Constructing a social subject: autism and human sociality in the 1980s

This article examines three key aetiological theories of autism (meta-representations, executive dysfunction and weak central coherence), which emerged within cognitive psychology in the latter half of the 1980s. Drawing upon Foucault’s notion of ‘forms of possible knowledge’, and in particular his concept of savoir or depth knowledge, two key claims are made. First, it is argued that a particular production of autism became available to questions of truth and falsity following a radical reconstruction of ‘the social’ in which human sociality was taken both to exclusively concern interpersonal interaction and to be continuous with non-social cognition. Second, it is suggested that this recon- struction of the social has affected the contemporary cultural experience of autism, shift- ing attention towards previously unacknowledged cognitive aspects of the condition. The article concludes by situating these claims in relation to other historical accounts of the emergence of autism and ongoing debates surrounding changing articulations of social action in the psy disciplines

Drawing a line in the sand: affect and testimony in autism assessment teams in the UK.

Diagnosis of autism in the UK is generally made within a multidisciplinary team setting and is primarily based on observation and clinical interview. We examined how clinicians diagnose autism in practice by observing post-assessment meetings in specialist autism teams. Eighteen meetings across four teams based in the south of England and covering 88 cases were audio-recorded, transcribed and analysed using thematic analysis. We drew out two themes, related to the way in which clinicians expressed their specialist disciplinary knowledge to come to diagnostic consensus: Feeling Autism in the Encounter; and Evaluating Testimonies of Non-present Actors. We show how clinicians produce objective accounts through their situated practices and perform diagnosis as an act of interpretation, affect and evaluation to meet the institutional demands of the diagnostic setting. Our study contributes to our understanding of how diagnosis is accomplished in practice.Wellcome Trust Investigator Awar

What is psychiatry? Co-producing complexity in mental health

What is psychiatry? Such a question is increasingly important to engage with in light of the development of new diagnostic frameworks that have wide-ranging and international clinical and societal implications. I suggest in this reflective essay that ‘psychiatry' is not a singular entity that enjoins consistent forms of critique along familiar axes; rather, it is a heterogeneous assemblage of interacting material and symbolic elements (some of which endure, and some of which are subject to innovation). In underscoring the diversity of psychiatry, I seek to move towards further sociological purchase on what remains a contested and influential set of discourses and practices. This approach foregrounds the relationships between scientific knowledge, biomedical institutions, social action and subjective experience; these articulations co-produce both psychiatry and each other. One corollary of this emphasis on multiplicity and incoherence within psychiatric theory, research and practice, is that critiques which elide this complexity are rendered problematic. Engagements with psychiatry are, I argue, best furthered by recognising its multifaceted nature

Apocalyptic public health: exploring discourses of fatness in childhood ‘obesity’ policy

Recent‘ obesity’ preventions focus heavily on children, widely regarded as the future of society. The National Child Measurement Programme (NCMP) is a flagship government programme in England that annually measures the Body Mass Index (BMI) of children in Reception (aged 4–5) and Year 6 (aged 10 –11) in order to identify ‘at risk’ children and offer advice to parents. Using Foucauldian discourse analysis this study explore show discourses within the programme construct fatness. The NCMP materials contain three key interrelated themes (concerning the hidden threat of ‘obesity’, the burden of ‘obesity’, and bodies that pose a greater risk) that combine to construct a ‘grotesque discourse’ of apocalyptic public health. ‘Obesity’ is constructed as a social and economic catastrophe where certain bodies pose a greater threat than others. We argue that this discourse has the potential to change health service policy in markedly regressive ways that will disproportionately impact working-class, Black, Asian, and mixed race families