Sexual violence, deviance, and the paraphilias in American psychiatry, 1952-2013.

This article explores arguments within American psychiatry from the 1950s around whether rapists were mentally ill. It analyses debates in the lead-up to the various editions of the American Psychiatric Association's (APA's) Diagnostic and Statistical Manual of Mental Disorders (DSM) from 1952 to the latest version in 2013, focussing particularly on a diagnostic category called 'Paraphilic Coercive Disorder' (PCD). Since the first DSM, American psychiatrists had routinely considered people who committed certain forms of sexual violence to be suffering from mental disorders. For example, 'Paedophilia' and 'Sexual Sadism' had always been considered valid diagnoses. However, the APA refused to pathologise non-sadistic sexual violence committed against adults. Opposition can be classified into four overlapping arguments: uncertainty about 'normal' male sexual aggression, feminist worries about 'excusing' harmful sexual behaviours, concerns about the misuse of psychiatry in courts, and the need to defend the psychiatric profession from encroachments on their 'territory' by non-medically trained psychologists, social workers, and anti-psychiatric activists.

Military Sexual Trauma: Gender, Military Cultures, and the Medicalization of Abuse in Contemporary America.

Sexual violence is a serious problem within armed services. This article explores intra-service rape in branches of the U.S. military from the 1990s to the present. The article begins by establishing the parameters of the crisis of sexual abuse within the U.S. armed services. Second, it explores systematic failures to recognize forms of suffering. Victim-survivors in the military are vulnerable to military-specific obstacles to reporting their abuse and being believed. Attention is paid to differences by gender and sexual orientation. Third, it analyses the medicalization of suffering in the modern military and its effects. What meanings are assigned to 'military sexual trauma' (MST) and how has that label affected victim-survivors of rape or sexual assault? The article concludes by arguing that the concept of 'trauma' as it is applied to victims of sexual abuse does a formidable amount of political and ideological work.

Police Surgeons and Victims of Rape: Cultures of Harm and Care.

Between the late 1960s and the late 1980s, police surgeons found themselves under concerted attack for their treatment of victims of rape and sexual assault. This article explores the tensions they faced between the needs of victims and their legal responsibilities. Should they prioritise care or the collection of evidence? How did they respond to criticism and why were reforms inadequate? I show how institutional structures and ideologies help explain the longevity of cultures of harm within the sub-discipline of police doctors. However, to understand the tenacity of these practices, we need to interrogate more fundamental processes associated with bodily interactions, emotion and language.

Pain sensitivity: an unnatural history from 1800 to 1965.

Who was truly capable of experiencing pain? In this article, I explore ideas about the distribution of bodily sensitivity in patients from the early nineteenth century to 1965 in Anglo-American societies. While certain patients were regarded as "truly hurting," other patients' distress could be disparaged or not even registered as being "real pain." Such judgments had major effects on regimes of pain-alleviation. Indeed, it took until the late twentieth century for the routine underestimation of the sufferings of certain groups of people to be deemed scandalous. Often the categorizations were contradictory. For instance, the humble status of workers and immigrants meant that they were said to be insensitive to noxious stimuli; the profound inferiority of these same patients meant that they were especially likely to respond with "exaggerated" sensitivity. How did physicians hold such positions simultaneously? Pain-assignation claimed to be based on natural hierarchical schemas, but the great Chain of Feeling was more fluid than it seemed.

Pain: metaphor, body, and culture in Anglo-American societies between the eighteenth and twentieth centuries.

This article explores the relationship between metaphorical languages, body, and culture, and suggests that such an analysis can reveal a great deal about the meaning and experience of pain in Anglo-American societies between the eighteenth and twentieth centuries. It uses concepts within embodied cognition to speculate on how historians can write a history of sensation. Bodies are actively engaged in the linguistic processes and social interactions that constitute painful sensations. Language is engaged in a dialogue with physiological bodies and social environments. And culture collaborates in the creation of physiological bodies and metaphorical systems.

WHAT IS PAIN? A HISTORY THE PROTHERO LECTURE.

What is pain? This article argues that it is useful to think of pain as a 'kind of event' or a way of being-in-the-world. Pain-events are unstable; they are historically constituted and reconstituted in relation to language systems, social and environmental interactions and bodily comportment. The historical question becomes: how has pain been done and what ideological work do acts of being-in-pain seek to achieve? By what mechanisms do these types of events change? Who decides the content of any particular, historically specific and geographically situated ontology?

Bodily Pain, Combat, and the Politics of Memoirs: Between the American Civil War and the War in Vietnam.

This article analyses the languages of wartime pain as seen in British and American memoirs from the American Civil War to the present. How did the rhetoric of wounding in these war memoirs change over time? One of the central shifts lies in the way that wounded men presented themselves as stoic in spite of severe wounding. From 1939, and in an even more dramatic fashion by the war in Vietnam, physical suffering remained a test of manliness, but the tone was defiant and aggressive rather than stoic or resigned. The article also looks at the role of individual publishers and the introduction of psychological dimensions of wounding in latter memoirs.

Sexual Violence, Bodily Pain, and Trauma: A History.

Psychological trauma is a favoured trope of modernity. It has become commonplace to assume that all 'bad events' - and particularly those which involve violence - have a pathological effect on the sufferer's psyche, as well as that of the perpetrators. This essay explores the ways victims of rape and sexual assault were understood in psychiatric, psychological, forensic, and legal texts in Britain and America from the 19th to the late 20th century. It argues that, unlike most other 'bad events', which were incorporated within trauma narratives from the 1860s, the ascription of psychological trauma was only applied to rape victims a century later. Why and what were the consequences?

Pain, sympathy and the medical encounter between the mid eighteenth and the mid twentieth centuries.

Witnessing people in pain inevitably elicits anxiety in physicians and other caregivers. Physicians are often required to inflict certain types of discomforts in order to alleviate other, more destructive, pains. Accusations that physicians lacked sympathy can be heard throughout the centuries. This article explores the diverse medical responses to such claims between the eighteenth and twentieth centuries. It interrogates changing definitions of clinical sympathy. The concept of sympathy was continually being reworked for each generation of medical professional. Crucially, in this reworking, philosophers (such as Adam Smith) and physicians came into dialogue. Cultures of sympathy were understood in both physiological and metaphorical terms, and were tied to changing notions of professionalization.

Sexual violence, marital guidance, and Victorian bodies: an aesthesiology.

This essay examines some of the emotional rules, encoded in grammars of representation and framed within law and prescriptive marital advice literature, regarding the expression of male sexual aggressivity within the bedroom. Despite the general Victorian idealization of marriage, many wives suffered physical and sexual abuse at the hands of their husbands, marital rape drawing particular attention from early feminists, psychologists, physicians, and evolutionary physiologists. In the 1870s, a belief that unrestrained sexual license was a symptom of degeneration led these commentators to consider marital rape particularly harmful to husbands. By the turn of the century, however, the focus of this harm had nominally shifted to women, who might become frigid if forced to submit to sex--a problem for wives but for husbands as well. As sexology and psychology gained greater influence, couples came to rely on the emotion-talk of commentators to negotiate mutually agreeable bedroom activity.