A Critical Approach to Abnormality 245
day. These trends represent the decentralization of mental health care
insofar as concepts and practices related to psychology are being circulated
beyond the institutional mechanisms that referee biomedical research. And
of course, they must likewise be situated in relation to broader social
impulses to collect and share consumer data that are fundamental to
contemporary capitalist markets—trends that have been described in terms
like data capitalism (Mayer-Schönberger & Ramge, 2018) and surveillance
capitalism (Zuboff, 2019).
In order to keep up with such data collection imperatives, the tools
used by mental health professionals—specifically, manuals and assessment
tools—are becoming more decentralized, as well. The latest version of the
DSM, for instance, has moved away from the largely categorical criteria in
the DSM-IV, where each diagnosis was distinguished by type, to
dimensional criteria, where individual diagnoses are understood according
to often-broad spectrums of conditions. This allows for a greater range of
behaviors to be included within the criteria for each diagnosis. Allen
Frances (2013), a psychiatrist who chaired the DSM-IV task force, has
become increasingly critical of this trend, noting that the term illness fails
to fully encapsulate abnormality and unnecessarily works toward bringing
a greater number of people into the fold of abnormal psychology. With
manuals like the DSM transitioning away from the traditional axis system,
wherein disorders were mostly separated categorically, diagnostic practices
have become more nuanced when describing symptomology while,
simultaneously, expanding the parameters by which clinical decisions can
be made. Ann McGuire (2017) is likewise critical of the move towards
more inclusive spectrums, which she suggests represents “a neoliberal
deregulation of disorder” (p. 403). Similar to Frances’ critique, McGuire
notes that such a deregulation (or decentralization) of mental health care
troubles any established boundaries between normal and abnormal, paving
the way for not only new subjectivities but more coordinated possibilities
for social surveillance and behavioral control, as well.