Search results

Purpose – In this chapter, I examine the ways that various trauma carriers, including social movements, self-identified survivors, professional organizations, and advocates make public claims about trauma and the PTSD diagnosis as they work to define moral and political issues.

Methodology/approach – Employing the method of social pattern analysis, I analyze a variety of narrative data pertaining to issues such as child sexual abuse, war, slavery, and genocide.

Findings – Trauma carriers engage in significant social memory work and collective identity work, define social problems, and practice social activism as they address the causes and consequences of psychological suffering. Within the context of modern diagnostic psychiatry, the PTSD diagnosis stands out as a unique narrative of social illness. The PTSD diagnosis is a powerful cultural script that various individuals and interest groups use to interpret mental health symptoms while attributing psychological consequences to social causes as opposed to problems rooted in the individual's psyche (as with psychoanalysis) or neurophysiology (as with modern diagnostic psychiatry). By implication, the social world must be “cured” for the individual to be healthy.

Originality/value of paper – I detail the unique sociocognitive implications of the PTSD diagnosis, highlighting its impact on our collective understanding of particular traumatic experiences and the shared nature of posttraumatic affect. I show the relevance of social memory studies, the more broadly conceived sociology of culture and cognition – especially as it pertains to collective identity and classification norms, the sociology of health-focused social movements, and the analysis of social problems claims-making to an emerging sociology of diagnosis.

Throughout the late 19th and early 20th centuries, one of the many techniques used by physicians and psychiatrists to diagnose patients involved external and highly public examination. Typically conducted as a lecture to other medical experts and students, the patient was placed in the center of a round room with onlookers arranged in tiered seating to guarantee an unobstructed view. As the lead physician detailed the list of symptoms, using the patient's body as an illustration, observers witnessed the behavioral signs for themselves and discussed the possible underlying conditions or pathologies. This process of consultation and naming worked to increase the relative reliability among experts and bolster the professional reputations of medicine and psychiatry alike (Conrad & Schneider, 1992; Gillis, 2006; Grob & Horwitz, 2010). As researchers have noted (Aronowitz, 2001; Foucault, 1973), this change from focusing on disparate, idiosyncratic symptoms as expressions of individual illness to a system that recognized disease states comprised of symptom clusters marks a historical turning point in the history of medicine. The shift toward a classification scheme that linked medicine with science and technology bolstered medical authority and the power of physicians. In addition to professional credentials, accumulated knowledge, and institutional legitimacy, the authority of modern medicine both rests on and is expressed by medicine's decisive power to name and categorize through diagnosis (Jutel, 2009). Even as medical prestige has eroded, ceding some of its power to other entities,¹ physicians remain the final arbiter of official medical categories (Pescosolido, 2006), judges of what is, and what is not, a “real” diagnosis. In the diagnostic process, one looks within to reveal the nature of disease from without – empirical observation becomes immutable fact. Of course, as critical perspectives on medicine have long pointed out (Conrad & Schneider, 1992; Zola, 1972), the scientific “fact” of one time and place is the mythology or ignorance of another. Diagnosis, as both category and process (Blaxter, 1978), is infused with all manner of things social, historical, and cultural. This volume explores some of these infusions. In so doing, it aims to clarify and contribute to the emerging sociology of diagnosis – an endeavor first called for by Brown (1990), but more recently revived by Jutel (2009).

How do transnational social movements organize? Specifically, this paper asks how an organized community can lead a nationalist movement from outside the nation. Applying the analytic perspective of Strategic Action Fields, this study identifies multiple attributes of transnational organizing through which expatriate communities may go beyond extra-national supporting roles to actually create and direct a national campaign. Reexamining the rise and fall of the Fenian Brotherhood in the mid-nineteenth century, which attempted to organize a transnational revolutionary movement for Ireland’s independence from Great Britain, reveals the strengths and limitations of nationalist organizing through the construction of a Transnational Strategic Action Field (TSAF). Deterritorialized organizing allows challenger organizations to propagate an activist agenda and to dominate the nationalist discourse among co-nationals while raising new challenges concerning coordination, control, and relative position among multiple centers of action across national borders. Within the challenger field, “incumbent challengers” vie for dominance in agenda setting with other “challenger” challengers.

Racial stigma and racial criminalization have been centralizing pillars of the construction of Blackness in the United States. Taking such systemic injustice and racism as a given, then question then becomes how these macro-level arrangements are reflected in micro-level processes. This work uses radical interactionism and stigma theory to explore the potential implications for racialized identity construction and the development of “criminalized subjectivity” among Black undergraduate students at a predominately white university in the Midwest. I use semistructured interviews to explore the implications of racial stigma and criminalization on micro-level identity construction and how understandings of these issues can change across space and over the course of one's life. Findings demonstrate that Black university students are keenly aware of this particular stigma and its consequences in increasingly complex ways from the time they are school-aged children. They were aware of this stigma as a social fact but did not internalize it as a true reflection of themselves; said internalization was thwarted through strong self-concept and racial socialization. This increasingly complex awareness is also informed by an intersectional lens for some interviewees. I argue not only that the concept of stigma must be explicitly placed within these larger systems but also that understanding and identity-building are both rooted in ever-evolving processes of interaction and meaning-making. This research contributes to scholarship that applies a critical lens to Goffmanian stigma rooted in Black sociology and criminology and from the perspectives of the stigmatized themselves.

Purpose – To explore the ideological effects and social control potential of diagnostic biopsychiatry and encourage the sociology of diagnosis to retain key insights of early medicalization scholarship.

Methodology – As the sociology of diagnosis emerges from medicalization, it is imperative that the new sub-specialty retains the critical edge of the early scholarship. With this in mind the paper reviews key aspects of the medicalization thesis, emphasizing the links between medical definitions and social control processes (e.g. Conrad, 1992; Conrad & Schneider, 1992; Zola, 1972). Based on this review scholars are urged to be mindful of the “diagnostic imaginary” -- a way of thinking that conceals the presence of the social in diagnoses, and which closes off critical analysis of the existential-connectedness and political nature of diagnoses.

Findings – The paradigm shift from dynamic to diagnostic psychiatry in DSM-III opened the door to a new biomedical model that has enhanced American psychiatry's scientific aura and prestige. With the increased presence and ordinariness of diagnoses in everyday life, an illusory view of diagnoses as scientific entities free of cultural ties has emerged, intensifying the dangers of medical social control.

Social implications – By illustrating that diagnoses are cultural objects imbued with political meaning, the ideological effects and social control potential of diagnostic biopsychiatry may be mitigated.