Deconstructing Psychopathology

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Ian Parker, Eugenie Georgaca, David Harper, Terence McLaughlin & Mark Stowell-Smith

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    Introduction

    This co-authored book is not designed to operate as a textbook, but as a polemical and accessible ‘counter-text’ for students and practitioners. It develops a deconstructive approach to the practice of professionals and researchers concerned with ‘psychopathulogy’. We will be doing three things in the course of the book. First, we will open up the notion of ‘psychopathology’ as it is conventionally used in psychology and psychiatry using a practical deconstructive approach to the language and institutions that hold it in place. Secondly, we will explore the implications or deconstructive ideas for the theories and practices that underpin clinical treatments. Thirdly, we will be describing alternative views of the language of psychopathology and models for critical professional work and good mental health practice.

    Let us trace the shape of the book. We are concerned in the first part of the book with how forms of mental ‘illness’ or distress have become divided from mental health, and how professionals participate in ‘dividing practices’ in the present day. As we describe how these dividing practices work, we throw them into question by deconstructing clinical categories. Deconstruction in this book is used to unravel suppressed meanings in texts, and to provide a way of re-reading and re-working ideas and practices that are normally taken for granted. In Chapter 1 we review the way in which abnormal psychology has been divided from the ‘normal’ psychology that most people are supposed to enjoy. Chapter 2 looks at ‘alternatives’ from psychoanalysis, anti-psychiatry, family therapy and cognitive approaches. In Chapter 3 we look at how symptoms are constructed, and how they reinforce popular stereotypes and different forms of oppression.

    We then turn our attention to the ways in which cultural images of psychological distress, which are so important a context for the development of psychiatry and clinical psychology, bear on the ways in which people who are categorized in the mental health system understand themselves. Chapter 4 explores cultural representations of psychopathology, and how those representations affect clinical practice. We look at the other side of the problem in Chapter 5, when we discuss pathological identity, and we trace the network of paths that lead people into the mental health system. This is all well and good. but we also want to ask what opportunities for change this picture presents to the professional reader who will want to know what theoretical and research alternatives our deconstruction opens up, and to the user of mental health services, who will be concerned with examples of better practice. In Chapter 6 we develop our account of ‘psychopathology’ as something that is embedded in cultural texts, and we look at research on language, and the ways in which traditional psychiatric work, which produces a circular argument confirming existing labels, can be challenged. The different practical challenges that have been developed are explored in Chapter 7, which covers the development of the alternative mental health movements.

    Psychiatric texts, like many other texts, try to cover over the contradictions in the argument they develop and the assumptions they use. This book too is interlaced with contradictions, and so it is helpful, we think, to anticipate some of the objections that will be levelled against us, and some of the disagreements between us that will have found their way into the book. This book is not a closed system nor a complete solution, and so Chapter 8 reviews some of the dilemmas and contradictions that face those critical of mainstream psychiatry and clinical psychology, as well as providing a resource list of groups that are taking our academic discussion forward in the real world.

    As we go through the book we show why it is necessary to ‘deconstruct’ psychopathology, and describe what we mean by ‘practical deconstruction’. We have come together to write this book from diverse parts of the mental health system – from clinical psychology, psychiatric social work, psychoanalysis, psychology teaching and action research – and have no desire to replace the old jargon around mental health and distress with a new one. As we unravel, deconstruct traditional notions in the following chapters, we suggest strategies for change, and hope that you will be inspired to participate in building, reconstructing something better.

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