Addiction Diagnoses as Involvement Controls

Abstract

There is a long, though now dormant, dispute between sociology and psychiatry. The most famous antagonism came with the antipsychiatry movement, which sought to disqualify mental illness explanations as “false,” as naïve and simplistic objectifications of complex interactional processes. Effectful as this antagonism was, it effectively pulled up walls between psychiatry and sociology that remain visible today. A contemporary sociological appraisal can transcend this conflict by resuscitating old insights generated by Erving Goffman, who famously stated that did psychiatry not exist, we would have to invent it (1971). To Goffman, as to pragmatists at-large, meanings are social products. That not only applies to the biomedical vocabulary, but also to any vocabulary critics wish to put in its stead, making the constructionist argument toothless for critical purposes (cf. Fish 1989). Rather than debate their truth or falsehood, pragmatists focus on the social contexts and situations in which they arise and on what is achieved by them in these concrete situations.Psychiatric categorizations of people can then be reframed as a tool to mend broken situations where sociation was in severe disarray in ways that protect valuable social realities: placing the causal source of the disarray in people’s bodies provides a clear pinpoint for influence work. It is often a last effort to affect actors whose justifications have retreated into “internalisms” such as “feelings” that became unreachable for other social negotiations of meaning or those who have changed behavior in ways that make them unpredictable or predictable in unwelcome ways. This is not an abstract unpredictability or unwelcome predictability, but one only to those who expect different roles from them.This dynamic is well visible in the case of what the biomedical model now calls “Internet addiction.” The paper will apply Goffman’s work on mental illness as a disturbance of the order of “place” to this contemporary expansion of the diagnostic canon. Place is here negotiated via time: “Internet addiction” is ascribed to those whose priorities concerning their time management worry, sadden and anger others. These others define their relationship and other activities functional to that relationship (i.e. concern with professional and social duties) as “high priority” and seek to enforce this priority over other uses of time that they mark as “useless,” as “a misdistribution of time.” The illness vocabulary is thus a practical tool to socially control and enforce “correct” time-management when other tools fail.