[Franco Basaglia: the body and the corporality of the encounter.] / Franco Basaglia: il corpo e l'incontro con l'altro.

On the centenary of the birth of Franco Basaglia - Italian psychiatrist and neurologist - it is incumbent upon us to question the ways in which Basaglia can critically illuminate or help us interpret the social uncertainty in which we are living. Many important contributions have enriched our knowledge of Basaglia's work in recent months. He was a modern practical intellectual, in the Gramscian sense, where the authentic intellectual moves from the real needs of the masses and seeks their solution from the given historical situation, recomposing it in the more general course of the world. Basaglia addresses our society: Do we want to be "fair"? Do we not want to remain in barbarism? Then, in our project of democracy, there must be a place for madness. It is not enough to stop marginalizing the insane or those whom, in the language of medicalization, we call "mentally ill". We have to make room for it. We must "reload" Basaglia's work beginning with restoring value to the centrality of the encounter with the other and to the corporality of the encounter, two themes that guided Franco Basaglia throughout his life.

Are All Gay Men at Risk of Developing HIV/AIDS? Why China's Mass HIV Testing Has Majorly Targeted Gay Men in the Era of Biomedicalization.

Global HIV/AIDS responses have been increasingly biomedically dominated over the past years. In line with this shifting paradigm, China has prioritized mass HIV testing as a practical approach to controlling its HIV/AIDS epidemics among at-risk populations, especially gay men and other men who have sex with men (MSM). This study analyzed why China's mass HIV testing mainly targeted gay men by understanding the perspectives of public health professionals, community-based organization (CBO) workers, and gay men. In addition, this study revealed the tensions and unintended consequences of HIV/AIDS prevention and the representation of gay men in China. The study involved fieldwork conducted in a major city in Eastern China from 2015 to 2019. Semi-structured interviews were held with participants from the three abovementioned groups (N = 25). The study identified four processes concerning why gay men are mainly targeted for HIV testing. Some public health professionals believe that being a gay man is equivalent to having HIV/AIDS risks. In addition, this study particularly noted tensions between public health professionals and gay men, including gay men-identified CBO workers, over whether mass HIV testing should target gay men or anyone who engaged in sexual risk behaviors. This study argued that a particular focus on gay men due to pursuing biomedical advances in HIV/AIDS prevention seems to have unintendedly stereotyped gay men based on the presumptions that they are at risk of developing HIV/AIDS. In addition, this study corresponded to the broader social scientific discussion concerning whether HIV/AIDS intervention should target specific sexual risk practices or sexual identity/population.

Resistance to the biomedicalization of mental illness through peer support: The case of peer specialists and mental health.

Certified peer specialists (CPS) are mental health professionals who draw their expertise from lived experience with mental illness and mental distress. They tale a nonmedical, nonclinical approach to providing support to community members with mental health difficulties and in doing so, emphasize the role of social environmental factors that contribute to mental distress. Their perspectives are contrary to the biomedical perspective of mainstream psychiatry. While there is a significant body of literature on CPS, there is a dearth of research on how CPS engage in and perceive the broader mental health system. They resist the biomedicalization of mental illness by moving past labels and the language of pathology to facilitate recovery from mental illness and to resist stigma. Drawing from in-depth interviews with peer specialists, participant observation of a peer-run organization, and a survey of peer specialists across the United States, I ask the following research questions: How and why are CPS challenging the medical model of mental illness? How do CPS consider social environmental factors in the etiology of distress and what are the potential implications for resistance to both biomedicalization and stigmatization? My data suggest that CPS, in their critiques of the medical model and the mental health system, are actively resisting the biomedicalization of mental illness and focus on social environmental factors that contribute to experiences of distress. This research has meaningful implications for research on CPS and hope for recovery from mental illness.

Una Historia Social de la corporeidad: del cuerpo físico al cuerpo vivido / Uma História Social da corporeidade: do corpo físico ao corpo vivido / A Social History of corporeity: from the physical body to the living body

In this work, a review of the different perceptions of the body that different societies have had throughout history is carried out. It will be seen how, in some moments, positive meanings predominated in the social representation of the body, while at other times the body was perceived from a negative point of view. For the realization of this article qualitative research was carried out based on the review of documents of the history of thought and social theory on the construction of social representations of the body. For this, the theoretical framework of systemic constructivism has been used -in particular, the theory of social imaginaries of Juan Luis Pintos- and the notion of epistemological rupture of Gaston Bachelard. Special attention is also paid to the gender perspective when carrying out the study. It can be concluded that the social representations of the body have been affected by a process of secularization and medicalization, affecting in different ways the perception of the female body, than that of the male. Building throughout the time a representation of the body as something changing and that assumes an identity role for people.(AU)

En este trabajo se realiza una revisión de las distintas percepciones del cuerpo que han tenido diferentes sociedades a lo largo de la historia. Se verá cómo, en algunos momentos, predominaron en la representación social del cuerpo significados de tipo positivo, mientras que en otros momentos se percibió desde un punto de vista negativo. Para la realización de este artículo se llevó a cabo una investigación cualitativa basada en la revisión de documentos de la his toria del pensamiento y de lateoría social sobre la construcción de las representaciones sociales del cuerpo. Para ello se ha utilizado el marco teórico del constructivismo de carácter sistémico -en concreto, la teoría de los imaginarios sociales de Juan Luis Pintos- y la noción de ruptura epistemológica de Gaston Bachelard. Se presta, además, una especial atención a la perspectiva de género a la hora de la realización del estudio. Se puede concluir que las representaciones sociales del cuerpo se han visto afectadas por un proceso de secularización y medicalización; afectando de modos distintos a la percepción del cuerpo femenino, que a la del masculino. Construyéndose a lo largo del tiempo una representación del cuerpo como algo cambiante y que asume un papel identitario para las personas.(AU)

Neste trabalho, é realizada uma revisão das diferentes perceções do corpo que as diferentes sociedades tiveram ao longo da história. Verseá como, em alguns momentos, os significados positivos predominavam na representação social do corpo, enquanto noutras alturas o corpo era percebido de um ponto de vista negativo. Para a realização deste artigo foi realizada uma investigação qualitativa com base na revisão de documentos da história do pensamento e da teoria social sobre a construção de representações sociais do corpo. Para isso, o quadro teórico do construtivismo sistémico tem sido usado -em particular, a teoria dos imaginários sociais de Juan Luis Pintos -e a noção de rutura epistemológica de Gaston Bachelard. É também dada especial atenção à perspetiva de género na realização do estudo. Pode concluir-se que as representações sociais do organismo foram afetadas por um processo de secularização e medicina; afetando de diferentes maneiras a perceção do corpo feminino, do que a do macho. Construindo ao longo do tempo uma representação do corpo como algo que muda e que assume um papel de identidade para as pessoas.(AU)

Disparities in the prevalence of ADHD diagnoses, suspicion, and medication use between Flanders and Québec from the lens of the medicalization process.

The prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD) diagnoses and medication use has increased over time around the world, but significant regional differences remain. This paper aims to determine and explain disparities in ADHD prevalence and medication use among school-aged children in two distinct school systems, in Flanders (Belgium) and Québec (Canada). We present detailed descriptive and comparative analyses of data from 35 schools, 114 teachers, and 1046 parents (children) that were collected as part of a comparative international project. The data concern teacher and parent suspicions, teachers' ratings of ADHD-related behaviors in children, teachers' views of medication use, and teachers' beliefs about ADHD. The results show that, compared with Flanders, Québec had significantly more children diagnosed with ADHD and more frequent suspicions of ADHD in children by teachers and parents. We refer to the conceptual, institutional, and interactional levels of medicalization to interpret our findings and conclude that social and cultural readings of children's behaviors differ greatly between regions. Medicalization of children's behaviors is more common in Québec than in Flanders.

'I just need to know what they are and if you can help me': Medicalization and the search for legitimacy in people diagnosed with non-epileptic attack disorder.

This paper focuses on the struggles for legitimacy expressed by people with non-epileptic attack disorder (NEAD), one of the most common manifestations of functional neurological disorder presenting to emergency and secondary care services. Nonepileptic attacks are episodes of altered experience, awareness, and reduced self-control that superficially resemble epileptic seizures or other paroxysmal disorders but are not associated with physiological abnormalities sufficient to explain the semiological features. "Organic" or medicalized explanations are frequently sought by patients as the only legitimate explanation for symptoms, and consequently, a diagnosis of NEAD is often contested. Drawing on narrative interviews with patients from a small exploratory study and using a sociological perspective, we propose that a psychological account of NEAD does not provide a sufficiently legitimate path into a socially sanctioned sick role. This is a reflection of the dominance of biomedicine and the associated processes of medicalization. These processes are, we argue, the sole route to achieving legitimacy. The stress-based or psychologically oriented explanations offered to patients in contemporary medical models of the etiology of NEAD engender an uncertain identity and social position and fail to provide many patients with an account of the nature or origin of their symptoms that they find satisfactory or convincing. These struggles for legitimacy (shared by others with functional or somatoform conditions) are sharpened by key features of the contemporary healthcare landscape, such as the increasing framing of health through a lens of 'responsibilization'.

Experiência entre Educação, Ensino, Diferença e Território / Experience between Education, Teaching, Difference and Territory

A leitura dos textos que aqui se apresentam não segue um itinerário linear e único, iniciamos com o texto de Renata Sousa para o deslocar da centralidade de especialistas para a articulação do cuidado em saúde de modo compartilhado com profissionais da educação, inspiradas pelo viés da estrutura de trabalho delineada pelo matriciamento ou apoio matricial. Psicologia, saúde e educação: caminhos que se atravessam na produção de um cuidado compartilhado com o sujeito é um recorte da dissertação do Programa de Pós-Graduação em Ensino/INFES/UFF, desenvolvida entre 2016 e 2018, cuja pesquisa aborda a questão da inclusão de crianças com autismo no ensino regular em uma cidade do interior do Estado do Rio de Janeiro, trazendo como foco principal o papel do psicólogo numa perspectiva de apoio junto aos mediadores escolares no processo ensino e aprendizagem. O psicólogo apoiador tenta se articular em diferentes territórios existenciais e tecer uma forma de atenção que não produza novos especialismos mas possa contribuir para a articulação de diferentes atores na construção de outros olhares. Neste recorte o resgate histórico nos dá a ver que a saúde que se faz no coletivo leva em conta a produção da subjetivi

Estado da arte sobre a produção científica nacional da medicalização do comportamento / State of the art research on the brazilian national scientific production of medicalization of behavior / Estado del arte sobre la producción científica de la medicalización del comportamiento

O presente trabalho apresenta uma pesquisa de estado da arte, de caráter quantitativo, que objetivou realizar o mapeamento das publicações científicas nacionais sobre o tema da medicalização do comportamento entre os anos 2000 e 2018. Neste levantamento, foram identificados os autores, seus respectivos estados, regiões e instituições de origem, número de publicações por ano, periódicos nos quais os artigos foram publicados e áreas de conhecimento desses periódicos, sujeitos-alvo das pesquisas, tipo de pesquisa e a ênfase da medicalização envolvida. Para isso, a base Periódico-CAPES ofereceu o material analítico, a partir da seguinte estratégia de busca: medicalização AND (comportament* OR desvio OR conduta OR transtorno OR sofrimento). A partir dos dados coletados, foram construídos gráficos com o fim de obter um panorama das investigações sobre o tema em questão. Os dados encontrados sinalizam, dentre outras coisas: o aumento do número de publicações a partir do ano de 2009; a concentração de autores nos estados das regiões Sudeste e Sul; a maior prevalência de publicações em revistas de Saúde Coletiva e Interdisciplinar; a predominância de pesquisa teórica relativamente aos estudos empíricos; a prevalência das mulheres como sujeito-alvo de quantidade importante de pesquisas sobre medicalização do comportamento. (AU)

This study presents quantitative state-of-the-art research aimed at mapping Brazilian scientific publications on the topic of medicalization of behaviors between the years 2000 and 2018. The research identified authors, their respec-tive states, regions, and institutions of origin, the number of publications per year, the journals in which the articles were published, the fields of knowledge of these journals, the target subjects of the research, the type of research, and the emphasis on the involved medicalization. Data from the Periodic Portal from CAPES provided the analytical material using the following search strategy: medicalization AND (behavior* OR deviation OR conduct OR disorder OR suffering). The collected data were used to create graphs in order to provide an overview of the research on the subject. The findings indicate, among other things: an increase in the number of publications since 2009; a concentration of authors in Brazilian states from the southeastern and southern regions; a higher prevalence of publications in journals related to Collective and Inter-disciplinary Health fields; a predominance of theoretical research compared to empirical studies; and a significant focus on women as the subject of research on medicalization of behaviors. (AU)

En el presente trabajo fue realizada una investigación cuantitativa del Estado del Arte que objetivó el mapeado de las publicaciones científicas sobre el tema de la medicalización del comportamiento, entre los años 2000 y 2018. En este levantamiento, fueron identificados los autores, sus respectivos estados, regiones e instituciones de origen, número de publicaciones por año, periódicos en los cuales los artículos fueron publicados y las áreas de conocimiento de estos periódicos, tema objetivo de las investigaciones, tipo de investigación y énfasis de la medicalización involucrada. Para ello, fue utilizado el Periódico-CAPES, aplicando los siguientes descriptores: medicalización AND (comportamient* OR desvío OR conducta OR trastorno OR sufrimiento). A partir de los datos colectados, fueron construidos gráficos con el fin de ofrecer un panorama de las investigaciones sobre el tema en cuestión. Los datos encontrados señalan, entre otras cosas: el aumento del número de publicaciones a partir del año de 2009; la concentración de los autores en los estados de las regiones del Sudeste y Sur; la mayor prevalencia de publicaciones en revistas de Salud Colectiva e Interdisciplinaria; la predominancia de la investigación teórica relativa a los estudios empíricos; la prevalencia de las mujeres como objeto de investi-gación de cantidad importante de investigaciones sobre la medicalización del comportamiento. (AU)

Os desencontros da medicalização da vida | Saúde+ Cast

A partir da construção de uma sociedade consumista, é possível entender que o atendimento médico só é bom se o paciente sai do consultório com prescrição. Mas, existir gera desconfortos e nem tudo precisa de remédio. Para falar sobre medicalização da vida, convidamos a farmacêutica Renata Imparato.

Chapitre 14. Le nouveau droit de l'assistance médicale à la procréation. Entre démédicalisation et stigmatisation : les tâtonnements du principe d'égalité.

The law of bioethics of 2 August 2021 is readily presented as enforcing the “medically-assisted procreation (MAP) for everyone”. It is true that opening up the MAP to female couples and single women made the law depart from the former legal framework which was based on a strong medicalization of this assisted procreation. This shift seems to be justified by the legislator’s intent to ensure equal rights when it comes to parental projects. Nevertheless, this “new” MAP right keeps facing differences in the treatment of applicants based on their gender or sexual orientation.

The dangerous trend of levothyroxine medicalization.

Thyroid hormone replacement is paramount in overt hypothyroidism; recently, however, thyroid hormone substitution is increasingly prescribed to patients with normal thyroid hormone levels. This forum article discusses the complex causes and the possible negative effects of overusing thyroid hormone replacement drugs.

Is non-medical use normal? Normalisation, medicalisation and pharmaceutical consumption.

The theory of the normalisation of youth drug use in advanced capitalist societies has had an enduring legacy in contemporary drug scholarship. While the literature on the normalisation of 'illicit' drugs is well developed, less has been written about application of the theory to emerging discourse of pharmaceutical 'abuse', and how this might necessitate different thinking around what can be considered normal consumption. Pharmaceuticals are not directly associated with criminality, and their use does not traditionally attract stigma. In fact, social science scholarship has illustrated how many substances deemed illicit are normalised in the context of an ever-growing set of medical treatments. This paper explores the assumptions about legality, sociality and pleasure which sit behind the drug normalisation thesis, by reflecting on the relevance of drug normalisation in relation to pharmaceuticals, as well as examining scholarship on the medicalisation of society and qualitative research on non-medical use to illustrate the parallel processes of normalisation that apply to pharmaceuticals. The paper argues that questions of normalisation in relation to pharmaceutical use require a deeper engagement with the normative expectations we attach to pleasure, consumption and medicine, and the way this is structured by proximity to medical authority, whiteness and middle-classness.

¿Tecnología o acompañamiento del parto? La relación profesional sanitario-gestante en España a lo largo del siglo XX / Technology or childbirth accompaniment? The health professional-gestant relationship in spain during the 20th century

En España, como en otros países del entorno, durante el siglo XX, la atención al parto hospitalario fue desplazando progresivamente al parto domiciliario. En el entorno clínico, la relación de los profesionales sanitarios con las gestantes sufrió grandes transformaciones, derivadas, fundamentalmente, de la pérdida de las posibilidades de elección de las parturientas durante el proceso obstétrico. Paralelamente, los protocolos y los adelantos científicos, como la monitorización cardio-tocográfica, propiciaron la tecnificación y medicalización del parto, lo que a su vez tuvo implicaciones en la relación entre gestantes y profesionales sanitarios, quienes no siempre fueron conscientes de cómo todas estas transformaciones afectaban a las mujeres durante parto.(AU)

In Spain, like in other countries, during the 20th century, hospital care for childbirth progressively displaced homebirth. In the clinical settings, the relationship between health professionals and pregnant women underwent major transformations, mainly due to the loss of choice for women in labour during the obstetric process. At the same time, protocols and scientific advances, such as cardiotocographic monitoring, led to the technification and medicalisation of childbirth, which in turn had implications for the relationship between pregnant women and healthcare professionals, who were not always aware of how all these transformations affected women during the labour.(AU)

The struggle with transnormativity: Non-binary identity work, embodiment desires, and experience with gender dysphoria.

I examine how non-binary people who have considered, or accessed, gender-affirming health care experience accountability to transnormativity using 12 in-depth interviews conducted between 2018 and 2019 in a midwestern American city. I detail how non-binary people who want to embody genders that are still largely culturally unintelligible think about identity, embodiment, and gender dysphoria. Using grounded theory methodology, I find that non-binary identity work around medicalization differs from that of transgender men and women in three primary ways: 1) regarding how they understand and operationalize gender dysphoria, 2) in relation to their embodiment goals, and 3) concerning how they experience pressure to medically transition. Non-binary people describe increased ontological uncertainty about their gender identities when researching gender dysphoria that is contextualized by an internalized sense of accountability to the transnormative expectation for medicalization. They additionally anticipate a potential medicalization paradox, where accessing gender-affirming care leads to a different type of binary misgendering and risks making their gender identities less, rather than more, culturally intelligible to others. Non-binary people also experience external accountability to transnormativity as pressure from trans and medical communities to think about dysphoria as inherently binaristic, embodied, and medically treatable. These findings indicate that non-binary people experience accountability to transnormativity differently than trans men and women. Since non-binary people and their body projects often disrupt the transnormative tropes that are the framework for trans medicine, they find trans therapeutics, and the diagnostic experience of gender dysphoria, uniquely problematic. Non-binary experiences of accountability to transnormativity indicate the need to re-center trans medicine to better accommodate non-normative embodiment desires and focus future diagnostic revisions of gender dysphoria to emphasize the social aspects of trans and non-binary experience.

The Perils of Medicalization for Population Health and Health Equity.

Policy Points Medicalization is a historical process by which personal, behavioral, and social issues are increasingly viewed through a biomedical lens and "diagnosed and treated" as individual pathologies and problems by medical authorities. Medicalization in the United States has led to a conflation of "health" and "health care" and a confusion between individual social needs versus the social, political, and economic determinants of health. The essential and important work of population health science, public health practice, and health policy writ large is being thwarted by a medicalized view of health and an overemphasis on personal health services and the health care delivery system as the major focal point for addressing societal health issues and health inequality. Increased recognition of the negative consequences of a medicalized view of health is essential, with a focus on education and training of clinicians and health care managers, journalists, and policymakers.

The biopsychosocial model: Its use and abuse.

The biopsychosocial model (BPSM) is increasingly influential in medical research and practice. Several philosophers and scholars of health have criticized the BPSM for lacking meaningful scientific content. This article extends those critiques by showing how the BPSM's epistemic weaknesses have led to certain problems in medical discourse. Despite its lack of content, many researchers have mistaken the BPSM for a scientific model with explanatory power. This misapprehension has placed researchers in an implicit bind. There is an expectation that applications of the BPSM will deliver insights about disease; yet the model offers no tools for producing valid (or probabilistically true) knowledge claims. I argue that many researchers have, unwittingly, responded to this predicament by developing certain patterns of specious argumentation I call "wayward BPSM discourse." The arguments of wayward discourse share a common form: They appear to deliver insights about disease gleaned through applications of the BPSM; on closer inspection, however, we find that the putative conclusions presented are actually assertions resting on question-begging arguments, appeals to authority, and conceptual errors. Through several case studies of BPSM articles and literatures, this article describes wayward discourse and its effects. Wayward discourse has introduced into medicine forms of conceptual instability that threaten to undermine various lines of research. It has also created a potentially potent vector of medicalization. Fixing these problems will likely require reimposing conceptual rigor on BPSM discourse.