Week 8 Flashcards
3 dimensions of marginalization
- When diagnosis oppresses
- When treatment harms
- When labelling decontextualizes suffering
Constructing Gender
Psy-disciplines central to articulation of gender norms
- Many argue femininity (in particular) has been crafted through psy-gaze
- psychoanalysis heavily gendered
Hysteria
roaming uterus > constitutional weakness > somatic unpredictability
- Shifting symptomology reflected “unpredictability” of women/ bodies
Micale: Constructing Gender
“dramatic medical metaphor for everything men found mysterious/ unmanageable in opposite sex” (hysteria caused leg paralysis)
Ussher: Constructing Gender
BPD simply “shorthand for angry, difficult, female clients”
Maracek & Gavey: Constructing Gender
“ideology of masculine society dressed up as objective truth”
Female Sexual Dysfunction Case Study
- Female Orgasmic Disorder
- Sexual Interest/Arousal Disorder
Female Orgasmic Disorder
- Men cannot make women cum; medicalized to justify
- Makes sex sound transactional
- “Sufficient stimulation” who defines?
Sexual Interest/Arousal Disorder
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
Diagnostics / Treatment
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
How do Symptoms/ causes of women’s mental health problems typically reflect underlying ideas about gender, especially in behaviors “appropriate” for women?
- Gender norms (violations) linked to mental illness
- Some cases might be better understood as resistance against gender norms
- Eg. suffragettes, divorcees, educated women
How might Psy-disciplines simultaneously “pathologize and protect” women?
- Makes symptoms be seen as a problem (validation)
- Relieves responsibility/ blame and offers reform with treatment
Queer encounters with psychiatry
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
Gender Identity Disorder (DSMIII)
- DSM IV: boys who wear dresses and girls who refuse to wear dresses
- Boys 6x likely diagnosed
Gender dysphoria (DSMV)
- Gender nonconformity NOT disorder: distress not rooted in social attitudes
- How is this possible? (Discrimination/ stigma?)
- Helps with diagnosis but does not make sense
Care and harm of Queer
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
How does the mental health care system have problems with race and class
- 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”)
J Metzel: Protest Psychosis
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)
Is it the disorder OR could social environment(s) cause both illness and violence?
- 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
Homelessness
- 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
O’Hagan: Homelessness
mental illness label paints you as a “bundle of needs” and prevents thinking about problems/ causes
Through their activities, how might psy disciplines inadvertently contribute to marginalization?
- 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
