Peter Conrad

Losing faith in your own singularity is the start of wisdom, I suppose; also the first announcement of death.

[T]here are no illnesses in nature, only relationships. There are, of course, naturally occurring events, including infectious viruses, malignant growths, ruptures of tissues, and unusual chromosome constellations, but these are not ipso facto illnesses. Without the social meaning that humans attach to them they do not constitute illness or disease: The fracture of a septuagenarian's femur has, within the world of nature, so more significance than the snapping of an autumn leaf from its twig; and the invasion of a human organism by cholera germs carries with it no more the stamp of "illness" than the souring of milk by other forms of bacteria. (Sedgwick, 1972, p. 211)

What each culture views as the cause of madness is dependent on its world view.

When a theological world view dominated, deviance was sin; when the nation-states emerged from the decay of feudalism, most deviance became designated as crime; and in our own scientifically oriented world, various forms of deviance are designated increasingly as medical problems. Thus we view the medical paradigm as the ascending paradigm for deviance designations in our postindustrial society.

Illnesses represent human judgments of conditions that exist in the natural world. They are essentially social constructions - products of our own creation.

...[D]eviance is an attributed designation rather than something inherent in individuals...

[S]ocial change is not clearly linear and rarely totally beneficial or detrimental. Social change nearly nearly always produces positive and negative effects that are distributed differentially in the affected population.

Public "facts" are not like pebbles on the beach, lying in the sun and waiting to be seen. They must instead be picked, polished, shaped and packaged. Finally ready for display they the bear the marks of their shapers.

A slow but steady transformation of deviance has taken place in American society. It has not been a change in behavior as such, but in how behavior is defined. Deviant behaviors that were once defined as immoral, sinful, or criminal have been given medical meanings. Some say that rehabilitation has replaced punishment, but in many cases medical treatments have become a new form of punishment and social control.

Reality" is defined not as something that exists "out there" for the scientist or anyone else to discover but as a social construction that emerges from and is sustained by social interaction.