Paper short abstract:

Patients with MUS endure sufferings of two kinds. Their physical symptoms cause them pain and distress reaching into daily life and psychological well-being and the primary care agenda and the system of social welfare create sufferings that affect the construction of identity and body.

Paper long abstract:

Being ill and seeking treatment always involves a relationship between the patient and the doctor that is characterized by a certain degree of hierarchy, mostly leading to acknowledgement and recognition of a sick role. Patients with medically unexplained symptoms (MUS), however, experience marginality and lack of recognition when seeking treatment, because of their illness behavior as well as their actual sufferings, which are difficult to categorize and diagnose.

For almost two years I have followed and interviewed 10 informants who were sampled from family practice and who at the onset of the study had a recent symptom history of MUS. The focus of the study is the social construction of illness behavior as a social process. My results point to both different ways of understanding illness and to different processes of developing identities and strategies in life, but also to various experiences of being subordinated, delegitimized and marginalized as an individual person. This experience is most often presented as an unambiguous experience of an embodied illness but also refers strongly to the power of institutional authority.

In this paper I wish to argue that the patients with MUS endure sufferings of two different kinds, although interrelated. First their physical symptoms experience cause them pain, uneasiness and distress reaching into their family life, economy and psychological well-being. Second the practices, procedures and norms exhibited by and implemented through primary care and the system of social welfare contribute with sufferings which affect the construction of identity and body.