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tlogan's picture

Doctors as "Cultural Adjusters?"

In my mind, doctors (and psychologists) play a key role in the meshing of culture and “disability,” as in their role of administering treatment; they must first determine who is sick and who is not sick. In a way, they serve the final judgment of what is culturally acceptable behavior, and provide the definition of “normal” or baseline. Again this is also the role that the DSM plays, that of an adjudicator. I am left to wonder whether those that control the DSM consider what “normal” is in terms of the culture of which we are apart. To define mental pathologies, they must have an internal working definition of baseline behavior, as otherwise they would not be able to distinguish what is considered abnormal. Does this mean that the DSM is inextricably bound to the culture that created, and thus are the definitions of psychopathologies culturally relative? This calls to mind the example provided by Natsu of the boy who would not follow what was culturally understood to be the rules of physical contact, thus could be considered out of the bounds of what is baseline.

On a sidenote: it would be interesting if one could examine what was considered disability historically, and possibly use this information gauge the culture at the time. As Prof. Grobstein pointed out in class on Tuesday, until the 1970s (I believe), homosexuality was included in the DSM, which says much about how homosexuality was perceived at the time. Could it be that bipolar disorder, or autism, or attention-deficit disorder are not pathologies of the mind so much as of the culture? I know that seems far fetched, but it strikes me that doctors do not take into account that these behaviors could be the result of “normalcy” in a different paradigm.

The problem with definition, though it creates more digestible packets of information, is that it also creates a matrix, with defined borders and assigned characteristics within those borders. Definitions are victims of paradigm. When doctors use these, it seems rare that they take into account the idea that they are based on observations made on a limited scope of knowledge. I believe someone also brought this point up in class, in that we would all exhibit symptoms characteristic of one of the pathologies listed in the DSM. I know I have gone on a tangent, but I merely wanted to indicate my discomfort related to the idea that doctors can define shape what culturally acceptable based on subjective observations. I suppose it is exceedingly difficult to reshape the culture that defines our every action.


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