A Sociological Alternative to the Psychiatric Conceptualization of Mental Suffering

Uncovering both the structural causes and experiences of suffering is a central sociological endeavor. Sociologists study many different kinds of suffering; after all, strife is experienced both physically and emotionally, because of internal factors such as illness, due to external factors such as trauma, and as a result of economic, political or natural environments. In this paper, I address one form of suffering: mental suffering. In particular, I describe the medicalization of mental suffering in biological psychiatry, which focuses on the genetic factors of illness and equates mental suffering with mental illness. The psychiatric concept of mental illness highlights the continuing, crucial role for sociology in both understanding the experience and identifying the structural roots of suffering. Since the dominant conceptualization of mental suffering is as a medical concept, it is vital for sociology to offer alternative explanations and contribute to a multidimensional analysis. The roots of mental suffering are much more than biological; social comparison, social inequality, and other social stressors are equally important etiological considerations. Therefore, a true understanding of mental suffering requires multiple perspectives, and sociological constructs guard against a total medicalization of mental suffering. The study of suffering is a longstanding tradition in sociology; after all, sociologists investigate poverty, racism, sexism, violence, illness, and many other hardships. As such, Iain Wilkinson, author of Suffering: A Sociological Introduction (2005), claims, ‘‘ … it may well be entirely appropriate to label all sociological discourse as discourse on suffering’’ (3). Macro sociological studies focus on the likelihood to suffer under certain social conditions, while the micro-level approach attends to definitions, and experiences of suffering. While the former is oft criticized as overly general, and lacking a true experiential understanding of suffering, the latter is critiqued for its inability to generalize. I contend that it is precisely the ability to study both the macro and micro that make sociology so wellequipped to address the complex concept of suffering. In short, this paper highlights the importance of a multidimensional perspective on suffering. As an example of the crucial role for sociologists in fully explicating suffering, I describe the narrow conceptualization of mental suffering (as mental illness) in contemporary psychiatry. Mental suffering is much more than symptom sets and medical diagnoses; it is an interpretive process and an emotional response based on myriad factors, from physical sensations to the complex web of social affiliations. After all, brains and bodies experience pain, but minds interpret that pain relative to a range of interpersonal and social factors. I begin with a broad overview of sociological understandings of suffering. Then, I provide a brief survey of sociological explanations of mental illness and mental suffering, as one example of the advantages of bridging micro and macro theories of suffering. Finally, I explore biological psychiatry’s approach to understanding mental strife in order to show that it is an incomplete perspective; sociological description of both experiences of and