Social Analysis in Psychiatric Formulation

1. Psychiatrist works very closely with the social worker but in most cases psychiatric case presentation lack thorough social analysis.

2.  In most cases, psychiatrists tend to focus on inadequacies inherent in individual genes, social interaction, inter- and intrapersonal relationships. That is OK. But definitely inadequate. For future presentation, the following themes in social history have to be given more emphasis:

a) tracing personal problems in the socioeconomic structure and what role they play in causing the problem situation.

b) social control i.e. function of certain groups and individual members of this group so that existing social and power divisions are maintained. I give example of how families are isolated from certain quarters that are powerful in the society.

c) some critique of existing social and economic arrangement.

d) issues like oppression, exploitation, gender and social change.

3. A gentleman is seeking assistance for stress management after his divorce. His wife said that the husband was boring. Though he has tried to be a good husband and very hard working, but it is still hard “to know what the women want these days” he confessed. “Now I can’t sleep at night because I am awake thinking none of my sacrifices been worth it”

4. Well, in this case, for instance, this man seems puzzled that he doesn’t measure up to his wife’s expectations. He is wondering whether this is his fault or his wife, or the fault of women generally for not being clear about what they want.

5. This man is worried about the current social expectations women place on men. He is implying women want too much or that what they want is unrealistic or they are unclear about it.

6. Stress management is the issue for the psychiatrist to manage here. Probing on anxiety, depression and a long list of psychiatric disorders is a must.

7. Not to forget issues like (1) socioeconomic structure of the family, (2) social and religious controls pertaining to concept like redha and tawakal (for Muslim) (3) critique on probable workaholic attitude that wife found him boring and last but not least is the issue pertaining to the stress of modern living.

8. Social analysis helps for better understanding and management of the case.

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