Culture and Panic Disorder

By Devon E. Hinton; Byron J. Good | Go to book overview

5
Twentieth-Century Theories
of Panic in the United States
From Cardiac Vulnerability to Catastrophic Cognitions

Devon E. Hinton and Susan D. Hinton

ALTHOUGH PANIC DISORDER (PD) emerged as a nosological category in American psychiatry only in the 1980s, experiences of acute anxiety or panic that cause suffering and disability are hardly new to Americans or to American psychiatrists. Contemporary theories of PD and anxiety have grown out of a history of concepts in American popular and medical culture. PD is not a known, fixed entity but a particular conceptualization of acute anxiety that has evolved historically within psychiatric writing and research, particularly in North America—a set of ideas that continues to evolve. Cross-cultural studies of panic cannot assume a fixed disorder as the basis for comparison. In this chapter we perform a genealogy of our current conceptualization of the cause of PD panic attacks,1 tracing epistemic shifts linked to other shifts in society in the representation of panic's causation. By examining theories of panic in twentieth-century America, we put the panicker “back into the historical domain of practices and processes in which he has been constantly transformed” (Foucault 2005:525).

As each new theory of what causes acute anxiety and panic became viewed as “scientific,” as “fact,” its answers to basic questions (What causes panic? Are anxiety- and panic-type symptoms such as dizziness and palpitations dangerous? If so, which ones? What causes those symptoms? What can be done?) were popularized, and therefore profoundly influenced ideas about bodily vulnerability and created certain modes of self-surveillance. As medical theorists introduced new “frames of meaning” (Giddens 1984:285) and presented new panic theories, the panic experience itself changed as the result of a complex dialectic between the panicker's experience

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