Diagnosing Distress? Psychiatric and Therapeutic Constructions of “Traumatised” Young Women

Abstract

Although “trauma-informed” practices are widely accepted as effective and compassionate approaches to supporting women after violence, this study builds upon a small body of research which calls into question the dominant positioning of trauma discourses within psychiatric and therapeutic services. In particular, trauma discourses have been critiqued for their focus on women’s symptomotology, placing the problem of violence within individual women rather than within a broader socio-political context of gender inequality. As the period of adolescence is a life stage that is particularly problematised within mental health services, this study took the direction of critically analysing how medical, diagnostic and therapeutic discourses constitute women’s experiences of abuse in adolescence, constructing the concept of a “traumatised” woman. Narrative interviews were conducted with two participant groups: adult women survivors of adolescent abuse and social workers employed in adolescent mental health services. The research question that guided this study is: How did the participants negotiate psychiatric and therapeutic discourses when discussing the effects of abuse and violence? Four theoretical contributions of the study are discussed. Firstly, alongside the medicalisation of women’s distress following violence, psychiatric discourses relating to young women and violence are strongly informed by a discourse of responsibilisation. Secondly, therapy represents a highly problematic “space” for the enactment of feminist social change agendas after violence. Thirdly, resistance to psychiatric and therapeutic assumptions about women after violence involves a complex process of negotiation between competing knowledges and paradigms. Fourthly, the articulation of multiple “pathways” in the aftermath of violence offers a less totalising narrative than is provided by a trauma narrative that predicts distress and pathology, while still allowing for a lens of justice.