Since this blog is about medicalisation, it is necessary to describe what, exactly, medicalisation is. The definition of the term is relatively simple, so do not let the verbose or ornate scholarship on the topic dissuade you! Medicalisation is to 'make medical', as seminal medical sociologist Peter Conrad once said. Essentially, it is the process in which we transform non-medical conditions into medical conditions, usually as diseases or disorders. A more nuanced - but nevertheless similar - definition sees medicalisation as the process in which we collectively identify a human activity, socially desired as problematic or debilitating, and bring it within the medical purview for diagnosis, treatment, prevention, prognosis, and so on.
So, forget the jargon, forget the formalities, there is your concise, accurate summation of the term. Now, why we medicalise, why we discern certain human behaviours as problematic and others as acceptable, and why view medicine as a respiratory of truth are the more complex and challenging questions that will try to be answered on this blog. I just hope you'll take the journey with me. But, for now, let's hope we're all on the same page on what medicalisation means. Because, really, it is a deceptively simple concept.
Two common misconceptions about medicalisation
It is important to clear up some misconceptions about medicalisation, whether you are a student studying in the social sciences or simply wish to know more about it.
When I first started to read and write about medicalisation, I was obsessed with this idea of attempting to disprove the nature of diseases, usually of a mental kind. For example, I became ardent in trying to say 'ADHD is not a mental illness in the same way cancer or diabetes is a physical illness!'. As a sociology student, I proclaimed that all mental disorders were social constructions, often formed to reinforce dominant norms and control behaviour, and I made a rigid distinction between the mind and the body. So, as a result, I find myself challenging the science of a disease rather than the social processes that form them.
As you can see, it is quite easy to become attracted and appealed to this 'trap'. Yes, I called it a trap because, honestly, it is distracting and derailing. As social scientists or students studying in the social sciences, it is not in our expertise to challenge the nature of the disease. That is not what we do. We can leave that to the scientists, the psychiatrists, the psychologists and the neurologists. The sociological study of medicalisation is not about challenging, debunking or verifying the science of diseases. As Peter Conrad and numerous other scholarly authors on medicalisation have documented, we have to remain agnostic about that. Medicalisation is not about challenging the empiricism of science.
Thus, we should not be interested if ADHD, depression, Aspergers, or numerous other behavioural/personality disorders actually exist in the same way a physical malfunction of the body like cancer, diabetes or Alzheimer's does. Rather, we should be interested in how these disorders come to exist in the first place. Why, for example, did social anxiety disorder only first appear in the DSM under 40 years ago? What made us, as social animals, initially see anxiety as a problematic human activity in need of medical surveillance? Was there an economic imperative involved? Does it have to do with Western society's extroverted, assertive and loquacious culture?Is it a way for medicine to have greater jurisdiction over our lived experiences and conditions? Is it an example of medical imperialism? These are the questions we should be asking instead of challenging the science.
I have just highlighted the biggest misconception about medicalisation. Indeed, to recap, medicalisation is not about challenging the etiological foundations of a disorder or disease. It is about investigating why we 'made it medical' (i.e., medicalised).
A second misconception of medicalisation is that it is an inherently negative phenomena. This is, of course, not true. It is easy to equate medicalisation with 'over' or 'excessive' medicalisation, but medicalisation, on its own, is an ideologically neutral process. It is not driven by a single cause or event. It is not planned or engineered. Much like the other 'ions' in the social sciences such as industrialisation and urbanisation, there are positives and negatives. It is up to us to explore them.
A positive of medicalisation, for example, is how we have medicalised pregnancy. By placing pregnancy under the realm of medical supervision, we have considerably reduced maternal and infant mortality rates. No longer is it commonplace for a life to be lost during pregnancy, and this is because we have placed a natural, inherently non-medical condition into the province of medicine.
A negative of medicalisation is that we are eliminating a lot of human difference, and increasingly allowing the institutional forces of medicine to tell us what is healthy, normal, acceptable behaviour. By diagnosing a shy individual with social anxiety disorder, for example, we are subtracting a lot of his or her bodily autonomy and disempowering them from control over their bodies. What is wrong with feeling diffident and awkward at social events? Why should everyone be socially adept and extroverted? One may think their body is 'healthy' only to discover that their anxiety is an apparently debilitating condition. Thus, medicalisation extends the authority of medicine beyond a legitimate boundary, and infringes on one's bodily agency.
To wrap up, it's important to study, read and investigate medicalisation not from a preconceived notion of it being some authoritative, intrinsically negative occurrence. Rather, it is an impartial process that, of course, has both its negatives and positives.
When I first started to read and write about medicalisation, I was obsessed with this idea of attempting to disprove the nature of diseases, usually of a mental kind. For example, I became ardent in trying to say 'ADHD is not a mental illness in the same way cancer or diabetes is a physical illness!'. As a sociology student, I proclaimed that all mental disorders were social constructions, often formed to reinforce dominant norms and control behaviour, and I made a rigid distinction between the mind and the body. So, as a result, I find myself challenging the science of a disease rather than the social processes that form them.
As you can see, it is quite easy to become attracted and appealed to this 'trap'. Yes, I called it a trap because, honestly, it is distracting and derailing. As social scientists or students studying in the social sciences, it is not in our expertise to challenge the nature of the disease. That is not what we do. We can leave that to the scientists, the psychiatrists, the psychologists and the neurologists. The sociological study of medicalisation is not about challenging, debunking or verifying the science of diseases. As Peter Conrad and numerous other scholarly authors on medicalisation have documented, we have to remain agnostic about that. Medicalisation is not about challenging the empiricism of science.
Thus, we should not be interested if ADHD, depression, Aspergers, or numerous other behavioural/personality disorders actually exist in the same way a physical malfunction of the body like cancer, diabetes or Alzheimer's does. Rather, we should be interested in how these disorders come to exist in the first place. Why, for example, did social anxiety disorder only first appear in the DSM under 40 years ago? What made us, as social animals, initially see anxiety as a problematic human activity in need of medical surveillance? Was there an economic imperative involved? Does it have to do with Western society's extroverted, assertive and loquacious culture?Is it a way for medicine to have greater jurisdiction over our lived experiences and conditions? Is it an example of medical imperialism? These are the questions we should be asking instead of challenging the science.
I have just highlighted the biggest misconception about medicalisation. Indeed, to recap, medicalisation is not about challenging the etiological foundations of a disorder or disease. It is about investigating why we 'made it medical' (i.e., medicalised).
A second misconception of medicalisation is that it is an inherently negative phenomena. This is, of course, not true. It is easy to equate medicalisation with 'over' or 'excessive' medicalisation, but medicalisation, on its own, is an ideologically neutral process. It is not driven by a single cause or event. It is not planned or engineered. Much like the other 'ions' in the social sciences such as industrialisation and urbanisation, there are positives and negatives. It is up to us to explore them.
A positive of medicalisation, for example, is how we have medicalised pregnancy. By placing pregnancy under the realm of medical supervision, we have considerably reduced maternal and infant mortality rates. No longer is it commonplace for a life to be lost during pregnancy, and this is because we have placed a natural, inherently non-medical condition into the province of medicine.
A negative of medicalisation is that we are eliminating a lot of human difference, and increasingly allowing the institutional forces of medicine to tell us what is healthy, normal, acceptable behaviour. By diagnosing a shy individual with social anxiety disorder, for example, we are subtracting a lot of his or her bodily autonomy and disempowering them from control over their bodies. What is wrong with feeling diffident and awkward at social events? Why should everyone be socially adept and extroverted? One may think their body is 'healthy' only to discover that their anxiety is an apparently debilitating condition. Thus, medicalisation extends the authority of medicine beyond a legitimate boundary, and infringes on one's bodily agency.
To wrap up, it's important to study, read and investigate medicalisation not from a preconceived notion of it being some authoritative, intrinsically negative occurrence. Rather, it is an impartial process that, of course, has both its negatives and positives.
Subscribe to:
Comments (Atom)