.jpg)
My interest in critical feminist psychologies
has arisen from living with a longstanding diagnosis of myalgic
encephalomyelitis/chronic fatigue syndrome (ME/CFS) and working with people
with the condition in psychological settings. At the same time, I am aware of
historically dominant constructions of ME/CFS implicated in intersectional
oppressions. Though I term these constructions “historical," they not only
persist but are central to an ever-expanding
social narrative of "undeserving" forms of impairment
and disability.
In the UK, where I live, the National Health
Service (NHS) continues to classify ME/CFS among "medically
unexplained symptoms”. This psy-manufactured
construct perpetuates the view that ME/CFS is rooted in maladaptive individual
psychology and requires correction through individualistic psychosocial
interventions (typically cognitive-behavioural). This social narrative
continues despite health bodies in the UK and beyond removing
recommendations of psychological
interventions as clinical treatments for ME/CFS owing to lacking evidence and a
multitude of reported harm.
To date, mainstream critique of the
psycho-pathologisation of ME/CFS and "medically unexplained symptoms"
has understandably focused on paradigmatic
conflicts between a (preferred) biomedical and
(heavily critiqued) biopsychosocial model. Biomedical proponents argue that
social misrepresentation and medical neglect of ME/CFS is driven mainly by bad
science. They promote greater allegiance to the (Western) scientific method as
a route to emancipation from (bio)psychosocial dominance.
While hegemonic science is important in this
arena (e.g., for developing pharmacological interventions that can improve
quality of life), there is a risk of minimising the bigger picture, including
(1) how power differentials, cultural representations, and socio-political context
also impact health and life outcomes, and (2) how other epistemologies can
offer valuable pathways to knowledge production and social change.
In contrast, critical feminist theory engages
deeply with questions of power
and context: how power is deployed, by whom, in whose interests, and with what
impact. Moreover, feminist praxis is unapologetically partisan, committed to
challenging oppressive power relations and promoting social change. ME/CFS
could undoubtedly benefit from psychologically supportive approaches that
integrate a feminist ethos. The diagnosis has long occupied a site of
scientific, corporate, (bio)political and intersectionally oppressive powerplays,
with these powerplays reproduced in clinical encounters.
Moreover, critical feminist psychology’s indictment
of how hegemonic Psy individualises, responsibilises, de-politicises, and
commodifies suffering in complicity with neoliberal capitalism is highly
pertinent to ME/CFS and conditions classified as medically unexplained. Disabled
scholar-activists have produced a considerable body of literature locating the
marginalisation of many such conditions within a network of interests of a neoliberal-capitalist
mode of production and austerity
politics. Drawing on such epistemic labours, I
have elsewhere suggested that Psy's central role in the apparatus of power
relations implicated in this biopolitical project gives rise to a psy-corporate-state
complex.
Surely, there are benefits to integrating
critical feminist thinking into psychological praxis in this arena. However,
feminism has historically struggled to integrate
disability as a category of analysis.
This lapse is highly pertinent, since ME/CFS and “medically unexplained” conditions
represent prime disability
rights issues, and are haunted by intersectional
power/knowledge hierarchies that position disabled people as Other.
In this regard, feminist
disability studies has much to offer. The
field arose from disabled
women's and allied scholars' collective recognition that marginally situated
knowledges and experiences were being sidelined, both by the (predominantly
non-disabled) women's movement and the (predominantly male) disability
movement.
As an example of this promise, in {a new
article} for a special issue of Feminism &
Psychology, I contemplate disability as a feminist issue. I adopt a “feminist
disability standpoint”, drawing from the work of disabled feminist scholars and
other marginally situated knowledge-producers, to explore how psy might be
reimagined in an empowering, socially just and socio-politically cognisant
direction in the arena of ME/CFS as conditions labelled as medically
unexplained, energy-limiting
conditions.
Moving beyond binary and individualistic “biomedical-versus-(bio)psychosocial”
debates, a feminist disability standpoint highlights how both models overlook
the wider power-laden context that shapes social policies, practices,
subjectivities, health and life outcomes. This same context has facilitated the
hegemony of (bio)psychosocial explanations of ME/CFS and other stigmatised
conditions. This context, historically sidelined by biomedicine and “malestream”
psychology, must be acknowledged and addressed within psychological practice.
Addressing power and context does not mean
overlooking individual-level phenomena; it is vital to validate biological
realities in
ME/CFS and other contested illnesses. While people living with
psycho-emotional distress and madness (often called "mental illness")
are frequently harmed through psychiatrisation
(a form of medicalisation), those with ME/CFS and medically unexplained
symptoms are subject to medical neglect and (what might be better termed) 'psychologization'.
Therefore, as I discuss in the article, a feminist disability standpoint offers
conceptual resources to affirm biological/physical impairment effects in
interaction with a social context shaped by oppressive systems of power.
Perhaps most importantly, Psy practitioners
should seek to be allies to people living with these health conditions by
combining psycho-emotional support, advocacy, empowerment and (where
appropriate) information-sharing or "education" while being willing
to learn from service users' considerable knowledges. This alliance includes
supporting service users in determining their own values and meaning-making, as
opposed to values and meaning imposed by society or individual practitioners.
This move, I suspect, requires a radical
transformation in dominant practice as well as in the hearts and minds of many
practitioners. Integrating a feminist disability standpoint—and its wealth of
subjugated knowledges—into psychological theory and practice may offer an
in-road towards such transformation.
About the author
.jpeg)
Joanne Hunt is
a disabled researcher and research affiliate at the Department of Women’s and
Children’s Health, Uppsala University, Sweden. Her research interests
centre on the (bio)politics of stigmatised health conditions, sited at the
intersection of critical disability studies, gender studies, critical
psychology, and ethics. Particular interests include the psychology of ableism,
and challenges and possibilities in developing socio-politically and culturally
cognisant, disability-affirmative healthcare.
Twitter/X: @JoElizaHunt @HealthHubris
Find an article related to this blog on the F&P website
at: https://journals.sagepub.com/doi/10.1177/09593535241267091
