Robin on 'the sick role' and 'false illness beliefs' as espoused by Simon Wessely
Robin May 17 2010
''Validation is needed from the doctor. Once that is granted, the patient may assume the privileges of the sick role (sympathy, time of work, benefits etc)''
1992. Chronic Fatigue Syndrome: current issues. Wessely, S. Reviews in Medical Microbiology 1992:3:211-216
More on the sick role (http://en.wikipedia.org/wiki/Sick_role
Sick role is a term used in medical sociology concerning the social aspects of falling ill and the privileges and obligations that accompany it. It is a concept created by American sociologist Talcott Parsons in 1951.
Parsons was a functionalist sociologist, who argued that being sick means that the sufferer enters a role of 'sanctioned deviance'. This is because, from a functionalist perspective, a sick individual is not a productive member of society. Therefore this deviance needs to be policed, which is the role of the medical profession.
The general idea is that the individual who has fallen ill is not only physically sick, but now adheres to the specifically patterned social role of being sick. Being Sick is not simply a state of fact or condition, it contains within itself customary rights and obligations based on the social norms that surround it. The theory outlined two rights of a sick person and two obligations:
The sick person is exempt from normal social roles
The sick person is not responsible for their condition
The sick person should try to get well
The sick person should seek technically competent help and cooperate with the medical professional
There are three versions of sick role: 1. Conditional 2. Unconditionally legitimate 3. Illegitimate role: condition that is stigmatized by others
If Wessely weren't so malicious he would be fascinating! You can just deconstruct how he thinks, it's so antiquated and academic.
My experience with being sick hasn't matched this "concept" of the sick role at all. First, the exemption from responsibility is not clean at all like stated above -- you're still responsible for yourself, just unable to attend to your responsibilities like you used to so it's a huge struggle. That loss of function is so devestating.
Contrary to the notion of priveleges of the sick role, it's actually a lot easier if people don't know you are sick. Having observed people with non-maligned diagnosis (such as cancer) become stigmatized or treated with fear, or treated oddly, I'd much rather people not know that I'm ill. If they do find out, I'm often faced with a series of questions about my illness and how it feels, and the subsequent uncomfortable and awkward position of watching someone work it out in their minds the life implications and the concluding horror. It's better for me to "pass" socially as a well person.
As far as relationships go, they must change or adapt -- you're not simply "exempt" from them. Many fall away. There is no social benefit to illness. The worst part is watching people you love grieve the role you used to play in their lives. It's like watching your own funeral and the most painful thing I've ever gone through.
Losing an education and a career is the second worst part of being ill for so many years (the worst is not having children.) There are so many psychological advantages to working and earning your own money. There's the mental stimulation, sense of reward, and neurological benefits of learning. I've missed out on so much. Being on disability is, personally, humiliating. I hate it. But how else am I supposed to survive?
The notion that millions of previously happy, well adjusted, productive people are sick because of false illness belief gets more ridiculous the longer you think about it.