Illness as ‘Deviance’, Work as Glittering Salvation and the ‘Psyching-up’ of the Medical Model

[Kyla]

http://blacktrianglecampaign.org/20...strategies-for-getting-the-sick-back-to-work/

I haven't finished reading this whole article yet (it's a long one) but it is looking like a very thorough take-down of the UK 'BPS' school of thought and the effect it has had on the sick and disabled in UK.

Here is an excerpt:

The BPS model is consistently deployed in the framing by this group, across the span of their publications, of an ‘illness deviance’, its principles drawn upon to emphasise the (flawed) ‘subjectivity’ of those suffering ill-health in a way which seeks to undermine their credibility, asserting that there has been a proliferation of ‘medically unexplained symptoms’, juxtaposed against the notion that the majority of health problems are ‘common’, and therefore experienced ‘commonly’ within everyday human experience by most people. This purpose could not be further from the intent of its originator who declared that “[M]any illnesses are largely subjective – at least until we as observers discover the parameters and framework within which we can also make objective observations. Hyperparathyroidism, in many of its manifestations, was a purely subjective experience for many patients until we discovered what to look for and which instruments to use in the search”. (Engel, 1961). Engel further sounds a cautionary note for those involved in the production of new knowledge: qualifying a definition of research as “to see what everyone else has seen and think what nobody else has thought” with a caution not to fall into the trap of thinking that the ‘new’ thought is necessarily any more correct. It is something perhaps that the BPS lobby might well have borne in mind considering the serious effects their ‘theories’ are now having on the lives of the sick and disabled 1.

 

[harveythecat]

what a fantastic article!

 

[Woolie]

I really liked this bit (bolding is mine):

A noteworthy feature of the BPS lobby is the opportunistic aspect of their methods, drawing alternately, and selectively, from the fields of medicine, sociology and psychology those elements which best suit their purpose. The authority historically bestowed upon bio-medicine is drawn upon to underpin the legitimacy of their point of view – they are ‘experts’- a presumption underscored by their frequent holding of titles such as ‘Chief Medical Officer’, whether in the public or private sector.

This is the full extent of bio-medicine’s usefulness to the lobby as, outside of that legitimising function, they are at pains to present it as an inferior ‘model’ of modern illness. Concepts from sociology such as ‘illness behaviour’ and ‘the sick role‘ are deployed to support the idea that there are ‘gains’ or ‘rewards’ associated with being ill. Conscious, no doubt, of the social unacceptability of the suggestion that all sick and disabled people are malingerers, there is then the attempt to construct a ‘softer’ variant of the illness deviant via psychology.

This individual is more by way of being an ‘accidental’ malingerer, subject to a form of self-deception, in which they harbour ‘irrational’ beliefs about their condition, and how it affects their ‘functioning’ or ‘capabilities’.