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Chapter 6

SOC102 Questioning Sociology Chapter 6

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University of Toronto St. George
Lorne Tepperman

Questioning Sociology Chapter 6 – What does mental illness mean? Introduction - Where our modern notion of mental illness comes from, and the techniques and practices used to promote this way of thinking - Both anti-psychiatry and mad movements offer an alternative perspective on mental illness How do we know mental illness? - Scientific psychiatry developed in the 19 century as a medical approach to understanding madness by concentrating on the body as a site of mental distress - TUKE and PINEL  developed the modern-day asylum and its “scientific” methods of treatment - MICHEL FOUCAULT o Argues that TUKE and PINEL’s developments were moral, not scientific o Psychiatrists became experts on mental illness and used this authority to impose moral judgement on others o Many of the techniques place responsibility on individuals for their distress o As psychiatry grew more powerful, psy-experts developed o Psy  psychiatry, psychology, and other related disciplines - Psychiatry is used to explain differences in behaviour (e.g., classifying some people as sick and/or bad) o Makes claims about what we consider normal and abnormal o Assumes that anyone who acts outside this continuum of normality is abnormal and biologically different - Psychiatry is part of the medical model (e.g., allowed the discipline to gain credibility and to use neutral and objective language, regardless of its moral basis) o Psychiatry  study of the brain, where chemical changes are thought to create syndromes o Mental distress  an illness (e.g., a problem arising from a biochemical disorder, genetic predisposition, or virus) o Medical model  looks for a single, technical explanation for a problem and often ignores the social circumstances that bring about distress or a crisis o LIANG  Founder of the anti-psychiatry movement  In order to maintain the medical model’s connection to physical medicine, environmental factors are often thought of as triggers to biochemical changes in the body  Even in cases where there is little physical evidence to support a purely biological connection (e.g., no technical explanation), a medical approach prevails  Post-traumatic stress disorder (PTSD) is considered one of the few mental illnesses grounded in the social/interpersonal context, but psychiatric literature suggests that there is a psychological and biological predisposition to PTSD that is triggered by a traumatic event - Psychiatry’s connection to the medical model is evident in the Diagnostic and Statistical Manual (DSM) o Created in 1952 o Produced by the American Psychiatric Association (APA) o Used to classify the various mental disorders for the purposes of diagnosis o Aimed to provide stability and consistency to psychiatry o DSM criticized for being used to gain influence over the public, the media, and the government by presenting psychiatric diagnoses as scientific and research driven and by hiding the moral and political influences involved  Moral judgements hide behind the claim of scientific rigour  The addition, and later removal, of homosexuality from the DSM o Listed as a mental disorder in the first DSM o Removed in the early 1970s because the APA were inundated with protests about the validity of categorizing homosexuality as a mental illness o Afterwards, genetic identity disorder was added to the DSM, which some argue is a way to maintain homosexual behaviour as an illness The targets of mental illness diagnosis - The medical model survives in psychiatry because: o Psychiatry does not attempt to cure mental distress  Unlike physical medicine, psy-experts only claim to manage symptoms o Assisted by the law of repetition  if assertions are made with sufficient regularity, and by people of high status, eventually they will become accepted (BEAN) o Coupling with key players in the medical and pharmacological fields - Psy-discipline criticized for evidence suggesting that some groups (e.g., women, poor, racial minorities) are more likely to be diagnosed with mental illness than others o Overrepresentation of women in the mental health system  More likely to be diagnosed with personality disorders (e.g., eating, anxiety, compulsive, borderline)  More likely to be prescribed psychotropic medication and given electroconvulsive therapy (ECT) o Hypotheses about why women are diagnosed with mental illnesses more often than men 1) Women who do NOT conform to traditional notions of femininity,  Women are competitive, aggressive, or independent  These traits are devalued in women, although considered acceptable in men 2) Women who do conform to traditional notions of femininity,  Women may be overly sad, fearful, or dependent  HOLMSHAW and HILLIER  women are caught in a Catch-22 situation, in which either adopting the ideals of femininity or resisting them can lead to a mental illness diagnosis 3) Broad diagnoses that are gender specific to women and that may be applicable to any number of women  Premenstrual dysphoric disorder (PMDD)  a severe form of premenstrual syndrome o Criticisms of PMDD  Diagnosis can be used on any number of women to discredit them  Describing it as a mental rather than a physical illness reveals a moral judgement o Psy-experts rarely recognize poverty as the cause of distress  1 in 3 homeless people in Canada are labelled mentally ill  BRESSON  politically beneficial to equate mental illness and homelessness because it makes individuals responsible for being fragile and vulnerable than the social environment  SNOW  the very nature of homelessness and the most common responses to being homeless are considered symptoms of a mental illness o Overrepresentation of racial minorities in the mental health system  White people are more likely to perceive African Americans as aggressive, unintelligent, and lazy  Psy-experts are predominately white  Institutional racism  a collective failure to provide the same type of care to people based on their race and to explain the disproportionate number of mental illness diagnoses for certain racial groups  CONSTATINE  people of colour who experience racism on a daily basis may develop coping mechanisms (e.g., becoming suspicious of others, feeling a sense of persecution), which can be considered symptoms of paranoid personality disorder or schizophrenia  Racial minorities are less likely to receive support and counselling - The mental health system may be perpetuating stereotypes and managing certain populations What happens to people labelled mentally ill? - Medical model uses several strategies to treat, manage, and control individuals diagnosed with a mental illness - Most popular techniques are hospitalization, ECT, and psyschotropic medication o Asylums  institutions for individuals diagnosed with a mental illness  To control individuals deemed to be a danger to themselves or others  Called total institutions (GOFFMAN)  People’s daily lives are completely controlled and these actions are justified in the name of science  Faith in hospitals led to an abuse of power (e.g., using patients as uninformed research participants for medical experiments, especially for new forms of psychotropic medication)  Involuntary commitment is a technique used for managing the mentally distressed, especially for individuals linked to the criminal justice system and those designated as the most dangerous o Electroconvulsive therapy (ECT)  sending an electric current to the brain in order to induce a seizure  Most controversial form of treatment  To treat depression, schizophrenia, and mania  Used twice as often on women than on men, which perpetuates the overrepresentation of women who are diagnosed and treated for a mental illness  Accepted among psy-professionals o Psychotropic medication  medication designed to have an effect on the mind  Most common/popular form of treatment  Chlorpromazine  to reduce hallucinations among individuals diagnosed with schizophrenia  Often used as the only form of treatment  Relying primarily on psychotropic medication
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