Ian Parker Et Al Deconstructing Psychopathology

 

DECONS UCTI PYHPAH GY IAN PARKER, EUGENIE GEORGACA, DAVID HARPER TERENCE MCLAUGHLN AN AND D MARK STOWELL·SMITH STOWELL·SMITH

 

DECONSTRUCTING P S YCHOPATHO ATHOLOGY LOGY

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DECONSTRUCTING PSYCHOP ATHOLOGY

I Pk Eug Ggc v Hp Tc cLugh  k wh

GE  Lodo

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oud k w Dl

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©  rr ug Grg v pr T Mugl  Mr Mr SwlS SwlS    Fr publ 5

Al rg rv  p   publ  b rpru, r   rvl  r r ulz     b  , r  ppg rrg  rw wu pr  wrg fr  ublr SAGE ub  6 ll Sr  A 4 SAG ub  455 llr R Tu O lr 0 SAG ubl  v    , M Ml l Mr Mr  Grr Kl  w  w  l l   0 0 0

ii Libra aaguing in Pubiain aa A lg rr fr  b  vlbl    brr S   0 0  70  S S  0 00    7 pb)

Librar  ngr aag a nbr 9575 Tp b pr rqu v re  Gr r   vr  brg

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Cott ntroduction

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Md d Mody

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Aliv Al iv o Abomliy

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o Sympom o 

37 

Rpo o Md Poloi dii Pyoi Diou Rdil Ml Hl Douv Rpo d Rou

46 59

eference ndex

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56 72 92 12 3

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toutio This co-authord book is not dsignd to opera as a txtbook, but as a pomica and accssib 'countrtxt for studnts and practitonrs. t dvops a dconstrctive approach to th practic o prossionals and rsarchrs concrnd with psychpathogy W wi b ong thr things in th cours o the bok First w wi opn up th notion o psychopathoogy as it is convntionay usd in psychoogy and psychiatry using a practica dconstructiv approach to th anguag an institutions that hod it in pac Scony w wi pre th impicatins o

dconstructiv idas or th thris an practics that undrpin cinica tratmnts hirdy w wi b dsribing atativ vis o th anguag o psychopathoogy and mods or critica prossiona work and good mnta hath practic Lt us trac th shap o the book. W ar concrn in th rst part o th book with how orms o menta inss r istrss hav bcom dividd om mnta hath an hw possionas participat in diviing practics in th prsnt day As w dscri how th diiding practics work w thow thm into qustion by >nstructing cinica catgors Dconstruction in this book is us to unav supprssd manigs in txts and to provid a way o rrading an rworking ida an practic prac ticss that ar nma takn or rantd In Chatr  w riw th way in which abnorma psychoogy has ben divid rom th norma psychoogy that most pop ar suppo to njo Chaptr 2 loos t atrnativs rom psychoanaysis antipychiatry, amiy therapy an cognitv approachs n haptr  w ook at hw yptoms ar constructd, and how th rinorc popuar trotyps and rnt forms of opprssion. W thn tu our attntion to th ways in which utura imags o psychoogica distrss which ar so important a contt or th dvop mnt o psychiatry and cinica psychogy bar n th ways in which pop who ar catorizd in th mnta hath systm unrtan thmsvs haptr 4 xpors cutua rprsntations o psychopath oogy and how ths rprsntations at cinia practic W ook at th othr sid  th probm in haptr 5, whn w iscuss athooica idntity, and w trac th ntwork o paths that ad pop into the mnta heath systm his is a w and good but w aso want to ask wha opportunitis or chang this pictu prns to th rossiona rad

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VII

Decontructing pycopatology

wo wll w o kow w ol d  lv ou douo op upxmpl d o ou o ml v 6wo wll b od w b pl  Cp w dvlop ou ou ou o pyopoloy  om   mbddd  mbddd  ulul x d w look   o lu d  wy  w dol py wok w podu  ul um om x lbl  b lld.  d pl ll  v b dvlopd  xplod  Cp 7 w ov  dvlopm o  lv lv ml l movm. movm . Py x x lke my o x y o ov ov   od od o   um y dvlop d  umpo y u.  book oo  ld ld w odo d o   lpul lpul  w  k o p om o  objo  wll b lvlld  u d om o  dm bw u  wll v oud  wy o  book.  book  o  lod ym o  ompl oluo d o Cp 8 vw om o  dlmm dl mm  d odo    o l o mm pyy d ll pyoloy  wll  povd  o ou u l o oup   k k  ou dm d m duo duo owd   l wold. A w o ou  book w ow  ow wy     y y o dou dou pyopoloy d db w w m by pl dou

o.  v om o o w  book om dv p o  ml m l l ym ym  om ll py pyolo oloyy  py py ol wok wok pyol py oly y pyoloy  d d o      dd v v o d o pl  old jo oud m l d d w  w o  w uvl dou dol oo   ollow p w u  o  d op  you wll b pd o pp  buld ou om b

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1

Ma a Moity his s chap povids a hisoical viw o h dvlopn o psychopahology as h sudy o nal disod in Wsn culu culu  W giv an accoun o Michl oucauls wok as i applis o clinical cagois, and hn dscib how psychiaic and abnoal psychology xs and pacics can b dconsucd W also inoduc h noion o dconsucion and show how i can b ad lvan o his hisoy o cagoizaion, o h h  ways in which so popl hav bn akd o as di din n,,and as oh o

Abnormal psychology h noions o adnss and abnoal psychology as w undsand h a paicula and pculia o ou culu and ou i  ha is h saing poin o ou hisoical dconsucion o psychopaholog psychopahologyy  Howv, his

assion on is own is no long conovsial o vy adical Many paciions o psychiay and clinical psychology would accp ha h cagois w us o undsand nal disss a spcic o ou sociy vn adopd adopd libal Aican Biish xsoonvn h issu h has inology ovd on o h inold opposions o and  san/insan, halhy/sick o ons which y o scap a dical odl On popula opposiion ployd in psychology now, o xapl is ha o noal abnoal As on cn x pus i, abnoal psychology is h sudy o h Pobl o Maladapiv Bhavio (Saason and Saason, 987 Whil adnss is now coonly d o in invd coas, i is abnoal psychology i n hs xs h a is a add as a ac ac  h pobl pobl is ha no only dos h oulaion abnoal psychology bli h coninuing pow o dic dical al od odls ls o i llnss , bu i  is doubu doubull whh whh  siply adoping ha polaiy in pnc o h ohs will solv h pobls acing wha a on now calld h uss o consus o nal halh agncis wods w w wan us oodscib aan only pa o hh pobl ocus onaladapiv in his book,bhaviou bu hy a ipoan pa h s w us a loadd wih assupions, and hos assup ions a a poducd poducd on by on in h pacic o psychiay, i n is poo cousin clinical psychology, and in is vn o dpndn

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2

Dg o oatoo atoog g

relaives (in mental health nursing social work and so on) stuggling to make sense of disre in h cmmuny Words do not only denote a phenomenn but cay with thm an array of connotations These connotatio conno tations ns - of pahology, pahology, inapaciy inapaciy o lak  funn funnel el into into the scienti scienticc denitions tha ar ircate in txtbooks and medical manuals on the identication and desciptin f yps f 'psychopathology Each slot in the latest dition of the a a Statal Maua o Meta or DSM) pruc y he American Psychiatic Association 1994) or he ea eaa a   ato ato  ae ae (CD overseen by the Wold Heath Ogniation  992 boms occupied eithe by those rare human exemplars who t pcty or mor often by the difcult cases who spill ovr their asin plc and requi a complex combination of names to pin hm down hn the categis ae ae used they become chrg wih an mionl c whih ha farreaching conseuences fo those who ae labll N nly a patints pathlogized by the dagnstic clasiation ise but thy  furthe pathologized when they d not t becaus it d n wrk h labels ar no simply innocent counters availale o th chiis r linical psychologist to be tagged n  a cas an t pin  an pppiae remedy he use o mdical rminolo als affcts ths wh a eponibl o labelling he powe f psychiatry ress in lag a n it ability to oce psychologists nurses and social wrkrs who  n meically qualied to play only suppoting part in insitutions. It is h pw of mdicine itlf which sets the agenda tinton Roger 99; urne  Becaus clinica psychlogists and the es of the ca ofn pi  pchiaic powe we will need to look irty   pw nd hw it prate Choosing fenly uphmiss will nt olve he problem for the tradinal oppositions that nitute th ld of pychpathology can

alwas b reneabu. n \ill thenproblem hld thehas samebeen culural powr of exclusion an istitutinl his emphasized by those working with leaing isability in which he use of hundreds o difeent terms fail to escape emaning meanings Sinason 989) n this sense the shift  normal/abnmal simply ecnsitutes he opposition between healthy and sick  betwen sane and insane and the power o psychiaty is left my in plac. A h sam time however the move om one et of oppositions  nother open up new spaces o esistance spacs for nw voices o b hard. his is prt of the wk of deconstuc tion which was elaratd in Fnh philsophy by Jacques Deida and we hav o link that work  atil changes to nsu that the new opposiions do not simpy funcin  diide and oppess in the same ways s th ld Drria (for eapl, 970 9 provides a systematic reading o philosophicl et which c n th ways in which an agument is policed to gurant a xd een pint an essntial point o 'truth which th rade then taks f gne nd s a the oundation for other less

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adness and modernty

3

iporan hings A dconsrucion in his origina and purs sns idnis concpua opposiions rcovrs noions ha hav bn xcudd and shows how h idas ha hav bn privigd a dpn dn on hos hy doina doina  or xap  whn w spak i appars appars as as if a aning cos fro wihin our individua ind and hn ravs hrough anguag which opras as a r carrir ors of couni caion such as wriing ha s ou of h inds conro ar hn rgad rg ad o o a ssr pac Drrida (  978 draws anio anionn o phiosophica radiions ha ra wring in his way as i pur spch spch H hn gos on o argu ha bcaus anguag is a sys of rs ha is aways arady ou of our conro i coud b sn as a variy of wriing and so in his dconsrucion of h opposiion bwn spch and wriing wriing disrups h opposiion hs ars ar vry iporan o psychiaric knowdg o cours bcaus psychiary and ohr ci nica approachs hav bn concrnd wih wha gos on insid indvidua inds and bodis and hy hav rid o brush awayof h ro of anguag andin sociy in h xprincsns and ran disrss Dconsrucion h sric phiosophica offrs us a way of acking h inrna conradicions in psychiaric xs bu ha is whr w w sar no whr w wan o nish  I is hpu o b awar of of h origins origins of h r dconsruc dconsrucion ion  bu w ar using i  in a ss pur way in his book W wi b inking our dconsrucion of psychopahoogy wih an anaysis o h pracics of powr ha hod radiiona opposiions in pac o do ha w nd so hisorica accoun and w wi b ocaing our criica rading of xs in hi insiuiona insiu iona conx his is why w us h work of h hisorian oucau oucau a wrir who aso had a cinica psychoogy raining (Parkr 99a W wi b adoping a oosr for of dconsrucion ha conncs psychoogi ca criu wih poiica poi ica conx  Pakr and Sho Sho  99 990) 0)  I n is os os radica for for posodrnis in psychoo psychoogy gy is anohr codwor codwordd or or h sa yp of chang o h discipins o h ind (va 992 Anding o poiics and powr whn you do a criica rading and

hinking hrough h ffcs o your criiu on insiuions and fors o knowdg is wha w r practcal deconstructon

Der erly Dconsrucion s abnora psychoogy  for for i ooks oo ks a a hi ngs ask askw w sing hi ngs ha do no a rs ganc s o b b hr hr  i is vry suspicious and i braks h rus o show ha wha is usuay rad as nora is isf ray rahr odd Whn w rf rfrr o our rading as abnora hr hr w risk rinforcing h nora ngaiv connoaions aachd o diffrn bhav iours and xprincs bu w ar aso aki ng rs rs and usng usn g h aganst radiiona syss of knowdg and powr acknowdging h ncssiy

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4

Dnrung oaoog

 upicin and deying he uine ay i i pahlgized Decnuc in i a pce  eading hich unael he ay inane caegie ae ued  uppe uppe dieen dieen pecepin and behaiu beha iu and i eun he  he ppiin beeen  exampe ilne and heah I k ih a ange pahlgically cuiu aenin  language pacice ha a meaue ha  ick ickne ne i needed  uie in hi h iand  ld ld and an d   h h ha he diiin beeen ickne and healh i no dicninuu and me han ha ha he diiin i cnuced in uch a ay ha i pdu p duce ce he he  end  h e cninuum  A  he ame im e decn decnuc uc in ece he ubdinae em in a cncepual ppiin and anm i  ue i again he dminan eam In pliical uggle he em back and gay ee aken m he eapny  peudice and ued deany by he h ee abelled in uch a a y ha  hey diuped diuped imple hhan hhandd pahl pahlgiin giingg in ee eeyday yday language The nin  heah  example equie a decipin  ickne  make ene  culd n exi ihu he ppie ha dene de ne i The em i naniy  i ne ne  abnmai y ae hen pu unde unde eaue  ha ha e d n ue hm in he  he impe imp e ay hey ae uually ued and dened by hei pe peu ull pa pa ne ani y y  heah heah  nmaiy) nmai y) bu ahe ah e a cncepua ee  h he anguage  mden mena men a hea h eah h plicing in quein T pu mehing unde eaue i  quein i akenganed meaning  mak i a a pblem  be chaenged Me M ee e e mu chalenge chalenge n  nl y ne e  pp ppiin iin bu al he ay hey ae linked gehe in a e ha cniue he ppula and peinal den p deniin iin  he hing ha ie uide  e eanable anable ciey ciey  Th  pcicl dcnucin  in hi h i bk   he cncepual ppiin ha ucue pychpahgy in abnma ucue  egegain egegai n and egulain ha hae accumulaed a peaie peaie and inidiu pe e he yea in Ween cuu he cuue e ee  a u hugh  e ae ying  keep u diance diance hee)   i pacical pacical in h e ene ene bh ha i cue n he ay language k in maeia appaaue  medicine he ae and he cmmuniy and in ha i i deigned  be ueul  ciical paciine and he ugging a he hap end  he menal heah yem Ang he ay e i be decibing h he ie uch a Fucaul  ) h a cenally cncened ih

pe can be ued in hi ciical uggle uggle  Thee language Th la nguage  abnmal pychlgy i enmehed ihin i hin i ni niuin uin  mena diagni and ueilance Thee heme il un hugh hi  chape and hen appea in he e  he bk The  i ha an undeanding unde anding  anguage i cucia cucia  a ciica accun  pychiay and i idekick The ecnd i ha e hae  cnnec language ih he iniuin in hich i i ued ne  he m impan ay  ding h a i i   ee hing m he andpi n  he h u ue e pychiay  The hid heme i ha e need me accun  he iainal  he uneanabe in human expeience hich language exclude I exclude

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Mane an moernt



hat it deems t be iatina at the ey mment it cnstucts it This means that e hae t think tacticay abut h t make aliances ith such cnstu cnstucted cted and excuded phenmena phen mena at the same time as deeping an undestanding as t t h they unctin unctin  In this cultue e il need sme ntin  esistance t accmplish that task When e appeal t the iatinaity that is shut ut  e-atina cinica knedge e d nt ant t impy that e beiee in that iatinaity as a pue suce  ibeatin in the same ay as smene h uses a gun i n a libeatin stugge is using a eapn that is i s cnstucte cnstuctedd by the system they ppse) And e ae nt ny taking abut things cnstucted in anguage but as Fucault ) did abut the cnstuc tin  physica appaatuses  pe and esistance esistance  ike pis pisns ns and guns g uns chemicas chemic as and bdies)  T pusue these thee themes it ill be necessay necessay t gie a citica histical ana ysi ysiss  psychiaty and a bnma psych psychgy gy  This is hee u decnstuctin decnstuctin is i s gien a uthe uthe een me adica tun  as e il see in the next sectin We shuld ask h the cmmnly used indicat ind icatss  menta menta i llllness ness and the peu peu institutins  menta heath came int being Psychiaty tels a sty  pgess t suppt its k and its ay  iting histy needs t be chaenged What appeas t be cmmnsensical must be endeed stange When e put cncepts unde easue easu e that des nt mean that e il nee use use them agai n e hd and tans tans m m them  We il use them in i n a dieen dieentt ay ne thing e shuld nt ease in a pactical decnstuctin is u memy in this case as a cunte-memy Fu Fucault cault   )   h h this state state  things came t be be 

Three histories of anormaity Thee ae thee types  histical accunt e cud gie  madness The st is a aily uncntentius accunt  the deepment  madness as a pblem in Westen cultue since the Middle Ages and  changes in diagnstic categies The secnd is a me adical examinatin  the ntins  mental health hich ie unde thse categies and the thd is ne hich ths int questin the ey ntins  easn and uneasn hich language c ces es int bein being g We ill un  in i n tun  thugh these thee thee accunts

The hral ey f dag aegre Thee hae  cus cusee  been many man y diee dieent nt expanatins expa natins  madness e the centuies and th adical and apid shits in denitin testiy t the dicuty einace tyingAges t deciphe hat it beteen ealy eal y isate Takeand the madness lin ks that that ee made the inMidde  exampe

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6

Deconstructing pschopathoo pschopathoog g

n the Cntnent the melanchly  the Englsh as eplaned by ay  ur m artme clmate all ths thsee ne drplets  ater that penetrated the channels and bers  the human bdy and made t lse ts rmness, predspsed t t madness Fucault 9: 3) It s n ths cntet that mages  the Shp  Fls suddenly appeared n the teenth century These shps accrdng t the cntemprary ppular representatns especally n art  travelled arund th the mad ma d t be be ccasnally sghted by the nhabtants  prt tns Althugh the hstrcal accuracy  Fucaults descrptn  these shps has been questned Grdn 1990; Sedgck, 982) the symblc mprtance they played n the ppular magnatn s the key pnt at ssue here Accrdng t Fucault (91) up untl the teenth century the great ear as death alne Frm the teenth century maness makes a n entrance en trance as the ghastly scurge scurge  the Western Weste rn m n nd d Whlst death death as a threat that came rm thut and at the end  le le  m adness s smet hng alays present present as a threa threatt rm rm wihin and as an everpresent pssbl pssblty ty Peple then realzed that he head that that llll bec  becm mee the the sk skul ulll s al alre read adyy em empt ptyy    Madness s the dja-ta [already there  death Fucault  9 9   :  6) 6)  The mad then lled the space that as pened pened u p by the clsure clsure  the leprsara at at the end  the Mddle Age Ages s epers ceased t be the m an prblem n th e utskrts utskrts  le le  and th e ne dse dsease asedd  mn d ccup ccuped ed ther place but t as nly ater the cnnement  scal devants n general that the mad became marked ut r specal treatment The General Gen eral sp sptal tal  Pars Pars establshed n 656 rst  all pened ts  ts drs t varus vagabnds and as prmarly a place  cnneme nt rather than a place  treatmen What e n desgnate the mad ere thrn n th a med bag   devants  and thn a shrt tme  by 66 the Kng rdered that there shuld be such an nsttutn n every cty These places ere enrmus Pars r eample sa ne n a  00  ts ppulatn ncarcerated n a e mnths In England t as decded that huses  crrectn shuld be set up n each cunty n accrdance th an act  55 That Cnnemen Cn nement t acrss acr ss Eurpe Eur pe as a plce matter matter, ntetensn nensn  medcal care car care e came later n nsttutns and then as, an ete  the nsttutns n ut nt the cmmunty agan an ssue e eplre n Chapter ) It as cmm cmmnn knledge Fucault ntes that untl the end  the eghteenth eghteenth century the mad ere nt seen as sck sck  The anmalty anm alty  madness madn ess prtected the lunatc lu natc rm hatever mg mght ht be rag ragll e, precar precarus us and sckly n man Fucault 9 4) The brdge t the medcal treatment  the mad as the mral treatment  the nsane n spec specal al places treatment hch as prvked by ppular ears that the dstressed nhabtants  the large nsttutns n ctes ere cntagus The nhabtants  Pars near the Hptal Gneral r ea mp mple le  had lng cmplan cmp laned ed abut the dangerus va pu purs rs hch ated

ut and hch threatened t make them mad t It as the renterpre tatn  the ssue as a mral ne n e hch set the ay r releasng the mad

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adnes and mdet



om hei chain Samuel Tuke one o he Englih Quake eome ounded a eea a Yok in i n 72 o example and adoaed adoaed am bah bah  and human kindne ne o Fouaul moe conoeial agumen i ha he noion o kindne a a cue a o meh ino medial model hich h ich ould hen in un e nmeh he mad in ohe moe poe poeul ul iniible iniib le chain  Fouc Foucaul aul  ae i ha ha he human hu manizaion izaion o eamen eamen  o he inane encouaged he inenalizaion o he diculie hey exhiie The mad hen had o ake eponibiliy o ue and he kind eamen hih eplaed he od and hip ould ok i ay inad in ad The oniene o he menally ill ould a a a el-dicipline all he moe iien han he ocial dicipline o he geneal hopial We ill un o he implicaion o hi i nenalizaion o eamen and e ep ponibili onibiliyy o menal men al diod diod hen e look a a moe adial ay o hi hioic oicizin izingg phiai paie in a momen he moal eamen eam en o madne a a o gie a ayy eenuall ee nuallyy o edical appoahe bu he ie o moden pyhiay ollod a uained peiod hich laed hough he nineeenh enuy and ino he enieh unil ae a e he Fi Fi Wold Wa a peiod in hih he medi ee lile mo moe e han helpmae in egime o moa moall i mpoeme mpoemen n  Thee egime did did oen oen inole phyical inendedbu o bing indiidual engagemen iheamen iilied oiey ine he madne aback eenno a ana combinaion o an inheied oniuion and unounae lie een ahe han any undelying dieae eniie lile medial nenion ould be made The moal egime eg ime duing hi ime  ime onied o a mixue mix ue o noion noio n he o mo impoan being being oganiim oganiim  inhe ied eakn eakn  and hygiene  lack o cleanline an andd oial adjume adjume n . Thi eion eion o moal eamen a o lay he bai o moden ull-blon medial pychiay. The mad ee aing o be een no o muh a ompleely ouide bu a poblm inide oiey he paadigma ube o he modenizing pychiai appaau poed a hea only in o a a hy aed like gi n he iniuional mahiney o hool induy and elehee They epeened a oue o oial iiaion a lo o poenial 8   eame e eienc iency y and a uue o buden upon heegulae ae ( oe eam increaingly impoan monio and hoe ho migh all inoe hi condiion and caue uh iiaion and h obeaon and onol o menal die coninued hough o he  hen he oalled pyhi ai miacle dug alloed medical noion nally o iumph o onl y did o did he elae o h hee ma madd om h hee lage lage anonymou anon ymou pion pion  in he eigheenh and ni neeenh enuie and no in he enieh cenu a hem a pecial cae bu i alo man ha hy hen a peial cae needed o be obeed caully and claied Thi claiaion ha poceeded apace unil he peen day he emphai no i on he indiidualiy o he paien and he peiiy o he ympom hey diplay In hadli ne medial medial appoahe appoahe he emphai i on he ympom ympom and i n he oe oe humani  aieie aieie he pe peon on i alu ed a he a ai i o o

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8

Deconsrucing pschopaholo pschopaholog g

he sypo s. Howeve hese  hese ae wo wo sies o a pocess pocess whic whichh iniviual iniv iual ies isess isess  an an  eas i apa om om social conex conex  The caego caegoies ies in he h e vaious vesions an evisions o he DSM o D D have o be expane  an alee evey ie o give a supposely moe accuae moe caeully obseve se o caegoies Since he obsevaion is ae in eical es i always ails o wok as a nea aay o pigeonholes people ae neve only paiens bu  complex complex hink h inking ing huan beings an so so hey jus will no   This oes oes no ean ha a simpl emphasis on he iniviualiy in iviualiy o he suee will solve he poblem o couse because he heoic o iniviualiy uncions o wench he peson om he vaious social conexs ha have conibue o he isess all he oe Meical language isel is ooe in social conxs i is sill ame by moal poi ical acos acos an i is ninually isu isupe pe by he oo. Thee oe Th o e ecen changes in  iagnosic caegoies sill ollow changes in oal easonin easoningg in he h e suouning suouning sociey sociey  an  he ecision o ake ak e ou  a caegoy oen eecs changes in moaliy An example o his is he eoval o hoosexualiy om om wha was o becoe becoe he D SM-II I- he  he hi evise eiion o he DSM) In 3 he Aeican sychiaic Associaion Associa ion Boa o Tusees voe voe o ake  go-ysonic omosexua omosexualiy liy  o is lis o enal illness ill nesses es Wilson    3) 3) an he Aeican sycholog sychologi i cal ollowe sui wo yas shoul be noe ha h aAssociaion pesisen an an  make isess aboulae abou onesIsexual sexu al oienaion' oiena ion' hough wass sill wa given as an example o sexual ysuncion in he DSM-III- Aeican sychiaic Assoc Associaion iaion   8 2 26) 6) . I  is also also no acci accien en ha changing noions o sexualiy oul oce he aleaion o psychiaic caegoies Th  beau eniions o abnomal an pevese behaviou an hinking cl use aoun aoun sexual aciviies aciviies in his oen oen culue which is so sauae wih sexualie noions noion s o o sel an ohe Fouca Foucaul ul   8 ) . The These se changes no only aes o he agiliy o he cuen caegoy sysem bu also show us soehing soehing abou he assumpions which unelie i i  The T he ype o hisoy we have ace so a allows us o see wha he ole o he iscipline o abnoal psych psycholo ology gy is in his sociey sociey Bu his is j us he s s sep. We can go uhe han his an we nee o go uhe o link a hisoical accoun wih econsucion o make i a econsucive hisoy

lral hae  he exeree f dre Mig h ou suspicion ha  he language la nguage we use use o escibe escibe psychopahology is culually cul ually specic specic also also be woh iecing iecing a he phenoenon i s sel? el? I i s no  only h e ems ems ha change pehaps pehaps b u wha we im agine o  eally' lie uneneah he  O cou couse se ainseam psychiaiss psychiaiss ike oh an Koll 86) will see he ealiy o menal illness as exising a evey ie an place wih ieen culues siply having ieen wos o i'. Howeve ieen culues have such aically ieen concepions o

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Maness an moeniy

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wha we call menal men al illness il lness ha h a we have have o consie he he possibil iy ha no only he al k  bu also wha is escibe escibe is aica aically lly i ieen  Take he case o noions o maness nealy 2 cenuies ago in Geece ael,   8  )  Hee he epeience o isess isess was no o a umoil insi insie e he hea o he suee bu o a clash o wills ousie The aciviies o ieen eiies emaning con ici icing ng couses o o acion acion om a human subjec woul lea o conaicoy an uneasonable behaviou In h cenuy BC agy in Ahens o  o eample we have accouns accouns o he ma as isolae om ohes because hey ae seen as paiculaly angeous Bu he h e gea ea which a nim nimaes aes hose who have o eal eal wih he ma is ha he peson who is ma is in some o way close o he gos. Maness is he sign o his closeness. ach go pus pessue on he peson o ac in ceain ways an has a vese vese inees in ha behaviou While he gos oen coeis peaceully hei ineess may someimes clash an hi s is whee poblems will aise . When h hee go gos s make ma ma hose hey wish o esoy esoy  hey can o so by a pocess pocess o isolai on  an an  i is hee ha one o he mos in ineesing eesing conass beween concepion concepionss o maness maness in h cenuy BC Geece an ou own ime aises I is pecisely he conas he iffeene ha we wan o emphasie in his econsucive hisoy We o no o eample wan o subscibe o aiional psy chiays omaniciaion omaniciaion o ancien Geece Geece an o he noio noionn ha all he eepes uhsoabou humane he naue wee eveale hee havel cone chosen his eample emonsae emonsa isconinuiy beween haWe culua culual an ous. To ake one on e eample o he he i i eences in language acoss he cenui cen uies es we shoul be awae ha he nglish wo iio which plays such an impoan pa in he escipive vocabulay o he eveyay eamen o iaional o supi' pesons came om he Geek wo iioes' This Geek wo wo means pivae peson peson  an Geek culue culue a ha h a ime i no a all value noio noions ns o pivacy o soli soliue ue  The consequence consequence is ha he wish o isolae one's sel om ohes woul be evience o abnomaliy. I woul also be a sign o a peculialy close elaionship wih a go Moe han ha  he  he uge o isolae onesel onesel woul be epeience epeience as abnomal . I n his vey ieen wol he ma an he ema ae isance om ohe people uhe by eelings boh by he eelings ohe people have abou hem an by hose hey have abou an in hei maness' ael,   8     4 ) . The moal eamen o he iios om he en o he eighee nh cenuy in uope in places like Tuke's Quake asylum asylum on he ohe han  equie he eea' , he  he seclue eecion o he peson on hei iniviual isess. Soliue hee is a peconiion o he solace moal eamen an hen meicine woul povie How people une san soliue an asylum hen, is culually consiue. Ieniying he culually specic popula epesenaions o isess is no simply a mae o hisoical an anhopological inees opula epesena ep esenaions ions o no oa aoun eay o be use use a will by b y whomsoeve whomsoeve

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Deonrung pyhopahology

ay wh but a ogan n atal tuctu o pow a prae opua opu a pntat p ntaton on a a put to u u n  ay an po poon onal al pactc that al wth nvual n t an poona cou no an chang popula pntaton Intyng th utual laton b twn pntaton an pactc o not only bak th tncton btwn ba' ay knowlg an poonal xpt but t alo contbut to unavlng th coplx wb o laton btwn po   on onal al  nttuton n ttuton an th publc  It  th n kn g o o th nt nt o o  o knowlg about pychopathoogy an noalty that utan cunt tho an oonthpopula anagnt oaton t Tho an pactc toaypactc t no  pnt p ntaton  o what  noa an what  au to hav gon awy whn popl o not act noally Foucault wok ha bn nvauabl n awng attnton to th way languag  ogan aoun nt yt o anng whch o poton o pow to ctan catgo o o popl popl an an pow  pow oth oth  Th yt o anng a oure. In cnt bat n py chology ctca wt tuyng tuctu o pow n cou hav bn takng ouly what opp popl hav long known that th way w talk  boun up wth pvlg an ot tanc (o xapl ak 2) Contpoay bologcal xplanaton o chophna o xapl both aw upon an o popula pntaton an vo o popula uppot Th pntaton a boun togth n cou yt o tatnt about th wo that cat lv alt Th aon why th cal ol ha uch pow now  that popl tut cn an wll bc wng actvly to  h cal conol o th ntaly l Mont by ont h pntaton o what  wong bco a pactc whch cat th pobl an t agn agnay ay oluton oluton   On xapl i th Schophna Aocaton o Gat Btan SAGB) whch  an oganaton o lay popl popl  any  any o who a atv o tho agno a chophnc  It  cunty tyng to to a un un to bu an nttut to cov th bologca ba o chophna h pot poca that th bakthouh  nnt an th nwltt agu agant ocal an aly ntacton xplanaton o th lln. On pot ay ay Schophna Schophn a  nt  n th n n  It I t a act th boy an th th ban. It  a phyca a h ag  ct at a noncal aunc Th qutonna th SAB n to b ocu on t oth ca o an ly hto an conu o cal tatnt o chophna a ncouag to ntpt th t n bologcal t Th nthua o ca tatnt l h SAGB n  4 to ugg uggtt that th u b put  n th wat n I an an  Bona to t pychot volnc an o nd wa. h atonal Schophna Flowhp  SF) n co coua uag g th opttc opttc vw o bologcal ach too an t pychaty goal th bak though' , whch t cannot  o cou th cou  lv Th pactc o pychaty ,

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nss n morniy

11

n pa conone b consue ean o he cue o a sease an also oe so b a oe pagac spo anageen agena ha s se b he ug copanes ach nees an uls an s une pessue o he ohe hough he ug copanes see o be ong bes ou o

he eal a he oen Bggn 1991 Th ecen hpe o he epesson ug oac also conenenl blus he sncon beween eceaonal ug use an ecal ug abuse Wuel 1995 The lage ug copanes assgn a akeng pesenae each o aoun sx geneal pacones pung ncebl pessu on alea oe-woke ocos n he pocess ecse gues ae cul o oban as one woul expec bu one epo n 989 esas ha US ug copanes spen 2 llonn ollas on aesng o llo o geacans lg an oges 993 Man coneences an ecal jounals enjo an sue he paonage o he ug copanes. t s also woh nong as we conse he nepla beween popula an poessonal epesenaons o soe ha ohe olk knowleges ae heal scene oo One exaple whch we scuss u uhe he n Chape 5 s ha o he noon o ace ace  ) Apa o o  he h e bologcal oel whch unwes he ecal conol o pscha hee s he aa o pschoanalc appoaches an pschoanalss sel has plae a poweul ole n he caegoes use n een esons o he DSM an C) unnng alongse he UK pschoanal pscho analc c n suons such as he Bsh s scho choAnalcal Analcal Soce he Insue o schoAnalss an he Tasock Clnc ae a hos o ohe soc ohe socal al wok an counsellng counsell ng oganaons oganaon s an he heap ap cens whch aw on an populae pschoanalc eas These eas can hen ee back no he nsuons when paens ean a pacula eaen whch accos wh he oel o he n he use o unesan heseles . Wok n Fance a he en o he  50s o o exaple  oun oun he socal epesenaons o pschoanass ha ecoae hough he Fench populaon o such an exen ha people escbe heseles n es o    ego an  lbn lbnal al es Moscoc Moscoc  976 The cue he hen wane was a alkn  alkngg cue cue  n whch he coul alk oe abou hese hese hngs In Aeca an he Une Un e K ngo oo oo n a ae o suble was whch nclue aesng an ashon n scplnes lke socolog an lleaue eaue popula noons o pschoanalss hae e n o he publc n an hen use b peopula pesons sons o escbe unesan an expeence expeen ce ela he  he own nneae enal les. al heap has also helpe o hese noons o he geneal publc o exaple Sknne an Ceese 983 Thee a no hae been an Opus coplex n Sophocless a espe he connual use o he heocal ece whch clas ha he souces o all pesena knowlege abou people wee scoee b he ancen Geeks Feuan alk o such a hng a hae ceae he poble an he cue. I we unpck un pck h hee opposons ha  ha sucue oen a a scous scousee abou enal healh an sckness we wll n ha ecal pscha oes no

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Donutng pyhopathology

an alone a a pe yem of hogh o only   ooe n many mey pacce   ao eae a  ae y he may ohe pe agan  The faae of he na ph ha ae peene y he Ba n eeach eeach Aocaon Aocaon Deca  Decae e of he Ban Ban   he  0 0  fo fo example exam ple  fanae ha ha ae of a pece wh oogcal pychay  al alo o fee fee a conme movemen ha fee ha  ha h gh o peak ao hee hope oo. The pea pea of paameca n n o o offng offng pychoaaly pychoaaly

o pychoheapy a a eame aonge o a an aeave o g gve pychay pychay a hman face a he ec  ec aenon o he mpoance of alkng hng hogh Th  o o ay of coe ha ehe a ologcal macle o pychoaay ae goo olon o maneam pychac an clnca pacce an we wl e ecng ohe moe aca come come moveme  Chape Chape   Wha we ee o nean nean now  how hey have ee coe a aenave an a pa of he polem.

Rea ad rea Thee  a fhe w we ca a o he hoy of mae o gve   na l anomal econ econc cve ve chaace chaace Wha f he vey ac of vng eaon fom neaon wee a poc of ce? Hee we come o he h  mo acal of he hoca hocall ac acco co Th agmen  avance avance y Focal 7) of anheay ha a we ane of he clal poco aoa gooome hgeang a he aonal a ee not only t    ao o e gooy om o m hg whch ee polce I  o goo enogh o h o wha  fel o e aonal fo we he h e have o ga ga epeaely agan h hee hea of  en en  We ee ook o fhe han Decae wg  eveeeh-cey Holan fo a example fo ex ample of he cal y poen poen pl wen m  a o oyy whch now le Ween cle Decae o ony ve he hman eng fom he e of he anmal pece wh he agmen ha ce of pa wee mee ceak of a oly mechanm  owe anmal whle he concone conco ne of of pan pan wa qalavey ffen ffen n he hman m n   he alo p he mn a he pnace o eahy vale He  h wh he agme ha ony oe h g ema when a hman e g p eveyhng eveyhng n oThe he aee ceanyfo hahehe  a who  ong wa hahe og hkng hma ofo Decae ecog non ha  hnk heefoe I am a h heocal evce fo   no moe han a heocal evce a he Fech aaly acan wa o how)   an cogo go um  mak aoa hma o off agan he anmaly of he ma A ece eceay ay coollay coollay of h pc pce e of h e elf  he  he gaanee we gve o he poeal elf elf-f -fcecy cecy o he he hma hmann mn mn   aly o o Fo Decae   whe we lo he aly o o ha o aonaly

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Maness an moeniy

3

sappears an sappears an    s Foucaul Foucauls s arguen arguen ha  ha  h e excluson excluson o aness aness as an rraonal oherness where oub has sappeare s also hen soe hng ha requres polcng I s no accen ha Descares akes a sncon beween reang as a sae we can raw back ro an assess n wakng le an aness as a sae whch we canno agne leavng once we we have alle allenn no   I s as as  when I o no h nk I no longer a. Ths s a concepual concepual polcng wh ch parallels parallels an s j us as poran as he physcal physc al polcng o he a wh ch he consr consrucon ucon o he ars General ospal porene DAco 984) Ths age o he selsucen n s also now an age o he n as soehng nvual' consere o be unve an separae) I s neresng o noe

Derras 973) crque here o he ascnaon n Wesern culure wh he ea ha h a here s an n negra egrae e sel-conscous sel-conscous cor coree o he huan h uan beng b eng an ha    us be possble o scover scover hs presence ly ng n every perso personn an every e owever we wan o ephasze wh Foucaul ha hs ascnaon s a hsorcal prouc. One way o concepualzng h hee brh o reason reason as eboe n a raonal subjec he nvual s o rase he queson o moeiy. Whls he conneen o he a along wh oher labelle evans ook place accor accor ng ng o Foucaul Foucaul  n a Classcal Class cal Age beor beoree he urn ur n o h hee egh egheen eenh h cenury he care o he a as pable enally ll persons neeng care an rehab rehabl lao aonn began as he Mo Moern ern Age Age  or oerny  he represen represen aon o he worl as organze by ea-narraves e a-narraves o huan huanze ze scence progre pro gress ss an nvual nv ual eanng ea nng  cae n o beng I s also necess necessary ary o o acknowlege crcssaccuracy. ha haveSegwck been ae o Foucaul's on grouns o hsorcal 982) argues haaccoun  s over scheaze an gnores or sors  n noraon oraon an aa ha  s ncop n copa a ble wh he overall schea. The way  s presene n hs chaper a es oe also also ake   re rea a lke he  ru h  bu we hope ha you w rea rea  lk e a guebook as helpul helpul n oren o ren ng yoursel Descaress work was a phlosophcal phloso phcal ancpaon o oerny oerny ha whch s soees calle he nlghenen n Wesern culure) Fro aroun 800 he ecal approach appro ach was seen as par o scence  an a n   was hope ha hs supposely supposely progressve oveen woul reach a ore accurae unersanng o enal llness The nvual n ecal approaches s assue o be responsble or ang he process o cure an hen o accep agnoss an ecaon n suerng slence Turner  987) su 987) The psychoanaly psychoanalyc c verson s ha  becoe bec oess h e re ressponsbly o he nvu nvual al o speak as hey seek cure cure  The coon core o boh ecal an psychoanalyc varans o psych arc pracce hough s ha he abnoral s experence as soehng whch s ineal o he person Ths woul also be rue o he cognve oels o psychopahology whch currenly whn he UK appear o enjoy a leas coparable  no greaer populary han he psycho analyc oel soehng we scuss n he ollowng chaper) Ths

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4

Dconucng pyhophol pyhopholog ogy y

nvual epeence of anomaly s such ha  mus be epesse elease n oe o b assuag Hee we have he noon of confesson ha Foucaul Foucaul      saw saw as cenal cenal o mon mon pac pacces ces of sub subjecvy jecvy . Moeny s hel ogeh hen y soes o pogessve aonal scenc scovey scovey of he na ue o he eeo wol wol an an  he  neo of n vual peoples mns  o eak fom fom ha vson of he wol s o be aonal' Wha econsucon has o o s o look a ha aonaly an wok wh  n a acal empoweng way no o ea he aonal' as  s convenonally eae ea e as he usbn concep fo wha moeny's aonalyy canno hanle  u as someh aonal someh ng ha sgnes essance o he ple ap ha ou hsoy n hs chape has ace so fa Wha hese heee h socal appoaches have allowe he allow e us o o s o un   egee egeess an  ec ou gaze gaze no a he masou a he culue  ns uo uons ns an language whch make maness mae much

Abnormal psychology's ohers Wha ases fom fom hese hsocal hs ocal sues s he h e ea ha he oganzaon o language s cucal o an unesanng o menal llness anguage oes no only oganze eason u  also sucues wha we magne o le ouse eason  sucues no only wha we alk aou bu wha we magne we canno alk aou vey me we pu ha epeence no language of couse we ae necessaly speakng o  n he language o eason o o gasp   o oe   as s povokng fo hs eason ha some objece o y Foucaul Foucauls s suy of maness a nosalga o a have m e me pas when eason an uneason wee no spl apa o eample Segwck  2 I he use o lang languag uagee eques ha spl maybe he polcal consequences of Foucaul's aack on psychay ae no ha acal meely hopeless hopelessly ly uopan DA mco  4 4  Wha hs wanng aws aenon o s he woy ha smple opposon o he psychac sysem can somemes en up eng j us as a as as   o pa o o   hs s no o say ha we can sep ouse any sysem of hough o pacce compleely Deconsucon Dea 73 pons ou mus use he sones o he house ' as weapons weapons o hee s nohng else avalable avalable . Wha we nee o keep n m n s ha hee ae sks n ong ha ha  an we mus be suspcous suspcous of anyh ng ha looks lke a oo smple an easy answe answe  In he ne chape we wll look a some of he ohe pacces ha have evelope alongse an agans mecal psychay an clncal psy chology We wll focus on psychoanalyss h e anpsychay anpsychay movemen fam ly heapy an cognve appoa appoaches ches Fs hough hough n o e ha we ae no hea hea  o e nave ealss who wan o wsh he boy away we shoul say somehng aou ology Ou econsucon o psychopahology s no only concene wh he auhoy vese n cean conceps o n he

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Madne and modey

5

po powe  o allowe  langua language. ge. We ae aan e also copaccal ncene econsucon wh he ma e eal al ms s o wha wewe ae o say heconcene ol m he ole n clncal nsuons

The rd ad l f laae Ou counehsoy ases quesons no only abou he elaonshp beween eason an uneason bu also abou he elaonshp beween meanng an bology The keysone o he mecal moel an o psychac pacce s ha hee s an oganc ounaon o he sess people somemes epeence We canno jus wsh away he nuence o physology by lookng a he oganaon o language We nee some accoun ule o ha n hs  hs  wll wl l necessaly all oo be b e As a geneal we hough nee have no book ouble accepng ha be bologcal pocesses nom he sense we make o he wol  we hol m o he ea ha human bengs atbute meanngs o hose bologcal changes an  we always aen o paens o powe ha sucue wha we ae allowe o

abu e o wha. Ins uons o powe an k now nowleg legee sucue sucue h way we unesan physcal healh an he ways n whch we unsan he elaonshp elao nshp bewee boly lls an menal m enal scom sc omo o San S an on oges      Tune 8). vy appeal o heoes o he boy an s lms s sel sauae wh culually specc assumpons ous no les so when we aw polcal lessons n a momen om Olve Sackss 84) mecal all ales The lesson we wan o aw aw om om he hsoy o  maness  s ha he sucues o meanng we use have change an wll connue changng. We nee also o go on o show how sucues o language ae emboe n clncal ns nsuons uons an by vue o ha enjoy a cean cean ype o powe As we pone ou eale he sess on language oes no mean ha bology oes no oen nsnuae s way no he way we ac an speak. Thee may be physologcal coelaes o epeenal phenomena whch sem o an een  o elne sem elneae ae a poblem an make   unesana unesanable ble Wok on aphasas o eample can open up aeas o menal vaaon whou eplanng hem away. Aphasas ae unesoo n psychac es n  n a numbe n umbe o  een een ways w ays an a n cove a vaey o cules ha people have n unes unesanng anng an poucng language language Wok on aphasas oen o en uncons o un poblems o meanng n o bologca poblems poblems n he peson pes on.. I s sll possble  howeve howeve o  o lnk a bologcal accou accoun n wh a moe humans appoach. Take he case o eacons o aphasa an onal agnosa paens wachng a polcal speech a case poe by Sacks (84). The paens ae sng wachng a spech by he Amecan esen whom we guess om he conex mus b onal eagan. Th Thee aphascs wee wee pule an an s len len n he wa o a ew ok o k hospal  an he onal agnoscs wee laughng Why?

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6

Deconsrucing Dec onsrucing psychopaholog psyc hopahology y

Sack provie an illuminaing accoun of he manifeaion of hee iorer which conra he abiliy of he ype ofrporely paien oin pick up meage in he peech  Fo For r he aphaic hewo lo i  purporely i pu he lef hemiphere hem iphere of he brain an in he abiliy o uneran he he lieral mea ning of each wor Thee paien concenrae on he expreive emoional meaphorical apec of communicaion The wor are bafing becaue he y are are r ricly icly  lierally peaking nonene an o o hey wach wach in ilence. For he onal agnoic on he oher han  we are ol ha he h e iorer iorer lie in he righ hemiphere an hi reul in a failure o uneran he emoional one. They aen o he lieral wor meaning. The onal agnoic are are creae creae up wih laugher a he incongruiie incongruiie in he language of he broaca A concluion i ha in he peech o cunningly wa ecepive worue combine wih ecepive one ha only he brain amage remaine inac uneceive (Sack 984 80) Thi i an i nerei nereing ng cae for a number nu mber of rea reaon on Here we we have a pychiar pychiari i who aribue he ifculy o an organic ior iorer er in he bra brain in  J n hi repec he i following he meical moel A he ame ime however he eek meaning in he paien experience he accoun nee no necearily reuce ha experience o biology

Languae and pwer e houl no forge ha he aribuion of meaning i boun up wih power The queion of power power which ha ofen ofen fallen ino in o he backgr backgroun oun in criique of he meical moel bu which i here implicily in he accoun of he iniuionaliaion of he inane now nee o be fore groune ychiaric iniuion operae a power rucure which operae regarle regarle  of he iniviual in inenion enion of power holer Mil ler an oe, 986). e can give an accoun of heir growh which nee no involve conpiracy heorie abou nay pychiari, an we houl be clear ha pychiary ielf i no he originaing caue bu an eec of regime of power. e omeime ue he erm pychiary a a horhan erm in hi book bu reaer bewa beware re when i ee m a if larg larger er hiorical hiorical an poliical rucure are being le off he hook We are caugh in a hiorical proce ha poiion pychiari clinical pychologi an oher menal healh profeional in relaion of power over uer or conumer conumer  of ervice an  he be we can o i o ieni ie niffy he faul line lin e iagain n ha h a power power  o open up ne new w pace of reiance fo forr hoe hoe working workin g in an a n he clinical apparau Thi bring u up o he preen an o he accumulae effec of ebae over ebae over he nau naure re of mane an unr unrea eaon on over he cenurie cenur ie The operaion of power accor righ o peak o cerain peron an ake hem h em away from oher oher Take he following repone repone by onal eagan in in

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Maness an moernty

7

a prss conrnc whn h was ask whthr h wou b prpar to ras tas Bu   pobm pobm          o ou      mnu, mnu,  pnng,  ou ou  , o go go non pou, pou, og og m -  pnng  oug 23 o 24 p n n So   n    nng nng   nu nu  ng popoon popoon  m n  ou b    pop moun  ou,   ou b kng om  p o (Ob, 25 Oob 1987)

Ths s o cours nonsns  Ths t t  howvr a psychatrst spcazng n anguag  anguag sor  sorrs rs s not on han to t us what th anng o t ay b an ock ths an up Thr Th r ar ssus hr about th organzaton o anguag an  how th rghts to spak n an spay ratonaty ar apporton Th prob strtchs byon th anngs o ach nvua wor or phras to th ways ths anngs ar h n scourss that run through th practcs o powr n orn cn psychatry an cnca work W ar conront conront wth assuptons about th ratona ratonaty ty w pct o pop pop n rnt rnt postons n vryay  Cr Crtan tan prsons n crta crtan n postons an stuatons s tuatons cou concvaby conc vaby b push n to th catgors o th DSM or CD or th rspons agan gav For so howvr t counts as nora Hr thr ar aso rcty potca consratons as to th uncton unct on o psychatry Sgwck  982. Cass  rac gnr an ag ssu ssuss shou b at stak n any ana yss o th structur structur o anguag an cutur an thy crtany ust b  w want to hav a crtcal unrstanng o psychatry psychat ry an abnora abn ora psychoogy psychoogy  Th structur structur o psychat psychatry ry oprats oprats

as w w s n th oowng chaptrs as an apparatus whch can b try opprssv to won an to back pop W w aso ook at attp attpts ts to Dcontructon brak out ou t o that anguag n th work o thatantpsy antpsychatry chatry ovnt as us to ook or cosy a borrn cas n th psychatrc nsttuton how anguag accopshs an rpro ucs th spt btwn rason an unrason n th nvua subjct Th constructon o th varous oppostons that ho psychopathoogy n pac can thn a us to a practca potca assssnt o th ways n whch subjcts a n  provr provrss o srvcs srvcs can vop so  unrasonab an usu progrss progrssv v atrnatvs. atrnatv s.

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2

Alav o Abomaly I his chape we eview some o he aeaive ways o ookig a psychopahoogy ha have eveope aogsie maiseam psychiay sychoaayic ai-psychiay amiy heapy a cogiive appoaches each povie spaces o esisace a om cuious aiaces wih psychi aic moe m oes s a we eview some o h avaages a isavaages isavaages o hesee i he couse o he chape hes

Psychoanalysis: psychiatry's rival and twin Thee is a cose hisoica ik bewee moa a meica eames o mea isess Fou Foucau cau     ) agues agues ha his eais bigi bigigg io beig beig mea chais which he peso peso weaves weaves o o him- o hese hese as hey ake o boa aibuios o esposibiiy esposibiiy o  hei aboma sae o mi a o he pogess o hei cue. This ik bewee moaiy a meicie has bee obscue i aiioa psychiay a espo esposibii sibii y appeas o pass ove o he oco. Th ae ae ceaiy ceai y som avaages o o he paie  paie'' i he sick oe which is avocae avocae by he mica mi ca mo e. ou pu pu youse i he has o h e oco a  by oowi oowigg he pescib eae eae o he

ee you ca peso appea o esposibiiy cue io hasa o a auhoize I shi psychoaaysis heo ikhebewee hehemoa meica oios o he aboma is eioce We wa o ocus o he assumpios which ueie h appoach a aw aeio o he poweu oe o aguage i he psychoaayic accou o pobems a hei cue. Thee ae hee easos why we ee o evoe some aeio o psychoaaysis i his book. Fis psyhoaayic heoy is vey iee om he caicaues pai paie e o i i mos mo s aiioa aii oa psychoogy psychoogy exbooks  a i acuay ies om much acaemic a popua psychoogy i is emphasi s o he se as somehig somehig ha is onstue ahe ha beig a esseia pegive hig Isea o pesoaiy beig see as wie io bioogy psycho psychoaay aaysis sis ooks a he way he h e ai ai y eviome eviome a he suouig cuue poue iee omspsychoaayic o subjeciviy.heoy Secoy hee is a pecuia coaicio bewee a pacice ha ees o be aesse ecisey because psychoaayic heoy he oy oes oes a a i eesig a aacive cosuciois cosuc iois view o he se se  i

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Alenatives to abnomaliy

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 any aa n na hah wok no apng a h a  aonay hap pa a o n  na. Ahogh pyhoanay hoy on aona a o xa onaon o xap any pyhoanay an pyhoanay pyhohap  a gay ny a pahooga. Thy pyhoanay noon o pon an hn n n o hap pa an ha n h h han onng whh akny   a a bng nanay non-pyhoanay Whn Anna 0  a pan o F oag Jo B a h xpn h akng ' h naga a aon o nwa on an akng o xp ha paon a va a Fz  6 an Ca og 6 aboa yhoanay  a ak an an aon aon o h p p  bwn bwn na  naon on an aon whh ha po wh nang nny n h nh ny o ony o  p h wo  o xpn apa n h po po  o png p ng  consuc aonay a ohng ohng oh  whh ha   A  o h o b hanng ha nng o  appang o onhp h waybwn w na nan n ov. h     pop po p wh h aonhp a h  o na  an language In o o aan a  h anayan h pan  n ana y  p h npo npokn kn   no wo an y h anay away ook byon ho wo o xpo nono anng yhoanay yh oanay  haa haaz z by wo nana noon no on Th   h a o h nono nnng aong h aona aon a  ono ono n  Whn w ay h  non nono o    ha  o a n n non  a a   a   w w  a hng h ng a paa paa h ng o bng wh   own   an  nnon Th  on o h ap a p o ang angag ag an w ho b awa awa ha h a F nanng nan ng o wha wa nono nono wa wa o o b han ha   8 844  Th nono  a on y an onnay a wha  ong n h ono n Th F onan noon  ha o nan xay. Agan  ay o aa o agn h ayng ha nan hav xa  an ov n  h a way a a a o. ah   h oh way on aong o F an w hav xa

 an ov a o v ha pa an oy ho w xpn n nany nan xay  n b ba o h xpn o gowng p an pon  ha o b ova an  o o  by  b h ay   o onn on n an no h way w xpn o xay now Th a boay pakng wo n n o pha n pyho anay. Th aona o w  h booga naa n an a haa o pyhoanay Th wo appa o b h han vay o nna n Aan gopyhoogy Haan n   8 whh a n o Haann o o h h  n h  6 60 0  o o aa onn wh h pow o pyhay Thn h  h o han han n an ay anay appoah whh waan h

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Deconsrucing psychopahology

conepoay ake up o psychoanayc eas no psychoynac psy choheapy chohe apy (Beelhe (Beelhe , 986). The ean ha psychoheapy psychoheapy shoul be avalable as an alenave o ug eaens s sll a acal ean hee s a sense hough n whch hs huanzaon o psychoanalyss coul wose I ay he soluon appoach acalschwee hopngbe o.akng We canhngs go a lle uhe noono n hebe psychoanalyc appoa  an aw on hese noons o huan scence an  he poance o ean ng o show how language s cucal o he whole o Feus pojec In he pocess o eevng hs non-ecal veson o psychoanalyss o psychay we can o oe econsucve wok o see whehe  eally s goo enough as a acal alenave o aonal vsons o psycho pahology

Ahaa  hyera I we ace he h e eegence o psychoanayss we wll wl l se seee ha  ha  was closely e o bologcal heoes an   s no supsng ha  shoul have playe playe an poan pa n aonal psychac classcaon syses. A he sae e Feu e o beak om a puely bologcal oel o hysecal sess. Well be beo oe e he  he eve evelopen lopen o psychoanayss psychoanayss , Fe Feu u was neese n aphasa as a bologcal an enal phenoenon, an as a poble o o wh sucues o anguage n he nvual subjec (Foese, 980). Feu saw he eence beween aphasa an hysea as lyng n he lnk ha wa wass se up beween causaon causaon an cue. cue. In hysea  h e caus causee s no a physca physcall les leson, on, bu a s  wee wee he  es eson on o an ea . h hee hysec hys ec sypos wee oe oe when an unplea unpleasan san expeence esonae wh epesse eoes o he pas nan sae The conepoay ea j one wh he epesse epesse eas an so los ouch wh he oeang oean g nuence o vebal conscousness They wee hus os as wo pesen aons  an ese unegou unegoun n as hng pesenaons pesenaons  Wha akes he paen ll s slence (Foese 980 3 ). Feu spoke o he pocess o cue as  he epesse eoy ssolve when  was eune o conscousness ha s, o he wo pesenaons leve Feu says Once a pcue has eege o he paen's eoy we ay hea h say ha  becoes agenay an obscue as he pocees wh hs escp

on o   h on hee paien is as i were ge gein ing g ri ri  of of i by urning i in ino o wors (ce n Foese, 980 3) So  was ha psychoanalyss was ubbe he alkn g cue' cue' .

y ad here sychoanalyss oes no see he enal sess o s analysans as a scee, specal sae We have ahe a coninuum beween hose who

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Alernaive o abnormaliy

2

ae ey unhappy an hose who ae elaiey wel ause A he eee en en  o he s goup go up ae hose sueing sueing o psychosi psychosiss who ae unable o ake uch connecion wih anguage a al A iiaion o uch psychoanaysis is ha because hese peope ae unable o speak abou he poble, unabe o ecognie ha hee is a poble, psycho analysis een oo sa. he oheoen o heepeiences coninuu an ae hose oisusunable who sue heAepession painul epea hose eoies in ou eas an slips o he ongue An aanage o psychoana psychoanalysis lysis is ha i alows een he  he os no noa' a' o us o epahie wih he isesse by epeiencing o soe een he sae pocesses.. The Ho ywoo pocesses ywoo esions o psychoanalysis , whee he anaysan goes aha, now I eebe, I cue is quie wong hough Aeican analyss who ae capue capue by he eica eica  oel soeies soei es see o beiee i heseles Fench analyss such as Lacan ague ha psychoanalyss in Aeica hae aape o ha culue no only o hey eicalie pobles bu hey aso iniiuaie he all he oe ouinesco, 990). A chaaceisic o uopean psychoanalysis is ha i is oe sensiie o he h e oe o ang an guage an o oee suspicious o psychiay ahough i us be poin poine e ou ha i sil  uses he he sae iagnosic caegoies We wil see his ieence beween Aeican an uopean psychoanaysis again when we look a he eeopen o ani-psyc ani-psychiay hiay  uopean aieies o psychoanalysis hae been ipoan o einis wies who hae ha e wane o eclai soe accoun o he unconscious o o he paiachal soy pesene by Feu Michell, 974). In ecen yeas ei einis nis psychoheapy has blene soe o he oe pogessi pogessiee aspecs o acan's wok wih AngloAeican objec eaions' heoy o eaple, ns an Maguie, 987) an hese ebaes hae oun hei way ino einis einis  counseli counseli ng o eaple, Chaplin , 988). In pacice, he picu m ynic i n his psychohepuic woking woking o us us ieas has been he os ipoan an pogessie aspec an he iscouse o einis heapy shows ensions beween copeing poiica escipions an eucionis psychoogical eplanaions o isess see Buan 995). sychoanayic heoy on is own oes lile ha is pogessie only when i is inke o a ciica accoun o sucues o powe pow e in isco iscouse use an i nsiuions oes o es i beco becoee helpul o hose wihou powe.

Vbla

Bu we shou s consie quesions abou he alue o psychoanaysis an he powe i wies Thee ae concepual pobles in analysis which ow o he eph o inepeaion which is eane. As wih slips o he ongue an o o he pen,which eas coulbanal be inepee wayThe o associaions siiaiies ae quie Tipanao,by 97).

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22

Deonrucing pyhopahology

pobm s ha h anays s pu no a poson o pow n whch manngs can b mpos nsa o bng coopavy ach Th may b an  a a psychoanayc psychoanayc s uaon whch s nv acuay aanab pcsy pcs y bca bcaus us o ha pow mbaanc m baanc Th Th  a aso p pobms pobms wh ch m g om om h  cn hsos o Fus scov scovy y o nan suay  Th T h mssag mssag o som  cn accouns s ha F Fu u ngag ngag n a pocss o vcm -bam -bamng ng Masson   4 4))  Th v o o psg among h mca po pos sso sonn o Vnna a h n o h as cnuy  Fu o abanon hs sucon hoy whch h omua a hs m n as suyng suy ng un Chaco Chaco n   6 6 Th was much vnc hn ha ha  a hysa an mna sss cou b ac o acua nsancs o ch abus I was howv mo convnn o Fu o aap o h anch cma o Gmany an Ausa an o cam nsa ha h ann ass o suco a suconn w us  ha  fanaie consuc ou o h s o h ch o h pans pans  Accong o Masson Masson hs was hn n  noc oc whn Fu amp o cov up o h mapacc o hs n Fss a an opaon on on o hs pans Ahough hs cam o pubc anon n h uo ov Masson's vaons Macom 4), h has bn a ong aon o m m ns cu whch has awn awn anon o msogyny an abus n Fu's wok o amp M 77 ush 4). A conacon uns hough psychoanayc pacc pacc  o  cous cous  n whch h  h ana ys s h p p  bu w  a h pan pan  as havng a goo goo a o ps n vang an ssng' npaons Th abuon o sponsby o h pson howv may pon o vn p pobms Th man ang o psychoanayss cou b ha  bns h pson no a aonshp whc us absou subonaon Ths s nmc o psy psychoanay choanayc c pacc pacc an w can s  vnc vnc o hs n h  pa amps by psychoanayss o sov h pobm o pow somms by nssng ha hapss mus an om h pan' Casmn ) somms by ugng coagus no o sga pans' oaccouns Hobson 6) an somms by abanonng h pocss npaon aogh omas 7) Dsp hs mo cuy cu y popos poposas as  h m an pobm mans man s ha  s no goo nough o say wha h anays wans o ha you mus believe  As psychoanayss vs p an p h anaysan mus gv accouns whch bng a n manng o wha hy ha ognay sa Ths mans ha no ony mus pans spak bu hy mus connuay can connuay a h asy o wha hy ha o h anays jus bo Hnc Foucaus agumn ha psychoanayss nocs moa mos o con sson Foucau ) I  hs pcu  s u u o cou cous s hn h nw hum ansc angs angs o psychoanayss psyc hoanayss whch pn o vau wha h pan says may b vn vn

mo pncous han h mca mos I s hn a h mo h sponsby o pans o accoun o h sss an o why hy

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Alenaives o abnomaliy

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ean uck n     nea o o beng an aenave aenav e o o aona pychay pychoanay wou wou hen be een a   uppeen uppeen .  hou be pone ou ha  ha he  he ove o Feu eveopen o pychoanay hou no necessaily ea u o ay ha he heoy  wong Depe o pehap becaue o Foucau 8) aguen ha pychoanay  a eep pa o ou cuue we have eaon eaon o be abvaen abvaen owa owa   nn nngg  epugnan an aacve a he ae e. We n h abvaence a wok agan when we ook a he acve o he anpycha

Anti-sychiatry medicine and its others oe o ena e oen oen uncon a a cope The pychoanayc  oe en o he anea eca oe.  oe no neceay an n oppoon o  A ea h  he poon n Ban an Aeca. ychoanay a an nuon  govene by he ec n he ngh peakng wo an   h whch gave he o-cae anpychay' oveen whch eege n he wave o poca une n he 60 a pacua o. The oveen aoun D Lang ene o ao be hoe o pychoanay even Lang he ew heavy on pychoanay n h wng). Wehough ae gong o ay oehng abou ha oveen bu we hen wan o cona  wh he anpychay oveen n Fance Thee  pychoanay  he ype o pychoanay whch ha gane avou n en an on he Le hee n ecen yea Fooh     Mche F Mche   4)  wa wa ee eenn a an ally o he oveen oveen   ueu o unean why an wha he eaonhp o Lang wa n Chape  we w ook a ohe pacca aca aenave o pychay whch have been eveope an whch have been poan o aca n ena heah goup.) Ahough he anpychay oveen wa a boae han he goup gahee aoun Lang an Dav Coope ue ene o be peonaze an euce o Lang own acve. The conbuon o Coope 2) o exape wa poan bu wa puhe he haow by aoun he Lang cu A evew oobjecon h e o hen oe o e aono neceay evove evove h acve  Lang he eca oe o ena  n ne' e'  an o he powe o o pychay ae oe oenn upe ogehe wh hoe o Thoa Szaz. We hou be cea hen wha he eence  beween hee wo gue an ao cone he oe aca veon o an-pychay whch ouhe bey bey  n Fance.

La ad exeal One o he an ak o a cca appoach o pychay  o pove a hoca accoun o expan why ecne gane he angeho  . Ahough Lang Lang wa conen o eave eave h ak ak o ohe  he wa wa eponbe ep onbe  o o exap exapee  o o he pubca pubcaon on o o Foucau     ) Maness

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Deonsruing psyhopahology

an Ciili Ciilizaio zaion n n B an  wha Lang  was o o aack psychay  o o

w hn by eusn whn eusngg o eploy eca caego caegoes es He nsse on ewng he pa en as a peson peson  Ths Th s was was o o an exsenas exsen as pos on whch was o lea h   n un  o look o socal eaons  pacualy pacualy o socal socal elaons elaons n he aly xsenals whch Lang ook o he wngs o he Fench exsenas phlosophe Sae 6 woks on he assupon ha each peson akes sense o he wol wol  an knows wha he bes way o beng-n-he-wol s A cucal pa o beng a secue peson s he ecogn eco gnon on we gan o o ohes he a aon we ecee ecee Ths bengn hewol caes wh  anxey an he hea o onoogca nsecuy' A peson wh o eeas eeas  no schzophena oes so because because he heas o o he  exsence as a peso pesonn necessae ha eea Lang L ang   6 6  agues agues  n he Di D i ie Self Self ha os o  anxey su su e ee e b y a n onologcal onologcalyy  nsecu nsecue e peson wl nole expeences o engulen he oss o eny ploson wh he wo poung no he sel an esoyng  o pecaon beng une no a hng I s Lang says he ask o exsena phenoenology o acuae wha he ohes wo" wo" s an ways o beng n  Lang 6: 2  Ths le La ng o a nube o conclus conclusons ons o s o whch whch he was oe cauou cauouss abou bu whch hs suppoes n he an-psychay oeen oeen enhus saniy sani y wo or psyhosis psyho siswhere is es ese e ascalyofook up Langorsuggess ha egree onjunion isjunion beween persons he by onehe is sane by ommon onsen' Lang 6: 36 ephass n he ognal A

oe exee concuson s ha nsany ay poe nsgh ha he osensbly sane ae no abe o achee So Lang cae ha  he cacke cacke n o he schzophenc ay e in gh whch oes no ene he nac ns o any sane peope whose ns ae close' Lang 6: 27 ephas ep hasss  n he o og gnal nal Alhough Lang sae o o as a psychas   qu ckly becae appaen appaen o h ha he an-psychay oeen eque een nsuons Ths s why p aces ke Kngsey Ha  an  h e hlaelpha hlaelpha Assoc Assocao aonn  n Lonon wee wee se  up Th Thee hlae pha Assocaon s sl gon gong g a n was one o he s psychoheapy anng oganzaons n he UK o use Lacan's wok wok  La Lang ng aways ene ene h se as a psychas psychas an one o hs coplans n ecen neews s no so uch ha hs alenaes o psychay wee no successul bu ha exbooks gnoe h an Szasz Lang 86 The aacks o aona psychay wee pecaby seee They clae ha populazaons o Lang's wngs coul lea people paculay aolescens o y o e n he lgh an becoe schzo sch zophenc phenc Boy Boyes es an O O    7    The suaons whch Lang's paens who wee oen young people lng a hoe  oun hese e ess n wee oe oenn al al y suaons Because o hs he sucue o he ay sae o oo lage an lage n Langan wok Lang wng wh Aaon seson ha ague ha aenon shoul be ece o he aly nexus' Lang an seson

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Alternatie to abnormality

25

1964) t shul the be pssible Laig (965) ague t ietiy

schiphegeic' ailies. Hwee while supptes  Lag hae seties ptaye hi as beig ctical  the Weste Weste uclea aily as a istituti his case stuies ealt with the paticula stuctues  the ailies which puce the patiets he saw. hee is a issue hee which ws  the tu  iiiuals t aily iteacti iteacti t what cul be tee i e aistea psychi psychi atic j a ag g a aily ieacti el Segle a Os 1977) hs cces Laig's elatiship with psychaalysis. O the e ha the w  aily iteactis iteactis ew  systes they. We ha systes'  stuctues' which wee aulty a we hea the cies  help  the ictis  thse systes systes . his app appach ach wes little t Feu Feu  a Laig was tae by ay  his his supptes a citics t be hst hstile ile t psychaalysi s. O the t he ha  Laig i use psychaalytic psychaalytic ccepts. ccepts. he eis eiste te tialis he t  Sate was ltee thugh his w uestaig  psychaalysis a i se seses Sate (1974) hisel was sypathetic t Feu. Ulie staight eistetialis Laig always ague  the iptace  the ucscius. t has bee ague that the eistetialist psiti which Laig escibe was t a psiti which a pactisg psychiatist psychia tist which he was cul ee apt but that Laig L aig eally always ahee t a aiet ahee aietyy  psychaalysis psychaalysis ahee aheece ce t eistetialist eis tetialist pecepts pecepts ie at beig ale ale i the wl a s s977)    was a epe epessi ssi  s ste tess ss by the ucscius Cllie But what  yu  with peple i istess peple wh hae bee esse up by thei schiphegeic ailies a hae g eass  the behaiu they ehibit? ehibi t? O Oee aswe which w hich has lgstaig his hist tcal cal esaces esa ces gig bac t ue's Quae etepise at Y is t pie a eteat' whee they ca llw thei juey thugh aess Fucault 191 A well-w well-w eaple i  he Lagia Lagia aii is t he case  May May Baes Ba es at igsley Hall .  1965 this c uity  abut 20 peple was set up. May Baes a e use wh was labelle schipheic egesse t a ia state. She wet bac t beig e e  a bttle bttle  t beaig thigs a t eusig t eat i h e j uey thugh thugh aess his juey is ece ece i the Baes a Bee (1973) b a she gaie se ppulaity i the atpsychiaty eet thugh he ehibitis  paitigs puce whe she was at igsley Hall. he pbles with this appach which has bee tee by citics wig i the eical el the psycheelic el'  etal illess Siegle a Os 977) is that the etal health pessial abas espsibility  the saety  the pes. At a etee the attepts t peet a istesse pes  cittig suicie ae abae. Suicie cu cul l be see i this th is aew aew  as a atial' atia l' way ut  a a ipssible ipssib le situati . he iatiliati  the patiet als puces puces a aea  pessial abuse. Hee we ay als hae ce t se  the liit li itss   the aical plitics pli tics that Laig abble with i i  the 1960 Laig

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6

Deconrucing pychopahology

publhe n lewng journal an are o wen h objeon o

oe y n general re oey reerrng errng o a worl gone gone a an hoe labelle a a beng v who aw he ruh abou oal realy. he oluon however were oen eher ple nvua earhe or eanng an a way o bengn-he-wo bengn-he-worl rl  or elberae rerea r ro o polal avy av y n o hzophrena ang evenualy appeare ro vew or a whle a he heae or y ya all enlghenen  n Sr anka. So e o ang ang r on  he e e  have alway be en upou upou abou h raal preenon preenon  a n have no  been urpre urpre a ang journey ou o pol n o y y an hen h en bak n le o pyhar pyhary y a hubler an.nhe ol r r o hzophrenogen a a are overaken by prae h  h laer work or noral ale a lurae n oe o h ree vere wher eree no eye ar aree pec eck ke ou    wih a nice whh alk o coy ne / wh mummy an ay e n Segwk 98, ep epha ha n he orgn orgn al .    alo argue argue ha only o n e ype o narrave o  a hzophren hzophren aree areerr  erbe er be by ang ha o  an au auee pyho pyho epoe epoe an h e lenele o h e  hlaelpha A Aoaon oaon were a hghl y ovae elel elelee ee group. erhap   neeary o be rea rea  abou he value valu e o eal approahe n orer beer o hallenge her abue o power Segwk 98) yhoanaly en en  objeon o ang n h ounry whh raw on he Frenh reang o Freu have alo vewe h raal aeen wh a jaune eye Jule Mhell argue ha ang rven-a-by he-aly-neu hzophren  every aoleen wr large Mhell 974 79) h hee eperene eperene a ng erb erbe e are boun up wh w h he  he raua o leavng hoe  an have away arre arre he eage eage ha  he al al y wa poenally a plae whh houl be epare. There are alo ehoe here o he raonal r aonal pyh pyhar ar onenaon o ang whh aue aue h o panern pan erngg o preonable aoleen who ou oul l rea h erpon erpon a prerpon or lbera lberaon on r ro o oa rule rule  parularly par ularly ro ro he rule o he aly Boyer an Orr 97)

Szaz a ad d lberara lberara hle ang wa aakng pyhary n Bran hoa Szaz wa arryng ou a ue eren eren aau on eal e al oel n Aera. Sza Szaz z 96) reaone ha organ aage oul lea o he abene o parular enal unon unon   wo woul ul be ue unproblea o orr eaple eaple  or h o rea Sak (984) work on aphaa a reurng oe eal aoun However he probe e a he bounary beween obvouly organ orer an he anee an eperena pan whh are oonly oon ly een a a enal l ne ne'' . For Sza Szaz z o urn o ene here  o lookk o he oern ay euv loo euvaen aen o ere eon  Me Me  never n he proble prob le  bu he y preen preen  e Meanwhle  he y rea rea he peron peron a a paen an he k roe nhb reovery   alo epenen on a onepon o ene a beng objeve an valueree  houl be

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Alternates to abnormalty

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born n  n that n so ways a agnoss o physcal l lhalth s as uch a oral an poltcal jugnt as psychatrc agnoss Illch, 976). Szas Sz aszz was, an  s, a psychatrst Howr, h s crtcss o o th th cal ol wr always or concptually racal than Lang's Ths s

paraocal , or th poltcal conclusons o Lang paraocal Lang s work ns n s psychatry wr a goo goo al or racal than t han Szasz's  For Szasz, thr s  s no plac or or any concpt o ntal llnss sychatry s just ology Ths s n larg part, to o wth th altrnat ol h subscrbs to, an th poltcal consquncs o hs poston It s prhaps syptoatc that whl Lang tr to n clu Szasz n hs attpts to ro ror r psychatry, Szasz has bn hostl to any such allanc all anc , clarng that th th  antpsychatrsts ar all sl sl clar socalsts, counsts Szasz, 976 4 an that Lang n partcular partcu lar was a prachr prach r o an or or th sot" unrbl un rblly ly o th th w Lt' Lt' Szasz 976 . Szasz aopts a oral poston whch rqurs th nual to tak rsponsblty or tratnt In ost cass ths woul consst o b haoural progras progras Hr w w ay s , prhaps, why wh y Szasz's poston s so congnal to psychology H alls out o cn nto th war brac o bhaours, nto a w o strss whch trats nuals an whch oprats on a strct stncton btwn what s noral an abnoral', btwn what s approprat bhaour an what s, n th phras o a anstra ttbook on abnoral psychology, alaapt bhaour' Sarason an Saras Sarason on  987) It shoul also b pont out, an thr s anothr anot hr layr o parao hr, that Szasz, or all hs tuprat, arguably antstc attacks on Fru an psychothrapy Szasz, 979) also practss an wrts as a psychoanalyst Th poltcal Th polt cal upshot o th ths s n n ual ualst stc c oral post poston on s ry  rnt ro that o Lang's supportrs n Brtan Szasz attacks psychatry ro h n gh.  h n n   hng  y  cal tratnt, an h has n propos a lgal procur whrby nuals n uals can c what tratnt thy woul prr prr whn thy t hy ar n a goo stat bor a brakown. Hs objcton s to th stat prong ntal halth on th wlar, outs th prat sctor. ow w o not want to ruc Szasz's coplants about cal psychatry to ths poltcal attrs n a cru way, but t s as wll to b awar that hs concpton o nual rsponsblty r ro th sck rol s a bt lk nsstng that popl shoul stan on thr own two t an stop bng ollyco oll ycol l A At trr all ,  t s tru that thy can tak rsponsblty' rsponsblty'  why o thy n hlp anyway cpt as an rcs o r choc?

Laa La a ad ex exe eal al   Or on on th contnn contn nt t th objctons to th powr o o psychatry ha bn bn gn a rnt twst by th stnc o a or acal or o psychoanalyss Frst o all th work o Lacan, who was pll ro th

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Deconucing pychopahology

aioa sychoaayic Associaio i 63, has aways b ciical o psychay a scoly h iuc o Foucaus ias o h hisoica poucio o ass has b  by so aica psycho aayss  Whi Whi aca s oco ocoa a hsis pubish i  32 was ossiby i aisa psychay psychoaayc hs w alay appaig h  Sypoa Sypoaicay icay  hs ias w w closy lk wih h h  populai populai  aios aio s big bi g spa spa by h suass suass  aca hi sl wo i h  3 3ss o suais agais a Dai was a cos i Macy, 88)

O o h c a all cocs o h acaia aig aigss o F Fu u is wi h laguag aca  aca    )) saw laguag laguag , a ai g i ga ga , as cop copis is ig a Sybolc o W us h laguag o a culu o hik a couica a o whi ha o al a h sis a wishs o h ucoscious quaig h ucoscious wih h Syboic allow acaia psychoaaysis o bak o h iiviuais o o psychiay a o oh psychoaalyic psychoaalyic s  ouisco,   ) ) Th ucoscious is o wha is wihi h iviua bo socialiaio O h coay i is h effec o h iiviu i iviua a o h h culu i which whi ch sh o h s bo Th ucoscious h co o h subjc, is, h, boh iiviual a colciv h subjc i acaia psychoaaysis is spli bw h ucoscous a cosciousss Th ia ha h subjc is ui ay a coh s oy a l lusio ha covs up a is his spi spi   his way aca subvs h cay o Dscass oubig  as a uiay big ha cou c o s o a sig posiio Cos qu ly aca baks apa apa h isicio bw aso aso a uaso , a isicio upo which o psychiay is bas acas ) cypc a ausv sa  I hik wh  a o ho  a wh  o o hik psss acy ha spli  a is h coss psso ps so o h uh o h subjc subjc whch sis i h h  ucoscious ucoscious  hik is h ilusoy wok o cosciousss Big a hikig, h ucoscious a coscousss, a wo posios ha ca v b ui h aiy is s as pa o h Syboic o  ac acaias agu, h is always a auaic alaio awag h chil, ha h ah wil s al h pow  h ay ay a   h culu by viu o hi big a, a his s iv ho uig h Oipa coics ha accopay acc opay h ac acquisio quisio o aguag aguag A ah gi gi cosquc s ha poliics i s also s h as pa o h Syboic oivi o Youual cou h s a acaia  posiio as bi g ual ual wh h viual i s cssaily cs saily oppos o vy aspc o ha o) o cosvaiv cosvaiv  bcaus opposiio is pobably uilss) uilss) A as hs w h wo opos pciv i h  6 6s s owaays, hos who aop acas aca s  p pao ao o Fu o o s i as poiig o h poac o cuu a h ipoac o ag o h way oogy opas  cuu o pac pop i i i  posiios posiios  a  os cucialy cucialy g posiios  wh hy hav, o o no joy pow Gos, 0)

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Alternatives to abnormality

2

aca's psychoaalysis i o go ar eough  ee o be he coseraie lesso ha was raw ro his accou o he Oeipus cople a he power o he Sybolic orer he power o laguag laguagee  The wor o Foucaul o he oher ha while ore cauious abou psycho aalysis  siulae si ulae a ee ore roaic iew o he uco ucoscio scious us as he reposiory o ruh or he boy a is pleasures Foucaul, 8  reacio o ay social orer or eaig he ucoscious represse boy was see i he wor o Foucaul a his ollowers as a collecio o esirig achies Turle 8. Fro his ollowe he isaly a assiely popular wor o Deleuze a Guaaris  Anti-Oeipus For Deleuze a Guaari i was a isae eer o hae sai he i' or i' a hey ure o schizoaalysis' as a celebraio o he corolle

eliriu i which oe s persoal ruh a esire Wha Deleuze a Guaari eeciely i here was o ouaig aig. The uclear aily isel was ow see as cosiuioally schizophreogeic a psycho aalyss who srucure oral psychology arou he Oeipus cople reprouce ha aessiucig srucure. The ers o he ebae abo psychiary a aipsychiary were so so uch ore raical i Frace  a coeary o he case o Mary Bares Guaari   84 84  wh whoo sare o o as a acaia psychoaalys aes a isicio bewee a real schizo phreic jourey a a ailialis regressio alog peybourgeois lies' Guaari  84 4.  soe seses he eree aipsychiary oee i Frace has collapse alog wih he pos68 e There were sill grassroos groupigs hrough o he 80s howeer such as Gares Fous, which were o so uch cocere wih psychoaalysis  a were clo closer ser o coepor coepor ary raical healh oees i he UK Turle 8  is as well o reiew his bcle i raical' eal healh, is collapse io psycho aalysss a he ba o syhary aalys syha ry beau beause se he h e aes o hese eas ae sill arou i hose waig o challege raiioal oios o psycho pahology oay. We wa o ur ow o aoher proisig area area  a irec iereio io he  he poliics poli ics o h ail y a place i herapy h erapy where raical raical ieas are sill goig srog.

Famiy therapy: the identied patient ee aigia s he eal hhe ealh syse o r goo go o or ba i aily ai-psychiary herapy. Wheees aig argue i healh 60s ha or we shoul sop ryig o ieiy schizophreogeic aessiucig ohers a loo o he oerall aily srucure srucure he paricipae i a yaic ya ic which coul be resole i wo ways Faily herapy chages our cocepios o wha oral a aboral psychology loos lie because i locaes all he sypos o a psychopahology i he aily ui raher ha i he iiiual. This is he rs cosequece o looig a aily ieracio

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30

Deconucing Decon ucing pychopaholog pychopahology y

he secon way of lookng at the tuctue of the faly teats that stuctue as a poble athe than as oeth oeth ng to be be patche up. Faly theapy s concene wth pattens of eanng We can focus on that eanng  n two ways. One way looks at at the patcula pattens whch esh fa fa  l es togethe. Hee H ee ae those those councaton cou ncaton pattens that can keep a noal faly gong, o ake an abnoal faly hell fo one o oe of ts ebes. ebes. he othe way way l nks  n the eanngs wth the stuctu stuctuee of language as a whole an the way language language postons people people n fales. t s the foe concen wth the councaton pattens ntenal to the faly whch pove th ba fo uch faly theapy.

a Sch ophena Schophen a wa st st teate as a poble of faly pattens by the ao Alto Mental eseach nsttute n the  5 50 0 oste oste   8. 8. t was hee that Gegoy Bateson 2 looke to cybenetcs systes theoy an

councatons theoy to pove the bass fo aequate psychotheapy Schophena n ths th s  F Ft t oe oe cybeetcs cybeetcs'' oel, was seen seen as a esult of stote councaton Cetan councatons, oublebns', wee seen a s especally angeous . hee ae thee en enn ngg chaactestcs chaactestcs of a oublebn t, thee  an ntene eotonally sgncant elaton shp whch exsts btween the patcpant seconly thee s a sene of the ouble-bn' eage who en two oes of essage n whch one enes the othe an th ly thee th ee s a ece eceve ve of the essage essage who cannot coent on the spaty btween the two oe ake a chl who s contn contnually tol to ow aeto a eton n t o a about paent paent  an then s e t bya colnes, col nes, an then th ually en s blae fo the fo confuson abou t the essages. Such vct of a bn ay then be unable to untangle the ffeent levels of esage sent outse the faly o to attbute attbute eanng to the own feelngs. feelngs. Such a vct ay then show the ocaton of feelngs fo thoughts that chaactees chaact ees schophen schophen a. hs v ew of the th e cauaton cauaton of schophena schophena wa s extene by he heoo ooe e L   63 who ene ene what a healthy healt hy essental essen tal yna c tuctue tuctue of the the faly ght look lke L, who also antcpates soe of the wost noatve stuctual notons of eal faly functonng agues that t s t h e falue falue of the the faly popely popely to ene gene oles oles an  to a ntan a stncto st nctonn between geneaton n the fal fal y whch gves se to to pobles pobles . L goes on to ague that n the eal faly en have nstuental oles an nwoen expesve oles. s then abletuctue to explanHee how tthe weakness one ole can affect the He whole faly s evatonn fo evato fo the Westen Westen nuclea faly stuct stuctue ue whch  s seen as the poble hs s the context the n n whch Lang booste booste nteest n the schophenogenc schoph enogenc functon of fal fal es . Although uppotes uppotes of Lan Langg wee ctcal of fal fal es  faly theapts geneally opeate on the th e assupton that the faly was essentally a goo thng.

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Alenaiv  bnoli

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Srral aly Therapy Lke Baes L a a Lag  M uch uch     4) 4) vs vs f f fa y hea heapy py see he pes wh see wh he pbe pbe as bg bg h    e e e pae pae    ex pae  ))  The cue cue u be ece ece   h h  fa fa y f whch ha pae  s a ega pa ach fay ee eaes  he hes hugh uae acves whch cay eag Thee uae acve ae he asaca pae whch he fay heaps w y  ucve The fay as a ys as wh  ay u-sye A vua ay be be a ub-s ub-syse yse a w beg  u u  he sub-syse Th Th pae f xape w cue a sub-sye wh pecc ecse   acs acs  a he ch   ahe  The ua ua ee wh wh pac pac paes  ff ffee  subsyses subsyses A ee ch ay b ve esp espsb sb y as pa fpaes he paa  k he hes bh bgca ae usub-syse f he h Th af ay h a whe ehg  ha a s p pee a ae bewee bewee h he ay a h h h   Th aa a ac c ay h bece bece a ca ca   aas aas he fa y e Such a ca ay he b cfug  he ch cau h buae bewe he ffee fay sub-yses ae uca u ay hav

appeag wha Much wu  a csgeeaa yfua asaca asa ca pae pae M uch    4 4 6 2) . The heapss jb s  esucue he fay  egag  acca aaces wh fay ebes   Much ws  facae he aea ce f subsub-sys syse e ha p p he ag a gwh gwh M uch  4 256. Much  caefu  wa fay hap aa vewg he exe fay as csay pahgc Such fae h say, ay fuc fuc  pf pfc cyy we we   Hwve  pacc pacc  he fa fa y heaps w f have  ap ap a e f h g fa fa y  a eas f h   fa y ee Wh e hs    pe u u a ep epc c  a   w w   has  vve a vw f he g fah a h g he e f he agus agas sucua fay heapy  ha he sye a subsyes ha he heaps ceae ce ae  a asue  peae gaess f ca cex Th ca cx ue  h sucu f vua fa y way f he ucu f aguage acua bs ae  puce by ua bu he aea f he bs s pve by he uu cuue W w e a ca xape f he way such b b  ca be epuc epuc by pyha pyha  yy   h h  ex e x chape whe we k a he way agc ag c sys peae  pychay  cca psychgy a ae pfss

  r rr rl l hol Ahe a uce  wk wh fae  h saegc a whch pck up Ba ) a a py he

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3

Deconrucing pychopahology

prmtlly  t wor o y Hly 963 d Mlto Ero or xmpl Ero Ro toototr  rt  otot o  rmt trptd u tr 99 powr Hr ttlly v  ml   t trdto tt br oluto-oud trp u  d Szr 985 lo om rom r  bot truturl d trt mly trp t trpt dd rt t wt ml or mpl v tm rt t d o o  roup o tl mly trpt b to mpz t m mport port  o t t tul ovrto ovrto wt t mly  t ut o trpy  Ml Sytm modl drbd or xmpl by t Ml ot Slv lzzol rt Boolo d C C  Sv t   98 980 o ou udd lmot xluvly xluvly o t powr o word to produ produ   ml ml  Somtm trpt trpt d tt t propt or  md o lt tt ty tully  tr trutd utd ml ml  ot to  Su uto uto wr tr trmd md prdol trvto dtr rly u tqu to b ud or rom tr trt t t M tm trd to b dt tmlv u tqubd ppro d b to ou mu mor o t  mport mport  o quto quto prtulrly rulr quto quto dd dd to lt  udrtd  t trpt d t mly o t ytm tur o t probm tt  ow t w td up  t mly rlto p Evtully t tm plt to two roup Slv lzzoll d rt o t o d d Boolo d C o t otr wt t lttr roup b mor op to potmodr potmodr u u 

ay hay'  Altou mly m ly trpy d wy b op to rtm r rom om outd prturly rom mor dvduly o ou udd pyodym trpt t lt 90 d t 980 w  prod o utd rtm rom wt t ow r  prtur t wor o mt mly trpt l Vr oldr qutod t domt mly vlu o ptrrl rry d trutu trutur r dm  mu mly trpy trpy oldr  993 Mo d Mllr Mo Mllr  98  rpt rpt wor wt  volt d ully buv m m  oud tt ll u vlu w tully prt o tr trput wor  ddto  umbr o otr ommttor qu tod t ptmoloy udrly mly trpy My lt tt Bto d dd ot t ly wt  v rlt vw o t world rtr turd to t t l  o Mtur Mtur d Vrl 980 d otr  tr ttmpt to dmrt od ordr ybrt w md t wdr ytm  w trpy w lotd rly ml y trpy trpy u o xprt xprt powr  d bd owy owy mrror mrror d d  out prdo prdol l m m  d o o o  m to quto quto td worr l ro C or xmpl C  d Ry  993 vtd trpt trpt to b rrvr  rrvrtt o tort tortl l dom

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Alenaives o abnomaliy

33

To Anesen 987 suggese ha aily heapy eas shoul hae he i iscussion iscussion in on on o he ail ail y which also iplie ip lie a oe especu especull kin o conesaion Daian pson an Michael Whie Whie an pson pson  99 99  soe soe oan inculcae inc ulcae expli cily explicil y polii poliical cal iew o psychologi cal pobles' pobles'    is in he la lae e san san ha soe soe hae seen seen he possibiliy possibiliy o a econsucie heapy' an his is soehing we will iscuss in Chape 6 Faily heapy has ie o show how people in isess ae caugh i n a achiney beyon hei con con ol . We also nee o be aw awa aee o a ouh ajo aiion opeaing i n ension ensio n wih wi h psychiay ha looks o a achiney insie people's heas heas ha is causing causing he poble an we un now o hese cogniie appoaches.

Cognitive approaches: the mechanics of the mind n he pos-wa cliae o heapy o he asses behaiou heapy appeae o ule supee. nceasi ngly  psychologiss an appeae an  sall goups o nusing sa sa aine in behaiou heapy poe poe hei  heapeuic ele in applying opean opean coniioning coniionin g oen o aginalize goups like auisic chilen people wih leaning isabiliies an so so on o he poin whee in he case o leaning isabiliies os ohe heapies wee oally is coune. Whee he likes o Azin o exaple Azin an Holz 1966 was oing his in Aeican insiuions wies like Wolpe 198 an achann o exaple  ysenck an achan  1 96 acha 964 4 eise behaioual pogaes poga es o obsessi obsessional onal an ohe oh e anxieyela anx ieyelae e pobles pobles i n he  he UK 

Howee he cuiy echanisic an soeies especially in insi uions puniie p uniie naue na ue o any o hese heapies le o heapis heapiss s looking ino he so-calle back box' ha  ha eiae behaioual behaioual esponses esponses an so so behaiouiss wee oc oce e o eun again o he in  in  n ee o oay ay een soe aical behaiouiss will be willing o iscuss phenoena pe iously egae as enalisic. The heapy lieaue soon began o alk less o opean esponses an oe o cogniions an aibuions. Howee he saus o he cogniie eoluion o he 196s has been uesione wih soe like oie 1983 aguing ha cogniie eseach ha nee isappeae an ha h a alk  alk o a eoluion was siply a poweul poweul heoic o helping o oun a new paaig in psychology.

Th aag  bhau hay wh cg;  u  ych The weling The wel ing o cogni cogniion ion ono on o ie an an  use behaioual heapies hea pies was poliically use useul ul in he U K in he  9 9s s  a ie when clini cal psyc psycholo hology gy was suggling o ceae an auonoou auonoouss i en eniy iy sepaae o psychiay psychiay

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onung phopahoo phopahoog g

n ying o moe on fm pyhomei n he o w-be bhiou pogmm  oken eonomy. A woking ompomie w pyhoogi eing wih neuoi pobm ike nxiey obeio  h ik wih pyhiy ing wih ppohe pyhoi' pobem n Tehe 2) Hw gnii wee oon(igim being ue wih pope who w p wih hem uy poing moe efffie hn miion  By he e   n ey  0 ef 0, , he ognii pigm w king e in m piouy ege  pyhiy own Two goup o ogniihiou woke foue on hio pheni The  goup w hie by wok ike Bihwoo n Tie 2) n w ey n Kuipe (4) ex  oy ep h   i i y f h ignoi ig noi of of hiopheni  Th eo goup g oup mpi by by n   (  )) onruting Shiophrenia, queine he iiy of o f hiph hiphni ni  bu epe epe h h  uinion n  uion uion i ei n h ogniibehiou ine in eenion enion wee wee effei in euing hm Ahough i  m foe, om of hee woke em gnio gnio in hei mi ion fo fo o og giiim iiim  Ben Ben  (   2) 2) f x xm mpe pe  h k  k  iing  ognii eion o he peioi ble fo pyhophooy Ining hen h be o hepie h e poi poii i b    n pyh pyh  y f fe e  h he e bei in i ifny, imi o he on whih w i e ono of ei fo peope wih eing iiii i whih in he 6 he ineingy beom mng ih y oi wke o pyhoogi The  nion bween pyhgy pyhgy n pyhi pyhiy y in he  K oe oe ogiie ogiie ppohe w uiou n e bu ome eing ogiie hou hep hep   pyhi pyhi (Ao (Aonn  Bk (   ))  mo mou u o hi wok wok on on pe peion ion  in he  S  n I Mk Mk (Mk e  .  )  we known fo fo hi wok wok on oeion oeion n phobi phobi  i n he  K, e pyhii) ini yhoogy   iipine hu poe exibe i kn  kn g on ie om hepui iion ike ogni ogniii iim m n fom fom ohe

pofeion n hen ying im o h ioy Ineingy howee oh pof oh pofein gup gup ugh on o h  h in he h e new HS m ke kepe pe in h K pyhoogi omp wih ommuniy pyhii ue n oupion ou pion hpi in poii poiing ng gniiehiou gniiehiou hepy.

Critiquing cogiivism u   ogni ognii i hpy h py  i i ph Mn Mnyy poponen poponen  he gue gue h h  i i  i n h h  i i i  fw of h humn hum n ig igh h iue whih whih m mee m ny hiou  hni u hiy uiu  n ie of he ogy ogy heoei heoei umpion o pyh pyh mi mi wk wk  (  n hei efe efen n  m y behio behio i wou im h hiu mho ou e ue o u n h h y fw uuy pi umpion) Cogniie he pi h gu h   n ppoh whih i fei, n be

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Alernaives o abnormaliy

3

exin ed im y  cien exined cien  nd which i e deenden n exe exe  cn e e gien wy . Ececic hei cn heefe heefe ue ue cgniie echnique n  mx-nd-mch fhin. wee uch imm fi  cknwedge me f he heeic nd ic enn which he ecme ince ingy eiden  Cgnie che che cme hf-wy hf-wy dwn dwn he mden h in cknwedging cknwedg ing h we cn nee e e in diec cnc wih eiy e iy  wee hey e miguu u he exience f ne eiy nd he ujec ein  i hu i cud e id  e cnuci he hn consrucionis In he hey ieue hee em e fen ued inechngey een hug hughh i  i i mn  kee ce  he diincin eween eween cn cnuc uc ii che which e imy cncened wih he wy indidu iew (cnuc) he wd nd hei em in dffeen wy nd cnucini che which k  he wy cuue nd ci ucue ucu e cnuc cnuc  ei ei y which which in diidu hen he  ee wihi n . N··e N  e ei umin um in e wideed wideed i n  h e cgniie ieue  ieue whee cien e id id  he in in  died died   ed ed cgnin cgnin  n uiingy  hee h h  nee een  hughy uie u ie ccun f wh  cgniin i. ee cien e fced wih hei king f emiic eidence f f hei eief. Chceic y cgnie cgni e he wud cim hei ch w ue-fee. wee  he he ned cgniie che e ed n n ndidu/ci dum n which wh h en inide ee hed fme fme wh   hening in he ci wd ( if hee ide f he me cn wee neceiy w ee henmen). ee  mnn n in eween cieni c fc nd cmm cmmn n ene (wih he e u u ne neyy deded)  I  y ief en  mechniic nd hiechic ineein wih em ike cgniie chiecue ucue nd chem undng. hee difcuie he eened  nume f chenge f cgnie y chgy w cn i end  en chgy en wh e eny eny incni inc nien en n hei eief e  cncened u ue  ey nd wh eem  hink h ink dynmic y he he hn hechcy? hechcy? In cice cice  hei migh encune cien wh fe h keeng die f hei ehiu  chenging ch enging hei cgniin w n en enugh ugh  ce wh hei die die nd

inceingy cgniiim h cme unde e y wie ike ie i ( 198 1989) 9) nd Did Did Smi Smi (  987). In ecen ye cgniiim h ed i exiiy gin in he ending f cgni cgni ie che che wih ychdyn ychdynmic mic cnce in Anhny ye (199) Cgniie Anyic hey (CA). A n ch h h ecme inceingy u  i ineeing f  nume f en. i i cmine  diin fcued n exic deniin f em (cgniie) wih ne  ne h  i fen ue ue ( nyc)  Sec Secndy ndy  i  end  diin funded funded n dynmic n dyn(cgnie). mic ei ei nh nh  dy iue (ny y c) n wih h  eiey new  hey hdy h    cmine c(n mine emn hi hi  n deied ychgic fmu fmuin in i n he  he  few few ein f emen emen

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36

Deonuing pyhopahology

wih an ececic disead o he eapeuic oienaion in he oowin sessions. ouhy CAT incopoaes he ex o he session ino he heapeuic poces pocesss as i a ex simpy encapsu encapsuaed aed is o e exena wod. wo d. ina y, is emphasis emphasis on a ie peiod o wok wok (app (appoximaey oximaey  6 sessions) sess ions) end endes es i  paaae paaae o seice manaes manaes a a ime when one he a apy py conacs conacs ae ae i nceasin nceasiny y comin ino quesion

Concluding commens We expoed he isoica emence o adiiona eimes o psycho pahooy in Chape  as pa o ou deconsucion o e noion, and enn ooked e ook ed a ow he ohe  ohes s o opposies opposies o psyciay (psycoanaysis, (psycoanaysi s, ani-psychiay amiy eapy and coniie appoaches) hae aisen aonside  he opposies hae oen opeaed as sujuaed and suesie sues ie oms o knowe knowed dee , u we ha waned wan ed o show ha i is no ood enou simpy o appea o one o a o hese as a u-own poessie aenai aenaiee  Wha Wh a may aso e e sinican is e way in wich a moe pacica possie impeus is ien o each o hese oms o k nowed nowede e when  hey ae in inuence uencedd y sucuais sucuais and poss possucu ucuais ais ideas (acan, oucau and eida), e ideas ha inspie ou decon sucion o psychopahooy o a is aus, psychoanayic ideas, paicuay acanian o oms ms empasie he oe o anua anuaee i n he ceaion o dieen oms o aionaiy and iaionaiy Ani-psychiay has eneed om oucaus isoy o adness and ciiiaon and he aumn ha psychiay is pa o a wide sysem o sueiance and euaion amiy heapy as now saed o ake up eidas ea oaion o deconsucion o show a wha has een consuced can e unaeed unaeed as a om o seundesandin and empowemen cecic paciiones usin conii appoaches hae aso een ae o ake echniques and use hem in a posmoden spii in a mixand-mach asion as pa o se-hep wiou susciin o any coec undeyin mode. ac o hese osensiy adica oms o knowede is so eaiy condiioned y wha i oppos opposes es maked y i i ha i ods ods ey quicky i no a om o psychiaic pacce se when i s emped o pu unde pessue o do so eeheess in ine wi he deconsucie aumen

ha you hae o use use e sons so ns o he house o aack a dominan sysem  we wi e dawin cauiousy and seeciey adicay and ansoma iey upon hese opposiiona oms o knowede in ae chapes.

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3

Who Symptom, of What? h chape ocue on ympomaooy on he way n whch peope oday ae undeood accodn o pacua caeoe o de We dece he way n whch he Amecan Pychac Aocaon Diag nosi an Saisial Manual of Menal Disoes DSM and he Wod Heah Oanzaon Inenaional Classiaion of Diseases JeD ae uedd o poduce ue poduce d deen pcue o he  nddua a anoma  . We hen ook a he demacaon dpue eween deen deen dcp dcpne ne  pacualy eween ew een clncal cln cal pychooy pychooy and pychay pychay oe he naue and eamen o menal de. We ao dece dece he way n whch ohe oh e po poe eona ona ae aeced y h dpue We open h  h  chape chape wh a e o  puz puzze ze he hee e puzzle puzzle concen concen he alue o he DSM o he leO adequaely o epeen he dey o human expeence o de and he oe o hee caeoy yem n pacce whch neny he de o cean oup n ocey he pacce hemele ae he polem o coue and we wl eew he way n whch hey mpac on hoe aeady oppeed o make hn woe. We hae o ead no ou deconucon o pychopahooca caeozaon n h way n pa ecaue we ae moe concened wh maeal oppoon conadcon n acual eamen han mee con cepual undne. und ne. he chape  dded dded no n o ou ou man econ econ he n  he  lay ou a hoy o how he peen yem o cacaon came aou he econd exploe aou exploe he endeed aca acalzed lzed and caed aleeld aleeld whch  mena heah cae and he poem h poe o caeoy yem DSM and leO. he hd look a he way n whch he caeoy yem yem epeen he ue epond and a a  he ouh econ un o wan wan endence endence whn mena heah dc dcplne plne .

Enshrining abnormalty A poweu heocal dece he

DSM and leO ou oun n ly employ n n he  he

undeandn o de  o nddualze  o  no lone eem o make ene o conde he ende o ace o omeone who  en danoed. h houd e one n mnd a he ackdop o each o he man caeoe n he danoc yem ha we dece n h econ

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Deonuing pyhopahology

he wo compeing yem e fomued by pofeion bodie he Diagnoi an an  Saii Saiial al anu anual al o enal Dio Dio e e whc whchh  now n  fouh fou h eion ( DS-V) , i oeeen oeeen b y he Ameicn Pychiic Aoci Aoci ion (nd he Ameicn Pychoogic Aociion foow ui) nd he Ineaional Claiaion o Dieae now in i enh ediion (CD-), i  he bby of he Wod Heh Ognizion (nd o i  moe moe Euopen Euopen bed)  i woh hexmpe hee ,mnu eof eiey ecen deeopmen. Boye (noing 990 9 90  fo h ked ey emp ey  dignoic cicion being choic e emp ppeed moe cienic bu wee bedeied by cicu gumen (fo exmpe, wih cegoie bei ng eed cegoie eed nd eidence eiden ce being fou found nd po ho o bck hem up) . oeoe, dignoe dignoe ee  wide iey of i nee  ee eech, ch, eg , dminiie d miniie  nd e uppo uppoed ed o eec eec  conenu iew, hu ome deciion e e oed on. Wion ( 993 h poided  hioy of he DS which i eniie o ome o hee powe dipue Numeou ciique he been mde m de of hee cicion cicion  h hey h ey eec comme comme ci inee (Kik nd Kuchin 99 h hey e indiiduiic (omm, 990 h hey impy eec dominn concepion of he Ween ef (Gine, 99 h he y e oci conucion conucion (cNmee nd Geg Gegen, en, 99 nd h hey e empiicy inid (Boye 990. he cieniciy of dignoic cicion w ided by he deeop me n of wh wh Beio ( 988 988 h decibed decibed  he nomo-cinic iew i n medicine in he nineeenh cenuy In foowing medicine  i guide, pychiy focued on he om he hn he conen of ign of mdne A hi poin he hioy of pychiy chnged nd he echnoogy of mdne chnged fom negie o poie, fom being biny o being compex nd muifom hee cme ino being   echnoogy of he pyche (oucu (oucu , 980 85 Anyone ooking   dignoic dignoic mnu wi be uck by h e wide wide iey of cegoie incuded DS-IV, fo exmpe co coe e diode diode  c co o  he ifepn eing o ubnce bue, chizopheni nd ohe pychoe, mood (in cuding dep depe eion), ion), nxiey, exu exu  nd gende gende ideni ideni y, eing  eeping, i mpu mpue e cono cono (incuding gmbing gmbing n d e eeing), eing), d djumen jumen nd peoniy peoniy CD  fo foow ow  imi pen pen Wh i o up upiin iingg i ho w ey diffeen diffeen cegoie cegoie of behio behiou u e gouped gouped ogehe. Nucko ( 9 99 9 k u , fo exmpe exmpe , o conide whehe he behiou behiou ecke diing , cu ex nd hopiing beong ogehe hey do, he noe, becue, ccoding o he DS hey e  innce of bodeine peoniy diode Simiy, ccoding o DSV, gmbing, e eingg (pyomni ein (pyomni ) nd pui ng one hi ou e  exmpe exmpe of impue cono diode oeoe hough he mnu woud ike u o beiee h ech cegoy cegoy i  pue fom fom of phoogy, phoogy, he expeience of pc p ciione iione i  ofen ofen o omeone who eem boh nxiou nd depeed, depeed, of peope whoe pobem eem mbiguou nd mey, no   cieni c.

ndeed i i unce how oen dignoe e cuy ued in eeydy This SAGE ebook is copyright and is supplied supplied by Dawsonera. Unauthorised distribution forbidden.

 

Whose symptom of what

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c inica cin ica pacic pacic  on i ony on y pup pupos os sms sms o b admin adminisai isai (ik ( ik bin codd on ospia disca oms). Wa n a w o mak o a is? W woud au a w wi coninu o  o un ino pob pobms ms i  w bi a suc dianoss dianoss a a simpy simp y dscip dsc ipi i o aiy ou   a s  s cao caois is a consttte I n o o  wods  xisnc o s cao caois is acua yy cas cas s pobms pobm s Tus Hpwo Hpwo and Gin Gin ( 99) a a aud aud a  discoy o anoxia nosa in  ae ninn cnuy was con sucd by a numb o discou sucd discouss ss (o scinc  mdicin  o m min in in iniy iy and so on) in od o mdicaiz s-saaion psnin i bo as a ypicay minin condiion and as a naua cooay o minin iaionaiy. os (199: ) as nod ow suc caois mak a nw sco o aiy inkab and pacicab in a oms o sub iiy bcom ansad i no objcs o b uad ou  sysma ic onmn o  psycooica domain by manain subjciiy accodi acc odin n o noms caim in  saus saus o scinc scinc . oowin suc an anaysis w coud s dianosic caois as discusi compxs Discouss can b sn as ss o samns a consuc objcs and an aay o subjc posiions and discusi oms conain con ain spcica spc icaions ions o yps o objc and saps o subjc subjcii iiyy (Dais (D ais and Ha 99 Snn 99) Tus paicua dianoss s up cain posiions wic pop may pac mss in (o xamp by in a y a anxious and oi n o i doco doco o o p) o in wic y may b pacd by os o xamp   youn pson pson wo is i s po podd by i pans o i doco a akin abou ain oics En ou w i in a cuu wic caims o b iba abnomaiy is si powuy dind wi nc o wa is considd o b noma baiou and aionsips Indd aou dimnsiona mods a bn poposd as anais o  cun caoica sysm (s o xamp Godb and Huxy 992) y simpy ac as a so sion o paooizaion sinc  a si indiiduas a  nds o  dimnions wo a pcid as abnoma

Diagnsis and discriminatin Wa Wa appns o pop wo a a pusd o  d ds s o wa wa is considd noma o o  nds o a psyciaic dimnsion is a y a posone a pac is makd ou o m and a s o baious and xpincs is dnd o m m  T concp concp o posii posiionin onin becoms usu usu wn w ook a som o o   conadicoy conadicoy ways psyciay cassis pop accodin o i nd, coou cass and so on and i is o is a w now un ou anion. W wi discuss  way posiionin woks in aion o nd ac and cass and daw anion o som common pocsss o mainaizaion and oppssion.

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4

Deonsuing psyhopahology

x,  x,    a ad d a ac c I i  uim h men heh eice e diciminy nd  wide iey f iic uce eify  hi UK Depmen f Heh iic fm fm 1 98 9866 hw h wmen e me  ikey  be dined dined wih fffecie pyche f pyche i ke depe depein in wice   ikey)  nd neuic dide dide ike nxiey wice  ikey) Men e me ikey  be dined wih chim wice  ikey) nd ihy me ikey  be dined wih chipheni nd peniy peniy dide dide Piim nd e e  1993) . he DSM-IV Ameicn Pychiic Aciin 1994) ep  wide iey f ende diffeenc diffeence e in dine . Wmen e hee ime  i ke y  be dined wih pnic dide nd wice  ikey  be dined wi h depe depein in  Niney N iney pe cen f f he he wih n nexi exi nd buimi  nd 75 pe cen f he dined wih bdeine peniy dide e wmen In cmpin men e me ikey  be dined wih pymni  mbin pbem pbem w-hid e men)  pnid pe peniy niy dide nici peniy dide hee ime me ikey) nd beie cmpui e dide dide wice  i key)  Hw d we ccun f he dipiy beween men nd wmen in hei en cune wih pychiy? pychiy? he cic ex f f wk n he e emen men f ende by pychiy i Phyi Chee (1973) Women an Maness. Uhe (991)  pide  uefu pemic eiew f hee iue Chee ue h wmen e cuh in  ype f dubebind. he menin which ch  behiu f men nd wmen in fmiie e ien by he wide ci cnex nd Chee decibe he bind  fw On he ne hnd he cic feme e demnd  e f behiu nd expeience which uded in n unendeed nm e cinicy neuic eme pychy i bnm pychy nd bin  wih i   me f cue nxiey  depein depein nd pni. On he  he hnd  einc eincee i in n h nm i  ibe  be inepee inepeedd  deiin Hee wmen in expe he ympm f n bnm pychy which cud be beed  chipheni peniy di de d e pmi pmicuiy  ebinim ebinim  In um Wh Wha a we onsie onsie "ma "manes nesss  wheheole i appeas women o in men is eihe of he evalue female o he in oal o paial jeion of aingou ones sex-ole seeoype

Chee 973 53 emphi in he iin) hi hen f cue  dd  picu weih  he ppein f ebin nd y men) in pychiy nd pychhepy Bun nd Newne 994). Sciic wie empin  expin hee diffeence end  e   fundmen duim i nked  he f fc c h ciey i dicimi dicimi ny h i  i diciminin diciminin  h cue cue men die die   h i i hi h  ed  bied dine dine On bh b h ide  f hi ppiin ppiin hee e puib e en pu fw fwd d  nd ece ece bjecin Hwe Hwee e i hu hud d be ned h  he bjecin  ech f he expni n e n n ideied nd eenii  iew f wh  wmn i nd wh he expeience mu be

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Woe mptom mptom of wa wat? t?

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lk. W ould prhps s h of ths xplntons s  prtl xplnton xpln ton pplbl n ryn msur to prtu prtulr lr ndduls nddu ls f  f w tk srously th d tht ll xprn s ontrdtory. Wht th ulturl rprsnttons of womn nd mntl dsordr my pont to s not so muh th funton of ntrnlzd strotyps but th xstn of dffrnt hstorlly onstrutd dsourss whh rry wth thm rtn postons for ndduls to dopt nd ply out out  A dsours dsours s  st of sttmnts sttmnts bout bou t n objt whh ll ows popl popl to dn d n nd spk bout thns thns rkr 1 99 99  ouult ouult 1 971   whos whos work w dsuss dsussd d n Chptr 1  ws onrnd wth th dlop dlopmnt mnt of  mdl dsours dsours bout mdnss rhps wht w h hr s th lnkn of dsourss bout fmnnty wth tht mdl dsours Dsourss lwys ntl rltons of powr nd th powr prsnt hr s dstrbutd ordn ordn to th struturs struturs of ptrrhy ptrrhy trrhy n b dnd s tht st of sol sol rrnmnts n whh mn domnt womn nd oldr mn domnt younr mn lltt 1977 hr r furthr problms wth trdtonl onrns bout ndr nd dnoss whh rt th ontrdtory ontrdtory ntur of ultur ultur h rst s tht most of th work quotd s bsd on urs of thos n ontt wth forml srs. sr s. Whn w tlk bout dstrss s s t s xplord throuh ommunty surys th ptur boms mor omplx. hus Goldbr Goldbr nd Huxly  1 99 1 9 ru tht mn xprn smlr sml r rts of psyhol psyholol ol dstrs dstrsss to womn but tht womn r mor wlln to knowld llnss to mk ontt wth  dotor to prsnt psyholol omplnts nd to rmmbr hn hd psyholol symptoms. hs pont mht ld us to xmn xmn  th th  dsour dsourss ss whh poston poston womn nd wth n whh womn my poston thmsls s thos who sk hlp wthn  psyholol frmwork.. hs both brns thm n to ontt frmwork ontt wth srs whn thy r ulnrbl and t postons thm s mor pron to dstrss A sond ontrdton s opnd up by th ft tht s w notd womn r not or-rprsntd n ll dnoss. hus w s tht mn r or rprsntd n rts of dru nd lohol problms nd ths my rt domnnt domn nt ptrrhl dso dsourss urss bout bout pproprt pproprt ondut ondut for m n. Som wrtrs h rud tht mn dl wth thr dstrss throuh turnn to drnk nd drus or rm rm y nd lso mor lklybn to om to th ttnton of psyhtry noluntrl noluntrly forr xmpl throuh ston stond d undr th ntl Hlth At somthn oftn ssotd wth  dnoss of shzophrn or throuh forns psyhtry ftr bn ontd of  rmnl offn. A thrd ontrdton s whthr w pt th us of ths dnoss to rt th dff dffrnt rntll xprns of mn nd womn or whthr w hlln th truth of th tor torl l systms thmsls s systms of knowld tht smply sm ply rt th proupton prouptonss of our ultur t  prtulr pont n tm urnr 1987 dsrbs how th trtmnt of womns mntl dstrss hs hstorlly bn bound up wth th mdlzton of womns

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Donrung pyhopahology

epeence. Hystea was a psychosomatc epesson o an emotona poem whch esuted om the dson o the soca wod y a puc

aena o authoty and a pate wod o emoton and sens sens  ty une 1987: 16) Note hee how the dstncton etween eason and uneason has een used use d to daw a ne etween the puc sphee n whch men m en act and the pate sphee n whch women wok. ow, accodn to une condtons ke anoea whch was onay desced as a hysteca syndome hae stepped n to take ts pace Each condton eeas somethn o the ae n whch thy wee desced whe hystea n the nneteenthanoea centuy nwas up wth the smoa seuaty thound twenteth centuy oundestant up wth o thewomens deaz aton o womens seuaty n puc m ae aess o he he ody Aaae soca soca meanns condton epeences o noma and anoma epeence. Showates Showa tes ( 1 987) wok s on the way way emae nsanty nsant y oe oe the the past past  5 yeas has een suu suuse sedd wth seua mean n nss . Hys Hystea tea o o eampe  has on een n ked wth emae seuaty. he wod hystea' comes  om om the Geek hyron wom   In ancent Geek medcne the wom was was thouht thouht to e a knd o anma that oned to eneate chden. I t emaned aen t ecame dstessed and stayed aound the ody causn poems aectn the espaton and tanquty o the occupant Once the epoduc epoducte te ue o o the wom was sats sat sed ed , the t he dstuances ceased ceased.. Showate shows how the ee that a noma heteoseua eatonshp coud soe hsteca dsodes dsodes pessted pessted n psychaty nto the twenteth entuy What s then at stake n psychatc pactce and n the epesen tatons tat ons o women women s seuat n tea teatue tue s the nomazat nomazaton on o women women s epeence . h e cu e nos he epace epacement ment n a amy stuc stuctu tuee wt h a man  poduc poducn n chd chden en  Hee thee s a n epct aenda o pos postonn tonn, , whee the teatment teatment o the aeant aeant woman noes n oes physcay postonn postonn he ack ack n the home. he way ths aenda pays ts way out thouh, s thouh the myad dscouses that denty the woman and he poems daw he nto the psychatc system and epesent he madness to the outsde wod. We aso see ths cose connecton etween what oes on nsde psychaty and the cutua epesentatons that suound t n dscouses o ace and acsm

Race and dentty A ance at psychatc statstcs eeas the estence o nsttutona acsm Skn coou n the dect epeence o acsm s o couse temendousy mpotant Howee those who ae not decty and m medatey dented as othe suh as Ish o ewsh peope do aso

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Whose sym ptom of what symptom

43

uffr from rim nd diffrn in hir prin of pyhiry Grnld (1993), for mp, h hown h h r of pyhiri dmiion for immirn o Enlnd fom h norh of rnd nd Eir r hihr hn ny ohr immirn oup ilwood nd ipd (989) dri how Hidi Jw n  pid ino h pyhiri ym whn hir lifyl r miinprd y door

y    y      p  y oo  A 1 977 udy rld rld h W ndin  nion immin im min hd hihr r of pyhiri dmiion hn Briih popl whr ndin nd Pkini immirn hd low r (Mrr 986) f w urn o mhod of dmiion , olunry dmiion i h norm ou of of ny fo fo whi pin.rBk likly o  ompld nr. Bl k popl wipop  likyr mor hir whi whi  ounrpr ounrpr  (i f youoonrol on rol forr , fo , ndr nd nd l) o  hld und und ion  36 of h  983 Mn Hlh A (Mrr 1986) Moo, mpoy kdown i mor li kly o  rd  hroni pyhii illn , nd hr h r i idn h hmohrpy (h i pyhii dru) nd lro lroonui onui hrpy i mor ikly ik ly o  in in  h h  oh id of h oin i of our our  h l lkk pop r l likly o  in nonphyil mn uh  pyhohrpy (rnndo 993) Blk pop r or-pnd in rion ur uni On On  in in , mny mn y wrir run o  dulim o plin h or or nd undrrpr undrr prn nion ion of lk popl popl  Ain diimi nio nionn nd rim  ud o pin oh midinoi nd hih r of pyhooil di hi dulim nd ilf prd o in h iii of om wokin wihin wi hin h pyhiri ym o ry o dd polm polm of r nd rim rim  h impliion of h ii r diurin nd h wy hi mi rmn on wih ri royp prompd om lir py hiri o  up h rnuu Pyhiry Soiy (CPS) in h UK n  97 9766  h ly wok on nulul pyhy whh  h on on for h work of Philip k (982), who w h  hi TCPS nd ilwoo il woodd nd ipd ipd ( 989) do do mk  r diin diinion ion wn h undrlyin pyhiri prolm nd h uurl mnifion nd o oh iln nd uur r d   hin h n hn  uld round in diffrn wy in diffrn mdil oun n Ki work for m  mpl pl, , i ini ni m mnif nif  i ion on . .  r olod y oioulur fo (Ki, 972 3) Diffrn uur nd lif ym h diffn wy of undnd undndin in inil diordr nd ppop ppopi i iu iul l fo din din wih wi h hm. rnulurl pyhiry oiiny w i ro  diin nd undrndin uluround diordr or rnulurl pyhir pyhiry, y,  undood y h foundr of h CPS CPS , h undryin prolm i n   polm of ommuniion hr min poin mrk rnuur pyhiry (CP) ou from rdiionl pyhiry. h r i h h door hould know h pin uur h dripion of immirion prn in k (982) ook o h h purpo of puin h  h undrndin undrn din in  wid on . h poin poin of

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Deconsucng psychopahology 44 the docto knowin the patient cultue i that elationhip between docto and patient hould be impo docto im poed ed It i hoped that then ethnocentic aumption aump tion will be aoided in the ma kin kin of of a diano dianoi i  he econd pecep peceptt o f C C  i  that the pat patient ient houl houldd not be iewed a bein a poblem. In taditional pychiaty the black peon i not only moe l i kely to be labelled a pychotic, but the type of teatment off offeed eed alo make it eem a if the peon peon i  to blame blame . ntead of of bein a poblem poblem the patient hould be iwed a hain a poblem at of thi hift of emphai i eected in the way C adocate pychotheapy and othe

non-phyical teatment, a well a a eat emphai on the ue of intepete he thid point alo um up the oeall aim of thoe inoled in C today houh undetandin and communication moe accuate dianoe can be made It hould be poible fo a pychiatit eed in the cultual peculiaitie of the patient to ditinuih bette between  nomal and  pathol patholoical oical behaiou Bette dianoi dianoi will then make fo bette mental health eice and make the exitin eice moe acceble to black people (ack 1982). hee ae objection howee to thee popoal, and ome of thee ae oiced by ece (1986 It i inicant that C inoe o eade talk of ace  and ubtitute ubtitute fo ace the notion of culue. It attempt to to et away fom the old bioloical denition deni tion of ace  but it ue of the tem cultue cult ue i , pehap, not a ueful altenatie. altenatie . hee ae ae two two aumption in C which ae paticulaly poblematic he t i that imply empathi in with the black patient and epectin thei identity ha the effect not only of indiidualizin the poblem, but alo indiidualizin cultual diffeence, makin the peon into a epeentatie and exempla of thei community It i made to eem a if the community in quetion wa homoeneou hom oeneou , an d fo fo the pupoe of dianoi and an d cue not affe affect cted ed by ende and cl a diiion he econd poblem poblem i to do with pofe pofeional ional inteet Undetandin ace and diffeence a a communication poblem allow the ood docto to liten to the patient, but it inoe the fact that the poblem pobl em of mi no noity ity oup owe at leat a much to tuctual acim a to comm communication unication poblem poblem  In addition  the peoccupa peoccupation tion with with cultual diffeence can einfoce teeotype (of, fo example the Afo Caibbean a aeie aeie and and excitable , an andd the Aian a meek and docil docile) e)  hi ha the effect of etoin cdibility to pychiatit who want to cateoize diode. otice alo that C dicoue locate the white peon a the docto and the black peon a the client hain the poblem hi apect of the dicoue ie ie to jutiable upicion that intead of makin adical chane in the mental health eice C i j ut concen concened ed with makin makin  the ame old ic ic moe acceible. acceible. What the dicou dicoue e of C C  do do  the n i to eplac eplacee ace with cultue cultue  hi cultualim cul tualim then play a pat in the ueillance ueillance function function o f the tate tate  In the oucauldian teminoloy which ece (986) boow, it become pat of the ae by which the tate tun it ubject int object he nal

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Whosee symptoms symptoms of wha what t Whos

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ws s  wen e nddul peson n e poblem' uns up n fon of e sol woke, doo, psys o psyolos, ey e eed s f ey ndduy onn  ose ess w obn o e ommuny s poess s one of subjeon'. ou wl eonze e fouuldn eme ee of e peson n onempoy psyy ben foed o ke esponsby fo e dsess e poson  s mde lble o subjes of s psy ze s one wee ey mus dsply ppope ppope uu bues o be nom  s mkes  dful fo someone o spek ousde of e ple  lbel psyy ees fo em s n nddu w en oup es s e nddulzon of e poblem s lso mpon n e se of ss.

la ad cal wer Clss s  powefu en of dsmnon n dnoss. ues e de o ome by ee sne ofl ofl sss do no olle nfomon on ss. e Sols Hel Assoons (1987) epo Goobye o All ha? noes ow ese s onnuy llused lss dffeenes n men e folown folown Honsed nd eds eds ( 1 958) wok n e US w sowed  m embes of sol lss V (unskled m nu) we weee ee mes moe kely o be osplzed n ose fom sol lsses  nd  (busness nd po pofe fesson ssonl) l) . Godbe nd Huxley ( 1 992: 19) e noed  w few exepons, mos sudes sow ee es fo ommon menll dsodes men dsodes n ose of lowe s] so lss'  ey o on o menon men on Bown nd Hss (1978) lss sudy w ued  wokn-ss women d e es of depsson beuse ey d h es of seeee fe eens nd mo see m o sol dues dues   oud be ued ued   ss ss s eled o expeenes of unempoymen w Goldbe nd Huxley se s ssoed ssoed w eeed es of dso dsode de  (1 99 992: 2: 2 1 )  Ab Abmow mowz z nd Dokek (977) e noed ow sudes e onsseny found less foube nl judemens ben mde of owe s opposed o mddless pens oeoe, ey noe: lowe solss s been ssoed w less epby fo emen, fewe oupen ss, emen by p m moe oepy py e n psyo psyoep epy, y, nd less pe eed smy o dmn esdens [psyss' (Abmowz nd Dokek, 1977: 462) One n, expnons e uned by e fm dusm  s lss  bo uses msdnoss by pofessons (wo e lkey o be mddle ss) nd uses psyolol dsess. In ou dsusson of ssues of ende nd e nd dsess we e ed some of e ondons n ulue ul ue nd posons    e en en o peop peope. e. owe owee, e, peps, peps , e ese ese

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Donun pyhopa pyhopaholog hology y

con conadici ha nimlying han aound he iue of oinceaingly f cla. Alhough i ey adicion naueon a moe ocialiden conc a gou, clayha ecome a em o  alid o indiidual Woe han hi, clae ae dened in he ycholgical lieaue wihou any efeence o he exloiaion exloia ion of laou alienaion o oei oeion on (Pake and and Sea, Sea, 1995 1995)) Indeed cla i head of l and we now hea moe of ocio-economic au au   an indiiduali indiidualied ed ai aial alee  Pilg Pilgim im and Roge Roge   199) A Soiology o Menal ealh an llness include chae on gende, gende, ace and ehn ici iciy y and age u only only a cion on cla cla owee, deie deie al hi eidence cla c la i incaingly diaeaing diaeaing a anyhin g oh ohe e han a ocial faco o ye anohe aiale Bomley 99) ha noed ha he a decade ha een a deah of ea each ch on cla and ychoheay (and i  i noewohy ha een Bomley ue he em lowe cla a well a woking cla o dene he olem) Goldeg and uxley whil deailing he in uence of of a ace ce  cla unemloymen  age, gende and he hyical enionmen on diagnoi a no oin heoie aou why hi i he cae alhough oiou candidae include acim exim woking

condiion and alienaion Some heaie in ying o deal wih cla ofen eoduce cla diiion hu Bomley 99) quoe eud in 19 oining ha hoe aien who do no o aien oe e a ao aona nal lee deg dege eee of ed educ uca aion ion .  . hould e efued. Young 988 8) ugge ha aional emoie heai woking wih lowe cla clien need o deelo a oiion of command hough he ue of a loud oice oice (which  accoding accoding o he ex i  one of he mo effecie way of gaining he aenion and eec of uch clien), uing commanding gesurs', rmmbng  uh he clien (in a foceful deemined way) hough ying o ealih and exloi a euaion (y imly announcing in a m loud, elf-aued oice ha you ae indeed an exe ex e  and hough dilaying ueio ueio widom widom and knowledgee  . Alhoug knowledg Alhoughh ca Young dicuion dicuion oide oide ome inigh in o he ule woking and cla aumion of ohe heaie he oiioning of eole ideni ed a eing of lowe cla hen , no only ocue he eal naue of he olem, olem , u alo make i woe a he ey momen when i aea o e aken eiouly. Wellmeaning ychiai and ychoheai hae ied o u aide hei ca iilege i ilege  o he owe ha h a i gien y gende o ace u ofen einfoce einfoce he oeion of hoe who uffe mo fom die and fom clinical aue

Abnormal categories: the materiality of distress We hae een ho how w diffe diffeeni eni al diagnoe do no imly i mly eec he imac of gende, gen de, a ace ce o cla a i ndiidual aiale a iale  Rahe hee diagnoe eec

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Whos Whos sympoms sympoms of ha ha??

47

h acua psiins a pp nd hmss in f xamp a yun unmpyd sin mhs  unmpyd back mn Each f us is muipy muip y psiind i n ms  ms f hs diff diffn chaacisics chaacisics and hus u  xpincs xpi ncs a smims si mi a smims diff diffn n bu aways cna cna dicy. n cnas h diansi masus aains which w a cm pad by h psycmpx y  appa as bjci uhs minimizin disiy and cnadici n  Of cus h pain f hs cais cais is inimay ad  cuu and Chap 4 wi xp his ainship in m dai dai  H H  hw w wish  xamin  sm f h ens ensins ins and cnics in hs cais in h way hy a usd f w a  dcnsuc h ways ha diansi di ansiss xs n u nd ac ac and cass w nd  undsand m abu hw paicua cais funcin. Ou xpinc is aways mdiad huh dminan discuss andd h sam is u f an f mn mna a ha h a k and wiin as his is n  dny ha h a pp in diss dis sss . ah i mans as kin m abu h mediaion f disss hw did u idas f psychica disss bcm cun cun and wha wha a hi i mpici  assumpins and impicain impicain  W wi bi y mni n six ca cai iss  i usa hw a dcnsucin dcnsucin f h discuss discuss ha ha  sus ai n disd mih mi h b usfu  dmysify h wa psychiaic knwd mbacs pp in disss

Axy Smai 1987) has susd anxiy is a n ha pp nd hmss in whn hy bcm awa f f h bjcifyin bjcifyin  a f f sci sci Haam   99 994) 4) ns sm f h idica cnx cnx f anx iy incudin inc udin h ky  ha i pays in a sysm f scia cn basd n sf uain ha s h ida ha w mus an  cp wih h ns o ah han sk piica chan chan    is insin in his cnx ha i  i f ah is m iy  b wmn wh a pacd and wh may pac hmss) in his psiin

D Win and acus 1994) ha aud ha h cncp f dpssin indiiduaizs a scia ansacin hpssnss pwssnss and wh whssn ssnss ss ddpssin n ccu n ccu inss scia aua  1994 22) . Aw Awd d  99) has as nd hw a numb f scia funcns uin pp  s h ns f if as a ma f  psych ah han h pubic dmain  ncu ncuain ain inna sf sf uain uain , spci spcicay cay f f wmn wmn  and a s a pniay damain fm fm f iba humanis hum anis hap hapui ui hy hy mphaizin psna spnsibiiy ah han a nd f scia chan

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48

Deconrucing pychopahology

O agai t  o supis that wom a th most likly to  positiod i suh a atgoy

Eg b  a ss th atig disods a o o th last ampls o th utios o diagosis Ovwhlmigly wom a th lagst goup to iv this diagosis yt th ist o this disod mystis th latioship tw ultu ad woms latioship with thi odis h gdd atu o aoia ad ulimia vosa is thus gadd as iidtal ath ath tha as sstial ad ad uda udamtal mtal Hpwoth 1 994 994:: 1 8 1  h a s dsi dsid d how th dis disou ous s o o  mi mi iity a show us th assum assumptios ptios mad i th ostutio o mi i iity ity wh wh  tai psyhiati atgoi atgoiss a assigd y to wom a also tll us a gat dal a aout th ostu omostl stutio tio o masuliity masuhis liitydisous 

hzh his is a diagosis most likly to  giv to lak ad wokig lass patits ad it has  agud that th vy ist o this diagosti atgoy svs svs to mysti myst iyy th latiosh latioship ip tw a a lass povty ad ad distss Ou atttio i s ditd ditd o to mtal phoma ath tha ou

positio i th wold t at th sam tim th psyhoti phoma th symptoms a atgozd as g yod th wold o omal huma disous o at last th talkig u This is o ous th itt lgay ud oth th adial thapist ad l th opopulatios mtal halth svislt Wtoa osv a olatio olatio  y soial soia lassus o th populatio s ot ot ligil o psyhothapy ad po to shizophia t at th sam tim ud u d ould dmostat isight isigh t o th gal qustio o diagoss hy h y s sml ml th So Sott ttis ishh Ki Kig gs s tst tst o o id idt ti iyi yig g wi wit th hss    his kig dlad dla d h was i i  possssio o a i i alli l mthod m thod o og ogizig izig a with H had th wom stwd i a auldo o oilig wat ad th tastd th ot ot h  twads h was al to say: that was a with o o that was ot o  t is th sam with u s pt that that we a th su sus s ud 1 973 [1 933]: 1 9 1   his lightd a ud ado dot t  ts ts oth th l ltt positio o th shizophi patit ot o high doss o uolpti mdiatio ad th totuous path o th sydom itsl though th aals o psyhiaty  t also als o vals somthig o th owi situatio that a psyhiati patit is i o th doto assums that somthig lis outsid th tt wh thy aot d th sigs o shizop shizophi hiaa withi what th patit says h atgoy o shizophia is ddd as i it w th jwl i th ow o psyhiaty ad this d has povd sistat to th most siti ad atioal agumt Boyl 199 1994

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Whose symptoms of what?

49

Prhp th rrtnty f th dgnt ytm  mr f  prm thn th prm th ytm m  d wth.

Pychahc dd Burn (1988 h drd th rptd fur f rrh t dn hrnty  pyhpth prnty. nn (1992 mp tht th rh t dntfy  dtnt prnty typ  wy undrmnd y th ft tht ntn f nt- hur r rd n  prtur   ntxt Dpt uh tt th frm wthn nd wthut pyhtr rthdxy, pyhpth drdr rmn n ntgr prt f th Engh mdg frmwr Bth htry nd n th prnt dy t  dntd wth  typ f prnty dpd twrd prptrtng nt  hur On f th mt pur thng ut th mtn dtrut mg fth f tht pyhpth th mg r pry thtr rdntd prdnnd rtd ntht ptt ty.

Paaa rdtn pyhtr pdmg rrh ndt tht th dg nd  prnd r mr y t  prr,  frm  wr   h  dutn nd  mmgrnt thn th ttrtng thr pyhtr dgn (ndr, 1982 Hr thn,  trutur h rdy ntrnd th h f ptn pn t th ujt. A

Smpn (199 1227 h pntd ut, th rptn f dntty n th mnn  nt mpy mnt, n th tm y whh n dntty  rd  dr dr th tu mtr rt wthn whh wh h th  r d. xt f upn rut wdy n Wtrn utur nd prd fr thr hrtr  n f mn nd purp,  n f untn gnt  prd thrt It  n urpr prhp tht m pp, prtury f thr trutur ptn ffr thm fw thr h, h , my dpt uh uh  tn tn . h hy y , hwr, mght  thm thm nt  prnd ut, rthr  prn wh nw wht  really gng n. At th m tm , w xt  n  pnpt utur whh rgut rgut ur wn nd thr hur, nd thu th ng  txt f upn m ptnd y thr  prnd Of ur th my w hppn th thr wy rund: th ujt m mrd ut, th jt f  rty rt y rgnd rgnd grup grup (fr (fr xmp , mu m u gp, j n ndd  n n  A  rut, th ujt my  th  th ptnd  prnd ( n  h r h mmnt n th tutn nd my ptn thm th wy n th m n f  wrd whr thr ry r ut t gt yu h ptn f prn tnd t  grntd t th wth tt pwr

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5

Dcostrct psychopatholoy

uch a ne poca oup o oaed nddua hoe n poweu oca poon can adop a dcoue o du whou ea o en caed paanod (a ea y hoe who mae)   e wha onccoun ha mena heah o poeona houd uch powe den dene coun a an exce upcon when   hae an mpoan  mpoan pa o o he  oe o e neney upcou upcou o he  pan pan  In ad addon don   we we un o he ae o he men a heah dc dcpne pne  we nd hem o e maked y ne n ena na don d on and conc whch eec he conadcoy naue nau e o he whoe moden cnca enep

Disciplining mental health oown ou concen o ook a pychopahooy y exam he pacce o he py-compex   me o un o he pacone o mena men a heah and un h e oecyn oecyn ae o he compex ack on e. We can een e en ue he anuae  anuae o pychopaho pychopahooy oy n decn he h e owh owh o he py dcpne a ympomac o nena enon and conadc on. on . Indee d, o oe e ( 986) ha noed how how moden pycha pychay y  no one one mono hc u nead e o   pacce pacce hae poeaed poeaed oh n em o eoaphy (o exampe om he hopa o he communy), n em o cacao cacaonn (o (o exampe  he  he deenaon deenaon o new poe poem) m)  n em o new ec echnq hnque ue o  nomaz nomazaon aon and new he hea ape pe a nd n em o ne w make a nd a n w d du uon on o  po poe eona ona powe powe. . A we poned ou n hape 1 and 2 he mena heah yem opeae unde pychac ue, wh a aey o deen poeon jon o pace aen on and ndepende ndependence nce . In ecen yea a ay ay conce conceed ed chaene chaene o pychac heemony ha een mouned y cnca pychooy and we un o ha dcpne .

l l al al yhlg yhlgy y he poeon poeon o cn cnca ca pychooy aduay ecame eahed n po wa Ban. he 195 aw he pedomnance o wha Pm and eache (992) em he pychomec oe whch poed no hea o pychay and, ndeed wa o aue o  n meaun he pychooca chaacec o paen. Pm and eache noe hee campan whch aw cnca pychooy yn o eak om h cono: he  wa Eyenck aack on pychoanay (o exampe Eyenck and achman , 965)  he econd wa wa a aed) aed) aemp o e e pychoo pychoo  n cono o he edca econ ( now Pychoheapy Pychoheapy econ) econ) o he B h Pychooca Socey (BPS) he hd wa he ennn o ehaou heapy whch cnca pychooy champoned champoned Addo Addona na y, wok a he

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Whose sympoms of wha?

51

Tiock inic n d Ti Tiock Tiock ock Ini e i n ondo ondonn w ohe emp o e knowedge gined ding he w eo in ciiin ie. en  hi ey ge cinic pychoogy w on eween pychonyic nd ehio mode. By he mid 196 cinic pychoogy hd moed ino i ehio hepy oe Hee he imge he cieni-pciione eigned peme. I doce eieed in heoighowd ppicion o pychoogic knowedge o men die. By he e 97  moe ececic oe hd emeged nd cinic pychoogy eimge w o pciione who dew on  diegen e o heoeic mode. Pigim nd Teche qoe om  199 dy which howed h cinic pychoogi oowed om  iey o hepeic diion cecic (16 pe cen)  Behio B ehio/ening /ening (22 (22  2 pe pe cen) cen)  Pychodynmic Pychodynmic (21 pe cen)  ognii ogniiee (   5 pe pe cen) nd Syemic Syemic (62 pe cen) The 97 hd o een  key poiic en he eeing o cinic pychoogy ink o pychiy. The Tehown epo (Depmen o Heh nd Soci Seciy 977) heed in n e whee cinic pychoogy eice inceingy ogh nd ond ee diecy om gene pciione h ecoming e dependen on pychiy Een Ee ni i y hi hi w w h hee emegence e megence o  oh ge o o mngeiim nd poe po eion ionizion izion i n cin ic pychoogy which w mo cey i ed in he BPS encoging he Depmen o eh o commiion  geened eiew o he po poei eion on in ode o incee ini  ini ng pce on cinic pychoogy coe. The eqen epo pihed in 989 ged g ed h hee we weee hee e o o pych pychoogi oogic c ki  ee  incded ic coneing ki. ee 2 incded he cookook e o cein echniqe (o exmpe nxiey mngemen) ee  inoed he heoizion o new poem y ing  wide nge o pychoogic mode Ony cinic pychoogi i w ged hd ee  ki whee ohe poeion migh we he ee 1 nd 2 Pigim nd Teche Te che (  99 992) 2) he  ge gedd h  h hi w ye nohe exmpe o cinic pychoogy pychoo gy ying o cone he mke  i n die nd he he poined o he ony egie o heed Pychoogi   imi emp  poeionizion Ahogh heoeicy i poee ome poeni o chenge py chiy (nd  we w in hpe 2 cinic pychoogi e inceingy

encoching on  encoching diio diion n pychi pychiic ic ein) cin ic pychoogy pychoogy i i  m poeion (ppoximey 25 in he UK). Ao hogh he mjoiy o cinic pychoogi e women mngemen poiion e dipopoioney occpied y men nd Bck peope e nde epeened in gene in he poeion (Pigim nd Teche 992) Pigim nd Teche Teche o o noe i mien mi en c  : : on he one hnd  midde c gop o meioc poeion ney  cinic pychoogi ecommied meme oohe heNion BPS) on he ohe hnd gop  o de nioni Heh Seice (nd ney cinic  pychoogi pychoogi  e meme o he de nion nio n S) Thi poiion

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5

Deconstrctng psychopathology

ma s that mas tha t lal psyhology psyh ology as a prosso prosso ould at at both bo th as a a\y a\ y or or ad as a obstal to radal hag  prats aroud mtal halth syhologal trtos ord by lal psyhologsts prod a altrat to urolpt altrat urolpt mdat mdato o ad rasgly appar as mor usr rdly ad drawg uqu ddual apats or slhalg ad opg t would woul d b a mstak ms tak to org orgtt that ths th s was o o o th prpls prpls o whh Hpporats oudd md. hs ha\g th has th pottal to rsu psyhatry psyhatry rom som o ts urrt xsss as muh as mprog th lot o psyhatr psyhatr  patts Hr l th possblts or w partrshps At th sam tm mltatg agast ths s th prat o takg rsarh udg rom drug ompas ad wrtg up rsarh paprs as  psyhologal tratmts ar omplmtary to th drugs whatr mght b sad bhd th ss But t s prhaps bhd th ss that suh partrshps ar mad.

Pyha ug Nursg s old wth psyhatry at thr lls patt day patt ( day hosptals ad  th ommuty (CNs ohsto (1989 has otd how ho w ot psyhatr psyhatr urss workg o wards ar th popl most llkl kl y to xpr xpr how popls pop ls ral ls do ot t psyhatr atg atgors. ors. Howr sh Howr s h also al so ots ot s how th powr d drtals rtals btw ursg sta sta ad psyhatrsts  para\lg th dstrbuto dstrbuto o pow powr r throughout throughout md  prt aythg progrss mrgg rom ths lash h rasg rol o th Commuty Psyhatr Nurs (CPN has allowd mor spa or a dpdt prossoal rol to dlop. Smlar to lal psyhology CN srs ha rasgly aptd drt rrrals rom Gs thror bypassg psyhatrsts. Howr CPNs ar stll rqurd to admstr dpot mdatos ad thus stll otu to b pu\ pu\d d bak to arrrals hadm ad hadmad pro stylot styl  or oror or thspd thy y ar muh ot ot   udat udatd d wth whh prossoal massoal mas s thy ar ot uab uabl l to tm wth thr lts. oo ot th ommuty psyhatr urss ar aught btw psyhatry ad th ommuty hr ar spas or rssta hr hr  hus CNs ar rasgly rasgly bomg old  motor mo tor g mdato ad  prodg psyhosoal trtos to patts dagosd as psyhot but ths atts ar usua\y dpdt o th xst xs t o ooprat psyhatrsts ad ar stll oudd o rlatly

tradtoal rsos o psyhopathology

Pyha a wk Currtly soal work has a dual rlatoshp to psyhatry hs dualty rts o th o had ts otud rts otud mmrso mmrso  a modrst outlo outlook ok 

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Whose sym symptoms ptoms of what what??

5

whi n h hr i india i mmn ward a mr p mdrn a f in mdrn ing. g. A Arding rding  Hw Hw (  994 994  ia wrk r r mrgd in h n in innh nh nury and dipayd a mdrni nrn h wih h undrying au au and wih nin nin f ur ur and ramn. ramn . I im f high mdrniy am in h  h  97 97  whn hr wr ariu amp  ynhi dipara ia wrk apprah in a mmn hria a hrugh whih ia prm ud  akd. Suh nrn rnad wih pyhiary wn mdrni prj and,  h xn ha hr ar mdrni rmnan wihin ia wrk hr i a ai f a pariuar yp f aian. hi aian ak h frm f ia wrk xnding pyhiary gaz ynd h ini and hpia and in h ia arna. Barr (1988 dri hw ia wrk fd fd in  an gia prpi in whih h pyhiari ympm an  undrd a par f a aua rainhip wn h pain hir nirnmn and hir rainhip  ignian hr. In prai  hi migh m igh ak ak  h frm frm f ia wrk fuing fuing upn h fami y and dinai ng pahgni pahgni famiy pr pr . . h ia ia wrk prpi migh a diffu h pain ympm in hir ia nirnmn y unring unr ing a krna fwhy ruh induina wha , fr xamp priuy ha n nidrd if r migh ida (Barr (B arr  , 1 98 988 8 . ah f h manur man ur r r h purp purp f i nra nraing ing h raiy au f ympm and diagni. h p-mdrn diriain f hry and prai and h nin f pimgia quian wn mping hri and xpana in hwr ha had ignian i mpiain fr ia ia wrk. wrk . ir hr i n rar rarhin hingg hry  xpain h ia wrd. Sndy  h an f a mprhni mprhni hry ha undrmi nd h au f ia ia wrkr a xpr xpr  . Hw ugg ha n  n ff ff f h hi i pr ha n    rfu rfu ann upn h ac rahr han h acor f hr  n hngy aaia  manag h in r pain hn hir haiur mu  nrd nr d d day ay mphai dmand dmand  ha ar ar hang hang hir a n y uring fauy mind u y hwing din (Hw 994 527. Sia wrk urr urrn n arain wi h pyhiary in Car anagmn , a prai ha an haiy ward hi nr and urian md m  i ura ura h i  apaiy apaiy   ammdad ammdad wihin hi nw framw fr amwrk rk and fu furh rhrmr rmr i nin uing aiiy  wrk in andm wih pyhiary rguai prai.

Occua Occu aal al h ha ay y Oupaina hrapy ha rad a ng dan frm whn pyhiari ward ruin wr punuad y akwaing and imiar aiii.

Ahugh h r f h Cmmuniy Oupaina hrapi (O ha dpd inpain in pain upaina hrapy hrapy i rugg  rak h in k wih h pa. O nd ward a hii phiphy u hi i a

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54

Deconstrctin psyhopatholoy

punc ue by  func puncue funcon on  ppoch ppoch o o e (oc uhoe u hoe empoy OT o e e whehe peope peope wh be nee pon  home)  Sm o cnc pychooy n  m numbe n pmec poon n m o nun n  nuon hoy n ocon n heence o mec moe occupon hepy offe ome po be fo chne whn he m e by he pychc yem bu o u uf ffe eou conn whch peen  fom mon beyon hoe m.

Gc al halh wkr he  98 n 1 99  w w he h e emeence eme ence of  new bee of f fff n n he h e h , oc uhoy n ouny ece. h new eneon of enec men heh woke wee uuy fom  ey of bckoun. Thee eeopmen pun fom  numbe of poc moemen he Conee oenmen npofon nce ece nee fo chepe ff n he nee fo woke o eec he exbe nee of ece ue he hn he ne of he nuon Ahouh hey poe  poen fo poc chne  he ck of fom fom onon onon h o f  me he  nuence . Sup Suppo po woke woke e houh  key o he he me e unon onon  cnc pychoo (S Ahouh Ah ouh he e unon n n he  he ef ef n ene he been on o nyy en n un-c on ue of men heh   epocon epocon (uch  we emp n h book cou pce hee ue ue m m y on uch en. en. Howee,, whee Howee whe e uppo woke chcecy chcec y f  ffe fe fom fom pycho o  n he nm n m cy of eon eon wh me c coue coue wh  hey e expece o poe pec k of communcon wh meny  cen he cemc qucon e eey oue he phoo n cpne Th e up  pec n poeny ubee eonhp wh he cen pookn ue of powe boune pofeonm n compnce, chenn hoe n he moe eue cee he queon  whehe uch poen cn be mne ou o become  ouce of ene n nnoon. Such woke occupy  poon emncen of h n  hepeuc communy (one poe on of ce n he cmmuny cm muny  bu  he me me n  que ffeen ffeen poc conex The poen mh ee n he eeopmen of  pm fo eech whch ce n empowe uch woke n cen  n eon o he ebhe fo fom m of pycho pychophoo phooy y he ue fo u   whehe econucon cn poe uch eo eouc uce. e.

Dividing practices and symptoms We opene h chpe by ookn  he pue h e e up by he mey yem of ceoon offee by Amecn pychy n he

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ymptom of what Whoe ymptom what??

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Wrd h Org Orgnii nii n , nd n d w h urnd ur fcu fcu wrd h nd f h chpr n h mn hh prfin h ry  dminir h cgri h quin f wh ympm r  iu i n imprn n, nd i  i  pib  dcnruc h wy in which diffrn diffrn cinic dicipin p h quin ndiidu r uuly rd  h crrir f ympm, nd, in h mdic md, hir ympm r n xprin f n undrying di niy f w k cr hugh w dicr h pricur rgd, nd h pychiric dicur h grup i ud r  undrnd hmh yngug mr bu h wih h pwr  dn hn h wh r dnd W wn  rgu h h dicur h run hrugh mdrn cnc prcic r ympmic ympm ic f dp prbm , nd h w nd  c h mingy ming y cinic cin ic bdi f f knwdg in h  h urrunding cuur. hy uuy d h piining, bu w nd  piin hm W xpr h iu furhr in h nx chpr

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4

Rpnan f Madn  ths haptr w xam ultural rprstatos o psyhopatholoy, ad th way  whh mas o llss ad aormalty ar struturd  laua, s  ordr to udrstad th prat o psyhatry t s ssary to udrstad ultur  th rst sto w show how ultural ors ad th ors o psyhopatholoy ar ot sparat, ut trwo W prolmatz th dstto tw lay ad prossoal owld, dsuss th oto o madss as a ultural rprstato rprstat o ad show how ho w tradtoal hstors o psyhopatholoy psyhopatholoy ar awd W also dsr th mporta o laua  rprst madss ad trodu ouaults oto o paoptsm to hlp us udrstad udrs tad how rprs rprstat tato o s ot a mtal mattr ut somth somth  that s rulatd ad srd to our ls  th sod sto w llustrat how w a dostrut y o pay oppostos W ot thatlal suh aators dostruto dostrut s otattto smp ly atomatt smply m mplt attrr o prl ddual suordatd trms ut, rathr y trasorm th oppostoss thmsls opposto thms ls   th th  thrd sto w xplor th twowa twowayy tra tra tw popular ws o psyholoal dstrss ad lal prat W loo at th ways  whh shard struturs struturs o o l aua, or dsourss that th at ar aalal  ultur at prossoal judmts aout drt orms o dstrss, ad also how thors that ha  dlopd  lal wor d to popular ultur h al sto susts som o th  trsts srd srd y otos o psyhopatholoy, partularly that o ora

Culture nd mdess So ar w ha arud that a dostrut approah to madss sstats a rtal udrstad ot oly o th hstory o psyhatry ut also o th hstory o ultural xprs o mtal mtal dstrss ad o th ultural mas o raso raso ad uraso uraso  W ha also lamd that thr s a d to aalys th laua ad sttutos whh ostrut madss as thr ojt W ha usd ths osdratos  ordr to prod a drt aout o symptomatoloy hrouhout our aalyss w ha otually rrrd to th mporta o ultur. Som radrs mht wodr what ultur has to do wth th study o psyhopatholoy ad

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Representations of madness

57

bi that th i a tit ditintion btwn popua and poiona iw, o that it i poib to ditinuih ay om popy inti aount o pyhopathooy n thi hapt ou aim i to pobmatiz thi ditintion ditintio n and au that it i impoib to paat paat di di nt am o knowd in a a thoouhy mbddd in utua pati o on kind k ind o anoth. Suh an anayi ha ditin ditintt i mpiati mpiation on whih w wi dop uth in at hapt.

ay ad al' kwldg iim and o  199 ) bin thi Socioloy of Mental Health and Illness by kthin out  di dint pp ppti ti th ay iw iw  pyhiaty pyhoanayi py hoanayi pyhooy pyhooy and th th aw.  n thi aount aount o th ay iw, thy a au u that ath athouh ouh th th  a o-utua o-utua di di n n mot utu ha om notion noti on o mnta dit dit. . Thu, thy ut ut that ommonn ommonn ok notion both o on own mnta hath and o th bhaiou o oth pu pu poio poiona na and thnia thni a pyhiati pyhiat i tm. Thy Th y o o on to dmontat th impotan o utua ato ik a, nd, a, thniity and a on pyhiati tatmnt. Th iu intt not ony oiooit but ao oia pyhiatit  uh a Godb and Huxy )  oth pointd out, dit th notion o om oia iHow, nunin a an ntity ntit y ad aha d mnta mnta  in i n dit attntion  om it ato oiay oiay ontutd natu  Bant Banton on t a  198 19855 ) 

Rg ad Txt uh uh a th dmontat dmont at th aptan aptan o om utua u tua in inun un on ou undtandin and xpin xpin o mnta dit. But whih om t a ay o a poiona notion? Can a tain motiona tat o bhaiou b aid to ha xitd i  th w w no n o tm to diiminat it om  om oth tat and bhaiou? b haiou? Hap  1994a) , o xamp, not how ntnthntuy ihad Napi 42 patint with tom atoizd byainit aDonad upiioun Did ymp th  981 ) a had pop  mmb mmb,, thi wa   ya bo bo  th t pyhiati pyhiati ua o o th wo wodd paanoia paanoia  ha paanoid duion? And in wha whatt n did did anoxia xit bo doto wot about it in th nintnth ntuy  Hpwoth and Gin, 199) ? iht th b om tuth in th iw that th di mitatio mitationn o a pyhiati pyhiati onpt onpt atuay at a whih t it diption? On annot ay that omon i dpd o anxiou un th wod a a utuay aaiab aai ab  that i, w ha a to th wod wod and know what thy man )  Thu th idntiation and atoization o oth i at at dpndnt on, i not ntiy atd within, anua

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58 

DecoSlruing psyhopathoo

When we lk bou culul eenion howee i  ion o be wo be wo on n nd    uch uch noon n e ey gue  lo  if he eenon e oing ound n cuul ce Hee

when we  lkn bou eeenon w e lking of clue of cice of ou kind hee coul include he nuionl cce ocied wih chic dignoi o h ccounng cice doinn n ou  ociey ociey (fo exl  h ge of he d nd dngeou dngeou ndiidul equiing confneen confneen cunly conue u b he one oneie ie goen goen en n he ) c hc oduc ocl eeenon include he edi nd h wy eole lk bou dne h w d eole e gied nd eclue Secondly hee eenion  no unifo he hey e fg ened nd d I   coonlc n olil heoc o ee e  enl nlyy condicy dcu dcu nd eenon  eenon clled uon by he e eke o uu  y of oliicl inee (deln  dwd n d o  2 I i hee h eefo fo  necey necey o g gee n ccoun no  on ly of doin doinn n cul ul eeno of dne bu  lo o ccoun o he wy he nd o ubugd eenon e clled uon o full cein olicl ine hu dfeen eeenon e doed by donn o oed oed gou gou ( hnk of h debe beween beween hoe who y hey he oice nd oe o y hey he udioy hlluci non)  How Howee ee   h     h  enon enon  by ue uedd y wih dffeenh occonlly inee Hence n  he  Kgou  dcou dcou  eng hoe dgno dgooing nod d  n ll ll e olen olen o  le oenilly o  d boh by igh-wing oonen of conn con n gl glon on couo  couo couni  en ode ode fo ex  l bu lo b ch i D o cgn fo bee funding of couny ce  ullici  enon  ofn found n he in enl nconiency o hiic cgo cgoe e o  le he ge ge of he hol holee nod en en e eu u he ge of he ien  ien who    gh nd h legi nd i 

h a rd he ying culul i bili  of of cin led whee oee coeno o o conuc icul eion h   ho een hough diffeen wod  e  dnoe  hing h ning i held o be he ee  A oon  new conce  conce e dcd exe hen d dcoe coe ce of i in he  in ce ciion o ou oliicl liey nd elgiou gue Such n och e� n enli nd conexul iew of hoy hoy I gnoe gnoe h xi xinc nc o o  dic diconi oni nuie n hioy hi oy nd he fc h wod y he  dffeen enng n diffeen hioicl conex (Dnige 0 Sih 1 98   . Deeon fo exle i no he e  el ncho w  y ychoh choh nd no do do no en now

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Represenans  ma madness dness

59

wha hey mean when wh en hey were r ued Een hoe who end oward oward an eeniai eeni ai  hiory roui rouine neyy noe he differen differen mea meanin nin  he ame word word ha oer oer i me (for examp e , ewi 1 979) oreoer oreoer uch iew of hiory inore he way ha pychopahooy i iuaed in wider cuura and poiica conex We noed in Chaper 1 he aryin way in which homoexuaiy ha een dea wih y he APA DS

gug  d ly oe (199) ha arued ha he ocauarie of he profeion aied o he pycompex are anuae of oernmen [which] do no merey myify dominaion or eii mae power hey make new ecor of reaiy hi nkae and pracicae pracicae (oe, (oe, 1 99 99 15 15))  Pychi Pychiaric aric cae are hu rouh forh forh y he aai aiiy of a anuae o decri decrie e hem in way way ha diffe differeniae reniae hem from from im imiar iar cae cae (ndez, e a  1 98 988) 8) n hi repec he praciioner of he py-compex are no differen from oher exper priieed y our ocieie a oher hiorica momen Hiory proide u wih oher exampe of excudin pracice which draw on a anuae of ocia reuaion u which are no now par of he py compex Ahouh i i a crude exampe which ha een uec o hiorica deae, he work of oman Cahoic ceric in deain wih he European wichcraze of he idde Ae proide an inance of hi ki nd of oper operaion aion  he markin ou of(uch oher dianoic procedure and rue of eidence a comparion he Malleswih Malecarm Kramer and and Sprener, 1 97 1 ) can can e een a work work hen  a hey can now, in he modern mena heah care yem Hence i i no ju he py compex which excude aher, i i profeiona eie and he reaiy which i  conruced y hem hrouh anuae hen hen wihe were widey hed o exi whie now hey are widey hed no o exi he difference here i ha hee new eie are empoyed y he ae raher han he church and empoy new echnooie in which are conained oder excudin and diidin pracice

Pul P ul   d d  l k kwl wldg dg d  d   cl culu We wan o  o moe on now o eaorae oucau oucau iion of modern cuur cuu re and o ocae a deconrucion of pychiaric caeorie in ha cuura conex ainow (1984) noe in a reum of a foucaudian iew of ureiance in cuure, hrouh paia orderin he panopicon rin oeh o eher er pow power, er, conro conro of he ody, ody, conr conro o of r rou oup p and and knowe knowed dee    i ocae indiidua in pace in a hierarchica and efcieny iie oran or aniza izaion ion (ainow,1 984 19) 

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60

Decostrct psychopatholoy

Th uan nay fo th udmnt of whth on aton a noma noma  ua ua h n ouau (  977 977 wok wok Dscp Dscple le ad P Ps sh h h dd a d whh h aw a ymon h knd of onant monton whh ou n modn oty. Th wa Jmy Bntham Panopon whh wh h wa a tu tuu u affodn affodn max mu mum m uan fom fom a nta oaton. oato n. Th noon of th th ua pon qu qun n ony a wadn at h nt to o  pn fom h onpt. Th fat hat th o mht  unn na th pow of th fom of oao oaonn n ho o od d w w  ha a f thy a n wathd j u n a dpn hu mo fom omhn nd on oth to omhn

whh om  om ntnazd nt nazd and w mo fom uaton y oth to f f uaon. (1984 no how pod fom an oanzaonRanow of nddua nddua  n pa pa  and an d  dpn qu a p p  nou of pa pa  (1 984: 1 7  Thu  panopa panopa pa pa  a mata oanzao oanzaonn of hn uh hat w om uatd no ony y oh ut, nany y ou    Th Th   not ony on y ahd thouh thouh th t h ud ud u of ahttu ahttua a pa ut n h thnooa a houh h mata oanzaton of ypa n th nfomaton od on u on ompu thouhout h wod (Gandy J, 99. Th xpn of uan, Sa (1987 au, au , n h anay of of h Sh Sh a a (ud, (ud,  97 9799 1 91 1   may ad o th aton of f-utny to h pont wh on om a quntntay panopa n paayd y paanoa Wthn th d of mna hah h noon of uan y oth and y th f ha aoud aou d nan nan nt (fo (fo xamp  Sma , 1984; Wh and pton pton , 199.   mpoan o a h onx n mnd whn w ook at h way utu p nto y na judmnt ha a mnta hath po fon f ona a mak m ak  C na ao ao opa opa y xudn xudn th ontado ontado n of utu u ah ampt o po th puty of h ato oap und pu W an dntfy x pon at whh h a o an  dontud. dontud.

econstructing cinica categories  ap (n ( n p p ha n an xamp xam p of how dontuon an  ud potyy o xamn pot xam n h mp m p onadoy aumpton o oppoton oppoton n  h dano aoy of of paano paanoa a That anay an  oadnd to oh pyhat ato. n uh an xamnaton, t  ufu o ad a atoy a a du ompx  a fom fom of dou wh a ym of amnt ontu an o  hn w a fonouy n th du nau of a dano Athouh th a a wd an of o f uh tam t amnt nt fo dffnt ao ao  may  hpfu h pfu o fou fou on x paua oppoon aound whh mot pyha dano a

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Representatons o madn madness ess

6

cnsucd. Ech ppsn ppsn wks  n cnjuncn cnjunc n wh h hs nd w wll s h smply mpn  su n whu h hs ds n sl s l h plm u  mly cnsuc cnsucs s  .

Th ddual ad h al h s ppsn,  h nddul/scl, pducs h dulsm nhn  n mdn Wsn culu. h psycmplx hs n n n  h nw nw   ns nsun unss whch whch hs sd sd  nddulz plms. plms . I s sy   h hs dulsm hs nly n wh us snc h m  Dscs u  cm plclly usul  h h  h mdn s whn h nddul cm  un   nm nmnl nl cncn. cncn . h nn  plms n lcd n n nddul ms ny spnsly m scy, lhuh h s  nd   cncp  h scl (h nml

ppuln)  cmp h nml nddul wh. On spns  hs ppsn mh   pl h scl  h nddul. In  sns hs hppnd wh h s  h mly hpy mmn. Hw, Hw , cnly mly hpss sm   unn  h nn n n  h nddul s h lcus  chn (nkns nd Asn, 1992). hus  mp  x mnn  h scl nd  h pl ks dwn snc scy cms  sc  p p (nd hus s sn s cnsud cnsu d y ndduls) ,  u p pl ln n h  nddul sl cnnully ks dwn dwn snc h nddul nly xss ns h ckund  scy.

Ra ad a d ura ura A scnd ppsn clsly cs h sps  h s snc nly s s cnl  h mdn Wsn cncp  h sl s nddulsm. Psychy cls hs sl nd ms  cus n hs wh d n pssss pss ss sn. ucul nd Dd dd dd whh   ws  pssl pssl  lk u unsn snc, Dd ssd ny mp  d s clnzd unsn nd nsmd  n sn (Byn, 199). Onc n n hs ppsn w s cndcns cpn n. dn cn psychly whch lns hly n  nls mdl hs  dculy undsndn why ppl  n nl nd  n ncnssn nd s n.  smply  pl unsn mh  nn usls  h spnsly  hlp nd undsnd hs nd, sds, ns h cnsucd nu  h ppsn.

Pahlgy ad raly A hd ppsn ms  plc  m m dsncn ds ncn wn wh s  s nml nd wh s phlcl. As wh h pus ppsn,  hs wh dns hs s phlcl  psn  nmly s scd nd

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Deconsrin psychopaholoy

oud aeh poded foh queo lemay of he ew oeoe a wok ohe wayhe wh u ded haohe  ompa o wh ohe omal people hee mu e omeh wo wh u. hu, oe aa oe pole  depede o he ohe fo  mea. Clam  ha he paho paholoa loall   eally omal doe o help u eape eape h houh  e we eed o hallee he lue lue of ohe oppoo oppoo

 ad  Dao hedule alway pay muh moe aeo o he fom of de ha  oe. eal healh pofeoal ae ofe moe oeed o kow   ome omeoe oe    hea hea  oe o ha ae houh ho uh ha o d ou wha he oe ae ay o wha he houh ae aou. I pa h  due o he medal paadm eah fo aa eeal ule, fom whh pyhay emeed Howee h ap of mede eome oadoy e may of he deo aou fom ae depede o odeao of oe ( a deluo peeuoy o

adoe? Doe D oe he houh ome fom he peo o oude? ad o o . Oe ao plee oe aloe e   alway medaed  ome fom ad     o mply e  e  ao whh  he h e polem (e  ma y ofe ofe e helpful

Pu ag u y al l A wh he fom/ fom/oe oe oppoo oppoo  pyhay oeo oeo wh delea delea   dealed kd o ae  loely aled wh he dee of he py dple dp le o follow follow medal ee  lam lam  he auhoy auho y of he aual ee o du a pue paholoy mea oe aod du he eale amue of he ddual pae. hee  a aekeep meham meh am of equ ea ympom ef efoe oe e aed a aeoy aeoy whh allow he py aze o dede whehe he ae , fo eample ypal o aypal. ay pof pofeoal wll kow ha fo fo ay oe peo a ume of daoe wll hae ee eeaed. h  aely a polem e dao maual ae oh hhly dealed ad ye alo ele eouh o oe a ume of eeuale Suh amue ae ee y joual edo a ofoud aale ad eeah  hu oly pulhed f eeahe maa he pae of epaa dffee lal oup he po polem lem  o oe of e dao yem u of akowled ha he pae of dao  o appopae o huma dfule.

P P al u ula  lay ay ad a d a a  w hee oppoo a e ee a wok  a aey of pyholoal ad pyha e ye he ex hemele fom pa of a al oppoo

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epreenaion o madne

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in th  w podd b poion h knowd tht i d in dinoin oth i t o know omwd tho in do not ptiipt in th podtion o tht kno d oth n in th ith thi w  not in tht th iw o i   ni homono o t bt w  notin tht th   hd ndd mn tim th  d-itimizd d-iti mizd ii iim m nd Ro qot on iw iw  o   hh  hin hin  ttd ttd  in om o th ptint w in in om pnoi nd oth om dpion it wod h bn  bi ption to hk th obti  o ttmnt with th mdi od o th ponib phitit on 196, qotd b im nd Ro 1993 Atobiophi ont  otn on pbihd in inti jon whn th  with domin dominnt nt phiti onp onpt t  o xmp xmp  th it on tion o Sci Sciopren oprenia ia Bullei Bullein) n)  t ttntion to   n o tobiophi tobiophi  th xit  diit o xpntion xpn tion o pop n nhppin hppin (piit  pp pphooi hooi   ono onomi mi poiti nd o on On option h miht b to pii th iw o i . How in w  xit in t th iw otn ho dominnt t toi nd m not hp  p th tp Wht i ndd i mo int in thn hn btwn btwn th two two  A thi th i o o w wo wo dd bin to  th i no  ditintion btwn poion nd  knowd W wi  in th nxt tion tht poion knowd too i dp

mbddd in wid t toi.

Ta T a  g g      A w notd bo it i not noh imp to pii on id o on oppoition Doin tht t two pobm it it ontin to x mni n t on id nd imp xd th oth Rth w nd to t t th onpt poiin whih im to kp th two id pt pt Wh o o xmp do w nd  ption btwn th indiid nd th oi? Sond i w on d with on oppoition b tnomin th oppoition oppo ition o xmp xmp  b in  onpt onpt tht impi imp i th indi id nd th oi ik poitionin bt i to dontt th oth oppoition th pobm i imp onttd onttd o  mi mi  thp  n xmp in thpit miht wih to oid indiidiztion b tin th intpon nd tmi ontxt o  pobm. How i it do o withot qtionin th notion o pthoo o o xpt poion knowd (o (o  th oth oppoition notd th pobm t t it in  dint di nt om

Pouar cuture and the rofessionas O donttion h dmonttd tht h p ini to i dpndnt on t mt mt i  Now w w wnt to mo on to onid onid how

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64

Decntrctn pychpathly

that utura m ate atera ra repreent repreent mage of of madne, m adne, and  n partuar partuar the way t deegtmze upon y ewng t a a pyhopathooga tate of mnd , a tat tatee of paran paranoa. oa.

Th bddd  kwldg  culu Soa ontrutont reearher hae demontrated how ent on ept are emedded wthn the taken-for-gr ta ken-for-grante antedd knowedge kn owedge o f the uture and wthn theore aout reaty hu Bery urt (1994 ha argued that een a urory gane through the teratu terature re of our oetty oetty reea that ma ny of the dea we hae aout madne are nformed nformed y, and nf n form orm,, a rh and ared ared oet oeton on of preen preentaton taton of the mad m ad  n pantng, photography, photo graphy, m  popuar t ton on , theatre theatre and ong ( 1 99 994 4 1 5 1   artoon artoon are one  u utrat traton on of th  for exampe the ate e a man ( 1979 Dr aman Dctnary  Pychanaly and Barne (1986 oeton of unh artoon (Shrnk Rap Pnch n the Analyt ch) Suh artoon hae ao een an oet of profeona nteret (Water, 1992 ontemporary nema ha had a at nuene on utura repreen taton of madne. t ha portrayed the nttutona fe of ayum Bedlam (1946, dretor ark oon Shck rrdr (1963, dretor Sam ue uer and the eratory eratory One Flew Oer the ck Net (1975, dretor o orman. But more uuay, t ha proeted an mage of the mentay  peron a a oent and threatenng gure n m ke Pych (196, dretor Afred Hthok Play Mty r Me (1971, dretor nt Eatwood, The Shnn (198 dretor Staney Kurk

and The lence  the Lamb (1991, dretor Jonathan Demme. O aona ao na y , there ha een an attemp attemptt to undertand undertand ome of the dynam wh whh h produe unhappne, unhappne , for exampe Famly Le ( 1 971 , dre dretor tor Ken Ken oah. mage of madne preoupy not ony the nema, ut the new and entertanment meda ao. ho (1994) report on a tudy examnng teeon tee on new and an d pre pre report reportn ng, g, popuar po puar magazne, magazne, hdr hdren en  tera tera ture and tona V (uh a oap opera, m and drama. A ontent anay an ay produed produed e e man ate ategor gore e : oene to other  harm to ef ympathet oerage oerage  rtm of aept aepted ed dent denton on of ment a    ne and  om mage mage . Oera Oera n the oera oerage, ge, the atego ategory ry of oene oene to other wa y far the mot ommon outweghng the next mot ommon, ympathet, y a rato of amot four to one. We ao found thatt te m nkng tha n kng menta   ne and o oen ene e ten tended ded to ree reeee head ne treatment, whe ympathet tem were argey ak page n ther proe , uh a proem page etter or heath oumn oumn  (h o, 1 994 1 73 Sott (1994 49, n an anay of natona newpaper oerage of me nta nta heath he ath ue,  ue, found that arte ontent uggeted uggeted a preoupaton preoupaton wth foren ue and thee frequenty promoted the ew that danger oune  ynonymou wth me nta  ne  h dep depte te the ndng ndng of the the

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Representatons o madn madness ess



99 Byd mm itt that ly 22  appr apprxi ximatly matly 700 700 Britih Briti h hmiid wr mm mm ittd by ppl wh had b i tuh with pyhiatri rvi rvi i th prviu 2 mth (ihill 99a. Suh vrag i i tar trat tra t t th la  publ publi i r abut th timatd  dath a w aud by pyhiatri drug ardig t ID (ihi 99b. Phil (99 ha td hw mdia prtati ar al a vry pwrul i u  bli bli abut abut th atur atur  mta mtall ill il l (  99  73 ad that thi t vr-rid ppl' pral xpri, mthig whih i xtrmly uuual i mdia rarh

T uc  ula culu  al judg Prial aut th, at b paratd rm th widr ultural txt Hw might uh rprtati iu pral aut  mad mad hr ar at lat thr pibl pib l way  Firt, a wpathlgial, hav td, thy a a t t th atgri  bhaviur whih ar idrd rmvig thm rm big udrtd i rlati t th bradr ial txt S Sdly dly , thy th y a at t th itrprtati itrprtati  bhaviur (ad (a d what i idrd t t a atgry hird hirdly ly , thy at at th id  itrv itrvti ti rd (r xamp, thr i idrabl vid that bla ppl riv r iv mr phyial' ad puitiv pyhiatri pyhiatri tratmt tratmt  Fra Frad, d,  993 993 I thi haptr w will largly xami th rt tw tw  th  t.   th mt pwrul xampl  thi i th ara  pyhiatri diagi r th pr pr  idtiati'  pathlgial' pathlgial' bhaviur bh aviur A rmu amut a mut  wr ha hw hw diagi diag i i txtdpdt txtdpdt (Rha ,  973, 1 97 97.. Hwvr, rar rarhh al pit t th imprta imprta  arlir putuati i mtal halth arr Fr xamp Smith

(97 h bhaviur dbd i rgardd  by  thr utga ut whh u wh m' ixpliabl ardig t rmal ial rul h i, rt ad rmt, th, a ial ad ultural, t a pria r a ar th umru dii mad at latr pit (r xampl, whthr t ult a publi agy r hlp. Cuttig Cutti g ut' ur ur i th widr ultura ulturall txt al al  t t  th th mdia mdi a rp t th twday r i auary 993 ttld h rt itratial r that xp a Glbal Dpti' whr a wid varity  par argud argud that wrld-wid pirai wr i prati prat i. . Hr, wpapr ud a umbr  rhtrial tratgi t dlgitimiz th viw  th r rgaizr by uggtig thy wr paraid (Harpr, 993  ur, uh marig ut ad xludig prati ar gagd i, i , t  t ly by uralit, uralit , but al by a pr' pr' rid, rid, rlativ ad mtal halth prial Gldbrg ad Huxly (992 hav dribd th wid rag  atr whih dtrmi why m apprah thir gral pratitir (GP, hw pyhiatri ill' i rgizd by th GP, what dtrmi i a rrral i mad t a

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Deonrucn pychopa pychopah h olo oloy y

psyhs d hw suh  l s dl wh As  sul  suh ulul us ( md by pul ulul pss w d w ppl g hugh h ls bw hs sgs. As h dvdul h h s   ml m l hlh p p ss ssl l hy bm bjd by  ll g whh suppsdly ds sympms d mp hm wh dgs . wv,  umb  wks hv suggsd h hs pss s  s sgh wd B 98  hs sudy mpg h mdl d   dgs vw wh  sp  h vw dmsd hw mdl s  hl sus m  mbguus  mbvl vw sps hs s w pdud hugh h us  ms whh bdg ly d pssl lms Hk  98 989 9 hs d sml hugh m hl wk mg  muh h sm luss B   9 9   d h wh lkg bu ps pssls md us   ml shm  lssyg ps bsd  ly 8 I ps  mdss ml dsusss hlh wks smm l9  ls s dd'  sm sm  wy Im s ds  ds hwv B pd h psyh vw vss w smd hugh h us  md yps' whh w wds  phss whh bgd ly ps  ml llss d pssl ps  shph'   9 9   7). Elswh, B 988 hs dsbd hw   psyh vw, h psyhs md quss   s lv  ms  ly udsdgs  ml llss H hs pd u hw hs  wk  mgs uly ul y h  sub sub  gm gm  s  d d by h pps pps  hs   vw vw y  ws ll v v   h w w u u 98: 273. h u h ws  m  wg whh dmdd h ls pu ps pv d psl ml xps  dd

dms h uld ly b u   publly vlb um dsus' (B  6. Rh h sghwdly gzg psyh dsd p

ssls uld b sd  bg h  su psyhphlgy by us   lgug wh whh  p  dsd hus dgs  uld b sd  b jusy gums h h bjv sgs vws wh ml hlh pssls wuld sm  m hs. Hp  99 994 4 hs msd hw pssls mv bw bh mp s s ( h s s  d bjv bjv ug ug d g g (h s subjv d psl ug dsuss  xplg dgss. dgs s. v h us        ds d sus us  d dss p pss ssls ls  gd dl  xbly   xmpl dlg wh hllgs   dgss by pg y vd  y dug w  (Hp 994 hs ps s  smhg h psyhy  h dspls lk ll psy psyhl hlgy gy     by bmg m  s' ( xmpl 

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thrugh th u u  mr rma trvw prt  th th  mpy mp y ad t mr tyzd ad arta rmuat rmuat  dd pyhatry  urrty urrty udr atta rm rarhr trgy pug t (a ppd t mpy dga vau (Bta t a. 9 By 990  pra wdg th mpy a rprtat  ppuar wdg a mr rma mar  uttg ut whh g   vryday  h tuat d t appar t b a traghtrward a th Fr xamp Curt (99 dug G (99 wr t that athugh m  th mad ma d haratr haratr dtd  hr h r rt tudy tudy  rprtat  mad mappd aty  t pyhatr dagt atgr at gr  may dd t. Fr xam xamp p th gra ppuat d t draw draw a harp dtt btw btw th dr drdd t b mta m ta y     rm th drd t hav arg dabt h at that pria aut au t d t mpy m py m rrr  aut aut a b  a a attmpt by pr pr  a a t dmtrat dmtrat  thrugh th dtt thy ma  that thy hav pat xprt ad hav a dttv trbut t r (Burdu 9 Bwr 9. dd pra t m t b axu t tr th xprtAat trbutDianosic thy hav t Fr xamp th Amra Pyhatr andr. Saisical Manal of Mena Menall Diso Disorders rders (D (DS- S- -R tat that that bau th rdary rdary Egh mag  th trm parad uggt y upu th mr gay drptv trm Dua Drdr"  ud (Amra Pyhatr Aat 97 20  trg thr pam t   urpr thrr that thr ar trrtra dput btw pr a w w aw  Chaptr 3. dd Barrtt ( 99 99  ha drbd drbd th th rut  hw uh a dv  abur at pra judgmt.

Th cl  l kwldg  h ul d  ur th  t a -way tra G (99 t that tad th rathp rath p btw btw  tradta  w ad d  b b ad pra pr a vw  a data da ta ad tratv .  . hu urrt ppuar b bm th w tradta b rvr athugh pr a b ar havy hapd by ppuar ti pra vw

prat ba t ppuar utur ad h ar ttutv  ur urrt ppuar a raty Hady (97 pt ut that th dg  th a  ar t y prdud wth a wdr utura mu whh wh h u  u thr rm rm but may a d d ba t ad u that  u  t u r     pychg pychgt t hud xam  xam  th  t t whh thr thrzg m a y h a v     t y       g a t   . th u  partuar md  trug raty  a  (Hady 97 . Examp  th th a b      V ta hw Hardy a dt  th th US Da Dahu hu r prah ry  ry hw g g by wthut th t h appara  a

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Dettg pypatgy

psychoheapis of some so and his phenomnon is on he incease in Biain (iingsone and n  We see Ba and his popa TV caoon famiy Te p aendi aending ng fo fo amiy amiy heapy heapy  in o disgace ike home (      diecos  e egg gg Vano Vano and Ken Bewo Bewoh h  Gacie imswenieh imswenieh eny ox  as hae hae fami fami ies in he BB adio Te ce seia and heeae BB mna TV seis Inceasingy newspapes and magaines heahEatEe. poessionas as expe commenaos (fo examp biding p offende poes he ess of pos-amaic sss on chin and so on o as wis fo pobem pages. Moe and moe magains ae aios kinds o pesonaiy qesionnaies heping s o ae anyhing fom o aggession o o sexa ifesyes To ake psychoogiss as an exampe we nd ha he Media Wach page and n h ai comns com ns in he B iish sychoogi sychoogica ca Sociey jona Te Pygt show h wide ange of media psycho ogiss ae inoed in he many wies noe he seepage o mena heah pofessiona discose ino eeyday ife Ths Bman (5 has descibed how discose anayses of epesenaions o he sef can seem bana becase of he pemeaion of heapy-speak ino eeyday ways of descibing expeience (Bman  7 Some hae caimed ha sch seepage is pehaps a sign ha Wesen ce has beome a psychiaic sociey in which peopes pbems ae inceasingy concepaied in medica o psychoogica ems and in which medica jdgemens hae an expanding inence on he way we i (andy 87 65. Howee sch a focs on negaiey aed psychiaiaion dies s fom f om consideing he socia socia consences of h e goenance goenance of he sef and aspaons o an ideaed   ee ee and geni n sf s f miniscen o he moe posiiey aed conseing psychoheapy and psona gowh moe mens (Bman (Bman  ose       The exen exen  of sch seepage can be seen in he  he way echnica ems ge ge aken p in eeyday eeyday if if  o exampe  he concep of paanoia paanoia is widey wide y sd in popa ce c e and we can see how i has had a as as inence on wiing ( onn  2 m (Bake 2 hisoy (Gamann and Moscoici  7 poiics (Biig      and eeyday conesaion (see fo exampe wok on gossip osnow and Fine 76. Sch popaiy popai y is f fowned on by psychiaic ges ike ewis (7 who ages ha he iay and enaca se of paanoid" as meaning mean ing eseny dissf dissf  i s as inexac as he coes coesponding ponding se of hyseica"  (  7    . . espi hi s w ca each ohe oh e paanoid if we ee ee someone some one is being be ing oey sspicios o if we wan o moe egiim egi imacy acy fom someones iews. In doing his we hs bing o bea he sigma of

psychopahoogy on he ohe oh e ain aingg someone someone paanoid is ikey o hae hae moe of an effec effec han caing hm oy sspicios sspicios An exampe of he pemeaion of his echnica em can be seen in a caoon fom h back coe o ea te (Sheon/ip f Pess 85 a (see comicige deaiing scapades of he abos Feak      h Bohes nninss is oedeemined andy we can see

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Repreenaion of ma madne dne

9

Figre 4 Feeling paranoid lately? (Reproduced by permission, Knockabout Comics)

ha h aroo i humo hu morou rou o orr a umbr um br o o rao. Fir Fi r w a   h

opraio oprai o o wha wha Gilbr G ilbr ad ulay (  98 hav rmd h proo-jo proo-jo whr oradiory diour ar ud imulaouly produig a

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70

Deconstrctin psychopatholoy

icoruou ad humorou ct  rlatio to paraoia th proto-jok would b ut bcau m paraoid dot ma thyr ot out to t m  othr word o th o had th artio o paraoia i a claim that you  th radr ar bi patholoica patholoically lly upiciou upiciou  thiki that th crt polic' ha a l o you) whilt o th othr had thr i a rcoitio that thr i a ood dal o urillac carrid out o u by both tat ad priat aci Campbll ad Coor 1986). hu i proidi th trm paraoia with multipl mai a baic rul' o laua i brok ad at oc rmarkd urdi 1993) hi ct i hihtd i w kow that th abulou urry rak Brothr ar thr m who idul i a wid arity o illicit dru  thi ca th trm paraoia parao ia i proidd with at lat two urthr urthr mai mai. . hu o c ctt o crtai illicit dru i to mak th ur o o th brothr or poibly a radr) l upiciou or paraoid Applyard 1993) ot th particular cotrolld ubtac th [i th 1960 widly aailabl  dop pd ad ad acid  w wr r all all paraoia iduci'  1 993 1 6)  Moror ur would ha roud to b b upiciou upic iou i ca o polic urillac ad dru raid or i iold i political actio.

Maness, governance an culture t o lor m ibl to talk o proioal ad lay cocpt a parat thi ic th ditictio btw thm i ot o much i th kid o dicour ud by pakr but rathr th poitio rom which thy pak  A pro pro ioal ioal may m ay u a l ay dicour dicour ad a lay pro may u a proioal dicour  th am way a mtal halth ta may ay a pychiatric patit i o or ttld Barrtt 99) o a lay pro may pak o cliical dprio or dlibratly u tchical trm rathr tha popular o or xampl chizophric' itad o mad or axiou itad o arul) hit ad Epto or xampl ot that claicatio" at tim tim  pcially wh thir pro ha b courad coura d to u citic to dcrib cocr pro or poblm  ditio i trm that ar iormd iormd by xprt kowld" 1990 53)  ha arud that mad ad it cott ar locatd withi dicour o dirc dirc which r to rulat ctor o ocity ad that t hat thi cocpt i hitorically allid with a umbr o politically domiat ititutio ad thir practic mdici th wlar tat ad o o) Crtaily i t appar appar that ocially alud phoma pho ma lik  happi ar ar ot icludd ic ludd withi  diaotic yt ytm m althouh altho uh a ca coitt coitt with pychi atric thory ca b b mad Bt Btal alll  992b) ithi uppodly uppodly dmocratic tat th oly way i i  which wh ich to coduct coduct uch a orac o th th oul' i throuh th cratio o a proioal cla ad laua which appar to proid objcti hlp wh popl ary rom a idalizd orm  thi ot

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Representatons of madn madness ess

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o occr coercive (hrogh h reerra o peope or pchiaric reame oowig arre b he poice or exampe c oger 99) b ao voai (oe 989). Th he diagoi o made hrogh he e o diereiaed vario bcae ca be ee a a orm o regaor rega or pracice which wh ich operae a orm orm o gover goverace ace o he o a he more be ice i i  i drve o o b coercio b ao b a deire o be orma (oe  989 Smai   984). S Sch ch a poiio i exre exree e   or or a democraic ae (ae e a. 99) The creaio o pchiaric caegorie ca erv ma cra ad poiica iere. Term ike axie ad depreio or exampe ocae he orc o ea earr a d happie wihi  he idivida idi vida b bam b amig ig biochemica cha chage ge or hi ki g error error raher raher ha he hig peope have bee bjeced o emoioa phica ad ecoomia hrogh heir ive (Smai   98 984 4  98 9877   993) . The The cocep par parao aoia ia  eabe eabe  pic picio io o be pahoogized. Th he view o hoe we d comorabe ad bewiderig ca be de-egiimied b ocaig hem wihi a dicore o made Sch caegorie are o ed probemaica i a owa ahio however ice ma idivida ad grop adop paraoid or copiraoria copira oria  rheoric o erve paricar poi poiica ica ed. ed . Th Th  drig her ime a Prim iier argare Thacher akd o he rade io a eemie iwihi ike paraoia he,more deeae a dicrive poiio which Cocep oe ca ocae oee ad impora ocae ohe (Davie ad Harr, 990).  i i he creaio o hee bjec poiio ha ide ideiie iie are creaed ad raorm raormed ed ad i i o hi ha we r or aeio i he ex chaper.

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Pathologcal Idtt I prous chaprs w ha cosdrd how madss' ca  hsorcally locad ad cosud w h dscour dscourss ss o d drc rc  I hs chapr w w wa o cosdr h way  whch yps o dy ar cosrucd  rlao o psychopahologca cagors ad hr w wl  amg h d d s s ha ar cosrucd aroud h lgal ad cl cl ca cagory o psychopahy.  wl rac h cagory o psychopahy as  mrgd  h co o h U ad loca s orgs as par o h succsso o ypologs ha oowd h dscurs cosruco o h ssu o dagrousss Foucau 978 I hs way w wll  racg h ouo ou o o h cagory as a s o s ad a d wl w l  ocusg upo som o h coradco coradcoss coad coad wh hm  coradc coradcos os whch  w wl suggs sugg s rc a amp o  o  gra gra  cocg ss o clca ad lgal lgal dscourss.  wll h mo o o cosdr hs ual rals as h maral hrough whch parcuar yps o psychopahc dy ar ormd hrough a accou o how such ds ar ld ou wh h dscurs ara ara o h Spca Hospa  w wll  llusra h way  whch coradcory or paradocal orms o dy coc wh udrlyg ual coradcos coradcos Addoal y hrough a amao amao o h yps o sucy ha ar mpld y h r-ual rlaoshp w dscourss aou rac ad psychopahy w wll argu ha laguag s sgca sgc a  d drmg rmg h ddual's poso ad passag passagway way hrough hrough h mal halh work. Th dcosruco o h dscours o psychopahy, h lads us o cosdr how psycharc ad prso suos s uos prook prook ad coa a aorma orma ds

Laguage ad ideiy  way o cosdrg dy s o s  as a hory aou h sl o whch wh ch  o oologcal saus s cssary ascrd zgr ad Sa o Rogrs 985: 168  wl argu ha such hors ar always coyd  laguag ad ha hy may ak h orm o somhg ak o auoboraphy Harr 983 argus ha  s hrough auoography a ar srucur ha  prms pas  prs ad uur uur o  oud oud oghr ha orms o prsoa prsoa ad soca dy d y ak shap. I hs chapr w

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F  Harr' dimenion of ychoogica ace

h t mp mp  Harr Grd  Pha Pha Spa (983) a a ma ma   ptuaz th a  hh a dur dur  mpat mp at up ddua dd ua autbraph thrb u bth th tp  ubjtt ad dtt that ar bruht t b h rd  pha pa  rprtd  Fur 5 .  .  a b  th rd mpr ur quadrat rmd thruh th t rt  t p h rt p ru a a d tr ddua duat t tuum  hr th pr rprt drat haratrt haratrt t thm at th ddua d ad th t ta hard haratr t h d p ru a a pratpub tuum th rmr b a dma  hh att ar arrd ut a ad th attr  hh att att  ar atd  t h pr  th Harr td that quadrat  th pubt dma  ta th matra rm hh hh pha paraphra paraphra a a uh a th   trutd th th quadrat th  rma udrtatd ad  Harr aut t mr a t pa t quadrat t a a pr  pha mb  ad Shttr 94).  th pr th hd h d  dpd a a t t  mta mt a ad a b ad m m t  t a ha ha  bth a pt   ad a b th u  at  quadrat thr th hd  hd rt up t a th ratr  at at ad pt   b abd t d th thruh ner ala ha add t th pra pru h r a t ut atat a tat th ra razat zat  pr pr  arud a tra pt p t th th  ht mutau at a a r that atat rt up ad rhp  that pr Harr (983 5) aru that th mmt rm quadrat  t thr  th rat  pra b thruh th trarmat   a hrta that  thruh th amat ad trarmat  a tr  r

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7

Dctructig Dc tructig psopatoo psopat oog g

dioue heoie and meapho (Thee ae paae hee wih aanian heo in a uh ha he ube i oaed' b being xed wihin wi hin a pe-exiing onpua em (Buki  191)) In quadan ou ou oia being eo when hough a poe o pubiaion idion

ai maeia i bough ino he pubi aena Thi migh inoe he pubiaion o e a epeened in a aie o wa o examp b pei ignie inuding inud ing e noun uh a  m e' u'  o pop pope e name Aenaie i migh be hough he pubiaion o a paiua dioue meapho o naaie ihin hi hema i an be een ha aguage i o ena impoane o he e and ideni oh ae dep enehed enehed in he maeia uue uue o an gu guag ag and hi enme hn o o o he poibii poibii o aeing aeing o dioing  ue' e  ha ei ouide o  angua anguage. ge. oie bing ou hi poin b diuing diuing he ui uii i o Roueau Roueau aemp aemp in onesons o gie a poai o hime in ee wa u o naue (1992: 27). He make he (ao aanin poin ha  e poe o wiing (o peaking peak ing ake Roueau awa om om he h e qu o he anaied ue e in ha  ha hi aemp aemp  o deibe hi e e  o uneah and dei neae ome kind o deepuu deepuue' e'  i dio dioed ed b he pe-g pe-gien ien uue uue o o exampe  meapho and meonm ha ae aead embedded in he ex. n a imia wa Middeon 199 eje inopeion and oneiona naaie a a mean o nding ou abou he deepuue o moden mauine idenii He ague ha o empo naaie i o enmeh one in peeiing uue oe whh he wie ha no ono. Thee impoe upon h e o o o aoun aoun a moe wokedou wokedou iew poin  nd ba eading and undandng n a pua wa o exampe he moe e iia he one o uh wiing paadoxia he moe iuou he naao wi appea appea   1 99 9 1 )

The relvance f eaphr he eeane o meapho o ou aionhip wih he wod ha been deibed b a numb n umb o ie (o eampe eamp e  ako ako and and Johnon John on 1980) In eaion o he e Loie (     ugge ha een om o ubjei ubj eii i ae ae onued ou ou o a omp ompe exx o meapho (and (an d we a ann e eee uh meapho  being onaned whin a' pubioeie domai n ) The The a  a e e o buiding buid ing bok o om m whih paiua paiua pe o ehood a made poie oie ie uh meapho a he head o ie whih ee onnui om he beginning o end o ie he i e   whih emphaie p pe e hamon hamon and ineg in egaion aion and he oe oe  h idea o hee ing a ne o ou om whih hing gow and unod S undamena i he maa deibed b Loie in eaion o he  ha i an be een  uiing he au o a oo meapho pp  The oo m apho i a i nguii dei deie e whih poide poide he ai anaog ound wi wo em o knowedg knowedgee ae oganied oganied

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Patgca ntt

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ithi a articlar cltr root mtahors acqir a tak-or-gratd stats as ol bcom icrasigly sbmrgd withi thm As sch it bcoms diclt to rtai a rxi drstadig o sch dics as mtahor so that what wr oc ttati as i ways o coctaliig th world bcom rid ad litralid. h owr o ligist ligistic ic matrial matrial  sch as th root root mtahor mhasis o o th challgs chall gs to a dcostrct dcostrcti i aroach aroach I xlorig hom

a sch as idtity dcostrctio might sk to xos th cotigt ad ragil ragil atr o th li gistic matrial o which idtity is odd odd owr i mas  mas ki g this rlatioshi  ral ad tagibl  ct ctss coti to b associatd associatd with thir th ir xistc  art  this th is rslts rom th act act that th matrial is i s xd withi cltr as both rmat ad biqitos h h diclty o moig byod ths strctrs is catrd by Cixos who stats that thr ar liig strctrs that ar caght  ad somtims rigidly st withi historicocltral limits so mixd  with th sc o istory that or a log tim it has b imossibl (ad it still is ry  diclt to thik or  imagi a lswhr (Cixos 975 83. atr o i this chatr w will cosidr th way i which th clits o sychiatry sccmb to cliical discors abot sychoathy ad how th biqity o articlar tys o discors maks it imossibl or thir sbjcts sbj cts to to  thi thikk or  imagi a ls lswhr whr   cit Cixos hr hr also as somo who has gagd with sychological thoris i ordr to dcostrct tm ad i ordr to rst a imag o th sl which is somthig aki to a rmat dcostrctio o idtity.

Psychopathy, forensic psychiatry and disciplinary  society h roots o sychoathy ca b tracd back to th mrgc o a st o ractic ra ctics s  with i modr assmtios abot abot th atr o kowldg kowldg  i both th discilis discili s o lgal lgal sychiatry ad th hilosohy o law law Both o ths aras ca b s as rrodcig ad cotribtig to a rcoc taliatio o sbjctiity ithi th law a sigicat shit ca b idtid i th abadomt o th classicist classicis t traditio o ishmt i which th scal o altis was st i rlatio to th dgr o rcid social harm (ocal (ocaltt 977 his modl adhrd to th logic o rtribtio discotig th d to ay atttio to t t idiidal idii dalss mtal stat stat as th th crimial crim ial was o mor tha th rso to whom a crim cold b attribtd ad cold thror b ishd (ocalt 978: 2) owr by th start o th itth ctry ct ry modaliti m odalitiss o ish ishmt mt had com to b ocsd ocsd o rhabili tatig or tratig th crimi crimial al rathr tha tha ishig is hig th crim pr  his shit is symbolid by th momt away rom th body as th targt or

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Decostructg psycopatoog psycopatoogy y

puset to be replaced by a puset tat acts i dept o te eart, te toug tougts, ts, te iclatio iclatios s (ouc (oucault, ault,  977 16)  t ts ew paradg t was ecessary, as a precodto for eectg e ectg treatet, rst to kow t tee criial   s reasos, reasos, s otives, i s er wll , s tedec tedece e s s  s sticts sticts (oucault,  978 9 ). It terefo terefore re becae ecessary to ope up te id of te crial ad a uber of coe co e tators ave ave descrbed ow te eteeth ete eth cetury saw te te prolfer ato of teores postulatig uversal truts about te cral, ad te cral cr al d (for exaple , orsaw orsaw ad ad olli ,  99 990) 0) . owledge of te crial psyche was furter suppleeted by wat Foucault Foucau lt ( 1 978) as tered te costructo of te ssue ssu e of dagerousess.

hs ss ue, orrc ssue was associated te coceptual coceptu probles posed byeteet a seres of atypcal, atypcal offec off ecs swt occurri occu rrig g i te alear early ly decades of the cetury . e ofeces ofeces lked lk ed wth tese cases were probleatc  tat they could ot be attrbuted to eiter logcal reasoig or existg coceptios o saty  Te atter were based upo te otos of furor ad demeta codtos that we were re detiable by teir exteral af a festatos (excesses of passo, rage, ager etc) I respect of tese cases, owever, te beavour be avour appeared appeared to to arse fro a ero ero state of of saity saity (oucault (oucault,,  978 4  hat s,  s, tey struck wtout ay prior warg warg  te for for of exteral exteral sgs of dsturbace o the part of te perpetrator oucault argues tat tey were explaed throug te creatio of the cocept of hocdal oo aa  the dager of saty  ts ost arful arful fo for r ; a axu of cosequeces, a iu of warig (oucault, 978 7) Foucault pes tat tis coceptualiatio sgicatly redeed existig otos of subjectvty by peraet peraetly ly scrb scrbg g te possbty of dagerousess to te socal body Te ctio of hoicdal aia etails that te spectre of dagerousess dagerousess peraetly peraetly iserts tself to socal socal l ife  that vsble oralty ceases to be a guaratee agaist te presece of a ostrous pa pat tolo ology gy (Owe, (Owe,  99   9) 9) hlst te category of hocidal ooaia as log sce bee abadoed, t ca be see tat te detio of psycopaty that has eerged fro te Egls edicolegal tradito  wc te codto s approxated to te otio of oral isaity as uc  coo wt t Psychop Psy chopath athyy as ora isaity isaity ca ca b e trace tracedd to Piel w o   80  descrbed mae sas sas de dere re  a codto charactered charactered by bouts of viole t at-socal behavour occurrg i te t e absece of psycoss Pel suggested suggested tat ts codto could be attrbuted bot to early evroetal expereces ad to costitutioal factors (stct de fure A silar elaborato s give by squirol i 88 who coied the ter foe morae to descrbe a codito caracteried by iparets of te will ad eelgs, tellgece t ellgece retag ts ts tegrity (quoted  Pcot,  978 56) . t Egls psyciatry  85 Pritchard descrbed te cocept of oral beclty, te ai dcators of wic were te occurrece of

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Pathoogica ientities

77

iespnsibe behaiu in he absence f any discenible enal illness Madsey Mad sey spped spped his nin n in and  in an fen qed qed passage passage f f   87 8744 he epdced epdced by he he Eysencks Eys encks descibed i hs h s As hee ae pesns pesns wh cann disingish ceain clus haing wha is caled clu blindness blind ness  s hee ae se wh ae cngenia cngenia ly depied f al sense (qed in ysenck and ysenck 978 97) A f hese hese accns ephasie ephasie psychpahy psychpahy as a disinc cinical c inical eni eniy y whi ch despie he absence f cle clea a bigical  psychlgica psychlgicall celaes is is sngly assciaed assciaed wih paens f ani-scial behai u his  his assciain has cnined hgh he cse f he wenieh cenuy being enshined in successie successie ena healh acs f he  9   Menal Deciency Ac hugh  he Mena Heah Ac f 98 whee i is dened as flws Pot orr   etet oe or blt o  weter o o lg gt t o tellg w rt  bo

ll ggr o ol roble ot o t rt o te ro o HMSO 93 

sychpahy akes as is bec a paicla ype f pahgical self. llwing in he adiin f ine and Esquil nueus heiss hae aeped  elabae a saisfacy deniin f he psychpahic sef ha can be accdaed wihin an hdx cinical faewk An iniia bseain hwee is ha wihin his faewk he nin f psychpahic disde eains a cnenis cnsuc. Signicany he e e  has n pace in eihe f f he aj diagnsic diagnsic syses (D (DSM SM ICD) ; hwee i  des hae analges in h  h e caegy caegy  f ani-scia ani-scia pesna pesnaiy iy disde as specied in DSM-I- (Aeican sychiaic Assciain 994) and in he ICD caegy f disscial pesnaliy disde (ld Healh Oganizain 99) h (99) sggess ha i is aey pssibe  encapslae he ais  an indiidual indiid ual wihi wi hinn a singe diagnsic diagns ic caegy caegy pide pidedd by eihe C CD D  DSM He ang wih he heiss delineaes a fule cinica picue which incdes feaes sch as pahgica egceniciy iaiy an inabiliy  lean f expeience and an inabiliy  display  eceie affecin Se f hese eeens ae incpaed in Cleckleys (964) inuenial diagnsic cieia which ae heseles fuhe ewked by Hae (  98 980) 0) wh sggess sggess ha a cn head  un hgh hese cieiaa is an absence f inepes ciei inepesna na wah  a qali qaliy y which he sgh  idenify in his wn sychpahy checkis: 

  4 5

6

ibness/special cha andise sense f sef wh eed f siuain/pneness  bed ahgical ah gical ying  Cnning/anipuaie. ack  ese  gil

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7

Dctg pycpatgy

7   0   3 4 5 6 7  

Sh allow a Shallow aect  alo/ack o em ah  Paraiticc i e Paraiti et te e Poorr behaiora coro Poo Promic Prom ico o ex exal al beha behaior ior arl beha behaior ior ro robem bem ack o realitic ogerm a miit rreoibiit Faire to accet reoibii or ow actio Ma hortterm marita reaioh Jeile dei deie ec c eocatio eoca tio of coditoa reae

0 r rim im a er eratii atii

lre a a problem for po accon of pychopahy ommo omm o to a  o thee decriio decriio i a edec to emlo exiti exiti  orm

o ocial  accetabe behaior a a bec bechmark hmark agait which to meare or diaoe choath choath    ar hi  hi i i  jied j ied o the th e rod that a marked mark ed diarit bewee he idii i dii da a add ociet ma be deleterio to to both  Fo Forr exam e th thee choah emoioal detachmet, detachmet, halowe, mailatiee, egocerici ad imliit are rait tha ead to the dealatio o the other, hereb tetiaig tetiaig atiocial behaior Howeer he reaioh bewee ocia orm ad choathic eroali ha bee a aricar cocer to oitii exoet o the choath coce o he  he grod ha ree reearch arch ha coitet aied aied to ideti a aricar eroal te wth which articlar orm o diordered behaior emoio ad coiio ca be aociated  reiewig reie wig exitig exitig ieratr ieratree   ackbr (   5   oit t o the ac actt that reio tdie hae aed o ideti a ile te o abormal eroalit whch i roe o chroic rle iolatio ad hae made the taxoomi taxo omicc error o coi ocia deiace with eroa eroa  deiace   a earae artice he cocde ha Pchoathic diorder or atiocial eroali e roali are iml mbre a term which coer a mixed ro o eole who hae i commo o a hitor o ociall deiat behaior lackbr 0 57 Herei lie a ma or diic diicl l  th thee diagoi o  choahi choahicc diorder i the t he abece o cear aeioogca aeio ogca a act ctor or  o roe biological btrate btrate exit ad there i ambigi a o he chooical caatio lackbr    a tatological i i erece occr occr i which the th e diorder diorder ha  come to be dedced rom rom the behaior which it i oed oed to exlai hi robem ha coied to dog choath throhot it hitor eeo  hihigh ome o the abrditie to which thi ca lead

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Patooga ete

79 

He ors ha i praie psyhopahy is iked wih soiay devia behavior o his by argig hasoia soiaorms deviae is isef i sef deed de ed by a fairead o adds oorm o he prevaiig Hee oppoes of  ai re i  ai erma y oppoe oppoes s of segre segregaio gaio i he Ameria soh ad Aparheid i Soh Afria ad rrey Amrias who are o devoed o ireasig heir osmpio dipay a psyhopahi  red (eveso 99 5 He aso arges ha wha is deed as pahoogia y aisoia behavior aso rees rees a ommime ommim e o prevai ig soia vaes ad pois o ha SM-- rieria for Ai-Soia Persoaiy Pers oaiy  isor isorder der make o refere referee e o h praies as as despoiig he evirome ad desroyig oher speies for peroa proi" ma ipaig ohers o heir derime i he od of maageme desroyig he og erm prodive apaiy of a eoomy i he ieres of shorer shorerm m pro" or  sig deepive deepive praies praies o obai pbi ofe  (eveso 992 55

Discourse, race and psychopahy A frher israio of he assoa bewee ormaive ray based jdgemes jdg emes ad spposedy sp posedy objeive iia aegorie aegoriess is provid provided ed

by he reaioship bewee ehiiy ad psyhopahy This is a area ha hihero has reeived ie aeio wihi he heoreia ierare We have fosed fosed po i here sie we regard regard rae  rae as a s a powerf powerf poiia poii a ad disrsive disrsive pheomea ad a d herefore herefore see he ire i rea a reaioship bewee rae ad psyhopahy a a oge eampe of how igisiay based reaiis a deermie boh he idivida eperiee of ma heah ad he dvda oao wh he mea heah sym Saisia differes i he freey ad severiy of mea disress ad he raes of of psyhiari psyhiari digosis wihi eh ehi i grops are are ow widey kow ad have aready bee oidered i haper 3.  ha haper we saw ha paers of over-represeaio wihi ipaie psyhiari seigs have bee desribed amogs Asia ad bak peop he aer geeray haraeried as beig mor ikey o be dagosed as sferig from mea disorder i pariar shiophreia) ha heir whie oerpars. Addiioay we saw ho bak peop wre more ikey ha whie peope o be oeriey iroded ad maiaid wihi he psyhiari sysem hogh he se of ompsory deeio proedres. here is geera agreeme ha bak peopes eperiee wihi he rimia sie sysem paraes heir periee wihi psyhiary i ha ehi eh i mioriy mi oriy grops are are haviy over-repre over-represeed seed a a eve s The e e res of hi s red is a disproporioa res disproporioae e high per perea eage ge of bak pope i he priso sysem  oa ehi mioriy gops omprise  5  5 per e of he mae priso popaio he maoriy of hes (0.7 per e

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Deconstuctin Deco nstucting g psycopatoog psycopatoogy y

g drw rom h Ws IduysAr sugroup Ths s  srkgg ss g h h lr group osus oly 1   pr  o srk h ol UK populo wh h mory groups s  whol, omprsg w omprsg w 4 d 5 pr   o h populo populo ACO , 1 991  1). 

  h  h  sso ssoo o w w h dgoss o psyhophy d  sol hour Blkur, 19 d h llgdly rrry dso whh s o md w h prso o ordry' o odrs  h prso sysm d popl dd  hospl s rl psyhophs Al l  1 9 977 ; Colls, 1 991  ,  mgh  ssum ssumdd h ou o hs ou ouso so sg umrs o h mory groups who hd ommd  sol o os, dsplyd hsors hsors  -sol hour  ldg o o hr rg rg usodl prso prso ss  mgh  m d  d hmsls rg  dgoss dgos s o psycopatic dsordr, ldg o hr h r do  sur psyhr sgs I, howr h p d or gol Sur Us d Spl Hospls Hospls s md  h suos mos llk kly ly o udrk h r d rm o o suh popl popl  h reverse o hs pr s s o  ru I rsp o gol Sur Us  umr o suds h dmo srd h dsp  ss o lk ps hr s  orrspodg s o lk ps dd d d udr h lgl gory o psyhop psyhophy hy Cop d dgw, 1990; Jos d Brry, 194 Wh h Spl Hospls  smlr dsrpy ss ss Whls h mory m ory ps orm orm  dsproporoly hgh prg o h orll p populo ordg o h Spl Hospl D Bs hr r omprly w w h mory h mo ry ps dd dd udr h lgl gory gory o psyhop psyhophy hy .

orrss 194 sudy o h dshrg d gro o ps rom Brodmoor od  ssoo w hy d dgossd 64 pr  o wh Brsh ps wr dgosd s shophr h mjory o h rmdr s psyhoph whrs or h owh poppulo, 92 pr  wr dgosd s shophr d oly  pr po  s psy psyhop hoph. h. O wy w y o oug oug or h s ordo ordo s  o osdr h omm surly o dsourss ou psyhophy d h yps o oj h rl dsours osrus  hs wy SowllSmh 1995 osdrd how hr pprd o h o hd  rud  w wh ws ommoly dd  horl lrur s oh h or urs o wh , m l sujy d h or ur wh urss o psyho psyhophy phy d, o h ohrr hd,  gos rloshp oh rloshp w hs hs sm or lms o h psyhophy op d h psyhologl  urs urs rud o h lk W ml h lrdy lr dy od som o h h ky k y lms lm s  horl dsours ou psyhophy Hsorlly hs dsourss g rs o  prulr ypolo yp ology gy  h o hom homdl dl moom   whh so sol l hour hour ws dd wh  prulr modl o md  h prs dy h

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Patoogica identitie

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i  i ubiu or or pr proaiy oaiy bu  hr i coo rou rou i ha h ic o hi al iy i aai ik wih h occurrc o ai ocial bhaviour h prviouly crib uy by SowllSih 1995) ouh ao ohr h o plor h rlaiohip bw pro ioal praaic appicaio o h pychopahy cocp a hir orulaio o h black pych  aociaio o i hi uy wa ha pychopahy wa or ooly ii a a iiviual paholoy pr a wha wr coru a a araio o oral rai. oral rai icu h  or auooy a ary. h pr i hir ara or hy wr crib a ai o a iali bw h iiviual a hir couiy  orr o ry hi pychohra puic irvio wa  cary. hi wa ocu a h lv o h indiidua, a obciv o ra bi h coura o rpoibl iiv i iviuali iuali  a a prcoiio o liv livi i a or aiacor aiacoryy li wihi h couiy Rac a icour ha b coir by a ubr o hori. Mil  1 989: 10 ) or apl apl  aru aru ha racial icour icour ca b cociv cociv a a a y o iir whch whc h r i a ia  iaci cicc bw bw S a hr i which h aribu characriic o hr rrac corai characr iic o S a vic vra. Sapo 1993a 1993b) wrii i h Ui Sa coir rac aohr aiaio o hi hr rlaiohip arui ha iio o racial ioriy roup r aai h backrou o h ab aar o h whi Ui Saia or. Boh Mrcr 1986) a hrl a Por 992) or iiar accou arui ha rac a h ra cocp o cuur cu ur a a hici hic iy y ca ac a a a li liuii uiicc rou rourc rc hrouh whi ch variou or o ubjciviy ar brouh io bi.  ioucio o icours abou rac a cuur io  ciica

oai i uually  a havi h bi oiv o rlaivizi irc a aciia urai o ohr culur  h uy coir hr i wa appar ha whi icour abou rac a cuur ih a o lvl b or a havi a poialy uivra applicaio a aohr v hy rai ry ocu upo back pai voki ia o irc a ohr. h ia wr paricularly appar i raculura accou o al iorr. h accou appar boh a a cohr work o a i hlv h lv a a a co r or or ha ha o o rac   o orr h black bl ack pai culur wa pr a a ourc o pycholocal uac or  A corollary o h poiio wa ha whil ilocaio ro h aiv culur wa cociv a bi poially pahoic rocaio wihi i ururi prc appar o hol ou hrapuic opporui i I hi  icour abou cuur provi a horical lo poulai roup iicaio a a pychooical  or black popl) which riorc o o h crur ia ircly ici ro

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Decotuctig pycopatoog pycopatoogy y

intiw patiipants onning th ommuna aspts o th bak is isty ty   An   t t o this typ o disous disous is that idosynati idosyna ti atu atus s o th bak subt w not sb th hathy bak subjt was sn as on who was p on pty ty nttwnd n ttwnd with hs h s o h utu utu to suh suh an xtnt xt nt that thy th y oud a most b gad gaddd as a iph o that that utu Aounts whih dnd th whit subjt how w oganzd aound a qut dnt st o thms Most onspiuous amongst ths was th mphass mphas s upon th xstn o n apsy apsyhi hi quaits  suh as th unonsious and ogntons and mbd inddua quats suh as dangousnss  Th Ths s smd to at at a p-gin p-gin i nnwod o th whit subjt stting him apat om th soio-utua ontxt and ndowing hm wth a sns o iiviuaity. Th wht subjt was oatd as an  nta ntatt pat o a dhotomous tonshp btwn th ind idua idua and th xtna wod Th hathy whit subjt was th on who was ab to attan m ast asty y and autonomy o th thats o th xtna wod . Th typ o ps ndiduaism assoiatd wth th noton o psyhopathy tho nompatib nomat assumptons mad about baksms ma quit subjtiity Hnwith nn 967 quotd in Mod  982 89) mg mght ht not mnton mn ton skn sk n oou n dsbng dsbng th psyho psyhopat pathh thus th us Th T h h hoo o o ou ou ag is th th psy psyh hop opat athh   .  om sponsbiity  om gut  om anxity h pusus hs goas opoation psdnts statsmn duatos physiian his aing is iant; his aus a ywh th sam   How How  w ntuit  ntuitiy iy a az z that th psyhopa psyhopath th whh wh h h onia  y dsb dsbs s h h  oud not b anythin g oth than wht 

The y-colex and he endurn aeal o ychoahy n pious stions w ha dning onsidd som o th onning th possibity o ohnty psyho psyhopathy pathy as pssimsm a nia ntity n tity This pssmism pssm ism is podud podud in attmpts to spiy spiy an d impmnt imp mnt appo appopiat piat oms o tatmnt.

Pssmism about tatmnt an b datd bak to th 960s whn a onsnsua w mgd mgd that th th  99 Mnta Hath A Att had bn o ambtous n th o t had xtndd to psyhiaty in th tatmnt o psyhopathy This tnd was aknowdgd by th appnding o a tat abty qumnt to psyhopathy in th 983 Mnta Hath At somthing whh i m td th th n umb o o HS nts D and obts obtson on  1 988 27) po pot t that that in ] 984 th w ony  suh mn dtand in NH S hosptas und st stion ion 3 o th th 983 Mnta Hath A Att  Th suts o sah xaminng th tinss o tatmnts o pop dnd as haing a psyhopath disod s n gna ith quioa o disapponting disapponting.. A gna impsson is gaind o an atttud o sptism spti sm towads th possib possib iit iityy o su suss ssu u tatmn tatmntt Doa Doann and oid

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Patooga dettes

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(199 267 akoedge th atttude but add that reearher have repeated aed to deveop dev eop tratege or or ether provg or dprovg the eetvee o treatet th phopath ad the ugget that ept  about the treatabt o phop phopath ath a     part reut ro ro the proeoa adequate aeet  the rt pae ooed b a abt ab t to deveop deveop  derbe ad reearh ad adequate deotrate deotrate the ea o treatet tratege Soe o th th ept ept  otaed  the bee be e about the phopath phop ath at to dpa a eve o ttutoa adjutet hh oea ther uderg propet propet or urther atoa atoa behavour behav our Fauk ( 1 990 990  or or eape due tude hh have evauated Gredo phatr pro (a ttuto hh ota ate broad ategored a beg phopatha dordered e ugget that he opared to a oparabe pro popuato popuat o the th e hoed a greater degree o adjut adjutet et ad redued eurot ptoatoog hoever eve o atoa behavour behavo ur  ree reeted ted  rate rate o re reo oedg  at both a to ad teear teear oo up hoed o d deree eree A A  a pe eape o th tred tred  Roth (1990: 447 te roadoor the ae o but Graha ho pooed three peope paed through ooYoug ater beg dharged otted ar oee th te poog a group o orkate ad Roth rte rt e that havg bee arreted At hoe ere oud a a [] ebe eb e drag o graveard graveard ad other othe r objet aetg aetg adt atae I h h  a ear o oeet oeet  road roadoor oor he had bee quet o oeve ad e behaved Doubt about the ueue o treatet aed to the prevou derbed dute  o oerg erg a atator derpto o phopath phopath  uderp the debate a to hether the ategor o phopath ght be reoved ro the eta heath egato Rao (196 argue hoeve that ethe eatt o deto or dute th treatet are uet to dodge phopath ro t pae th the eta heath te She pot out that up ut the 1940 phopath reeved tte atteto th atrea gh phatr ad argue that evet durg the Seod ord ar haged th o ator are partuar partuar  gat gat  Frt Frt the eed or or oheo ad produtvt durg the ar ed to a epao o the pp-ope ope ad to the p phoo hoog g ato o evera tpe o oa uderabe o-produtve behavour I th th  ee t reeted the reag aoato aoato  betee phoog ad

produ prod ut tv vt t  h hh h the the ade adequ quat atee ad ad    the optu utog o the dvdua ubjetvt ha bee redeed  ter o t reato to produto (Mer 196 17 A evdee o th aoato Rao pot out that durg the ar the death peat or deerto a revoked ad deerter ere ore ed e d to be treated a hav havg g deabe phooga pho oga eed  eed hh oud pob pob be et b the ork o Fouke o e t a  o the treatet ad reoaato Fouke reoaato o phatr phatra a dturbed oder (a ategor hh a aued to ude phopath

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Deconstructin Deconstruc tin psycoptoo psycop tooy y

through the use o therapeuti ommunity. Seondly there was a need to aount or atroities ommitted not ust by the enemy but by the alies Ramon suggest suggestss that th thee onept o psyhopathy psyhopathy proided proided a useu means mea ns o promoting a psyhoogia expanation that shited blame away rom wider soial inuenes and on to indiidua psyhopathology Ramon 1986). Ramon thereore, argues that psyhopathy ontinues to proide yet another oneptua oation within disiplinary soiety through whih partiular orms o subjetiity ome to be insrbed positioned and reguated. Its enduring endurin g appea is based upon those eatures eatures whih proid proided ed the impetus or its inreased popuarity during the Seond orld ar namey its apaty or proiding a medioega basis or aounting or and organizing persistent oenders whose ant-soial nonprodutie behaiour ould not be readily understood or deat with either by the existing rimina  usti ustie e or wear wearee systems systems 

Leal ad lal eleme  dre ab yhahy e saw earlier how both historia and ontemporary appiations o the ategory o psyhopathy integrated eements o both legal and inial disourse the ormer ormer pertaining pertainin g to issues o ontrol, the latter to issues o pathology and treatme treatme nt  his i s partiulary apparent apparent when the position o patients pati ents detained in Speial ospitas under the legal ategory ategory o psyho pathy is examined. e aso desribed how psyhopathy has reeied imited attention within manstream psyhiatri institutions and that, in genera , the ontainme nt o  psyh psyhopath opathss has been res restri trite tedd t o orensi orensi i nstitution s. his trend reets the need to proide a degree o ontrol oer the anti-soia anti-soiall behaiour o the psyhopath no longer aailable in genera psyhiatri settings, whose moement away rom segregatie ontro eetiey meant that only seure institutions had the aiities to manage the partiular set o probems posed by this group Pigrim and Rogers 199 14) For a ariety o reasons the treatment o psyhopathy is something whih has been oused upon in the three English Speia ospitals  Broadmoor Rampton and Ashworth. he most reently aaiable statis tis hae shown the population o psyhopathially psyhopathially disordered disordered patients to stand at 86, omprising 4 per ent o the tota Speial ospital populationn . In al populatio a l but two ases ases eah person person was detained under setions o o the 98 ental ealth At amilton 990)

Critial historians who hae eshewed the traditiona narratie o enlightenment and progress within whih onentonal aounts o the rise o psyhiatry are oten written hae noted how rom their eariest origins, regimes Speialis ospitals hae always embrae em braeddsegregatie issues o ontro ontro. . hesuh issue as o ontro m ad adee expliit explii t within the

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Paoogica idenities

85

Spcil ospil  is lgl lgl foundion foundion  h  97 9777 i ionl onl lh Sic Sic Ac  quiing i o po poid id boh mn nd  s scu cui i y. Richmn nd Mson (1 992 comm commn n upon h wy in which Spcil ospils mploy  ocbuly ldn ldn wih ms such s c nd mn m n which h hss mny m ny similiis sim iliis o h mployd in oh oh  mdicl sblishmns. ow ow  in h conx of h Spcil ospil hs similiis my b illusoy nc mdicl concps such s c nd mn   i mpo mpo dd ino in o h Spcil ospil bu bu  whn linkd o  o hos ciminologicl nd cusodil cusodil concps which  mo indici indici  of h nd fo conol conol  hy cqui cqui  qui diffn diffn mning mnin g nd pupos pupos Tnsions mg whn pins h succssf succ ssfull ullyy compld compld hi mn'  mn' o c pogmm pogmm bu  ih sill und sicions o  sill considd dngous by ousid gncis gnci s nd hnc cnno cnno l l h h hospil hospil (Bowdn (Bowdn  98  Gosin 986. Som of hs condicions  bough ou by sudis which h shown lngh of sy in h Spcil ospil o col wih siy of offnding bhiou h hn psychologicl funcioning (ois 98 nc h mo s h h offnc offnc h long h mn m n quid qui d Th conolmn ssociion ssociion hs lso lso bn bn highlighd hig hlighd by Gounds ( 987 who sudid h nsf of inms fom pison o Spcil ospil bwn 1960 nd 1983  nod h hough h cous of his piod snncd pisons w likly o b fd o hospil   poin incsingly n o hi lis d of ls This nd suggsd h h conol nd polongd cusody of h inms h hn hi c nd mn ws h pim considion mongs boh h fing gns nd hos insiuions which cid hm. A simil picu is dlopd by Dll nd Robson (1988 in hi ccoun of of non-psychoic(h non-psychoic(h i s psyc psychop hophic hic mn in Bodmo Bodmoo o Thi Thi udy m  num of lin oin. i  h  of h sudy mn ppd ppd o b b gin  low low pioiy  wih only on ly  minoiy min oiy of mn  35 p cn  picipi piciping ng in ny fom fom of psyc psycholo hologicl gicl hpy hpy Th Th uhos simd h fo h moiy of hi im in hospil non psychoic mn w nggd in no spcic mn Scondly n iud of scpicism owds mn ws licid fom Bodmoo consulns Consulns w ofn unbl o dn h spcic hlp quid by pins which hy hd dmid und h psychophic cgoy nd i n only 38 p cn of cs csss ws i xpcd h h poision of psychologicl mn would mk mo of  difnc hn h simpl pssing of im im  Thidly dspi h complxiy of issus suound suound ing h dischg of pins fom h hospil on fco mind consn  no on dind und his  his cgoy ws ws poposd poposd fo dischg dischg bfo  piod of 3 ys f hi dmission hd lpsd Dll nd Robson (1988: 116 conclud fom hs fcs h whils i migh b ofcilly dnid pins dmid o Spcil ospil und h psycho

phic cgoy w xpcd o py bck im fo cim Considd This SAGE ebook is copyright and is supplied supplied by Dawsonera. Unauthorised distribution forbidden.

 

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Dostructig psychopthology

og  udi ugg  cliicl m iu   l  qul i o ubodi u o cuodil d lgl o

Discurse, identity and psychpathy in the Special Hspital Ou li o  cgo o pcop  o  ow up  ild m:   mgc o  cgo   polog coucd   om o ubjcivi md poibl wii  modi pim; codl  u lioip bw ciic modl o pcop d wid ocil pcop ocil om  d idl i dl i  lio o  bov bov   o ciic  cli icl pcic  coiu coiuig ig  pc pcop op   dbl d bl  cbl i   dd  mo pgmic ocliicl  o pplicio coiig  igic lgl lm d big cocd wi  coim coi m d d dio io o pcop pcop wii cu gim I i cocludig ci w will k o ig  umb o  m b coidig  mpiicl xmpl o ow picul dicou  pld ou wii  ig o  Spcil Hopil (   w will lik o H publiccollciv domi d ow uc dicou op oug  poc o imilio d publicio   liguiic ouc oug wic idividul wo v civd  dig oi o pcop pcop  mk  o mlv mlv d o I  ud  ud bi dcibd   mp w md o idi d dli   viou ccou d mod o lk bou pcop pcop  d mog    d pi populio wii  Spcil Hopil  Accou o pcop w idid pimil oug  pplicio o Q modolog (Mc  ow ow d om  98 988 8   p p o p p lic ppoc  pupo o idi id i coguio o popoiio popoiio wii  populio popul io o i i  I i ud  popoiio popoiio  w w divd om om wo wo ouc  om   oicl li u o pcop d d om mi mi ucud iviw coducdbou wi  pi pi  d io   wii wii  Spcil Spcio l Hopil  Sixo Six o m bou   cu di diio dm pcop w divd om  ouc d  w  od log  po mix (gdig i ccodc wi  ocd  po po  om om  Fo Fo  picip compld   Q o o compiig com piig 3  poiol  om  g o dicipli d i pi ll o wom w did ud  lgl cgo o pcop  po w co ld d  popoiio coiuig  mg co ipd  iviw om wic om o  m w divd di vd w cibd d povidd  ouc o d o illu om o  poibl w i wic bo  d pi dplod d wokd wi  idid ccou  ccou w coidd   i o cocpul locio o x wii wic

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Patoogica idtiti

87

ndduals sbject to detenton by the lea cateoy o psychopathy could be ead and postoned (D aes and Ha  99 99  he esuts esuts o ths smal study eected a wde spectum o descptons o psychopathy Analyss dented sx ntepetable actos and be detals o these ae en below  T tr trata atab b pycopa pycopat t  hs acto amed the ole o adese le

expeences and enonmental actos n nuencn the abeant

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behaou o the psychopath It dsmssed the eeance o ntnsc boloca eatues eatues o xed psycholocal psycholocal tats tat s and o o these easons seemed to oe oe the hope o chane thouh the ecept o psychooca teatment and the poson o a moe nutun enonment  T autoomou autoomou pyc pyco opat pat  Deant antsocal behaou s ascbed to olton and s not attbutabe to enonmenta actos Psychopathyy s locate Psychopath locatedd as a om om o  estyle whch wh ch cetan ceta n ndduas hae elected elected to to adopt adopt In a smla way psychopaths can wl the own eco e coey ey onsste onsstent nt wth ths account account one n tee eew w patcpant patcpant  a patnt  desc descbed bed a ctcal ctcal moment mom ent n hs l e when he was was cononted cononted wth a choce between a conentonal o moe antsocal lestye and chose th atte  T ictim ictim of ab abig ig  Psychopathy s pesented as a labe that makes abtay dstnctons dstn ctons between ops o people people It thee theeoe oe has ttle scentc scent c alue but sues as a lea cateoy cateoy whch s employed to euate and detan n secu nsttutons unconentonal non conomn con omn oups o antsoca oups  T parat popuatio hs acto downplayed the causal sn cance o e expeence and the enonment to the deeopment o psychopathy and constucted the psychopath almost as a sepaate speces spece s wth nque nq ue  dosyncatc chaactestcs thn ths naate naate th coe eatues o nne eaty o the psychopath wee pesented as mmutabe mm utabe so that th at a popensty o o antsocal behaou was peseed  Pycopat a a  a ap apparac parac ad a rait raity' y'  hs appealed to notons o the psychopath han an undelyn depth-ealty whch was nheently bad e and unchann and a suaceappeaance thouh whch supecal conomty to soca and nsttutona noms wee a aected Illustate o ths poston was one nteew patcpant who spoke o an nmate at endon Undewood whom she descbed as ben psychopathc as han a st class honous deee n endon lanuae  Pycopaty i a obj objcti cti citic citic ab  hs pesented a conen tonal  mpcst account o psychopa psychopath thy y epesentn t as a cate cateoy oy that s neutay and accuately apped to descbe an aleady ntact oup o people

he eatonshp between powe anuae and the sel was mpled by the act that despte the act that many o these accounts dd not seem

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Deconstructing psycopato psycopatoo ogy gy

partiularly ur rindly rindly to pyhopath pyhopath  apparin to to xpr xpr a omb inati ination on o yniim an andd thraputi pimim  h hr r wa wa vidn providd in i ntrviw with patint o thm bin bin  radily tan up  hr hr ar vral poibl raon or thi n xplanation miht b that th aount o pyhopathy idntid by Q analyi wr amont th mor powrul or plauibl on in irulation within th intitution and in thi n thr wr ri in ailin to idntiy with thm. hottr (1993 ha arud that vryday vryday raonin and an d diour diour ha a oriv oriv quality to it  ior n a muh that it i  onl by in w in an d to talin aboutid about thin thin n a r rim imnt ntdd i ntitution ntitutionalizd alizd wayy that om b ronid ron by iothr mmbr o a om om munity a r rp ponibl onibl and omptnt Barr Barrtt tt ( 1 988 988 ha i ndia ndiatd td how thi pro miht b aumntd whn it oprat in pyhiatri ttin H ut that throuh rpatd amnt and intration with proional ta patint inrainly om to dn thir xpri n in rlation to proional norm and atori and a uh om to b n a omptnt patint h rvr o thi  howvr i that thy ri rtion or dirditation throuh idntiyin with mor priphral un orthodox orm orm o nowld h aount dribd hr hr an alo b n a dnin dni n th boundari boundar i o  a partiular onptual univr How w rt upon and dn ourlv i dtrmind and ontraind by th trutur o nowld availa bl to u within that univr availabl uni vr  A thi tudy ut utdd that th abov dription wr amont th mor popular and viibl it hould not b n a urpriin that thy wr dployd a part o popl' vryday attmpt to ma n o thmlv and th world n intrviw th  moray mor ay o ori riv v pu  o anua anua oranizd oranizd throuh throuh diour diour  wa illutratd by th rutratio rutrationn o patint patint who who  havi n initia in itially lly xprd thir oppoition to th trm pyhopath' ound thmlv durin th our o th intrviw inorporatin th trm in thir dription dri ption o thmlv and othr. Hr it md that th intitutional voabulary wa o o aturatd with thi partiular lxial itm it m that th at it bam diult to avoid uin it i t  A nu mbr o in trvi trviw w xprd antipathy to th onpt but thn a th intrviw prord ound thmlv mployin th trm quit radil radily y For xampl xampl  on i ntrv ntrviw iw aid: nne e or        o n  nne nne o   o o   no no  en o n nn ebe e I  ono r  I  ng  er o b og I  onn ng i I i ie i n  ene.

An additional ad ditional at atur ur o o th diuriv diuriv matrial idntid i dntid onrnd it ontraditory ontradito ry pattrn and pra prati. ti. om diour diour ar opnly antaon iti (or xampl h tratabl pyhopath' ompard to h parat population diour hatvr th xplanation or thi variation mut b onidrd hihly rlvant to th rlationhip btwn lanua and idn tity  Davi Davi and Harr (  990 46 hav u utd td that a prolira proliration tion o ontraditory diour allow or at lat th poibility o notional hoi' by ivin to th pron om rdom ovr whih partiular

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dene e ahlgcal den

89

rrtiv r tr t  d gg i rr 983)  rgud tt

idtit ut t t iilti  ill vilbl tri d tplt  b ltig t b t ubjt r bjt   prtiulr rrtiv r diur t idividul  b   ivig t ti uti  lgug dplig  prtiulr ut   ttpt t rt  p r piti witi wi  prtiulr r  idtit uld rg Fr pl t dpti   bjtivit ut  p pt igt b itd wit iti rptbilit  lbllig ut wit big rdil  d  pp ppr r  rlit ut wit big trtwi   uggti d r i tt i dvlpig d wrig wit prtiulr tp  trditr trditr rrtiv i it trviw rviw  wr t big iitt but bu t wr ggd i  r  idtit pliti  ttptig t gtit  vu vurbl rbl idtit i dtit r tlv trug t dplt    tt i prptiv wi piz t acn rtr t rrtil uti  lgug llw u t  bt t uidit d ultipliit ultipli it  idtit idtit   tp tp  ppt ppti i idtit wi wi  w v v dribd r  b   itrill trutd itig plitil trut ivd r ttil purp rtr t t iti dlit wit  rid ir tt  ppr  ttl ttl itig itig  tr piti d t   vt wi t iv llw u  glip  t t l   r r t t   u  u  ubj ubjtiviti tiviti   tt i rlti t dirt tp  trditr tt lrdi 98) Fr t w r bl t grp grp t ti uti  diur d r bl t rt up tlv  t bjt   iti diur tr i t pibilit  uull ritig rgilizti r dvluti Fr u ppl wvr  trt i t pd b big t ll ligd wit t il rdr d  lig idividulit I ti  Brrtt 988)  dribd w pitri ptit trug t ur  rptd t  irigl t d tir pri i rd wit  pril diti  pitri ill A u t  t b  b liii  ptt ptit w idi rti quliti r wllwd up witi glbl pitri tgri  t t  r u u ppl ppl  d r r t ptit i ti tud w w  il i l idtit id tit i  tru trutd td witi t rrtiv rrtiv dribd bv i i  t rti    uiqu trug ritig t ppri  dit rrtiv  pttil r u rit rit i prittd pritt d b t til ti l i tt prit t ipulti  trditr diuriv tril i rd  wit t dd  t diuriv tt i urrd witi itrviw  prtiipt vd trug  vrit  dirt diuriv piti  llwig trt i irl rprttiv  ti pttr At  rl tg tg i  t itrviw itrvi w t prtiipt  ptit pti t pp ppr r t dpt dpt  bjtivit piti Erm, yes [ae]. Obvio Obviously usly on m y denitions already I v vee shown or said about two diff diffeen ypes of psychopah psychopah Er its where you draw he i ne eay. 's ke

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90

De De   pyhpathg pyhpathg   go  o t o o t t  t o wt  [] t wo   

A a  ae pn he abane f dagn dagn and denn   emphazed emphazed  o g  go o  to  o g   

t o tg  ot og tkg to o  t  to t  ot t   t o og  wt t  w    t t 

Sen nn f eame wee a deded when  wa aked whehe he pn f any kd f amen nened hange O   t o t   t     o g t o  to t  oo  o o tt   to   ot ot  t t  ok w o t  t o  o got to o  t  O o o t t ot o t tt  t  t ot wt  o    tt t o    t  o t  t got ot to  oo  ot w wt t gog t o So t got to    t ow  t   t  ttg w  ow  gt ow  tg to t tt ot o to t o wo  t

he paen  heefe aepg he dmnan de b mbnng h wh a me pephea de de ne n epea epean n f h eqene eqene  ha by dawng pn h be epee he paenpyhpah  ae  defend agan bemng he mde paen he mee phe a he ene f he     y deepng a p p ha  a aane aane wh he eahed de S m a ean   e ffe ffeed ed y deepng a pn aed pn a epaae ppan   fadeph y ne naae whh nad and haeg he dman de f bey and eame he pn adpd he mgh emphaze he nheen dffeen dff eene e f he pyh pyhpah pah  nd hee he mp mpb by y f  png png hem n he a de de  n ny y   mgh e he he fa fa ha hange hange hgh eamn epe ny ke mpane n he pa f he pyhpah. ndeneah he deyng penay e eman na and hene dday  peeed

Cocludig commets n h hape we ha gh  ge fhe ndean  he way n whh anga angage ge n e ee e  epe epee ene ne  f  f and  f mena de de e ha e eped eped h  hgh hgh a eamna f he way n wh whh h bj bje ey y mgh mg h me g gee n ea  pyha e e hae hae ney ney aded aded mak ng he  ndda  he f f f  anay ana y and hae he henn n  ead ead  eamne he de de p pe e hg hghh whh he ndda  he dange dange  man  he pyhah pyhah  ha een een gh n beng n ean  h ex

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Pahlical ideni ideniies ies

9

 hv td hw th tt r t t th pr d prvd tp  lwld d udrtd  l td hw th trlzt   prtur tt r tl hlth tr uh  phpth  td wth th prt  ujtt th ut  th tt r tr tvl prtpt   dur tht tr d rult thr lvd rlt. A uh th tt w lw r th jut wrd  hv dtrutd t  dtt hr trt  phpth dtt t hw hw th   w

ld t tt d ut  tutd  prtulr r  truth d pwr  wll dr urthr th tur  durv pwr  rlt t pht lu    th t h w hptr

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6

Pychotc Dco This hpte ooks t eseh on lnguge nd the wys in whih tdition psyhiti wok on psyhosis whih podues  iul

gument onm existing els n e hllenged Some ltentive theoetitoppohes dwing on pgmti psyhonlyti nd n tive thepy ides e desied Impitions o eh o these dieent wys o intepeting nom tlk e exploed

Clinical disorders in langage In pevious hptes we hve disussed the ent oe o nguge in the podution o psyhopthoogy We hve exmined the wys in whih utul disou di souses ses ente into in to nd in in om poession poession ntives nd hve n nysed how lnguge is t oe o po poession ession pties pt ies o dignosis ndysed ssition nd o thethe onstution o pthologil identities. We hve seen how y oneng the oe tht nguge plys in the podution o ini tegoies nd pties these tegoies nd pties e e ntulied ntulied nd  ustied n this hpte we wil move om om this nlysis o the wy lnguge untions in onstuting nd justiying linil tegoies to the wy lnguge is tken s the sujet o lini eseh u topi he wil e eseh on psyhoptholo psyhopthologil gil speeh in psyhity nd linil psyhoogy his shit in pespetive wi low us to ompement the nysis we deveoped in the pevious hptes with the exmintion o  seies seies o new question s ist we wi w i use inil in il eseh eseh on psyhopthoogil psyhopthoogil speeh speeh s one moe exmple o how pthoog pthoogyy  in thi thiss se se pthologi pthologil l lnguge  is onstuted y poe poession ssion pties pties  We wil ook t the eseh nd lini poedues though whih individuls ome to e dignosed s speeh disodeed. Seondly we wil exmine how the tegoy o speeh disode hs een onst onstuted uted y psyhiti eseh on lnguge nd speeh The gument we wil pusue is tht psyhiti eseh does not simpy desie nd lssiy hteistis o goups o individuls ut tht it tivey otrut  veson o oth noml nd

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Psychoc dscors

3

abrmal ph, whh  h appld  dvdual wh d up bg ad a rmal r abrma Mrvr w wl llura h muual rla  uppr bw lal rarh ad pra  rprdug la agr  wll  hw rarh draw  g lal agr ad hw  ru ar d bak  h dag ym hrdly hr dly h aaly aaly   rar rarh h  pahl pah lga gall laguag laguag wll w ll allw u  rval aump abu laguag ad ph ha udrl ad mak pbl bh rarh ad pra  dag ad laa  hav argud  h prvu hapr ha laguag d  mrly dr d rb b r pla pla , bu bu  ha  ru  bj  Pyhar Pyhar  laguag, mbddd  rarh ad la pra u h vry pah lgal phma   k  pla  Pyhary hwvr, prd   b     prd  udy ad a ay y wha  u hr, hr ,    dvdual md ad bd  a ural ad bjv way h, w wll argu  h hapr,  h   pyhar dal  h uv rl  laguag ad  h adp  h vw ha aguag  a ural ad

rapar ma  brvg ra raly By lkg a hw pyhar rarh ha udd pyhpahlgal ph w wll urav aump abu laguag ad ph ha udrl pyhar rarh rar h ad pra pra Fall y h  h rm  h h aum aump p wl lad u ward hr hr  h aur ad u  laguag ad ph p h  h h  d d hal  h hapr w wl am h hr  wl k a h h  way hy a b appld  h udy  pyh pyhpah pah lga ph ad a h pbl hy r r a -pahlgzg vw  dr  laguag  h  h a u  u  h hapr  aadd a hr  Alhugh h bklaguag h  w wa mp p  u h h a ur ur    hza hz  laguag aguag  a pwrul ma  rug ad maag ral  h a  pyha ah  ph h ra prdud vlv pahlgza lg ad margalza  h grup  dvdual ha all udr  auhry S laguag ha playd a majr rl    h h  dyam  pahlgza ur am     u h am ma  hghgh hgh gh , ad pa pally lly vrur    Our u  laguag laguag  a aal   pyhar rarh ad pra ha b abl  pra by lavg  udrlyg aump uarulad uarulad ad, hrr, uqud ur druv ak   arula h aump By hrwg hrwg lgh  hm , w wll b abl  qu qu hm , rva hr rad rad  ad adqua ad p up h way w ay  alrav ha  ha wuld ru ru l l pahlgzg ad mr mapag ral  Our   a qu r ruh   hr   ruh hr  hr  aguag r byd   p way  whh laguag  rgazd prdu p  ruh  w am  dablz hm ad ab ab alrav ruh ha wl l mpwr ad  margalz ha margalzg g h dvdual wh ph pr p r  ad bhavur al ud wha ha m    b dd a h  h rm

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94

Deconstructing psychopthoogy

Our aaly o h laua o pychopaholoy wll ocu o clcal rarch o pychoc pch u o h aumpo  pychary ha pch dordr  o o h ma ma  charac characrc rc o pycho ra rarch rch o pychoc pch  much mor v ha rarch o h pch o ay ohr pychopaholocal roup Furhrmor pychoc pch ha  codrd h rm o paholocal pch Rarch o py choc pch  h h  ampl or h aaly o how aump o aou ormal ad paholocal pch ar producd ad how h polary w hm  corucd

The onept of thought disorder h udy o pychoc pch da a ar ack a h  o h cury Boh Blulr ( 195 195 [9 1]) ad Krapl (199) codrd pch dordr o o h ma characrc o chzophra h aumpo  ll prval oday Spch dordr  o o h ma crra or h dao o chzophra ad ohr pychoc dordr

orovr B lulr ad Krapl  clam ha ad v orovr v horz horz ad rarch o h aur a ur o pychoc houh ad pch pch  Elucda h mcha mcham m o pychoc pch ha  codrd a cral cral way o udrad h aur o h cov ad urophyolocal acor uppodly rpol or a pychoc rakdow Krapl (1919) r alhd h dco dco  w dordr o h content o houh d dordr o h orm  whch houh ar prd corrpod rouhly houh h lar h udormr o dcr dordrd dordrd pcoh  dluoal pch h dco ha whl  rad o h pr wh dordrd pch dcrd a ormal houh dordr or mply thought isorer. p clam ha h rm houh dordr  mlad cau  qua houh ad pch Adra Adra 1979) ad dp amp o duh orval pch phoma rom rrd houh proc Chaka 99) h rm ha urvvd o h pr a o o h ma crra or h dao o chzophra ad ohr pychoc dordr Sud o the prelence prel ence of tho though ughtt isorer hav how ha   o a dcv characrc o chzophra a wa ally lvd Blulr 195 [191]) u ha   alo pr  ohr pychoc ad opychoc roup ad  ormal pakr pakr  pcally udr codo o r ad a au u Adra Adra  a   1985; Harrow  a 987). orovr  ha  ackowldd ha o all dvdual daod a pychoc pr houh dordr ad ha h o who do do o oly rmly Adr Adra a   a   1985; Pavy 98; Roch Rochr r ad ar ar 1979) Rarch o houh dordr ha rd o addr a r o prolm opd opd up  y h d d Fr h prolm o wh y oly om

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 cu P

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dvduas dagsd as sychc s huh dsd ad dbas abu whh a sgdsd udyg a cud xa  bh sc ad ack  hugh  d dvduas  h sam dvdua Scdy h ackwdgm ha hugh dsd s va   bh sych ad -sychc  -sychc gus c cd d sachs  vsga whh sc gus cud b dad by h au ad dg  hugh hugh dsd ha chaacs chaacs hm 

Reearch on thouht diorder h suds  h au ad chaacss  hugh dsd ca b bady cassd  h ma cags cca abay ad aua aguag sach avy ad a 

inica research ca sach mgd m h awdgm h h ms usd  dscb hugh dsd  h maj dagsc ssms Ama Psychac Assca 7 S ad dc  - hc gca hkg, sg  assas, mad udsadaby 

w   vagu vagu , ad  h  h   usu ab  vad ad ab  dagss dagss h am  h sach was  aa h cc  hugh dsd ad mak  m dab  sach ad dags uss uss aa a ccd  m m c ca  v vws ws (Adas (Adas  97 ad vba sg ssss (aw ad ua  Jhs ad ma , d th chcteiti nd dee f t h  u h t did e eed by ad as Adas 7 s h s  h hugh aguag ad Cmmu Cmmu ca sd sdss dx  dx wh h ca m ha hugh dsd dsd s y  sch hma ad h  shud b auy aad m d udyg hugh csss h dx sh csucd hwv s susd  mas bh hugh aguag ad cmmuca  aus h scas (Haw ad ua  Jhs ad Hma 7 cud v m dvg hma hy a dsgd  masu aus  h syaa gammaca ad xca v aus  bsv vsaa us dva m h us  gc ad cmmss cmm ss ccs , ad  a aa a a  v v ad sych sych m bhavu Lavg asd h us   ad hw hs scas masu h acs hy a susd  masu h basc mss  such a s  d  b usd us d   wds hw suh a vay  gusc, cmmucaa ad bhavua hma ca b sd ud  cc , ha  hugh ud hugh dsd dsd h us cms v v

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96

Decnsrcn psychpahly

or iportt ipor tt i light li ght o th  t tht thought thou ght diordr ii origill orig ill t to d pulir ph  l r uppod to ur bothrthub-or qulit dhih th dgr o thougt diordr For thi purpo thr giv t ur o dirt group o pho  ll  th totl thought diordr or or Although th ubor ubor hv hv b ud i o tudi tudi  it i t totl or tht i idl ud i rrh d liil or. h oqu i tht idividul oud to b thougt diordrd  dipl  vrit o ph d bhviour puliriti. o idividul ith th  dgr o thought diordr  prt opltl dir dirt t ph d bviour hought diordr h bo  ubrll tr udr hih  tp o p ph h d bhviour bhvi our pulirit  b iludd h tur o diordr i lo quit problti hought diordr l r t to ur dvi but thr i o diuio bout ht thought diordrd idividul r uppod to dvit rm. h or i ot th  orl pr tl. hi i obviou ro th t tht thr i o diuio i th l o th  tht th orit o th pig popultio tl Morovr orl or l pr pr r lo oud oud to v  ild dgr dgr  o thoug thought ht diordr h l hv b otrutd otrutd it uptio ot bout ho tl i but rthr bout o tl ould b. hougt diordr i th urd git  potultd idl o p d ouitio  ill diu ltr ht thi idl i h urt  urt o thought though t diordr bd o th l i i  prord prord b trid rtr. h thod o rtig rri  ri o uptio. Firrt  it pruppo Fi pruppo tt orl pr hv  i tuitiv oldg o t ru o ovrtio d t  ppl thi h udgig othr pro ph. hi  to otdit th dig o t  tudi

tht orl pr  lo b ildl thought diordrd Sodl th rol o th rtr i uppod uppod to b obtiv d utrl utrl  d o thr i o diuio o o prol prol  oil o il d ulturl r rtr triti iti o rtr rtr  iu thir udgt d produ dirt or or th  rgt ith ith th xptio o Mhr t .   987 987  hirdl t rltio rltio bt ph d it i pt o th rtr i ud to b trprt hr i o dititio bt th proprti o ph d t ipr io it rt o th litr. hr i o otio tht th litr ubtiv udrtdig  dit bt th rtig d th ph   tp b ro th otio or  ot d rd t oppoitio tht r t or hr dotrutivl  ill  o bizrr uptio bout th uppod tur o orl ph Hr orl ph i   opltl pur d uotitd b  idior  opltl d pr d litr Surlutrl  hv to  tirl hthrtrprt o vrbt p i tht  d to rvr th privilg giv to thi tp o ph ovr th othr ot hr borl  borl or  ot ti ti  vrio o o orl orl ph itl vr borl d i it ot th  tht idor bi d i r

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Psycotic iscourse

97 

prs o norm ommuniion he bnorml nure o his idelied norm speeh i n he h e psyhoi lnguge lnguge reserh reserh is ll l l he h e more ppren when we urn o he wy i  is viewed in ogniive ogniive sudies.

abrary reear Lborory reserh ws iniied by Bleuers (95 [191] im h inoherene nd brup or unexplin unexp lined ed shis o opi whih re hr hrer er isi o shiophreni speeh re due o n inrusion o irreevn ssoiions in houghs. Bleulers model o shiophreni ws  moel of evint cognition: disurbed ogniive proesses were held o be direly reeed in speeh. Lborory reserh hs been ryng o ideniy ogniive disurbnes h re held o underlie underl ie devin spe speeh eh hrough he nlysis o speeh rgmens produed in experimenl ss. he min res o reserh re ssoiion ssoiio n sruures reviewed in Shwr 1982, onepul biliy reviewed in Reed 97, seleive enion reviewed in Mher 972, shor-erm memory reviewed in oh 1978 nd inormion proessing reviewed in Frih nd Done 1988. hee m in hrerisi o  hese lborory h lborory sudies is he ssumpion h hough h houg h disorder is i s n ee ee o h hee iure o some ogniive or neuro physiologil mehnism o he psyhoi subje. he im is o ideniy h mehnism h me hnism hrough vr vriou iouss experimen experim enl l ss. he r rs s problem wih suh n enerprise is he rnspren relion h is ssumed o exis beween ogniive proesses nd speeh produion. Indeed he relion beween hough nd speeh hs hrdly been heoried n mos o his reserh. rese rh. he   h here is no n o  oneoone orr orresp espondene ondene beween ogniive proesses nd speeh phenomen seems o espe reserhers. he seond probem hs o do wih he mehod o mesuring hese supposedly ogniive ors. mesuremen ogniive deis is rried rundelying ried ou wih h ighyy sruured high sru uredhe experimen experimen  ssowhih hve

nohing o do wih ul everydy speeh. he mos imporn problem however is h one lborory reserh hs rehed ern onusions bou he nure o hough disorder lborory s pero perormn rmnee i s oen oen used s  mehod or he dignosis o hough disorder. A u irle is hereore rehed. Individuls wih speeh h is diul o undersnd re dignosed s hough disordered. Hypoheses re mde bou he nure o heir speec dei. xperimen ss re hen se up o mesure h dei nd he sme ss end up being  mehod or he dignosis o hough disorder. he probem hen is no jus h mny reserher rese rherss hve hv e los r o he  h hough ho ugh di sorde sorderr ws originlly dened in erms o speec h ws very diul o undersnd und ersnd nd n d oen oen nonsensil Hrvey nd Nele in he dignosis originl. he enr probem is h viious1983:17 irle is emphsis reed where nd reserh enourge one noher eving heir ssumpions unquesioned while m inini ng he sme pries. pries.

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9

Decnrut ppat

  oud   m p png ng n h gh o hs c  c ooy sud suds s o dconsuc h onshp n nom nd nom spch y  ssn ssng g s  dd dd   h h  yd ydyy spch spch s mkd y j us h k d o dosyncsy dosyncsy  s nd mssnss m ssnss h  sch schss phoog phoog nd h  shoud spond y p gn gngg ydy ngug o h d d spch h occus n cogn cogn  su s  Bo Bo   k ou dconsuc dconsuc dg o hs sh ny uh ho  shoud ook cuy  h psychc rsch dos hn  ooks  ydy nu ngug

Naa angage eeah u ngug sh ocuss cusy on ngusc poducon. Ths yp o sch oushd ou o h cknodgmn h  hoough nyss nd undndng o h us o psychoc spch  pquss o ny hypohss concng concng h nu nd cus o h h psychoc psych oc kdo kdo Th u  s up o ds ds h pcu s o psychoc psychoc spch  y comp ng  h h o oh psychophoogc psychophoogc  goups nd o nom ucs Ahough mps  xpno  occsoy md  nu ngug sch nds o  mny dscp  Foo g opm opms s n psycho psycho nguscs nu n u ngug ngug sch gduy mo om h sud o h od o h sudy o h snc nd o dscous mnng h o sucu o spch sch o o pdc pdc y nd nd pon (d n n B      989 Hochkss d y 9 hs n gduy pcd y suds o h n n n nn nn n n (An  dd An  98  s s        9 cohon (ochs nd Mn 979 nd scous hchs (Hom   92. onsquny h cms h psychoc spch pcu y s du o pcu od od nd snnc omon omon (h k 97 h y cms h h pom nd 982 nd ogc ogc n  ksuccdd s n n snncs  dn  dn  (Ho (Hos mnh    ngusc  h conso conson n us  no oyd oyd (D s son on     98. u ngug sud h h ossso h ojcy nd omsm h undp h s o h ppochs mond o

Som  o h m d  d ds s y yss o nyss h  pp pp o  u n d o msu dcy h pops o p pc chh (o (o xmp xmp   yp-okn o  d  oono  9     hn nd n sc syx ( Th Thom omss     99 99  cohson nyss ( och ochs s nd Mn Mn   97 9»  Fo ohs h cm o nuy  cy pomc Fo xmp n h co pocdu (oono 9 h consuco mhod u 99 9 n h dscous hchs msumn Homn       2   h suppody nu o o h  s quson  I s no c hh h s ms quson msu udd  h po pop ps s o spch sp ch o h  mpsson spch spch hs on h  sn r Mos Mos o hs suds  h dsncon unhod omn (Homn 19 Hom 

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Psychotic discours

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a  .  982 amp o dal wih hi bu d himl i a dadd. Hi argum i ha hr hould b a diiio bw ph ad h udradig o i   H do alo oidr ha h udradig o p ph h i ubiv. H argu argu howvr ha h a om omhow how h udradig o h lir orrl orrl r r h prop propri ri o ph ph Our laim i h a a lo g a ii rarh hold oo h diour o ural i  i i doomd o all io uh impa ad oradiio. A doruio hr d o hom i o h mig ha i mad b pakr ad lir a maig makig ha rarh o hough diordr m uabl o udrad.

iticisms of eseach on thought disode arh o hough diordr r h d o phiar o dirgard h pri o h ubj ad o ora o ormal hararii o hi or hr ph.  i idiaiv ha whil iiiall hough diordr rrrd boh o diordr o orm ad diordr o o i iraigl bam idid ol wih ormal hough diordr diord r  arh o phoi ph ha focus ocusd d o o  th th form form i whih hough ar prd. Sudi o o o hough Gohalk ad Gr 1979 Oma  a. 1982 ar pio. Coidraio o o do om io hough Diordr Sal bu v i ho a h pri pri  o h pakr i dirgardd. dirgardd. Co i i  ad ad ol i rm o logial ir rom o  o h  rmd illogial hi ki kig g  dviaio rom rom ommo ommo    ad h amou am ou o iormaio providd rrrd o a povr o ph' A mai hararii o all h p o udi i h ompl supprssio o th cotxt o itrctio. Sph i ak ou o h iuaio i  whih i wa produ produd d  ad i i rad a a obj ha h a a b aald a ad laid. Bu ph o a abra rio o ha h ogiiv a o h pakr i i hidami produ o produ a iuaio ivolv pakr ad lir lir i ra raig ig i a pi im ad pla Or a Sall Swar Swar a  a  ao b aid o b impl iohr iohr  i  i iohr o a pariular lir i a pi pi iuaio iuaio  Swar Swar  1994 32 hi poi oward aohr problmai iu i h p o r rar arh h th rol of th listr.  ma ma  rd o rarh h ro rol l o h li lir r  ad oqul ad oqul  h ha a o h h rar ad ad o h rarhr rarhr  ar ar rad a

obiv ad uproblmai  h va maori o udi h rol o h lir i ompll uhorid whil om hav v argud ha h lig o h lir li r dirl r h  h problm o o  h  Ho Ho ma ma  198. Ol v vr r w rar rarhr hr hav poid ou  ha  ha h hararii o h lir iuc h udradig ad hror h raig o ragm ragm  o p ph h Mahr  a .  1987). B maiall ouig h propri o ph wih h imprio i mak o h lir ad b

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ttg t tg p py y pt pt gy gy

ignoing e fac a ndesanding is no a dic effec of e popeies of speec b e sl of an acie inpeaion on  pa of e isene eseac epodces dicomies beween noma and abnomal speec and beween abnma speakes and nma lisens e mos impoan pobm wi seac on psycoic speec in uty

genea is i spodcion ofndin bo laboaoy langagegops eseac e speec psycoicand andnaal nonpsycoic is compaed wi e aim f nding h caaceisics of eie speec o cogniie mecanisms (ha spposdy ndeli e spech) a cold diffeenae e gops  gops a s aken-fo-ganed naal caegoies and eseachs n assm a y wil b abe o nd ndeying caacisics a ms disingis em fom one anoe he fac ha ese gops ae tt by diagnosis is sysemaicaly ignoed emoe  diagnosis inclds spc as one of is main componens e gops a n  scd by amongs oe facos ei speec podcion and en i speec is scinied in ode o aie a conclsions abo is caaceisics en wose e ess of eseac ae eenay incopoaed ino  diagnosic pocede eie as descipe concps o as as diagnsic moods Wasae discssedinsead discssed aboe aboe ow laboaoy ask pefomanc ndsm beods sd a diagnosic of expanaoy oo n addiion seaces on psycoic speec ofen discss whee e ype o speec anaysis y ae deised can be sed fo diagnosic pposes (Andeasn  Moic and ngam ) As Mae and is coeages ae p i as ong as esaces analyse e langage feaes of gops diagnsd as sc g langage ey do (Ma   a. a.     ). ow ow noing mo an dis dis    M    (Ma pesmaby ey wi discoe M li sspecing ha hey ae engaged in powefl pacices wic acay consc i eey ime he pobem of compaing gops cnsced by diagnosis becomes een moe peinen sinc e cieia f diagnosis ae eie age o eeogeneos. ince e diagnosic ciia fo og disode ae so eeogeneos indiidas diagnosd as og disodeed end o dsplay an exeme aiey of lingisic pnomena ompaing gops a ae nenaly so eeogeneos is doomd o podce inconsisen esls  emoe  eaing e gops gops as inenay consisen and ying o exac e mean diffnce bwn aes of ei speec besides podcing a fase image of mogniy does no conibe mc o e exploaion and ndesanding of e aiy of ingisic penomena a one encones in psycoic speec  eo indes insead of enancing a moe oog ndesanding of e phenomenon nde sdy . We wil ag age e in    nex secion of  chape a examining n a

posiie way is aiabiiy as mc moe insig o offe ino psycoic speec an seie saisica coain nce we ae acknwdged  cica and consced nae of psyciaic diagnosis and sach on psycoic spec wo qesions

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Pytc u

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emege The s es he aswes ha sh a appah mgh be able  gve  pblems ha ese eseah ah has has bee y ygg  eal wih f f he pas e eae aess  Th se s s he f ha ilaiy has   he mai eae f psyha psyha paies paies e f he es s ha es esea eah h i he pas eaes has ampe  aswe s why  all ivals iagse as psyh aally pes speeh ises (haika 990 Havey avy 96  The a a ha  ivials ls ha pese speehh spee ise93  s ly 96 miely has he alsivia bee asse (Aease  99; hak hak a  990 hese hese a Ma   9 99) 9) . ese eseahe ahes s wkig  he assmpi ha iffee sbypes f psyhsis ae e  he beakw f eai giv  ephysilgial mehasms ae fae fa e wih he ask    e eifyig ifyig a mehaism mehai sm whih wl be espsble f bh he abse a he ieme pesee f hgh se The ask bmes eve me ifl give he heegeeiy i ligis fails pefme by psyhi paies The seah f a gve  ephyslgial fa ha l a f sh a vaey f ligisi phemea i he speeh f psyh paes has ieviably bee filess The aegy psyhi paie is s hgh iagsis a s  as we s we age bee bee  h aswe a swe  h h pblems has  be be sgh i he  he iagsi eia Speeh se is e f he mai ieia f he iagsis f shiphea a he psyhi ises b  a eess e essay ay e . This eplai s why e eai ai  i vials iags iagse e as psyhi psyhi pese hgh se while hes   Meve he ieia f he agss f hgh ise ae heegees Ths eplais he vaiey f ligsi phemea ha ivials iagse as hgh isee pese As  he em p f see speeh hs a be mh bee eplaie by lkig a he e f lgs p ha by skg a mhasm a  h sb ha wl a f  As  why ivials iagse as psyh e  have me me via speeh p p ha -psyh  -psyh sbes he aswe has  b sgh   h beig psyh wih all he implia im plias s h m  m as  b  a sees f he fas fas f he sbes sbe s i a f he  This wll be fhe issse belw. B s we ee  sie he es as  why psyhiay has sysemaially ige h bvs fa fa f he si  si f he aegies f psyhsis a f he ilay bewee hey a eseah  psyh speeh The aswe has   wh he maieae f he aaem a psyhai pwe. as   essaily  essaily esp esp  a eea l ealiy  a as s ae se se by assais assais bewee  gps gps f pfessials a isis by pas ha big hem  eisee a mai ai hem  ( s  spisig spisig ha he same same ames keep keep ig p i eviews f maseam eseah Thee s a sh-i i eseah  hgh ise  whh h same pple wkig i he iffee

sas kp g a mmg  e ahe) e f he This SAGE ebook is copyright and is supplied supplied by Dawsonera. Unauthorised distribution forbidden.

 

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Deconstrctn psychopatholoy

prrquiit of t ratio of fat i tat tir otrutd aratr oud b oad  ti way ty aquir t tatu of fvidt rprtatio of tra raity yoi, izopria, tougt diordr av aquird t tatu of fat troug it iia ad aadi wor ovr dad dad t i tir fatua f-vidt f-vidt aratr aratr tat a ow rar rarr r ad pratitior pratitior to otiu aayig, diagoig ad tratig idividua wo arry to atgori t i t fat, rpro dud by a ri of ao aoiatd iatd prati, prat i, tat av aowd aow d pyiatry ad iia pyoogy to p tir powr for t aagt of ua ditr ovr t pat tury Fa ditr Fat t do ot rprt rprt a pr-itig raity, rait y, but ty rtaiy rat raiti Ad t raiti otrutd by pyoi, iopria, tougt diordr ar of a apowrfu pyiatri tabit wi a t uiv rigt ad obigatio to trat pyoti ad tougt diordrd idividua

Developing and deconstructing alternatives  od od word w ord of aitra r rar ar  ito i to tougt diordr ow d to b opd up, ad w a ow tur to o atrativ way of ooig at aguag wi ta ott, ubjtivity ad otraditio riouy   oud a it ar a t ti poit ta tatt w d o ot  ay of t t tr tr atrativ appr approa oa tat w wi  dr drib ib a fu fu y ford ford outio Ea otai auptio about oraity ad pyopatoogy tat ar probati Ratr ta oo to t to av u, w por t ow i doruiv pirit Ta i w u  o troub t aitra approa to pyoti diour, to bo a rtur to aitra oppoitio btw ora ad abora ta  y ar our do dotru tru  tiv par i t wor of t iia trut ai o u t dotrutivy, t, w ao av to ti tatiay, ad giv up t obio wit d trut tat driv traditioa rar

Seeh a a he ra  raa Ato ug t ratio Atoug rat io btw p ad ad tougt a a b utorizd i ot of t rar rar o pyoti p p,, t udryi ud ryig g auptio  to b tat p i a dirt rtio of t par ogitiv ad uropyioogia tat  od of p ud i t ajority of t tudi i o of commncaton i a trit ad ita  of t tr  par ad t itr ar dpitd i a ottua ad utura vauu , ad a d a ag i  a traittd traittd fro fro t o to t otr aguag i oidrd to to b j ut a diu troug wi tougt ad fig ar prd i a dirt way f Eatop, 199)  ida ubjt ubj t i d  d to b o wo a atry ovr tir iguiti produtio produtio S ow wat  wat to ay ad ow to ay it ad t ag

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Psyot discouse

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reecs drecl he eos ad deas  he md o he seaker he schoc subjec  hs ramework s he oe who has ls hs udame al maser Pschoc dscourse dscourse s descrbed descrbed as he resul o a breakdow  he abl o moor oes ow lgusc roduco Frh ad Doe 9 McGrah 991). hs argume s suored b debaes  he scharc leraure oer wheher schoc subjecs cosder ha her seech corresods o wha he waed o sa ad wheher he are aware ha he al o commucae Chaka 974; Ha Harr rrow ow e a a  , 199) h he deelome o ordar laguage hlosoh lguscs dscoered ha messags do o ol coe ormao bu ha he erorm acs Aus 92; gese 95). he assumo ha laguage does wha he seaker eds  o do s relacd b he recogo ha he orce o he uerace s deede o a are o lgusc ad o-lgusc acors o he cox eso 193). he rassso o ormao akes s lace as jus oe more o he ma ossble ee eecs cs o lgusc era  eraco cos s he ackowledgeme ackowledgem e ha  ha es o dscourses ha are o srcl ormae hae a mac ad roduce eecs e ecs oes u he eld or ose ose research o  o es o  erac eraco o ha h a would reousl sml be cosdered o be commucae alues   h e ramew ramework ork o research research o  o schoc dscours dscours ragmacs allows he sh rom he olar bewee commucae comeece or alur o he sud o wha dere es o seech do ad how he roduce eecs. hs ragmac aroach leads us o look a sech o as a ed roduc ha ca be solaed ad aalsed bu as a ar o a damc roce r ocess ss  sead o o lookg a he message as a objec  allows a aalss o he pocess o s geerao  a secc cotext A aalss o schoc seech seech should ocus ocus o he relao bewee seech ad coex . t hold exe he w the cotext  ecoded  eech . the elto bewee eaures o seech ad eaures o he coex   ad bewee a d he  he wa boh he seaker ad he lseer ls eer are osoed    relao o wha wha s beg sad. sad. Uoruael here has o bee much research o schoc seech whch ollows ollows hs rado o lgusc lgusc aalss. aals s. Va Blle (97) as oe examlesubjecs aalsed assere seech acs scho hrec' order o exame how  hecoersaos ruh o wha wh s beg sad s esablshed I mos coersaos he ruh o wha s beg sad s egoaed ad arred a b cosesus bewee h sakers Va Belle cocluded ha  he ruh o o  he ueraces uer aces o schohrec subjec subjecs s s oe oe o cosesuall aldaed ad  sead ,  s graed graed o he lser ls er or some some oher exeral auhor Swar ad Swar (97) argue ha  s o ossble o udersad seech w whou hou akg ak g o  o accou h h arcas assumos abou how alk s ad how  should be. B aalsg hese assumos as he are exressed  commes o he eraco  a erew wh a mac ae he showed ha ma reousl com rehesble ueraces could become clear clear.. I a laer arcle Swar Swar (992)

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Decoucig pycopoogy

dmotrtd tht miudrtdig i cortio with pychotic ptit r ot ot du ot to th uit u itigi igi bii biity ty o th ptit pch but to ctor rtd to th umptio o th itr d th xpcttio tht ri rom th ititutio cotxt i which th itrctio t pc  Aro d Robrg Robrg (1990) ( 1990) too up bo d d Fh ( 1 977 cim tht cohrc i ot bd o rtio btw uttrc but btw ctio prormd by th uttrc By ucorig th prgmtic orc o th uttrc thy mgd to rcotitut th mig o  pprty icomprhib rgmt o chizophric pch h tudi h tudi  mtiod mtio d bo cotitut  poiti tp tp i th th  yi o pychot pyc hotic ic dicour i tht th thyy t ito i to ccout th cotxt o itrctio itrctio d thy xmi th ctio d uctio tht pch prorm hy ti howr ot t or grtd th ctgori o pychoi d chizophri chizophr i  proprti proprti itr to th pr A   o idiidu uity d ittioity udrpi thi trd o rrch Athough gug i ot coidrd trprt d it i cowdgd tht th ctio ctio  pc pchh pr prorm orm r ot uy cotr cotro odd by th pr pch pch i  ti    mr too pr u or th productio o ctio d ct Moror mig i ti cocid i  uiorm wy h umptio bout th wy mig i cotructd tht udri thi typ o rrch dirt tho o mitrm rrch hr i tir howr  rom umptio bout orm pychitric wy through which mig i  producd producd h im o th tudi mtiod bo i to how tht bhid th pprt diorgiztio o pychotic pch thr r orm mg tryig to b coyd W w rgu tht dpit th good ittio o th rrchr rom th momt tht orm pch i dd th pority btw orm' d borm i boud to b rproducd h ry id o ormity' i oudd upo th id o bormity  o tht which i outid outid th ditio o th th orm orm  A truy rdic ppro pproch ch cot b bd o rdig d xpdig th otio o ormity d th rguig tht pychotic dicour i ihrty orm' A dcotructi pproch im to br dow d ortur tho ry ctgori ctgori y i th pority btw ormity d bor mity c to xit c opthoogiig wy o ooig t dirc b mpoyd

The dce cc  bjecy a ychaalyc aach Crti trd withi th pychoytic trditio h to  crti xtt cpd thi rductioim d h did wy o yig pychotic dicour tht ithr t idiidu ittioity or grtd or um tht mig i cotructd i  ir hio I pychoyi pch

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Pychoc dcore

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lo pror ct  ct r ot, owvr, prord trou  cocou ct o wll o t pr  pr  lo cottutd  

ubct trou r ow dcour dcour  ubct  pcoltc pco ltc tor  ott xtror o xtror to lu  u u   o t ut  tool tt t ubct u to xpr rl  ubct  bor to  bolc uvr orzd  d trou lu, d t  cc to t bolc bol c t tt v to t ubct  plc wt t u cout u  t, t pc wt wc ubctvt  cotructd I vr lutc trc to, ubctvt  t pl, ottd btw two ubct, rd or dd rcozd rcozd or ltd (c (c , 1 977 977  rtv ( 1 969 d d Brt ( 19 1981 81  1 973] ptoz t t vw vw o lutc trcto  crtcz t dot trdto  lutc d t u cc wc vw t ubct  utr d l uct, wo  t rtor o r ow , u rpoblt or t d u lu to xpr rl o t cocpt o cto t oppo t cocpt o ncance wc vw d cour   proc wrb t ubct t cottutd d ltrd b t wor o lu lu pc   r o o lu lutc tc trcto, trct o,  ot  ctvt but   n n yn yn  pracc prac ce e  dlctcl trpl tr pl btw t ubct d lu, wrb t r bot rproducd d trord  l o dcour ould t x t w  wc ultpl or o ubctvt r cotructd  pc trou t drt or o coutr btw t ubct d lu  pcc cotxt Iott rwor t ubct wo cotrol r lutc producto prrqut but  eec o crt tp o  prctc, o ot  pobl tp o ubctvt cotructd  d trou pc  cocpt o cc llow  t ro t pl probltc o cotrol vru lc o cotrol to t l o t w ubctvt t r lo cotructd co tructd d rproducd  w dr dr tp o ubctv  dcour Irr Irr  ( 1 985 , or xpl xpl  l ld d ow t pr pr d d t ltr ltr r cottutd cottutd  pcotc dcour trou trou t trpl btw t I  d ou'  pc cour  t pproprto o lu b  prtculr pr  t ctul ot o t o trcto  cour  lw ddrd to oo  I  , t , dt t pr  t ot o pproprto pproprto o lu d t dt tt pro to wo dcour  ddrd Accord to ou Irr t ou ddr  ot   t dcour o dvdul dod  czoprc Morovr, t   do do ot clrl corrpod corrpod to t pr t t t ot o trcto rd pro proou r ud td d t wol od o p ppr to to b dtcd ro t tuto o trcto Irr coclud tt czoprc pc   pc o ctto d ttt bout ttt t  ot  prctc o prtcll covrt  lu to dcour  coquc  tt t pr  ot cottutd   utr ubct wo produc d ut r dcour

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Dcotucig psycoptog psycoptog 

bt he bee t b eh ehn n a i  e e that ea t ee n n it n an i nt bn t the inteatin ni (99, a ing in thi fae anae naatn f na iagne a hiheni a ene t an eitn f a eie  aing aing aatin ee a itntin beteen the at f teng a t an the eent that ae bng eibe. Mee it

ee a tane beten the eae an the t he e the eae ea e  bth enib enibe e f an etahe f f it. In hihen naatn aing t ni bth itintin ae t he at f naating an the naate eent a ege he t  th be eente hee h ee a haeni ng at the a tie an an  a being a ea a the at f eaing. Atenae eent f the itatin f inteatin  ee intega a f the t. Fthe the t  ethe a a ea an bjeti n a tina   the eae  eg ith he atin an feate f the eae Bth gaa an ni tie aie t itant e the eatin beteen ie an ntet an the ntttin f the hti bjet thgh he ie nba an Snne (198 e bth n a henie ae an ae at a n n at thee att he age that the T an  ntea nt n  nitte the eae an th th  aeee aeee f ie bt a  that it   eentia in inking i t the itatin f nteatn an the int t t pysica eene  the eae an the itene. In hiheni i the  e nt ntitte a tabe tene, hie the T i eaab b th eeen. eeen . ne neqent qent  eeh eeh ee          e  the ea ea  an aee t the the tene. the h  ae n  the  ae f th th eae an the ie ente eeh n n neiate a  a e the hihni bjet bee iee behin a ie he annt tan, hie the ie e tahe f the itatin f inteatin.  atenatie tie an aahe e aa f the ta itin itin  aaig aa ig f ee eeh h ith  ith   a eetin eetin f inia in ia gnt gntie ie  ehgia ei  a niatn. he t hee  hat h  hti  hihen nia he eeh an be anae n ae t na eeh Gegaa an e 9 hae tie t ee ee th a atn tn he age that bjeti bjetit t i  nt ehing inheent t the the i nia  bt that t  ie ntte in igiti inteatn nta  ee bjetitie   th nte a iffeent ent in ie n e t ee iffent hetia e hgh an anai f inteie ith inia iagne a hti the entate h  ange f bjete tin     the tin f the nita nita  bjet h tain he ie  the itin f a bjetit iee n ifeent if eent ie ie  ae e in e t t e e ean itib itibte te nibtie  jtif ain

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10 Pho dour  h p o ud  o paholozd b b opard o a or o oh roup. hr   oralzd b la ha hd h appar dorazao hr ar oral a r o b od Alro ad Robr 1990. Boh approah rprodu rpro du a w o ph ph a rapar ad ura urall ad rdu ph ph o ouao. I ad plor dr  a po wa b aa h arou wa o a  do h wh ph ad produ . oror pho dour  o aald a h ph produd  pho ddual'. Pho  radoall Psychc dscrse

lad o dorazao dorazao ad raao. raao. h rhl ar o wd a propr propr o dual bu a propr propr o dour dour  I h r pho pho  ha o b rad rad  ad h  dbaabl dbaabl  o d dr rb b al ho hara h  do o rr o pho ubj a rad ddual bu o pho dour a dour dour  ha a  ad ha   ha h a ar dr dr r ro o wha wha   radoall odrd odrd aul aul or ll  ll bl. Iddual daod a pho do o or a hooou roup ha har ha har da d abl bl harar Pho ar a roup orud b dao dao whh lu lud d rl dr dr rra rra  ad  oqul oqul hr lu produo  a hroou a a ohr radol ho roup. Bu a h a  bau o h dao rra ub daod daod a pho pho ar or lkl lkl o prod produ u arou p o uuual ph. I ha  pho  a plar a or h aal o h ulp o ooor wa o a . Sph hould o o  b ad wh h a o draw oluo abou h o ooal or uropholoal a o h pakr Corao hould rahr b  a  pra a da pro bw ddual  p o h ubj o aal  o pho ph a h wa ddua daod a pho pak. I  rahr pho dour ha  o a h ulpl wa  whh a  oud oud dou o ouao.

They ad heay dw de decci i acice? I h la wo o o h hapr w ha drbd alra o ara rarh o pho ph  ha rall ad hr poa  a wll a hr dawba or h aal o paholoal ph ow w wll o ro h ld o ra rarh rh o h ar araa o lal pra.  wll a a or o hrap ha ak h uo o laua  phar o aou ad r o d hod hrouh whh phar dour a b dorud  lal pra hl h prou o wr or rla o rarhr  h ld

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108

Decostructi psychopathoo psychopathooy y

 p t lat t  aat tap a a ampl   t da tld tl d ab a bm lat t patt patt   appa appa  a dlpd t  t bt tm aml tap tap  tadt  tala ad N Zalad tat pd a t ampl am pl  dt dtt t  pat   a dbl-t dbl-t  t     t t t t  m Ft d Cbt Cbt    t aml   a a tm  pd patl  a mmb t dtd patt   t     b t aml t pd t pt d t d d Cbt   t tapt  t aml a tt t pbm bt  t al cuded  t tm  p tal ad tapat mmat m tapt t am am l t al al   t t pt pt   pat  t pblm pblm  ad t  t  pbl t  t patt a pat  t lt  d t  m

t laa  t am t t d d tat lat t lt ad  t  pb t a at t pt ld abt p   t at ta ddal m  t dbl-t a ald t bt  a ptmd tap Nam ad G 1992).  dtt p t t a p tat pltl l dtt t Falt (9, 198) bat  lla ad    t paat t p m m t pbm  ad t m t ptlt m t dda d da t t tm  pt pt tat ld tm  pla ad ld tm  t dt Naat tap  amp Ept ad t 1989) l t t t  a   t bjtat bjtat  dat at ad  ppl a b td aat tl  dtt  t pl  t ta m  ld ad t tal t al al a l  tat p p   t td d  matal pat  t laat ad ddaat In h pocss o xnalzng polms, cltal paccs o ojccaon a z agans cta pactcs o octcaton Th pom slf s xtnaz so hat th pson s no th pom nsa, h pom s th polm hs octcaon an xnalaon o h polm changs hos nazng tchnqs of scntc classcaon an oh mo gna ng paccs (Wh 1987 

 p  t t   t am a b dpd t lp l p t  a b lablld b t pat tm t pl t a t laa  pt d t p ad t b abl t d b t t a ta dta t pbm  appap  t a tap a am tt  t  t 98 54), ad  t tt a dt atp  md bt t p ad t pt ad tm   t    t a t pblm a b ta tald ld ad t  tm tm  tat ap t ptat  t am mmb ad pal  p tl tat mmt a ptdd t  bt ad a bld tat t d

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Pyoti diou

9

(98 Whies as disussion nd o he prediamen hose he whoareer' hae een diagnosed shiophreni hemseles in rerames he hae o adop as an inhe-orner liese n he exampes he presens he proem is exernaied b uesions ike n wha was hae ou e pushed ino a orner  shiophrenia and his exernalied proem is hen disaned urher hrough ideniing sraegies ha oma i How do ou hink suh seps ould weaken shiophrenias inuene on our ie The onex ma hen e reaed and so made manageale b srehing i o isiili perhaps  reraming i as a arie o soap operaa   esou oper esoures res are are idenie iden iedd  and hese ma m a hen be addressed addressed o dea dea wih wha is usual ermed reapse in more radiiona inia ineren ions io ns Her Heree  Wh ie suggess suggess uesions suh as How are ou ou going o eah eah our impaiene ha ou an make our own disoeries a a pae ha

suis ou and no i  In one example o he appia appiaion ion o hi s appro approah ah in a group group seing seing eil  eil l and Sokel ( 199 used Whies (1988 disussion o reaie inuene uesioning airl ssemaial o ode he ran srips rom 8 week sessions wih oung men who had een diagnosed

shiophreni The pariipans were able in he proess o moe rom onee name he gae o on o heir group group  h hee Losers Losers'' group group  o anoher  The Worh Wor h o isu isussion' ssion' group group  and his ransormaion ransormaion in riv otiv diagoi had ees on he res o he ommuni in he enre Tapping 991. This deonsruion in praie  hose who are aeled shiophreni hus reerses he priori ha is gien o exper researh on hough disorder in whih iniians dene who is disordered. The deonsruie herap we hae desribed here is a wa o drawing aenion o he wa ses o i nial aegories ha x  x shiophrenis are hemseles hem seles par o a pshoi disourse Whie 99 When he proem is exernaied he probem is reae reaedd as h e prolem prolem raher ha n he person person  a nd we an hen see how ha pshoi disourse disourse operaes as par o he probem. probem . I shoud be poined ou ha some proponens o his si somei mes end o push awa par o pshoi anguage ino he reams o illness and wil urn o pshoeduaiona work on oasion o more eeie om muniae wih amiies amii es aou he naure o he experiene ha he  he laeled ami memer is suering or example MGorr 1991 his also i usraes he impossi iii i o hoding a pure pson ps on and Whie approah approah and ensuring ha i is no aken up and appied in was ha olude wih radiiona pshiari noions espeial  ousing on pariular eh niues The deerene niues deerene o a medial rame o reere reerene ne when  he disress disre ss is er serious hen sis uneasil wih aemps o deelop a new o onsrued iew o shiophrenia Lee 992 eerheess here is a serious aemp o grappe wih he wa radiional undersandngs operae oper ae as miro  miro-pr -prai aies es  and he was in whih hose who are xed in plae as he shiophreni an sar o speak ak and redene he uniueness o heir experiene experiene in a supporie supporie onex onex .

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Doctig Do ctig pycopatoog pycopatoogy y

Concluding comments  ce ce he ooo bewee omal omal  ad abomal ha bee deco uced uce d ad oce oe wa of aalg dffe dffeec ecee have bee foud foud    debaable whehe he em choc hould be comleel abol hed o whehe  hould be eaed wh a dffee meag h ueo eec moe geeal debae deba e aoud he acce ac ce of deco decouc uc  o. I he am of decouco o abolh comleel em ha mak he ola bewee omal ad abomal   o moe ueful o oeu he dco ad ea he evoul devalued em bu ude a dffee meag  he em choc wa abolhed aohe em would cee  o ake  lace oce he chace  gve fo he ola o be ecoucd  eag he em oducg  o aohe aoh e famewok famewok ad gg  a dffee dffee alue  he h e dage of collag back o he ame dco ca be feded of I cha he em choc ee o dvdual behavou ad acce ha deae om a oulaed omal whch  oed a he deal We hae ake eeal e o decouc h ola bewee omal ad choc eech  we hae how how he ola doe o eec a obece uale o eech bu   couced b

he ve oce ocee e of of each each whch eek o decbe decbe .  . Secodl we have agued ha wha  eed a omal eech  o he wa omal eole eak  he eeda eaco bu a eled coexle fom of eech whch chac heoe have ake o be he deal N vyy   m m m ha chac eeach hold  o be ad heee cao be cleal dguhed fom o ooed o choc eech Thdl we have clamed ha eech  o he dec eeco of he coge o euo-hologcal oee of he eake bu a cooeae ee bewee eake  ecc coex The em omal ad choc choc do o  he heefo efoe e efe efe o he ual e of he eake bu o uale o dcou dcoue e a   uavel uavel  ec ecc c eacoal uao u decoucve uaellg of he ola bewee omal ad choc eech ha aomed he meag of boh omal ad eech  uch a wa ha he ooo bewee omal om al ad choc cao be uaed a lge We do howee ea he h e em wh a dffee famewok I he famewok we ooed owad he ed of h  chae he e m cho choc c e efe fe  o aable ad mulle m ulle dcoue dcoue ha oduce om meag bee vew aowl deed a com mucao he oude momewha h ha aow of commucao  educed o ju oe amog he ma wa of makg ee he wha we deed a choc dcoue ae o deva bu dffee fom of eech The ud doe o comae hem o a oulaed om bu aale hem a dffee wa of makg ee. Moeove

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P 

 

hese ypes o disos a no conned  h spech of pscoic indiidas b ae ps o speech noma pepe se o podce meaning I wod be mpng o psh his deonscion a sep he and age ha  he phia phiacc ysem of ass asscaion caion s a o om m o syhoic discose ha posiions paiens as he on wih h pobem. he m psychoic is eained b his ime aciing posii connoaon Psychoic discoses become a sbjec sbjec of seach and inica i nica pacice in hei own igh and hei sdy nd his pespecie an ee mch moe abo he nion o an angag gag and speech speech han h d o n nma ma commnicaion

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7

Radcal Mal Halh h hpt  th dlpmt  ltt mtl hlth m m t. h llw u dtut dtut  tdtl tdtl du    d u mmtm mm tmt t t tm ut ut ll wk by pt   puly ld  pyht pt I th pu hpt w ud tht u bt  ly huld b pyht du  th th ly wth h ddul pyh huld b ltd  du pt. H w wll  th umt  uth dtu t twt d d pyh   ppty  th uqully hd llt du  phpthly I th ud tly um l  t lt dttly umtbl th u dtut   ptl  It my b uml t yu bu yu  ly w t pht ph t tml tm lyy d bu t t lu l u  phpthl d lkk l k  b l b  l l      . It m y b umtbl umtbl bu bu yu  ud t th wy  pk d w  thw mth t qut tht t  pt  u m mm m .  t tdd t pl ddul x ttl d  lt t th pblt  pltl  d w l t t  t th th  tt tt m humu h umu  th pyht pyhtd d ptt ptl l  prl prl uh uh  t dd th pw  pyhty t th pt

wth h pyhtt hll t wh th dt t d th t  2,000 A m mbl pdlly pdl ly tt   th tut d th tu  th DSM. I th hpt h  m  l t t th t m m  b bu     tt tt   u pyhty. pyhty.  wll b dd m    th dl p t pyhpthl pyhpthly y Bt t  985 Sdwk 982) d k hw  thy buld  dlu btw  d u  u tht tk mtl lll l    lt   bd wy  d th th  d tht w d t b w w  th wy  whh pyht pw ut tl t pt tht pm t t ht t mpw u u h pw pw  dt l l  th u  pyhtt  my  t ltt tht h pu up  th y.  du dudd m  th  Chpt Chp t 2  d w w tu t th m dl xpmt xpmt tht h   dlpd. dlpd.  wll t xm hw ltt ht  wtt d ld b d th qu  th t t xpmt xp mt d mpwmt wk     wll  th xp  dt t  Gmy d th S d th th m uhm  t h K  th H V V Ntwk Ntwk h l l

This SAGE ebook is copyright and is supplied supplied by Dawsonera. Unauthorised distribution forbidden.

 

Raica menta eat

113

w draw draw ou ou rom  movm movm  mpai mpai   i mpora o ox ox polii ad xpri i radial praial doru doruiv iv work work 

Reason and silence  ar wi a quo rom ouaul ouaul  pra pra o Man Maness ess an Civiization: Civiization : quo  rom As  a cn langag t is n sc ting;  at t is n sc ting any ng t cnstittin  adnss as ntal inss at t nd  t igtnt cnty ads t vidnc  a kn diag psits t spaatin as aady ctd and tsts int livin al ts stad, ipct wds witt d synta n wic t cang twn adnss and asn was ad  langag  psyciaty wic is a ng  asn about adnss as n staisd ny n t asis  sc a sinc.  av nt tid t wit t isty  tat langag t at t acagy  tat sinc (Fcat 197: -i)

 i i  apr apr w ar ord ord o priorii priori i a or wi i ild il d b popaolog ad i ioria. o ak o xampl o (1993 i  r oarl ior o  mal al rvi drib  ral rol o oial rorm i r ior o  lm opial bu gl o mio a i  olklor o  ur movm i ior bga wi  dlam rio wi pro against om bad marial odiio ad lak o ood.  ol (1990 mak lar wr i i Clar (197 rpr rprig ig  progriv aur o p piar iar or Sdgwik (1982 idig wi  pai pai  wrir i i ld ar all oo o o ui uidd i  aumpio o  xi o mal ill a  arig poi o or ad prai.  oiu  moologu o rao about mad .  u ar wi Sdgwik  or i rviw o  ai-piar ai-piar movm provid u a powrul arig poi or radial riiqu. Ev Sdgwik draw bak rom a oial oruioi l alo a

doruioi a oward  oio o mal ill . H argu a  rig o rmov ad rdu  op o mal ill  rviioi rvii oi ori ori  av mad i a bi ardr or a powrul ampai ampaig g o rorm i  mal m al al rvi rvi  o g o  groud  Sdgwik 1982: 4 1   Sdgwi Sdgwik k wa wa ilid i lid o b di miiv o ouaul ai-piari ai-piari romaiim: a istica pid in wic Rasn ngagd in an qal diag wit Unasn is a s cntpint t  way  dn ways  disissing t insan t is nikly t sap any t avi  t past tan tat  an intligntsia wic as always pd t ty wit adnss as a litay  atistic spctac. (Sdgwick 1982135

 arg o ai-piari romaiim wi i rouil mad agai rii o  mad door pa ad pr i a ommo o mmo d b  mdial door ad r v Sdgwik i aug aug aili a ili g i bar o

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4

Dconstructing psycopatoog psycopatoogy y

the d Th ctque gve ht ht t the epeve epeve actvte  the pathlgzed when they the y ty t beak m medcal dcue dcue . A t the ame te we need t em nd uelve uelve that that ntn    llne' pvlege the form  dte dte ve the cntent cnten t  the dteng epe epe ence ; th  typcal   eaple  the teatment  heang vce what pychatt call audty hallucnatn n the dagne  pychtc dde whee whethe the vce ae n the thd pen  nt  teated a beng  geate cnequenc cnequencee than what the vce mght man t the the heae. hen Sedgwck ee t llne he  nce agan teatng mal ppte  epeence a beng me mptant than the cntent. The cntent  epeence alway ecape tct mal catege but the p patent cannt ecape The cnequence  th th patent  then  the denal  the accunt acc unt  a nd even the denal  the pblty pblty  a talkng cue whch the nave patent  gd  ll ha been led t epect  the pychatc eamnatn. The act  labellng  nw an mpeatve and the gd patent pat ent m u utt adde the the cinicians pblem  the pathlgy pathlgy and puue a pgn pgn  thugh the bzae ema emant ntcc mne mn ee ld  th thee pychtc dcue t whch he  he  ubjected wth quetn a t when a hallucnatn hal lucnatn  n act a peudhallucnatn and  n n cntat we can ecve m ucault wd nt nly a ctque elatng t the phlphy  cence but the pblty  cmmuncatn thugh decntucted dcue Intead  pvlegng medcal ean we want t pen up a place  that whch ean eclude t be able t peak Smetme what t peak wll then appea t the n the de  ean nt t a ke ene Hw Hweve eve t  nt u  utt ucault ellptcal ty tyle le whch wh ch accunt  the lack  eeence eeence  ucault  n the th e eveyday battle agant pychpathlgy and hee Sedgwck  ght  that tyle de have a patcula appeal t the ntellgenta and t the delght n mytyng peple utde the way t peak ucault hmel can be und late eectng me  the ambtu amb tu clam he made mad e n Mans Mansss an Ciiization when a a taned clncal pychlgt he gew away m Geman phenmenlgy and the cncen cncen  the cmmn nane Mace y 1994). A we hall ee the pltcal demand  ue  evce  uvv  pychaty   vce heae wee t be mly tamped n tem  the ownrsip  epeence epeence a dema nd ttng ttng unealy wt h the

late e bcue ucaulda ucauldann decptn  ubjectvty and cntep ay adcal publc plcy ake the wh thnk th nk that t  enugh t tnke wth langua language ge a nd pecemeal em em the we m ght call the ucauldan ucauldan n hgh place place Cpetng dcu dcue e dene th thee hty and pbl pblee pactce pen t actvt an andd n addeng pychpathlgy pychpathlgy they metme cnm the dcue agan n deent way. Thu wtng wthn the dcue  (985 9)decptn pychdynac theapy Bantn al ucauldan whlt eeng t ene the mptance  pwe n et the eek t make t theapeutc adcalzng mental health can mean makng publc

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Rdic me heh

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ht  hdd, kg op d grou ht  od, d kg poltl ht h b rdud rdud to to prol prol , lt p .   d to k, though, ht th ould   prt.  r ttdg to tl hlth htor   trdto o dotru to, th  upou , th  dtto th th ot opprd, d  r r kg to uovr  vo vo hh    ot orll ptbl  ptbl   tt book or udr th phtrt phtr t gz. Fr Fro o th outt  hv ought to rgu tht th progo o phot dordr ot b trd th th dvdul , or v th  pl obto o th dvdul d ot, but through th l o dcoue h our o pho, thortll d prtll  pututd b polt. ht ,  prt o ph p htr tr tl k , th coruc th  pho th l to dovr. dovr. h dour d our  r pl plt t,, th th r rgtr, rgtr, th th r phot' phot ' .    ho th ork, ork , d h th dotor r r o rght rghtd, d,   look t o o th  g o pho r otrutd  th ll ltrtur

The demonology of madness in clinical discourses t  ut to koldg,   hv, th dotrutv ork o phoptholog  rlto to t vldt, gt d bohl rrh, thout odrg th por rlto pltd  th produto o koldg. t u  Froh' ( 1991) tto ro th pholt Frud, , Bo d Rold  th lght:   k ourlv ht t  tht gv th hrtr o trg to th ubttutv orto d th pto o hzophr,  vtull o to rlz tht t  th prdo o ht h to do th ord ovr ht h o do th thg' (Frud, d  Froh, 1991 . Frud hrtrzto o hzophr  th por o ord ovr thg tk d ggrtd   out ot tht lgug o ot olup gv prdo' prdo ' , but  r rdr drd d pbl o bolto o vrthg l  Rpudto o trto, orlour o t gr gr  bo bol l bolto bolto o th th phllu   (, td  Froh, Froh, 1991 12) hl ' orulto r bg dvlopd  Fr, qull r drpto r gthrg p  th  th Bo dtg Btlt, hh r th obt tht  b vutd or ud or  kd o thkg tht dpd o th pulto o ht r lt to b thg  thlv   to ubttut uh pulto

or ord or d' (Bo, td  Froh, 1991: 14).   bzrr dotruto o th rltohp bt lgug d objt, th phot ubjt (d, or Bo, thr   phot prt to vr ubt  bl to pul  pult' t' ord   th r obj objt t Aro Aro  th td Stt, Stt , Rold uttgl ptur othg o th d o th ovt o pr to lgug, d th rto o d

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6

Decotuctig pychopathoogy

bt o aua  pycharc dcour  h dcuo o projcv dtcao dtca o   t m  pt tt t pjt  t m pt  t l t t lt t pmt T t  t p  g m m   tm t  t ptt   tt t t ll tt   t m k t t ptt pg m tl   t At  tm t ptt   g  tgt (R (R    t t      99 :    

od dcr dcrb b th way   whch th pychatr pychatrt t   rd rd   th pychotc prc bu h p h  uabl to a  to  that prc a b a effect o th vry laua h ha b u Ev Froh  bwtchd by th horrb ary or ta tat that h cojur up ad whch h a py o b dcrb what  o o  oo ' had wh h or a dcrpo o boc bta lt hy jut  hr rat toad that thy ar trttly ap who to pac dvour cocou dvour l wth othr dvour dvour thouh (Fr (Froh oh  99  74)  wat to ar wth Froh 99  78) cocuo cocuo that Al  h  a thory thory  otbly pla th pychotc codto ; troloy codto but   h pychotc tat a wll' Ad  w accp pychoaalytc or th o   w ht rpr h dcour dcour ad practc practc o pychopathooy a a pychotc pych otc dc dc .  wat to aru hr ha h a a  o  ad tha ar rlayd  clcal  cotuct a raty or h cca that  atac ad rh ad ha t  th o urpr that pychatrt who wrt ad rad h u houd b o rhd o b  th prc o oo who  ad. h ty typ p o ta  a add h  h practc that oow ro ro t a t dcu or practtor practtor o wor acro h dvd btw rao ad urao h doooy d oooy o pychotc prc  pychatrc tt cra th ap  ad  a all th or othr' th prc o tho t tal about Ay altratv approach uch a h o w dcrb  h chapr hav had to buld alratv aua hat rdr h varty o hua prc  a way that a h dad o ur tlb ad raoabl   hould b otd that Fro Froh h th tp tp bac  howvr a d ur cauto ad rpob rpob yy  a  ar rct o Sdwc rpo rpo  to Foucaut t  cruca hat th vocao do ot ao obcur th ur raty o th chzophrc codo (Froh 991 78). Froh aoca (tr) dcotructo wh a aac o ral v. h codo  aa  th  rd r d ad ad o   a   wa a ral ral'' th ou hr h r  outd aua a ua oud al al  o th pruav ad ad corcv corcv pracc pracc that brouht t to b ad whch aa  aat h prott o o

ay patt t ca b dcud wth th dcour o ta halth provo uch a w hav  th pychoc dcud  th clcal  tratur  hould po ou that t  ot our to hr to to l out

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Radica meta heath

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pchanal pchana l a  the nl vllan ; cl nca pc pchat hat  and pchl, pchl, whlt ht n the pet al take delunal  t when the eek t nae nde nde (Ble (Ble ,  990 90 , and then when the eaue eaue halluc natn Clncal dan, n t t cncete pactce, et ut te atcall t undene the patent bele te (Chadwck and Bchwd,, 1 99 Bchwd 994. 4. hee pnt need t be kept n nd Each  t d wth the epductn  pwe n clncal pactce he t  ptance  pchatc lanuae aned nt dcue whch cntuct pathl  n wa that ean that the dct  en enun une e htened   the aet aet   the patent paten t and   h  he he wn aet aet.. Medcal pwe pwe enue tha thatt thee ae ak the tpe  expeence patent ae petted t decbe. he ecnd  the ptance  the dct n an altenatve appache Medcal pwe  expeed n e  the t adcal adcal ant pchat' expeent n  n the wa the pchatt a expet  tll allwed t take the lead n an an the e e (and, (a nd, a we hall ee , th apple t Baala n et etee , Hube n Gean, Gean , and Re n he Netheland. he thd  the ptance  that pwe n e pae whch pe a patnehp between the dct and the patent. e ae nteeted n edcal bud n pwe budn a dalue, but weedneed t keep the ned centen thee  u ana anal l hw  epduc epduced and hw t  t c hallened challe tpe  allance. h  cucal  we ae t undetand ad decntuct pwe n pchpathl. pch pathl. et u tun t e  the pactcal wa thee dcue and pactce have been decntucted, n e cae  the bae up.

Three fates f resistance Ppula textbk n the ht  pchl and edcne ten cence the naatve wth the ancent Geek Ft ea pchl undeaduate,  exaple, ae expected t be peed b the knwlede that the Geek beved a elatnhp between htea and the eale epduc epductve tve an (c une, 1987  e ht have pee peeed ed t cence wth the equall cntveal the  the pchlt ulan ane (1976 n whch he aue that up t 1500  all the Geek head vce, bee the latealatn  ban hephee and the develpent  cncune Rathe than ann the bennn  atnal cvlz cvlzatn atn hee, we ht ephaze the wa n whch the Geek n ped ped   c c and decnakn decna kn ltened l tened t the vce  the d and pehap pehap taked back  walkn walk n the t tee eet t wthut the al panc whch enue tda (even thuh Hppcate wa nt happ wth th tuatn. tuatn . Steppn back   the  ht   pchpathl pchpathl  w e nw want t  ve ve  t ntead e  the tatu  thl athe than centc ht. h t. S ,

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118

Decostructig psychopathoogy

w will wil l b guidd by th rt Ft Clotho   pychopth pychopthology ology i i bor ito th world  th gz tr th ylum d  bdlm thrt to pill out i to th th  com com muity  H Hr r w wil l mi th th  t t o th ri rit t primt d mtl hlth work combid with politicl ctio i workig c commuiti h udr th y o chi th cod Ft w look t th li o ritc th Ft t h pric pric o dirct ctio i th rm ocilit ptit collctiv i th US d i mor ocil thrpy Filly with Atropo wth corot ivitbl o pychopthology  w mi rdiclth chlg o th th dth Hrig Voic Ntwork i h Nthrld d th U hi i our third Ft or ow

h  1978 i tly  mtl hlth rorm lw (w 80 w pd by prlimt which tipultd tht mtl hopitl hould b phd out d tht thr hould b b o mor compulory compulory dmiio hi w w whic w hichh cm  ito  ct ct i  1 98 1  w  rpo rpo  to ctiviti by  cmpigig group clld Psichiatria Democratica which hd mgd to collct igtur or  rrdum o mtl hlth proviio Although thi movmt w ld by pychitrit th mot importt big Frco Bgli it icludd ctivit rom dirt r t group ptit group d rom th Comm uit Prty which t tht tim w o th vrg vrg o giig powr hr w th  cott or rctio d mpowr mt mog dirt mrgilizd group d Bgli took th ld i th Northr city o rit to lo th mtl hopit S iovi d to provid rvic or  w ctgory tht h dubbd th mrgitd h popl icludd h icludd tho who hd b i S iovi or who might hv trd th pychitric ytm ytm  d  d y oth othr r popl popl who might m ight d ocil upport h philoophy o th rit rorm (o-clld prtly bcu Bgli w th drivig orc orc i rit d bcu othr locl uthoriti drggd thir t ovr th w w tht ill w  prio o ocil circumt circumtc c tht ctivit hd to gg i diti tutioliztio ot imply dhopitliztio It w cry to chg th mig o mtl mtl dtr through tivl tivl hi hibitio bitio d through mki g S iovi  commuity comm uity rou rourc rc (Bgli (Bgli 1 98 987 7 Pychologit workig i th hopitl chgd ob i thi w climt with om workig i S iovi op commuity c d om workig  grdr O o th ditictiv tur o th rit mpl mp l i th grl hotility to pychothrpy pychothrpy  d th mphi w o th collctiv work tht rvic ur could could udrtk i th cooprtiv cooprtiv which rgd rom hirdrig to uriturmovig dictio w ud oly to tbiliz d ot  prt o  trtmt rgim A twork o v Commuity tl Hlth Ctr w opd through th city with o bd t th old hopitl it likd dirctly to th cooprtiv

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Rada mea heah

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workshops ad aothr or th Sloa morty commuty  rst) hs ctrs wr ru through op mtgs whch cludd usrs. (hos (h os who ha d b  Sa Goa Goa  or or m ay yars ad wr uabl to cop outsd wr calld gusts ad had rgts to partcpat  th mtgs thr) Actstss rom Actst rom othr urop uropa a coutrs a s wll a s ro rom m at Amrca Amr ca ha tralld to rst to hlp ad partcpats  that prmt ha tralld back  rtur to attmpt smlar prmts outsd Italy Comparsos btw Ital y ad th stuato  othr Comparsos ot hr coutrs also ral th scal o th problms acg Phara Demoraa (Ramo 1985 Ramo ad Gachdda 1989) ad t looks ow as  poltcal ad coomc orcs ha bat back th rst rorms ust as t s mpossbl or slads o socalsm to sur  a captalst world so t s mpossbl or cooprat trprss to compt  a hostl coomc rom r om t ad or or mtal actsts to st udr a crasgly rght rght wg local ad ctral gormt. As a orld Halth Orgazato plot ara th srcs had always to b prodd to thos dsgatd as surg dtabl llsss ad thr has b prssur rom amly orgazatos orga zatos to to rtroduc hosptal hosptal tratmts. h hosptal clc whch s stll  th grouds o Sa Goa     addto addto  was always hostl to th rorms. Som commtators o commuty car ha argud that  som placs th psychatrc wards  gral hosptals ha rproducd som o th worst aturs o th old mtal hosptals such as physcal rstrat o patts ad th dscrmat us o drugs (Barham 1992  4 1)  hs aturs hs aturs crtaly appar appar    th U K  whr thr  s a gratr gratr spac spac or rssta rsstac c prcsly pr csly bcaus bcaus  o th stc o th Mtal Halth H alth Act Act.. I Italy  prcpl at last th psychatrst was mpowrd rlasd om h -k o th buau.  h UK  h mot wll mag psychatrst has b caught  th msrs o gormt gormt polcy (Colma ad Mcaughl 1994). hr has b o mass momt dmadg th closur o th asylums  th UK ad a he ame me buldg a twork o local mtal halth ctrs. I othg ls th rst showd a progrss poltcalsrcs cottthat mass chagsprmt could b mad rythat astwhch would prod wr mor usr rdly. rdly. O o th ro ros s  all th ths s s that bcaus th drugs drugs bll was lowr  rst atr atr th closur o Sa Goa  th t h proso o good mtal halth car was actually chapr or local ad ctral gormt  ca oly coclud that th bggst problm acg a radcal mtal halth momt s ot so much th balac o th budgt but th balac o powr ad th tt to whch that m ay b thratd. It s  mpossbl to dd dd slads o prog progrss rss  mtal halth car  a hostl poltcal ad coomc clmat but ach sporadc attmpt to mpowr usrs s a ampl ad lsso. O O cas  th U K whch was partcularly cocrd cocrd wth workg class ad wom s commuty comm uty acto

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Decostructig psychopthoogy

wa th ht t prct  t d  hav draw attt t th abc  wrtg ad act ard cla  th pchatrc tm ad th th  ht t prjct tad t t  t t gagmt wth th  at th am a m tm tm  a t tackl d thr vart vart  pp ppr r  Sm dcrpt dcrpt  th th wrk la havl   pchaaltc t bt b t th prjct prjct  whch wa bad  attra ad th ht t attmptd t bld pch thrap rvc whch tk rl th trrlathp btw gdr rac ad cla    th xprc  alat ad dpr dpr  dr captalm Hlad 992 Hllad ad Hllad 984) h tala xprc  a mxtr  cc ad alr wth g r radcal that t  pbl t dp wth larg alm ad hard pltcal l abt wha t happ wh a htl ht l cmc clmat tart t pr pr    h  h actvt  th ht t prjct dd t v hav th bt  a pplar actvt mvmt ard t pprt thm hat th rrm dd achv thgh wa th lkg  thraptc wrk bradl drtd) wth mpwrmt ad cal act Each ca lltrat th mprtac  th wdr ctxt r radcal mtal halth wrk h rt xprmt xpr mt rvvd  rvvd  lg bca  a vart  rc ard t that wr mpathtc mp athtc whl th ht ht t prjct prjct trggld trggld t t rvv  a drt mr dclt ctxt ad matad tl r a br prd agat th dd  tr t m thr xampl  drct act xt whch wh ch hav hav  had t tackl prblm  pltcal ctxt ad hav trd t d  b lkg l kg wth brad bradrr pltcal mvmt a all  a ht htl l cltral vrmt

eche  Grma th Soziistche Ptietekoektiv SPK) wa dd b lgag lga g Hb Hb  at th th Pchatrc a add rlgcal U vr vrt t Hptal Hptal  Hdlbrg Hdl brg  90. 9 0. h SPK argd that mta mtall ad ad phcal ll wa wa a rvlt agat a a wrld  captalm alat pllt ad rprv xal mral It ght t tr ll t a wap hl rcvg lttr ad pprt rm Sartr ad Fcalt th grp acd mch rtac rm tdt grp th vrt admtrat ad th plc  h SPK dbadd dbadd  19 1 9  at atrr whch vr vral al mmbr wr wr tcd t pr a trrrt. It wa all lkd wth th Rd Arm Fract. hl  ltar cmt  93 Dr Hbr dd th Ptietefrot whch ha xtd ctl c that tm Spadlr  994) h SPK actd al r th mt part ad th ha b a apct apct  t wrk that ha markd t actvt c Radcal act alwa rk allg t ctara qabblg wth rval grp ad that vc crcl ca l b brk b bldg calt acr drt campag.

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Rdic ment heth

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h epeee oe  o e wh he e ewokg  obbg o oh me   he oe o me pgmm hl hom S oll poe 

em mke o o he lbeo moeme  he pe pe o he oh me  h ouel ume ume  le o   ow ow  ee o gg ool o mel heh ee. Ju hmbel e he poo e mu emembe h em ke me e o ho phe e ueul ol  he help u o ue wh he ebe hmbe  1988 1988:: p. p . hmbel w oe oe o he oue oue membe membe o o he ol ll e o Mel e  ome ome  1 985 985 ee o o he bolo o ou ph eeo  he eelopme o ue u pogmme  ue ee o he ph em.   mpo hee h ollowg S he oep o me e  queoe   eplo o eg hum behou. I 199 hmbe w be o epo he begg o  le bewee he b moeme  ph uo oe he em o e oe o e ph ph  ( Dendron News Summe 1994 5. h moe o ol om  ppoh o me e wh  o ouo mewo m ewokk   wg o he h e po o bl bl  bu lo oe wh ohe m ho he wheeh emoo  Fe og e b he Comit de utte des Hndicpes o he oupo o Soke Mele hop  he U b ppeg  980. Segwk w pehp peh p oeome oeome b pemm pemm  g h h  Mel pe e e mog hee mo h mo p p  ee o   e e  . . . he gm he l o he ou ble  llee uull pee mo o hem om eg  goup e  publ o he pupoe o emoo o l ppel Segwk 182 222. e o  he Ue e how h   pobe  oge ollee g ph eo  hough ueobe o o bu  lee ommu whh wl uppo hoe who ee .  uhe eeopme  he Ue Se  o ome ge.  o o he ole leg o hom S  Hebe Spee     be o  M M  o  e ll ll hum hum  eg o he Soe pholog Vgok. he ue o So hep  o ol he o  pubhg  ul ulu u ee ee  wh  ow Vgok Vgok lboo hoo bu o h  om ow pol p. ohm oue Fe ewm ube he po eeop mem he pm o epo  he oe o phphlog. Folowg o om ee o Vgok  -pholog  Hol Ho lm m 1 995 ewm 1 99 99  book book ets Deveo  hme pop' pho phoog og   book h wl w l hge hge ou le' le' . I  owe   phol wh okg o oue o gowh  hep me   m publ  pog  me o eeee o hoe ombg he phologg poeo. ewm' pe o goup  gok gok  oe o pom eeopme  o  he eo eoue ue o he

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Dcotructi pycopaolo pycopaoloy y

lhlp movm i  cordicor w o xcludig h hrpi (i dd hrpi r o pr o h group or dig  gg gg m i poliic Chrcriicll Amric ml hlh pliic r orid owrd rdr udr h lgl m.  h c o h wm  wm  group group  ck o hir  hir pcholo pcholog g proc ld h group o k cio i h cour gi h FB i rpo o h chrg lvlld gi hm  hm o culim . Thi Th i w i h cox o h ig o co d

h prcd (d h proi hi  or h rm o group who ppd ouid h g o h iiuio o pcholog (d h iroducio o piriul diordr   w cgor i DSM-V migh rv o xcrb xcrb uch r. r.  hould hou ld b poid ou h h ciol ciol civii civi i o h wm group hv md h r o h    u  wr o hm (Hrri 995; rkr 995b.  h U oo h rol o h ml hlh chri MD i coil rmd coil rmd i i  rm o lgl dvocc dvocc  dd iu o hu hum m righ righ   ll  iol MD i h wk o h Blom-Coopr Hll d Murph ( 1 995 rpor Murph rpor (wih (wi h  wirdl wirdl Jugi il i l  h Fllig Shdow  d h bloid hdli o Sl Slughr ughr i i h Commui Comm ui  dd h lik li k  o rpor h umbr o dh ribubl  pr o urolpic mdi cio  o dh  wk ccordig o MD (Mi hil l  99 9944b .   i o h locl uoomou brch h w mu look or w iiiiv d o h dvlopm o workig or hir rliio v h grroo orgiio o h pro-pchir iol Schiophri Fllowhip (SFd Mkig which ollowig h SF pli  hi h pr p r dpi dpiSp  h  h group ddicio ddic io o mrgd h iol orgiio orgi io  o biologicl rrch d h d o crr Som S ocl group r mor progriv h ohr. lig or cr i h commui h ld o umrou u mrou ur ru rvic rvic lhou lhough gh m would  hi  okim i h cox o h cu i iol Hlh rvic udig. mpowr m i h buword i hi cox d vrwhr xmpl o good prcic r hrldd. Mwhil  mdi wr h b dclrd roud h iu o cr or orcd rm i h commui Hr h ml hlh chri SA h h high prol bckd grl b h iol pr A wll  drwig io o h imporc o cox h dvlopm dvlopm  i dirc cio i rm h Uid S d d h U mk clr h  h mporc om poliicl poli iclU rmwork rmwork or o ml movm.  ihi rpco civi i h hv much lrhlh rom dvlopm i ohr couri d  poliicl udrdig d dcorucio o pchir pchir h o iclu iclud d  irioli irio li prpciv prpciv d h dcorucio o prochil hikig So r w hv rcd  movm ddicd o civil righ d coomic d hrpuic pro viio  bu ill prdicd prdicd o h xic o ml ill. i ll. ow w w ur o o o h mo rdicl o rc chllg o cliicl ro h work o popl who hr voic who hr o urvl pchiric

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Rdi me heh

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ator ro ro t d wl w l arr orward orward t da da  o rtqu ad powrt tat aratrz t ovt w av dud o ar

Aroo T Har Vo twork (HV all t alt o tal ll ad rd ara o xpr outd ll outd  t patr apparat apparatu u I t to w wll ou o t dvlopt o HV a radal

ovt dtud b t otut wt t tradto o Dorat Patr ad a rtqu o t dal odl. It al or partrp btw vo arr arr ad all all  ad t  t  attrat o tral tral ud. It  popular aot rv prvdr ad dvlop  paralll wt a row bod o poloal rar rtal o t opt o zo pra  ad t  tpp w t a to t w ouauld ouaulda a tor o patr a tor ot o da patr da but o disourses T tor o HV  t UK t b trad to br o t twork Survvor Spak ut Howvr t  prl t tatu o vt w HV td to ubvrt totr wt t opt o popatolo T vo ar  a ral I tat to rtur to Fouault tatt about t dalou btw rao ad urao raoabl Crtal  tr o t lxo o aboral polo audtor alluato aot b ral. Bol ( 1994 9 pot pot out tat t quto quto o ralt ad ubjtv rprt rprt  a prooud prooud u partularl w t porta porta o ultur  tak to aout To lal polot t dla av potd to t poblt o a altratv zopra rar prora oud or xapl o pto ratr ta ro dao (Btall990; Bol 1994 Ev t t o a arr t ow dar tou ad altou Btall (1990 or xapl tak t poto at t vo ar ral  t ar ow t ubt ad pto o a w patolo Vo ar a a dt oal ta  wtr t  ud b t at o a aou ou vo arr  wtr t b Ju Crt Cr t oad J oa o Ar to Curll or Crtopr Clu  or pl b t ovto tat talk to ourl or to vo  ot aptabl For aru Ro t Dut proor o Soal Patr wo   a t oudr oudr o t  ovt ovt  t lo o attd attd to t  oe o vo wa ot ol to upport t dvlopt o poloal trvto but alo to tak vo vo  out o t ll odl od l to  t a part o a pattr o proal rowt rowt ad a a at o ua xpr xpr  u a lt-add or ooxualt T trat to t tablt  o a lobb apa to rov vo ar ro t DS.

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Decotructi Decot ructig g pycoptoog pycoptoogy y

Romm ouragmt to vo harr  thu drt rom othr radallyy humat radall huma t tratmt o hzo hzophr phra, a, a bg wl outd th da modl r t a   993). But or Romm th ov da ovr ro o dd ot om aly; h aout drv attt attto. o. F m a n  m an a  a ld man a n ang c n  mnd  c g  d  d   d ng and dmna   cmll cmll  S  a n ald ald al m m and dagnd dagnd a ang cna Nlc a n c n  c alg  d dc  an nnal  dg al dc  mnal aln cnqnl  d n ak mdcan   lng d n d  man lng a an nan n   ald Nl  c a ncangl lad   ddng   d ng  ad ala ld La a addn  alk mm and c m qnl cld  ang a a  mga  ncd nand T

nl  n n  cnan a a m a dd     ad dld a  na   c T  a ad n a k   mcan clg Jln Jan The Oigin of Concioune Concioune in the Beakdown o the Bicamea Mind (  976) 976) S nd nd  ang  ad a  ang  c ad n gadd a a nmal a  makng dcn nl a 1300 Be. ccdng  Jan  nc  ang c a alm nl daad and n lacd  a  n call cncn  gan  nd   mg    a gd cmmnca    al ad c and   mg nd   accal  l  g  mg a a  ac n  lan  cdal ndnc and  lng  dndnc n  c g  and  gan  lan a n c  mg a m   nc and  n d c   nn mng   c   a  lnng    cnan  a ck ad agn  c  cgnd n an nc nall  nd  dcl  ll  cnan  m a  cnn  a and a dna and  all  a l dcd a g  cnd a al ld   and n l l (Rm m and c c 1 993: 1 1 )

t  qut lar rom th aout at lat to vo harr that HV had two ou oudr dr  Pro Proo orr Maru Romm Romm  ad patt Paty Hag  ad rom ow o, thr th r wa to b two ompt omptg g htor Romm ad Hag rarh tratgy drv a ullr aout.  th rt pla thy both appard o a popular tlvo hat how to talk about vo ad pyhatry ad appald to vwr to otat thm Th ormd thr rarh ampl ad th ba r orgazg th rt vo harr or  Utrht  198 whh wa attdd by th Duth mtr or halth . Th rpo o th Duth mda wa ympatht  otrat otrat to th mda md a  othr outr. Th Duth rarh rarh ha b publhd  dtal lwhr Romm t a   992) 992),, howvr a ovrvw ovrvw o th th dg  prtd hr ot oly bau t ottut th ba o a xpadg trag programm dvlopd by HV but alo bau t po mportat quto or th dotruto o hzophra Th dotruto  playd out byod th lal joural  a growg

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Rdic me heh

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wrk  mdca lhlp grup. Aga  a backgrud  h alur urlpc h mrgc a hrd  Rmm ampl  a cpg wh vc whu rcur  pychary wa mpra. Thr vc wr  a rm whch wuld arac dag by a pychar. pych ar. Th rp rp  ugg uggdd ha  wa pbl  accp ad lv wh h vc ad a  culd b  pv valu  cpg wh l v Thr  w a grwg lraur  clcal apprach  cpg wh vc. Th vdc a parcular  bw cgv cgv bhavural ad pychdyamc mdl   hrapy mdl whch whc h  ualy wh h prcp ablhd  h lhlp grup Mrvr hr  a vacuum vacuum  grup apprach  h clcal g a ac whch crm h praccal rl  h lhlp grup Thr  al a  bw vc harr  HV ad hr clcal rarch all wh ar  yg udg r clcal ral by drug cmpa Vc harg  hr rmul rmulad ad a a rdual r drug ra ympm  wh wh  h   h DSM r CD ad ubc ar maad  abl urlpc md ca hl hr  hg abl  h ur abu urlpc mdca h crma  da au ac a a cur  h

pychhrapuc rv. Th u  crl ubc l d cly uhca l whl r r h kg  rduc r r lma lm a mdca hg   r r hl h uc  dpr ad dlual b ym  cpg wh vc mrg a a prma dg prblm h r rm m  clcal rv    rv  rcrm h h vc harr  h rl  vcmhd wh h rarchr am  g rd  h vc ad  akg whhr hy mgh b a mpra par  h harr dy. Th   vc harg a a apc  grwh  crmd by a mpl bu pwrul ccpualza  h xprc mvg hrugh hr pha h arlg pha pha  h pha  rgaza ad cpg ad h pha  ablza ad gra. Th arlg pha  h prd    vc vc   dr ad ar   prhap mhg mh g ha crrpd m clly  h ppular ad clcal pcur  acu pych;   ca la a l-m bu d . B Br r h alkg alk g ar ar h vc harr wll hav dvlpd ram  rrc h hallmark  h rgazaal pha pha   bu h h may b cagr cagrzd zd a dlu dlual al ym. Th ablza pha   ly h gra  h vc h ympm) bu a wdr chag  h cy  h pr ad h cc wh a rg plcal rad  HV whch   har wh cra cra rad  grup-rd pychaaly)   pracc  h wrk  h l l hlp grup dvlp rm aclag accpac  h vc  bg abl  alk abu h c  h vc h rggr rlahp ad cpg rag. lmaly h dyamc  l-hlp  HV rqur crg ad rcrg h budar bw pha. A h har  ha acvy  rc up h aur ad racdc  vcm au.

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Donstructng psycopatology

ht sms s ms most i mportt is tht th t orms o o xpltio xplti o r cssry to to hrrs copig  strtgs It s i th o xpltio thtoth pths o voc prossols smr to ivrg   btt scourss Tlpthy s  cs cs  poi t; th th D S stictly stictl y row rows s upo upo t , rgrig rgrig it s pthologcl, pthologcl , whrs i i  th Hrig Voics twork t i s ccpt ccpt s  v xpltio  it is hlpul or th voic hrr Th circumstcs circ umstcs o ost wr  proccupto proccupto tht orm orm  prhps th most m ost cotrovrsil cotrovrsil spct o o th rsrch. rsrch. Romm  schr (1993) i c ct t tht 0 pr ct o voic hrig h rig ws triggr triggr by trum, trum , by li l i vts It is lso worth otg tht my ptts rport th ost s big trggr by hospitltio or mcto Furthr to ths, HV trrs us  tchqu which simults th xpric o voic hrig, mo strtg tht th scory symptoms o schophri r i ct ons quns o th th xprc xprc o hrig voics Th cosqucs cosqucs o this r twool For psychtry t icts tht lrg umbrs o schophrc ptts shoul b rctgor wth post trumtc strss sorr' For voc hrrs t crts th opportuity to ttmpt to xm thos l trums Thr r  umbr o mplictios mplicti os o this work to o wth th rltio btw mci  commoss,  rltio tht th ctvty o HV ctvy costructs. Th rst mplctio woul rqur  rcl

rvso o psychtrc thory  prctic whilst th sco woul rquir  chg  th cultur o psychothrpy (whi ch is grlly grlly tgostic tgostic to th possblty o workig with psychotc' ptits  woul rs  qusto or voc voc hrrs bout wht k k  o srv srvc c thy rqur k th costructiv thrpy w scrb  th prvous chptr (hit,  987, 99) 99) th th rlty rl ty o th th vics s tk srously   th symptoms symp toms'' r xtrli' so thy c b rss by th hrr s prt o thr rlity , s hrmul hrmul or hlpul hlpul to thm  Rthr lk qur' politcs, which rws  orml' prvrsios to th rg o xprcs tht th movmt is ghtig to hv rcogi s vli s prt o th vrity o humty (Butlr, 990), so hrig voics' is rcocptuli s som thg tht t ht vryo s  ct by. Th vry t to o o wht it i t s to hr'  voc s pck prt  prctc by HV s th umbr o rt xptos xpt os or or th phomo m ultpl ultply. y. h hth thrr t is s s s  vrty o ttus or tlpthy , voc hrig couss y mcl systm whch trs to ctgori ctgori symptom symptoms s Th spotlght is th tur rou rou , s wth th qur movmt, o to thos who r ub to tolrt th vrty  mbiguty o itity tht rsults. It hs b rgu,  ths costr co struct uctv v sprt spr t , tht clcs cught up  ths wy o 1994) thkg m y my b surg rom Prossol Thought Disorr' (owso, Att to s rw to th typs o scours tht isst o rg ctgors or m t stts ,  scours tht obsssivly ctgor ctgorss ccorig to  logc tht prts to b rsobl but is ctully vry ursobl,  scours tht w coul cll psychotc' HV hs so r mg to

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Rdc mnt t

127

cnnect an attenin t cntex and pliics wih a sensiivity t and engagemen wih expeience

Cncluding cmments have be We have been en cncened in thi thiss chape  cnn cnn the enigma cntained cnta ined in Fucaults statement abut the elain between easn and its the Alhugh sme wites have pined ut that the phlsphical impli catinss  Fucaul ts histy  psychiaty catin psychiaty and Deidas decnstucin ae deent and that decnstucin nds it dicult t lcate isel in any kindd  histy  kin  exam example ple Byne By ne 10 u task hee has been t tun decnstuctin int a plitical weapn and  that Fucaults wk has been invaluable. n ecding a histy  he prcic dcontructon  psychpathlgy we d nt want  educe educ e quest questins ins  cl clini ini cal pwe t t a simple analysis  lnguage independen  cntext  t educe the challenge  adiinal psychiaty t a quesin  talking  nt abut he cnent cn ent  expeience  We have theized theized elsewhee elsewhee n this bk abut abut the naue  cmmu nicatn as smething scial thugh and thugh bu hee we ae cncened with the pacical elatins between the pahl gized and the pathlgizes pathlgizes with the elains  pwe with plitics  he lack  cmmunicatin bidges between pessinal and clien ae cmmn knwledge kn wledge in mental me ntal health healt h discuse discuse  and the medical p pess essin in has e enn been held as a mai mainn culpi . hee is a j jke ke in use use cicles Wh

is the psychiaists st patient patient m whm e leaned his h is cmmu nicatins skills and his bedside manne? t which the answe mus be A dead bdy in medical lgic hy  this is psychiatists shuld medically tainedschl. in hehe wds shuld n exst as they nt d e a pesen. he he de t this pictue is the le  psychlgy as a discipline which pmises  epai behaviu and ebuild bidges with cliens. ecen develpments in sevices have been chaacteized in tems  use nvlvement nvlvement . A useu useull exampl e  this s he emege emegence nce in he U  Suvivs Speak u. Many membes ae als membes  HVN which is cmmitted t a me decnstuctive decnstuctive appach  diagnstic categizatin categizatin  his n nly n ly tesies tes ies t hw divesity ad adds ds t the stength  the the esistance esistanc e mvemen but it als helps set the sage  talking an advance n he sapbx sapb x and an d the sap pea eatment  distess  this pcess is en en applied he tag  empwement. As we have nted in elatin  the talian expeience we evaluaed have t ask wh  is eally being empweed his empwement can be in ems ameliatin  scial elatins but nt in ems  wneship  the means  pductin  psych pathlgy pathlg y  ne espnse t this way  cnceptualizing the pblem is i s t develp  cllectivist  axist mdel  selhelp Cleman and

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Deconstructing psychopathology

augh 1995) o ha we have o u o he ex A polal eooy of hs ex howeve woud have o lude a aou of he ways  whh he foes ad elaos of poduo ead o psyho pahoogy o alow  o be asfoe asfoedd ( Wae 1994) We ae oeed hee wh deosuo o oae psyhopahoogy wh he ex I expadg he oo of dsouse o ude paes of egulao ad essae we ae oeed wh he plaos of hs fous fo uses' of psyha psyha seves seves  ado adop pgg he e use ' as opposed opposed o eal pae' o ea heah avs' we ae osous of offeg a dsguse fo he ealy ha hs use' ofe s o voluay ad ha fo he os dsessed oee ad eae s deeed by he eal Healh A ad s subsued  psyha dsouse whee he oo of foed ose s o ope o eogao he e osue osu e s eve wose wose  ad s suely o he kd of de deyy ha ayoe would wa saped o he Alhough people do soees efe heselves adplae usually soeeeg) heapeu o sa oo plae of asylu (a safe fo expe esg ad he suppo osue' ofe foed o sele fo a age of bad edes All hese es ae augh  dsouses ha soees waa ad soees obsue oppessve paes he dsouse of paes of ae  he ouy  fo exaple  as so as as o sofe poles eadg o opusoy eae  he ouy ad egses of hose osdeed dageous he Beda os dae ha hages ha ges  aeal  aeal odos ae he key o hages  he aegozao aegozao ad eae ea e of he a d ad he foues ad ses of apals apals povde he deg bakdop fo how eal healh s oed o goed (Wae 1994) Ou ask s o deosu he elaoshp bewee aeal foes ad he eag people gve o he o bg hose poesses o awaeess o he ex ad o epowe people o hage

(199) he Ahough as aBoyle ouaspa laks se shzophea shzophe a s sll powefull egapos powefu oep o ep of h he e ealvaldy Heal h Healh A fo exap exape e  As suh  s aso he sub e of po pos s ad hee we ae oeed wh he oe of aguage o defy he dyas of powe elaos ad o upse he  a a of deosuo ouaul's heses o he Wese asylu  elao o he se of apals apal s a be ed o he speale speale of he  osue osue  he ue peod  Ia y ude he he auspes of Psich Psichiatria iatria Democratica a add  B a ude he sues of goveea ake deology Slay S lay  wh  he dese of uh edae possby of oeve ao (a eas wh he suos) he sea of essae sees o ove dsusvely o poy akes I aohe sese a ehos of paeshp' (bewee doo ad pae) pevades eal heah eseah ad pae ludg he dspesg dspes g of he l ed fuds fuds ade avalable hough houg h he pogae of ae  he ouy hs a aso be see as a exeso o eal healh of he ppe of papao he ole of pae goups  geea pae (hadso ad Bay 198) vdee of a goudswel

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Radi Ra dia a mnta mnta ha hath th

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 us ad ssta t th atshp tw a pshat ad th phaaut phaauta a dust ad tus tus th s w sta st ash shd d H , 98  ha t t d ut wh ths ssta ht ad  ht tak  ad B's (1990) aut that th ass st shpha pa pa s dusa ad udstad udstad h pa (1994)  thda ta'  dp dp w sa sah h ut t th ds t  ad a who u  sa sahs hs shud   a d t appah what t as wh a su spaks, wh  has stak a a t w th p phaps  ps a   ppt ats wth th aats aat s  dsus As a paad shph shph  sad t   us us Just aus I thk th pshatst s ad, t dst ha t  a pt dtat Ou dstut  ths k has  dtd at th aua ad pat  pshpath u  s t shw hw th k dau' Fuaut dss, th ak  dau, s  sussu wh th s a sustad attak  spas  ssta A ada appah t ta hath ssa s a d  ths spas, ad a utpat  utpat  pata pata has ha s t a pw that a a t k ts  dt tts wth a pta awass ad attt t p It shud  a  th aps  ths hapt that tha t th st stps t a pata dstut  pshpath ha   tak  a ts  s s ths k as pd s aass, aass , sus ad  t  that stu wad

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8

Dccv Rp a Rc Thi al chaptr aim to do two thi Firt w wi aticipat om o th ractio to th armt w hav dvopd i thi boo Critiq o pchiatric dicor dicor ad c iic iica a practic alwa hav to cotd with a ra o c ad dc rom tho who colld with, or v activ mpl mplo o traditioa otio o pchopatholo Th ra ra rom rom tird worot roti that war dow radical i mta halth to vitprativ ad apratd attac o ao who dar to t that thr macritiq b athi a thi wrotoW wilom b pici p om th b ractio to othr ad tri or tio thatoma  or tho wori i ad aait th mta hath tm Scod w wil b iti ad dcribi om o th practica rorc did to pport a critica prpctiv W do ot prtd to hav b th rt to hav voicd diarmt with traditioa cliical otio ad or wor hr wold ot hav b poibl withot th aciv ritac o mta mta ha lth rop ovr th ar  ithr ithr do w prtd prtd that dcotrctio dcotrctio i th  a wod i a adica p ppect pect  nd pac pactice tice a d w hop that or or radr who mov o to b ivovd with om o th ropi ad twor w mtio dcotrctio wil ol b th rt word th rt tp

Reactins and respnses What miht impatit pchiatrit wordwar cliicia ad brtot paramdica paramdi ca mtal ha th worr worr a abot abot thi boo W hav trid to aticipat th wa i which or boo miht b (midrtood Th

ario poibl claim claim  ad compait abo abot t it hav b ro ropd pd blow ito worri abot thortica ramwor th rio atr o ditr ad th rad radrh rhip ip or th boo 

The he  eca  a aew ewk k W imai that om pop wi hav rad Drrida ad Focat ad will wat to dmotrat thir owld ad prti i tho ida b poiti poit i ot o t whr w hav dviatd rom a corrct drtadi drtadi  o thir

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Deconstructve responses and rsources

 3

wr. h rs rs mplan mgh m n  n h rm   gnral rran ha h a tthe he boo b ook k doesn doesn t accurat accur atel ely y chara character cterie ie theoretical theoretical sys system tems' s'  Ardng  Fuaul nwldg hral and sn ds n dsrb a pr xsng xs ng raly bu nsru nsrus s ral rals s ur n nrs rs ls ls n h rals ha ur us  sp hral sysms mas pssbl  h us us s n h way w xsng an us sysms hs hral sysms rdr dnsru h alrady  nwldg and npra l a hs hrs wh h am  ndng wha s usul  us n usng hm as hrs whh ral sm nd  ruh hs ds n man ha w ha h rgh  drm and msrprsn hrs I ds man hwr ha h a aura aura hararza hararzan n s n ur prmary am  hr al nps ar n hr  b p pur and b wrshppd bu  b usd n ways ha nabl alrna undrsandngs and pras ur pn has bn  lay mr mphass n xpsng nradns n and mplans  hrs. h mpla mpla n abu hry m gh b drd drd mr spally spally  suh as this isnt deconstruction at all just a critical reading' h prnpl  dnsrn s ha  unrals h nradns n whh plars bwn rms ar augh up and rurns hs plars n aur  h lss prlgd rm  ha llwd hs prnp n h b Drrda hwr s purly nrnd wh h dnsrun  xs  ar mng n hs b bwn h dnsrun  xs and a mr praal dnsrun  pwr rlans and h plars ha undrl and sruur hm n w m rm xs  pras h mhd has nssarly  hang nsqunly w ha llwd bas dnsru dns ru prnpl prnpls s bu ha als ammdad ammdad h mhd  h subj ara ara  ur wr wr And  w mgh as wh wns h dnn  dnsrun Sm radrs mgh bj ha this is a caricature o oucaults work' ll     ur wr ds ds n sm uauldan uauldan nugh nugh    s prbably baus w ha n adpd muh uauldan rmnlgy whh s ull  jargn and xdngly dul  undrsand  ha hwr llwd llwd h prnpls  Fuauls Fuauls wr  and hs hry  h rlan bwn nwldg pwr and pra n ur analyss  h psyhar sysm and h way psyhar nwldg and pras ar nrwnd wh nsuns and pwr.  urs r smn wanng a dald xgss  h wrngs  Drrda Drr da r Fu Fuaul aul hs b wll wll b dsappn ng ng hs was n ur as hwr and w ar dlbraly usng dnsrun and Fuauls hsral wr wr n a wa y ha wll pn up wh wha a psyhary and hr lnal pras pra s aually d  h prs prsnn as pa n . h wrngs  Drrda Drrda and

Fuaul ar nrusly nassbl (w ar n ld and prhaps n mr s h  h rqus  hm . Y hs ramwrs ramwrs may b sn sn as h radal undrpnnngs  a nw paradgm n h sal sns and psyhary psy hary  wh whhh has h as urnd urnd  h analyss  ds dsurs. urs. Bu w mgh nd ll dn dn  suh analyss whn h pls  mnal hal h a las

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13

Deconsrucing psychopahology

m  adpi   u m u mvm mvm   gagm gagm  wi  Fr Fr ik av i  a grai ak pa bid  vi  pmdrim  a w mig wa  addr abu i uura rd i i d w wad ad  apiia   imp im p iria iria  ad i pa wii  d  i drm W av  imp ug  ami am i  aadmi igia  a radia radig  d dui ui  ad pruuraim buu  diiv u mmaig  praia u Ni av w aid  p; a mpai abu i wu d b udradab wr mig rm rm  a ad r  parimiu rii (W prvid  gar  ru  ag W av avidd paiig u pag;  pi i r a b  mu  a Wi Wi  u aig wa ward rd pi pi rapui rapui ivi av mgd ugu  bk w ar rd m wi  dvpm  mm  abu  prai  pwr. W ak  dii ibui  duiv uaudia ad ari wrir iu bu i i a impra  mak  ria ida m  radii i mig uu i i w w av dvpd wa w a a paia dui  ppag wi i a pragmai gagm wi  dir rugg agai adiia adii a iia i ia i W av a draw draw up up argum argum a av b dvpd u   pai  radia ma a ad mii mvm, mvm r wi r i  ig pa i I  p, w av d m pua vi  pur ria m  m  i  bi bi a i i  diersiy  iiqu a giv i r rg g W d  mprd ad ag  maagm  abmai m ma di dii. W av dribd ia appra i  bk ad  m i s oo o o heoreical heo reical an and d full of of un unnecessar necessary y mi g bj bj   i ad a  his is jargon' Pap a pi i bk i  ria ad i dir iua adii a av mad dir udradig pib,  bk a ig  ia m ad rm r i impra  udad bau wiu i ag  di kwdg kw dg ad prai prai ar ar  pib pib  W d    wv, wv, a    a  v  r r W   u r   rui rui  dir dir  prai I i awa ad  avid uig diu ia p w quiig ak-r-grad u ad ppig u  vrda udadig Bid wud u b ird ird i  bk bk imp im p  dd u wa u aad kw? I wi a pbab b aid b m a he book doesn ake ino accoun recen rese resear arch' ch'  u wk   bad   piivi paradigm  i i,, ar ardig dig  wi  aumuai aumu ai  ii ra rar r wi wi  vua prvid  r udradig  wa i u r, i rai  W d d   m   ii ii prg prgr, r, a ad dig ig  wi 

m  m   rar rar  r    ru ad ra raii  i i d ida a b a uu . W a, wvr awar   ra ad w d u

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Decnstructive respnses and resurces

3

t n ths book hs charge aso negects the pont that recent research usuall usual l reers to new act acts s rom current domnan do mnantt ramewoks rather than new concepts whch mght mgh t n nterpret terpret such acts n d derent erent was was  Standard Standar d pschatr thnks t uncovers new acts but deconstructon helps us to nd somethng ver derent e have made choces n ths book book  a nd no doub doubtt that wl anno some readers who ma want to object wth somethng along the nes o what abut x m my y av avu urite rite radica theris therist t whse wrk w rk has nt n t been discussed? discussed?'' 

t o whch we can on sa that ths s ust a book! e cannot nclude everthng Is t the case that this just ks ike d antipsychiatry Smpl because because crtcsms have been mad madee beor beoree doe doess not no t mean the  are not stl relevant In pat t s the gnorng o basc concerns that makes some o these deas even more mportant tda oreover we are not smpl repeatng oder crtqus crtqus  and we de derr rom rom prevous theorsts n a number o was or example, n accountng or wh people desre to be norma rather than than ookn ookngg to to smpe coercon or a abellng bellng theores  an andd we are not proposng one utopan mode or therap Some  manstream manstream approaches approaches have drawn upon opposton opposton deas n the past and we have n o doubt that some o the crtques crtques we have deveoped n ths book wl appe appear ar aongsde aongsde cncal arg arguments uments n the uture uture Nothng wl ever guarantee that a radca radc a crtque wl sta that wa e do ndeed have to take serousl the recuperaton recuperaton  the neutrang and assmaton o crtca deas and we have traced both the was n whch some ant pschatr notons aled precsel because the were absorbed b man stream pschatr and the was n whch som deconstructve therapes have been lnked lnk ed wth tradtonal pschatrc pschatrc practces practces Aga Aga n  the soluton does not le n the purt o crtue n the hope that ths wl make us unassaabe but rather n the exble and tactcal connecton wth new radca aproaches that arse arse o repace the od ones on es here s awas place or hope here  e have hav e ound that t has h as been the th e attempts to grapple wth the worst cases cases o dstress and  nsttutonal abuse that have ed  ed to the most nnovatve deas e are aware o  and ths connects wth the second set set o crtcs crtcsms ms that m ght meet the book  how serous these matters are are

he er er ne ne  dr dre e e magne that some readers wl be less concerned wth the ncetes o theor and rather be mpatent wth the hghhanded wa n whch we seem to dsmss th thee serousness o the the probems we dscuss Some wl w l sa but what d we d with dangerus pepe? It shoud be ponted out that t has been conssten consstentl tl demonstrated demonstrated that mental me ntall l ll ll  people are are not more dagerous than the rest o the populaton Anwa we are not argung that dangerous people do not exst e are argung aganst the transor maton o the the gal  nto the pschatrc pschatrc  the pathologzaton pathologza ton o resstance as dangerousness and the egtmaton o oppressve practces on the bass o

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Deconstructing psychopathology

n  n n ponl commm com mmn n o nou nou c Alo n h  h book w hv hhlh hhlh om o h cuv lmn n h u o o nou nou n nn h lmn no ocu  no per se, n umn o bnonn ll om o cvl conol ov ponlly nou popl   cn b n   b o conn om o h mbu o pychy lonhp l onhp o h oup. oup . Th on o h h lonhp n h lm  clm cl m o ucc ucc n h pn u u  h h  no nul nul  on why pychy houl um um h ol ol n mnn h oup Dl wh hm  o on no   mnlly ll   n h w   no whn whn o omncz conon n h  h hopl hopl o pon pon boh cn b ully buv Moov  houl b pon ou h h mnlly ll' y n hopl lon hn on o n pon). hp w houl k why noun  n u. Th  no cnc vnc h book o chzophnc  nhnly nou o h communy; h  own vnc h nuolpc mcon oppon mnlz on n lncn o pn  W hv no n Chp 4 h noun  ovmphz n mnl lln n h v  n umb umb o pow powul ul n o ouu  mo mo  l kl klyy o b b kll k ll by omon no mnlly m nlly l l n n   cmnl c c u u  by omon omon you know mo pobbly n x-pn  hom o ou  pub h oun wh whch  hnk clm o wllh nowoy oubbou b m h econstruction justw puk pull llss eve ever rything own leaving those thos e who suer with nothing not hing''  u conucon lv ho who u wh   o nv. u nl h h  unvl uh o no mn h h  nohn l o h nyhn o. om unnng un nng n pc pcc c  cc ccly ly b hn oh oh  n ho  h on w  un n un o o    ho wh whoo u u ply u bcu o ho pcon who clm o c c o hm  om wll n h book oo xm n y omhn omhn lk it is too to o angry angry an loses loses sight o the reality o o practi practical cal care ca re  I  xcly h ly o pccl c w  ln wh n h book. Th book how how h pccl c  lnk wh ho n pcc h  connn n oppv. ccl c  no  om h lmn h hv conu h un nvul who un c o o An Mo ov   n ypooho pccl c w  houl ho ul b pon ou h h  uch ch  on wn by vw who  poc poc n ou o ouch ouch ! W hv no wn n n n  w hv hv bn concn    how h ym m o ovwhlmn. Th buon o on on nv  nv moon moon  o mnl m nl   on y y u by h powul o -lmz ccl vw. n h vn w mh  h ponzn lmn h this is not much use or the registrar at minight Wll   o u  h    wll n o uon uon wh h o h   on on  o k whh    lly o u o h popl popl hy    n whh h  oh wy ho popl cn b hlp. W  no pnn o v y np nw

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Decnrucve repnes and reurce

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menall ll llne ne' '  Y, a abou  car a h dene he realy  mena i i ac wa  book do  i  rai o a i  , , i    a i cai a a i i o oi i pop ad bu wic i corucd b pciaric ori ad pracic O  or ad i do o d  rai o a , ic  pciaric corucio o a i a ra c o  pop wo a io i caor caor ad i bco bco ir rai Para o i,  book do o d  rai o uri o  a i', bu i aru a a coidra c oidrab b par o i uri uri i  c c o pciar pciar   ar o di a pop ur pcooica dir bu a dir i awa diad ad corucd Our cocr i o ad o a diaio, ad o ak wa ir ar rd b  curr corucio a a car wi ao b ikd i o ca o  car a h h  rre rrepnble ad appeal appeal  vulnerable mprenable peple'.  poari udri i kid o a  a bw cic ad roric roric  Scic da wi  ac o o  word ad do o r o pruad, wi roric i  ar o pruaio, ad pcia o urab, iprioab pop i i a poari a d dco ruci, ad w a ad o p p i i dircio i  book  a  ow cic i  o  ura ad objci ud o  word, bu i d i ad aiaid rou pracic a io powr

 pruaio ciic kowd o  powr i aru or o i or io corrpod corr podc c wi do oo kidr o ra raio rai, , bu o i io i powru iiuio  a b upicio up iciou u rou rou  cour o  book abou  wa i wic ori abou dir aqurad a ru, ad  wa i wic a ru i i  r r  orcd orcd upo pop wo a i  powr o o ri  ar w awar o   o  pai a pop ur, ad our work i rap,  pciaric ocia work ad cica pcoo i o a acadic ar i bo book ok i a uc bad o our pracica ad proa pric o  iu a i i bad i rarc, ad i i a uc a o b a pu pracica irio a i  a o b a ducaioa  or or o i  d o a a  a   poi ad u o o  ird  o poib copai a i b d aai u, a w ar o ur ur wo w ar  addri addri

Wh  h hee     h hee bk b k  did  book o orr acii, ud ud ad a d pro proioa ioa iod i a a work, o cour or i ciica pracic, bu w a o ip wri i a a book oriw o  k iu i i a cour-  i b caid a he readerhp  h b  unclear  i  a rid o dcoruc  poari bw aca dic, u ud d ad praciior  radiioa acadic ad ud ud

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Deontutng pyhopathology

ad hcal su s u and a nd pacns ad su h ha a has  d wh h  h

pacc w ha d  ad such dsncns and nclud a xu  h ca cas s Acadcall nad ads ads h nd h h  k  paccal and pacns h nd   acadc  a dla appaln  a ds audnc  ak dwn s  h undas ha h a an a nan an ppssn ppssn  us/p us/ps ssna sna  sach sachsa sachd chd  and s n  F F   ln ks ks ha n ad a sal l spaad spaad scns  h ppulan Snc  s ad a an hn n wll pck hls n  acadcs   n n hca nuh pacns  n  hcal s nnd n h plcs  nal halh  h  F hsand alad jcd ha  th th     too au autou tou and wo wont nt go o fa fa a to ugget ugget oe oety ty  mad.  d n n  sus h ha a sc s ad  and ha  ha s  s caus caus w w l ha h a  adns adnsss ds ds n xs. x s. Acual w a a n as cauus as as hs wh wa n  an h  adnss u jus xpand   h wh  sc sc  n cnas w au ha h ca  adnss sl s nhn ls han a scal cnsucn. Sa ccss h pl ha s luna chan s ncssa  s u wha au h ppl n dsss wan  h un? Th s hn a nd  pcal sas whch sss ds n nlhc accs. S h us n lk h pspcs w ha hsn and sa shn lk th book plege etan theoetal oentaton o famewok oe othe'  d n cla hcal nual.  d pl hs nans na ns whch w cnsd s us usuu   u h auhs sha dn dn nans nan s  d n cnsd cnsd an  hs nans h slun  h p u w d anwld ha can n ans a ns can pd  anas anas han hs  anhn s pl pldd  a as   d wh h dnan dscuss n whch w a psnd whn w alk au adnss And h h sl  h lnn w ha tt  no n o t lealy df dffee eent nt enough eno ugh fom fom ma mante nteam am appoahe not to be amlated by them    h h sd hs s appoahe wha clncans d anwa'  clncans culd alk h wa wa u  a pap pap a  ad chan !  ns nsu uns ns wll n wan  chan; chan chan  n has    cd cd.. h h  nsu ns uns ns wll w ll  huh  huh pcsss  spndn spndn  cal calss  chan chan nn h  caln h lan lan  san h a danus whn h a a ha) and nall apn  assla h. Rspnss  hs k culd  sn as spac  ws nsunal psns.

Resources for change sd h a s ups ha ha an acs and capann cus aund nal n al ha ha h h ah  ah han n sp sc sc pds pds..  ha ha

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Deontrutie repone and reoure

137

nt bn b t ncud  ncud vythng vythng  n ndd th  undubtdy ny th gup tht hud b put n  n n updtd t  cnnt vuch vuch   th gup nd w  yng n  c n th dcpn thy gv  thv B wnd nd t c. c.  hv nt ncudd nt nt

 hp gnztn tht dbty pduc dc ntn  wh d t tdtn cntc p pt t n nt dt.

Aabbean Mena Heah Pjec Fd n Mncht n 99   dct ut  cncn pd n th cunty but th quncy wth whch cnd gntn Acn Cbbn yuth w dttd t pychtc hpt nd th gn nc unt t cud n th wy n whch dn t pc ttnt tc nd hung. t ncug nt hth vc t bc  ntv t th nd  th AcnCbbn cunty tut dbt dbt btwn cunty cun ty gup  ctt ctt th ptn  nt hth u nd uppt th tbhnt   hp gup h pjct  t Zn Cunty Hth nd Ruc Cnt Zn C C cnt cnt Hu  Mnch Mncht t  M 5 5B Y h     nt ntn n gup gup th Cbb M H  whch cn b cntctd t ACbbn Mnt Hth Actn 3537 ctc Avnu Btn Bt n nd ndn n  S9 P P  U 

Aance  Wen n Pychy h gup  t pvd ctv uppt nd  ctc ctc  vc   wn n n pychgy nd wn u  pychgc vc t n nd  wn  gnd dtbutn  n pyh pyhg g   nd du du  tn t cct ntn but wn n pychgy nd t ct   cntct nd uc cnt  t    nd w wth th wn w nd wn wn  gup nd th dc gup gup n pychgy pychgy  t cuntct dv ppgnd nd ttypng  wn nd t cunt dc ntn gnt  wn wht cgnzng nd vung dnc btwn btw n wn w n  nd t ncug ch ch n  n wth th th    AP whch cncn b b ud t dnc/ ndthy ttpt t nunc cAvnu pcy.Rd AP cntctd udun 15 t th  tht tw w nd ndnn   7 9S  U .

Ay h   quty gzn  dctc pychty t   nn ptn u u  dbt dbt   nyn nyn  wh  n nyw  nywy y nvvd n Mnt H    t h  .  h Aylum dt Gup bv tht nt hth

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Decnrcn pychpahly 138 v u b o doa ad hua h qu v ao o ha ha ad a d a ol     o doa dba  hh al d a obu ad b had eqally ou a  dal abou ubb o oo    ao a hohol hoh ol a a  hal hal Sd Shl Shl d S3 3  

APO h Capa a ha ha ppo ppo a  up  1 985 bu ha oo  h apha ov o ba o 973 ad h  o h o d du u al a o ad h Cou aao o o ha E E C o o h ad dba h oh oaz h oazao ao  ad adal al al halh h alh ad aa o o h o adal l o d d oup C a b oad a 28a Eda Hou ad Ea Hoo Road odo E9 

h h publao   aoal oual o holo ad ho hap hh  publhd a a aad oual b l ad alo uo a h hou oual o h holo ad hoha oao h a al b popl o  d aa o al halh a pooal o u o v ad h a  h doal o ah u ha   h ol oual hh valu poal p  pholoal hap abov pooal bouda ad d o      a l  a a o    h ul  a lbao o h hua h ua o b oud oud  h b d o p phol holo oal al hap hap ad a a a  abou h d o ol d  hh h h  lv lv  ad o  h Edo  Ca N N holo holo  Coula Sv Roal Shbu Hopal o Hah Shbu S3 8N 

y Pyhy wrk h o opl a ou pholo do hh l all ho popl ho hav pd   h da o ou pholo  h  h  po o o a l  h S oual The Pychl u 1993 o houh ada a o o h o  Noha  1 993 993 o  Na Na   1 99 994 4  o bua bua  995 995  h o o b oh  popl ho a o  ou pholo

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Deconsrucive responses and resources

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 tt dd  t Btk St Mlluh  Sh  hl Dptt d Hu 21 Bhdl Rd pl Ntt Nt th h NG8 3E U K.

Dlwh ee h t publh publ h  ul ul  ltt hh h u udd   t  pbl  pl hlp th pl u u   pl ult d pl bu) h t  th h  th Ept d ht dtut t  ptd thp; ht  t th dld b d Ept Ept   N Zld Zld h  

hlhp d h h  l thpt  th ut h  dd  Dulh t Hutt Stt O B 7192 dld 000 Suth ut utl l  Dulh t publt publt  l b ttd t td t    Ept Ept  2 Qu u u Bll  ukld 4 N Zld Zld  d t lt l t l hp O B 3418 Stt B  Vu V u  B V 4N1  d d 

Fl ee h t t  Hutt  N Zld  th b     thp ut hp hh tk ul th l  lzt d l pt d ptult  th th d pt  pl hlp h t  ll t up   h b d t  pt lt pt th th hlp h   th put  t  t t b t  th  th lut ppt ppt thtd  l tutu tutu pu d  ddt ppl h l t h t dd dd   O B 3 10 71 b bu u Rd    Hu N ld

He Ve ewk h Ntk HVN) hh b tth ppl h h  h tl t t  hh du th d d  t t th d p tt tt  tht h b dlpd  l up h uhd  th d  th 1980 1980 d  d  t  d d tt k   dud  th up  p th th  udtd th  lbt th  hll th  th      pt pt th  HVN  b ttd  t Suppt u Hu Hu  1   Stt St t Mh Mht t  M  2E U K 

E A    h     dpdt lut up  ppl h  d but th d t  Eltulhp

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14

Deonuing Deon uing pyhopaholo pyhopaho logy gy

EC  r mpatt upprt r urr tr aml ad r r d d All qur qur  w b b  tratd  t trtt d  av  t wt a Hat Ha t Autrt r Sal Srv Srv dpart dpartm mtt  rup  r a w l dtrd abut tr pat r prt EC tratmt tra tmt r  r a aml m mmbr mbr r rd rd w l  d  upprt r w rqur mr rmat abut EC ad t atr t Ctat EC EC Amu at a t 14 1 4 t tr r Avu Rdd Rddt t  l t r rk k B D2 D2 5D  U 

ADESS ADNESS  a tr at ad rmat du lt r ppl w pr md w rt v ad v pl   ADNE ADNESS SS rat a ltr rum ad dtrbut dv  rr

a wa t a al tm tat tu pl  ad r dtrbut a rmat ad rur tat mt b uul A ba prm   ad rar  al a vau  ADNESS t ar ur d wt tr  mmuat wt tr pl  d mal ma t ADNESS@juvmtjdu  ubrb d a mal ma t ltrv@juvmtjdu wt t mmad  t bd  t ma ubrb ADNESS urrtam urlatam

AE ANE arjr A Natal Emr  urrtl b t up  t U  rp t mda ar tr ad ampa t rr mda mdl  mta l patrd b t Ral Faml  Brt vrmt al ar  t mmut m a trw ma dtrd ppl  t t trt ad t  t patr tablmt av b mblzd b rd juralt tru bd k SANE Szpra A Natal Emr  A N E a b tatd / / HVN HVN  Cratv Supprt Furwa Hu  16 ar Strt atr 1 2E U

ID  rup rup wa t up a t Natal N atal Aat Aat r r tal Halt Hal t  ad Natal IND prat a a tv lbb ad rmat bd arud u  patt rt ad mtal ptal lur a wl a a rdat rd at tr r r a l l a add pt p tall all dparat llt  lal IN D razat razat It pub a maaz alld alld Op d a wll a uul pamplt ad t ld a aua atal  r r  It  al t

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Deconsrucive responses and resources



ase o o MIND N the Natoal Natoal MIND osume Netwo Netwokk )  Some o the local gous ae actve aoud the oltcs o metal health as well as sevce ovso ad the addesses ca e otaed om Natoal MIND  22 Hale Haleyy Steet Steet odo odo  W N 2D  U 

Nana Aan  Pyhar rvvr Ths gou ased  Da kota Ths kota says We am to omote the huma hum a ad ad cvl ghts o eole  ad out o sychatc teatmet stuatos wth secal atteto to the asolute ght to eedom o choce; to wok towad the ed o volutay sychatc tevetos cludg cvl commt met ad oced duggg estat ad secluso hodg that such teveto agast oes wll s ot a om o teatmet ut a volato o teveto lety le ty ad the g ght ht to co cot to o oes oes od odyy ad ad m mdd . . . We attemt to move the ualty ual ty o le o o sychatcally laelled laell ed eole y  y addessg addessg housg emloymet legal ad educatoal eeds ad comatg ds cmato  these aeas ad addess the eeds o homeless ad oo eole.

o uthe detals wte to: NAS  Box 68 Soux alls South Dakota 5 7  0  , USA.

NUVUPY A New Vew  Pyhy/Pyhary They say NUVUSY s a oum to shae ots o vew ctcal o the theaeutc state ad sttutoal sychaty ad those suotve o cotactual cotactu al sychotheay sychothea y ad ad sychaty. We'e teested  dscussos coceg the elatosh etwee ety ad esoslty ad ts mlcatos o clcal legal ad ulc olcy. The lst wll seve o omote alteatve vews to exlag uwated ehavos'. To susc susc e e sed sed the oll ollow ow gg comma commad d y ema emall to stsev@s stse v@s uvm  st stjohs johs .edu  su susc scee uvusy uvusy stame stame lastame' lastame' .

PAE Ths oect o Advce ousellg ad Educato sevces ovded y lesas ad gay me was estalshed  985 y a small gou o volutee cousellos cousello s to addess the metal health ssues s sues acg acg lesas ad gay me  the odo aea  atcula the eed o a couselg ad sychoth eay sevce that does ot athologze homosexualty At eset they oeate css shottem 12 week) ad logtem u to two yeas) cousellg sevces -house o dvduals ad coules ee o o a sldgscale) ad they have a vate Theasts eeal Netwok o eole eo le al alee to aod aod a maket mak et ate o couse cousell llgg o sychotheay. sychothe ay. The

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Dosruig psyhopholog psyhophology y

ullg ta ad vlutr m rm a wd rag  thrtl prpv th ay ad humat hl PACE a wth  tatd at 34 xttl Harhm Rd d N7 9 U

Pae Pwer Th mthly mt hly magaz Brkhrough   at atal al mthly m thly magaz prdud prdu d try tr y y  y u ur rr rurv urvvr vr  mtl    mta mta dtr ad arr t prp am ar t duat rm ad mt mprtatly p up l  mmuat tw rv ur d th pra arg rv Brkhrough  pulhd y Patt Pwr Ptt Pwr lv tha t  vl that th vw  urrurvvr d rr r ltd t. t wll k t prmt thr v thrugh vlvmt  t rgazat ad mt mprtaty wrtt matrl. Fr urthr rmat rmat aut Patt Pwr ad Brkhrough tat Rhard Marx at 13 S Athy' Hu Caldk Avu alkr Nwatl Nwa tl up Ty NE6 3SE U .

POP  P OPAN Prv  Prsa Au Ntwrk m t g 

arly 1 990  rdr rdr t ddr ddr h u  u  x xual ual u  pyhtrap pyhtrapyy  Ev wthut wth ut pulty t  t ha h a m larmgly larm gly ar t  th rdat rdatr r that th whl u  au  all th -ld arg pr  wdprd xtrmly damgg ad whrvr p wpt udr th rpt y pr pr  al al ' S Jauar J auaryy  991 p p hu twrk twrk mt g hv  arragd vry mth r th ud  thrpy d  thrr pr th pra a rathp  Th twrk  lkg at th valalty  Cd  Eth ad Prat Prat d Cmpa Cmpa  Prdur Prdur POPAN a a  tat tatdd t Fla Fla 1  20 D alham Grd Grd d d  N 5DA U.

Phara eraa P P PD  th th  rgzat t up  al  alyy t upprt Fra Fra Bgl Bgl  mv t  th mtal hpt  Trt ad uld a ytm  mmuty mta hath r a a mpwrg altratv t md rgm Th Tr xamp h h   mprta m prta  t Amr d t wr  PD  rprtd rprtd  th Eghpakg Eghp akg wrld y th lgul Eg d tala ural Pr L Slu Ml Prh rhrh ulur dlliozio Th ura Asylum a tk prat rm th Trt xampl xamp l ad lthugh t v vr r a wdr rg  ltratv t  t tl arr th uttl Th Magaz  Dmrt Pyhatry

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Decontuctive epone and eoce

4

PD ad Pe La alute Mentale ca b cotactd at Via S iio  6  3400 Trit tay

Pywch Pywatch i South Arica i a pychiatric ictim upprt group ad coumr group bad o th critiqu o Thoma Szaz t i curty campaigig o bha o dtaid pati i South Arica pychiatric hopita ad i dmadig th rpa o th Mta Diordr Act For urthr dtai cotact obi Edward Dmark Hou  3 ouwkoop oad odboch 00 ap Tow South Arica

Pychly Plc Rence PPR PP wa oudd i 994 a a twork o pope  both pychoogit ad opychoogit opycho ogit  wh whoo ar prpard to oppo oppo  th abui u o pychoogy Thi ma chagig th ida withi pychoogy that ad to oppri practic upportig tho who ar o th rciig d d  ad uig pychoogica kowdg k owdg poiti poit iyy to hp tho gagd i trugg trugg or ocia jutic Th group dcidd a it rt tak to buid a op databa digd to oprat a a rourc twork or th orgaizatio ad o orr ayo who wat to t o ca  upo upo PP or it i t dir dirt t ubgroupig ubgroupig or iormatio or hp Th databa wi b op o th ctroic mai twork a a a itratioa itratio a rourc rourc ad o it wi  b aaiab aa iab to ayo who wat to cotact pop iod i radica pychoogy or wat to

orgaiz othr mtig or iitiati PP ca Th b cotactd ia Meooia th Dpartmt o Pychoogy ad Spch Pathoogy Mache Uieiy Hahea oad Machtr M A UK

Pychly nd Pychherpy Acn PPA Th PPA wa oudd oudd i 1973  thir th ir adrtiig thy ay Th objct o th Aociatio ar to xpor ad pciy th impicatio o makig th pro ctra to pychoogy iquiry pychothraputic practic ad tachig i both pychoogy ad pychoogica thrapi. Th Aociatio Aociatio aim to proid cotxt or arig traiig ad mutua upport Pychoogica ad pychothraputic workhop ad traiig mtig ar orgaizd charg' ad a mmbr rci Change th PPA joura r o Appicatio orm ar aaiab rom Py opigr Bi h ouig Sric tox Hou Triit oad Dudy t Mid ad DY B UK.

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144

Decotruct pychopatholoy

Sczpena Meda Aency e he chiphenia Meia Agency (MA wa launche in Decembe 994 t mae it mally unacceptable t ptay peple with chiphenia a vilent an angeu n the ne han  pathetic an pitiable n the the. t publihe a blet Fee t Kill whic whichh etail cveag cveagee at the height  e ece cent nt pe pe  at atta tac c n pe peple ple wit withh chi chip phe henia nia    MA will al encuage an acilitate the pe an meia t ept iue cncening chiphenia in ieent an me inteeting way that eectt the actu eec actual al expeie expeience nce  peple peple with the iagni iagni  t ha p puce uce a leaet lea et with with guieli ne n epting  an can be cntacte cntacte via Nigel Re Manchete MND 23 New Munt teet Manchete M4 4D UK

Spp aln Inenanal uppt alitin ntenatinal bing tgethe a wie vaiety  activit gup  28 at peent gup peent  aun mental health an publihe the 6000 6000 cpy cpy ciculatin quately newpape Dedro which ha been ging ince 1 988 Dedro i an nepenent nnpt evice  the glbal pychiatic uviv mvement an u allie. hi newpape with it lgan  M ane Netw Netw New i a quately 20 20 page page baheet baheet i t i active in builing lin with the iability wmen an antiacit mvement campaigning againt ce electhc ce pychiatic ugging an acm n pychiaty t pmte tel a the Geenpeae  mental health. n the next pei the evelpment  electnic mal will unubtely expan the inuence an ubveivene  the netw Membehip  uppt alitin ntenatinal inclue a yea ubcip tin t Dedro an it can can be cntact cntacte e at D enn enn P Bx 1 128 1284 4

ugene R 97440 UA.

S Speak O SSO At thei cneence in in eptembe ep tembe 1 987  agee agee a 1  pint hate  Nee an an D eman  which in clue valuing   tt han expeience  emtinal ite pviin  euge cunelling an chice  evice an euce euce a gvenme gvenment nt eview an aequate uni uni ng ng epeentatin  ue an exue  evice n tatuty bie acce t penal meical ec an legal ptectin the ight  ta t eue t a minite amin ite any teatment an an  the phaing ut     an pychugey pychugey inepenent mniting  ug ue an pviin  inmatin n teatment an an en t iciminatin againt peple wh eceive  wh have eceive pychiatic evice.

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Decnrucie repne and reurce

145

SS n b ond /o /o P P Cmpbll  33 hld Rod ondon   2 2 R G  U  .

UKAN h Und ngdom Adoy wok  h Fdon of U-Run Pn Counl Coun l Suppo Goup Adoy Poj nd U Foum whh  nold o nnd o b nold n h plnnng monong nd unnng of mnl hlh  of ll knd wh h ky m of mpowng h popl who u ho . Con UA  Pm Hou 14 Co Bug S Shfld S 2HG U.

WISH omn  n Spl Hopl Hop l   gd gd hy h wok on on bhlf b hlf of womn h n o d fom Spl Hopl Rgonl Su U n nd pon pyh un. un .  bod m  h fom fom of pyh poon fo womn by ng wn nd nng ln h Addonlly Addonll y   n doy funo funonn fo fo womn who  n-pn nd k o mpow mpow  womn who h bn d dhg hgdd fom pyh pyh  onnmn. SH n b ond  h followng dd SH omn n Spl Hopl Hopl n d Su Su Pyh Pyh Un Un  25 Holl Rod ondon ondon 5 1X U.

VAK VA  nd fo fo Vomuunuunn  Vomuunuunn ky kyon on khm khmkku kku (whh mn m n Cn Cn  fo Rou Rou nd nd Cln Cl n ok ok  h n n Hlnk Hl nk  n xmpl x mpl of n mp o dlop good good p p  n hpy 

n ln o mnm pyhodynm ppoh n Fnlnd  mx oluonfou mx oluonfoud d mod modl l wh h pon pon nd h wok:  lk of pful onon unng o pful nd mgn/plyful onon  lo h  nng pogmm n Round Cln ok  nd un ho mng o du du hpu hpu ou nd mpowmn u. VA n b  on ond d  o Rkonn  V A Ruuulnk Ruuulnku u 1 0 026 2600 00 Hln Hln k  Fnlnd F nlnd .

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References Abmowiz  n Dokecki PR. (9 'The polc o cnc ugmen e empiic eun Pyhlgl Blle 8 . Alen H. (98 Je Uble Geer Pyhry  Jl De. Buck inghm pen Unive Pe. Alen HA. n Alen D.S (98 'Poive mpom n he ognon whin n beween ie n chizophenic peech Pyhlgl Mee (   -88. A lwoo R. (  99 'The ocil ocil conucon conucon of of epe epeion ion  Ppe Ppe peene peene   Une Unen n ing he Socl Wol confeence Huee Jul Aveon H  n Roenbeg Roenbeg S. ( 99 99 'Dicou 'Dicoue e n n o chizo chizophen phencc peech  ciue n popo Apple Pyhlg     - -8 8.. Amecn Pchiic Aocion (98 Dg  l Ml f Mel

Drer 3 ev. en. Whingon D Ameicn Pchiic Aocion Ameicn Pchiic Aociion (99 Dg  l Ml f Mel Drer (DM_W™) h en Whngon D Ameicn Pchc Aocon Aneen T (98 'The eecing em Fmly Pre  8. Aneen .. (99 Though nguge n communicon oe  nc emen enion o em n evluon of he eibi Arhve f Geerl Pyhry 3  3  3 . Aneen . Homn RE n Gove W.M. (98 'Mppng bnome n nguge n cogniion in M Alpe (e rvere  hphre hge  ss w k Gul Pe pp 99. Appe B. (993 'Bn Apple on pnoi The Iepee Mgze   M M  . Auin . (9 Hw T D Thg h r xfo xfo Unive Pe Azn H n Holz W.. (9 'Punihmen in WK Honig (e Oper Behvr ew ok Appleonenuof Bnon lfo P. Foh S. ou 1 n Roenh J (98 The Pl f MelR. Helh onon Mcmn. Bhm P (99 lg he Aylm The Mel Pe  Mer ey. Hmon woh Penguin. Bke A. (99 'e n whipe wh i  pno movie k Am Bke gh gh      lookng  wok om oppol o FK   . Bne M. n Beke  (93 Mry Bre Tw A f Jey Thrgh Me Hmonwoh Penguin Bne P. (98 hrk Rp Ph  he Aly h onon Gon

B WB Bile R.M. Gobeg E. Kpln E n Mukheee S (989 'The neuopcholog of chzophenic peech Jl f mm Drer  339. Be RJ. (988 linc wiing n he ocumen conucon of chzophen lre, l re, Mee    Pyh Pyhry ry  99 Be R .J . (  99    P Pch ch cc pci pcice ce n he enion o ch chzoph zopheni eni  Dlwh ere Newleer  . Bhe B he  R  (  98  9 93 3 'The 'Theo o o he ex n R ou oung ng (e (e  Uyg he Tex onon Rouege. pp 3

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Reerene

4

f  Bg. Bg . ew o Bgli F (198 Pyhy Ie O eee g f Columbi Univei y e Beon G 9 ep   Egy f M ew o Bllnine Bec AT (196 ge hepy  he Em e ew o nenion nenionl l Univeiie e Benll R (ed (199 Reg hphe ondon Rouledge Pyhg Be f f he Benll R 99 'Reconucing pychophology he Pyhg Bh Pyhg ey Febuy 61 Benll R 99b A popol o cliy hppine   pychiic diode J f Me h  8 99-98 Benll R con HF nd ilgim D (1988 'Abndoning he concep o chizo pheni ome implicion o vlidiy gumen o pychologicl eech ino pychoic Bh h J J  f f    Pyhg Pyhgyy   333 phenomen B Beio GE 1988 'Hioicl bcgound o bnoml pychology in E Mille nd  Coope ed A Abm Pyhgy Edinbugh Chuchill ivingone Beelheim B (1986 e  M  ondon Flmingo Billig M 991 Iegy  Op e  Rhe Pyhgy. ondon Sge Bichwood M nd Tie  (199 I  he Pyhg Mgeme f hphe. Chichee Wiley Blc Helh Woe nd ien Goup 983 ychiy nd he copoe e Re    ( 9 Blcbun  R   988 988 'n mol udgemen nd peonliy peonliy diode: he myh o o pychophic diode eviied B Bh h J f f P Pyh yhyy  13 -1 Blcbun R (199 'Temen o he pychophic oende clinicl ppoche o woing wih menlly diodeed nd exul oende in K Howell nd R Hollin (ed Ie  mg  eg Pyhgy. eicee: Biih ychologicl Sociey Bleule E (19 911 eme Pe  he Gp fhphe. n  Zinin ew o Inenionl Univeiie e BlomCoope  Hlly M nd Muphy  99 he g hw. ondon HMS Boudieu  198        qe qe f h hee Jgeme Jgeme f f  e e n R ice ondon Rouledge nd Kegn ul Bowden  1981 'Wh hppen o pien eleed om Specil Hopil? Bh J J  f f Pyh yhy y 138 33 Bowe  988 Review ey on e   yhy ey Ae  Beh Beh   Bh J f f  Pyh Pyh gy gy  1819 Boye R nd ill R ed 91 R . g  APyhy. Hmondwoh enguin Boyle M (1 99 99 hphe  e e? ondon Rouledge Boyle M  1 99 9 Schizopheni nd he   o o he oluble he Pyhg  9: 399 Boyne R (199   e he Ohe e f Re ondon: Unwin Hymn Beggin  (199  Pyhy ondon Hpe Collin Bomley E (993 'Socil cl nd pychohepy eviied pe peened  Biih ychologicl Sociey Annul Coneence Bighon Mch Bown GW nd Hi T (198  Og Og f f ep epe. e. ond ondon on Tv Tvi ioc oc Bulhn HA (98 Fn Fnon he evoluiony pychii Re    (3 1 Bui I (1991  ee he hee e f f he  m f Pe Pe y y.. ondon Sge

Bumn E (99 Idenicion ubeciviy nd powe in Femini pychohepy in hepe  eyy e  Beh Beh  hge w w    Siegied ed hepe M-Ay  hepe Pe Reeh ew o Ablex pp 6989 Bun  nd ewne C (ed (199 Hmey P Pyh yhhepy hepy    ey ey Specil Iue hge:  Ie J f Pyhgy  Pyhhepy  

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48

Deconstructing psychopathology

utl, J 990) ender Troube d: Rutdg m M 1979) r Cmn onry o Pyhony d: W  A Su rel lne ne Com Compu puer er n d Pry Pry mpb m pb   D   d  , , S  1 9 96) 6) On he Reord Sure he Inde Sory d: Mhl Jsph smt  195) On Lernn rom he Pen d Rutldg st  stl l  F   st stl  R d v v , A 1 97 979) 9) he Pyhr Soey Nw Y: umb F ss h G  G d R, WA 1993) Fm sttgg t tvt twd Journ rn o Mr Mr nd Fm my y Ther herpy, py, 19 125136 v  sstm pt Jou hdw,  d  hw hwd d M  1 99 99) ) h mpt mpt f vs  gtv pph pph t t udt hluts Brh Jou o Pyhry  6: 19 192 201 01  h, E.O 97) A gust ls t shph lgug Brn nd Lnue, 1 : 25 257 727 276 6 h EO 990) Underndn Pyho Speeh Beyond Freud nd Chomky Spg ld  hls  hms hmb J 19) On Our Own Pen Conroed Aerne o he Men Heh Syem d: MND hp J 19) Femn Counen n Aon d Sg hs  973) Women nd Mdne d: Al  us  1975) Sts  E Ms d  d utv ds   New Frenh Femnm. sss Suss vst l A   976 76)) Pyhry n en Conroer ue n Thouh nd Pre d: vst ,  96) The Mk o Sny St us, MO: Msb lm R d Mughl  199) m b!  suppt f sstg ttm Ayum,  2): 26-2 lm R d Mughl  1995) A ltvst mdl f slf hp Ayum  A. 977) R  n he Phoophy nd Po Po o P Pyhoherpy yhoherpy sss Suss vst ls  991) h ttblt f pshpths Journ o Foren Pyhry 2 1) 3 3-11 1 sl S 1 97 979) 9)  t t du psh pshtu tu   M Rbtts (d) Vr e rembne du ee pyhoque s: Su pp 376 p, D 97) The eh o he Fmy mdswth: gu. p R d Ndgw D 1990) Eth dffs  dmss t  Rg Su t Journ o Foren Pyhry  3) 365-37 l, G 93) h l d wtt pduts f shph ptts Prore n per permen men Perony Perony Reerh Reerh  12: 152 Teu euy y nd n d ss Te Te on on Tr Troubn oubn So n d Pyhoo Pyhoo Sen Sene e ut . 199)Op ughm vst DAm R 19) t d tt: Dd d Fuult  Dsts  J. Ft (d) The Sruur Aeory Reonrue nouner wh he New Frenh houh Mhst Mhst vst ss Dg K 1990) Gtv mtph d th hst f pshlgl dsus  DE  (d.) Mephor n he Hory o Pyhooy. Nw Y mbdg v st ss ss Dvs, . d , R 199) stg: th dsusv pdut f svs Jour Journ n or or he heory o So Behour 20 33 Dws F tu, G d um M 19) gug d shzph: twds  sthss Comprehene Pyhry, 2 11  11-90 90 d Shz 195) ey o Soon n Bre Therpy d Nt Dluz G d Gutt F 1977) AnOedpu Nw Y: Ath ss Dl S. d Rbts G 9) Senened o Hop Oender n Brodmoor Ofd

Ofd vst ss

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Reerences

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epartmet  Health a Sa Seurt 977) Th Ro o Psyhoogiss in h Hh ri Th Trhow Trhown n Rpor) Rpor)  L HSO erra  1973) ph nd n d Phnomn Phn omn  n nd d Ohr ssys ssys on Hussr!s Thory o igns Evast L rthwester Uverst ress erra J 976) O rmmoogy atmr a L: Jhs Hps Uverst ress erra J 97) Wriing nd  nd ir rn n L Rutge a Kega aul la  a C C J  993 993)) Psyhophi nd n d A nioi Prs Prson oniy iy iso isordrs rdrs Trmn nd Rsrh Issus Easthpe A 1990)  L gtta useGasll wrs whe  ta t u: strtg the ther  mmuat   arer a J Shtter es) onsruing oi Psyhoogy L Rutege pp 7690 Ema M 1977) Poii Lngug Words h ud nd Poiis h Fi L: Aaem ress Ewars  a tter  992) isursi Psyhoogy L Sage Epst . a Whte  99) ir ns o Thrpui nds. Aea: ulwh Cetre uats Ers . a Rss E.L 979) Hypnohrpy n porory Csbook ew Yr: rvgt Erst S. a agur  es) 97) Liing wih h phin Pprs rom h Womns Thrpy Cnr L: Wmes rss. Ese HJ a Ese SG 97) shpath prsa a geets  R. Har a  Shag s) Psyhophi Bhiour Approhs o Rsrh

Chhester Ese Hh a Wl Rahma S 96) Th Cuss nd Curs o Nurosis L: Rutlege a Kega aul Fau   1 99 990) 0) He aestes rs Gre Gre Uerw Uerw     R lug lugass ass a . we es) Prinips nd Pri o Fornsi Psyhiry L Churhl Lvgste Fera S 993) shatr a rasm Chngs n Inrnion Journ o Psyhoogy nd Psyhohrpy, 0: 6 Frrester J 90) Lngug nd h Origins o Psyhonysis L amlla. Frshaw  a Rl H 990) he hstr  res pshar  Ega  R ugass a . we es) Prinip Prinipss nd Pri o o Fo rnsi Psyhi Psyhiry ry L: Churhll vgste Fuault M 97) dnss nd Ciiizion L: avst rss Fuault M 977) isipin nd Punish h Birh o h Prison L: Ale Lae Fuault  197) Aut th ept  the agrus vual  9thetur legal pshatr Inrnion Journ o Lw nd Psyhiry        d Inriws nd Ohr Wriings -77 Fuaut 190) Powrknowdg. rghtMHarvester rss Fuault . 191) Th Hisory o uiy vl  Harmswrh: egu Fwler  Garet  a Kupers  99) Cognii Bhiour Thrpy or Psyhosis Thory nd Pri Chhestr Wl Fras W Kg K Thma  a Keell RE. 96) he agss  shphra  laguage aass Briish Journ o Psyhiry  2727. Freu S.  1979 [19 [ 19 1 1 ) shaalt tes  a autgraphal aut aut  a ase ase  paraa meta paras)  A. Rhars ) Frud Pin Librry o  Cs Hisoris II. Harmswrth egu. Freu S 9 [9]) Th Usus  A Rhars Frud Pin Librry, v   .    On psyhoogy. Harm Harms sw wrth rth gu Freu S 973 [933]) Nw Inroduory Lurs on Psyhonysis,  A  Rh Rhars ars Frud Pin Librry vl 2 Nw Inroduory Lurs on Psyhonysis Harmswrh egu.

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15

Dconstructing psychopathoogy

Fh D. nd Don 0.1. (1988 Towds  nuopsychology of schophn Biti Joul of ycity, 153 437443. Fosh S. (1991 Identity Cii Modenity yconlyi nd te Self ondon Mcmlln. Gns A.D. (199 Fom DSM o R; vocs of slf msy nd h oh A culul consucvs dng of US psychc clsscon Socil Science nd Medicine 35 3-4 Gndy  O. . (1993 Te noptic Sot  oliticl conomy of eonl Infomtion Oxfod: Wsvw ss Gogc E nd Godop A.. (995 Subcvy nd "psychoc dscouss  plmny sudy n M. Sullvn (d. yconlytic Semin 1991-1994 ondon TER Glb G. nd Mulky M 1984 Opening ndo Bo  Sociologicl Study of Scientit icoue mbdg: mbdg Unvsy ss. Glson K. (199 Ou of Ou Mnds h dconsucon nd consucon of mdnss. hD dsson Unvsy of Rdng Glnn M. (967 ss of fdom Vige Voice 14 Sp Spmb mb Goldbg D. nd Huxly  (99 Common Mentl iode  BioSocil Model ondon TvsockRouldg Goldn V. (993 ow nd hchy ls lk bou  Fmily oce 3 15-16. Godon  (99 Hitoie de l folie n unknown book by Mchl Foucul Hitoy of te Humn Science 3     36. Gosn  (986 Intitution Obeed Towd  New Concept of Secue oiion in Mentl Helt. ondon Kng Edwds ospl Fund fo ondon. Goschlk A. nd Gs G. (1979 Content Anlyi of Vebl Beiou. w ok Mdcl nd Scnc Books Gumnn .F nd Moscovc S (ds (1987 Cnging Conception of Conpicy w ok SpngVlg Gnsld  . (1 993 993  don gn gn d: sh popl popl nd mnl hlh s svc vcs s Cnge n Intentionl Jounl of ycology nd ycotepy,    17- 17-37. 37. Gos E. (99 Jcque Lcn  feminit intoduction ondon Rouldg Gounds A. 1987 Dnon o psychophc dsod pns n Spcl Hospls ccl ssus Biti Joul of ycity, 1: 474478 Gu F (1984 Molecul Reolution ycity nd olitic. Hmondswoh gn k T. (989 onsucng  psychc cs n B Tood (d Tet nd Tlk  Socil ctice. Dodch ollnd: Fos ublcons Hly 1 (963 Sttegie of ycotepy. w ok Gun nd Son. llm RS. (994 Som consucons obsvons on "nxy nd s hsoy n TR. Sbn nd 1   Ksus (ds Contucting te Socil. ondon Sg. Hmlon K. (199 Spcl hosps nd h s hospl n R. Bluglss nd . Bowdn (ds inciple nd ctice of Foenic ycity ondon huchll vngson. o f t tee Bit Biti i ycologicl ndy .A (987 sychology nd socl conx Bulletin of Society 4 61167. H RD (198 A sch scl fo h ssssmn of psychophy n cmnl populons. e eon onlit lity y nd  nd Indi Indiidul idul i if ffeence eence  1   1  - 1  7 . Hp 0 1 (993 Dscouss of conspcy suspcon nd msus "no nd s culul sgncnc Unpublshd mnuscp Hp 0.1. (994 Hsos of suspcon n  m of conspcy:  con on Auby ws hsoy of pno Hitoy of te Humn Science 7 8919. Hp O (994b Th pofssonl consucon of "pno nd h dscusv us of dgnosc c Biti Joul of Medicl ycology 67 3143 Hp 0.. (n pss Dconsucng "pno: owds  dscusv undsndng of ppnly unwnd suspcon Teoy nd ycology H R. (983 eonl Being Oxfod: Bs Blckwll.

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Referenes

Hai B  (  99 'Pych Hai 'Pychlg lgyy an Maxi Maxi pliic i n Ameica i n   Pae an R  Spea Spea (e scholog nd Mrism Coeisence nd Conrdicion nn: Plu Pe Haw M an Quinlan DM (98 isordered Thinking nd Shiophrenic schopho log. New  Gane Pe Haw M. Maeng J an PgueGeile DM (987 Piiv hugh ie in chiphenia: i impance i lngiuinal cue an impaie pepecie a a cnibuing ac in P Havey an EF Wale  osiie nd Negi Smpoms in schosis escripion Reserch nd Fuure irecins Hilll N: awence Elbaum Aciac pp 96 Haw M aninKeeing  an Mille .G (989 mpaie ppcv an hugh Schizophreni ullein pahlgyH. an pychic : 602 Hamann Hin. chiphenic ( 98 go scholog scholog  nd i he roblem of Adpin  New Y: ne nainal Unieiie Pe Havy P (98 Spcech cmpnce in manic an chiphnic pych: h acain bewen clinically ae hugh  an chin an eeence pm ance journl of Abnorml scholog 92: 6877 Haey P.D. an Neale M. (98 The peciciy  hugh e  chiphnia eeach meh in hei hiical pepeci, rogress in perimenl esonli Reserch 2 \80 Hepw Hep wh h  J ( \ 99 Quali aie anal yi an eaing ie: ie: ic icu u  analyic  ea each ch n anexia ne nev va a nernionl journl of ing isorders  198 Hepw He pw h h  an G Gi in n    (990 he icey  aneia neva icue  he la h cenuy Te 0: 21-8 Hill D (\98 The oliics of Schizophreni schiric Oppression in he Uied Ss nn Unieiy Pe  Ameica The Forms Mel of Helh Ache 83 HMSO nn: HMSO Hbn(98 R. (\986 Feelig Hr of schoherp nn avic Hman R.E (\986 'Te ucue he w  liening an chiphenic icu: a eply  Beeig an Bwn ri nd Lnguge 27: 8-9 Hman RE Kiein , Sp S. an Cicchi D (982 Apphening hiphenic icu a ucual analyi  hc lin a Brin nd Lnguge (2 207-2 Hllan Hl lan  S  ( 992 Fm cial cial abue  cial acn acn  a nighbuh nighbuh pychheapy pychheapy an an cial acin pjec  wmen Chngs n Inionl journl of schlog nd schoherp  ( 2 2 :        Hllan S an Hllan Hllan  R (  98 98  Depee Depee  wmen: up up    empie an cal cal   in in B Richa (e Cpilism nd Infnc sss on schonlsis nd oliics nn: Fee Aciain B Clss ss nd Men l lnes nesss  Nw : Hllinghea AB an Relich FA (98 Socil Cl Wily I.

Hlman L (e ( s Newman pacice  meh cmple ygy PaePlu an R Spea schol cholog og nd Mism Coeis Coe isence ence nd Conr Conrdicion dicionin  nn: Pe. Hchi AP. an Havey P D (986 nguiic analyi  pech  in pychi Clinicl scholog Reiew 6(2 -17 Hwe D. (99 'Meniy pmeniy an cial w riish journl of Socil Work 2 3-2. ich I (976 Limis t Medicin Medicine e The xpropriion xpropriion of Hel Helh h Ha Hamn mnw wh h Peng Penguin uin igaay  (198 r rler ler n es m mis is nure nu re Pai: Minui Jayne J (976 The Origin of Consciousness in he Brekdown of h Bicmerl Mind. Bn HughnMiin Jenin H. an Aen K (992 Family heapy wihu h amiy a amew  jour urnl nl of of Fm Fmil il Therp Therp    : -14 yemic pacice jo

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15

Deconsrucing psychopahology

Jenne, FA. Mnei A.D., Zglds J.A. nd unhOlivei J.A 1993 chzphrna: a Dsas r m Ways f Bng Human Sheeld Sheeld Univesiy

Pess Jhnsne L 1989 Us Usrs rs and A busrs f Psych Psychat atry. ry. Lndn Ruledge. Jhnsn, M.H. nd Hlmn PS 199 Assssng chzphrnc Thnkng: a Clncal and Rsarch nstrumnt fr Masurng Thught Dsrdr. Sn Fncisc: JsseyBss Jnes K 1993 Asylums and Aftr a Rvsd Hstry f th Mntal Halth rvcs frm th Early 18th Cntury t th 0s Lndn: Ahlne Pess Jnes  G nd Bey Bey M  1 98 98 Regin Secu Secuee Unis : he emeging emeging picu picue e  in G Edw Edwds ds ed Currnt ssus n Clncal Psychlgy vl.  Lndn Lndn:: Plenum Plenum pp. pp. 1  1-1 19  Kendle K.S 198 'Demgphy  pnid psychsis delusinl disde  eview nd cmpisn wih schipheni nd ecive illness Archvs f Gnral Psychatry 39 899 Kiev A 19 Transcultural Psychatry New k Fee Pess DM:: Th Rhtrc f  f cn cnc c n Kik S.A. nd Kuchins H 99 Th llng f DM Psychatry. New k Aldine de Guye Kizinge . nd Sinn Rges R 198 A Qmehdlgicl sudy  lesin ideniies Eurpan ual f cal Psychlgy 1: 1618 Kh S.D. 198 Rememeing  vel meils y schizphenic yung duls in S Schw ed. anguag and Cgntn n chzphrna Hillsdle NJ: Lwence Elum Asscies pp 99 Kepelin E. 919 Dmnta Pracx and Paraphrna ns R.M. Bcly Edinugh Livingsne Kme, H. nd Spenge, J 191 Mallus Malcarum. Lndn Aw Bks Kisev J. 1969 EX Rcheches pu une smnlyse. Pis: Seuil. Kvle S ed. 99 Psychlgy and Pstmdrnsm Lndn Sge. Lv W nd FnshelPess D 19 Thraputc Dscurs: Psychthrapy as Cnvrsatn. New k: Acdemic Lcn, J. 19 crts a lctn ns A Sheidn Lndn: visck Ling R.D. 196 Th Ddd l an Exstntal tudy n anty and Madnss. Hmnds wh enguin. Lng RD 986 Sniy mdness nd he psychiic pessin: n ineview Asylum 1  13 13 1 . Ling R.D nd Esesn A 196 anty Madnss and th amly: amls f chzphrncs Lndn: Tv Tvs sck ck Lk G nd Jhnsn M 198 Mtaphrs W v By hicg Univesiy  hicg Pess Lee, M 199 Schizpheni: m he inside u Dulwch Cntr Nwslttr 1 : 1 8   Levensn MR 99 'Rehinkng psychphy Thry and Psychlgy  ( 1 ) : 11. Levinsn S. 1983 Pragmatcs midg midge Univesiy Pess. Lewis, A. 19 Pni nd pnid  hisicl pespecive Psychlgcal Mdcn   1 Lewis, A 199 Th atr Paprs Paprs f f r Aubry A ubry w  ws s Oxd Oxd Univesiy Pess Lidz  1963 Th amly and Human Adaptatn New k Hpe nd Rw Liewd R nd Lipsedge M 989 Alns and Alnsts: Ethnc Mnrts and Psychatry nd edn Lndn Unwin Hymn. Livingsne S. nd un, P 199 Psychlgiss n elevisin. Th Psychlgst  11. Lms P 198 Th mts f ntrprtatn What's Wrng wth Psychanalyss Hmndswh Penguin Lvie A. D 1 98 983 3 Aenin Aenin nd nd hv hviu iuism ism -  c c nd cin. cin. Brtsh urnal f Psychlgy  31 31-31 -31. . Lvlie L 199 Psmdensm nd sujecviy in S. Kvle ed Psychlgy and Pstmdrnsm. Lndn: Sge

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owon D (994) neranng rofeona og orer a ge for ervce er an a caenge for rofeona Aylum 8 (2) 2930. MacDona M (98) Mytical Bedlam; Madne and Healing in eventeenthCentury England Carge Carge nvery Pre McCor  (982) The Pychpath and Milieu Therapy a ngitudinal tudy New York Acaec Pre McGo Mc Gorry rry P D  (  99  ) e czoren czorenaa conce conce n r eo eoee yco yco oe   an 

 arf? Aec of ycoecaona work n e r eoe Dulwich Centre Newletter 4 444 McGra  (99) rerng og on og orer Britih ual f Pychiatry 8 3036 McKeown  an Toa D (988) ' Meooogy QA l 66 onon Sage McKnnon McKnno n . an Mer  D. (  98 98)) e new ee eeoogy oogy an e Man aroac aroac fen urnal nal f f Marital and amily amily Thera Therapy py  3 39. an ocooca coneraon ur Thera erapy py a cial Cntructin Cntructin onon Sage McNaee S an Gergen K (992) Th Macey D. (988) acan in Cntext onon Vero Macey D (994) The ive f Michel ucault onon Vnage Maer A. (92) Te angage of corena a revew an nerreaon Britih ual f Pychiatry 20 3 Maer .A. Mancreck  Hoover TH an Ween  (98) Tog orer an eare feare of angag rocon n corena n PD. Harvey an E. F Waker (e)  Pitive and Negative ymptm in Pychi Decriptin Reearch and uture Directin Hae N awrence Era Aocae . 9-2 Mar M. (989) Between Pychlgy and Pychtherapy a Petic f Experience onon Roege Maco  (984) In the reud Archive onon Fango. Mark  Haa R. Connoy  an Po R (9) Nuring in Behaviural Pychtherapy onon Roya Coege of Nrng. reud eud  Abandnme A bandnment nt f the eductin Thery Maon . M (984) The Aault n Truth: r onon Haronwor Marana H.R. an Varea F (980) Autpiei and Cgnitin the Realiatin f the iving Dorrec D. Ree. Mne .. Coo F an Marana HR (988) Te rngng for of aoogy Irih ual f Pychly 9: 4 Mercer K (986) Rac an rancra ycary n P Mer an N Roe (e) The Pwer f Pychiatry Carge Poy Pre. Meon P (992) The Inward Gae: Maculinity and ubectivity in Mdern Culture onon Roege M C (994a) Warnng gn gven y ena aen wo ke Guardian  Ag .  . M C. (994) Tranzer "k one a week " Guardian 2 Ag  4. Me R (989) Racim onon Roege Mer P (986) of work an neoyen n N Roe an P Mer (e) The Pwer fPycoeray Pychiatry Carge Carge Poy Pre. Mer P an Roe N (e) (986) The Pwer f Pychiatry Carge Poy Pre Me K (9) exual Plitic onon Vrago Mncn S (94) amilie and amily Therapy onon Tavock Pre Mce  (94) Pychanalyi and eminim Haron Haronw wor or  Pengn. Morce P an Ingra C.. (982) angage anay n czorena agnoc Ne w Zealand  urn urnal al f f P Pychiatry ychiatry 6 caon A utralian and New 6   2 2  Moc Mo cov ovc c S . (  9 96) 6) a Pychanalye: n image et n publ 2n en. Par Pree nverare e France NAC reng (99) Race and Criminal utice onon

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Deonsruing Deons ruing psyhopaholo psyhopaho logy gy

D lp p  A Gud t Cnnuu Penal Grwth. New rk Nwa F. (994) t Dl Cail Ieraal c New  ad Ser  (1974) Hw aie cuca cucae e  Nw Stateman and Scet 29 345-34

Nrri M (984) ntegrat f Spial Hpital Patient nt the Cmmunt Ader Gwer Nuckl CW (992) rduci Reckle drivig caual ex ad lfig wa yciaric caegri culure ad iry revel u eac er Scal Science and Medicine 35: 2 ODel P (1992) Egederig aa i cerary arraive Bundar 2 An nteatnal urnal f tature and Cultur 9 81204

ONeil M. ad Scke   G (  9 9  ) Wry f dicui cllaraive gru eray A utralia and Nw N w Zaland  u ual al f f amil amil Th ap ap   2 (4) 20 2020 206 6 Owe Ow e D  (  9 9  ) Fucau yciy ad e ecre f dagerue urnal f renic Pchatr 2 (3): 238 238 24   Oxa .E Reerg SD ad ucker G 982) e aguage f araia A mercan urnal f P Pchiatr 93) 25282 Pade R (98) Made i fceury C.) Aeia ragedy i P Heela ad A ck ed) ndgnu Phl: th Anthrplg f th Self d Acadeic Pre Parker I (992) Dur Dnamc rtial Anal fr Scal and ndvdual Pchlg. d Ruledge Parker I (995) Micl Fucau yclgi Th Pchlgt 8      2426. Parker  ( 995 95b) b) ' Rig aid Fred   xy r urgei gru eray e cae f e Iiue fr Scal era hang: an nternatnal urnal f Pchlg and Pchtherap 3 () 2 Parker Parke r   ad Ser Ser   ed) (99 Dentctng Scal Pchlg. d Ruledge Parkr I ad Sear R ed) (995 Phlg and Marxim: Cetenc and Cntra dn d Plu Pr Pav D (968) erl eaviu i cr Pav crei ei a a review review f ree ree udie Pchlgcal

B 0

6

Peer (942) Wrld Hpth. rkeey CA: Uveriy f Cfria Pre Prl F. (1969) G Glt lt rap rap Vbat  afayee CA: Ral Pele Pre Pi  994) Meda ige ad ular eie Pchiatrc Bulletn 8 34 Pi P (  97� 97� Psy Psyopathic opathic avur: a irica verview i R.D Hare ad D Scai d Pchah haur Apprah 10 Rearch. Ciceer  Wey Pigrim D  d gr A 9 A clg f Metal Health and llne uckiga O Uveriy Pre Pilgri   Trace   lnal Plg erved. d Ruledge. Per  (   8 8 Ct Ctcal cal r ( th amil amil d Plu Pre Prd S 99) Cmd he Me f Dcur d Harveer Weaeaf Raiw P ed (9R4 h ault Readr Hardwr Pegui Rack P. (8) Rac Cultur and Mntal Dirdr d avick Pre Ra S (985) e Iaia ciarc refr i S Mage ed) Mntal Halth Care in th upan Cmmunt ecea Ke Cr Hel Ra S (986) e caegry  ca i ria ad cial cex i riai i N R Re e ad ad P Mi er ed)  Pwr f Pchatr. Caridge Pliy Pre. Ra S  ad Giaicedda M d) (989 Pchiatr in Tanin the Brtih and talan pin d Plu Pre. Reed    (90) Scizrec ug dirder a review ad yee Cmpehenive Pchatr   : 403432 Ricard A ad ray C (98) Prmtin Health Th rugh Particpat Particpatin in:: E Epri prience ence f f Grup fr Patint Partcipatin  Genal Pract. d Picy Sudie Iiue

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Reerences

155

Ran  an Maon T (992) Qo a te Sea Hotal n F. Sott G Wlla S. Patt an H. Toa (e) Prat Rsks and Publc Dangrs Alerot Avery Roeter SR. an Martn .R. (99) Crazy Talk: a tudy f th Dscurs f chz phrnc pakrs New York Plen. Roger Rog er A . (  990) Pong enta orer orer ontrov ontrover ere e yt an reate  cal Plcy and Admnstratn 4 263. Roger C.R. (96) n Bcmng a Prsn oton Hogton Mfn Roe M an Eer A. (993) Accptng cs onon MIND. Roe M .  Hong A .  Noort Noorto oor orn n E an Eer Eer A. (  992 92)) Co Con ngg wt earng earng vo voe e an eanatory aroa Brtsh Jual f Psychatry 6  99 99- 03 Roe N (  98 986) 6) Pya Pyatry try te n nee of ental ental ealt  n P Mller an N. Ro Roe e (e) Th Pwr f Psychatry Carge Poty Pre. Roe N. (989)  ng ng th ul:  ul: Tchnlg chnlgss f Human ub ubc ctty tty onon Rotege.

Roe N. (990) Pyology a a oal ene  n I Parker an . Sotter (e) Dcnstructng cal Psychlgy onon Rotege. Roena  an Sonne H (986) Th anguag f Psychss New York New York nverty Pre. Roenan D. (93) On eng ane n nan ae cnc, 9 28 Roen Ro en an D. . (  9) e ontextal ontextal natre natre of y yatr atr  agno agno Jurnal f Abnrmal Psychlgy 84 4624. Ronow R. an Fne G.A. (96) Rumr and ssp th cal Psychlgy f Harsay New York Elever. Rot M (990) Pyoat (ooat) eronaty orer n R. lgla an P owen (e) Prncpls and Practc f rnsc Psychatry onon Crll vngtone Rot M an Kroll . (986) Th Ralty f Mntal /lnss Carge Carge nverty Pre Roneo E. (990) Jacqus acan & C: a Hstry f Psychanalyss n ranc 1925-1985 onon Free Aoaton ook. R F (984) Te Frean CoverU Trubl and trf 4 29-38. Rtter DR (99) Te reontrton of oren ee Brtsh Jual f Psychatry  34 3639 3639 Rtter D.R. (98) angage n oena te trtre of onologe an onver aton Brtsh Jurnal f Psychatry 46 39904. Ryle A (990) CgntAnalytc Thrapy: Act Partcpatn n Chang Ceter Wey Sak O. (984) Th Man wh Mstk hs Wf fr a Hat onon Dkwort Saon E.E (993a) Ientty olt alenge to yology nertanng Amr can Psychlgst 48 930. Saon E.E (993) Clbratng th thr: a Dalgc Accunt f Human Natur Hee Hetea Harveter Weateaf Weateaf Saraon IG an Saraon R. (98) Abnrmal Psychlgy: th Prblm f Maladapt Bhar New York PrenteHa. Sartre P. (969) Bng and Nthngnss: an Essay n Phnmnlgcal ntlgy onon Meten Sartre .P (94) Btwn Exstntalsm and Marxsm onon New eft ook Swartz S. (  98 98)) I tere a zo zoren ren  langage? langage?  Th Bhaural and Bran c cn ncs cs  96. Sott . (994) Wat te aer ay Psychatrc Bul/tn  8 489 9 9 . Segwk P. (98) Psychpltcs onon Pto Pre. Selvn Selv n Palazz Palazzo o M .  oolo oolo .  Ce Cen n G an Prata G (  98) Paradx and Cuntr Paradx New York aon Aronon

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56

Decontructing pychopathology

Sevii aaoi M, ooo,  Cei G ad ata G (90 'Hyoteiig iuaityeutaity ee gui di o  oduo oduo o e e io, amly Prc 9 3

Seto GRi ff e (95 rak Brthr N  odo okabout Coi Sotte   (993 Cultural Pltc f Eryday f cal Cntructnm Rhtrc and Knwng f th Thrd Knd K nd ukiga e iveity e Sowate  (9 Wmn Madn and Englh Cultur 830-1980 odo Viago f Madn Mdl Mdl f Mdc Mdcn n odo Siege M ad od H (9 Mdl f Maia Siao, V (99 'Te yoiguit o diiiato i  Riad (ed) Cr f th l urthr Eay n Pychanaly and Pltc odo Fee Aoiatio ook   Skye R ad Ceese J (93 aml and Hw t urvv Thm odo Metue Sai,  (9 llun and Ralty th Manng f nxty odo Det Sai  (9 Takng Car: an ltrnatv t Thrapy odo Det Sai  (993 Th rgn f Unhappn a Nw Undrtandng f Prnal Dtr. odo Hae Coi Sit,, D (9 'K i etay i te aatoy o a atua aout clgy  353 Sit Sit, R (9 'Doe te itoy o yoogy ave a ubjet?, Htry f th Human

cnc        Soiait Heat Aoiatio (9 Gdby t ll That? Rthnkng th Pltc f Mntal Halth odo Soiait Heat Aoiatio Sade H (99 'To Make a Ay out o I ylum, 6 ( 55 Site, R ad Ediot   (96 Rarch Dagntc Crtra Nw Yok New Yok Stat yiati titut Staito Roge, W (  9 9   Explanng Halth and n: an Explratn f Drty Hee Hetead Havete Watea Stee  (993 Disou Disouig ig eaouy i E  ua ad   ake (ed) Dcur nalytc Rarch Rprtr and Radng f Txt n ctn odo Routedge StoweSi M (995 Ra yoay ad suevi ostgaduae wok  oge og e Ma ete Metooita iveiy Swat, S (99 'Soues o iudetadig i itevew wit syiati atiet, Prfnal Pychly Rarch and Practc     9 9 Swat, S (99 'Soe etodoogia iue i te aayi o yoti ee Jurnal f Pych P ych lngu lngutc tc Rar Rarch ch  3(   : 9 Swat S ad Swat  (9 ak about tak taoetay ad otex i te aayi o yoti dioue Cultur Mdcn and Pychatry    3956 Sa, T (  9 6   Th Myth f Mntal lln New Yok Hae ad Row Sa T (96 'Atiyiaty: te aadig o te udeed Mid Th Nw Rvw 3 3 Sa, T (99 'Sigud Feud te ewi Aveg Aveg  i Th Myth f Pychthrapy Mntal

Halng a Rlgn Rhtrc and Rprn od od iveity e Taig C ( 9 9  'Caegig te doiat toy beid te woty o diuio gou, Dulwch Cntr Nwlttr,  3539 Toa  Kig, K Fae, W ad Kede RE (990 'iguiti eoae i ioeia a oaio o aute ad oi atiets, Brth urnal f Pychatry  56 00  Tiaa Ti aao, o, S  (96 Th rudan lp: Pychanaly and Txtual Crtcm odo New

et ook To K (990 'A itique o te DSM Dulwch Cntr Nwlttr 3 5 Tuke S (  9    Fe aisyay  D geby (ed) Crtca Crtcall P Pychatry ychatry Haod wot egui Tue  (9 Mdcal Pwr and cal Knwldg odo Sage

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15

Ussher   1991) Women's Mdness Msogyny or Mentl llness? Hemel Hempstead Harvester Wheatshea. Va ele W 1987) Assertve speeh ats  psht dsurse  R. Wdak ad  Va de Crae eds), Neurotc nd Psychotc nguge Behour. Ceved Multlgual Matters pp. 332-35 Screen en duct ducton on  38 -2 Walkerde V 1981) Sex pwer ad pedagg Scre Walter,  1992) The pshatrist  Amera arts 1941-990 A ct Psychtrc Psychtrc Scndnc, 85 167-72. Recoer ery y from from Schzophren: Psychtr ychtry y nd  nd Pol Poltc tcll Economy 2n 2nd d edn. Warer R. 1994) Reco d Rutledge Wetherell, M ad tter  1992) Mppng the nguge of Rcsm scourse nd the egtmton of xplotton. Hemel Hempstead: Harvester Wheatshea. Whte M. 1987) Famil therap ad shphreia: addressig the therer lestle, reprted  M Whte 1989) Selected Ppers Adelade Dulwh Cetre ublats pp 47-57 Whte, M 1988) The press  questg a therap  ltera mert reprited i Selected Ppers. M. White 989) 37 ulwchCetre Centreubiats. Newsletter. 3pp. White, M 1991) Destrut adAdelade: therapDulwih 210 Whte M ad Epst D 1990 Nrrte Mens to Therpeutc Ends Adelaide Dulwh Cetre ress Weer  M ad Marus, D  1 99 994) 4) A siultural struti struti  "depresss "depresss  i TR Sarb ad  Ktsuse eds), Constructng the Socl d Sage Wls M. 1993) DSMI ad the trasrmat  Amera shatr a hstr Amercn Journl of Psychtry, 150 399410

Phloso ophcl nest nestgt gton ons s Ord: asl lakwell Wttgeste,  1958) Phlos Wlpe,   1958) Psychotherpy by Recprocl nhbton. Stard CA: Stard Uversit ress. Wrld Health Orgaat 1992) The C Clsscton of Mentl nd Behourl sorders. eeva Wrd Health Orgasat Wurtel  1995) Prozc Nton d Quartet Yug, H.S. 1988) ratsg RET wth lwerlass lets, i W Drde ad . Trwer eds) eelopments n Rtonl mote Therpy. Mlt ees Ope Uverst ress/ Tar ad Fras.

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Index ama pscg -5 s f 6 ama sc accus, 54 smpmag 3755 ama (aas ) apsca 39 cg appacs, 336

auus pcpa 87 A NH, 33

fam ap, 9-33 pscaass psc aass,,  8- -33 Amwz, C V. , 45 AfCaa Ma Ha c 37 A DS 98 A, H 8 9 Aac f Wm  scg 37 Aw R 47 aa ma  mms, see aca ma a As, H. 4 7 Amca scac Assca,  95 Ba f Tuss,  see als insi and Saisil Manual

Ba, WB, 98 Ba R, 53 66 67 7 8 89 Bas, R, 5 Basg Bas ga a a ac c,,  7  8  4 Bs, Gg 3 3 3 Bck Aa T 34 Bam B am  s, s,  3   8 au p/asm 7, 3 gw 4 6 Ba, R   34 67 67 7 7 3 Bam, m,  Bk ]    B B s, s,   E , 38 B, M 8

B  R R  5 7 7        Bam  .   Bak A, 6 Bas, Ma, , 9 Bas , 64

Bam Ba ms s,,   5

f Menal isrders

As, Aas A as, ,Tm N.  33  94   Aa O. (Bus pa, 9 a a aa sa sa 39 39 4 48, 57 Aniedius (Du a Guaa, 9 ap a ps sc ca a  m mm m  6    39 36 7 asca psa s 77 ax 47 apa ap as sa, a, 5 5-6 -6   6 Appa, Appa , B B   7 7 As As  K  6 Asw Spca Hspa 84 asscaa sucus, 97 Asylu (maga 378 4 asums 67 67 9   9- -  8 Aps (HVN cas su, 3-7 au auc s 58, 6 6   4 HVN    3-7 3-7  39 Aus , 3 augap 63 73

Bm B m  sp sp Bm     3 Bg, M , 6 Bs,  Cpg, 43 g  gca ca m,      6  B, B , 83 83   Bc B cw w , , M , 34 34  7 Backu, R 49 78  Bu , 94 97 BmCp L.   BmCp Bsc . 3 Bsck a 39 Buu , 67 Bw, Bw ,   85 85 Bws, J., 67 B Cmm  994  65 Bs R, 4 6 B M  38 4 67 67   3  7  3 88-9 B B , , R. 6   77 Ba Rsac Assca  Ba, C  

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10

Deonsruing psyopaology

C Me, 64 Cig Agist Psychtric Oressio (CAP (C APO, O, 1 38

cogitive ects (thought sorer, 97 cogtive oes 13 cogtive thery, 33 coheso ysis 98 Co J 823 Coe R., 119 1278 Coer A 25 Cos Co s P   8 Cm e utte e Haape 121 cou co uct cto o,, 3 54 1 14 sychot syc hotcc isc iscour ourse se 1 2 23, 3, 1 11 1 Couist Prty (ty, 118 Couity Occutio Therst 53 Couity Orgiztio for Psychitric ergecies, 138 couity sychtric urses 34 52 Couity Psychoogy Network 1389 cocetu bity 97 cofessio (roe, 13-14 22 18

Cbe, Cb e, D . , 7 Cbe, Peter 145 Cre Mgeet, 53 Cseet P., 22 crtoos (cutur reresettio of ess, 64, 68-7 Cste, F. 71 Cecchi, Gifrco, 32 Chwic Ch wick k P 1 17 Chik Ch ik .O  94 94 98 98 11 , 13 Chberi ui, 121 Chage (our 138 143 Ch Ch i, i, J , 2 Chrcot JeMrt, 22 Cheser Phyis 4

Cfei (Rousseu 74 Coor, S.  7 Coor, 7 coscious /coscousess 19-2, 28 Cos Co soi, oi, S  , 16 costructois 35 64 costructivis, 35 cotetfor cotetfo r 62 94 94 99 99 1 14 cotext, se seec echh , 1 1 , 13  14 coverstio, 12-4, 17 Cooer, Dvi, 23 Coe R, 8 Cooo G, 98 cutur rresettios 1 cuture  ess, 56 ecostructig cc ctegories, 63

chi buse, 22 reresettio of cie (cutur ess, 64

goverce   cuture, 7-1 our cuture rofessios, 63-7 cutur

Breakthrugh (ge 142 Breggi P., 1 1 Breuer, Josef, 19 brief theries, 32 British Psyc PsychoAy hoAytic tic Society   Britsh Psycho Psychoo ogic gic  Societ Society y 5 5 1  68 138 Brooor Sec Host 8 83 84 85 Broey  46 Brow Bro w G. W.  45 buii ervos, 48 Burktt . , 74 Bur, Bur ,  , 2 1, 68 Burs   4 Buter But er   126

circur uestios 32 circurty robe (of sychotic seech 1-1 Cixous H. 75 Cre A 113 css ee soci css Ceckey H 77 Cee C eese se,, J  1 1 ciic ctgores, 63 cic scourse scourse 84 46, 6, 1 1 5-17 cic isorers i guge, 924 ciic sychoogy, 334 5-2 ciic reserch (o thought isorer 95-7

Cotho (Trieste ref refor or 1 1 8-2 -2 cze roceure 98 Cogitive Aytic Thery, 35

chges (stress exeriece 812 ebeeess of kowege, 645 goverce , 71 ess  56 ostivist ccouts  789 cure roc roces ess s 13-14, 13-14, 19, 2 2,, 53 Curt Bery 64 67 cybretics 3 32 18 cyber cy bers sce ce  6 D Svor 28 DAico, R 13, 14 gerousess 72, 75, 1334 Digr K 58 Dvies Dv ies B   39, 71 , 87 88 88 Dwso F 98 eth (fer of/thret fro, 6

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161

Inx decstruct f clca cateres, 0-3 psctc dscurse, 1029 radca rad call metal ealt, 1 12- f trm, 2-5 decstructve terap 33 decstructve decstruct ve respsesreacts respsesreacts  30 30 deepstructure (patcal dettes, 7 Deleuze G 29 De  S . 82 De 82 85 deluss, 3 2 7 9 117 demeta, 7 deml f madss, 115-17 endron New 121  3 5 7 78 8 58 58 3 depress     3 depress deptrealt (f pscpats, 87 90 De r r  d a , J . , 23 1 2 2    3    1  1 27 27   30 3 01 Des esca carrte tes, s, R. 12 123 3 28 1 de Saer, 32

Ercks, Mt, 32 Erst, S 2 Escer, ., 2 2 Esqur ea Etee 7 77 essetalst str 58-9 Esters, ar 2-5 xstetalsm, 23-9 extera realt, 10-2 Ese E seck, ck, H.. , 33 33 50 77 Eseck S G , 77

dass, dscrmat ad 39 dastc cateres 5-8 37-9 gnotc nd Stttcl Mnul of Mentl order 2 8     7  37-8  0 5 9 9 7 77 79 79  00  12 122  23 25 25-{ drect dr ect act act, ,  12   2 33 dscplar scet, 759 clne nd Punh (Fucault 0 dscpes, metal ealt, 5 dsc d scu urrse 0 98 98   1 5 f femt,   8 dett ad pscpat, 8�90 leal ad ccal eemets 8 race ad pscpat 79-82 ee o psctc dscurse

Ferad, S, 3 5 ms (cutura represetat f madess,  Fe G., 8 rst rder ceretcs mdel 30 108 Fes F ess, s, 22 fresc pscatr,     759 759 frmc frm ct tet, et, 2 9 9 99 99 1  Frrester J 20 Frsaw, D., 7 Fuc F ucaut aut Mc Mce, e, 25 3 3 38 38 1     08 130  daerusess, 72 75-{ devepmet f f arma psc psc 1  -8       8 8

dscrmat, dass ad, dstress, 8 2  75 8 7 50 0  33 335 5 39 v  vded ded Self Self he (a, 2 Dkeck .R, 5 Da  82-3 De,  9 7 7 1 03 03

Fllng Shdow he  995    22 Fam Cetre (New Zeaad 139 fam fa ml l t ter erap ap     2933 33 3 3   3 psctc dscurse, 07-9 Fase      Faulk, Fa ulk,  , 83 femae pscl 2 femt, dscurse f, 1 8 femsm, 21 22 23 2 32

clne ndCvlton Punh 0 2  3 1 1 Mdne nd paptcsm, 5 59{0 pscaass, 8 223 29 rad ra dca call metal metal ealt ealt, , 1  3  1   20 1 27 27  1 2 9

drus,   , 52 12 25 Dulwc Cetre (ustraa ad New Zeaad 139 Eastp, . 102 eat prems 39 2 8 57 EC mus  39 39- -00 Edema M., 58 Edwards D. 58 Edwards R, 3 e/ e /e e ps psc c ,,  1   9 Edctt J 95 Epst Davd, 33 0 70 1089 39 15

Fukes, 83 Fwer Fw er,, D ., 3 Frek Brother (c (cmc mc , 8 87 700 Freed t Kl (SM 1 Freu Fr eud, d, S.  1919-23 23 25 27-8   8 8 0  15 Frt Fr t, , D . 97 97 10 1033 Frs, S , 23  15 15  Gaes .D, 38 Gad OH r., 0 Garet . 3 eder dffereces  dass, 2 Geeral Hspta f ars  13

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1

Doruig Do ruig yho yhoho hoogy ogy

geei ea ea woke 54 Geogaa E. 106 Gege K. 38 38 10 1088 Giaiea M. 1 1 9 Gibe Gi be  G N.  69 Geeo K 67

Hoza PS. 95 oiia ooaia 76 801 ooexai 8 59 oia 6 1 3  72 72 80 80 8490 90 1 1 3 1 11 9 Hoki P. 98 Howe D 53

Ge M. 82 Gee G 99 Gobeg D 39 41  45 46 65 65 Goe Vigiia 32   A Th  1987   45 Gooez  106 Goo C 6 Goi Go i    85 Go Go ak ak ..  99 goveae e a 701 Gaa Ga a CF  68 Geee ae 9    11718 Geeae  43 Geo ewoo 83 87 Gif C. 39 57

120 Hbe Wofgag 1 17 120 Hxe, P 39 39 4 1  45 45  46 46 65 eia 20 22 42

Goz E  28 Go  85 Gaai F 29

8 1  82 90 ifaie exai 1 9  22 ifoaio oeig 97 ifoe oe 128 ga .. 100 ie of Poai   ie fo Soia ea 1 2 1 eaioa Caiaio of Dieae 2  8   , 1 7  378  77 1 25 25 Ineaoa Poaa oaio 8 Iigaa . 1 05 1 06 iaioai 4 45 5 1 214 1617 1617 19 28 36 36 61

Hage Pa Pa 124 Hak  66 Hae a 32 Haa R.S . 47 34 58 58 1 17 aiaio 34 s  ao aao Ha M. 122 Haio K 84 Ha .. 67 68 Hae R . D .  77 Hae D.. 57  65 66 R. 39 71 73 86 87 89 Ha Hai . 122 Hai  45 Haow M 94 95 103 Ha Ha a a  H  1 9 Have P.D. 95 97 98 10l Heaig Voie Newok 1 12 1 23 23 7 1 39 Hew He wo o  .  39 48 57 Hi D 129 ioia ao of aboai 514

'    1 22- 1 3  28 7 3  74 1 05 05  1 06 i 1 1  29 ieie aie 3 1 iei 42-5 725 89   aoogia ieiie iio/ 9 i . 27 iiga (iagoi iiiaio) 43 iex aie 3 1 iivia/oia ai 7 78 8 35 61  63 iiviai/iiviai 7-8 -8 1 3 28 61 

7  1 24 24 ae  1 1 7 61 eki H ee F.. 1 24 138 oo M 74 oo M.H. 95 ooe . .  52 oe G 80 oe K. 63 1 13  ea 139

Kee KS 49