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Mental Disability, Medical Discourse, and Rhetorical Action

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Mental Disability, Medical Discourse, and Rhetorical Action University of Louisville ThinkIR: The University of Louisville's Institutional Repository Electronic Theses and Dissertations 8-2017 Articulating the new normal(s) : mental disability, medical discourse, and rhetorical action. Andrew Wesley Holladay University of Louisville Follow this and additional works at: https://ir.library.louisville.edu/etd Part of the Rhetoric Commons Recommended Citation Holladay, Andrew Wesley, "Articulating the new normal(s) : mental disability, medical discourse, and rhetorical action." (2017). Electronic Theses and Dissertations. Paper 2787. https://doi.org/10.18297/etd/2787 This Doctoral Dissertation is brought to you for free and open access by ThinkIR: The University of Louisville's Institutional Repository. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of ThinkIR: The University of Louisville's Institutional Repository. This title appears here courtesy of the author, who has retained all other copyrights. For more information, please contact [email protected]. ARTICULATING THE NEW NORMAL(S): MENTAL DISABILITY, MEDICAL DISCOURSE, AND RHETORICAL ACTION By Andrew Wesley Holladay B.A., Union University, 2005 M.A., University of Louisville, 2009 A Dissertation Submitted to the Faculty of the College of Arts and Sciences of the University of Louisville in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in English/Rhetoric and Composition Department of English University of Louisville Louisville, Kentucky August 2017 Copyright 2017 by Andrew Wesley Holladay All rights reserved ARTICULATING THE NEW NORMAL(S): MENTAL DISABILITY, MEDICAL DISCOURSE, AND RHETORICAL ACTION By Andrew Wesley Holladay B.A., Union University, 2005 M.A., University of Louisville, 2009 A Dissertation Approved on June 12, 2017 by the following Dissertation Committee: __________________________________ Dissertation Director Dr. Brenda Jo Brueggemann __________________________________ Dr. Karen Kopelson __________________________________ Dr. Mary P. Sheridan ___________________________________ Dr. Amy Clukey ___________________________________ Dr. Margaret Price ii DEDICATION For Beth iii ACKNOWLEDGMENTS At many times along the way, completing this dissertation seemed an impossible task; I benefited from the advice and kindness of so many people who offered a hand even when I was not looking for one. First, I want to acknowledge the boundless knowledge and patience of my dissertation director, Brenda Brueggemann. She helped me navigate a project that mixed perspectives, methods, and disciplines, letting me explore the academic landscape while keeping me grounded in the work of Rhetoric and Disability Studies. I hope to follow Brenda’s example of personal investment, relentless care, and uncompromising honesty in my academic and personal life. My committee members have been enormously supportive and given me invaluable direction as I, often less than gracefully, worked through the dissertation process. Karen Kopelson, who reminds me of her support while challenging me to be more thorough; Mary P. Sheridan, a model of consistency and transparency who eases tension with her humor; Amy Clukey, who brought an outside perspective to my academic work; and Margaret Price, who helped me situate myself in a specialty and whose writing about mental disability will always be a guiding influence. Thank you also to the other faculty at the University of Louisville that have mentored and supported me over the last nine years of graduate school, administration, and teaching. Bronwyn Williams helped me discover a passion for teaching writing and iv rhetoric, both in the Composition program and the Writing Center; he was instrumental in my entrance into the PhD program, and then into professional life as an academic. Most importantly, this dissertation would not exist without tireless support and persistent encouragement from my wife, Beth. You believe in me when I don’t believe in myself. Thank you for showing me that a better, more just world is possible and worth fighting for. v ABSTRACT ARTICULATING THE NEW NORMAL(S): MENTAL DISABILITY, MEDICAL DISCOURSE, AND RHETORICAL ACTION Andrew Wesley Holladay June 12, 2017 “Articulating the New Normal(s): Mental Disability, Medical Discourse, and Rhetorical Action” studies the writing of people diagnosed with autism and post- traumatic stress disorder within online discussion boards related to mental health and outlines their unique rhetorical strategies for interacting with biomedical ideologies of psychiatry and activist discourses. The opening chapter situates this dissertation in relation to previous scholarship in Rhetoric, Disability Studies, and other fields. I also provide a summary of the set of mixed methods I use to gather and analyze my data, including rhetorical analysis, corpus analysis, and qualitative interviews. In Chapter 2, “Medical Terminology and Discourse Features of Online Discussions of Mental Health,” I explore the ways in which medical discourse appears in discussions of mental disability through medical terms that writers and speakers use when discussing a diagnosis. Using methods borrowed from linguistics, I demonstrate that the writers in my study make different linguistic choices than the general public, and that the most prominent differences are related to the social construction of mental health and medicine. vi In Chapter 3, “Inhabiting Biological Primacy with Chiasmic Rhetoric in Mental Health Forums,” I describe and analyze a variety of common topics in online conversations that connect mental health and expert knowledge of the brain. I argue that this connection of mental experience and brain science constitutes a chiasmic rhetoric. The writers foregrounded in this chapter acknowledge and accept much of the claims of medicine and neuroscience regarding the brain but, uniquely, work to divide that knowledge from the path of normativity and optimization. Chapter 4, “Classified Conversations: Psychiatry and Technical Communication in Online Spaces,” examines the practices of participants in online mental health discussion forums conversations as they interpret technical documents. I detail four salient forms of the manipulation of medical discourse in online communities. At the close of this chapter, I explain how these insights can inform academic study of writing in mental health contexts and transform the content and application of medical and technical texts. In Chapter 5, “Re-Forming Mental Health: Rhetorical Innovation and the Language of Advocacy,” I summarize and synthesize the core arguments of earlier chapters, with an extended caveat regarding the ethical dilemmas of this study. Finally, I offer a set of practical recommendations for different communities with which my research has been conversant, the fields of Rhetoric and Rhetoric of Health and Medicine, Disability Studies, and activism related to mental disabilities. vii TABLE OF CONTENTS ACKNOWLEDGMENTS ................................................................................................. iv ABSTRACT ....................................................................................................................... vi LIST OF TABLES .............................................................................................................. x LIST OF FIGURES ........................................................................................................... xi CHAPTER I: UNDERSTANDING THE PSYCHIATRIC SUBJECT: GROUNDING CRITIQUE IN LANGUAGE AND RHETORIC ............................................................... 1 Chapter Overview ......................................................................................................... 33 CHAPTER II: MEDICAL TERMINOLOGY AND DISCOURSE FEATURES OF ONLINE DISCUSSIONS OF MENTAL HEALTH ........................................................ 36 Competing Conceptions of Mental Disability .............................................................. 39 Linguistic Foundations.................................................................................................. 48 Taxonomy and Technicality ..................................................................................... 51 Corpus Linguistics and Collocation .......................................................................... 55 Linguistic Analysis of Corpora ..................................................................................... 59 Diagnosis................................................................................................................... 59 Autism ....................................................................................................................... 68 PTSD ......................................................................................................................... 74 Collocation Patterns and Medical Ideology .................................................................. 80 CHAPTER III: INHABITING BIOLOGICAL PRIMACY WITH CHIASMIC RHETORIC IN MENTAL HEALTH FORUMS ............................................................. 82 Biological Primacy and the Rise of Brain Science ....................................................... 82 Biology, Medicalization, and Mental Health ................................................................ 88 Linguistic Analysis of Study Corpus ............................................................................ 96 Brain .........................................................................................................................
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