Challenging the positioning of premenstrual change as PMS : the impact of a psychological intervention on women's self-policing

The positioning of the reproductive body as a site of madness or badness functions to marginalize women and to medicalize their distress. Taking Premenstrual Syndrome (PMS) as a case example, this paper rejects this pathologization and argues that self-policing practices are associated with the experience and construction of premenstrual change as PMS. Drawing on interviews with 12 British women, it is argued that women's experience of distress or anger premenstrually is connected to self-policing practices of self-silencing, self-surveillance, overresponsibility, self-blame, and self-sacrifice, and that their positioning of this distress as PMS takes place through a process of subjectification. An outline is given of a woman-centred psychological intervention, which identified and challenged these self-policing practices. It aimed to allow women to develop more empowering strategies for reducing or preventing premenstrual distress, build an ethic of care for the self, and no longer blame the body for premenstrual anger or depression. Pre-intervention, the themes which emerged in interviews were: PMS sufferer as split; self-silencing; and overresponsibility. Post-intervention, the themes were: increased equality and agency; resisting pathologization; and resisting self-sacrifice and overresponsibility. The implications for the conceptualization and treatment of PMS and for the positioning of the reproductive body as site of psychiatric disorder are discussed