A.Symbolic Interactionist Perspective: The Social Construction of Illness
Symbolic interactionists attempt to understand the specific meanings and causes that w.: attribute to particular events. In studying health. symbolic intcracrionists
focus 011 the meanings that social actors give their illness or disease and how these affect people's self-concept and relationships with others. According to symbolic interactionists, we sod ally construct "h ealth" and "illness" and how both should be treated. For example, some people explain disease by blaming it on those who are ill. If WI!attribute cancer to the acts of a person, we (an assume that WI! will be immune to that disease if we do not engage in the same behavior. Nonsmokers who learn that a lung cancer victim had a two-pack-a-day habit feel comforted that they are unlikely to suffer the same fate. Similarly. victims of AIDS are often blamed for promiscuous sexual conduct or intravenous drug use, regardless of how the)'
. contracted HIY. In this case the social definition of the illness leads to the stigmatization of individuals who 'suffer from the! disease. Although biological characteristics provide objective criteria for determining medical conditions such
as heart disease, tuberculosis, or cancer, there is also a subjective component to how illness is defined. This subjective component is very important when we look at conditions such as childhood hyperactivity. mental illness. alcoholism, drug abuse, cigarette smoking. and overeating. all of which have been medicalized, The term medicalization refers to the process whereby nonmedical problems become defined and treated as illnesses or disorders. Medicalization may occur on three levels: (I) the conceptual level (e.g., the use of medical terminology to define the problem). (2) the institutional level (e.g . physicians are supervisors of treatment and gatekeepers to applying for benefits), and (3) the interactional level (e.g., when physicians treat patients' conditions as medical problems). For example, the sociologists Deborah Findlay and Leslie Miller (1994: 277) explain how gambling has been medicalized Habitual gambling ... has been regarded by a minority as a sin, and by most as a leisure pursuit- perhaps wasteful but a pastime nevertheless. Lately, however, we have seen gambling described as a psychological illness-« "compulsive gambling." It is in the process of being medicalized. The consequences of this shift in discourse (that is, in the way of thinking and talking) about gambling are considerable for doctors. w o now have in gamblers aa ne market for their services or "treatment": perhaps for gambling halls. which may find themselves subject to new regulations, insofar as they are deemed to contribute to the "disease"; and 1I0t least, for gamblers themselves, who are no longer treated as sinners or wastrels, but as patients, with claims 011 our sympathy, and to our medical Insurance plans as well.