Biografier från gränslandet - en sociologisk studie om psykiatrins förändrade kontrollmekanismer

Sammanfattning: The modern era of psychiatry is predominantly a history of confinement. Individuals suffering from mental disorders were banished to asylums and mental hospitals. During the late twentieth century, however, the Swedish psychiatry was a recurring topic for political debate and the target for numerous reforms. At present it is reorganized around three fundamental principles: participation, normalization and integration. The general question that this doctoral dissertation is concerned with is how the control mechanisms of psychiatry have changed in late modern society. It argues that the new psychiatric sector has shifted focus from the organization around the discipline of individuals to the control of their social environment. The aim is to increase societal participation among those with a mental disorder. To this end the dissertation illustrates how the transformation of modern psychiatry – into a new psychiatry – has created a complex organization around persons with a mental illness.

The findings of the research are presented in four articles based on life stories told by persons with a psychiatric diagnosis. The articles deal with how psychiatry is turned into an organization in which medical knowledge, political reforms and organizational structures are concretized biographically in the life of the individual. One central aspect of the analysis is the adaptation phase that refugees with posttraumatic stress disorder go through. The overall aim of the articles is to understand how a psychiatric diagnosis intervenes in a life story. The first article analyses the absurdities that arise when a person contract a mental disorder. The article shows that these absurdities emerge when institutions influence the course of events in a patient’s life. The second article focus upon the adaptation phase that refugees with posttraumatic stress disorder must pass before they are included in a new social context. It is showed that the adaptation phase can be more traumatizing than the actual trauma that has been diagnosed. The third article problematizes the tensions between the autobiography of persons in a marginal position, and their biography as patients positioned on a field structured by psychiatric knowledge. In the fourth article it is discussed how the autobiography created by, what is commonly referred to as marginal experiences, may be used to develop existing theories on the construction of the sick role. A key finding in the four articles is that the discrepancy between the new forms of psychiatry and the patients’ life situations, creates a critical element – a borderland – that involves a loss of agency in how the own life is unfolded.