Medicalization of Deviance

Medicalization of Deviance

Order Description

As the medicalization of deviance has expanded, “remedies” have multiplied. Our ‘magic bullets’ now support our norms and values of happiness, sexual potency and youthful energy, cognitive ability and appearance. We have also provided more opportunities for deviance (e.g., human growth hormone has become a street [or gym] drug and pharmaceutical companies have been fined for selling off-label HGH [anti-aging, athletic edge]). In short, we have socially constructed deviance even as we attempt to reduce the stigma of deviance.

Your task:

Review Unit VIII (prof’s notes), text resources, Unit I discussion (sports)
Review C. Wright Mills (chapter 1, Unit I [prof’s notes])
From Wednesday to Friday (8 p.m.),
Discuss your understanding of the medicalization of deviance: you may identify forms that you have observed (do NOT equate medications with the process of medicalization, even though this may be a result [“treatment”]).
Discuss the pros and cons of medicalization, medical dominance
Consider: “juiced” athletes may have troubles and this is certainly an issue: are they ‘cheating’ or are they subscribing to contemporary cultural norms and values?
Remember, this is a dialogue: a minimum of three to five entries is expected, first-time late entries prevent dialogue and thus diminish the benefit to you and your colleagues.
Speed Bump comic
Used with permission of Dave Coverly and the Cartoonist Group. All rights reserved. Reprinted online with permission.
By Sunday midnight, submit a paper that responds to this question:
How would C. Wright Mills analyze the structural sources of the trouble/issue of “juiced” athletes (use your sociological imagination)? (You will find Conrad’s critique helpful here.)

(NOTE: The above is one of five options from which you choose three to complete and electronically submit.)

This is prof’s Notes for this assignment:

Discussion and Commentary

Deviance, rule-breaking, is a violation of our norms. Humans make rules, this is how we create social order. Humans break rules, this is why we identify rule-breakers as we strive to maintain social order. Sociologists are interested in:

how we identify deviance
how we explain or interpret deviance
how we curtail deviance
Despite our best attempts to socialize people, rule-breaking does occur and methods of social control are necessary. Social analysts examine the relationships between moral entrepreneurs (who defines what is deviant?), rule-makers (who defines the norms?), rule-enforcers (who ensures conformity?) and rule-breakers (who is identified as deviant?). We are a species of Mother Theresas and Adolf Hitlers (both of whom could be considered “moral entrepreneurs”); history has been on the side of Mother Theresa.

Throughout history, humans have developed strategies to identify who among us is a threat. At the time of Aristotle, one who looked like an animal was thought to possess the characteristics or character of that animal. Lions were brave, weasels were shifty or sly and so, the theory went, a man who looked like a lion was a brave man…pity the man who looked like a weasel, clearly, he was not to be trusted.

Julius Caesar warned:

Yon Cassius has a lean and hungry look. He thinks too much. Such men are dangerous.

(Shakespeare: Julius Caesar: I, ii, 191)

Cassius’s appearance reflected his bad character.

During the European “witch-craze,” women, particularly older or barren women, were examined for witches’ marks. These “marks” were small, horny growths on their skin used for suckling their incubi (demons). If marks were found, the women were declared to be witches and burned at the stake. We now know that these growths are caused by excessive sunlight (keratoacanthoma) and that the women were labeled as witches because they violated the norms of proper womanhood of that era – for example, midwives, the infertile, the unruly – they were dangerous, a threat to the rule-makers.

In the 19th century, phrenologists (“skull-feelers”) were experts at discerning character by examining the bumps on people’s heads Over 35 characteristics could be identified in this way – greed, destructiveness, nobility, for example (Adolf Hitler was ‘diagnosed’ as noble).

Stand in front of a mirror. Do you have:

thick, dark hair?
a thin beard?
bushy eyebrows?
pale skin?
wrinkled skin?
long arms, short legs?

are you left-handed?
These are the features that once indicated atavism, the “born criminal” or “ape in our midst,” people who were innately evil (“bad seeds”) according to Lombroso and his nineteenth-century followers.

As late as the second half of the 20th century, one’s physicality was suspect. An athletic build (mesomorphic) predisposed one to deviance or criminality, according to Sheldon and his colleagues, although Glueck and Glueck argued that this was due to a more detached relationship between muscular children and parents rather than an innate predisposition to criminality. Men with XYY chromosomal composition have also been suspect .

Today, young offenders are often diagnosed with attention deficit hyperactivity disorder (ADHD) and/or conduct disorder; conduct disorder is thought to predispose one to criminality or psychopathic personality in adulthood. This contemporary approach to who is a threat is a psychobiological approach and reflects our increasing tendency to medicalize deviance, to convert “bad” to “sick” or “mad.” We will discuss medicalization more fully later (Unit VIII). Today, current research is focusing on the biogenetic substrates of “psychopathy” versus “psychopathic personality (disorder).” Researchers in both Canada and the United States are using both questionnaires and fMRIs to investigate contemporary “bad seeds.”

To summarize: throughout history, various biological characteristics – stigmata – have been identified as signs of defective character. People exhibiting these signs have been stigmatized as a threat: they are discredited, their identities are tainted. Consider: we still mistrust people who avert their eyes when conversing, we characterize the plump or obese as slothful or self-indulgent, we label the excessively thin as mentally ill (anorexia nervosa) and we suspect that people with brandings or piercings are self-mutilators. In short, biological and psychobiological signs of deviance persist.

A sociological approach to deviance, however, is based upon the recognition of three basic principles of deviance:

Deviance varies according to cultural norms.
People become deviant as people define them that way.
Both rule-making and rule-breaking involve social power.
Let’s take a look at these principles within the context of the three theoretical paradigms.

Deviance is socially constructed for this time, this place. As society changes, we create new forms of deviance (cf. computer hacking, for example); deviance is always identified, but it is defined differently within different historical periods and social contexts. As Emile Durkheim asserted, within a society of saints, even the apparently smallest infractions will assume serious proportions. Erikson’s study of the Puritans supported Durkheim’s contention and their “Scarlet Letter” (A for adultery) has become a part of our literary tradition.
Durkheim, the structural-functionalist, argued that deviance is functional for society. How and why did he determine this, given his propensity toward integration and social order? Deviance and our awareness of deviance, Durkheim contended, performed four important functions:

Deviance affirms our cultural norms and values. It is insufficient to simply define the “good;” the “bad” demonstrates the good for us.
Responses to deviance clarify our moral boundaries. Note when you read (or hear) a judge imposing a sentence, he/she will often conclude by saying, “We must make society aware that this behavior is not tolerated.” The judge is speaking to two audiences: (1) to the deviant, ‘this is your punishment for your violation’; (2) to us, ‘such behavior violates our moral and ethical boundaries (don’t!)’. Public hangings2 and media reports fulfill the same function, they express the limits of our moral boundaries. The popular crime shows on television also signify the ‘bad’ and its consequences.
Responses to deviance promote social cohesion or integration, and value consensus. These responses re-affirm our moral ties: WE are good, THEY are bad. (Conversely, awareness of deviance may generate fearfulness, disunity.)
Deviance encourages social change. Broad violations of norms may generate a re-thinking of the norms. Drinking alcohol, masturbation and gambling were all defined as deviance, yet all were widely practiced. Today, drinking alcohol is conventional within most groups (although there exist religious constraints); masturbation is accepted as ‘normal’ and as sexual therapy; gambling has been legalized (not without controversy) in many areas and garners huge revenues for the rule-makers who formerly prohibited it. Note, however, that both over-consumption of alcohol and excessive gambling have been converted into medical conditions, “addictions.”
The current controversy over the legalization of marijuana is an apt illustration of how deviance can generate change. After many decades of prohibition, Canada’s marijuana laws (covered under the Controlled Drugs and Substances Act) are in a state of disarray. Since the last third of the 20 century (post-“hippie” era), moral entrepreneurs have argued about our marijuana laws and rule-breakers have violated these laws, both covertly and overtly. With the introduction of the Medical Marijuana Access Regulations at the turn of the century and the proliferation of “compassion clubs,” efforts to deregulate marijuana have been strenuous – and controversial. New legislation has been expected to decriminalize marijuana, including small amounts for personal, non-medical use. Just the expectation of loosening restrictions has been contentious, however. (2008: Federal drug laws to be tightened.)

opponents of deregulation contend that deregulating marijuana would increase drug use, including ‘hard’ drugs like heroin;4 medical access to marijuana is controversial within the medical community; the U.S. government has threatened to retaliate5 by strengthening border restrictions on Canadian goods.
pro-deregulation groups see the proposed introduction of fines for possession (versus sentencing) as too little an advance for their cause; they are in favor of deregulation per se and easier access to legal marijuana.
What we are observing here is a conflict between two groups of moral entrepreneurs, each of which is attempting to influence the rule-makers. This long-term controversy has been sharpened because of the widespread violation of the norm (legally enacted): marijuana usage is bad. The medical access regulations, divisive within the medical profession, and the legal federal cultivation of marijuana (in a mine shaft in Flin Flon!) both represent alterations by the rule-makers that have satisfied neither group. Let’s watch this ‘morality play’ unfold…it is an opportunity to see concrete evidence of the structural-functionalist paradigm.

Durkheim’s approach has been elaborated by more recent analysts. Robert Merton’s “Strain Theory” is an attempt to categorize the ways in which we respond to the normative (valued) goals of society. What is the most prominent goal of Canadians? While our most desired value is happiness, Merton (and students in our classes) define money as the normative goal of western societies. What Merton categorized was how (the “means”) we go about attaining money:

conformists accept the goal of making money and the conventional means – for example, getting an education and a job
innovators also accept the goal, but reject or are blocked from the conventional means – for example, selling drugs could be an innovative means
ritualists reject or lose hope of achieving the goal, but they doggedly (ritualistically) plod on accepting the means without expecting the goal
retreatists reject both the goals and means, they withdraw (retreat) from society, they are disengaged, alienated
rebels either reject or substitute both the goal and the means – in effect, they create new goals, new means of achieving them – and thereby work toward social change
A simpler, related dual category differentiates between two forms of deviant behavior:

aberrant behavior, a violation of norms for self-interest (e.g., buying and selling pot in order to have a ready personal supply)
non-conformist behavior, a violation of norms motivated by values or principles that challenge the norms (e.g., making pot available in a compassion club)
How would these two categories fit into Merton’s model?6

As you can see, there are a few problems with the social strain model that are not problematic in the simpler, more abstract, dual model. Merton’s model assumes that the poor or deprived are most likely to deviate (they want money), while we know that members of all social classes deviate and, furthermore, that not all deviance is motivated by material gain. Indeed, even if the legitimate means of attaining a goal is blocked, one must still have the opportunity to deviate.

This is the basis of “opportunity theory”: one’s location in the opportunity structures (including subcultures, countercultures, gangs) of society affords one the opportunity to deviate or conform. Subcultures (and gangs), by definition, have a system of behavioral guidelines, values and norms that a member is expected to support. A member of “Youth for Christ,” for example, would be encouraged (and have the opportunity) to conform to the broader norms; a member of a gang, on the other hand, by defending his “rep,” is encouraged (and provided with the opportunity) to deviate from the broader norms.

Deviance, like beauty, is in the eye of the beholder. We are only deviant if we are perceived, labeled or defined as deviant – named deviant. The question of who is named is addressed by symbolic interactionists: all of us deviate, some of us are named as deviant. Labeling theory is the symbolic interactionist approach that looks at the who.
Labeling theory argues that a “deviant career” is the endpoint of a process:

primary deviance is a norm violation that is unremarked or unremarkable
if the primary deviance is reacted to, labeled as “deviant,” then the individual is perceived (and treated) as deviant, stigmatized, and may internalize the label, which then becomes a self-fulfilling prophecy – it may shape the self-image and future behavior of the violator, secondary deviance
as the deviance continues (deviant career), the individual’s past (retrospective labeling: “he was always a troublemaker”) and future (projective labeling: “don’t trust him”) behaviors are also stigmatized – i.e., both his biography and his potential are perceived as deviant
Labeling theory is an updated version of Cooley’s “looking-glass self” (Unit V), we see ourselves as we think others see us, then we conform to that image. In short, the labeling approach argues that the deviant is simply who is labeled as deviant. As Goode7 asserted:

“People see deviants as dangerous because they are already condemned; they do not condemn deviants because they are dangerous.”
Labeling theory can help us understand some of the horrendous crimes that have been committed by young people who have been stigmatized (and/or bullied) by their peers (e.g., school killings). Yet, we must be aware that labels can be embraced, rejected or neutralized by the labeled – the non-conformist who is seeking social justice, the aberrant who is motivated by simple self-interest, the deviant who puts a different spin on his/her activities and thereby redefines them as legitimate.

Differential Association is essentially an approach that argues that the company you keep influences your behavior – that’s why your mom said, “Keep away from those kids!” This approach is similar, of course, to the notion that a subculture or gang affects your behavior.

Why are you a student rather than an inmate? Why do you conform? Is it because your parents or friends would be ashamed or disappointed (attachments) if you committed a crime? Or, because you are committed to gaining a good job? Or, would your reputation be spoiled if you committed a crime (involvements)? Perhaps you feel a strong moral or religious responsibility to conform (beliefs)? These are the reasons/motivations for conformity that Hirschi advanced in his Control Theory, a theoretical approach that analyzes why people stay on ‘the straight and narrow’ despite temptation. The basic thrust of Hirschi’s argument is: the more you have to lose, the less likely you are to deviate. Conversely, people who lack conventional strong attachments, commitments, involvements and/or belief systems are less likely to be deterred from deviant behavior. (For example, even gang members are controlled by their attachment to the gang [sometimes referred to as “family”] and their commitment and ‘reputation’ as a member.)

The symbolic interactionist approaches, including labeling theory, have been most useful for interpreting relatively minor forms of deviance. Currently, it can help us to understand that “ethnic profiling” results from stereotyping – labeling, stigmatizing – members of certain groups as “dangerous.” Understanding this may make us a bit more compassionate, as Peter Berger would hope.

The law forbids both rich and poor alike to sleep under bridges, to beg in the streets and to steal bread. (Anatole France)
Neither structural-functionalists nor symbolic interactionists focus on the rule-makers: the social conflict approach to deviance addresses the issue of who names and blames, the issue of unequal power. Clearly, given France’s quote, some people are more equal than others under our laws. Thus, a “squeegee kid” is more likely to be arrested than a corporate executive who ‘cooks the books’; people on public assistance are denigrated as “welfare bums” while politicians who ‘double-dip’ are being rewarded for public service; the drunk asleep on the street is a “lush” to be thrown into the tank while the drunken student on Spring Break is “sowing his/her wild oats” and gets a warning. The distinctions are based on power differentials.

Goode8 asserts that:

In every society, certain members have more power to shape public opinion and the legal structure than others do. These more influential members may see in certain behavior a potential threat to what they have. It often happens that what they have was obtained at the expense of less powerful members…The powerful want to maintain the status quo…the powerful [may have] their ideology translated into the criminal code.
The capitalist economic strategy, for example, is based on private property, hard work and obedience to authority. When these values are threatened (by theft, by being unemployed, by disobeying an authority), these activities are defined as deviant. And our most common crime is theft: is the thief a greater danger than the corporation that pollutes the environment? People who conform to capitalist norms and values are at less risk of having their behavior defined as deviant. That is why social conflict theorists may focus on white collar or industrial crime – the laws, they argue, reflect the interests of, and protect, the powerful. The powerful are the rule-makers, they name and blame.