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Interrogating biomedical dominance
Abstract
This chapter examines contested understandings of “mental health”, from the most dominant biological perspectives through to less well-known social and political explanations of mental distress. It outlines key components of a critical perspective on mental health, most notably, its exploration of the intersections between mental health diagnostic practices and social power relations. Critiquing claims of objectivity within psychiatric practices, the chapter argues that constructions of mental health and mental illness are shaped by the norms of patriarchal and neoliberal societies, which privilege “productive” and “rational” forms of personhood. Following this, the chapter discusses how psychiatric practices both reflect and perpetuate gender inequality through using mental health labels to categorise women’s experiences as dysfunctional, while ignoring the social contexts of women’s distress. Consequently, women may experience mental health labels as initially useful, but ultimately disempowering. Feminist critiques of psychiatric practices are discussed, including the diverse contributions of second-wave and poststructural feminisms. While second-wave feminism offers an incisive analysis of how patriarchal power is both reflected and reinforced through mental health systems, poststructural feminism allows for women’s resistances and diverse experiences to be more fully acknowledged.
Aim
With high rates of trauma in the population, known links between trauma and perinatal distress, and the intimate and close nature of the nursing and midwifery roles, ensuring awareness and understandings of trauma is crucial for guiding practice. This paper aims to explore the relationship of trauma to the perinatal period, based on theory and practice, to consider on how nurses and midwives can deliver trauma‐sensitive interactions.
Design and Methods
This discursive discussion draws on relevant research from the fields of trauma therapy, attachment theory and nursing and midwifery practice to consider elements of trauma‐sensitive practice in the perinatal period.
Results
Nurses and midwives can foster safety for people who have experienced trauma through noticing and responding to triggers, supporting awareness of attachment and its relationships to trauma, undertaking psychosocial screening with care, supporting linearity and cohesion in narratives and developing collaborative care plans that maximise safety and agency. For nurses and midwives, understandings of the relationship between trauma, pregnancy, birth, early parenting and distress is crucial for effective care delivery.
Delivering perinatal nursing or midwifery care of any kind, without universal trauma precautions risks reinforcing, misinterpreting or re‐enacting dynamics of trauma. To be trauma‐sensitive in this period requires nurses and midwives to have awareness of the dynamics of trauma in relation to pregnancy, birth and attachment.
Implications for the Profession and/or Patient Care
This paper fills a gap in the translation of theory to practice for trauma‐sensitive care in the perinatal period, with a focus on the therapeutic relationship formed by nurses and midwives. The findings highlight that nurses and midwives can foster safety for people who have experienced trauma within their practice, when they hold a robust understanding of the relationship between trauma, pregnancy, birth, early parenting and distress.
Patient or Public Contribution
No patient or public contribution.
'Psychiatric Hegemony' offers a comprehensive Marxist critique of the business of mental health, demonstrating how the prerogatives of neoliberal capitalism for productive, self-governing citizens have allowed the discourse on mental illness to expand beyond the psychiatric institution into many previously untouched areas of public and private life including the home, school and the workplace. Through historical and contemporary analysis of psy-professional knowledge-claims and practices, sociologist Bruce Cohen shows how the extension of psychiatric authority can only be fully comprehended through the systematic theorising of power relations within capitalist society. From schizophrenia and hysteria to Attention-Deficit Hyperactivity Disorder and Borderline Personality Disorder, from spinning chairs and lobotomies to shock treatment and antidepressants, from the incarceration of working class women in the nineteenth century to the torture of prisoners of the ‘war on terror’ in the twenty-first, 'Psychiatric Hegemony' is an uncompromising account of mental health ideology in neoliberal society.
With the recent proliferation of categories of mental illness and an increasing acceptance within western society of such categories as evidence of real disease, this chapter is a timely reminder of the social constructionist challenge to the existence of mental illness, and thus the validity of psychiatric practice as a whole. With reference to some of the key research on categories of mental illness, it is argued that while the social constructionist understanding of the discourse of mental illness as a myth and psychiatry as an institution of social control remains valid, the explanatory power of the approach is limited. Social constructionism can explain increasing professional power as part of state surveillance and control of populations, yet it cannot account for tensions and disagreements within psychiatry nor processes, which appear counter-productive for psychiatry such as the occasional de-medicalisation of some mental illness categories over time. To understand fully Western psychiatry, the chapter argues that we need to conceptualise the profession as an ideological state apparatus, which conforms and functions to the needs of capital and the ruling classes. This is illustrated through a survey of some of the Marxist writings on medicine and a demonstration of how this can work within the field of psychiatry; in doing so, time is given to exploring the discipline's role in the reproduction of gender inequalities and the normalisation of patriarchal relations. It is concluded that further critical work around the idea of psychiatric hegemony could be most productive in light of the forthcoming publication of the DSM V.
Introducing the rationale for the Routledge International Handbook of Critical Mental Health, Cohen surveys the history of critical approaches from the 1960s and 1970s, and theorises as to why there has been a retreat from critical thinking in the social and health sciences—and consequently a move back to conservative “social causation” approaches—since that period. With the evidence base on mental illness remaining highly contested, he argues that now more than ever critical perspectives are necessary to effectively problematise the practices, priorities, and knowledge base of the mental health system.
This paper presents a user/survivor researcher perspective to the debate among psychiatrists on the suggested introduction of Community Treatment Orders in Ireland. Critical questions are raised about evidence and the construction of psychiatric knowledge. Important questions include: How is this evidence created? What and whose knowledge have not been considered? Some critical issues around coercion, ‘insight’, and attributions of ‘lack of capacity’ are briefly considered. Further legal considerations are then introduced based on the United Nations Convention on the Rights of Persons with Disability. The paper concludes with a human rights-based appeal to reject the introduction of coercive community treatment in Ireland.
Over recent decades, poststructuralist theories have allowed critical disability scholars to challenge essentialist understandings of the human species and to contest discourses which divide humans into ‘normal’/‘impaired’ subjects with respect to a wide – and ever expanding – range of corporeal and cognitive traits. For critics, however, these theories are deeply flawed. By focusing primarily on language, poststructuralism shifts our critical attention away from the often harsh material realities of life for disabled people. This has led some to turn to critical realism and to effectively re-essentialise impairment. In this article, I wish to consider an alternative approach. I suggest that the recent ‘ontological turn’ in social theory has seen the emergence of new-materialist approaches – including Deleuze and Guattari’s ontology of assemblage and methodology of assemblage analysis – which allow us to consider disability as a material phenomenon without a return to essentialism.
Wellbeing has become a keyword in youth and social policy, a construct deployed as a measure of a good life. Often associated with physical and mental health, wellbeing encompasses numerous indicators, from subjective experiences of happiness and satisfaction to markers of economic prosperity and basic human needs of security. This article examines wellbeing as an organizing concept in discourses on young people and argues for defamiliarizing its truth claims and cultural authority by investigating what wellbeing does. We begin by examining the rise of wellbeing, drawing attention to its conceptual muddiness and ambiguity. Framed by the Foucauldian notion of problematization, the analysis proceeds along two routes: first, through an historical consideration of wellbeing as a relational concept with antecedents, focusing on ‘self-esteem’; and second, through a reading of wellbeing in contemporary educational policy. Informed by Somers' historical sociology of concept formation and Bacchi's critical policy analysis, we illuminate the mixed dimensions of wellbeing's reach, placing it within longer traditions of youth studies and psy-knowledges and showing its transformative promise as well as its individualizing effects. In doing so, we elaborate a methodological approach that can be adapted to examine other keywords in youth studies and social policy discourse.
This article draws attention to the relationship between neoliberalism and psychology. Features of this relationship can be seen with reference to recent studies linking psychology to neoliberalism through the constitution of a kind of subjectivity susceptible to neoliberal governmentality. Three examples are presented that reveal the ways in which psychologists are implicated in the neoliberal agenda: psychologists’ conception and treatment of social anxiety disorder, positive psychology, and educational psychology. It is hoped that presenting and discussing these cases broadens the context of consideration in which psychological ethics might be examined and more richly informed. It is concluded that only by interrogating neoliberalism, psychologists’ relationship to it, how it affects what persons are and might become, and whether it is good for human well-being can we understand the ethics of psychological disciplinary and professional practices in the context of a neoliberal political order and if we are living up to our social responsibility.
This article contributes to the existing literature on neoliberalism as an ideological hegemonic project by addressing how the image of social reality it advances normalizes the medicalization of human life. Because success, virtue, and happiness in a neoliberal market society are often associated with material wealth, prestige, and “coming out on top,” it follows that normalcy itself is typically conceived along these reified objectives. Acquiring services and/or products that might aid people to meet these results is thus viewed as benevolent and perhaps even indispensable in the pursuit of a fulfilling and productive life. What this also suggests is that integration, mental health, and human well-being become largely functions of consumerism. We address how an emphasis on medicalization, particularly the use of psychotropic drugs, can be traced to the psychopharmacological revolution of the mid-twentieth century and its obsession with situating illness within the individual. We then address how this obsession with medicalization and the tendency to treat “mental illness” as a problem within the individual continues to be supported within the prevailing neoliberal logic that downplays the social realm, treats individuals as self-contained agents, and pathologizes thoughts and behaviors that deviate from what the market defines as functional, productive, or desirable.
The neurodiversity movement claims that there are neurological differences in the human population, and that autism is a natural variation among humans – not a disease or a disorder, just ‘a difference’. A ‘politics of neurodiversity’ is based on the claim that the ‘neurodiverse’ population constitutes a political grouping comparable with those of class, gender, sexuality or race. This paper considers the limits and possibilities of neurodiverse political activism, and concludes by calling for a politics of identity that does not depend on a politics of ‘us’ and ‘them’.
Starting in the 1960s, many of the critiques of psychological science offered by feminist psychologists focused on its methods and epistemology. This article evaluates the current state of psychological science in relation to this feminist critique. The analysis relies on sources that include the PsycINFO database, the Publication Manual of the American Psychological Association (American Psychological Association, 2010), and popular psychology methods textbooks. After situating the feminist critique within the late-20th-century shift of science from positivism to postpositivism, the inquiry examines feminists’ claims of androcentric bias in (a) the underrepresentation of women as researchers and research participants and (b) researchers’ practices in comparing women and men and describing their research findings. In most of these matters, psychology manifests considerable change in directions advocated by feminists. However, change is less apparent in relation to some feminists’ criticisms of psychology’s reliance on laboratory experimentation and quantitative methods. In fact, the analyses documented the rarity in high-citation journals of qualitative research that does not include quantification. Finally, the analysis frames feminist methodological critiques by a consideration of feminist epistemologies that challenge psychology’s dominant postpositivism. Scrutiny of methods textbooks and journal content suggests that within psychological science, especially as practiced in the United States, these alternative epistemologies have not yet gained substantial influence.
Este artículo plantea que los diagnósticos psiquiátricos no son válidos ni útiles. El uso del diagnóstico psiquiátrico aumenta el estigma, no ayuda a las decisiones sobre el tratamiento, se asocia con un empeoramiento en el pronóstico a largo plazo de los problemas de salud mental e impone creencias occidentales sobre la angustia mental en otras culturas. Se analiza la evidencia disponible acerca de hallazgos empíricos relacionados con la etiología, validez, fiabilidad, tratamiento y resultados, el pronóstico, el colonialismo y el impacto de la política cultural y pública. Esta evidencia apunta hacia diagnósticos basados en contextos de comprensión e intervención en los problemas de salud mental incapaces de mejorar el conocimiento científico o los resultados en la práctica clínica, sugiriéndose un alejamiento de la dependencia de los enfoques basados en diagnósticos para la organización de la investigación y la prestación de servicios. Están disponibles modelos alternativos basados en la evidencia para la organización efectiva de la atención en salud mental. Por lo tanto, los sistemas de diagnóstico psiquiátrico formales, como la décima edición de la Clasificación Internacional de Enfermedades (CIE-10) y la quinta edición del Manual Diagnóstico Estadístico (DSM 5) deben ser abolidos.
This article calls attention to the complexity of trauma by enhancing the awareness of the intersectionality of race, class, and gender among oppressed groups, specifically women from marginalized populations, and underscores that consideration of such is essential for the creation of systems of care that are truly trauma-informed. Advancing the integration of theory and practice, we provide a rationale for adopting a postmodern feminist perspective to facilitate the creation of trauma-informed systems of care that take into account the complexity of trauma among this population, leading to comprehensive treatment that furthers the social work mission of social justice.
The psychoactive effects of psychiatric medications have been obscured by the presumption that these medications have disease-specific actions. Exploiting the parallels with the psychoactive effects and uses of recreational substances helps to highlight the psychoactive properties of psychiatric medications and their impact on people with psychiatric problems. We discuss how psychoactive effects produced by different drugs prescribed in psychiatric practice might modify various disturbing and distressing symptoms, and we also consider the costs of these psychoactive effects on the mental well-being of the user. We examine the issue of dependence, and the need for support for people wishing to withdraw from psychiatric medication. We consider how the reality of psychoactive effects undermines the idea that psychiatric drugs work by targeting underlying disease processes, since psychoactive effects can themselves directly modify mental and behavioral symptoms and thus affect the results of placebo-controlled trials. These effects and their impact also raise questions about the validity and importance of modern diagnosis systems. Extensive research is needed to clarify the range of acute and longer-term mental, behavioral, and physical effects induced by psychiatric drugs, both during and after consumption and withdrawal, to enable users and prescribers to exploit their psychoactive effects judiciously in a safe and more informed manner.
Gave a sex-role stereotype questionnaire consisting of 122 bipolar items to 79 actively functioning clinicians with 1 of 3 sets of instructions: to describe a healthy, mature, socially competent (a) adult, sex unspecified, (b) a man, or (c) a woman. It was hypothesized that clinical judgments about the characteristics of healthy individuals would differ as a function of sex of person judged, and that these differences would parallel sterotypic sex-role differences. A 2nd hypothesis predicted that behaviors and characteristics judged healthy for an adult, sex unspecified, which are presumed to reflect an ideal standard of health, will resemble behaviors judged healthy for men, but not for women. Both hypotheses were confirmed. (21 ref.) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Epidemiological research consistently reports that women experience higher rates of depression than men. Competing biomedical, psychological and sociocultural models adopt a realist epistemology and a discourse of medical naturalism to position depression as a naturally occurring pathology within the woman, caused by biology, cognitions or life stress. Feminist critics argue that this medicalizes women’s misery, legitimizes expert intervention, and negates the political, economic and discursive aspects of experience. However, the alternative model of social constructionism may appear to dismiss the ‘real’ of women’s distress, and deny its material and intrapsychic concomitants, as well as negate relevant research findings. A critical review of sociocultural and psychological research on women’s depression is conducted. It is argued that a critical-realist epistemology allows us to acknowledge the material-discursive-intrapsychic concomitants of experiences constructed as depression, without privileging one level of analysis above the other, in order to understand women’s higher rates of reported depression.
In this article, I use the example of “gender-bending” chemicals to explore some of the ways we think about “nature.” Feminist biologists occupy a tricky position, having both to accept the reality of nature to some degree (especially if working in the lab, or when critiquing biological determinism); but we must also recognize the ways in which knowing about nature is socially constructed.
Lisa Cosgrove and Sheldon Krimsky examine the new competing interest disclosure policy of the American Psychiatric Association (APA) and report that DSM panel members still have considerable financial conflicts of interest.
Violence against women is a significant public health issue. One form of violence against women, intimate partner abuse or domestic violence, is prevalent in Australia. In this article, we summarise the main theoretical and methodological debates informing prevalence research in this area. We explain why studies finding equivalent victimisation and perpetration rates between the sexes are conceptually and methodologically flawed and why coercion and control are fundamental to the definition and measurement of partner abuse. We conclude that while male victims of partner abuse certainly exist, male victims of other forms of male violence are more prevalent. A focus on gendered risk of violence in public health policy should target male-to-male public violence and male-to-female intimate partner abuse.
Taking a discourse analytic approach, this article explores how a biomedical understanding is drawn on and mobilized in women's accounts of their depressive experiences. Through talk of diagnosis, and by drawing comparisons between depression and physical illnesses, participants constructed depression as a medical condition with the effect of validating their pain and legitimizing their identities. However, participants' accounts also indicated an uneasy fit between the objective discipline of biomedicine and their subjective experiences of depression. Without tangible evidence to validate the 'reality' of their condition, speakers were on precarious ground for talking of themselves and their distress within a biomedical frame. The social construction of biomedicine and stigma for marginalized forms of distress are discussed.
We now have a new kind of psycho-politics; a brutal and destructive alliance between neoliberalism and an expanding psychiatric empire. This article will explore how mental health service users/survivors and other mental health campaigners can connect with the critical analysis and action embodied in the work and values of Peter Sedgwick at a time of crisis and reaction. They have seen ideas like ‘user involvement’ and ‘recovery’ co-opted and undermined, and both their experiences and aspirations individualised and devalued. Emerging interest in mad studies, it is suggested, offers a way forward that challenges both the marketisation and medicalisation of people’s distress. This discussion will explore the continuities and discontinuities with Peter Sedgwick’s pioneering work and highlight, as he did, the importance of making explicit the political and ideological relations of survivors’ struggles within and against the psychiatric system.
This article seeks to contribute to current person-centred research exploring post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG), by offering a person-centred political critique of some individualizing/pathologizing ways in which these two discourses seem to be developing. Notions of lower resilience (Regel & Joseph, ), faulty brains (Bell, ), lower intelligence (Bomyea, Risbrough, & Lang, ), faulty femininity (Lilly, Pole, Best, Metzler, & Marmar, ) and personal deficits (Joseph, Murphy, & Regel, ) are identified. Some troubling parallels with the borderline personality disorder (BPD) discourse are drawn. Yet, while the meanings/implications of a BPD diagnosis increasingly attract stringent criticism, current PTSD and PTG research is not being sufficiently challenged from a political perspective. The article argues that person-centred approaches (PCAs) need to be more recognized as treatments for PTSD - this work is already underway (see Murphy, Archard, Regel, & Joseph, for instance) - and that, concurrently and then increasingly, practitioners of PCAs must intervene in the PTSD discourse, also challenging themselves to conceptualize what is now termed PTSD as actually just one incongruence amongst many, rather than a psychopathology encountered by some (deficient) people.
In this article, I critically evaluate a characteristic tendency that is found across the various traditions of poststructuralism, both narrowly and more broadly defined. This is an increasing propensity to be preoccupied with ontological questions and seemingly at the expense of either a refinement of political concepts or a concrete analysis of forms of power and domination. I consider the reasons for this development and stress how this characteristic feature of poststructuralism appears to follow from the very fact of ontological pluralism. What we see in contemporary continental thought is a proliferation of different traditions, and each side seeks to defend their position in ontological terms. Following this, I advance the idea of a relative autonomy between ontology and politics, where the former does not determine the latter in any direct or straightforward fashion. I argue that we need to stress this relative autonomy to open a little space between ontology and politics, space where we can return poststructuralism to a more concrete engagement with ‘the political’.
Despite increasing evidence of the impact of health inequalities on mental health (Pickett and Wilkinson, 2015), there is only limited recognition of the potential role for mental health social work in addressing ‘upstream’ as well as ‘downstream’ challenges of poverty, disadvantage and oppression affecting many people experiencing mental health difficulties. This paper presents some of the current evidence concerning mental health inequalities and the opportunities for mental health social workers to promote well-being. A theme throughout the paper is the need to avoid the many examples of dichotomous thinking that frequently characterise thinking about mental health and mental health practice. Additionally, the limitations of an individualised recovery discourse are acknowledged. Drawing on Krieger’s (2011) eco-social model, the social determinants of mental health are considered and the concept of embodiment is examined for its contribution to a more nuanced understanding of the relationship between inequality and health. Finally, the paper offers a version of mental health social work that ‘faces both ways’, involving issues at both the individual and the wider societal levels. This includes developing and extending partnerships with service users and carers and with other professional and agencies.
Psychiatry Under the Influence investigates how the influence of pharmaceutical money and guild interests has corrupted the behavior of the American Psychiatric Association and academic psychiatry during the past 35 years. The book documents how the psychiatric establishment regularly misled the American public about what was known about the biology of mental disorders, the validity of psychiatric diagnoses, and the safety and efficacy of its drugs. It also looks at how these two corrupting influences encouraged the expansion of diagnostic boundaries and the creation of biased clinical practice guidelines. This corruption has led to significant social injury, and in particular, a societal lack of informed consent regarding the use of psychiatric drugs, and the pathologizing of normal behaviors in children and adults. The authorsargues that reforming psychiatry will require the neutralization of these two corrupting influences—pharmaceutical money and guild interests—and the establishment of multidisciplinary authority over the field of mental health.
Psychiatry and the Business of Madness deconstructs psychiatric discourse and practice, exposes the self-interest at the core of the psychiatric/psychopharmacological enterprise, and demonstrates that psychiatry is epistemologically and ethically irredeemable. Burstow's medical and historical research and in-depth interviews demonstrate that the paradigm is untenable, that psychiatry is pseudo-medicine, that the "treatments" do not "correct" disorders but cause them. Burstow fundamentally challenges our right to incarcerate or otherwise subdue those we find distressing. She invites the reader to rethink how society addresses these problems, and gives concrete suggestions for societal transformation, with "services" grounded in the community. A compelling piece of scholarship, impeccable in its logic, unwavering in its moral commitment, and revolutionary in its implications.
p>In this paper, I suggest that one way to bring mad perspectives and discussions about saneism/mentalism--systemic discrimination against people who have been diagnosed as, or are perceived to be "mentally ill"--into higher eduction is to situate them within existing curricula across disciplines. One of the ways curricula can be modified is by adapting existing theoretical frameworks from other interdisciplinary fields to mad issues and contexts. As an example of this adaptation, I turn Peggy McIntosh's article "White Privilege: Unpacking the Invisible Knapsack" (1988), a staple of undergraduate humanities curricula, into a teaching tool for showing not only the ways in which "sane" people--those who have never been psychiatrized or perceived as "mentally ill"--have access to privileges that mad people do not, but also the ways in which saneism/mentalism intersects with other forms of oppression such as racism, sexism, classism, heterosexism and ableism.
Keywords: saneism, mentalism, mad studies, privilege, feminism, intersectionality, pedagogy</p
The paper presents an historical critical policy analysis of deinstitutionalisation and the introduction of neoliberal forms of governance in mental health policy. It focuses particularly on a major period of policy reform in the 1980s and 1990s in Victoria, Australia. Many of the particularities of the Victorian experience can be generally observed with deinstitutionalisation throughout the world. In particular, the policy discourse of rights and entitlements, consumer choice and empowerment, at times stood in tension with the service void created by the transition from large, stand-alone psychiatric institutions, to dispersed forms of service provision outside the hospital. Further, certain policy features could be seen to perpetuate patterns of coercion, abuse and neglect. This article offers a number of potential lessons for mental health law, policy and practice today, which is poised for further advances of neoliberal governance, including through the policy of personalised services, individualised disability funding and human rights-based reform.
Introduction Since the end of the 1970s there has been a change in the nature and activity of institutional psychiatry. Neuroscience research, which aims to uncover the biological origins of psychiatric disorders, has burgeoned and flourished, gaining a high degree of credibility outside psychiatry as well as within (Cohen, 1993). In addition, psychiatry is no longer confined within the walls of an asylum, ministering to the severely disturbed, but now plies its wares to a widening proportion of the population. Use of psychiatric drugs has risen dramatically. In the UK, forexample, prescriptions for antidepressants rose by 235% in the 10 years up to 2002 (National Institute for Clinical Excellence, 2004). In the USA 11% of women and 5% of men now take an antidepressant drug (Stagnitti, 2005). A larger proportion of the general population are now willing toidentify themselves as needing psychiatric help and psychiatry has become a more confident andbiologically inclined profession.These developments in psychiatry parallel profound social and economic changes, referred to hereas “neoliberalism,” that have occurred to varying degrees throughout the world.Thequestion I shall address in this chapter is whether these two developments are related. Does a newly invigorated biologically oriented psychiatry help to create the social and cultural milieu favoured by neoliberal policies? Have those policies in turn helped a certain view of psychiatryto become hegemonic? Psychiatry and economics.Psychiatry has always had an intimate relationship with economics.
The positive association between ‘mental illness’ and poverty is one of the most well established in psychiatric epidemiology. Yet, there is little conclusive evidence about the nature of this relationship. Generally, explanations revolve around the idea of a vicious cycle, where poverty may cause mental ill health, and mental ill health may lead to poverty. Problematically, much of the literature overlooks the historical, social, political, and cultural trajectories of constructions of both poverty and ‘mental illness’. Laudable attempts to explore the social determinants of mental health sometimes take recourse to using and reifying psychiatric diagnostic categories that individualize distress and work to psychiatrically reconfigure ‘symptoms’ of oppression, poverty, and inequality as ‘symptoms’ of ‘mental illness’. This raises the paradoxical issue that the very tools that are used to research the relationship between poverty and mental health may prevent recognition of the complexity of that relationship. Looking at the mental health–poverty nexus through a lens of psychiatrization (intersecting with medicalization, pathologization, and psychologization), this paper recognizes the need for radically different tools to trace the messiness of the multiple relationships between poverty and distress. It also implies radically different interventions into mental health and poverty that recognize the landscapes in which lived realities of poverty are embedded, the political economy of psychiatric diagnostic and prescribing practices, and ultimately to address the systemic causes of poverty and inequality.
There is no straightforward definition of feminism today. In spite of this, scholars and researchers who describe themselves as ‘feminist’ continue to produce work that both interrogates the specific and general conditions of women's lives and explores the more ubiquitous construct of ‘gender’, and in social work, feminist understandings remain central to practice, theory and research. This may, in large part, be reflective of the continuing over-representation of women as providers and users of social work services. It may also echo social work's broader emancipatory, ‘social justice’ aspirations. Whichever is the case, we are currently witnessing a resurgence of interest in feminism across the world, with a claim that we are experiencing a ‘fourth wave’ in the global North that has its birthplace primarily on the Internet. Given that this is so, this paper asks: what (if any) is the impact or possible influence of fourth wave feminism on teaching social work today?
This article reports on a study that used qualitative interviews with 10 social workers about their therapeutic practice with women who were sexually abused as children. It explores two dominant discursive themes that were identified in the analysis: normalizing the effects of childhood sexual abuse and gender power in practice. The analysis found that while engagement with narrative therapy brings a strong emancipatory orientation, normalizing the effects of abuse by distinguishing them from “real” mental illness comes at the cost of restigmatizing other groups of clients, and dualistic understandings of feminism and post-structuralism narrow engagement with the complex ways in which gender power operates in women’s lives.
The overall aim of this article is to provide a critical feminist perspective of culture and self. Five main points of view are presented. First, cultural feminists’ essentialist claims of ‘gendered’ experience for all women are critiqued. Second, a deconstructive reading of essentialist self from postmodern feminist perspective is discussed. Third, the ongoing critique of western autonomous self is critically reviewed. Fourth, a further deconstructive reading of dualist thinking in cultural literature is suggested. Finally, a critical feminist perspective and its implications to feminist research and clinic work are provided.
Discusses psychiatric services with respect to psychiatric rehabilitation from the viewpoint of a user who has been organizing in the mental patients' liberation movement for 20 yrs. The key issue is forced treatment. Good models exist for partnerships between patients and professionals; illustrative examples of client-run programs and user involvement in planning are included. Rehabilitation must mean assisting patients' readaptation to society and recognizing ways in which social practices prevent readaptation. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
About APA & psychiatry. Retrieved from www. psychiatry.org/about-apa-psychiatry
American Psychiatric Association. (2014). About APA & psychiatry. Retrieved from www.
psychiatry.org/about-apa-psychiatry.