Medicalization

In a recent journal article, I argued that as the health function system increases the sensitivity of its diagnostic instruments, it identifies new illnesses, disorders, or forms of suffering that it can treat—not necessarily cure, but treat. Thus, conditions that in the past were considered a normal part of human life and not even given a name are identified as treatable disorders—e.g., Attention-Deficit-Hyperactivity Disorder (ADHD), Generalized Anxiety Disorder (GAD), Oppositional Defiant Disorder (ODD), Hypersexual Behavior Disorder. This, of course, is not a new insight. In the 1970s, “medicalization” entered the lexicon. Conrad (1975: 12) wrote,

By medicalization we mean defining behavior as a medical problem or illness and mandating or licensing the medical profession to provide some type of treatment for it. Examples include alcoholism, drug addiction and treating violence as a genetic or brain disorder. This redefinition is not a new function of the medical institution: psychiatry and public health have always been concerned with social behavior and have traditionally functioned as agents of social control.

In this early article, Conrad takes hyperkinesis, now known as ADHD, as an example; he describes how what once would have been considered “disruptive, disobedient, rebellious, anti-social or deviant behavior” among children came to be classified as a medical disorder. More recently, Conrad (2014) observes how this now classic case of medicalization has extended into Adult ADHD and spread throughout the world. 

Adopting the second-order observational stance of systems theory, one notices that many of the social problems that have become medicalized were not always even social problems. Disruptive student behavior was not a social problem until the modern education system defined it as a problem.

Systems theory reframes this controversy by observing how the identification of new medical disorders produces new medical specializations (i.e., new subsystems of the health system), and new specializations, in turn, produce new disorders. This is a positive feedback loop. In other words, the health function system enhances its resonance capacity every time it identifies—or, more accurately, creates—a new medical disorder. In this way, the health system reproduces itself from moment to moment and day to day. Through the lens of systems theory, one could also analyze how the pharmaceutical industry (a social system comprised of pharmaceutical companies and their lobbyists) structurally couples with the health function system, and how these two social systems co-evolve.

Function systems blindly reproduce themselves. Only other systems can check their expansion.

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