08 June 2010

"illness" as mismatch

Julian Sanchez | The Boundaries of Science

Science can inform our thinking about these questions [of homosexuality and psychiatry], but the core of the question is often beyond the strict scope of science. An “illness” is a kind of mismatch between an individual psychological disposition and a social norm where we are prepared to reflectively validate the norm.
That's what I was getting at when I said this in regards to the call-for-comments on the new DSM:
The majority of questions that psychiatry currently concerns itself with are about "normality." I do not think there is a way to avoid this sort of Truth-by-public-opinion balderdash when it comes to these issues.
Not only are the politically and socially tricky issues like homosexuality bound up in social norms, most of psychiatry is. It's a wonderful field, but it's not really Science. How happy or sad should someone be in response to the particulars of their life? How much should a child be able to sit still and concentrate? How much sex (or food, or danger, or attention, or...) should someone want? How anxious should you be? How joyful? How contented? These are not scientific questions, they are public opinion.

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Being overweight is also only an illness in so much as it is incongruent with social norms.  There's little evidence that being mildly overweight — not obese, but mildly above what is declared appropriate — is bad for your health.  In many ways it may be preferable to being underweight.  But it doesn't jive with how most people think we ought to be, so it's categorized as not only an illness but an "epidemic."

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