Mental illness is not always an illness - lay rationalities about mental suffering: a sociological study in the north of Portugal
DCSG Universidade Aberta - CEMRI Porto, Portugal
Societies relate to madness in accordance with their dominant concepts about the world. Modern rationality has created mental illness as an ?object? controlled by medicine. In lay knowledge the concepts, attitudes and practices associated with mental illness are culturally distant from the scientific representation of body, disease and patient. The semi-periphery condition of Portuguese society allows us to believe that mental illness here contains modern and traditional elements.
This study focus lay knowledge about mental suffering and mental illness. How do people identify, conceive, explain and deal with mental suffering and with mental illness? Data is gathered from interviews with a sample of sixty eight men and women in the north of Portugal.
Results show that the concept of mental illness includes the one of illness (there are ill people) but it always refuses it (mental suffering is not illness). Lay narratives refer to ?ill people? and not to ?illnesses?, placing the nosologic holistic entity before the disease. This rationality categorises people in three kinds: the ?ill-people?, the ?week-people? (these may turn into ill-people) and the strong-people (these ones succeed in the combat with mental suffering, a normal event during life). Illness clearly is inscribed in the body and its causes can be organic or moral.
In lay knowledge psychiatry has a control role via treatment and exclusion. Social representations emphasize biomedical instead of psychodynamic model. ?Talking? is the most valued therapeutic resource and is the attribute of other dominant professions (psychologists) or professions from the alternative systems. This represents a culture of resistance to psychiatrisation (medicalisation) of mental suffering. And gives relevance to the individual agent (?talking? reinforces individual strength to combat the tendency for turning ill).
Mental illness narratives (concerning ?the others?) and mental suffering narratives (concerning the self) represent a confrontation with the self and its identity. Illness and non-illness are entities allowing individual construction or destruction.
Briefly, this research fount that lay relationship to mental illness (in medical language) is made of diverse, complex and multiple logics. It proposes the concept of lay rationalities, in plural, about mental suffering and illness.