Interrogating nonsuicidal self‐injury disorder through a feminist psychiatric disability theory framework

Abstract

This article explores the proposed psychiatric diagnostic category of nonsuicidal self-injury disorder (NSSID) through the lens of feminist psychiatric disability theory.Mobilising insights from labelling theory's accounts of stigma and recovery, in conjunction with critical and feminist disability theory's attention to emotional and physical pain, we suggest that a feminist psychiatric disability approach to NSSID can illuminate the limits of a fully demedicalised engagement with self-injury.While remaining critical of psychiatrisation processes, we explore the implications of 'strategic (dis)identifications' with illness labels as mechanisms through which to manage and access care, treatment and recovery. Such a nuanced account engenders more deeply material considerations of pain, stigma, treatment and 'cure' at the site of NSSID, opening new avenues of engagement with self-injury for sociologists and critical disability scholars alike.

Introduction to special issue: New dialogues between medical sociology and disability studies

“…Redikopp and Smith (2023) argue that non‐suicidal self‐injury disorder (NSSID)—proposed by the Diagnostic and Statistical Manual of Mental Disorders (DSM‐5) to distinguish patterns of self‐injury from other diagnostic categories—is a fruitful area of enquiry for medical sociology and disability studies. Taking NSSID as an entry point and drawing upon feminist psychiatric disability theory, the authors claim that NSSID illuminates the limits of a fully ‘de‐medicalised’ engagement with self‐injury whilst ‘locating the socially and historically specific nature of the production of “disability” and madness itself’ (2023, p. 1206). Medicalisation has historically been a vital conceptual tool for questioning modes of labelling behaviours and ways of being, together with highlighting power hierarchies permitting labelling and misidentification of social/political failures as personal failures requiring cure and treatment.…”

“…Medicalisation has historically been a vital conceptual tool for questioning modes of labelling behaviours and ways of being, together with highlighting power hierarchies permitting labelling and misidentification of social/political failures as personal failures requiring cure and treatment. Nonetheless, Redikopp and Smith set out to recognise that ‘conditions of oppression can be themselves maddening’ and require response, including medical treatment (2023, p. 1208). Here, both medical sociology (with its focus on diagnostic processes and labelling) and disability studies (emphasising embodied and affective dimensions of pain) have something to offer for their analysis.…”

“…They show how some people can engage with the diagnosis of NSSID with awareness of the scope for such a classification to stigmatise and de‐emphasise the social and material conditions that lie behind their issues, whilst making use of it to alleviate the pain—through medical treatment—that their self‐injury practices produce. Nonetheless, focussing on everyday embodiments, for Redikopp and Smith, shows us how self‐injury practices can be a way to ‘cope with, survive or respond to structural and social forms of gendered, racialised, ableist and classed violence’ (2023, p. 1214).…”