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

Patten, Ashley L. (2014) How is self-mutilation constructed? An examination of discourses of gender, the body and risk in the DSM and by psychiatrists. Masters thesis, Memorial University of Newfoundland.

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Abstract

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

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