PSYC 3000 Reflection 9- Epistemology and Social Constructionism

Using and understanding language feels like second nature. Social constructionism

challenged this second nature, demanding academics to ponder their verbal realities. This week

in class, Burr and Durheim helped the class understand how social constructionism and how it

applied to numerous psychological branches. However, I wondered how social constructionism

applied to clinical psychology, since language and pathology often go hand in hand. Using the

following guiding questions, social constructionism in clinical psychology will be observed and

critiqued though the lens of autism spectrum disorder (ASD):

1) How has social constructionism influenced clinical psychology’s inherent paternalism?

2) How can social constructionism move psychology away from overpathologization?

For context, social constructionism is defined by Durheim is a theory of knowledge which

highlights social, historical, and collective natures of the human consciousness. Social

constructionism posits that many characteristics typically thought to be biological like ability are

instead shaped by social contexts and human interaction. I noticed social constructionism tied

directly into Richard’s discussion of paternalism in psychology. To recap, paternalism is when

people in authoritative positions restrict freedom or autonomy of people in positions of lower

power. If in clinical psychology, the practitioner is authoritative, and the client is the passive

receiver of service. Therefore, socially constructed ideals around the psychologist-patient

relationship bred paternalism, intentionally or not, within the therapeutic agreement.

To further elaborate on this point I will mention an essay I wrote last semester called,

“Pathologizing Autism Spectrum Disorder (ASD): The Hidden Stigmatization in Defining

Abnormality”. In it, I mention how ideals of psychological “normality” are socially constructed,

which in turn causes frequent misdiagnosis and therapeutic mistreatment for adults with ASD.
Within the diagnostic criteria of ASD, the word “abnormal” reoccurs to signal how

neurodivergent body language, communication, and interests deviate from the socially

constructed “normal”. Language, given by the practitioner for the patient, has merit. Therapeutic

and diagnostic language has implications for both the patient and the paternalistic practitioner.

For the patient, language like “you are (or are not) neurotypical” has real-life implications,

like Burr pointed out. In my essay I noted how adults diagnosed with ASD find it socially helpful

to camouflage their neurodivergent behaviours to better fit-in with the socially constructed

psychological “normal”. As for the practitioner, they may misdiagnose or mistreat the patient. I

stated in my past essay that 50% of therapists believed people with ASD tended to be aggressive

to others. That is a false generalization of neurodivergent people. However, education gaps

pertaining ASD often go unchecked because academic titles influence paternalistic “all-

knowing” beliefs in the practitioner. The words “licenced psychiatrist” and “licenced

psychologist” are titles, words holding recognized social merit or action. The title claims they are

knowledgeable; the social actions are diagnosis and prescription.

I showed how socially constructed norms can influence paternalism in the industry.

However, social constructionism can move the discipline form overpathologization as well.

Social constructionism posits that words create reality; therefore, social constructionists believe

neurodivergence was invented, not discovered. Burr claims from the social constructionist

perspective, what people regard as truth varies historically and cross-culturally to understand the

world. In westernized 21st century clinical psychology, words like “abnormal” are frequently

used in the DSM-5 diagnostic criteria for ASD. The word “abnormal” originated from centuries

of media conditioning in plays, writing, or otherwise. This influenced people to understand

“normality” as a lack of “abnormality” in a western society prioritizing order and uniformity.

 Simply by gaining awareness of the origin of terminology and diagnoses, psychology can

move away from excessive medical pathologization. Previous academics have pointed out that

some diagnoses are entirely social constructs, challenging clinical psychology. Moving away

from pathologization has its drawbacks and strengths. On one hand, overpathologization may

induce “learned helplessness” of the patient. If they self-identify has having a psychological

diagnosis, they could risk losing self-esteem. For example, if a person is diagnosed with ASD

and jobless, they may think they cannot find work since they are labelled “neurodivergent”. This

example is extreme, but thoughts influence words, which influence action, or lack thereof. On

the other hand, pathologization and labelling can help people with ASD find social supports or

community. For example, provincial financial supports are provided to specifically aid

neurodivergent people, since only 33% of Canadian autistic adults are employed. People with

ASD may also find comfort in building community with fellow neurodivergent people.

The objective of this work was to observe and critique social constructionism in clinical

psychology. Burr stated social constructionism relocates psychology from the pathologized,

essentialist sphere of clinical psychology. I believe this to be a partial truth because social

constructionism may just as well direct the discipline towards pathologization. Words have

merit, and language evolves. All psychology may hope for is that academic terminology evolves

in a sense which strives toward education, universality, and medical equity.