Huw Green
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| Mental health problems: Constructed or discovered? |
Anyone who has
spent time reading or listening to psychologists recently is likely to have
encountered the idea that mental health problems are ‘social constructs’. What
is meant by this is that entities such as depression or schizophrenia and
personality disorder, which we might ordinarily think of as diseases; are
actually descriptions that flow out of our culture and moment in history. There
may be good reasons for thinking about mental health in this way. Anybody who
claims that there is no social construction involved in the disorders outlined
by the American Psychiatric Association (APA) is unaware of the way the manual
is written. Prior to 1952 there was no DSM, and every 15 years or so since, a
revision has appeared. These updatings are usually chock full of new diagnoses,
many of which have been regretted by the very people who helped bring them into
existence.
Indisputable though this may be, it is a form of description which can stand in
the way of understanding the true complexity of such problems. If they are just
constructs then why do so many of the people who experience them find the
experience so like a disorder; so real? In order to be clearer about
this we need to ask exactly what we mean by social construction.
For some
commentators, the implication seems to be that if we stopped talking about
‘schizophrenia’ or ‘personality disorder’, then they would more or less
disappear. This is the argument which Mary Boyle appears to make in the final
chapter of Schizophrenia: A Scientific Delusion? In this line of reasoning, there is much
to be gained from demonstrating that life events, social inequality, abuse, and
even the mental health system create ordinary, understandable distress, which then
gets inaccurately and arbitrarily labelled. It is likely that this depiction is
true in a good many cases.
