Making sense of a diagnostic category : a study of the relationship between theory and practice

Members of scientific disciplines and lay persons alike commonly hold the view that the practical work carried out by those very same members is theory governed. The problem undertaken by this study was to observe, in a psychiatric hospital, the practical work of psychotherapists, with the intent of characterizing the role played by theory in their work. An ethnographic approach was employed, and the research was focused on psychotherapy with patients diagnosed to be members of a single diagnostic category. The researcher began his fieldwork with the assumption that his knowledge of psychiatric theory would allow him to make sense of his observations. Contrary to his expectations, he was unable to discern the theoretical significance of the activities that he observed. This led the researcher to conclude that there was a "gap" between his knowledge and his observations. The researcher developed a number of plausible explanations for the "gap," none of which proved to be adequate. The "gap," in itself, raises a hitherto unacknowledged issue of the relationship between theory and practice. It is argued that the "gap" exists not only for the researcher, but also for any persons who would study a body of scientific theoretical knowledge, and then observe what purports to be the practical application of that knowledge. The "gap" seems to be integral to any theory-guided discipline. The study explicates, it is argued, a characteristic of scientific work. The lack of an adequate explanation for the "gap" is not a failing of the study, but rather points to the lack of a standard which specifies what "theory governed" means. Although the study presents us with a puzzle, it does not put into question the efficacy of theorizing with respect to the accomplishment of practical work in the clinical or any other disciplines.Arts, Faculty ofAnthropology, Department ofGraduat