Hi
I have heard psychiatrists several times in the media talk about ‘pathologies’ as in ‘dysfunctional cases/individuals’. I had not heard the term used that way before. It wasn’t use to mean the disease itself, but the diseased individual/case. Is it a misuse of the word? I have not found it in dictionaries. I hope someone can find this definition for me.
Pathology: The study of disease. Pathology has been defined as “that branch of medicine which treats of the essential nature of disease.” The word “pathology” comes from the Greek words “pathos” meaning “disease” and “logos” meaning “a treatise” = a treatise of disease. The word “pathology” is sometimes misused to mean disease as, for example, “he didn’t find any pathology” (meaning he found no evidence of disease). A medical doctor that specializes in pathology is called a pathologist. Pathologists are experts at interpreting microscopic views of body tissues.
a) If you have a pathological heart condition, you are a person with a mind and a personality and behaviors and plans and memories who happens to have a medically compromised heart. If you have adult-onset diabetes, you are a person with a mind and a personality and behaviors and plans and memories who happens to have a pancreatic insufficiency. But as a psychiatric patient, it is your mind, personality, behavior, plans, memories, etc, that are the basis of your diagnosis. Theoretically you’re still a person with a mind (etc etc) whose mental and emotional activity is only being interrupted in certain highly specific and narrowly defined areas defined as the locus of your mental illness, but in practice it doesn’t work that way: every thought, plan, action, choice, manifestion of personality, etc becomes evaluated as a potential symptom; everything that you are and do becomes shadowed by the likelihood of being perceived as “part of your illness”.
b) There are longstanding claims to there being a biological cause or correlating condition that is the actual illness – a “chemical imbalance” or a structural brain difference or some such thing – and your observed behavioral manifestations are just symptoms of that. These longstanding claims have no basis in research-corroborated fact though. In particular, there is no legitimacy to the “chemical imbalance” theory. The notion that mental illnesses are “chemical imbalances” was backwards-engineered from the belief that certain medications had such nice desirable outcomes (at least from the institutional point of view) that GEE, they must be directly addressing an insufficiency or overabundance or something like that, and that “something” is therefore the true mental illness that the medication is “fixing”. Turns out not to be true, but the claim continues to be made.
c) There is no physical test for “serum schizoprenerase levels” or an MRI that confirms your diagnosis as bipolar. All diagnoses are made on the basis of your observable behavior. See a) above.
Have to point out that, at least colloquially, this usage extends to organic diseases. E.g. “the appendix in bed 7” could refer to the person in bed 7 who is there because of an inflamed appendix.
The attitude which underlies this usage is of course deprecated in medical practice, but is still fairly widespread.
That’s not what AHunter3 was talking about. You’re talking about a shorthand, an ellision of “a patient with” which depending on whether the medic is or is not an asshole does mean they equate the person with the case or simply that they’re using a grammatical feature (the ability to skip over a part of the sentence which is given by context); he’s talking about the so-called-disease being the person’s very core. What he’s saying is, on one hand, that if someone is bipolar, authistic or schizophrenic (or pretty much anything from the DSM), the “cure” is equivalent to changing the person in ways in which fixing a broken bone does not; on the other hand, that there is an over-reliance on pharmacological solutions, a lot of emphasis on coming up with that person’s “magic pill” rather than with teaching them how to learn to be themselves in a healthy way.
Note: reinterpretation of AHunter3’s post does not, in this particular case, signify 100% endorsement, but I do agree with him partially and understand that in his case this is a very sore point.
Rhetoricians use “synecdoche” to describe when a part stands in for the whole (“the appendix in bed 7,” or “all hands on deck”) or when the whole stands for the part (“legal says we have to change the ad copy,” where “legal” refers to an attorney in the legal department.)
I agree with Nava that AHunter3 wasn’t using synecdoche when he asserted that the patient is the disease. Similarly, I’m not endorsing all or even much of that post’s contents, though I don’t have the context about that poster’s situation that Nava seems to (and I’m not really seeking it, either).
IME, it’s not limited to the medical field. I’ve heard (and used) technical issues described as pathological (which generally means “f*ck, the whole network environment is suffering from the same symptom… what the heck is causing it?”).
Often used phrases include: pathological liar (sorry, that’s not a disease - it’s a personality disorder that borders on psycho/sociopathic tendencies… but they’re both called pathologies); I’ve been diagnosed with a pathological spinal condition (doesn’t bother me too much, other than when I sleep; I get concerned if I wake up without back pain, and MRIs actually do show that it’s a bit messed up and getting worse).
The pathological term comes from it’s etymology: mid 17th century: from Greek pathos ‘suffering’; related to paskhein ‘suffer’ and penthos ‘grief’. These came from (mostly) Grecian languages.
So pathological depression, pathological pain, pathological societal suffering (makes me think of various parts of Europe after WWII) fit that bill.
It’s just a word. It has a meaning, but it’s adopted many more. Languages have a tendency to grow both more simple and complex (think of the old meme on how many ways to use the word f*ck in a sentence).
According to John Hodgman, specificity is the soul of narrative. I’d like to have the OP relate one or two specific examples of how ‘pathology(ies)’ was used to refer to individuals. “The pathology walked into my office”? “The bipolar disorder was refused a bank loan”? “The congressman is pathologic”? I’m not clear on what sort of usage the OP is questioning.