Psychosomatic histories and the causes of contemporary biomedicine

This thesis considers shifts in twentieth-century American psychiatry and their impact in three sites of contemporary biomedical discourse. Between the 1930s and the 1960s, American psychiatry was strongly psychoanalytic in orientation. A mounting scientific and cultural criticism, from the 1950s, of psychoanalysis, psychotherapy, and psychiatry culminated in the third Diagnostic and Statistical Manual of the American Psychiatric Association, published in 1980. This document asserted that psychiatry was to be predominantly biological in flavour, and bracketed a focus on psychological causes of mental illness, thus both reflecting and solidifying a rejection of psychodynamic psychiatry. Etiological understanding of peptic ulcer, long associated with acid and with psychological and emotional factors, has shifted in the last twenty years with the discovery of a relationship to the Helicobacter pylori bacterium. Scientific and popular discourse about ulcer reveal a tendency illegitimately to infer, from the bacterial findings, that H. pylori is the sole cause of ulcer. A desire for a ‘magic bullet’ that will cleanly target the condition, combined with a desire to distance the field from psychogenic hypotheses of the past, makes possible the problematic etiological inferences I discuss. Female Sexual Dysfunction (FSD) has emerged as a highly visible diagnostic category. The ‘medicalisation’ of female sexual problems by medico-pharmaceutical interests has been much invoked and criticised. A conceptual and historical analysis of ‘medicalisation’ reveals equivocations which speak richly of the contested status of the psychological in disease causation. In a key medical text, the histories of medicalisation and of psychiatry are invoked so as to assert the legitimacy of a medical but non-psychiatric ownership of sexual problems. Psychiatry, despite the DSM’s efforts, figures in FSD as an intensely problematic endeavour.EThOS - Electronic Theses Online ServiceGBUnited Kingdo