Okay- in my last blog entry I talked about subjective feelings and objective tests. But there’s one more category yet to be discussed- behaviours. Behaviours are a grey zone. On the one hand, they are observable, rather than subjective. On the other hand, as far as our current scientific understanding goes, the source of behaviours is currently kind of subjective (“Why did you do that? I felt like it.”). Consequently, until relatively recently, behaviours fell more into the moral realm than the medical realm. (Actually, to be accurate, so did physical illnesses, until disease theory came along. You got sick, or engaged in certain socially undesirable behaviours, because you were morally weak.)
The thing about the medical profession is that it has power in our society. So labelling something as a disorder or a disease is powerful. In the case of behaviours, the medical profession has the power to take a collection of behaviours, and label them as a disorder. Now, the interesting thing is that, in some cases, it’s the people in power- the medical profession, government, etc. who try to take a behaviour (like homosexuality) and label it as a disorder. In this case, they are *pathologizing* the behaviour, because by labeling it a disorder, they’re going to gain further powers over that behaviour. Here’s an entertaining example of a reaction to this, where someone pathologizes the behaviour of mental health professionals in entertaining ways.
What’s interesting is that, in other cases, the reverse is true. In these cases, it is the people with the behaviours (e.g. fibromyalgia) who are pushing the medical profession to recognize and label their behaviour as a valid disorder, because in this case they themselves (perhaps quite legitimately) want the power that goes along with the label. And further, since physical disorders have more legitimacy for many people than psychological disorders, they want their behaviour recognized as a physical disorder, rather than as a pyschological disorder.
Which, at long last brings me to sleep disorders like delayed sleep phase syndrome. Basically, there’s a number of questions you can ask about this syndrome. One is- who wants to label this set of behaviours as a syndrome- the people who have it, or the people around them (including doctors)?” Another is- “If it is a ‘legitimate’ disorder, is it a psychological disorder or a physical disorder?” And another is “If it isn’t a disorder of any kind, does that mean it is some kind of moral, personal or social failing?”.
I happen to have been diagnosed with this syndrome at one point, and I
flip flop on all these questions. For sure I can say that both prior to
this and after it I have been put, as a result of my behaviours, into the
moral/personal/social failing
category (i.e. lazy, self-centered, weak-willed), so it is actually some
comfort to me
to have a possible alternate explanation- that it isn’t a moral failing
but some kind of medical disorder. Having said that, since I
believe psycholgical disorders to be entirely real and legitimate medical
disorders, I have
no problem putting it into the pyschological disorder camp. And since I
don’t wish to have this behaviour, and find it quite disruptive to my
quality of life, I’m perfectly willing to tackle it by
psychological means. There also seems to be some growing evidence that
there are some objective physical measures for people with this, and
that it may in fact be a ‘physical disorder’ but I’m
not sure about the treatment implications of that, since they probably won’t
translate to new options any time soon. Plus, I tend to think the
‘mental/physical divide’ is kind of a crock, so there you go.
posted at 10:55 on Thu, 01 Feb, 2007 |
path: /living
All material copyrighted by Jen Schellinck. All rights reserved.