it might be
insufficient, and also wrong, to talk about children as a fixed category, and I argue
that it also underpins children`s vulnerability to epistemic injustice.
Carela and Györffyb (2014) claimed that the
question of epistemic injustice in relation to children is of particular importance in
health care. This is because children have important information about their own
well-being, and Carela and Györffyb emphasized how one can easily disregard what
children actually tell us. Murris (2013)
acknowledged this as well, proposing that “hearers` prejudices cause adults to miss out
on knowledge offered by the child, but not heard by the adult” (p. 246). Despite these
important perspectives on children`s prone position in relation to epistemic injustice,
the literature is remarkably silent on children in this context, and it is further
silent on what influences adults when hearing children`s voices and what we regard as
“real” knowledge (Murris, 2013). “Queer
listening” (Bonenfant, 2010; Hadley & Gumble, 2019), which involves
“developing a certain virtuosity” (Bonenfant, 2010, p.
78) might be one way for adults to hear the knowledge offered by the child,
and I will consider this further when examining different virtues for epistemic
injustice.
In relation to hermeneutical injustice, I argue that children often experience exclusion
from meaning making. This might create a “gap in collective hermeneutical resources”
(Fricker, 2007, p. 6), and thus possibly
prevent children from making sense of their own social experiences. In some social
contexts, hermeneutical injustice happens when someone is “socially constituted as
something they are not” (p. 168). Fricker exemplifies this with Edmund White`s (1983) book A Boy`s Own Story,
where a boy growing up in 1950s America has a strong sense of dissonance around their
own feelings for other men and the authoritative hermeneutical constructions of the
social identity of being gay. The boy`s young self is, in this context, formed through
all of these different constructions about homosexuality around them, exemplifying how
some might thus “be prevented from becoming who they are” (Fricker, 2007, p. 168). Connecting this with queer epistemology
and the previously mentioned mandatory testimony of one`s gender and sexuality,
hermeneutical injustice might also contain epistemic violence.
I understand hermeneutical constructions as the primary harm of hermeneutical injustice
in relation to children, as well as the epistemic violence that occurs when facing
pressure to inhabit an identity category. Considering the different aspects that
predispose children to epistemic injustice, it is crucial to find ways to prevent
epistemic injustice when working and doing research with children.
Epistemic injustice and patients in mental health care
One might also ask, is epistemic injustice relevant when communicating about patients in
mental health care? I argue that it certainly is, considering the many identity
prejudices against patients in mental health care that are clearly present in society
(Johnstone, 2001). Central to mental health
legislation, “some people lack the capacity to make decisions” (Lakeman, 2010, p. 151). The implication of this is that the words,
preferences, and choices of “some people” (i.e., patients in mental health care) and
their interpretations of their problems, “lack coherence, logic or credibility” (p.
151). Considering how Fricker (2007)
identified the primary harm of testimonial injustice, patients in mental health care
seem to be vulnerable to testimonial injustice. Lakeman (2010) argued that testimonial injustice is foundational for
other forms of injustice, such as social and procedural justice, exemplifying how
decisions in mental health services are based on assessment of the credibility of the
person`s testimony.
Patients in mental health care might also experience hermeneutical injustice in that
they might be deprived of their means of understanding and communicating their own
social experience (Wardrope, 2015). This is
central to the critique of medicalization. Wardrope (2015) claimed that “medicine`s epistemic authority eclipses all
other understandings in our collective hermeneutical resources” (p. 342). Patients in
these concrete social situations might suffer an unjust disadvantage and hence a sort of
“structural discrimination” (Fricker, 2007, p.
161). Wardrope, however, does not agree with the critique of medicalization,
referring to the risk of committing the other kind of epistemic injustice, testimonial
injustice. Wardrope (2015), here referred to
how the critiques ascribe insufficient credibility to the testimonies of, for instance,
children with ADHD diagnosis, where the majority of the children who were asked
“rejected the medicalization critique`s analysis” (p. 348).
The main disabling barrier in mental health care is considered to be social stigma
(Beresford, Nettle, & Perring, 2010;
Rolvsjord, 2014). An epistemically and
ethically blameworthy ignorance might occur where lesbian, gay, bisexual, transgender,
and queer (LGBTQ) individuals in mental health care experience pervasive stigma in
mental health care (Bain et al., 2016; Hadley & Gumble, 2019). This stigma might
affect how LGBTQ individuals are heard as mental health patients and willful
hermeneutical ignorance (Pohlhaus, 2012)
happens.
The virtue of epistemic justice
Fricker (2007) suggested different virtues
for the two different kinds of epistemic injustice. In order to avoid testimonial
injustice, Fricker claimed that the hearer has to have a “corrective anti-prejudicial
virtue that is distinctively reflexive in structure” (p. 91). The ideal is to neutralize
impacts of prejudices, and one should overcompensate to increase the level of
credibility that would have been there without prejudices. “The virtuous hearer
neutralizes the impact of prejudice in her[/his/their] credibility judgements” (p. 92)
Fricker claimed. The virtue of hermeneutical justice is also corrective in structure,
and it involves a more “socially aware kind of listening” (p. 171). In order to avoid
hermeneutical injustice, one has to possess a sensitivity or alertness to the
possibility that our interlocutors’ difficulties in trying to make something
intelligible in the communication is not because they’re not intelligent, but rather
because there is a gap in collective hermeneutical resources. One has to realize that
the speaker might struggle with an “objective difficulty, and not a subjective failing”
(p. 169). Fricker, however, does not meet Mason`s (2011) nor Pohlhaus’ (2012)
critique in these virtues, failing to recognize the non-dominant interpretive resources
which subjects in marginalized groups might possess, as well as the willful hermeneutic
ignorance in dominant situated groups.
The previous mentioned “queer listener” (Bonenfant,
2010) might be related to Fricker`s term the “virtuous hearer” (2007). Bonenfant (2010) suggested that the voice is a “form of social touch” (p.
77) and that this touch can “activate reactions in bodies, literally, by vibrating them”
(p. 77). “Queer is a doing, not a being” (p. 78), and the queer listener “listens out
for, reaches toward, the disoriented or differently oriented other” (p. 78), as well as
finding appreciation of the other. Connecting this to music therapy, Hadley and Gumble
(2019) claimed that when engaging in
queer listening, “music therapy can be transformed into a space” (p. 226) where this
appreciation can happen. As Fricker (2007)
was also emphasizing, when “listening out for queer desires and needs” (Bonenfant, 2010, p. 78) a sensitivity is
required.
Hearing the competent and credible child and embracing epistemic humility
As I have advocated earlier, children and patients in mental health care seem to be
vulnerable to epistemic injustice. In my Ph.D. project, the children who are
participants in the study are both “children” and “patients in mental health care.” What
kind of precaution is needed in order to avoid epistemic injustice in this context?
Exclusion from knowledge is, as earlier mentioned, the primary harm of testimonial
injustice, and one might also argue that this is the primary harm in research. According
to Fricker (2007), prejudices can shape our
credibility judgements despite our own beliefs, and testimonial injustice thus might
happen without us being aware of it. To avoid the injustice, then, the hearer has to be
critically aware and identify the impact of identity power in their credibility
judgement. The hearer has to be alert not only to the speaker´s social identity, but
also to the impact of their own social identity on their credibility
judgement. Being reflexive and critically aware to how we perceive “children” and
“patients in mental health care” is hence a key issue to avoiding testimonial injustice
in the interaction with those children in mental health care that are participating in
this study, as well as how we perceive ourselves (“adults”/”researchers”) in this
context. Another important aspect is a critical awareness regarding the
difference as structured discursively in the binary oppositions
between “children” and “adults” and “researchers” and “patients in mental health care.”
There is further importance to how this might impact relationships, and thus the
interaction, between the researcher and the children participating in the study. The
“otherness” of the fixed categories of children and of patients in mental health care,
and the prejudices one might have connected to this “otherness”, implicit or explicit,
are crucial and important to interrogate and be aware of in efforts of avoiding
testimonial injustice in the research process.
Fricker (2007) argued that a more socially
aware kind of listening, as in the virtue of hermeneutical justice, involves “listening
as much to what is not said, as to what is said” (p. 171–172). When
searching for these other voices, the queer listener has to possess a virtuosity and a
“certain kind of attunement to hearing beyond syntax” (Bonenfant, 2010, p. 78). Listening to what is not said is
particularly interesting in relation to children, considering, for instance, the
previously suggested child-centred perspective and the plentiful advice for implementing
varied techniques when interviewing children (Einarsdóttir, 2007). Children often communicate and express themselves
through different modalities and not just through words. As earlier mentioned, even
infants communicate and actively take part in communication through an inborn
“communicative musicality” (Trevarthen & Malloch,
2000), and the knowledge about this non-verbal communication gives us an idea
about what adults might miss if they ignore what is not said. Important
information and relational initiatives from children can be missed, resulting in an
exclusion of children`s knowledge and ways of expressing themselves from hermeneutical
resources. Hermeneutical injustice seems to affect children more strongly than other
groups, and to avoid this injustice requires, according to Fricker (2007), a reflexive and critical awareness, but
also, I argue, a more general analysis of structurally embedded power in the different
social situations.
If we consider this alongside the work of Mason (2011), the case of hermeneutical injustice might also relate to another kind
of unknowing, which is not a hermeneutical injustice but rather an epistemically and
ethically blameworthy ignorance. Children might possess “non-dominant interpretive
resources” (p. 295) which can be used to “understand and describe their experiences” (p.
295), and according to Mills (1997), it is
not always the marginalized that fails to understand their experiences but, just as
often those in power, those in the dominant group. Pohlhaus (2012) argued that hermeneutical injustice, as Fricker (2007) has defined it, happens when “a
marginally situated knower has no community with which to develop adequate epistemic
resources” (Pohlhaus (2012, p. 731) to make
sense of their own experiences. However, willful hermeneutical ignorance occurs where
marginally situated knowers have a community where adequate epistemic
resources are developed, but dominantly situated knowers do not want to acquire this
knowledge.
If adults then systematically ignore what children communicate, what implications might
this have in research? Will it, in light of this question, even be possible for adults
to understand what children communicate about their experiences?
When our interlocutors have difficulties in trying to make something intelligible in
communication, Fricker (2007) emphasizes
that it is not because the interlocutor is not intelligent but rather because there is a
gap in collective hermeneutical resources. Because of this gap, we have to possess a
sensitivity or alertness to this possibility. But is this sensitivity and alertness
enough? Do we have the right tools in our epistemic capacities to go beyond the gaps
developed through a systemic ignorance of children`s different experiences and
expressions? Wardrope (2015) critiques
Fricker`s suggestion to not engage with “the root causes of epistemic injustice” (p.
350). Wardrope`s (2015) alternative is
“epistemic humility” (p. 350), an awareness of one`s own epistemic capacities and the
limitations of these, as well as an active searching for contrasting and complementary
perspectives outside oneself to go beyond these shortcomings. Wardrope argued that it is
important to not just involve personal awareness but also to involve public expressions
of the epistemic limitations one has. This might be a useful perspective to bring into
research with children and patients in mental health care.
Conclusion
Who has the right to knowledge? And whose knowledge are we seeking? Doing research with
children in mental health care involves many different challenges. One of these includes
the risk of epistemic injustice, and this risk is a central issue within this specific
context. Children and patients in mental health care seem to be vulnerable to epistemic
injustice – both testimonial and hermeneutical injustice, as well as willful
hermeneutical ignorance. In order to avoid this, it is of special importance to be
critically and reflexively aware of the prejudices one might have as a researcher
towards the fixed categories of “children” and “patients in mental health care” and also
to deconstruct binary oppositions in an attempt to disrupt identity prejudices. It is
also crucial to maintain a sensitivity and an alertness, a “queer listening” (Bonenfant, 2010; Hadley & Gumble, 2019), to the difficulties that children in
mental health care might have when trying to express themselves to the researcher in a
way that is clearly understood.
It is of special importance to be aware of modalities other than words when interacting
with children in efforts to avoid epistemic injustice. It also seems to be crucial to go
beyond one’s own shortcomings and involve public expressions of the epistemic
limitations one has. Knowledge about how epistemic injustice exists in relation to
children and patients in mental health care, and how to avoid it, gives us an awareness
about why it is important to include children in mental health care and their knowledge
in research and to explore the different complex challenges.
About the author
Guro Parr Klyve is a music therapist working at the Department of Child and Adolescent
Psychiatry, Division of Mental Health at Haukeland University Hospital in Bergen. Guro
is currently doing a Ph.D. at The Grieg Academy – Department of Music at the University
of Bergen in Norway. The Ph.D.-project is a qualitative study where the purpose is to
gain more knowledge about how children experience music therapy during hospital
admission in mental health care. Guro uses she/her/hers pronouns and define herself as a
white cisgender heterosexual nondisabled woman.
Throughout this text, I use they/them/their pronouns instead of only his/her in
efforts to include those who do not use binary pronouns.
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