How psychiatry pathologises and marginalises emotions

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Psychiatry’s tendency to label non-normative emotions as disorders contributes to affective injustice, distorting emotional self-understanding and deepening inequality.

A growing critique of modern psychiatry focuses on how its biomedical model frames emotional experiences—especially those outside societal norms—as internal dysfunctions to be treated rather than responses to complex social and environmental factors. In a new article published in Synthese, Zoey Lavallee and Anne-Marie Gagné-Julien from McGill University argue that this approach perpetuates what they call “affective injustice” and fosters a form of sanism that marginalises individuals labeled as mentally ill, ultimately distorting how we understand our own emotions.

“This paper addresses one crucial manifestation of psychiatrisation, still little studied in the literature; namely, the psychiatrisation of our emotional lives. That is, the increasing influence of psychiatric conceptualisations on the ways we interpret our own and others’ emotions, especially when these emotions are extreme, distressing, unusual, or otherwise radically deviate from what is deemed ‘normal,’” Lavallee and Gagné-Julien write. 
“In this paper, we will argue that biomedical conceptual frameworks that pathologise norm-deviating emotions can, in fact, be a source of injustice, and we specifically draw attention to how this form of injustice is encountered by psychopathologised people—anyone who is perceived by medical professionals or others to be mentally ill, whether or not they have received psychiatric treatment or diagnosis.

By examining how the biomedical model pathologises non-normative emotional experiences, Lavallee and Gagné-Julien shed light on the ways psychiatry silences and discredits valid emotional responses, reinforcing systemic oppression. Their analysis highlights the harms of emotion pathologising, a process that distorts feelings as psychiatric symptoms while neglecting social and structural factors. This critical inquiry calls for an urgent reevaluation of psychiatry’s role in shaping emotional self-understanding, urging scholars and practitioners to dismantle the narrow frameworks perpetuating injustice.

Lavallee and Gagné-Julien add:

“We argue that, under the effects of psychiatrisation, processes and practices of emotion pathologising cause harm to psychopathologised people by influencing them to make sense of their own norm-deviating emotions using an impoverished set of interpretive resources that engender unjust disadvantages and prevent access to more empowering ways of understanding their own emotional lives.”

As the biomedical narrative of mental distress continues to permeate spaces beyond the clinic—a concept called the psychiatrisation of society—its influence extends into various facets of everyday life. This pervasive psychiatric language and concepts continue to shape how we understand and interpret others and our own experiences, with significant implications for individual and collective well-being.

In a new article, authors Zoey Lavallee and Anne-Marie Gagné-Julien from the Center for Research in Ethics at McGill University examine a less explored facet of psychiatrisation: the psychiatrisation of emotions. They argue that the biomedical model’s emphasis on diagnosing and treating non-normative emotional experiences fosters a form of affective injustice. This dominant model, which pathologises emotions, results in systemic discrimination and marginalisation of individuals labeled as mentally ill, as well as influences how individuals understand their own emotional experiences.

In recent decades, there has been a growing focus on “medicalisation,” which describes the process by which issues previously seen as non-medical are redefined and treated as medical conditions. This process has permeated the field of mental health, called the psychiatrisation of society, characterised by the expansion of the DSM, increased diagnoses, and the dominance of the biomedical approach. The biomedical approach extends its reach beyond traditional medical settings, permeating social practices and cultural institutions, attributing mental distress and suffering to medical disorders, and taking attention from social and environmental factors.

This article investigates one specific manifestation of psychiatrisation: the psychiatrisation of emotional lives or the influence of psychiatric concepts on the way individuals interpret their own and others’ emotions.

Emotion pathologising

The authors refer to Pisemenny’s definition of a subcategory of emotional injustice called “emotional pathologising,” a form of emotion misinterpretation that occurs when “emotions are distorted by being viewed through a medical lens, as they are regarded as symptoms of psychiatric disturbance,” which takes place both in clinical and social contexts.

The authors provide ample evidence of emotion pathologising where appropriate emotions are distorted and subsequently dismissed or deemed illegitimate due to pathologisation. Most notably, the case study of a patient named Dora, who was sexually assaulted and subsequently diagnosed with hysteria by Freud.

The authors write:

“Emotion pathologising enacts harm by distorting the appropriate emotions of (often marginalised) people, misinterpreting these emotional responses as symptomatic of some psychiatric condition, thus obscuring the social and structural factors that contribute to the emotional processes.”

They state that emotion pathologising processes and practices are informed by both the dominant biomedical approach to psychiatry and sanism.

The role of biomedical psychiatry in emotion pathologising

The biomedical approach to psychiatry, which frames mental illness as stemming from abnormalities in physiological or neurobiological systems, plays a crucial role in emotion pathologising. This model tends to view emotions primarily as symptoms of mental disorders, minimising the impact of social and structural factors.

This approach conceals the role of social context in emotional responses by focusing on individual pathophysiology and de-contextualising emotions from their social origins. The authors provide examples of Premenstrual Dysphoric Disorder (PMDD) and Oppositional Defiant Disorder (ODD), both of which involve various emotional norms.

The role of sanism in emotion pathologising

Sanism, what they describe as a “hidden” system of oppression, is defined as a “system of discrimination and oppression that systematically disadvantages individuals who have received psychiatric diagnoses or who are perceived as in need of psychiatric treatment.”

The authors argue that sanism is a critical factor in the dismissal and discrediting of valid emotional responses to social conditions, including those characterised by oppression and discrimination, resulting in the portrayal of psychopathologised people as unreliable, irrational, and not credible. They argue that in a sanist society, individuals perceived as mentally ill are particularly vulnerable to having their emotions pathologised, resulting in these emotions being systematically dismissed and undermined.

Emotion pathologising as an affect-related hermeneutical Injustice

The authors demonstrate how emotion pathologising manifests as an affect-related hermeneutical injustice that impacts self-understanding.

They write:

“When an emotional experience is pathologised within biomedical psychiatry, it becomes interpreted as a manifestation of an internal dysfunction that should be treated or cured by biomedical tools. Thus, emotion pathologising is a hermeneutical process in that it is a process to make sense of an affective experience via biomedical language and other interpretive tools.”

While alternative hermeneutic models exist, the biomedical model’s dominance suppresses other interpretive tools and restricts individuals to a narrow understanding of their emotional experiences. This exacerbates the effects of sanism and contributes to self-pathologisation and emotional disorientation.

The authors write:

Affect-related hermeneutical injustice might not only undermine the ability to understand one’s own emotions but also the ability to communicate these emotions to others, including emotional experiences of oppression brought by sanism.”

In conclusion, the authors state their purpose for the impact of the scholarship, writing:

“We hope this paper motivates further critical analyses of the intersection of sanism and psychiatrisation and exploration of avenues for challenging dominant biomedical narratives about norm-deviating emotions in order to deconstruct unjust constraints on emotional experience and self-understanding that marginalised psychopathologised individuals face.”

Their article contributes to scholarship that challenges the dominant biomedical narrative of emotions that deviate from societal norms, expands our understanding of emotional experiences and self-understanding, and re-directs our attention to social and environmental factors for understanding non-normative emotions and behaviours.

This article was first published here on Mad in America.

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Ally is pursuing a master's in interdisciplinary studies through New York University's XE: Experimental Humanities & Social Engagement. She uses the relationship between anthropology, public health, and the humanities to guide her research. Her current interests lie at the intersection of literature and psychology as a method to reframe the way we think about different mental states and experiences. Ally earned a bachelor's degree from the University of Minnesota in Biology, Society, & Environment.

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