Theorizing health and illness: functionalism, subjectivity and reflexivity.

Health and illness in contemporary psychology are remarkably undertheorized, with the consequence that implicit definitions of these topics are unquestionably imported into health psychology. Largely inspired and oriented to the medical system, health psychology is often subservient to biomedically inspired theory or directed to solving the problems of the health care system, not those of its patients or those who might ultimately benefit from health knowledge. Qualitative approaches have attempted to reintroduce the voice of the patient/sufferer/individual back into health psychology but without adequate theoretical integration this work has been marginalized and ignored by mainstream health psychology in the service of medical modelling. The point is not to develop a health psychology as an exclusive disciplinary enclave but rather to open up the possibilities of a responsible knowing. Using Kathryn Addelson's work on professional knowing I argue that the collective activity that constitutes health psychology can be made more explicit not only by devising reflexive theories and practices but by focusing on what the outcomes of that activity might be. Functional theories of health and illness, on the other hand, obscure our epistemological and moral commitments.