Medicalisation is a term given to the process by which aspects of life hitherto considered ordinary or natural come to be seen as medical disorders. It can be benign. Ailments that a darker age viewed as  a sign of personal failings – insanity say – have lost their moral sting and are on their way to being as value-free as a dose of eczema. But there can be disadvantages. Medicalising a problem can also mean that responsibility for solving it is passed to doctors or, more worryingly for some, the pharmaceutical industry. While few would query the medicalising of schizophrenia, shyness might be a different matter. The recent on-line publishing of a draft of DSM-V, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders has introduced a number of potential new disorders, including binge eating and ‘temper dysregulation’. What a less scientific age might have called the sins of gluttony and wrath are on their way to being diagnosable disorders and, presumably, disorders that will invite pharmacological regulation. While the loss of moral opprobrium clinging to these conditions will please some, others will argue that an unintended consequence will be a loss of personal responsibility for behaviour. In your view, is the widening of the net of psychiatry a good thing?

The problem is that we are trying to medicalise prejudice rather than illness. We can discuss long and hrad what makes an illness an illness and whetherv that is the same as disease, but many of the so called illnesses mentioned are ways of society showing its disapproval. Homosexuality is a case in point. With the decline in religion in the latter part of the twentieth century , moral prohibition of homosexuality decreased and laws to legalise sexuality were passed. But with advent of AIDS, the undercurrent of moral prohibition returned with the depiction of 'innocent ' and 'guilty' victims. The problem with medicalisation is that it leads to responsibility and that leads to blame which in the cases of many problems such as obesity, smoking and alcohol abuse which are social problems requiring governments to take action, allows said authorities to wash their hands and avoid action. We turn the sins of society into the sins of the individual.

What we are seeing is not the description of disease but more society through the new religion of healthism showing its diapproval. History shows medicine has a long history of regarding behaviours as pathological only to change their minds later on with masturbation being a prime example. In the nineteenth century there was even a disease known as drapetomania (the intense need for a slave to run away).

Addiction is an interesting example. It raises the question of what is happening when a doctor makes a diagnosis. Is the word addiction merely another way of describing behaviour, or is it pointing to an underlying condition or disorder that gives rise to behaviour? Sex, if done right, is ordinarily considered one of life’s deep pleasures, and it is reasonable to expect that people will want more of it. As an instinctive drive it is also quite good at sidestepping our reasoning faculties – our passions can often make a fool of our better judgement. At what point then do we decide that ordinary human folly requires medical intervention? Just how dysfunctional does our behaviour have to be? And what is happening when we label a pattern of behaviour an addiction? The struggle between desire and reason ceases to be something that we all have to live and struggle with – and when we slip up, take responsibility for. Our inability to be guided by our better judgement becomes instead the expression of an underlying disorder for which we are not to blame. I am not sure these questions are solvable, but I think they should give us pause before we reach for the prescription pad.