Week 8

Question 1

3 dimensions of marginalization

Answer 1

1. When diagnosis oppresses
2. When treatment harms
3. When labelling decontextualizes suffering

Question 2

Constructing Gender

Answer 2

Psy-disciplines central to articulation of gender norms
- Many argue femininity (in particular) has been crafted through psy-gaze
- psychoanalysis heavily gendered

Question 3

Hysteria

Answer 3

roaming uterus > constitutional weakness > somatic unpredictability
- Shifting symptomology reflected “unpredictability” of women/ bodies

Question 4

Micale: Constructing Gender

Answer 4

“dramatic medical metaphor for everything men found mysterious/ unmanageable in opposite sex” (hysteria caused leg paralysis)

Question 5

Ussher: Constructing Gender

Answer 5

BPD simply “shorthand for angry, difficult, female clients”

Question 6

Maracek & Gavey: Constructing Gender

Answer 6

“ideology of masculine society dressed up as objective truth”

Question 7

Female Sexual Dysfunction Case Study

Answer 7

• Female Orgasmic Disorder
• Sexual Interest/Arousal Disorder

Question 8

Female Orgasmic Disorder

Answer 8

• Men cannot make women cum; medicalized to justify
• Makes sex sound transactional
• “Sufficient stimulation” who defines?

Question 9

Sexual Interest/Arousal Disorder

Answer 9

US: 30% of women “have it” 2X+ men
- Different symptoms for men and women = unreceptive to sexual advances (not for men)
- Does not apply if distressed from “severe relationship issues”
- Does not consider factors of than abuse/ cruelty

Question 10

Diagnostics / Treatment

Answer 10

MDs assume men’s issues are physical and that women’s are somatic
- Implies that men are rational and women are not
- Women less likely to receive advanced diagnostics/ intervention

Question 11

How do Symptoms/ causes of women’s mental health problems typically reflect underlying ideas about gender, especially in behaviors “appropriate” for women?

Answer 11

• Gender norms (violations) linked to mental illness
• Some cases might be better understood as resistance against gender norms
• Eg. suffragettes, divorcees, educated women

Question 12

How might Psy-disciplines simultaneously “pathologize and protect” women?

Answer 12

• Makes symptoms be seen as a problem (validation)
• Relieves responsibility/ blame and offers reform with treatment

Question 13

Queer encounters with psychiatry

Answer 13

While psychoanalysis medicalized same-sex relationships, disciplines on fringe of psy-complex pushed back (largely unsuccessful)
- Homosexuality delisted 1973, replaced with “ego-dystonic sexuality” until the 80s
- Only if they felt distress over sexuality
- Gender Identity Disorder
- Gender dysphoria

Question 14

Gender Identity Disorder (DSMIII)

Answer 14

• DSM IV: boys who wear dresses and girls who refuse to wear dresses
• Boys 6x likely diagnosed

Question 15

Gender dysphoria (DSMV)

Answer 15

• Gender nonconformity NOT disorder: distress not rooted in social attitudes
• How is this possible? (Discrimination/ stigma?)
• Helps with diagnosis but does not make sense

Question 16

Care and harm of Queer

Answer 16

Psy practice attempts to treat queer/ trans via transformation
- Eg. Fruit Machine, somatic/ psychiatric treatments (aversion therapy and conversion therapy)
- Eg. gay porn > vomiting pills/ ECT for negative association
- Discredited aversion therapy, conversion still exists
- Treatment often rooted in moral issues

Question 17

How does the mental health care system have problems with race and class

Answer 17

• British psychiatric hospitals: black people 21% of patient population but only 7% of general population
• Race and class both structure likelihood of received particular diagnoses
• Working class mental health problems are more likely to be rated as “severe” than higher SES clients
• Black and working class less likely to be referred for psychotherapy (due to perceived “limitations of mind”)

Question 18

J Metzel: Protest Psychosis

Answer 18

looked through old records and noticed profiles for schizophrenia patients changed 60-75
- Typically petty criminals and non-violent; then shifted to violent, male and black
- Related to civil rights movement (Metzel: anger was justified)
- Criteria for schizophrenia changed (hostility and aggression known as symptoms)

Question 19

Is it the disorder OR could social environment(s) cause both illness and violence?

Answer 19

• People diagnosed with schizophrenia and addiction concentrated in areas of economic deprivation
• Economic hardship, sensing lack of control over one’s life and linked to violence generally, as stress increases anger and aggression // violence may attempt to resolve when powerless
• People with less economic hardship and more social support not more likely than the general population to commit violence

Question 20

Homelessness

Answer 20

• Traditional explanation is chalked up to illness and deinstitutionalization
• Mental health troubles are a product of homelessness itself, broader decimation of social services
• Many homeless with mental illness cycle through “Institutional circuit” failure to settle explained with illness instead of state of services
• Alternative explanation foreclosed via diagnosis

Question 21

O’Hagan: Homelessness

Answer 21

mental illness label paints you as a “bundle of needs” and prevents thinking about problems/ causes

Question 22

Through their activities, how might psy disciplines inadvertently contribute to marginalization?

Answer 22

• Through the establishment of norms which pathologize those outside those norms while also fostering beliefs about “healthy groups” that may be harmful
• Via treatment with the aim of ‘restoring normality’
• Via psychiatrization, which encourages us to individualize social problems