In The Shadow Of Diagnosis

A look at the history of psychiatry’s foundational impact on the lives of queer and gender-variant people. In the mid-twentieth century, American psychiatrists proclaimed homosexuality a mental disorder, one that was treatable and amenable to cure. Drawing on a collection of previously unexamined case files from St. Elizabeths Hospital, In the Shadow of Diagnosis explores the encounter between psychiatry and queer and gender-variant people in the mid- to late-twentieth-century United States. It examines psychiatrists’ investments in understanding homosexuality as a dire psychiatric condition, a judgment that garnered them tremendous power and authority at a time that historians have characterized as psychiatry’s “golden age.” That stigmatizing diagnosis made a deep and lasting impact, too, on queer people, shaping gay life and politics in indelible ways. In the Shadow of Diagnosis helps us understand the adhesive and ongoing connection between queerness and sickness.

Despite diagnosis being the key feature of a physician's clinical performance, this is the first book that deals specifically with the topic. In recent years, however, considerable interest has been shown in this area and significant developments have occurred in two main areas: a) an awareness and increasing understanding of the critical role of clinical decision making in the process of diagnosis, and of the multiple factors that impact it, and b) a similar appreciation of the role of the healthcare system in supporting clinicians in their efforts to make accurate diagnoses. Although medicine has seen major gains in knowledge and technology over the last few decades, there is a consensus that the diagnostic failure rate remains in the order of 10-15%. This book provides an overview of the major issues in this area, in particular focusing on where the diagnostic process fails, and where improvements might be made.

"Regina Kunzel here draws upon previously unseen case files to argue for a much subtler understanding of how 20th-century LGBTQ Americans conceived of themselves and the diagnoses they received from psychiatrists, showing the ways in which they assimilated, accommodated, challenged, rejected, and rearticulated the judgment that they were sick. She argues that, as central as psychiatry was to LGBTQ identity, the discipline's own expanding claims to authority were anchored in its assertion of expertise over gender and sexual difference. That is, shrinks told people they were sick; but in both acquiescing to and resisting this diagnosis, those people showed that shrinks were powerful"--

A look at the history of psychiatry’s foundational impact on the lives of queer and gender-variant people. In the mid-twentieth century, American psychiatrists proclaimed homosexuality a mental disorder, one that was treatable and amenable to cure. Drawing on a collection of previously unexamined case files from St. Elizabeths Hospital, In the Shadow of Diagnosis explores the encounter between psychiatry and queer and gender-variant people in the mid- to late-twentieth-century United States. It examines psychiatrists’ investments in understanding homosexuality as a dire psychiatric condition, a judgment that garnered them tremendous power and authority at a time that historians have characterized as psychiatry’s “golden age.” That stigmatizing diagnosis made a deep and lasting impact, too, on queer people, shaping gay life and politics in indelible ways. In the Shadow of Diagnosis helps us understand the adhesive and ongoing connection between queerness and sickness.

A revealing account of how families adapt to living with a chronically ill child What is it like to live with a child who has a chronic, life-threatening disease? What impact does the illness have on well siblings in the family? Myra Bluebond-Langner suggests that understanding the impact of the illness lies not in identifying deficiencies in the lives of those affected, but in appreciating how family members carry on with their lives in the face of the disease's intrusion. The Private Worlds of Dying Children, Bluebond-Langner's previous book, now considered a classic in the field, explored the world of terminally ill children. In her new book, she turns her attention to the lives of those who live in the shadow of chronic illness: the parents and well siblings of children who have cystic fibrosis. Through a series of narrative portraits, she draws us into the daily lives of nine families of children at different points in the natural history of the illness—from diagnosis through the terminal phase. In these portraits, as family members talk about their experiences in their own words, we see how parents, well siblings, and the ill children themselves struggle, in different ways, to contain the intrusion of the disease into their lives. Bluebond-Langner looks at how parents adjust their priorities and their idea of what constitutes a normal life, how they try to balance the needs of other family members while caring for the ill child, and how they see the future. This context helps us understand how well siblings view the illness and how they relate to their ill sibling and parents. Since the issues raised are not unique to cystic fibrosis but are common to other chronic and life-threatening illnesses, this book will be of interest to all who study, care for, or live with the seriously ill.

“Gary Greenberg has become the Dante of our psychiatric age, and the DSM-5 is his Inferno.” —Errol Morris Since its debut in 1952, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders has set down the “official” view on what constitutes mental illness. Homosexuality, for instance, was a mental illness until 1973. Each revision has created controversy, but the DSM-5 has taken fire for encouraging doctors to diagnose more illnesses—and to prescribe sometimes unnecessary or harmful medications. Respected author and practicing psychotherapist Gary Greenberg embedded himself in the war that broke out over the fifth edition, and returned with an unsettling tale. Exposing the deeply flawed process behind the DSM-5’s compilation, The Book of Woe reveals how the manual turns suffering into a commodity—and made the APA its own biggest beneficiary.

Examines the diagnostic process to question how we understand autism as a category and to better recognize its intelligence and uncommon sense. As autism has become a widely prevalent diagnosis, we have grown increasingly desperate to understand it. Whether by placing baseless blame on vaccinations or seeking a genetic cause, Americans have struggled to understand what autism is and where it comes from. In Autistic Intelligence, Douglas W. Maynard and Jason Turowetz focus on a different origin of autism: the diagnostic process. By looking at how autism is diagnosed, they ask us to question the norms we use to measure autistic behavior against, why we understand autistic behavior as disordered, and how we go about assigning that disorder to particular people. To do so, the authors take a close look at a clinic in which children are assessed for and diagnosed with autism. Their research draws on hours observing assessment evaluations among psychologists, pediatricians, parents, and children in order to make plain the systems, language, and categories that clinicians rely upon when making their assessments. Those diagnostic tools determine the kind of information doctors can gather about children, and indeed, those assessments affect how children act. Autistic Intelligence shows that autism is not a stable category, but the result of an interpretive act, and in the process of diagnosing children with autism, we often miss all of the unique contributions they make to the world around them.

In what will be a tour de force in the field of psychiatry in all its complexity and depth, this important new volume explores the essential paradox of psychiatry—and offers a balanced understanding of its history and development in the medical world. Much is written about psychiatry, but very little that describes psychiatry itself. Why should there be such a need? For good or ill, psychiatry is a polemical battleground, criticized on the one hand as an instrument of social control, while on the other the latest developments in neuroscience are trumpeted as lasting solutions to mental illness.Which of these strikingly contrasting positions should we believe? This is the first attempt in a generation to explain the whole subject of psychiatry. In this deeply thoughtful, descriptive, and sympathetic book, Tom Burns reviews the historical development of psychiatry, throughout alert to where psychiatry helps, and where it is imperfect. What is clear is that mental illnesses are intimately tied to what makes us human in the first place. And the drive to relieve the suffering they cause is even more human.Psychiatry, for all its flaws, currently represents our best attempt to discharge this most human of impulses. It is not something we can just ignore. It is our necessary shadow.