Seeking agency: A discourse analysis of Generalized Anxiety Disorder

Abstract

A diagnosis or self-diagnosis of Generalized Anxiety Disorder (GAD) carries assumptions about an individual’s responses to threats to safety viewed through the lens of the biomedical model upon which DSM-5 diagnostic criteria are based. Such labels can constrain the way people perceive themselves and the expectation they can change or are perceived and treated by others; and may also constrain approaches in therapy. The construct of GAD outlined by two online informational websites was explored through a social constructionist, strengths-based lens guided by the concept of personal agency. Using a discourse analytic approach, encompassing a thematic content analysis and informed by positioning analysis, the findings included themes which distinguished between normal and abnormal, using a negative frame of reference and pathologizing language and strategies. People with GAD were framed as lacking the capacities to self-regulate, accurately assess risk and manage their worries. An analysis of positioning identified relationships of power connected to expert and authoritative sources and uninformed victims or sufferers of GAD. Discourses of pathologization and othering were used to differentiate people with GAD from others and personal agency was all but absent in the discourse. The sources used their position of authority to promote the biomedical model of mental distress, ideal sociocultural norms and a concrete version of reality. The place and role of personal agency was discussed in light of the findings with suggestions of incorporating a social constructionist framework and alternative language to convey an active stance and capacity thinking.