Diagnostic Culture or Cultural Diagnoses: The significance of context for the spread of psychiatric diagnoses.
Author
Abel, Thomas Sylvester
Term
4. term
Education
Publication year
2026
Submitted on
2026-08-03
Abstract
This thesis explores how the current spread of psychiatric diagnoses can be understood when the role of context in mental distress is taken seriously. It starts from the ongoing debate about whether the rise in diagnoses reflects better recognition of mental health problems, a genuine epidemic of distress, or a tendency to pathologize ordinary human suffering and life crises. The thesis combines a theoretical discussion with an illustrative analysis of the Danish Broadcasting Corporation programme "Hvad Fejler Fuhlendorff?" ("What is Wrong with Fuhlendorff?"), where the ADHD diagnosis is examined both as a clinical category and as a cultural story about identity. The thesis argues that the expansion of psychiatric diagnoses cannot be explained by a single cause. Instead, it must be understood as an interaction between historically changing ideas of what counts as normal, the classificatory logic of diagnostic manuals, popular cultural narratives about diagnosis and identity, and social conditions that both shape distress and make diagnosis appear to be the most accessible explanation. The analysis shows that diagnoses are not only clinical tools. They also work as social and cultural frameworks of understanding that people use to interpret themselves and their life histories. At the same time, modern diagnostic systems mostly classify suffering on the basis of observable symptoms. This creates a risk that the diagnosis itself is treated as a full explanation, even when it does not say anything about why the suffering emerged. The thesis concludes that psychiatric diagnoses should not be rejected, but understood in context. Mental distress does not exist only inside the individual; it takes shape in the relationship between the person and the world around them.
Denne afhandling undersøger, hvordan den nuværende udbredelse af psykiatriske diagnoser kan forstås, når man tager betydningen af kontekst for psykisk lidelse alvorligt. Udgangspunktet er den aktuelle debat om, hvorvidt stigningen i diagnoser skyldes bedre genkendelse af psykiske problemer, en egentlig epidemi af mistrivsel, eller en tendens til at sygeliggøre almindelig menneskelig smerte og livskriser. Afhandlingen kombinerer en teoretisk analyse med en illustrativ analyse af DR-programmet "Hvad Fejler Fuhlendorff?", hvor ADHD-diagnosen undersøges både som en klinisk kategori og som en kulturel fortælling om identitet. Afhandlingen argumenterer for, at udbredelsen af psykiatriske diagnoser ikke kan forklares ud fra én enkelt årsag. I stedet må den forstås som et samspil mellem historisk skiftende forestillinger om, hvad der er normalt, den måde diagnosesystemer klassificerer symptomer på, populære kulturelle fortællinger om diagnose og identitet, samt sociale vilkår, der både former mistrivsel og gør diagnoser til den mest tilgængelige forklaring. Analysen viser, at diagnoser ikke kun er kliniske redskaber. De fungerer også som sociale og kulturelle forståelsesrammer, som mennesker bruger til at fortolke sig selv og deres livshistorie. Samtidig klassificerer moderne diagnosesystemer primært lidelse ud fra det, man kan iagttage som symptomer. Det indebærer en risiko for, at selve diagnosen kommer til at stå som forklaring, selv når den ikke siger noget om, hvorfor lidelsen er opstået. Afhandlingen konkluderer, at psykiatriske diagnoser ikke bør afvises, men forstås i deres kontekst. Psykisk lidelse findes ikke kun inde i individet; den opstår i samspillet mellem mennesket og dets omverden.
[This abstract has been rewritten with the help of AI based on the project's original abstract]