180115 SE Performativity of gender and disease (2012W)

Gender and disease are tightly connected in their normative dimension. Judith Butlers model of the performative construction of gender can be used for analyzing the gender specific constitution of psychosomatic diseases and psychosocial counselling processes. Diseases manifest themselves as sociocultural constructions and interpretations of psychic and somatic conditions. The process of forming norms of health and disease produce gendered bodies. The psychoanalytic concept of the metamorphosis of a psychic conflict into a somatic symptom is shown as intertwined with critical social aspects. The performativity of gender and disease can be shown in the phenomena of hysterical conversion, anorexia and bulimia, self-mutilating behaviour and multiple identity disorder. In the exaggerated incorporation of stereotypes of femininity in these so-called female diseases the continuum between s.c. normal woman and s.c. pathological femininity becomes obvious. In the ambiguity of adaptation and resistence norms of femininity are hereby confirmed as well as subverted.
A feminist understanding of health and disease with its perspective of a normative
constitution of masculinity and femininity provides a new approach to the interrelations of
psyche and body, gender and society. No body, no disease and no gender exists outside the process of the construction of meaning. Language and body, discourse and materiality are intertwined. The materiality of bodies that are determined in a dichotomous way can be understood as a process of materialisation, as the most productive effect of power. The aspect of the intersectionality of gender and disease provides emancipatory potential for counselling, psychotherapy and medicine. The reflexion of this multi-layered constitution of body and gender needs a transformation of the perception of gender identity and psychosomatic connections in medical diagnosis and psychotherapeutic treatment (the expansion of only individual- and family-centered approaches) as well as a political transformation of hegemonic gender relations.
Butlers theory of the development of gender identity through incorporation and repetitive
adoption of norms forms the basis of a policy of the performative. The concept of performativity opens up new perspectives on feminist agency. This politicized conception of agency between being constituted by structures and situated individual power to act can be transferred into psychosocial counselling. Instead of remaining silent about discriminating conditions feminist counselling offers the opportunity to speak about the burdening pressure of normative femininity and the possibility of its deconstruction.
The perspective that our permanent reproduction of femininity and masculinity is in itself
unstable and characterized by ambivalence and its realization can never be complete, can have liberating and empowering effects. Norms are powerful and we are constituted by them as subjects but we are not determinated by them. Norms need constant repetition and are therefore open for new ways of individual and collective interpretations and transformations.
Resignification in counselling can result in the reformulation of a so-called individual psychic disorder; into critique of the hegemonic culture and the need for political change.
Feminist psychosocial counselling takes place between emancipation and normalization. The central ideas of poststructuralist philosophy, plurality, openness and the ambiguity of meaning, challenge psychosocial counselling to remain agile and reflect and question itself again and again. Psychosocial counselling needs sensibility towards the social and
discursive constitution of genders and identities, desires and fears as well as a willingness
for recognition of differences and contradictions. I therefore plea for a feminist attitude in
theory and practice of psychosocial counselling towards the liberation from the restricted
perspective of gender dichotomy.
My work as a psychosocial counsellor provides an example for the conflicting mediation of feminist theory and practice. Following Foucaults notion of theory as a toolkit I can put the instrument of critical reflexion at my clients disposal and support them to use it for their own needs and to widen their perspectives of agency. In this way feminist philosophy can function as an emancipating practice in psychosocial counselling.