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The sociocultural approach to abnormality looks no within the individual but out to the wider social context in which
the individual exists.
Labelling
Thomas Szasz (1979) said that labelling someone with a mental illness is nothing more than the ‘medicalisation of
madness’. He argues that using medical terms such as ‘treatment’, ‘illness’ and ‘diagnosis’ is a form of social control
that robs individuals of their freedom. Giving the label of mental illness excludes those individuals who do not
conform to our social and cultural norms
Scheff (1966) said that schizophrenia is a ‘learned social role’ determined by the process of labelling. His labelling
theory proposes that an individual who breaks one or more residual rules is assigned a label of ‘mentally ill’ (or
‘schizophrenic’). This label influences the individual to behave in a manner that fits the label (based on the
stereotype they hold) but also determines how others react to the behaviour of that individual.
Scheff believes that if we are diagnosed as mentally ill people begin to accept their new social role and find it difficult
to fit into normal society. Others find out about their illness, they may be unable to find work and, Scheff maintains
if they are hospitalised the attention they receive reinforces their perception and their expectations. The diagnosis
creates a self-fulfilling prophecy.
Rosenhan (1973) provides an example of how easy it is to receive a label and be ‘misdiagnosed’ as suffering from
schizophrenia
Aim: To investigate the reliability of diagnosing mental illness
Method: A group of 8 ‘pseudo-patients’ (pseudo=not genuine) free from psychological symptoms pretended they could hear an
unfamiliar voice (auditory hallucinations) which said ‘empty’ ‘hollow’ ‘thud’. All of the patients were admitted to hospital, seven
with the diagnosis ‘schizophrenia’. Once admitted patients behaved normally but reported a sense of powerlessness and fear.
All of their behaviour was interpreted by staff as ‘schizophrenic’.
Results: After admission to hospital the pseudo-patients struggled to convince staff they were sane. They were hospitalised for
between 7-52 days (average 19 days). ‘Normal’ behaviour was interpreted as ‘abnormal’ for example, a patient writing notes
was deemed to be showing ‘obsessive-compulsive writing behaviour’. Once labelled ‘schizophrenic’ the label stuck and the
patients were discharged with ‘schizophrenia in remission’
Conclusion: The unreliability of diagnosing mental illness was evident and patients were perceived according to the labels they
had been given.
Evaluation:
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This study and the follow-up helped to improve the reliability of diagnosis of schizophrenia. In those times it was less
well defined and much more commonly used as a ‘catch-all’ category
Rosenhan was criticised for being unethical and for deliberately misleading professionals
The study showed how a label can be difficult to change and does result in other people having expectations that we
will behave in ways consisten with the label. Perhaps schizophrenia is partly self-fulfilling as a result of the expectations
of others.
Generally, as argued by Scheff (1966) knowing somebody suffers from a psychiatric or psychological disorder creates a
stigma or feeling of social inadequacy in the person.
Overall evaluation
 The Rosenhan study helped to improve the reliability of diagnosis with the revision of the diagnostic criteria
(DSM-III, 1980). The study demonstrated that psychiatric labels tend to become self-fulfilling prophecies, and
that we begin to interpret behaviour in a way that ‘fits in’ with our pre-existing assumptions and beliefs
 Labelling theory only accounts for how symptoms are maintained, it does not explain the cause or offer any
kind of treatment
 Labelling theory ignores compelling genetic evidence
 Seriously ill individuals with a range of debilitating symptoms exist and require help, and labelling theory has
been criticised for trivialising a very serious disorder
EXTENSION
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Can you bring the debates in to make any valid evaluative comments?
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How can you COMPARE this explanation to the biological explanation which we have covered so far?