How personality became treatable: The mutual constitution of clinical
knowledge and mental health law.
SOCIAL STUDIES OF SCIENCE 2013;
43:30-53. [PMCID:
PMC3652711 DOI:
10.1177/0306312712457722]
[Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
In recent years, personality disorders – psychiatric constructs understood as enduring
dysfunctions of personality – have come into ever-greater focus for British policymakers,
mental health professionals and service-users. Disputes have focussed largely on highly
controversial attempts by the UK Department of Health to introduce mental health law and
policy (now enshrined within the 2007 Mental Health Act of England and Wales). At the same
time, clinical framings of personality disorder have dramatically shifted: once regarded
as untreatable conditions, severe personality disorders are today thought of by many
clinicians to be responsive to psychiatric and psychological intervention. In this
article, I chart this transformation by means of a diachronic analysis of debates and
institutional shifts pertaining to both attempts to change the law, and understandings of
personality disorder. In so doing, I show how mental health policy and practice have
mutually constituted one another, such that the aims of clinicians and policymakers have
come to be closely aligned. I argue that it is precisely through these reciprocally
constitutive processes that the profound reconfiguration of personality disorder from
being an obdurate to a plastic condition has occurred; this demonstrates the significance
of interactions between law and the health professions in shaping not only the State’s
management of pathology, but also perceptions of its very nature.
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