We live in a medicalized society. We have grown accustomed to hearing that yet another behavior, emotional state, temperament, or bodily experience — some feature of life not previously regarded as a syndrome or disorder or addiction or risk factor — will henceforth be defined and treated as a medical problem. Those unhappy with their shyness or fear of criticism may be diagnosed with social anxiety disorder. Women not sufficiently interested in sex may be diagnosed with female sexual interest/arousal disorder. Kids who do not pay adequate attention to their studies may be diagnosed with attention deficit hyperactivity disorder. (One fifth of America’s twelve-year-old boys have been.) Even homelessness now has a diagnostic code.
The number and scope of pathologies grows ever larger. And while some of them surely do capture cases of severe dysfunction, many are what we might otherwise consider normal, even if painful, struggles of life, or just part of human variation: mild inhibitions on life plans, social role conflicts, unpleasant emotional experiences, normal bodily processes. The term “medicalization” implies the capture of these kinds of things. As the psychiatrist Thomas Szasz once observed, we “do not speak of the medicalization of malaria or melanoma.”
In theory, it should also be possible to demedicalize features of human experience, much as we can decriminalize certain acts. Demedicalization, however, virtually never happens, even when all we mean by this is raising the diagnostic thresholds so as to reduce the sphere of human functioning deemed clinically relevant.
Why not? Why might the domain of pathology be constantly expanding, while the reverse, a contraction, almost never occurs? I want to venture an answer, one that centers on our ever more shrunken and impotent conception of ourselves, of who we are and what we can be.
Writer - Critic - Poet - Editor