Pollard on Peter Good

"The care chronotope is characterised by linear, clock governed time, where spaces are filled with brisk and purposeful activities. This chronotope is filled with different, often competing voices, which are all nevertheless oriented towards a positive future. In the patient chronotope time is slower and circular, and spaces and the bodies that occupy them take on a wholly different set of meanings. The way time is structured and by whom is determined by the dominant chronotope.

Dialogism, in isolation from Bakhtin's other ideas, is often erroneously understood as a purely linguistic concept. Bakhtin's concept of the chronotope contextualises dialogue by grounding it in a temporal-spatial and therefore physical/material reality.

Without such temporal-spatial expression, even abstract thought is impossible. Consequently every entry into the sphere of meaning is accomplished only through the gates of the chronotope".

"Good's travels take him into another part of the landscape via the moving accounts of practitioner patients, mental health workers who themselves became ill and find themselves, often suddenly, catapulted into the patient chronotope. The transition between the two chronotopes is traumatic, characterised by feelings of fear, helplessness, betrayal and abandonment".

"As he remarks, to change chronotope does not merely mean adopting a different intellectual perspective, it means changing your life. Academic analysis is replaced by a painfully vivid description of his experience of patienthood; his intense levels of anxiety, fear and uncertainty and the extreme speed with which he loses his self-management skills. Social encounters of any kind are exhausting. He becomes locked into solitary inner dialogues. No criticism at all is directed at the staff in the clinic who are seen as competent and kind but also imprisoned in a different time space. He finds himself totally unable to respond to their invitations to exercise choice...This later prompts him to question the philosophy behind consent theory or the priority now accorded to patient 'entitlement' and 'choice".

Rachel Pollard