construction


 * What can it mean that biology and society are constructed?: An account of severe depression in working class London women**

Consider the challenge of explaining some human behavioral characteristic, such as IQ, aggression, schizophrenia, sexuality, a food preference, and so on. The conventional wisdom is that nature and nurture interact to produce behaviors, just as they do for other human characteristics. It goes something like this: "We are not yet sure how much is genetic, how much is environmental; it will probably turn out to be some of both. Only extremists, motivated by some political agenda, insist that behaviors are 100% genetic or 100% environmental." Since the 1980s, however, the genetic contribution has been on the ascendant. The Minnesota study of twins raised apart, which eliminated many of the methodological shortcomings of earlier studies, has promoted the view that many behaviors have a more substantial genetic basis than previously thoughtÑdivorce rates, male homosexuality, depression, and many more (Bouchard et al. 1990; McGue and Lykken 1992). The possibility of molecular biology discovering genetic markers for various conditions has further enhanced the behavioral genetics program (Aldhous 1992) and strengthened the dichotomy of genetic versus environmental determination.

A less well known body of research, initiated by the British sociologists Brown and Harris in the 1960s, has interpreted the social origins of mental illnesses in a way that undercuts this genes-environment dichotomization. This research suggests how apportioning behavior to genes or environment might not, at least for those seeking to reduce the incidence of mental illness, be very helpful. To see how this follows, let me sketch their explanation of acute depression in working-class women in London (Brown and Harris 1978, 1989). I will also work in the extensions of their findings made by Bowlby, a psychologist who focused on the long term effects of different patterns of attachment of infants and young children to their mothers (Bowlby 1988).

Four factors are identified by Brown and Harris as disproportionately true of women with severe depression: a severe, adverse event in the year prior to the onset of depression; the lack of a supportive partner; persistently difficult living conditions; and the loss of, or prolonged separation from, the mother when the woman was a child (under the age of eleven). Bowlby interprets this last factor in terms of his and others' observations of secure versus anxious attachment of infants and young children to caregivers. In a situation of secure attachment the caregiver, usually the mother, is, in the child's early years, "readily available, sensitive to her child's signals, and lovingly responsive when [the child] seeks protection and/or comfort and/or assistance" (Bowlby 1988, p. 167). The child more boldly explores the world, confident that support when needed will be available from others. Anxious attachment, on the other hand, corresponds to inconsistency in, or lack of, supportive responses. The child is anxious in its explorations of the world, which can, in turn, evoke erratic responses from caregivers, and the subsequent attempt by the child to get by without the support of others.



The three strands of figure 1.1 (class, family, psychology) combine the observations above to explain the onset of serious depression. The factors are not separate contributing causes, like spokes on a wheel (figure 1.2), but take their place in the multistranded life course of the individual. Each line should be interpreted as one contributing causal link in the development of the behavior. The lines are dashed, however, to moderate any implied determinism; the links, while common, do not apply to all women at all times, and are contingent on background conditions not shown in the diagram. For example, in a society in which women are expected to be the primary caregivers for children (a background condition), the loss of a mother increases the chances of, or is linked to, the child's lacking consistent, reliable support for at least some period. Given the dominance of men over women and the social ideal of a heterosexual nuclear family, an adolescent girl in a disrupted family or custodial institution would be likely to see a marriage or partnership with a man as a positive alternative, even though early marriages tend to break up more easily. In a society of restricted class mobility, working-class origins tend to lead to working-class adulthood, in which living conditions are more difficult, especially if a woman has children to look after and provide for on her own. In many such ways these family, class, and psychological strands of the woman's life build on each other.

Suppose now, quite hypothetically, that certain genes, expressed in the body's chemistry, predispose a child to being more anxious in attachment compared to other children, even those within the same family. Suppose also that this inborn biochemistry (or the subsequent biochemical changes corresponding to the anxiety) renders the child more susceptible to the biochemical shifts that are associated with depression. (This hypothetical situation is depicted in the bottom strand of figure 1.3.) It is conceivable that early genetic or biochemical diagnosis followed by lifelong treatment with prophylactic antidepressants could reduce the chances of onset of severe depression. This might be true without any other action to ameliorate the effects of loss of mother, working-class living conditions, and so on. There are, however, many other readily conceivable interventions to reduce the chances of onset of depression, for example, counseling adolescent girls with low self-esteem, quickly acting to ensure a reliable caregiver when a mother dies or is hospitalized, making custodial institutions or foster care arrangements more humane, increasing the availability of contraceptives for adolescents, increasing state support for single mothers, and so on. If the goal is reduction in the incidence of severe depression for working-class women, the unchangeability of the hypothetical inherited genes says nothing about the most effective, economical, or otherwise socially desirable intervention (or combinations of interventions) to pursue.

This account of the origins of acute depression in working-class women displays most of the features I associate with the idea that something is constructed: Many different kinds of components are linked together over time, each step building on what has already been constructed. This implies that: The outcome has multiple contributing causes, and thus: There are multiple points of intervention or engagement that could modify the course of development.

Deterministic accounts, in contrast, tend in the opposite direction: The links between proposed causes and outcome are direct, e.g., severe depression is a biochemical imbalance. Few steps are involved in the construction and a single kind or small number of causes dominate. Few opportunities arise for things to have happened differently, in particular, social policy will not be able to change the outcome greatly.

In future chapters we will contrast constructionist with interactionist explanations as well, and we will apply a constructionist perspective to areas of biology proper, not just to issues of biology and society. Summary of Propositions and Open Questions

[insert Ps & OQs] Captions Figure 1.1 Adapted from Bowlby (1988, p. 177). His schema is, in turn, adapted from Brown and Harris (1978, p. 265). Figure 1.2 Multiple factors impinging on the outcome, displayed without reference to the process of development over time. Figure 1.3 Hypothetical genetic/biochemical strand added by this author. Literature Cited Aldhous, Peter. 1992. "The Promise and Pitfalls of Molecular Genetics." Science 257:164Ð65. Bouchard, Thomas J., David T. Lykken, Matt McGue, A. Tellegen, and N. Segal. 1990. "Sources of Human Psychological Differences: The Minnesota Study of Twins Reared Apart." Science 250:223Ð28. Bowlby, John. 1988. A Secure Base. New York: Basic. Brown, George W., and Tirril Harris. 1978. Social Origins of Depression. New York: Free Press. 1989. Life Events and Illness. New York: Guilford.