Deviance and Stigma.

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Deviance and Stigma.

• Dr Dominic Upton

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Some background.

• Norms The dos and donts of social life.
• Deviancy Non-conformity to a norm or set of
  norms
• Hence, is socially and culturally constructed.

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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.

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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.

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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.

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Stigma

• Characteristics that has led to a person becoming
  reduced or tainted in other peoples views.
• If there is a difference between the expected
  identity and the reality then stigma occurs.

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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.

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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

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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)

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Dealing with stigmatising conditions
Normalisation.

• Maintain generally expected social interactions
  and relationships, despite the socially
  acknowledged presence of a symptoms.

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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.

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Scambler (1989)

• Enacted stigma
• Felt stigma
• Found that felt stigma was greater than enacted
  stigma.

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In practice.

• Number of other deviant groups
• Elderly
• Homosexual
• Ethnic minorities
• Handicapped
• Obesity
• And so on

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Stigma and obesity.

• Crandall (1994) coined the term fatism.

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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)

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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)

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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??

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Sobal (1991)

• Stigma is like the weather everybody is talking
  about it but nobody is doing anything about it

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Sobal (1991) A four component model.

• Recognition
• Readiness
• Reaction
• Repair

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1. Recognition.

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

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2. Readiness

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

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3. Reaction

• Immediate coping with stigmatising acts
• Longer term coping with stigmatising acts

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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.

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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.