The muddle of medicalization: pathologizing or medicalizing?

Medicalization appears to be an issue that is both ubiquitous and unquestionably problematic as it seems to signal at once a social and existential threat. This perception of medicalization, however, is nothing new. Since the first main writings in the 1960s and 1970s, it has consistently been used to describe inappropriate or abusive instances of medical authority. Yet, while this standard approach claims that medicalization is a growing problem, it assumes that there is simply one “medical model” and that the expanding realm of “the medical” can be more or less clearly delineated. Moreover, while intended to establish the reality of this growing threat, this research often requires making arbitrary or unjustified distinctions between different practices. To better clarify the concept of medicalization, I will focus more on capturing the variety of medical practices than on the sociological aspects of medical discourse. In doing so, I will explore the distinction between medicalization and pathologization, a distinction that is often overlooked and that brings with it many conceptual and practical implications. After defining these terms, I will use some examples to show that while pathologizing is closely tied to medicalizing, both can occur independently. I will then further develop this distinction in terms of the different individual and social effects of these practices.     

Response to ‘Transgender medicalization and the attempt to evade psychological distress’ (Withers 2020) and to Herdzik’s (2021) response to Withers

Psyche is non-binary and multiple and clinical work in the analytic container must be held in the fluidity of multiplicity. Analysts are called to bring Queer energy to analytical attitude. Queer energy is intrinsically non-conforming and desires to confront a priori concepts in service to the unfolding of the Self. A Queer analytic attitude seeks to blur narrative, deconstruct language and listen deeply for what is emergent in the field. Queer energy is also deeply activating and often results in polarizations of attitude and a failure to hold what is emergent. This response to Withers (2020) and to (Herdzik 2021) is an invitation for all of us to engage our activated complexes around work with transgender issues and the fluidity of the Queer experience. The multiplicity of the Self seeks to be known through analytic process. Consciously held authentic experience of what is emergent and thus unknown is at the core of this process. An analysis capable of holding Queer energy offers a theatre for the exploration of gender identity and its expression.