I recently came across a thought-provoking article in The New Atlantis entitled ‘All Pathology, All the Time’ (https://www.thenewatlantis.com/publications/all-pathology-all-the-time.) The central argument of the article was that our society is becoming ever more medicalized, and more and more behaviours and emotional states were gaining a medical label of some sort. In essence, the threshold for the diagnosis of many disorders was being lowered. As a result of this creeping expansion of the definition of disorders, people who would previously not have been diagnosed with a condition now have a diagnosis and are subject to the medical management that comes with these diagnoses.
Illness, particularly mental illness is often a result of a multitude of factors. In the Western medical context, many illnesses are often reduced to an individual biological issue and treated accordingly. There are plenty of occasions where this is the correct way to deal with these illnesses. Sometimes, however, this approach is not sufficient and can at times exacerbate the issue someone is going through. As Suzanne O’Sullivan argued in her book “The Sleeping Beauties and Other Stories of Mystery Illness” (https://undark.org/2021/10/08/book-review-the-mystery-illnesses-informed-by-culture/), this narrow conception of medical health often misses important cultural and environmental factors behind the illness. What may appear to be a mystery or unknown medical issue can, with the right social context and perspective, be more easily identifiable.
The medicalisation of an ever-increasing number of behaviours and emotional states, and the increasingly narrow methods of treating other disorders creates perverse consequences. For instance, it has the effect of narrowing the bounds of ‘normal’ behaviour, and also makes the treatment of issues an individual’s issue, ignoring the social context of such issues. These diagnoses and subsequent labelling can also have a perverse effect on how people interact with others and the world at large.
I have first-hand experience with these problems as someone who was diagnosed with Aspergers Syndrome at age eight. In the years since my diagnosis, the criteria for diagnosis of what is now Autism Spectrum Disorder has changed multiple times. With the changes in diagnosis comes changes in how people interact with those of us with this condition as well as how the medical profession views us. To be clear, these changes in interaction have generally been more positive than they were previously. One decisively negative aspect of these changes, however, has been the increasing tendency to reduce us to what the changing definition of these disorders describes us as, taking away our personal agency in the process.
This creates a conundrum for those of us who are trying to grapple with this complex condition and find ways of adapting and growing in a positive and healthy manner. Even if we work to overcome some of the more negative aspects of our condition if society at large views us through the narrow lens of a medical diagnosis, how are we to properly integrate into society, and fully develop socially? Without the space to grapple with complex and difficult emotions, social situations and setbacks without immediately seeking a therapeutic or medical solution, our self-esteem, freedom and agency are diminished.
In saying this, I am certainly not arguing that medication, therapy and the like have no use or place for physical and mental health. However, they are just tools among a large number of potential tools for solving health issues. An over-reliance on these tools whilst ignoring other potential fixes cannot continue in the manner it has been without more serious consequences down the road. A more balanced, holistic approach to physical and mental health, which sees people as active participants, not passive recipients in their recovery is needed to avert the issues of our current pathologisation of medical health.