The contemporary culture is deeply in love with separation and labeling. Psychology studies the “personalities” of individuals so rigorously that it forgets that the concept of personality itself is a social construction – the inevitable product of a self-conscious mind that seeks to explain to itself and others why the person acts like he acts. The modern psychiatry studies and labels mental disorders so effectively that virtually everyone can be nowadays labeled as narcissist, antisocial or passive-aggressive.
In a way psychiatry itself has become manic with its goal to separate individuals from their social context and pathologize all behavior under some description of illness. The ubiquitous mental disorder discourses makes it easy for confused individuals to attach their personalities to any disorder.
Whereas sociology in psychiatry accepts the legitimacy and validity of what psychiatry is trying to do, the sociology of psychiatry wishes to examine and challenge precisely those assumptions. It is therefore inherently more critical, and has been accordingly less acceptable to many psychiatrists. Yet while certain elements of a sociology of psychiatry fit into an ‘anti-psychiatry’ framework, it is not necessarily part of that broad alliance. Three related strands can be identified.
In his second book, The rules of sociological method, Durkheim outlined a celebrated account of criminal behaviour. Crime is always treated as socially pathological and yet exists in all societies: therefore surely it should be regarded as a normal phenomenon. What is more, the identification and punishment of criminals has an important effect on the rest of society, purging it of guilt for the criminal act and defining the limits of social behaviour, thereby reinforcing a sense of solidarity and integrity to the social order. [...]
Psychiatrists have baulked at the sociologists’ suggestion that they are agents of social control, perhaps because of the element of coercion implied. Psychiatrists do have coercive powers, but use them only rarely; most of their work, they would claim, is therapeutic and not concerned with ‘controlling’ anyone.
What then does social control mean? First, the Durkheimian position on social control would be based on the concept of anomie, on the possibility of a failure in social regulation. If the goals and morality of the society do not pervade everyday life, then normlessness and consequent loss of direction and purpose will be the result. Various mechanisms and institutions therefore are required to regulate the core beliefs and values of the individual members of a society. Within this framework, medicine is an agency of social control because it is concerned with identifying and regulating illness – an important form of social deviance.
Psychiatry fits very well into this model of social control. As part of medicine it identifies sickness and processes it such that it no longer poses a threat to social order, nor leaves the sufferers on the deviant margins of society. But in addition, because of its
concern with mental functioning, it is even more directly concerned with the regulation of beliefs and values. From this perspective psychiatry can be seen as a beneficent social control agency of modern society. [...]
Durkheim’s final major work, Elementary Forms of the Religious Life, argued that the categories of human thought have their origins and patterning in social life. Extended to medicine, this position holds that there are no diseases existing in nature (either organic or psychiatric), they only exist as artefacts of human classifications. Thus Sedgewick has pointed out that a fungus on wheat is a disease because it harms the wheat; but if we wished to cultivate the fungus rather than the wheat the ‘disease’ would disappear. In similar fashion, all human disease categories reflect some aspect of social expectation of how the body should perform and new diseases may therefore reflect new social conventions, such as the appearance of dyslexia, in literate societies or the disappearance of homosexuality in sexually tolerant ones.