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The DSM and its lure of legitimacy
Abstract
The Diagnostic and Statistical Manual of Mental Disorders (DSM) offers a biomedical framing of people’s experiences of distress and impairment, and despite decades of criticism, it remains the dominant approach. This dominance is maintained not only by powerful corporate interests such as the pharmaceutical industry, but also through the everyday talk of people as they attempt to make meaning of themselves and their experiences. This paper explores how and why the DSM holds such cultural currency for individual speakers, and unpacks what is being accomplished in their taking up the language of psychiatric diagnosis. In particular, we argue that a biomedical construction of distress offers the lure, or promise, of validating persons’ pain and legitimizing their identities. However, we also argue that the very assumptions of biomedicine ensure that this promise can never entirely be fulfilled and, despite its lure, a biomedical construction of ‘mental illness’ all too frequently fails to protect individuals from delegitimation and stigma.
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“Psychiatric diagnoses may be experienced as attributing authoritative legitimacy to suffering, particularly for individuals who have been invalidated and silenced [5, 6].”
From A lived experience response to the proposed diagnosis of terminal anorexia nervosa: learning from iatrogenic harm, ambivalence and enduring hope (2023) · cites this paper as [5]
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Metadata
- Authors
- Lafrance, M. N., & McKenzie-Mohr, S.
- Affiliations
- St. Thomas University (CA)
- ORCID
- Lafrance, Michelle N
- Venue
- Feminism & Psychology
- Publisher
- SAGE Publications
- Published
- 2013-02
- Volume
- 23
- Issue
- 1
- Pages
- 119-140
- ISSN
- 0959-3535 (ISSN-L)
- 1461-7161
- OpenAlex
- W2158819391
- Cited by
- 102
- References
- 72
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 6 · 2022: 8 · 2021: 15 · 2020: 5 · 2019: 10 · 2018: 8 · 2017: 16 · 2016: 10 · 2015: 5 · 2014: 7 · 2013: 1
- FWCI
- 56.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Feminism & Psychology (publishedVersion)
- Topics
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Health Sciences › Health Professions › Medical Terminology › Medical Research and Practices
- Keywords
- DSM, psychiatric diagnosis, biomedical model of mental illness, legitimacy, stigma, delegitimization, pharmaceutical industry, everyday conversation, identity, distress
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