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

2. 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 2

3. 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) 3

4. 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) 4

5. MEDICALIZATION AND GENDER  Medicine conceptualizes the male physiology as ‘normal ‘  Women’s natural reproductive functions are medicalized, e.g.,  Menstruation  Childbirth  Menopause 5

6. MEDICALIZATION IS BIDIRECTIONAL  Demedicalization is when conditions once considered medical problems, are reconceptualized as not medical, e.g.,  Homosexuality  Natural childbirth movement in 1970s 6

7. 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 7

8. 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 8

9. ‘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 9

10. 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 10