Abstract
In this chapter, we use a case study approach to examine the ways that psychocentrism operates as a dominant discourse within the psychiatric institution to contain queer madness. Using a critical discourse analysis, with attention to analytical tools associated with socio- and queer linguistics we interrogate the psychiatric chart to reveal how one woman’s (whom we call Sheena) mental and emotional distress associated with same-sex intimate partner violence (SSIPV) is subsumed by a psychocentric logic that authorizes heteronormative gender relations and illegitimates queerness. Psychocentric discourse promotes the individualization and pathologization of structurally produced mental and emotional distress, as well as the responsibilization of individuals for such distress (Rimke 2016). We use the term “queer madness” to refer to mental and emotional distress experienced by queer (lesbian, gay, bisexual, pansexual, etc.) people as a result of interpersonal and structural sexual and gender oppression. Our analysis suggests that queer madness is less culturally intelligible than non-queer (i.e., heteronormative) madness within the psychiatric institution. We contextualize this phenomenon in relation to the psychiatric legacy of discursively constructing and regulating ideal (hegemonic) conceptualizations of femininity (Schippers 2007) (e.g., borderline personality disorder functions to delimit women’s behaviour by pathologizing women who express anger, aggression, and impulsive behaviour as hysterical and dangerous; while on the other hand, dependent personality disorder functions to delimit women’s behaviour by pathologizing submissive and dependent women, despite historic and continued patriarchal efforts to maintain women’s submission to men) and pathologizing queer sexualities (King 2003).
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Notes
- 1.
Rimke (2016) identifies ten characteristics of psychocentrism including reductionism , determinism , essentialism , presentism or ahistoricism, naturalism , ethnocentrism , double-standard, victim-blaming , positivism , and pathological individualism.
- 2.
This was the only chart from the pilot project that indicated SSIPV. However, our analysis of the charts indicated that in different ways, different experiences of gendered violence were largely ignored within the treatment plan. Psychocentrism played out in different ways through chart documentation in relation to institutional responses to women’s experiences of violence and the various ways that they were differently positioned in relation to sexuality, race, and class.
- 3.
It is not uncommon to see conflicting or contradictory demographic information in psychiatric charts. For example, demographic information on sexual orientation and race collected through the use of a multidimensional form in the ER would be contradicted by descriptions of patients in MHSP progress notes. We explore this in more detail below under the subheading “Ahistoricism.”
- 4.
We note, based on our review of the chart, that this particular nurse is the only nurse who included any information about Sheena’s relationship and SSIPV in her charting entries. We acknowledge the nurse’s ongoing attempts to engage Sheena in discussion about her relationship while speculating that in her absence the issue of SSIPV would have been fully neglected during the inpatient admission. It is conceivable that this nurse is Sheena’s primary nurse, and therefore, the detail about Sheena’s relationship falls primarily within her scope of reporting responsibility. However, if this is the case, we point to serious concern about inadequate attention to the issue of SSIPV during the nurse’s absence (e.g., days off, vacation leave, etc.).
- 5.
Women’s health care encounters, whether in emergency departments, family physician offices, or obstetrical and gynecological services, have been identified as representing opportunities to address intimate partner violence (IPV) (Freedberg 2006; O’Campo et al. 2011). Given the impacts of IPV on women’s well-being (e.g., psychocentrically described as depression , post-traumatic stress disorder, anxiety, insomnia, social dysfunction and substance abuse in the research literature) (Campbell 2002; Lacey et al. 2013; Rees et al. 2011), it would seem reasonable that psychiatric care settings also represent significant places whereby IPV in women’s relationships should be addressed. Sheena’s case scenario suggests that this may not be the case, which may be an outcome of psychocentric practices that decontextualize women’s experiences of distress from the social and structural context of their lives (i.e., gendered violence )—especially in cases involving same sex intimate partner violence, which is less well documented/recognized.
References
Barnes, R. 2010. ‘Suffering in a Silent Vacuum’: Woman-to-Woman Partner Abuse as a Challenge to the Lesbian Feminist Vision. Feminism & Psychology 21 (2): 233–239.
Beauboeuf-Lafontant, T. 2007. ‘You Have to Show Strength’: An Exploration of Gender, Race, and Depression. Gender & Society 21 (1): 28–51.
Bondi, L., and E. Burman. 2001. Women and Mental Health: A Feminist Review. Feminist Review 68: 6–33.
Bucholtz, M., and K. Hall. 2004. Theorizing Identity in Language and Sexuality Research. Language in Society 33: 469–515.
Burch, S. 2014. ‘Dislocated Histories’: The Canton Asylum for Insane Indians. Women, Gender, and Families of Color 2 (2): 141–162.
Campbell, J. 2002. Health Consequences of Intimate Partner Violence. The Lancet 359: 1331–1336.
Croft, L., M. Gray, and H. Rimke. 2016. Mental Health and Distress as a Social Justice Issue: Guest Editors’ Preface and Acknowledgements. Studies in Social Justice 10 (1): 1–3.
Daley, A., L. Costa, and L. Ross. 2012. (W)Righting Women: Constructions of Gender, Sexuality and Race in the Psychiatric Chart. Culture, Health and Sexuality 14 (8): 955–969.
Davis, K., and N. Glass. 2011. Reframing the Heteronormative Constructions of Lesbian Partner Violence. In Intimate Partner Violence in LGBT Lives, ed. J. Ristock, 13–36. New York: Routledge.
Dej, E. 2016. Psychocentrism and Homelessness: The Pathological/Responsibilization Paradox. Studies in Social Justice 10 (1): 117–135.
Drescher, J. 2009. Queer Diagnoses: Parallels and Contrasts in the History of Homosexuality, Gender Variance, and the Diagnostic and Statistical Manual. Archives of Sexual Behavior 39 (2): 427–460. Accessed May 5, 2017. https://doi.org/10.1007/s10508-009-9531-5.
Duke, A., and M. M. Davidson. 2009. Same-Sex Intimate Partner Violence: Lesbian, Gay, and Bisexual Affirmative Outreach and Advocacy. Journal of Aggression, Maltreatment & Trauma 18: 795–816.
Freedberg, P. 2006. Health Care Barriers and Same-Sex Intimate Partner Violence: A Review of the Literature. Journal of Forensic Nursing 2 (1): 15–24.
Gibson, M. F. 1997. Clitoral Corruption: Body Metaphors and American Doctors’ Constructions of Female Homosexuality, 1870–1900. In Science and Homosexualities, ed. Vernon Rosario, 108–132. New York: Routledge.
———. 1998. The Masculine Degenerate: American Doctors’ Portrayals of the Lesbian Intellect, 1880–1949. Journal of Women’s History 9 (4): 78–103.
Kanani, N. 2011. Race and Madness: Locating the Experiences of Racialized People with Psychiatric Histories in Canada and the United States. Critical Disability Discourse 3: 1–14.
King, M. 2003. Dropping the Diagnosis of Homosexuality: Did It Change the Lot of Gays and Lesbians in Britain? Australian and New Zealand Journal of Psychiatry 37: 684–688.
Koller, V. 2013. Constructing (Non)Normative Identities in Written Lesbian Discourse: A Diachronic Study. Discourse & Society 24 (5): 572–589.
Lacey, K. K., M. Dilworth McPherson, P. S. Samuel, K. Powell Sears, and D. Head. 2013. The Impact of Different Types of Intimate Partner Violence on the Mental and Physical Health of Women in Different Ethnic Groups. Journal of Interpersonal Violence 28 (2): 359–385.
Leap, W. L. 2013. Commentary II: Queering Language and Normativity. Discourse & Society 24 (5): 643–648.
O’Campo, P., M. Kirst, C. Tsamis, C. Chambers, and F. Ahmad. 2011. Implementing Successful Intimate Partner Violence Screening Programs in Health Care Settings: Evidence Generated from a Realist-Informed Systematic Review. Social Science & Medicine 72: 855–866.
Rees, S., D. Silove, T. Chey, L. Ivancic, Z. Steel, M. Creamer, M. Teesson, R. Bryant, A. C. McFarlane, K. L. Mills, T. Slade, N. Carragher, M. O’Donnell, and D. Forbes. 2011. Lifetime Prevalence of Gender-Based Violence in Women and the Relationship with Mental Disorers and Psychosocial Function. JAMA 306 (5): 513–521.
Rimke, H. 2016. Introduction – Mental and Emotional Distress as a Social Justice Issue: Beyond Psychocentrism. Studies in Social Justice 10 (1): 4–17.
Ristock, Janice Lynn. 2002. No More Secrets: Violence in Lesbian Relationships. New York: Routledge Press.
Schippers, M. 2007. Recovering the Feminine Other: Masculinity, Femininity, and Gender Hegemony. Theory and Society 36 (1): 85–102.
Tlili, A. 2007. Rendering Equality and Diversity Policies in UK Higher Education Institutions. Critical Discourse Studies 4 (3): 283–310.
Tupper, K. W. 2008. Drugs, Discourses and Education: A Critical Discourse Analysis of a High-School Drug Education Text. Discourse: Studies in the Cultural Politics of Education 29 (2): 223–238.
Ussher, J. 2011. The Madness of Women: Myth and Experience. London: Routledge.
Vaughan, M. 2007. Introduction. In Psychiatry and Empire, ed. S. Mahone and M. Vaughan, 1–16. New York: Palgrave Macmillan.
West, C. 2002. Lesbian Intimate Partner Violence. Journal of Lesbian Studies 6: 121–127. https://doi.org/10.1300/J155v06n01_11.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 The Author(s)
About this chapter
Cite this chapter
Daley, A., Ross, L.E. (2018). Uncovering the Heteronormative Order of the Psychiatric Institution: A Queer Reading of Chart Documentation and Language Use. In: Kilty, J., Dej, E. (eds) Containing Madness. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-89749-3_8
Download citation
DOI: https://doi.org/10.1007/978-3-319-89749-3_8
Published:
Publisher Name: Palgrave Macmillan, Cham
Print ISBN: 978-3-319-89748-6
Online ISBN: 978-3-319-89749-3
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)