A perceiver’s actions, although based upon initially erroneous beliefs about a target individual may channel social interaction in ways that cause the behavior of the target to confirm the perceiver’s beliefs. To chart this process of behavioral confirmation, we observed successive interactions between one target and two perceivers. In the first interaction, targets who interacted with perceivers who anticipated hostile partners displayed greater behavioral hostility than targets whose perceivers expected nonhostile partners. Only when targets regarded their actions as reflections of personal dispositions did these behavioral differences in hostility persevere into their subsequent interactions with naive perceivers who had no prior knowledge about them. Theoretical implications of the behavioral confirmation construct for social perception processes are discussed. If men define situations as real, they are real in their consequences. W. I. Thomas It has been fashionable for many years to view deviance as a process of social definition and social creation (e.g., Becker, 1963; Schur, 1971; Tannenbaum, 1938). The essence of this “labeling ” orientation is that “... social groups create deviance by making the rules whose infraction constitute deviance.... ” (Becker, 1963, p. 9). Of critical importance to this process is the influence of labels on the dynamics of social interaction. Having once been tagged with a label that implies deviance, one’s behavioral options may be constrained in ways that actually force one to become deviant. Consider the observations of Tannenbaum on the social creation of crime and delinquency:

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vestic Fetishism in a psychiatric diagnostic nosology is a complex topic that is best understood within the larger context of the history and poli-tics of diagnostic classification systems. The diagnostic labeling of gen-der-variant individuals with a mental illness is a topic of growing controversy–within the medical and psychotherapeutic professions and among many civil rights advocates. An overview of both sides of this controversy is outlined, highlighting questions about the potential dam-age caused by using psychiatric diagnoses to label sexual behaviors and gender expressions that differ from the norm, and the ethical dilemmas of needing a psychiatric diagnosis to provide legitimacy for transsexu-Arlene Istar Lev is a social worker, family therapist, and educator addressing the unique therapeutic needs of lesbian, gay, bisexual, and transgender people. She is the founder of Choices Counseling and Consulting in Albany, New York, and on the ad-

Reigning views on psychiatric nosology regard as "too subjective " certain features of diagnosis which respected psychiatrists have reported and several empirical studies have confirmed. We describe two of these persistent "mysteries " of psychiatric nosology: rapid diagnoses and the praecox feeling. We then demystify these mysteries by explicating the workings of "typification " in the diagnostic process. The criteria of disorders which are provided by classification manuals, such as DSM-III, are shown to presuppose such typifications. Psychiatric typification, although a preconceptual skill, can be rendered fully scientific and objective. The Journal of Nervous and Mental Disease 175:65-77, 1987 In recent years we have witnessed a remarkable resurgence of interest in psychiatric diagnosis and classification. Only two decades ago psychiatrists were seriously discussing Menninger's recommendation that classification systems be abandoned altogether and that psychiatric diagnoses by replaced by formulations (Menninger, 1963). Now, following the successful reception of DSM-III (American Psychiatric Association, 1980) and in anticipation of preparations for DSM-111R and ICD-10, the methodological, theoretical, and practical issues involved in nosology are being probed and debated by psychiatrists of different persuasions and viewpoints (Freedman, 1984; Mc- Hugh and Slavney, 1983; Kendell, 1984; Klerman et at., 1984; Spitzer et at., 1983). Such a change reflects a growing concern for the scientific stature of psychiatry. In the 1950s and 1960s, criticisms of psychiatry as a science, such as those of Szasz (1961) and Laing (1968), were augmented by discouraging findings from investigations into the reliability of psychiatric diagnoses (Beck, 1962; Katz et at., 1968; Zubin, 1967, 1968). This crisis in psychiatry was worldwide. Thus a report to the World Health Organization in 1959 concluded that the attitude of psychiatrists toward conventional classificatory schemata had become "one of ambivalence, if not cynicism " (Stengel, 1959, p. 602), and that there was "almost general dissatisfaction with the state of psychiatric

Abstract Shyness has become an 'unhealthy' state of mind for individuals living in contemporary Western societies. Insofar as its behavioural 'symptoms' imply a failure to achieve certain cultural values, such as assertiveness, self-expression and loquacious vocality, shyness is increasingly defined as a problem for which people can, and should, be treated. This paper first critically discusses the idea that we are witnessing a new 'cultural epidemic' of shyness, as evidenced by increasing rates of diagnosis for Social Phobia, Social Anxiety Disorder and Avoidant Personality Disorder. It then examines three main dimensions of the medicalisation of shyness: biomedical and genetic approaches, the therapeutic interventions of cognitive-behaviour therapy and 'shyness clinics', and the disciplinary regimes imposed by self-help books and websites. Within a cultural climate of pervasive anxiety and privatised risk, the medicalisation of shyness suggests a powerful new way of defining and managing certain kinds of deviant identities, but we can also find some evidence of resistance to this approach.

Self-with-other processing and construction play an important role in human adjust-ment, development, and change. This idea is critical for an adequate understanding of psychotherapy and psychotherapeutic change. A theory of psychotherapeutic change that combines elements of both social constructionist and cognitive constructivist thought is presented briefly. After reviewing salient examples of both forms of thought as these have manifested in theorizing about psychotherapeutic change, a sampling of original empirical demonstrations is offered in support of the theory. Psychotherapeutic change is described as a process of appropriation and practical application through which clients internalize therapeutic conversations and activities, which they then use as psychological tools to restructure personal theories, experiences, and actions. The theory of psychotherapeutic change presented in this article is nested within a larger theory of psychological development (see Mar-tin & Sugarman, in press) that attempts to integrate important insights from social construc-tionist and cognitive constructivist thought in social science and psychology. In this more general bridging theory, the individual is seen to arise from the social, but is not isomorphic with, nor reducible to, the social. It is precisely because the individual is not an exact replica of, and to some extent can transcend the social, that various kinds of human psychological transfor-mation such as learning, psychological change, and creative innovation are possible. Such a view goes beyond standard formulations of either social constructionist or cognitive con-structivist thought, while bearing an affinity with some of the ideas central to classic forms of symbolic interactions as developed by Dewey

Abstract With the increasingly close relationship between the pharmaceutical industry and the American Psychiatric Association (APA) there has been a growing tendency in the mental health professions to interpret everyday emotional suffering and behavior as a medical condition that can be treated with a particular drug. In this paper, I suggest that hermeneutic phenomenology is uniquely suited to challenge the core assumptions of medicalization by expanding psychiatry’s narrow conception of the self as an enclosed, biological individual and recognizing the ways in which our experience of things— including mental illness—is shaped by the socio-historical situation in which we grow. Informed by hermeneutic phenomenology, psychiatry’s first priority is to suspend the prejudices that come with being a medical doctor in order to hear what the patient is saying. To this end, psychiatry can begin to understand the patient not as a static, material body with a clearly defined brain dysfunction but as an unfolding, situated existence already involved in an irreducibly complex social world, an involvement that allows the patient to experience, feel, and make sense of their emotional suffering.

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I, the undersigned, declare that the work contained in this dissertation is my own original work, and has not previously been submitted for a degree in its entirety or in part at any other

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