Time to disclose, timing disclosure: GPs' discourses on disclosing domestic abuse in primary care

Abstract

Research has demonstrated that women are more likely to disclose domestic violence to a GP during the consultation in primary health care than in Accident and Emergency. Little is known of the process of disclosure in the context of primary health care, especially from the perspective of the GP. In this article we present data from a pilot study with GPs working in a city locality about their experiences of disclosure and the actual processes through which they suspect and explore domestic abuse. We draw upon the work of, amongst others, Strong (1979) and his analysis of medical encounters to consider the consultation in which domestic abuse is disclosed in terms of a ceremonial order. The concepts of time (Adam 2000) and myths (Barthes 1972) provide crucial dimensions to our analysis. GPs employed various concepts of time as vehicles for explaining the reasons for, and circumstances surrounding, violence as well as presenting barriers to further involvement. GPs mythologised time by asserting they did not have enough time and yet revealing their ability to control and suspend time in the consultation if they consider it to be appropriate. In the process of mythologising time, the ceremonial order can become paramount. In conclusion, we contend that the sociology of health and illness might gain further conceptual and analytical understanding of the consultation by merging notions of ceremonial order with a fuller appreciation of sociological theory on time and myths, especially as this poses barriers to the disclosure of domestic abuse and other sensitive matters.