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OnWords: Done With Dis-Ease

European Commission DG ECHO

My work in the mental health field has brought me into contact with a lot of disease. I mean this not just in the sense of diagnosis, but also in the sense of dis-ease: those things that put us ill at ease.

The proliferation of new disease categories, such as generalized anxiety disorder, with the publication of the new Diagnostic and Statistical Manual is actually quite controversial within the field. But it points to an uncomfortable idea: disease, rather than referring to something out there in the world, is actually a social construct.

But wait, you say, isn’t it all just a matter of viruses and germs and chemical imbalances and such? Well, not really. Disease categories are ways of describing the effects of those things. So the presence of e-coli bacteria in your gut is not called disease; it’s called digestion. That same bacteria becomes a form of disease when it’s found elsewhere in your body.

Taken literally, it’s the difference between the ease of good digestion and the dis-ease of a bad infection.

Thus, we can also see that disease embodies not only personal distress but social fear—fear both for and of the diseased person.

This also helps explain why using disease categories to describe emotional distress has, according to a recent study led by Bernice Pescosolido, actually caused more stigma and discrimination, not less. When we say that words have power, this is exactly what we mean: by labeling people as diseases, they cease being people at all.

Lael Ewy is a co-founder and editor of EastWesterly Review, a journal of literary satire at www.postmodernvillage.com, and a writer whose work has appeared in such venues as Denver Quarterly and New Orleans Review and has been anthologized in Troubles Swapped for Something Fresh.