Diagnosing Neoliberal Subjects: A Textual Analysis of the DSM

The American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) has become the most authoritative text on defining the nature of mental illness in western society. The psychiatric profession claim that this document reflects the advancement of scientific knowledge in the area and is unaffected by subjective and politically-motivated value judgements. In this paper I aim to question this assumption through presenting a textual analysis of mental illness classifications and symptomologies presented in each edition of the DSM (I-V). It will be demonstrated that, over time, the language employed by the APA has increasingly conformed to the development of neoliberal values and the closer surveillance of the self – this is an expert discourse where words and phrases such as ‘productivity’, ‘employment’, ‘school’, ‘leisure’, ‘play’ and the ‘home’ have taken on greater meaning and been enshrined in typologies of mental disorder.

 

The presentation will take time to consider the theoretical implications from this case study for understanding the structural forces which may aid or hinder the construction of psychiatric classifications. For example, following the neo-Focauldian argument of Nikolas Rose (1999), psychiatric discourse can be understood as a necessary technology for the management of neoliberal selves. Such a view suggests that the recent DSM additions of Social Anxiety Disorder, Pre-Menstrual Dysphoric Disorder and Hoarding Disorder reflect contemporary social problems and popular anxieties surrounding patterns of work, consumption, the family, and leisure. Utilizing a more traditional Marxist analysis, however, it could be argued that the reinforcement of neoliberal ideology identified within the DSM may instead suggest the increasing hegemonic role played by the institution of psychiatry in medicalizing social and economic problems within capitalist society.