(Un)bounding DSM 300.3: A Study of the Everyday Practice of Managing Obsessive Compulsive Disorder

McCloskey, Anne

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Description

Title

(Un)bounding DSM 300.3: A Study of the Everyday Practice of Managing Obsessive Compulsive Disorder

Author(s)

McCloskey, Anne

Issue Date

2008

Doctoral Committee Chair(s)

Zerai, Assata

Department of Study

Sociology

Discipline

Sociology

Degree Granting Institution

University of Illinois at Urbana-Champaign

Degree Name

Ph.D.

Degree Level

Dissertation

Keyword(s)

Psychology, Clinical

Language

eng

Abstract

"In this dissertation I explore how persons who identify with a diagnosis of obsessive compulsive disorder (OCD) fit it and its descriptions into the everyday practice of managing their suffering. I explore this topic through examination of research material derived from in-depth interviews, ethnographic fieldwork at the 2005 and 2006 Obsessive Compulsive Foundation conferences, observation of internet support communities, and extensive literature reviews of the professional, expert-produced research directed at laypersons and mental health and other professionals. Foregrounding the concepts of medicalization, Hacking's ""making up people,"" subjectivity, and practice, and drawing upon a wide variety of social scientific literature, including texts in the sociology of mental health, medical sociology, and science and technology studies, I examine three contexts in which management is carried out: within the context of internet support communities, where expert and lay produced ""classes"" of OCD are negotiated, within the context of public and domestic spaces, and within the context of the ill-defined variety of OCD known as ""hoarding."" I find that although identifying with OCD and its descriptions represses certain possibilities---especially the use of professional forms of therapy that fall outside the expert recommendations---it simultaneously opens up new possibilities, such as providing sufferers access to certain forms of professional treatment, attractive explanations for their problems (notably shifting responsibility from the character to the body), and a means for organizing with like minded sufferers. Still, even though the diagnosis facilitates the production of new realities within the lives of sufferers, the experience of suffering is not uniform, nor is it static, but instead involves continuous negotiation of numerous relational variables, including biographical/demographic features, space, access to emotional and material resources, and, as I especially emphasize, the particular nature of one's symptoms. As such, management practices which sufferers designate as appropriate, whether they involve professional or lay practices, inevitably vary within this population, and they vary in response to the above variables. To that end, even though sufferers do work hard toward maintaining their status as ""OCDers""---the identification is viewed as beneficial---when the expert knowledge, techniques, and technologies are found to be inconsistent with their everyday needs, these persons will ignore, contradict, or recast them so that they better fit into their lives. On balance, then, despite their years (and sometimes decades) of interaction with the medical world, my research participants maintain the ability to creatively manage their condition, and those most successful at doing so are those who avoid relying too heavily on the delegation of responsibility for their treatment to expert systems of management."

Graduation Semester

2008

Type of Resource

text

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http://hdl.handle.net/2142/86229

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