ABSTRACT
Social constructionism, as developed in the sociology of health, is a theoretical tradition which argues that concepts of disease and the body are the product of specific socio-historical periods rather than reflections of an independently existing nature or reality. The constructionist approach problematises medical reality, particularly the claim that health and ill-health can be understood through an objective natural science; it demonstrates how ‘objective’ scientific knowledge both shapes and is shaped by social relationships, and it shows how the technical realm of medical practice is a product of wider social processes. Applied to mental health, we can trace the constructionist approach in the works of Erving Goffman’s book Asylums: Essays on the Social Situation of Mental Patients and Other Inmates (1961), which opened up the critique of medicine as a value-loaded system of social control operating under the guise of scientificity. This was part of a wider critique of psychiatry as a form of social and political oppression, particularly identified in Thomas Szasz’s text The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement (1962) and R. D. Laing’s book The Divided Self: An Existential Study in Sanity and Madness (1962). Laing was followed by what became known as the antipsychiatry movement in David Cooper’s work, Psychiatry and Anti-psychiatry (1967). These authors argued that the categories that medicine and psychiatry used to label a person (that is, the disease labels) do not necessarily have an underlying biological reality but instead reflect the social values and prejudices of medical professionals and the society they work in. They held that this was particularly the case when the diseases were psychiatric and no physical basis for them could be established. Furthermore, psychiatry was seen as a form of political oppression. As Laing (1964: 100) put it, ‘I do not myself believe that there is any such “condition” as “schizophrenia”. Yet the label is a social fact. Indeed this label as a social fact is a political event.’ Laing’s point is that once labels are established (that is, become social facts), they have real consequences.
