In Episode 67, we explored how Andrew Abbott’s The System of Professions: An Essay on the Division of Expert Labor (1989) re-shaped the study of professions by bringing a systemic focus on how multiple groups vie for jurisdictional control of social problems. Besides offering a new paradigm and concepts for generations of scholars, the book also provides some case studies that showcase how these dynamics work out in practice. While the previous episode focused on the more conceptual aspects of the book, in this episode, we cover the third case study on the jurisdiction of “personal problems.” This is a timely conversation in light of the mental health crises that has gripped many nations during and following the COVID-19 pandemic.
In “The Construction of the Personal Problems Jurisdiction,” Abbott chronicles how social changes from the Industrial Revolution led to the ‘maladjustment’ and isolation felt by many individuals who could no longer reach back to the stable social structure from whence they came. As a result, several professions emerged and competed for jurisdiction over the diagnosis and treatment of such “personal problems.” Over the course of a century, some of these professions would dominate while others disappeared or withdrew.
Abbott’s examination covers initial competition between the clergy—who were ill equipped for professional work outside salvation—and the neurologists who slowly and haphazardly formed a variety of diagnoses and treatments. Then came the psychiatrists who migrated from state institutions for the insane and later the psychotherapists who operationalized Freud’s foundational work to build a whole profession backed by scientific discourse, academic institutions, growing numbers of clients, and public acceptance. Throughout, Abbott presents the story agnostically, trying to pay attention to the contingencies of the process. For example, he considers some of the (failed) attempts of other professions, including “gynecological neurology” and several later attempts by various clergical groups trying to reassert their perceived roles in helping people.
While the case examines these processes until the 1970s, professional competition both within the personal problems jurisdiction and around the social context (e.g., insurance standards and public funding) continued to shape the availability and quality of mental health care to the present day. In this changing landscape, social stigmas against those seeking mental health care seems to be have waned and the consequences of failing to identify and treat mental illness are recognized to be far greater. Still, the cost and lack of access to care has also led to alternative, mostly non-professional, approaches to dealing with personal problems. Grounded on Abbott’s work, we consider some of these dynamics in a time of technological changes and increasing challenges to professions and their expertise.
You may also download the audio files here: Part 1 | Part 2 | Supplement
Read with us:
Abbott, A. (1989). The system of professions: An essay on the division of expert labor. University of Chicago Press.
To Learn More:
Eyal, G. (2019). The crisis of expertise. John Wiley & Sons.
Eyal, G. (2013). For a sociology of expertise: The social origins of the autism epidemic. American Journal of Sociology, 118(4), 863-907.
Fish, S. (1985). Anti-professionalism. Cardozo L. Rev., 7, 645.
Gorman, E. H., & Sandefur, R. L. (2011). “Golden age,” quiescence, and revival: how the sociology of professions became the study of knowledge-based work. Work and Occupations, 38(3), 275-302.
Pakarinen, P., & Huising, R. (2023). Relational Expertise: What Machines Can’t Know. Journal of Management Studies.
Other Episodes Referenced from Talking About Organizations:
Episode 67. Professions and Professionalism — Andrew Abbott
