Contested illnesses are those that are questioned or questionable by some

Contested illnessesare those that are questioned or questionable by some medical professionals.Disorders like fibromyalgia or chronic fatigue syndrome may be either true illnesses or only inthe patients’ heads, depending on the opinion of the medical professional. This dynamic canaffect how a patient seeks treatment and what kind of treatment he or she receives.The Social Construction of the Illness ExperienceThe idea of the social construction of the illness experience is based on the concept of reality as asocial construction. In other words, there is no objective reality; there are only our ownperceptions of it. The social construction of the illness experience deals with such issues as theway some patients control the manner in which they reveal their diseases and the lifestyleadaptations patients develop to cope with their illnesses.

In terms of constructing the illness experience, culture and individual personality both play asignificant role. For some people, a long-term illness can have the effect of making their worldsmaller, more defined by the illness than anything else. For others, illness can be a chance fordiscovery, for re-imaging a new self (Conrad and Barker 2007). Culture plays a huge role in howan individual experiences illness. Widespread diseases like AIDS or breast cancer have specificcultural markers that have changed over the years and that govern how individuals—and society—view them.Today, many institutions of wellness acknowledge the degree to which individual perceptionsshape the nature of health and illness. Regarding physical activity, for instance, the Centers forDisease Control (CDC) recommends that individuals use a standard level of exertion to assesstheir physical activity. This Rating of Perceived Exertion (RPE) gives a more complete view ofan individual’s actual exertion level, since heartrate or pulse measurements may be affected bymedication or other issues (Centers for Disease Control 2011a). Similarly, many medicalprofessionals use a comparable scale for perceived pain to help determine pain managementstrategies.Figure 19.2 The Mosby pain rating scale helps health care providers assess an individual’s level of pain.What might a symbolic interactionist observe about this method? (Photo courtesy ofwrestlingentropy/flickr)The Social Construction of Medical KnowledgeConrad and Barker show how medical knowledge is socially constructed; that is, it can bothreflect and reproduce inequalities in gender, class, race, and ethnicity. Conrad and Barker (2011)use the example of the social construction of women’s health and how medical knowledge haschanged significantly in the course of a few generations. For instance, in the early nineteenthcentury, pregnant women were discouraged from driving or dancing for fear of harming theunborn child, much as they are discouraged, with more valid reason, from smoking or drinkingalcohol today.