Work-in-progress seminar: Åsa Jansson ‘”Creating a Life Worth Living”: Emotional Regulation and Dialectical Behaviour Therapy in Sweden, c. 1995-2009’
Monday 25th April, 2016
11:00, 3.15, Francis Bancroft Building, QMUL (Mile End)
The next work-in-progress seminar hosted by the Centre for the History of the Emotions will take place on Monday 25th April at 11am. Note the change in day and time!
“Creating a Life Worth Living”: Emotional Regulation and Dialectical Behaviour Therapy in Sweden, c. 1995-2009
Åsa Jansson
Abstract:
This paper investigates the uptake of Dialectical Behaviour Therapy (DBT) into Swedish psychiatry and psychology at the turn of the twenty-first century, with particular focus on the work of Åsa Nilsonne and Anna Kåver. Taking its cue from DBTs creator, US psychologist Marsha Linehan, Swedish research into and application of DBT predominantly focussed on the “regulation” of inappropriate, disproportionate and irrational emotions in (predominantly young) women. In 1995, a Swedish pilot study on DBT was launched as a joint initiative between Stockholm’s primary care trust and the Institute for Clinical Neuroscience at Karolinska Institute (KI). The purpose of the study was threefold: to chart the prevalence of Borderline Personality Disorder (BPD) among women who had repeatedly attempted suicide; to compare the efficacy of DBT, psychodynamic psychotherapy, and standard psychiatric treatment for this patient group; and to investigate the presence of clinical “subgroups” among suicidal women. The KI study marked the beginning of DBT treatment in Sweden, as well as the start of a fruitful professional relationship between two of the key investigators, Nilsonne and Kåver. The duo published the first comprehensive Swedish-language clinical manual on DBT in 2002 and went on to write extensively on behavioural therapy techniques, both for a professional and a popular audience.
Linehan created DBT as a targeted treatment for (primarily female) patients diagnosed with Borderline Personality Disorder, one of the most controversial and stigmatized psychiatric labels of the post-WWII period. The development of a DBT regime in Sweden was equally closely wedded to BPD. However, while the BPD label has been the target of much criticism both within and outside of psychiatry due to its perceived gender bias, such critique has been remarkably subdued in the Swedish context. On the contrary, multiple clinical trials of DBT carried out after the initial KI study commenced have deliberately recruited exclusively female subjects, predominantly with BPD or associated behavioural patterns. Moreover, the key techniques of DBT have subsequently been disseminated for a popular audience through self-help literature ostensibly targeting young women struggling with strong and uncontrollable emotions. In the most recent such book, Nilsonne merged documented psychological and behavioural effects of DBT with neuroscientific research, producing a model of “emotional regulation” geared toward long-term “restructuring” of the brain.
In sum, this paper will investigate the ambivalent relationship between psychopathology, neuroscience, and gendered ideas about “dysregulated” emotions, asking what was at work – and at stake – when DBT was imported into Swedish psychiatry and subsequently marketed as a self-help strategy for women unable to successfully regulate their emotions.