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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 l.jpg

Deviance and Stigma.

Dr Dominic Upton

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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.

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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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  • 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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  • 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.

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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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  • 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.