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problems as a part of human existence. For example, Barsky and Boros argue that
empirical studies suggest that
‘people are increasingly bothered by,
aware of and
disabled by distress and discomforts that in the past were
deemed less important and less worthy of attention’ (1995,
p. 1932).
The authors note that social and cultural forces can lead individuals to amplify pre-
existing physical discomforts, misattribute them to disease and seek medical help.
Thus, they see somatization (defined as the propensity to experience and report
somatic symptoms that have no pathophysiological
explanation
[Woolfolk and
Allen, 2007]) and medicalization are mutually reinforcing processes.
Medicalization of everyday and usual problems is on this account seen as troubling
because it makes us attend to them more, and increases the suffering by making the
problem more silent. In the same way that focusing on every single imperfection of
one’s body makes one increasingly notice and assign weight to imperfections that
would otherwise not be particularly troubling, medicalization may construct issues
that previously were seen as usual (even if imperfect) features of life as problems to
be fixed. In addition to increasing the weight of pre-existing problems,
medicalization might lead one to make a previously unnoticed or unimportant
feature or experience acquire a negative meaning, resulting
in a proliferation of
defects (Bordo, 1998). Susan Bordo describes how after a visit to dentist (motivated
by a need to address an altogether different matter) her perception shifted:
‘the gumminess of my own smile was of no concern
to me until after I had seen the dentist; but under his
care I began to wonder if it wasn’t
in actuality
something I’d better hide… or ‘correct.’ (…) If you
are trained to see defect, you will.’ (Bordo, p.213).
The argument may go as follows: when previously acceptable traits and experiences
become unacceptable we are faced
with a situation in which, although more and
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more imperfections are ameliorated and despite our increased capabilities, our
subjective wellbeing falls. I think that the worry raised by Bordo (1998) is
prima
facie
plausible, insofar as medicalization involves construing something as a
pathology, presumably at both an individual and social level. However,
the issue
raised by Bordo (1998) is also a matter of values and culture and not only
medicalization. For example, Francis examined the stigma experienced by middle-
class parents of children with physical, psychological and behavioural problems and
highlighted the importance of also considering ‘larger
contexts of an anxious,
intensive parenting culture’ (2012, p. 927). What is a reasonable response? The
focus here, I think, should not be on the medical or biomedical toolkit, but rather on
the cultural norms that may foster wellbeing or ignite stigma. The considerations
raised by Bordo (1998) could also provide reasons to abandon the discourse of
‘pathology’ and focus on the discourse of ‘improvement,’ as well as reevaluate the
value of ends that the medical means might be used to achieve.
A related problem raised by Bordo (1998) has to do with
the creation of new desires
and the cultural norms and context medicine is embedded in. This problem is not a
specific effect of medicalization but rather refers to the ‘creation of desires,’ which
could equally be an effect of advertisers wanting to sell us their products,
professionals wanting to sell us their services and more attention directed to the
possibilities afforded by a new technology. Where the creation of new desires is
unendorsed by the agent and happens without an easy
ability for the agent to be
able to engage with the influence, the issue merits our attention (For more
discussion see: Arrington, 1982; Crisp, 1987; Phillips, 1994; Dow, 2013). Luckily,
the fact that we could do something does not mean that we should do it, and that
something is available does not mean that it is valuable.
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