Since it was first included in the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980, post-traumatic stress disorder (PTSD) has become a medical and cultural phenomenon. Moreover, it has led to the belief that PTSD is a universal aspect of human experience. Traumatic Formations and Psychiatric Codifications: A Rhetorical History of Post-traumatic Stress Disorder challenges this view by examining the rhetorical processes by which PTSD and its predecessor diagnoses were codified. Using critical techniques taken from rhetorical studies, Science and Technology in Society studies, and historiography, this dissertation examines the social, medical, and institutional formations that created the need for psychological trauma to be codified as an actionable psychiatric diagnosis at four specific historical moments, beginning in Victorian England and culminating with the offical codification of PTSD in 1980. By attending to the rhetorical processes of codifying unique post-traumatic illnesses over the course of 150 years, this dissertation argues that post-traumatic illnesses are better understood as dynamic entities that respond to specific social problems. Furthermore, it finds that the diagnoses themselves must conform to the constraints of their day as determined by the institutions (government, military, or disciplinary) that call upon psychiatric medicine to intervene in social problems.
Traumatic Formations presents four historical case studies: railway spine in Victorian England, shell shock in World War I, post-Vietnam syndrome in the 1970s, and PTSD in 1980. After introducing the project in the first chapter, Chapter 2 examines how British legal courts in the late ninteenth century called upon physicians to determine whether train accident survivors were entitled to monetary compensation for their psychological injuries. To make psychological trauma legible to legal courts, British physicians codified railway spine as a psychological effect of a physical injury, thus connecting victims' mental problems to the accidents they survived. Chapter 3 analyzes how the shell shock epidemic in World War I ushered in a shift in theoretical understandings of psychological trauma. When psychiatrists located near the frontlines of combat demonstrated that soldiers did not need to be exposed to exploding munitions to manifest the symptoms associated with shell shock, medical professionals and the British military came to understand shell shock as a psychological problem rather than a physical malady. Chapter 4 examines how a small group of antiwar psychiatrists advocated for military veterans who had trouble readjusting to civilian life after fighting in the Vietnam War. They persuaded the American public, the federal government, and mental health clinicians that the veterans' adjustment problems were the result of a new psychological illness called post-Vietnam syndrome. Chapter 5 analyzes how post-Vietnam syndrome become PTSD. In the process of convincing the APA to include PTSD in the 1980 edition of the DSM, many of the unique features of post-Vietnam syndrome were compromised so that the PTSD diagnosis could be applied to people who were traumatized by events other than war. / Ph. D. / <i>Traumatic Formations and Psychiatric Codifications: A Rhetorical History of PTSD</i> takes a historical case study approach to understanding post-traumatic stress disorder (PTSD) as a medical and cultural phenomenon. Working from the rhetorical tradition, as well as intersecting traditions of historiography, medical and scientific rhetorics, and Science and Technology in Society studies, it investigates how disciplinary medical science intervenes in social problems and codifies them as post-traumatic diagnoses in order to meet the needs of other institutions, like legal courts, the military, and the American Psychiatric Association. This project begins in Victorian England with railway spine, then examines shell shock in World War I, post-Vietnam syndrome in the 1970s, and culminates in a case study of PTSD in 1980. For each case study, I conduct a rhetorical analysis of a large corpus of documents, including archival medical sources, government documents, and cultural texts. By analyzing post-traumatic diagnoses over the course of 150 years, I demonstrate that psychiatric diagnoses are rhetorical repositories of historical social problems and institutional goals.
| Identifer | oai:union.ndltd.org:VTETD/oai:vtechworks.lib.vt.edu:10919/86174 |
| Date | 06 June 2017 |
| Creators | Grant, Leonard Francis III |
| Contributors | English, Hausman, Bernice L., Pender, Kelly E., Dubinsky, James M., Sano-Franchini, Jennifer |
| Publisher | Virginia Tech |
| Source Sets | Virginia Tech Theses and Dissertation |
| Detected Language | English |
| Type | Dissertation |
| Format | ETD, application/pdf |
| Rights | In Copyright, http://rightsstatements.org/vocab/InC/1.0/ |
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