[CN: Sanist language]
Perspectives on mental health and illness
There are three main clinical perspectives used to address mental health.
As part of the medical field, psychiatry looks at mental illness in much the same way that other medical professionals look at physical illness. They focus on:
- identifying “sick” individuals through diagnosis;
- predicting the future course of the “illness” through prognosis;
- speculating on the cause through aetiology; and
- developing treatments to cure or ameliorate “symptoms”
The strength of the psychiatric perspective is that some viruses and bacteria can cause mental health challenges; however, the weakness is that many mental health challenges do not appear to have a biological cause.
This is an eclectic, fragmented discipline which works on a continuum principle: “abnormal’ and “normal” are interconnected and the distinction between the two is graded rather than a definite line.
The strengths of psychoanalysis include a comprehensive conceptual framework surrounding “mental abnormality” and psychoanalysis is more focused on ameliorating “symptoms” rather than determining cause; however, critics have highlighted that there is too much emphasis on the psychological rather than social causes, and psychoanalysis is not a predictive science.
Within psychology, there are four concepts of “normality” and “abnormality”:
- The statistical notion proposes that frequently occurring behaviours within the general population are normal, so infrequently occurring behaviours are not normal.
- The ideal notion proposes the ideal person is one who fulfills their human potential. The obvious problem with this is that it does not provide any kind of objective measure.
- The presence of specific behaviours is a concept drawn from behaviourism, and it distinguishes between acceptable and unacceptable behaviour. This leads to the question: “Who decides what is unacceptable behaviour?” The answer is “Those who have more power.”
- Distorted cognitions is a concept drawn from cognitivism, and again it distinguishes between normal and abnormal cognitive processes, and treats internal states as though they were external behaviours.
The important differentiation between the above three perspectives is that psychiatry subscribes to an illness framework where a person is either disordered or not, whereas the other two approaches emphasise a continuum between normal and abnormal.
There are four main sociological perspectives on mental health.
1. Social causation
Social causation accepts constructs such as schizophrenia and depression as facts, so the emphasis is on tracing the relationship between social disadvantage and mental health challenges.
- Conceptual problems associated with psychiatric knowledge are either unacknowledged or evaded.
- Psychiatric epidemiology investigates correlations between mental health challenges and antecedent variables, but correlation is not the same as causation.
- Provides scientific confidence associated with objectivism and empiricism
- Reveals tendencies
Hermaneutics is the science of making interpretations so the social context is of central concern.
- Theoretical centre fragmented.
- Requires social scientists to accept the legitimacy of the component parts and the conceptual and practical integration of both dialectical materialism and psychoanalysis.
3. Social constructivism
Social constructivism has been one of the most influential perspectives since the 1980s. The central assumption is that reality is not self-evident, but rather that it is a product of human activity.
- Demonstrating the reality of social phenomenon is irrelevant because more focus is placed on the social forces that define it. This means that the social actors become the focus of sociological investigation, which is a method linked to symbolic interactionism and ethnomethodology.
- Closely tied to the post-structuralism of Foucault and it is concerned with deconstruction. This is the process of critically examining language and symbols in order to illustrate the creation of knowledge, the relationship of knowledge creation to power, and the unstable varieties of reality which attend human activities.
- The production of scientific knowledge places more emphasis on action and negotiation rather than on ideas. This links to both symbolic interactionism and social realism.
The above three versions of social contructivism are not neatly divided within studies within medical sociology, but rather the core theme across all three versions is that it is important to view reality, either in part or as a whole, as the product of human activity.
Social constructivism does not necessarily oppose social causation or social realism, but it challenges those perspectives. It should also be noted that it might not be reality which is socially constructed, but rather it is our theories of reality which are constructed.
4. Social realism
This is the sociological application of the philosophy of critical realism.
Part of this has been influenced by Durkheim: External social reality influences human action and shapes human consciousness.
In contrast, part of this has been influenced by Weber: Human action intersubjectively constructs reality.
So, human action is neither determined by social reality nor does it intentionally construct social reality. Social reality exists prior to the lives of individuals, but we become agents who reproduce and transform that social reality.
That’s it for this section. I know these are scattered all over the place, but that’s just how my brain works when studying.
This is part of a series of summaries that I am doing in order to revise Sociology of Mental Health. It won’t be shared on social media, but anyone is welcome to read these posts if they would be of interest.
If you would like to read more, most of this information came from this book.