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© 2012 DAVID SKUBBY ALL RIGHTS RESERVED A HISTORY OF MEDICAL PRACTICES IN THE CASE OF AUTISM: A FOUCAULDIAN ANALYSIS USING ARCHAEOLOGY AND GENEALOGY A Dissertation Presented to The Graduate Faculty of The University of Akron In Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy David Skubby May, 2012 A HISTORY OF MEDICAL PRACTICES IN THE CASE OF AUTISM: A FOUCAULDIAN ANALYSIS USING ARCHAEOLOGY AND GENEALOGY David Skubby Dissertation Approved: Accepted: _______________________________ _______________________________ Advisor Department Chair Dr. Rebecca J. Erickson Dr. Matthew T. Lee _______________________________ _______________________________ Committee Member Dean of the College Dr. Cheryl S. Elman Dr. Chand Midha _______________________________ _______________________________ Committee Member Dean of the Graduate School Dr. Clare Stacey Dr. George R. Newkome _______________________________ _______________________________ Committee Member Date Dr. Brian Castellani _______________________________ Committee Member Dr. Margaret Carol Stephens ii ABSTRACT Psychiatric medicine constructs mental disorders from bodily conditions. Being able to medicalize disorders in this way, psychiatric medicine operates as an institution of social control through its power to label individuals as deviant and to establish particular bodily states as medical problems. In this dissertation, I apply Foucauldian concepts, theory, and methods to examine how the history of medical discourse on a particular bodily condition has produced truth about what distinguishes the normal from the pathological. Focusing on the case of autism – a modern-day disorder that now permeates the socio-medical landscape – I show how the relationship between psychiatric medicine and autism might be re-envisioned to provide an alternative perspective on how medical knowledge expands to construct a medical problem. Tracing the history of medical practices used on autistic children, I examine medical documents from the time that autism was constructed as a disorder in 1943 to 1987, when a treatment for autism was produced by behavioral psychology. Using Foucault’s concepts of the clinical gaze, discipline, and power/knowledge, I show how two quite different discourses about autism within medicine emerged at different points in time. Moreover, through the application of Foucault’s methods of archaeology and genealogy, I demonstrate how these disciplines determined what could and could not be stated about autism and how power influenced the production of these statements. Key among my findings are how similar disciplinary techniques gain and lose truth value iii depending on the context of their deployment and how disciplinary methods and outcomes privilege power/knowledge over individual and social bodies rather than seeking to understand and benefit the lived, bodily experiences of particular human beings. I conclude by suggesting that the history of medical discourse on autism has led to the development of practices that misrecognize, if not ignore, the actual bodily experiences of autistic individuals, and that a new discourse of acceptance and admiration needs to replace the discourse of normalization. iv DEDICATION For my amazing son Jacob, who is the inspiration for this dissertation. And for Joshua and Aaron, his wonderful brothers. All my love. v ACKNOWLEDGEMENTS In the process of writing this dissertation, I came to appreciate how many people truly cared about me, my aspirations, and my project. I also realized that it is quite a lot to ask these caring people to give and sacrifice so much so that I could realize my goal to complete my graduate education and to complete my dissertation. These are the giving people who have helped me so much over the past several years to achieve these goals. First and foremost, I want to profoundly thank Dr. Rebecca Erickson for taking me on as her protégé. The undeserved faith and trust in me that she showed through this process of completing this unwieldy project was beyond my expectations. The worth of her direction, from the germ of the idea to the dissertation defense, is incalculable. Whatever positive contributions I have made to the field, or whatever positive contributions I will make in the future, are directly related to her considerate and unselfish guidance not only as I wrote my dissertation, but all throughout my graduate career at Akron. I am indebted to her and again, I thank her. I also want to thank my dissertation committee, Dr. Cheryl Elman, Dr. Clare Stacey, Dr. Brian Castellani, and Dr. Margaret Carol Stevens, for their support. They had to read more pages than they probably expected, and I appreciate the time they put into reading my dissertation. Their thoughtful comments and suggestions helped shape what this dissertation is today and what it might look like as a publication in the future. I can’t thank them enough. vi I found some of the most important data for my research within the Archives of the History of American Psychology at the University of Akron Center for the History of Psychology. I am most sincerely indebted to Lizette Royer, Senior Archives Associate at AHAP, who worked tirelessly to find documents that were needed for my dissertation. Lizette should know that her work and her support contributed immeasurably to the findings of this project. I want to acknowledge the Institute of Health and Social Policy’s Selection Committee of the Barbara J. Stephens Dissertation Award, especially Dr. Richard Stephens and Dr. Peter Leahy. Their kind generosity helped fund the gathering of the enormous amount of data that I needed to produce this dissertation. I want to thank the entire faculty in the Department of Sociology at the University of Akron for their kindness and support. I want to especially thank those faculty members who I have had the pleasure to work with on their projects and in their teaching: Dr. Baffour Takyi, Dr. Rudy Fenwick, and Dr. Mark Tausig. I owe a special word of gratitude to Dr, Kathryn Feltey, who has constantly and consistently encouraged me all throughout graduate school career at the University of Akron. I also want to thank the Administrative Assistants in the Department of Sociology, Tammy Dixon and Christi Terry, as well as computer genius Cindy Steinel, for their patience when I sought their help in guiding me through all the hurdles. Dr. Kristen Marcussen deserves a special thank you for reminding me of my special interest in those who think about and experience the world in extraordinary ways. Kristen has helped me to understand my purpose, and I cannot thank her enough. vii I want to thank those whom I worked for and with at NEOMED, especially Dr. Chris Ritter for his encouraging words throughout my two and a half years there, and who truly helped me get where I am at today. I also want to thank three very special people from both NEOMED and Kent State: Natalie Bonfine, Mary Gallagher, and Kelly MacArthur. Each of them showed kindheartedness toward me that I can only hope to match. I leaned on them big time over the past several years. It is hard to imagine going through graduate school and completing a dissertation without their friendship, thoughtfulness, and support. The drinks and laughs we shared together…I’ll never forget those moments…and those moments, I hope, will continue. My graduate student colleagues in the department at Akron deserve special mention. I want to thank Teresa Sisson for her friendship and encouraging words throughout my graduate career. We shared much together, from commiserating over course work to AKD, to the special events in our lives. Teresa helped me make it through. I also want to thank Richelle Dykstra, Angela Adkins, Jodi Ross, and Liza Grossman for their words of wisdom during my graduate career. There’s no telling where I would be if they had not unselfishly shared their experiences and knowledge with me. Finally, I want to thank Marci Cottingham, Michael Rickles, Jared Rosenberger, Lia Wiley, Monica Oliva, Nicole Rosen, and Mike Steiner for their steadfast friendship and support over these past few years. I owe my colleagues at Hiram College a special thank you. I thank Dr. Elizabeth Piatt for taking me on as part of the sociology department at Hiram. Her door was always open and she let me talk and talk (and talk) about what was happening with my dissertation. I thank Dr. Robin Shura who always knew the right things to say to keep me viii going. And I especially thank Anisi Daniels-Smith who has been a source of support and kindness to me, from advanced data to now. I can’t thank her enough for her friendship. There is no possible way that I could have made it through graduate school without the love of my family. A great big thank you to my mom for helping me in so many unselfish ways so that I could make it to graduation. I want to thank my brother, Chris, who has been a constant and generous source of support and help as I made my way through graduate school. My sister Sue and her husband Paul, thank you for all the help and encouragement. And thanks to my dad who has helped me in difficult times over the course of my graduate career. I could never have reached the point where I am at today without the love and support that each of them has shown me throughout my life. I express my gratitude to Laurie Redmon, who has practically single-handedly taken such great care of the children. Despite a hectic life, she has done a remarkable job at raising three healthy, happy boys. Thank you! And a big thank you to Denise and Gene Redmon, whose help with watching the kids and whose support I wasn’t worthy of, deserves special mention. Finally, I offer a word of appreciation for Ruth Noles, for being there always, for the children.
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