living with chronic illness and disease Flashcards
(societal) symbolic interactionism
humans create reality through their actions and the meanings they give to them. Therefore, society is the cumulative effect of human action, interaction, and interpretation
underlying assumptions of symbolic interactionism
- humans act on the basis of meaning (rather than instinct)
- meanings arise out of interaction (and are dynamic and relational rather than fixed and unchangeable)
- individuals interpret meaning
- we develop a sense of self through interaction with others
key concept #1 for symbolic interactionism
: social construction **
-based on the idea that people actively “construct” reality
-> meaning that its neither natural or inevitable
- therefore, notions of normal/abnormal, right/wrong and even health/illness are subjective human creations and should not be considered universal or unchanging/unchangeable
-attribute and interpret meanings/behaviour
-emphasis on agency
examples of social construct ***
race - we have seperated and grouped those with different skin colors and features
money - humans agree on what paper and coins represent
countries - humans mutually agree and acknowledge their existence
gender - men and women act differently based on dictated gender roles
deviance **
-behaviour or activities that violate social expectations about what is “normal”
-who defines those expectations
-what causes or motivates someone to deviate from social expectations
-how is deviance understood through the lens of gender, age , SES, ethnicity, sexual identity, or other social inequalities
chronic diseases
health problems that require ongoing management over a period of years
disease
refers to a biophysical condition with a specific diagnosis
illness
the subjective response to the disease - includes how people perceive, experience, make sense of and respond to disease
social construction of illness
-health and illness not just medical categories
-rather they are :
social phenomena : interactions bw and among individuals and the characteristics, structures and functions of social groups and institutions
socially situated : the idea that the development of individual intelligence requires a social and cultural embedding
**textbook
components of social construction of illness
- meanings attributed to illness
-changing definitions over time and across cultures
-e.g. civil disobedience; drug and alcohol use; homosexuality; promiscuity - experience of illness
-shaped by contextual and individual factors
-eg. influence of gender and class
- it is not to deny that viruses and disease objectively exist
Diagnostic and statistical manual (DSM)
different conditions constantly being added to DSM
-for mental disorders
-big 5 includes hoarding, caffeine withdrawal, cannabis withdrawal, binge eating disorder
social interactions
lead us to understand and label some things as diseases instead of simply variation in the human population
eg. autism spectrum
osteoarthritis (OA)
-middle-aged and older participants with similar symptoms
-but different experience and interpretations
-> “normal aging”
-> “invisibility” of OA
symbolic interactionism key concept #2
stigma ***
-person has “an attribute that is deeply discrediting”
-leads to negative social reactions
-eg. disability, criminal record
-three kinds of stigma
stigma 1 : abominations of the body **
physical characteristics that are deemed to be deformities, unnatural and/or undesirable
-historically this has included, physical disabilities, obesity, visible illness or disease, tatoos or other counter-culture body modifications
stigma 2 : blemishes of character ***
character trait stigma
-associated with perceptions that an individual is weak willed, dishonest, has “unnatural desires”or other undesirable character traits
-historically this has included : addictions, homosexuality, radical or unpopular political beliefs
- acting not “normal “ or “socially acceptable”
stigma 3 tribal stigma of race, nation or religion
group identity stigma
-traits with negative associations or stereotypes that are passed through generations
- historically this has included : stereotypes or representations that label certain ethnic groups as lazy, dirty, dumb, greedy
implications of stigma
- contributes to various forms of discrimination
-often done “unthinkingly” without acknowledgement or reflection on how these meanings are created
REDUCES individuals life chances
eg HIV/AIDS
stigma/discrimination -> fired, evicted, shunned/rejected, denied treatment
a) abominations of the body -> wasting syndrome, lesions etc. often made disease visible
b) blemishes of individual character -> assumed to be result of lifestyle choices
c) tribal stigma -> initially only associated with gay men
eg. contested chronic illnesses
-limited or controversial physical signs
eg. fibromyalgia and chronic fatigue syndrome
-dismissed by some physicians as psychosomatic
mental health and stigma
-negative stereotypes
-silence and exclusion
-barrier to treatment -> 49% of those w depression or anxiety do not seek help
medicalization and social construction
process by which non-medical problems become defined and treated as medical issues, usually in terms of illnesses, disorder or syndromes
-deviation from certain behaviours, expectations and “norms” become defined and treated as illness or a medical phenomenon
-key roles played by “engines of medicalization” : physicians, biotech discoveries, health insurance, pharm industry
-both good and bad implications
medicalization and social construction
-defining natural biological processes as something that requires pharmaceutical, surgical, or therapeutic intervention
-many aspects of daily life = medical issues
-identification and classificaation required to become a legitimate “illness”
what does this medicalization do
pathologize (treat something as abnormal) normal everyday functioning
-diminish our tolerance for, and appreciation of the diversity of human life
-unduly reinforce gender norms
women and medicalization
women’s bodies and physiological processes deviate from the “ideal male norm”
-medical scrutiny due to beauty ideals
-pregnancy, child birth, menstrual cycle
female dilema of medicalization
legitimation of experiences of premenstrual symptoms as real and worthy of medical and public attention
vs
pathologizes womens bodies and views womens actions and thoughts as being determined by biology -> stigmatization -> sex discrimination
men and medicalization
connected to notions of masculinity
-baldness, sexual performance rooted in masculine identity that embodies physical strength, energy, hirsutism, sexual vitality
-all the more effective bc embraces by mens own concerns with their masculine identities
-andropause = male menopause
-> “normal” changes became pathologized as dysfunctions (viagra)
demedicalization
an issue once defined medical terms is no longer defined as such, and medical intervention is considered inappropriate
-eg. masturbation
-homosexuality
-childbirth
-case in point for social construction of illness and disease
benefits of medicalization (medicalization from below, by choice)
broadening of preexisting medical categories
to include more sufferers and situations
eg. adhd, PTSD
-promote medical intervention as necessary for well-being
eg. alcoholism,mental disorders, sub abuse
-reduce individual blame for problem
