BPS Core Textbooks Series

Developed in collaboration with the British Psychological Society

Chapter 22 – Behind the Mask: Psychological Diagnosis and the Politics of Interpellation

Chapter Summary

This chapter explores psychological diagnosis as a site of power, identity, and negotiation, using the concept of interpellation to examine how individuals are ‘hailed’ into diagnostic categories, and how they may resist, reinterpret, or reclaim these labels. The chapter shows how the removal of homosexuality from the DSM exemplifies diagnosis not as a neutral classification but as a dynamic and contested social act. Through historical analysis and five key case studies (PTSD, ADHD, autism, schizophrenia, and CFS/ME), the chapter traces how diagnoses are shaped by expert authority, political activism, and lived experience. It examines the epistemological frameworks used to construct diagnostic knowledge, the ontological consequences of being named, and the power struggles that determine what counts as a disorder. By drawing on the dialectical model of interpellation, the chapter invites a critical engagement with diagnosis as a process of naming and being named, a two-way conversation between clinicians, patients, institutions, and communities. Diagnosis, it argues, is a cultural and political performance that shapes who we are and who we are allowed to become.

Chapter 22 – Quiz

  • Chapter 22 – Flashcards

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  • Chapter 22 – Key Readings

    Angel, K. (2012). Contested psychiatric ontology and feminist critique: ‘Female Sexual Dysfunction’ and the Diagnostic and Statistical Manual. History of the Human Sciences, 25(4), 3-24. https://doi.org/10.1177/0952695112456949 

    Brinkmann, S. (2016). Toward a cultural psychology of mental disorder: The case of attention deficit hyperactivity disorder. Culture & Psychology, 22(1), 80–93. https://doi.org/10.1177/1354067X15621485

    Frances, A. (2013). Saving normal: An insider’s revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma, and the medicalization of ordinary life. HarperCollins. 

    Freeborn, A. (2025). Testing psychiatrists to diagnose schizophrenia: Crisis, consensus, and computers in post-war psychiatry. History of the Human Sciences, 38(2), 18-39. https://doi.org/10.1177/09526951241309504 

    Healy, D. (2014). Psychiatric ‘diseases’ in history. History of Psychiatry, 25(4), 450–458. https://doi.org/10.1177/0957154X14543980 

    Kornaj, J. (2024). “It’s a fight – the whole personality of the patient to win”: The development of concepts of psychosis in the Jewish Hospital in Warsaw, 1898–1943. Journal of the History of the Behavioral Sciences, 60(4), e22328. https://doi.org/10.1002/jhbs.22328 

    Mayes, R. & Horwitz, A.V. (2005), DSM-III and the revolution in the classification of mental illness. Journal of the History of the Behavioral Sciences, 41(3), 249-267. https://doi.org/10.1002/jhbs.20103 

    Moncrieff, J. (2010). Psychiatric diagnosis as a political device. Social Theory and Health, 8(4), 370–382. https://doi.org/10.1057/sth.2009.11 

    Moncrieff, J., & Timimi, S. (2010). Is ADHD a valid diagnosis in adults? No. British Medical Journal, 340, c547. https://doi.org/10.1136/bmj.c547 

    Noll, R. (2018). Feeling and smelling psychosis: American alienism, psychiatry, prodromes and the limits of ‘category work’. History of the Human Sciences, 31(2), 22-41. https://doi.org/10.1177/0952695117750341 

    Pienkos, E. (2024). Understanding, schizophrenia, and the limits of phenomenology. Theory & Psychology, 34(4), 427-445. https://doi.org/10.1177/09593543241266618 

    Pilgrim, D. (2014). Historical resonances of the DSM-5 dispute: American exceptionalism or Eurocentrism? History of the Human Sciences, 27(2), 97-117. https://doi.org/10.1177/0952695114527998 

    Reichardt, E. M., Stam, H. J., & Tan-MacNeill, K. (2023). “Mere guesswork”: Clarifying the role of intelligence, mentality, and psychometric testing in the diagnosis of “mental defectives” for sterilization in Alberta from 1929 to 1972. History of Psychology, 26(4), 283–313. https://doi.org/10.1037/hop0000236 

    Young, A. (2001). The harmony of illusions: Inventing post-traumatic stress disorder. Princeton University Press.  

  • Chapter 22 – Reflective Questions

    1. Why was Dr John Fryer’s masked appearance at the 1972 APA meeting such a significant moment in the history of diagnosis? 
    2. What does the concept of interpellation reveal about the way psychological diagnoses are created and experienced? 
    3. How have patient advocacy and social movements contributed to changes in specific diagnostic categories, such as PTSD or autism? 
    4. In what ways do epistemological assumptions shape who gets diagnosed, and whose experiences are excluded from diagnostic systems? 
    5. Why is it important to understand psychological disorders as ‘human kinds’ rather than ‘natural kinds’?

  • Chapter 22 – Weblinks

    Out of DSM: Depathologizing Homosexuality (Academic Article)

    https://pmc.ncbi.nlm.nih.gov/articles/PMC4695779

    This academic article discusses the Removal of the diagnosis of “homosexuality” from the second edition of the DSM, and discusses how this impacted treatment and attitudes towards LGBTQ individuals at the time, and is an excellent resource for students wanting to understand the real world implications of this action.

    Understanding Psychosis and Schizophrenia – The British Psychological Society (Academic Article)

    https://www.bps.org.uk/guideline/understanding-psychosis-and-schizophrenia

    This article provides students with a clear and accessible explanation of the British Psychological Society’s approach to psychosis and schizophrenia, and provides extensive links for further reading for students who want to expand their understanding of these concepts in a more contemporary setting.

    What happens when you have a disease doctors can’t diagnose – TED Talk by Jennifr Brea (Video Lecture)

    https://www.ted.com/talks/jennifer_brea_what_happens_when_you_have_a_disease_doctors_can_t_diagnose

    This 16 -minute video lecture provides students with an interesting real world example of what happens to individual struggling for diagnostic legitimacy, which enables students to engage much more critically with the topic discussed in this chapter.

    Remembering Bonnie Burstow – Mad in America: Science, Psychiatry and Social Justice (Academic Article)

    https://www.madinamerica.com/2020/01/remembering-bonnie-burstow

    This article provides an in-depth, but accessible explanation of the life and work of Bonnie Burstow, giving students an opportunity to engage critically with the work that she did alongside extensive articles for further reading on the various topics discussed, such as the Coalition Against Psychiatric Assault, and various anti psychiatry theories and activists.

    The Institute for the Development of Human Arts (IDHA)

    https://www.idha-nyc.org

    This web page gives students access to an interdisciplinary an activist collective focused on rethinking diagnosis and treatment through a community focused approach, giving students an opportunity to engage in real world examples of people attempting to reverse the damage done by archaic diagnostic practises.