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Deviance and Stigma.

Deviance and Stigma. Dr Dominic Upton. Some background. Norms : “The do’s and don’ts” of social life. Deviancy : Non-conformity to a norm or set of norms Hence, is socially and culturally constructed. . Entry into the sick role. Physicians serve as gatekeepers into the sick role.

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Deviance and Stigma.

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  1. Deviance and Stigma. Dr Dominic Upton

  2. Some background. • Norms: “The do’s and don’ts” of social life. • Deviancy: Non-conformity to a norm or set of norms • Hence, is socially and culturally constructed.

  3. Entry into the sick role. • Physicians serve as gatekeepers into the sick role. • Physicians have both a collective and individual right to attach labels to people. • Labels can have a serious and unwelcome consequence for the patient.

  4. Link? • So being labelled “sick” or “ill” is different from the norm, and hence can be classified as “deviant”. • Physicians label people as “sick”, “ill”, and hence “deviant”.

  5. Different forms of deviance. • Primary deviance: Occurs when someone has been labelled as abnormal. • Secondary deviance: When a behaviour changes as a result of label. • Master status: Deviant comes to dominate and push other roles into background. • Cultural stereotyping: “Deviant”/ill people are expected to act in a certain way- so they do.

  6. Stigma • Characteristics that has led to a person becoming “reduced” or “tainted” in other people’s views. • If there is a difference between the expected identity and the reality then stigma occurs.

  7. Why are some conditions stigmatising? • Conditions that set their possessors apart from “normal” people that mark them as socially unacceptable. • Varies according to: visibility, “know-about-ness”, “obtrusiveness” and “the perceived focus”.

  8. Living with a stigmatising condition. • “Discredited”: those whose stigma is immediately apparent. • “Discreditable”: those whose condition is not immediately apparent and are only potentially stigmatising. • Responses differs since • Discredited: direct attempt to correct the failing. • Discreditable: manage information

  9. Dealing with stigmatising conditions: Passing. • Pass oneself off without acknowledging symptoms. Obviously differs between illnesses. • May involve a high psychological cost: “the cloaks that they think protect them are in reality such tattered and transparent garments that they reveal their wearers in their naked incompetence” (Edgerton, 1971)

  10. Dealing with stigmatising conditions: Normalisation. • Maintain generally expected social interactions and relationships, despite the socially acknowledged presence of a symptoms.

  11. Dealing with stigmatising conditions: Disassociation. • Process of socially acknowledging a symptom, but withdrawing from generally expected social interactions and relationships into a social world where others have similar or related symptoms.

  12. Scambler (1989) • Enacted stigma • Felt stigma • Found that felt stigma was greater than enacted stigma.

  13. In practice. • Number of other deviant groups: • Elderly • Homosexual • Ethnic minorities • Handicapped • Obesity • And so on…

  14. Stigma and obesity. • Crandall (1994): coined the term “fatism”.

  15. Fat people are seen as… • Unattractive (Harris et al, 1982) • Aesthetically displeasing (Wooley and Wooley, 1979) • Morally and emotionally impaired (Keys, 1958) • Alienated from their sexuality (Millman, 1980)  • Discontent with themselves (Rodin et al, 1984) • Weak willed (Menello and Mayer, 1963) • Degenerate (Crandall and Biernat, 1990)

  16. Fat people… • Are not hired (Roe and Eickwert, 1976) • Discriminated against (Rothblum et al, 1990) • Not promoted (Larkin and Pines, 1979) • Do not attend college (Canning and Mayer, 1966) • In lower social class (Sobal and Stunkard, 1989)

  17. What about professionals? Holding a negative attitude: • Physicians (Price at al, 1987) • Medical students (Blumberg and Mellis, 1985) • Counsellors (Kaplan, 1982) • Nurses (Peternelj-Taylor, 1989) • Dietitians/Nutritionists??

  18. Sobal (1991) • “Stigma is like the weather: everybody is talking about it but nobody is doing anything about it”

  19. Sobal (1991): A four component model. • Recognition • Readiness • Reaction • Repair

  20. 1. Recognition. • Development of awareness that obesity is stigmatised. • Gaining insight, information, and understanding about stigma.

  21. 2. Readiness • Anticipating settings and people involved in stigmatisation. • Preparation for stigmatising acts. • Prevention of stigmatisation by information/exposure control.

  22. 3. Reaction • Immediate coping with stigmatising acts • Longer term coping with stigmatising acts

  23. 4. Repair • Repair of problems from stigmatising acts. • Recovery from problems resulting from stigmatisation. • Restitution and compensation from stigmatisation. • Reform of stigmatising actions and values of others.

  24. Implications. • Provides guidance on how to cope with stigma. • May extend to others within the family. • Uses sociological models for the benefit of patients/medical professionals. • Can be used for other conditions.

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