A critical analysis of the discursive formation of suicide as pathological and medical

• Main Author: Marsh, Ian
• Published: University of Brighton 2008
• Subjects: 150
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.485758

The thesis critically examines contemporary approaches to the problem of suicide and suicide prevention. An analytic strategy broadly Foucauldian in orientation (focusing on relations of power, knowledge and the subject) is employed to map the formation, consolidation and expansion of a 'regime of truth' centred on a compulsory ontology of pathology in relation to suicide. The conditions of possibility for such a regime, the site of its formation, the means by which relations of power and of power-knowledge acted to produce its truths and justify its practices, and its effects in terms of the objects, concepts and subjects formed, are identified. It is argued that suicide came to be newly problematised in the eighteenth and early nineteenth centuries. Understood in relation to shifting 'economies of power', suicide comes to represent less a transgression against God or the Sovereign necessitating punishment, and more an affront to a biopolitical rationality that sought to foster life and disavow death. The asylum emerges as the site where new, medico-scientific, truths can be formed, and medical authority asserted, with regards to suicide and the suicidal. Constituted primarily as patients, in the asylum the suicidal are confined, constantly watched and restrained. Here they could also be examined, diagnosed, and treated, the knowledge. produced through such means justifying the practices employed. New truths of suicide come to be formed by reference to insanity, and concurrently emerging theories of mental pathology are defined in part by reference to suicide. Through, in part at least, such a productive configuration of power-knOWledge the nineteenth century sees suicide established as an act of madness, the insane constituted as dangerous, and the necessity of alienism (later psychiatry) confirmed. Suicide as an act, the suicidal patient, as well as the responsible, accountable and culpable clinician, all come to be formed in relation to the production and circulation of medical I psychiatric truths and such processes are mapped in the thesis up to the present day. Suicide is now read, almost always, as a tragedy, one caused primarily by pathological processes internal to the individual that require expert diagnosis and management. The possibilities for thought and action of such a 'regime' are analysed, as are the limitations imposed by its dominance. Other meanings of self-accomplished death - an act of protest or resistance, of self-determination, choice or will, an event of moral, criminal or political concern, even as a subject of philosophical debate - have come to be marginalised. Established as an act of path910gy, suicide prevention for the most part now involves the identification, treatment or containment of an internal destructive 'force', usually linked to various forms of mental illness. The effectiveness of the 'regime of truth' to utilise self-accomplished deaths as evidence for the necessity of maintaining and I or extending psychiatric practices, and for the production of more knowledge in terms of causation and prevention, is noted, as is the vulnerability of individual clinicians within such a system to criticism and blame. In seeking to problematise the effects of such a dominant 'regime of truth' this thesis offers an original analysis that can serve to open up new lines of enquiry in the study of suicide.