Cultures of categories: Psychological diagnoses as institutional and political projects before and after the transition from state socialism in 1989 in East Germany.

How can psychological categories be understood as historical, political, and cultural artifacts? How are such categories maintained by individuals, organizations, and governments? How do macrosocietal changes-such as the transition from state socialism in East Germany in 1989-correlate with changes in the social and organizational structures that maintain psychological categories? This essay focuses on how--pre-1989--the category of neurosis (as a mental disorder) became entwined with East Germany's grand socialist project of creating new socialist personalities, a new society, and a new science and on how diagnostic preferences were adapted, modified, and extended by local cultural and institutional practices. It also examines how post-1989 the category of neurosis became redefined in accord with a formerly West German psychotherapeutic paradigm and was eventually obliterated by the bureaucratic health care system of the new Germany. East German practitioners adopted new therapeutic guidelines and a new language to make sense of the "normal", "neurotic", and "pathological" self in terms of "individualizing forms of knowledge" that tied in with efforts to remake East German citizens as liberal democratic subjects. At the same time, practitioners' clinical practice remained based upon face-to-face encounters in which formal guidelines and stipulations were often superseded by local, interactional, institutional, and cultural practices and contingencies.