Suffering and the Social Construction of Illness: The Delegitimation of Illness Experience in Chronic Fatigue Syndrome

Abstract

The author examines suffering engendered by the socially constituted nature of illness through the delegitimation of illness experience in chronic fatigue syndrome. Cultural meanings of physical and mental illness are shown to be reflected in interactions with others to construct an illness reality in which chronic fatigue syndrome is defined as either nonexistent or psychosomatic. Disconfirmation of the subjective experience of illness leads to suffering arising from the threatened stigma of psychological disorder, the alienation resulting from a decision to keep the illness secret, and the shame of being wrong in one's definition of reality. Patients also develop strategies for contesting the definition of chronic fatigue syndrome as “not real.” Delegitimation merits further exploration as a category for experience‐near analysis of suffering in medical anthropology.