The York Research Database

TY - JOUR

T1 - 'I just want permission to be ill': Towards a sociology of medically unexplained symptoms

AU - Nettleton, S

PY - 2005/8/30

Y1 - 2005/8/30

N2 - A significant proportion of symptoms are medically unexplained. People experience illness but no pathological basis for the symptoms can be discerned by the medical profession. Living without a clinical diagnosis or medical explanation has consequences for such patients. This paper reports on a small qualitative interview-based study of 18 neurology outpatients in England who live with such medically unexplained symptoms (MUS). The findings broadly concur with those identified in the related literatures on medically unexplained syndromes and unexplained pain: the difficulties of living with uncertainty; dealing with legitimacy; and a resistance to psychological explanations of their suffering. From a thematic analysis of the interview data we identify and elaborate on three related issues, which we refer to as: 'morality'; 'chaos'; and 'ambivalence'. Although this article presents empirical data its aim is primarily conceptual; it integrates the findings of the empirical analysis with the existing literature in order to try to make some sociological sense of the emergent themes by drawing on sociological and cultural analyses of risk and the body. We draw on Bauman's concept of ambivalence to suggest that the very processes associated with more precise 'problem solving' and 'classification' do, in fact, generate even more uncertainty and anxiety. On the one hand, we seek closure and certainty and yet this leaves no means of living with uncertainty. Indeed, society does not readily grant permission to be ill in the absence of disease. We conclude by suggesting that an appreciation of the experience of such embodied doubt articulated by people who live with MUS may have a more general applicability to the analysis of social life under conditions of late modernity. (c) 2005 Elsevier Ltd. All rights reserved.

AB - A significant proportion of symptoms are medically unexplained. People experience illness but no pathological basis for the symptoms can be discerned by the medical profession. Living without a clinical diagnosis or medical explanation has consequences for such patients. This paper reports on a small qualitative interview-based study of 18 neurology outpatients in England who live with such medically unexplained symptoms (MUS). The findings broadly concur with those identified in the related literatures on medically unexplained syndromes and unexplained pain: the difficulties of living with uncertainty; dealing with legitimacy; and a resistance to psychological explanations of their suffering. From a thematic analysis of the interview data we identify and elaborate on three related issues, which we refer to as: 'morality'; 'chaos'; and 'ambivalence'. Although this article presents empirical data its aim is primarily conceptual; it integrates the findings of the empirical analysis with the existing literature in order to try to make some sociological sense of the emergent themes by drawing on sociological and cultural analyses of risk and the body. We draw on Bauman's concept of ambivalence to suggest that the very processes associated with more precise 'problem solving' and 'classification' do, in fact, generate even more uncertainty and anxiety. On the one hand, we seek closure and certainty and yet this leaves no means of living with uncertainty. Indeed, society does not readily grant permission to be ill in the absence of disease. We conclude by suggesting that an appreciation of the experience of such embodied doubt articulated by people who live with MUS may have a more general applicability to the analysis of social life under conditions of late modernity. (c) 2005 Elsevier Ltd. All rights reserved.

KW - medically unexplained symptoms

KW - body

KW - ambivalence

KW - uncertainty

KW - risk

KW - UK

KW - CHRONIC BACK-PAIN

KW - PHYSICAL SYMPTOMS

KW - ILLNESS

KW - ENCOUNTER

KW - DISEASE

KW - UNCERTAINTY

KW - MANAGEMENT

KW - CHALLENGE

KW - ACCOUNT

KW - THERAPY

U2 - 10.1016/j.socscimed.2005.07.030

DO - 10.1016/j.socscimed.2005.07.030

M3 - Article

VL - 62

SP - 1167

EP - 1178

JO - Social Science & Medicine

JF - Social Science & Medicine

SN - 0277-9536

IS - 5

ER -