Introduction: The Social Construction of Normality and Pathology

  • Michelle O’Reilly
  • Jessica Nina Lester


Mental distress has been a focus of discussion for centuries, and, over time different views, perspectives, terms, treatments, and organisations have been utilised in response to people deemed to fit the label. In contemporary Western culture, psychological constructs in the context of mental health have been framed in biomedical terms and understood as dispositional within the suffering individual. This prevailing medicalised discourse of mental distress ostensibly offers a more legitimate and ‘scientific’ understanding of the problems encountered by the individual, family, and society. Importantly however, these ideas have been subject to extensive criticism from a broad range of fields, disciplines, scholars, and practitioners.


Mental Health Mental Illness Social Construction Social Constructionism Mental Distress 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Alvesson, M., & Sköldberg, K. (2010). Reflexive methodology: New vistas for qualitative research (2nd edition). London: Sage.Google Scholar
  2. American Psychiatric Association (APA). (2014). DSM history of the manual. As retrieved on 17th December 2014 at: manual.Google Scholar
  3. Bayer, R. (1981). Homosexuality and American psychiatry: The politics of diagnosis. New York: Basic Books.Google Scholar
  4. Braddock, D. L., & Parish, S. L. (2001). An institutional history of disability. In G. L. Albrecht, K. D. Seelman, & M. Bury (Eds.), Handbook of disability studies (pp. 11–68). Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
  5. Brown, P. (1995). Naming and framing: The social construction of diagnosis and illness. Journal of Health and Social Behavior, (Extra issue), 34–52.Google Scholar
  6. Burr, V. (1999). The extra-discursive in social constructionism. In D Nightingale & J. Cromby (Eds.), Social constructionist psychology: A critical analysis of theory and practice (pp. 113–126). Buckingham: Open University Press.Google Scholar
  7. —. (2003). Social constructionism (2nd edition). London: Routledge.Google Scholar
  8. Bury, M. R. (1986). Social constructionism and the development of medical sociology. Sociology of Health and Illness, 8(2), 137–169.CrossRefGoogle Scholar
  9. Canguilhem, G. (1989). The normal and the pathological. Brooklyn, NY: Zone Books.Google Scholar
  10. Caplan, P. J. (1995). They say you’re crazy: How the world’s most powerful psychiatrists decide who’s normal. Reading: Addison-Wesley.Google Scholar
  11. Chen, Y-Y., Shek, D., & Bu, F-F. (2011). Applications of interpretive and constructionist research methods in adolescent research: Philosophy, principles and examples. International Journal of Adolescent Medicine and Health, 23(3), 129–139.Google Scholar
  12. Clay, R. M. (1966). The mediaeval hospitals of England. London: Frank Cass.Google Scholar
  13. Crowe, M. (2000). Constructing normality: A discourse analysis of the DSM-IV. Journal of Psychiatric and Mental Health Nursing, 7(1), 69–77.CrossRefGoogle Scholar
  14. Davis, L. J. (1995). Enforcing normalcy: Disability, deafness and the body. New York: Verso.Google Scholar
  15. Decker, H. A. (2013). The making of DSM-III. Oxford: Oxford University Press.Google Scholar
  16. Erikson, K. T. (1966). Wayward puritans: A study of the sociology of deviance. New York: John Wiley & Sons.Google Scholar
  17. Foucault, M. (1965). Madness and civilization: A history of insanity in an age of reason. New York: Vintage books.Google Scholar
  18. Frances, A. (2013). Saving normal: An insider’s revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma, and the medicalization of ordinary life. New York: HarperCollins.Google Scholar
  19. Frances, A., & Nardo, J. (2013). ICD-11 should not repeat the mistakes made by DSM-5. The British Journal of Psychiatry, 203(1), 1–2.CrossRefGoogle Scholar
  20. Franklin, C. (1998). Distinctions between social constructionism and cognitive constructivism: Practice applications. In C. Franklin & P. Nurius (Eds.), Constructivism in practice: Methods and challenges (pp. 57–94). Milwaukee, WI: Families International Press.Google Scholar
  21. Gelder, M., Mayou, R., & Cowen, P. (2001). The shorter Oxford textbook of psychiatry. Oxford: Oxford University Press.Google Scholar
  22. Georgaca, E. (2013). Social constructionist contributions to critiques of psychiatric diagnosis and classification. Feminism and Psychology, 23(1), 56–62.CrossRefGoogle Scholar
  23. —. (2014). Discourse analytic research on mental distress: A critical overview. Journal of Mental Health, 23(2), 55–61. doi: 10.3109/09638237.2012.734648.CrossRefGoogle Scholar
  24. Gergen, K. (2009). An invitation to social constructionism (2nd edition). Thousand Oaks, CA: Sage.Google Scholar
  25. Griffiths, L. (2001). Categorising to exclude: The discursive construction of cases in community mental health teams. Sociology of Health and Illness, 23(5), 678–700.CrossRefGoogle Scholar
  26. Grob, G. (1995). The paradox of deinstitutionalisation. Society, 32(5), 51–59.CrossRefGoogle Scholar
  27. Gubrium, J., & Holstein, J. (2008). The constructionist mosaic. In J. Holstein & J. Gubrium (Eds.), Handbook of constructionist research (pp. 3–12). New York: Guildford.Google Scholar
  28. Harper, D. (1995). Discourse analysis and ‘mental health’. Journal of Mental Health, 4(4), 347–357.CrossRefGoogle Scholar
  29. Hopton, J. (2006). The future of critical psychiatry. Critical Social Policy, 26(1), 57–73.CrossRefGoogle Scholar
  30. Horwitz, A. (2002). Creating mental illness. Chicago: University of Chicago Press.Google Scholar
  31. Johnstone, E. (1998). Psychiatry – Its history and boundaries. In E. Johnstone, C. Freeman, and A. Zeally (Eds.), Companion to psychiatric studies (6th edition) (pp. 1–10). New York: Churchill Livingstone.Google Scholar
  32. Karim, K. (2015). The value of conversation analysis: A child psychiatrist’s view. In M. O’Reilly & J. N. Lester (Eds.), The Palgrave handbook of child mental health: Discourse and conversation studies, (pp. 25–41). Basingstoke: Palgrave Macmillan.Google Scholar
  33. Knibbs, G. H. (1929). The International classification of disease and causes of death and its revision. Medical Journal of Australia, 1, 2–12.Google Scholar
  34. Lafrance, M., & McKenzie-Mohr, S. (2013). The DSM and its lure of legitimacy. Feminism and Psychology, 23(1), 119–140.CrossRefGoogle Scholar
  35. Laing, R. D. (1960). The divided self: An existential study in sanity and madness. Harmondsworth: Penguin.Google Scholar
  36. Lester, J., & O’Reilly, M. (2015). Is evidence-based practice a threat to the progress of the qualitative community? Arguments from the bottom of the pyramid. Qualitative Inquiry. DOI: 10.1177/1077800414563808.Google Scholar
  37. Marks, D. (2002). Perspectives on evidence-based practice. Health Development Agency. As retrieved on 29th July 2015 from: Scholar
  38. Mayes, R., & Horwitz, A. (2005). DSM-III and the revolution in the classification of mental illness. Journal of the History of the Behavioural Sciences, 41(3), 249–267.CrossRefGoogle Scholar
  39. Middleton, H. (2007). Critical psychiatry. Mental Health Review Journal, 12(2), 40–43.CrossRefGoogle Scholar
  40. Morse, J. (2006). The politics of evidence. Qualitative Health Research, 16(3), 395–404.CrossRefGoogle Scholar
  41. Mulvany, J. (2000). Disability, impairment or illness? The relevance of the social model of disability to the study of mental disorder. Sociology of Health and Illness, 22(5), 582–601.CrossRefGoogle Scholar
  42. Neaman, J. (1978). Suggestion of the devil: Insanity in the middle ages and the twentieth century. New York: Octagon.Google Scholar
  43. O’Dell, L., Crafter, S., de Abreu, G., & Cline, T. (2010). Constructing ‘normal childhoods’: Young people talk about young carers. Disability and Society, 25(6), 643–655.CrossRefGoogle Scholar
  44. O’Reilly, M., & Kiyimba, N. (2015). Advanced qualitative research: A guide to contemporary theoretical debates. London: Sage.Google Scholar
  45. Porter, R. (1997). The greatest benefit to mankind: A medical history of humanity from antiquity to the present. London: Harper Collins Publishers.Google Scholar
  46. —. (2002). Madness: A brief history. Oxford: Oxford University Press.Google Scholar
  47. Rismiller, D., & Rissmiller, J. (2006). Evolution of the Anti-psychiatry movement into mental health consumerism. Psychiatric Services, 57(6), 863–866.CrossRefGoogle Scholar
  48. Rosen, G. (1968). Madness in society: Chapters in the historical sociology of mental illness. Chicago: University of Chicago Press.Google Scholar
  49. Russell, J. B. (1972). Witchcraft in the Middle Ages. Ithaca, NY: Cornell University Press.Google Scholar
  50. —. (1980). A history of witchcraft: Sorcerers, heretics, and pagans. New York: Thames and Hudson.Google Scholar
  51. Russo, G., & Carelli, F. (2009). Dismantling asylums: The Italian job. London Journal of Primary Care, April, PMID.Google Scholar
  52. Sarangi, S. (2001). Expert and lay formulation of ‘normality’ in genetic counselling. Bulletin Suisse de Linguistique Appliquee, 74, 109–127.Google Scholar
  53. Sayce, L. (2000). From psychiatric patient to citizen. Basingstoke: Palgrave Macmillan.CrossRefGoogle Scholar
  54. Sharfstein, S., & Dickerson, F. (2006). Psychiatry and the consumer movement. Health Affairs, 25(3), 734–736.CrossRefGoogle Scholar
  55. Shorter, E. (1997). A history of psychiatry: From the era of the asylum to the age of Prozac. New York: John Wiley and Sons.Google Scholar
  56. Sigerist, H.E. (1951). A history of medicine. Primitive and archaic medicine. New York: Oxford University Press.Google Scholar
  57. Sudnow, D. (1965). Normal crimes: Sociological features of the penal code in a public defender’s office. Social Problems, 12, 255–276.CrossRefGoogle Scholar
  58. Szasz, T. (1960). The myth of mental illness. American Psychologist, 15(2), 113–118.CrossRefGoogle Scholar
  59. —. (2010). Psychiatry, anti-psychiatry, critical psychiatry: What do these terms mean? Philosophy, Psychiatry, & Psychology, 17(3), 229–232.Google Scholar
  60. Thomas, P., & Bracken, P. (2004). Critical psychiatry in practice. Advances in Psychiatric Treatment, 10(5), 361–370.CrossRefGoogle Scholar
  61. Timimi, S. (2002). Pathological child psychiatry and the medicalization of childhood. London: Routledge-Brunner.Google Scholar
  62. —. (2005). Naughty boys: Anti-social behaviour, ADHD and the role of culture. Basingstoke: Palgrave Macmillan.Google Scholar
  63. —. (2008). Child psychiatry and its relationship to the pharmaceutical industry: Theoretical and practical issues. Advances in Psychiatric Treatment, 14(1), 3–9.CrossRefGoogle Scholar
  64. Timmermans, S., & Berg, M. (2003). The gold standard: The challenge of evidence-based medicine and standardization in health care. Philadelphia: Temple University Press.Google Scholar
  65. Walker, M. (2006). The social construction of mental illness and its implication for the recovery model. International Journal of Psychosocial Rehabilitation, 10(1), 71–87.Google Scholar
  66. World Health Organization (WHO). (2014). International Classification of Diseases (ICD). As retrieved on 11th January 2015 at:
  67. Willig, C. (2008). Introducing qualitative research in psychology. Berkshire, UK: McGraw Hill.Google Scholar
  68. Wykes, T., & Callard, F. (2010). Diagnosis, diagnosis, diagnosis: Towards DSM-5. Journal of Mental Health, 19(4), 301–304.CrossRefGoogle Scholar
  69. Young, R., & Collin, A. (2004). Introduction: Constructivism and social constructionism in the career field. Journal of Vocational Behavior, 64(3), 373–388.CrossRefGoogle Scholar

Recommended reading

  1. • Burr, V. (2003). Social constructionism (2nd edition). London: Routledge.Google Scholar
  2. • Georgaca, E. (2013). Social constructionist contributions to critiques of psychiatric diagnosis and classification. Feminism and Psychology, 23(1), 56–62.CrossRefGoogle Scholar
  3. • Gergen, K. (2009). An invitation to social constructionism (2nd edition). Thousand Oaks, CA: Sage.Google Scholar
  4. • Hopton, J. (2006). The future of critical psychiatry. Critical Social Policy, 26(1), 57–73.CrossRefGoogle Scholar
  5. • Porter, R. (2002). Madness: A brief history. Oxford: Oxford University Press.Google Scholar

Copyright information

© Michelle O’Reilly and Jessica Nina Lester 2016

Authors and Affiliations

  • Michelle O’Reilly
  • Jessica Nina Lester

There are no affiliations available

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