Talking about sexuality in a total institution: A clinical ethnography

Objectives

Talking about sexuality in a health care total institution is not an easy task insofar as it contributes to the disclosing of the subjective and cultural postures of professionals, in contexts still marked by the absence or lack of professional training on this subject. Talking about sexuality can also endanger or challenge the institution.

Method

This paper presents a secondary analysis of what is presented as a form of “clinical ethnography”. The materials used in this study were collected in 1996–1997, in the context of a crisis situation caused by the revelation of illicit sexual relations between a head special educator and a young woman labelled as mentally handicapped, in a care institution. In the course of a psychosociological intervention carried out in response to a request from the management of the institution, professionals from different categories were able to express themselves on these “events” and to address, more generally, issues related to sexuality in the institution. The sessions, moderated by the author of the study and a psychoanalytic research assistant, were recorded and transcribed for subsequent feedback to participants.

Results

The thematic content analysis of the transcripts of the sessions allowed for a better understanding of the psychosocial obstacles to communication about sexuality, the subjective difficulties related to speaking out, the phenomena of denial of sexuality, as well as the representations of sexuality in institutional situations.

Discussion

The documents discussed here invite reflection on the complexity of collecting information and stories about sexuality in institutional settings. They explore communication processes and, in particular, the difficulties of communicating about sexuality and sexual abuse in institutions in the health and social sector.

Conclusion

This study suggests ways in which clinical support can be provided to teams affected by and confronted with traumatic events and the personal and professional difficulties that may arise from such situations.