The Effects of Medicalization, Medical Practices, and Mental Disorder on the Subjective Experience of the Self in Sarah Kane's
Total Page：16
File Type：pdf, Size：1020Kb
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Trepo - Institutional Repository of Tampere University The Effects of Medicalization, Medical Practices, and Mental Disorder on the Subjective Experience of the Self in Sarah Kane’s 4.48 Psychosis Mariia Haatanen University of Tampere School of Language, Translation and Literary Studies English Philology MA Thesis April 2015 Tampereen yliopisto Englantilainen filologia Kieli-, käännös- ja kirjallisuustieteiden yksikkö HAATANEN, MARIIA: The Effects of Medicalization, Medical Practices, and Mental Disorder on the Subjective Experience of the Self in Sarah Kane’s 4.48 Psychosis Pro gradu -tutkielma, 102 sivua Huhtikuu 2015 _______________________________________________________________________________ Pro gradu -tutkielmani käsittelee Sarah Kanen 4.48 Psychosis -näytelmää medikalisaation ja mielenterveysongelmien sekä feminismin ja queer-teorian näkökulmista. 4.48 Psychosis kuvaa mielenterveysongelmista kärsivän potilaan suhdetta itseensä sekä hoitohenkilökuntaansa ja hoitometodeihin, joista selkeimpinä esiin nousevat lääkitys, mielentilaa kartoittavat testaukset sekä psykoterapia. Tutkielma tuo esiin Kanen vähemmän tutkitun viimeisemmän näytelmän uudesta näkökulmasta, jossa lääketiede, tekstin rakenne ja asiasisältö sekä feministinen ja queer-teoria luovat pohjan analyysille, jossa korostuu sekä lääketieteellisten käytänteiden vaikutus potilaan minäkuvaan, että potilaan minäkuvan ja tekstin vuorovaikutus. Pro gradu -tutkielma jakautuu kolmeen osioon: ensimmäisenä käsittelen medikalisaation sekä psykiatrian ja anti-psykiatrin teoretisointia ja analyysia, toiseksi käsittelen psykoterapian teoreettista pohjaa ja kritiikkiä, ja kolmanneksi tutkin postmodernin kirjallisuusteorian avulla tekstin rakenteen ja sisällön suhdetta potilaan minäkuvaan. Medikalisaation, psykiatrisen ja anti-psykiatrisen sekä psykoterapeuttisen lähestymistavan pohjalta tutkin, kuinka lääketieteelliset hoitokeinot vaikuttavat potilaan minäkuvaan. Analysoin, saako potilas hänelle tarjotusta hoidosta hyötyä, ja jos ei, kuinka hoitoprosessin voidaan nähdä vaikuttavan häneen negatiivisesti. Lähestyn kysymystä lääkäri-potilassuhteen analyysin kautta, jonka lisäksi tarkastelen lääkityksen ja psykoterapiassa tehtyjen mielentilaa ja kognitiivisia kykyjä kartoittavien testien vaikutusta potilaan ymmärrykseen itsestään mielenterveyspalvelujen asiakkaana. Teoriapohjaa analyysille luovat erityisesti Thomas Szaszin, Peter Conradin ja Joseph W. Schneiderin tekstit. Postmodernin kirjallisuusteorian pohjalta analysoin näytelmää myös sen tekstin rakenteen ja sisällön kautta. Painopiste pysyy edelleen potilaan minäkuvassa ja sen rakentumisessa näytelmässä, joskin fokus siirtyy medikalisaatiosta ja lääketieteen vaikutuksista itseilmaisun keinoihin. Tutkin potilaan minäkuvan sirpaleisuutta suhteessa tekstin sirpaleisuuteen, jota tutkin paitsi tekstin rakenteen, myös intertekstuaalisuuden tasolla. Teoriapohjana käytän ensisijaisesti Ihab Hassanin postmodernia teoretisointia. Avainsanat: näytelmäkirjallisuus, postmodernismi, medikalisaatio, mielenterveys, feminismi Table of contents 1. Introduction ................................................................................................................................................... 1 2. Medicalization and its Effects on Society ..................................................................................................... 9 2.1 The History of Mental Health Care and Medicalization ......................................................................... 9 2.2 Medicalization and Medical Power in Society ...................................................................................... 17 2.3 Feminist Criticism of Medicine ............................................................................................................. 25 3. Psychotherapy and Its Criticism .................................................................................................................. 30 3.1 The Basis of Psychotherapy .................................................................................................................. 30 3.2 The Criticism of Psychotherapy ............................................................................................................ 34 4. Identity, Medical Power, and Psychiatric and Psychotherapeutic Practices in 4.48 Psychosis ................... 37 4.1 “Doctors you’d think were fucking patients”: The Doctor-patient Relationship(s) in the Play ............ 37 4.1.1 The Character of the Doctor as a Medical Professional ................................................................. 39 4.1.2 The Patient’s Attitudes towards Her Doctor(s) .............................................................................. 47 4.2 Psychiatric and Psychotherapeutic Methods ......................................................................................... 55 4.2.1 Psychiatric Testing ......................................................................................................................... 55 4.2.2 Forcing the Medicine ...................................................................................................................... 65 5. The Collapse of the Textual Form and the Self ........................................................................................... 71 5.1 Fragmentation of Textual Form in Literature ........................................................................................ 71 5.2 “My Mind Is the Subject of These Bewildered Fragments”: Parallels between the Collapses of the Textual Form and the Patient’s Identity ...................................................................................................... 74 5.3 “Body and Soul Can Never Be Married”: The Separation between the Body and the Mind ................ 79 5.4 “Last in a Long Line of Literary Kleptomaniacs”: Intertextuality as Fragmentation ............................ 85 6. Conclusion ................................................................................................................................................... 95 Works Cited ..................................................................................................................................................... 99 1. Introduction Sarah Kane was a British playwright born in Essex in 1971. She died in 1999, being only 28 years of age at the time. Although Kane died at such a young age, she was a productive writer: she wrote five plays and a ten-minute screenplay during her lifetime. She started writing in her childhood, and she wrote some parts of her first play, Blasted, already during her time in the University of Cambridge where she studied playwriting. Her plays are regarded as a part of a branch of theatre called in-yer-face, which is famous for its brutality, emotional honesty, and use of taboos and shock tactics. The prime time of in-yer-face theatre was in the 1990s, and its main arena was Great Britain. The term “in-yer-face” was coined to this usage by Alex Sierz, a journalist, theatre critic and scholar (2002, 5). Sierz, who has done extensive work on both in-yer-face and Sarah Kane, states that in-yer-face was “the dominant theatrical style of the decade” (2001, 4). In his book In-Yer-Face Theatre Sierz argues that in-yer-face “saved British theatre” and that in the 1990s “contemporary theatre was in-yer-face theatre,” explaining the importance of the genre to modern European theatre (2001, xii-xiii). Although this particular branch of theatre may not be that well known, perhaps because of its locality and radical nature, it has had a big impact on contemporary theatre. Sierz argues that in-yer-face playwrights have pushed modern theatre forwards by making it more experimental (2001, 4). In-yer-face can be seen as a theatre of extremes, since it forces its audience to react, not allowing any emotional detachment like traditional theatre does. Themes typical in in-yer-face, such as violence and brutality, are nothing new in theatre, but have in fact been around ever since Greek drama. However, the way in which in-yer-face portrays them is essentially different from past styles of theatre, because whereas in previous styles of theatre violence has often been performed off-stage, in-yer-face brings the “shock-fest,” as Sierz calls it, right in the face of the audience and pushes the limits of what has previously been considered as an impossibility in stage performance (2001, 36). Besides Sarah Kane, some of the most known playwrights in the in-yer-face tradition include names such as Mark Ravenhill 1 (Shopping and Fucking), Philip Ridley (The Pitchfork Disney), and Anthony Neilson (Normal) (Sierz, 2001 and 2012). Sarah Kane is, as Catherine Rees describes her in the book Modern British Playwriting: The 1990s (edited by Sierz), one of the most “famous and infamous” and controversial playwrights of the 1990s (2012, 112). Kane's plays have indeed caused widespread criticism, and especially her first play, Blasted, raised a riot in the theatre circles of Great Britain in the mid-1990s. Blasted, first performed in the Royal Court Theatre Upstairs in 1995, is perhaps most famous for the comment made by Jack Tinker, a drama critic from the Daily Mail, calling the play a “disgusting feast of filth” (1995). Surely, the harsh themes of the play, such as cannibalism and rape, and its unconventional structure did not help the digestion of Blasted amongst theatre critics. The scandal