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Health and Medicine

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Western University
Psychology 2011A/B
Tom Haffie

Health and Medicine -symbolic interactionism does not define deviances in an objective but also in a subjective way -the medicalization of deviance: -the deviant behaviour is increasingly becoming medicalized and becoming more present in our society - over time, medical definitions of behaviour are becoming more prevalent in our society Medical labelling and time: Medicine, power and culture: -there’s a tendency for medical definitions for deviance to become more prevalent over time -in an earlier era, much of deviant behaviour was labelled evil -therefore, it was punished and chastised by the law, clergy, family and community -today, they are treated in a detox center -if you’re an alcoholic, you go into a detox centre that requires you to withdraw from alcohol use, you get rid of the toxicity in your system -someone who is prone to violent rages is medicated with drugs -someone who overeats today gets therapy and sometimes surgery (people can have surgery to staple the stomach – decreases the size of the stomach so they can’t eat as much) -this person would be called a glutton in the past – the person would be blamed for the condition -today, heroin addicts are put on methadone -a substitute for heroin used to treat heroin addicts -in the past, they were blamed for the condition -today when people do deviant acts, they are described as unable to help themselves -in the past people were responsible for their deviance -today, they are not responsible (involuntary deviance) -thus what used to be bad is now labelled as sick -when medicalizing deviance, they say that the person is the innocent victim of social forces -deviant behaviour is increasingly controlled under medicine and psychiatry - How did this all happen? How did psychiatry and medicine get control of deviance? (A) Mental Illness: Labelling and Delabelling: -psychiatry has been doing this since the beginning of the 20 century -vast changes in definitions have taken place over the last century -only a very thin line separates science from politics when it comes to mental illness – the line has become blurred -under some circumstances, politics today defines what is a mental illness and what is not -interest groups: a group of people that try to influence the way medicine, the government, etc. goes about their work and handles their business -interest groups have been able to influence the way in which psychiatry has labelled and delabelled mental illness - Ex. Homosexuality -before 1974, it was considered to be a psychiatric disorder -this was not based on any medical evidence -it written up as a disorder on the DSMdiagnostic and statistical manual of mental disorders (psychological) -they then suddenly removed homosexuality as a psychiatric disorder -probably the reason they had it in the first place was because of discrimination and prejudice -why did they delabel it? -the condition did not disappear -in 1974, the condition was more widespread and public than even before -therefore, when the condition became more visible, psychiatry stopped labelling it as a mental disorder -gay and lesbian activists began to lobby the DSM, telling them that there was no justification for labelling this as a mental disorder -they were able to exert pressure on the psychiatric community -these groups sought to destigmatize (remove the negative label), and they successfully lobbied the psychiatric community to remove it from the DSM -evidence was political not scientific Neurosis: -in 1978, a DSM task force decided to eliminate neurosis as a mental disorder - this caused an outrage in psychoanalysts -psychoanalysts come from Freud, and neurosis is a big part of their idea of a mental disorder -said that if the DSM task force eliminates it from the DSM, they’re going to sue you and block publication of the DSM -1979, the American psychiatric association (APA) backed down -therefore, it retained neurosis as a mental disorder -this has nothing to do with science -a lot of mental disorders that are defined by psychiatry are made up Part 2: - most of the current labeling that has happened has happened in the absence of scientific evidence Post traumatic stress disorder: -a new mental disorder of recent vintage -cultural context: -public and private organization find it profitable to come up with new mental disorders -pharmaceutical companies can come up with drugs to treat these disorders PTSD: -Vietnam war vets started returning home in 1971 and had problems adjusting -the war was very unpopular in America -men, and some women, came from home from the war -they weren’t treated as heroes -recession hit at so no jobs for them -by 1974 many had a lot of stress and problems; they believed that their problems were because of Vietnam - they lobbied the APA to create this into a full-blown disorder -they launched a national campaign and directed it at the APA -asked them to make it a mental disorder and eventually the APA caved in and made PTSD a mental disorder - PTSD was created because of strong political pressure -there is some scattered evidence that it was a disorder but it only became a disorder because of the political pressure -if you are injured while serving for your country, you get compensated by the government -the Vietnam vets saw that they too could be eligible for compensation from the government -so the APA made it a disorder and they got compensated -example of a mental disorder being delabelled: -self-defeating personality disorder”I am my own worst enemy” -feminists argued to delabel it – they said that it blames the victim as opposed to the real criminal (the DSM said that it is twice as common among women compared to men) -they argued before the APA that this amounted to blaming the victimwomen should not be blamed or saddled with this label because the real culprit is partriarchy which makes women feel inferior -the 1994 edition of the diagnostic and statistical manual dropped self-defeating personality disorder -thus see how politics played a key role -leads us to the conclusion that culture (sociological concept) plays a big role in determining whether or not you are healthy or not healthy -mental disorders are shaped by thing other than scientific evidence -social values, political forces, professional interests, corporations and their interests -psychiatric labelling - when you have prostate or cervical cancer, there are specific tests that determine if you have the cancer; there’s no such tests for mental illnesses -there’s no clear dividing line between mentally health and unhealthy individuals, culture plays a big part -there’s a sort of continuum -we don’t have the tools to measure it -there are a lot of social pressures that get in the mix and influence what is and isn’t a disorder -culture looms as critical in this process Political sociology of mental illness: -beginning of 20 century, there is one mental disorder recognized by feds and courts -can be used in the courts as a mitigating factor  don’t bear the full responsibility of your crime -and so the sentence is reduced accordingly -first happened in 1860s in common law -man murdered someone, the defence claimed he was innocent due to a mental disorder -courts went along with it - the number of mental disorders in the DSM has been increasing -the more mental disorders we have, the more the people that are affected by it -the most common mental disorder is depression – 1in 4 Canadian women and 1in 10 Canadian men suffer from depression -if you do vigorous cardio this stimulates the production of endorphins -they produce a feeling of well-being -being depressed is part of life and if depression affects you, you should exercise -the Canadian mental health association estimates that 1 in 5 Canadians will be affected by a mental disorder sometime in their life -definitions are extended and expanded to include ailments with no detectable biological basis like minor depression and borderline schizophrenia -the list keeps getting longer -psychiatrists are currently working on the new DSM (2012) -they’re considering whether to include post traumatic embittermnent disorder -if husband, wife, boyfriend, etc. leaves you and you are bitter/resentful for too long then you’re suffering from this disorder -internet addiction disorder -apathy disorder -compulsive buying disorder -compulsive pathological overeating disorder -hoarding disorder – people don’t throw things out, they keep accumulating things (even when they’re worthless/garbage things) Christopher Lane: book called shyness: how normal behaviour becomes a sickness - it’s in the interest of organizations (specifically pharmaceutical companies) to increase labelling What’s responsible for the increase in labelling? -corporate interests -it’s in the economic interests of specific corporate groups like pharmaceutical companies -they create new drugs for medical purposes -thus, they have an interest in expanding the list of mental disorders -ex. Prozac the world most widely prescribed anti-depressant -when the patent on Prozac expired, it was repackaged as serafem and marketed to women suffering from a newly discovered condition called premenstrual disphoric disorder (PDD) - Why? - Eli Lily is a huge pharmaceutical company that sold Prozac; it made 1/3 of its revenue from Prozac sales (6.5 billion) -if you come up with a new drug you need to patent it, and for a certain period of time nobody else can produce and sell it, you make all the money from it -eventually the patent runs out; it doesn’t last forever -in 2001, Eli Lily ran out of patent protection and they did not have an exclusive franchise on it – other companies made generic versions of Prozac -Eli Lily came up with serafem, which is slightly different from Prozac, for this new disorder -thus we can see why corporations have an interest in this expansion of labelling Everyone is an expert: -contributes to labelling as well -the self-help literature has grown rapidly over the years -we’re faced with self help experts (on tv or mass media – ie. Dr. Phil) everywhere -experts played a key role in the labelling of attention deficit disorder ADD -needed a drug to treat this disorder, which is Ritalin -it was prescribed almost exclusively for hyperactive and inattentive boys in the classroom -it is controversial, by the mid-1990’s doctors were writing 6 billion prescriptions a year for Ritalin -it’s an amphetamine (similar to Speed) -Children’s and Adults with Attention Deficit Disorder (CHADD) 600 chapters and 30000 members worldwide - CHADD and pharmaceutical companies have good relations – pharmaceutical companies give large amounts of money to CHADD -there is some evidence although highly controversial that people with ADD
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