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Cassie Long ENGL 3910 (Disability Studies) December 7, 2020 Paper 2 Wang’s “Psychiatric Hierarchy” within Diagnosis In this paper I argue that Wang presents diagnosis as a primarily social framework within which disabled individuals live. That being said, she still acknowledges the role of the medical model in the process of diagnosis as what gives it power, through discourse. Wang explains how diagnosis creates a hierarchy within the community of those who are psychiatrically disabled. She examines this structure within the disability community she calls the “psychiatric hierarchy”: “As in most marginalized groups, there are those who are considered more socially appropriate, and who therefore distance themselves from those so-called inappropriate people, in part because being perceived as incapable of success causes a desire to distance oneself from other, similarly marginalized people who are thought to be even less capable of success.” (Wang, p. 42) This hierarchy values disabled individuals who are high-functioning and more able above those whose diagnoses prevent this within a capitalistic society. The existence of this “psychiatric hierarchy” and Wang’s position within it give us more context to her thoughts on diagnosis. She says of this: “Some people dislike diagnoses, disagreeably calling them boxes and labels, but I’ve always found comfort in preexisting conditions; I like to know that I’m not pioneering an inexplicable experience.” (Wang, p. 13) It is important to note Wang’s position within this hierarchy because as a “high-functioning” individual she has a privileged view of her own diagnosis. She is more able to reveal her disability at her convenience and participate in a “normal” society. A “lower-functioning”

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individual may see diagnosis as much more limiting: “Giving someone a diagnosis of schizophrenia will impact how they see themselves. It will change how they interact with friends and family. The diagnosis will affect how they are seen by the medical community, the legal system, the Transportation Security Administration, and so on.” (Wang, p. 18) As Wang mentions, we see many examples of social hierarchies within marginalized groups. There are issues of colorism in communities of color, racism within feminist movements, and transphobia and biphobia within LGBTQ+ groups. These are rampant social issues that stem from the capitalistic idea that an individual’s value lies in their function, in addition to the individualistic notion that one person’s success is another’s failure. This creates a dehumanizing view of those unable to function in a society like the one in which we live, and people seek to distance themselves from these disabled individuals by identifying as things like “highfunctioning”. Robert McGruer says of this: “A system of compulsory able-bodiedness repeatedly demands that people with disabilities embody for others an affirmative answer to the unspoken question, yes, but in the end, wouldn’t you rather be more like me?” (McGruer, 93) This concept of striving to be more like an able individual fits into Wang’s “psychiatric hierarchy”. Despite how educated and self-aware Wang is, she too falls prey to these pervasive notions: “Because I am capable of achievement, I find myself uncomfortable around those who are visibly psychotic and audibly disorganized. I’m uncomfortable because I don’t want to be lumped in with the screaming man on the bus, or the woman that claims she’s the reincarnation of God. I’m uncomfortably uncomfortable because I know that these are my people in ways that those who have never experienced psychosis can’t understand, and to shun them is to shun a large part of myself.” (Wang, p. 44) As Wang mentions, she differs from “lower-functioning” individuals mainly in the realm of diagnosis. They share similar experiences, such as psychosis,

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but ultimately she is given a better chance at seeming “normal” in a society that requires it because of her diagnosis. This “psychiatric hierarchy” demonstrates the limitations of diagnosis. Margaret Price says of this,“In the view of the c/s/x movement, when psychiatry assigns a diagnosis of “mental illness” to a person, that person is marked as permanently damaged, and as one whose rights may be taken away—unless, of course, she complies with psychiatry’s requirements for “care,” which may include medication, incarceration, or electroshock.” (Price, p. 14) This quote highlights the difference between experience and labels, something that needs to be emphasized when discussing diagnosis. “Compliance” is another aspect of psychiatric disabilities that is markedly easier for those who are “high-functioning”. Therefore, according to Price, a “lower-functioning” individual is more likely to have their rights taken away. Wang, McGruer, and Price all agree that the rights of disabled individuals are in danger within both a medical and social model of disability. Wang expands on the thought and examines rights within a community of disabled individuals, in the context of function. She asserts that medical diagnoses label an individual based on their function within a capitalistic society, not solely based on their experiences. This is an important distinction because it demonstrates how the medical and mental health systems are intertwined with capitalism, and the harm done to disabled individuals as a result.

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Bibliography McGruer, Robert. 2002. "Compulsory Able-Bodidness and Queer/Disabled Existence." In Disability Studies: Enabling the Humanities, by Sharon L Snyder, Brenda Jo Brueggemann and Rosemary Garland-Thomson, 88-99. New York: Modern Language Association of America. Price, Margaret. 2011. Mad at School: Rhetorics of Mental Disability and Academic Life. Ann Arbor: The University of Michigan Press. Weijung, Esmé. 2019. The Collected Schizophrenias. Minneapolis: Graywolf Press....