THE SOCIAL CONSTRUCTION OF ILLNESS: MEDICALIZATION AND CONTESTED ILLNESSKristen K. Barker

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SOCIAL CONSTRUCTIONISM

A centerpiece in subfield of medical sociology Demonstrates complexity of answers to questions, ‘What

is Illness?,’ ‘What is Disease?’ Emphasize relationship between ideas about illness and

expression, perception, understanding, and response to illness at the individual, institutional, and societal level

Address who (or what) is defined as ill, why illnesses exist in one place or at one time and not another Stress that the experience of illness is shaped by social and cultural

context

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MEDICALIZATION

Medicalization: the process by which an ever wider range of human experiences comes to be defined, experienced and treated as medical conditions

Medicalization of deviance, e.g., alcoholism, gambling

Medicalization of social problems, e.g., antisocial personality disorder, obesity

Medicalization of life, e.g., natural physical changes from profound (senility) to the trivial

(baldness)

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MEDICALIZATION: EXAMPLES

Medicalization of deviance, e.g., alcoholism, gambling

Medicalization of social problems, e.g., antisocial personality disorder, obesity

Medicalization of life, e.g., natural physical changes from profound (senility) to the trivial

(baldness)

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MEDICALIZATION AND GENDER

Medicine conceptualizes the male physiology as ‘normal ‘ Women’s natural reproductive functions are medicalized,

e.g., Menstruation Childbirth Menopause

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MEDICALIZATION IS BIDIRECTIONAL Demedicalization is when conditions once

considered medical problems, are reconceptualized as not medical, e.g., Homosexuality Natural childbirth movement in 1970s

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CONTESTED ILLNESS

Contested illness: conditions in which sufferers and advocates struggle to have medically unexplainable symptoms recognized in orthodox biomedical terms, despite evidence from medical researchers, practitioners, institutions, e.g.,

chronic fatigue syndrome fibromyalgia syndrome, irritable bowel syndrome, TMJ, tension headache, multiple chemical sensitivity disorder, Gulf War syndrome, sick building syndrome

syndromes: characterized by cluster of common, diffuse, and disturbing symptoms, ranging from pain and fatigue to sleep and mood disorders

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CONTESTED ILLNESS: CHARACTERISTICS medical uncertainty, lack of medical consensus concerning biological

nature of syndrome not associated with any specific organic abnormality not detectable using standard diagnostic tools

diagnosed based on clinical observations and subjective reports

feminized, mostly associated w/women some suggest they are modern-day labels for hysteria

confront skepticism of medical authorities contested due to clash between medical knowledge and patient

experience especially concerned with environmental exposure, which is often seen as cause

reveal conceptual union between social constructionism and medicalization

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‘PILGRIMAGE’

Sufferers embark on a ‘pilgrimage,’ typically in pursuit of medicalization

Finding a name for condition, legitimates and validates suffering

‘Interactive kinds of things’ are critical: illness support communities, illness identity Today, the internet is a key pathway

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ILLNESSES - BOTH SOCIALLY CONSTRUCTED & REAL Things can be both socially constructed and real Seizures: real, but their meaning (possession vs. disease)

and their experience (stigmatized or medicalized) is socially contingent