The Labelling Theory

This week I thought id talk about a possible explanation of schizophrenia, the labelling theory.

Schizophrenia is a chronic, severe, and disabling brain disorder that features positive (not as in good, but a change or increase) and negative symptoms, ranging from hallucinations to social withdrawal. There are many explanations, but in this research task, I’ll be focusing on the labelling theory which was promoted by Scheff in 1966. He believed schizophrenia is the result of learning that escape to an inner world is rewarding; individuals who have been labelled as schizophrenic then continue to act in ways that conform to the label. Bizarre behaviour is rewarded with attention and sympathy, which is known as secondary gain. Early experience of punishment may lead children to retreat into a rewarding inner world. This causes society to label them as odd, individuals who’ve been labelled in this way may continue to act in ways that conform to this label.

Strange behaviour labelled as odd,secondary gain (rewarded with attention), behaviour is then exaggerated=labelled as schizophrenic.

This theory states social groups create the concept of psychiatric deviance (schizophrenia) by constructing rules for group members to follow. Thus the symptoms of schizophrenia are seen as deviating from the rules that we attribute to ‘normal’ behaviour. Therefore those who display unusual behaviour are considered as deviant and the label Schizophrenic may be applied, which becomes a self fulfilling prophecy that promotes the development of other symptoms of schizophrenia.

Therefore, if society sees mentally ill individuals as unpredictable, dangerous and reliant on others, then a person, who may not actually be mentally ill but has been labelled as such, could become mentally ill. The assumption is that we’re born with a blank slate, there’s a lot of emphasis on experiences and interactions we have with the environment, this is what forms our behaviour. Behaviourists’ studies show that schizophrenia is due to conditioning and observational learning and that people show schizophrenic behaviour when they are more likely to be reinforced. Ullman and Krasmer in 1969 said that staff in hospitals reinforced schizophrenic behaviour in their patients by paying more attention to those who display characteristics of the disorder. The patients see that if they disobey the staff and play up, the staff will make a fuss over them. This theory believes all behaviour can be explained in terms of conditioning theory. (Stimulus and response links that build up to produce more complex behaviour) there’s an absence of conscious thoughts.

 David Rosenhan explored this theory and criticised psychiatric diagnoses in his famous study ‘Being  sane in insane places’. This involved the use of healthy associates or “pseudo patients” who complained of auditory hallucinations in an attempt to gain admission to 12 different psychiatric hospitals. All were admitted and diagnosed with psychiatric disorders. After admission, the pseudo patients acted normally and told staff that they felt fine and had not experienced any more hallucinations. Hospital staff failed to detect a single pseudo patient, and instead believed that all of the pseudo patients exhibited symptoms of ongoing mental illness. The second part involved asking staff at a psychiatric hospital to detect non-existent “fake” patients. The staff falsely identified large numbers of genuine patients as impostors. The study concluded, “It is clear that we cannot distinguish the sane from the insane in psychiatric hospitals” and also illustrated the dangers of depersonalization and labelling in psychiatric institutions. It suggested that the use of community mental health facilities which concentrated on specific problems and behaviours rather than psychiatric labels might be a solution and recommended education to make psychiatric workers more aware of the social psychology of their facilities. This study showed odd behaviour was labelled as schizophrenic and these individuals would be admitted if their symptoms were known. This supports the labelling theory, as people labelled as schizophrenics would believe this professional opinion and may show symptoms of schizophrenia, retrospectively the diagnosis would then be regarded as correct. The wardens perceived the pseudo patients normal behaviour as psychotic due to the label. This shows diagnoses aren’t reliable; they were labelled due to behaviour which deviates from what society regards as ‘normal’. It agrees odd behaviour leads to being labelled ‘odd’ which then leads to labels of being ‘schizophrenic’ but it doesn’t necessarily agree that the label causes schizophrenia.

Strengths of thelabelling theory could be that:

Operant conditioning is a fundamental part of psychological explanations.

A large number of successful applications derived from this theory, behavioural theory is clearly successful for mental disorders such as phobias.

It lends itself to scientific research, focuses on observable and measurable behaviours, things that can be quantified and controlled. Broadbent (1961) believed behaviourism is the best method for rational advance in psychology.

The success of token economies offers modest support. (Institutionalised patients are given tokens as secondary reinforces, to promote socially desirable behaviour, the tokens are then exchanged for primary reinforces like food.) This shows that positive reinforcement encourages them to live to a label of acting appropriately according to society’s norms.

Weaknesses of the labelling theory could be that it:

Ignores genetic evidence, many argue it trivialises such a complex disorder.

Ignores conscious thoughts/motivation and significant life events which may have been a factor in developing schizophrenia.

Deterministic, Bandura argued that is action’s were determined solely by rewards and punishments, people would behave like weather vanes. (constantly changing)

http://www.nhs.uk/Conditions/Schizophrenia/Pages/Symptoms.aspx