چو عضوی به درد آورد روزگار ... : خشونت خانگی و عضو تشخیصی
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|36184||2014||9 صفحه PDF||سفارش دهید||محاسبه نشده|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Social Science & Medicine, Volume 122, December 2014, Pages 44–52
Diagnostic categories for domestic violence have shifted over time, transforming from a disorder of psychological passivity and acute injury into a chronic and somatically invasive condition. This paper links these changing diagnoses to constructions of the abused body and to victim-blaming narratives. Based on an analysis of medical journal articles, this research identifies two logics that undergird domestic violence diagnoses, the body, and victim-blaming: 1) the logic of injury (1970s–1980s); and 2) the logic of health (late 1980s–present). The logic of injury is associated with overt victim-blaming, a temporally bounded and injured body, and psychological passivity. Once the feminist anti-violence movement gained mainstream credibility, however, the logic of injury fell out of favor as an explanation for domestic violence. What surfaced next was the logic of health, which is associated with chronic diagnoses and what the author calls a temporally extended body. The temporally extended body is flexible and layered, linking up past, present, and future states of disordered embodiment. The author suggests that, rather than ushering in hope and possibility via the logic of health's somatic flexibility, this abused body creates spaces into which new forms of blame and self-responsibility can take shape.
That preoccupation with the future increasingly pervades our experiences of the present is a central claim of many theorists dealing with biomedicalization. We are made up of potentialities, constituted by our engagement with what is novel about the future. As Adams et al. (2009) point out, this temporal combustion pulls us in two directions at once: to know oneself is to know about one's future, and yet the future is quintessentially unknowable. Reflecting this dual orientation, one of the central features of biomedicalization literature is a tension between both the expansion of hope and of governance, between novel modes of flexibility and increasing self-responsibilization (Galvin, 2002, Orr, 2010, Pitts-Taylor, 2010 and Rose, 2007). The expansion of possible futures via technologies and biomedicine may yield unexpected configurations, transforming what is normative. Or, we may become subject to further regulation, investing normative standards with new power. The aim of this paper is to explore this tension at the level of the body, using the case of changing biomedical constructions of domestic violence. I will explore how diagnosis is used to capture domestic violence in particular ways, to label and make sense of the abused bodies that biomedicine must diagnose. I will also show how diagnoses shape the possibilities of the abused body, its present and future “health,” its temporal movements through biomedical pathologies. Tracking constructions of the abused body through biomedical literature from the 1970s (the early years of medical attention to domestic violence) through the present, I attend to the ways in which the boundaries of the abused body are reconfigured in line with cultural shifts in victim-blaming narratives and in diagnostic categories. Here, I define victim-blaming as the widespread cultural discourse and practice that holds victims of violence and oppression responsible for their own victimization. In this analysis, I will link together: modes of victim-blaming, the construction of bodies, and shifts in diagnoses. The construction of the abused body here is not just reliant on biomedicine; rather, biomedical diagnoses and victim-blaming tropes are entangled ( Murphy, 2012). First, I will review literature on diagnosis and the biomedical body, in which I take up this tension between increasing flexibility (Clarke et al., 2010 and Rose, 2007) and the ushering in of new forms of blame (Pitts-Taylor, 2010). Next, using data from peer-reviewed health journals, I will demonstrate the important role that diagnosis plays in defining domestic violence. Variably diagnosed as a disorder of pathological passivity, as a set of acute injuries, and as a chronic disease, I will argue that a profound transformation in diagnostic categories has taken place since the 1980s. I follow these diagnoses through health literature to reveal how they construct the abused body, both relying on and reinventing victim-blaming narratives. Ultimately, I argue that the chronic framework amplifies victim pathologies via temporal extensions of the body, which locate abuse inside the body, making the victim's future increasingly subject to her past abuse.
نتیجه گیری انگلیسی
After following biomedical constructions of domestic violence over time, it becomes clear that the boundaries of the abused body have been extended. But, what does it mean that biomedicine has developed this temporally extended body? What are the consequences for victims' lived embodiment, for their interactions with medical systems? Put simply, the temporally extended body is one example of the power of biomedicine to define past, present, and future somatic experiences. Like “patients-in-waiting” or patients marked “at-risk” ( Fosket, 2004 and Shostak, 2010; Timmermans and Buchbinder, 2010), abuse victims are strung up between health and sickness. All of victims' current and future ailments are linked up to their abuse, making them permanently mired in that relationship even if they have left it. The liminal space between health and illness carved out by the logic of health is less a zone of possibility than it is a marker of bad embodiment, a web of potentialities for pathology. While the hope is that this heightened biomedical attention will result in more and better resources for domestic violence victims, women may also be subject to unwanted biomedical surveillance under the logic of health. Women who have experienced domestic violence are increasingly defined in relation to those events, around and beyond their health status. In this sense, because the logic of health focuses on behavioral “pathways” between abuse and health problems, victims may come to blame themselves for their health problems. On the other hand, however, the logic of health also constructs the abuse victim as an active rather than a passive patient, recognizing her as a health decision-maker. While it is difficult to offer correctives based on these limited data, I would suggest that the focus in the biomedical literature on “screening” for domestic violence should heed the victim-blaming warnings of extensive surveillance and diagnosis. Furthermore, the current medical literature's focus on the category “female patients” with little distinction between race/ethnicity, sexuality, immigrant status, or class suggests that this paradigm is dangerously blind to the multiple marginalities at play in victims' lives (Richie, 2000). Biomedical screening and diagnosis involves risks to victims, not only in terms how they are represented within biomedicine, but also for their understandings of themselves as healthy or imperiled subjects. As literature on neoliberalism and biomedicalization would suggest, hope for better futures and amplified self-management mandates are suspended together here. By excavating this tension at the level of bodies and blame, I have demonstrated that the invasion of the present with future possibilities does not yield hopeful configurations so much as it rearranges and fortifies past pathologies, making them appear both novel and benign. Nikolas Rose argues that as “life” and its management via biomedicine come to define us more extensively, our personhood is defined by the limits of our corporeality ( 2007). What I am suggesting is that the limits of corporeality are not always a given, not always definable and constant. Rather, the limits of corporeality can be pushed backwards and forwards, temporally extended. The implications for these temporal extensions of the body do not only involve the power of biomedicine or the postmodern possibilities of flexible boundaries; rather, the construction of this temporally extended body changes the form and character of abused women's interactions with health systems and makes more aspects of their lives definable according to diagnostic categories. Blaming women for the abuse they suffer is by no means a new phenomenon, but under the logic of health, it has a powerful biomedical veneer, giving it fuel to travel to new regions of the body, to deep features of the future self.