How is self-mutilation constructed? An examination of discourses of gender, theudbody and risk in the DSM and by psychiatrists

摘要

My research is concerned with the production of knowledge and how the process ofudknowledge production might shape how we view and understand people’s bodies. Inudparticular, this research sought to understand the construction of knowledge about selfmutilation,udhow discourses of gender, the body and risk shaped how self-mutilation wasudperceived and whether or not these dominant knowledge(s) re-produced inequalities. Theudaim of my research was to explore the various ways of thinking that surround selfmutilationudand to map the connections and disconnections between the diagnostic criteriaudused to diagnose self-mutilation and psychiatrists’ understandings. Using a poststructuralistudcritical discourse analysis approach, I conducted a longitudinal analysis ofudthe Diagnostic and Statistical Manual (DSM) versions 1 through 5 (spanning 1952-2013)udand in-depth interviews with ten psychiatrists practicing child, adolescent and adultudpsychiatry. The results illustrate that knowledge produced in the DSM does impact howudpsychiatrists make sense of self-mutilation. Drawing on multiple theoretical perspectives,udsuch as the work of Deborah Lupton, Michel Foucault and Dorothy Smith, I show thatudself-mutilation discourses reflect larger dominant ideas surrounding gender, the skin,udhealthy bodies and risk; that self-mutilation is gendered and is linked to a diagnosis ofudborderline personality disorder; and that there are multiple ways in which DSM languageudis taken up, reproduced and resisted by psychiatrists. In sum, this thesis has outlined theudintersections between gender, power, and psychiatric knowledge.