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Erving Goffman (1963, p. 3) was the man who originally described stigmatization as it applied to different situations. In his book titled Stigma: Noted on the Management of Spoilt Identity, he was able to define stigma and explain the way it applied and affected the stigmatized people.
This book was the pioneer of a profuse research about the disease’s nature, the causes, implication on the victim and the impact of stigma. Since the seminal essay of Goffman’s studies on stigma, research on the same issue has been very productive. Consequently the studies provide a number of important elaborations, continual expression and fine-tuning of the concepts that related to stigma and the mental health patients.
Literally, the concept of stigma can be applied to different scores of situations ranging from mental illness, urinary incontinence, pregnancy outside marriage, lesbianism, being in debt and even foreign dancing!. Amidst this profusion of investigation and studies, it is imperative to understand why the stigma concept exists, why it still has implications on mentally ill people, explore its effects pervasiveness and persistence on mentally ill people.
The term stigma had been in use since ancient times referring to mark left by pricking. This was initially adapted to mark slaves and identify them as having a lower social status in the society. The same has been transferred into modern world to people suffering different conditions.
The terms were originally and officially defined by Goffman in 1963 as the attribute which deeply discredits an individual or a group of people (Goffman 1963, p. 3). The issue of stigmatization has been of particular interest to the sociologists, since its impact causes significant loss to the victims especially the social status where stigmatization is evident.
Actually, Bruce Link and Jo Phelan, 2001, note that the consequences are the immediate aftermath of negative labelling and prejudice. In most cases the loss of social status quo is a downward placement of an individual (Link & Phelan 2001, p. 371). Researchers have observed that the impact of that kind of loss also leads to loss of jobs, housing, and even breaking of a marriage (Link et al 2004, p. 511).
Link and Phelan (2001), notes that the reason why a person would discriminate another is because of inadequate explanation of the consequences of the stigmatization, (p. 372). First, prejudice on an individual happens because of blatant rejection of the stigmatized people.
Second, the organization and the daily patterns of the social institutions describe structural discrimination and then reduce the chances of the stigmatized people to advance (Goffman 1963, p. 3). Third, stigmatization could be manifest via social-psychological processes happening in the life of the victims. For instance, self-esteem is greatly affected (Link & Phelan 2001, p. 274).
Concept of Stigma
The study of the stigmatization is often faced with some hitches especially of the exhaustive description of the concept of stigmatization. Most of the investigators prefer to use the Goffman’s description and the idea that this reduces the status of a person to a lower level individual (Goffman 1963, p. 4).
There are five presumptions of the important to understand basically a biological issue, the problems of the disabled are because of the disability, the disabled individual is victimized, the disability is a core concept in the definition and the presence of the disability is synonymous with requiring assistance of social support (Corrigan et al. 2002).
The phenomenon of stigmatization was explored by Goffman where he mentioned physical deformities, medical conditions, behaviours of certain kind, prejudice against a tribe, and religion among other things (Goffman 1963, p. 6). Individuals who possess stigmatizing characteristics could face problems of respect, consideration and acceptance.
Mental health is the most prejudiced condition and it has undergone extensive research where most of the projects have sought to explore the occurrence of the problems and the reason why there is so much stigmatization against it (Goffman, 1963, p. 7). However, not much has been researched concerning how the victims actually deal with this form of prejudice.
Communication with the mental health suffers and survivors show that the issues are not sufficiently dealt with. The stigmatized individuals on the other hand talk of having experienced very painful conditions when they are excluded, despised, rejected and separated in a number of day-to-day encounters (Link et al. 2004, p. 511).
Even though many people talk of their friends, family members, colleagues, neighbours and bosses, these stories mostly point at the mental health service system as the main cause of then discrimination (Link et al. 2004, p. 511). Even with all these, there is still very little concerning the victims survival tactics.
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How Labelled People Handle the Situations
Some progress has been made concerning the elimination of stigma of mental sickness on the victims. The cause of the stigma initially comes with labelling. The mentally sick people have often been referred to as ‘psychos’ or ‘schizos’. Sometimes the labelling extends to jokes even on television referring to these people as ‘loony bins’ and so on.
However, when one is actually suffering some form of mental sickness, then these works are not just jokes or gimmicks, rather they are perpetuating the stigma related to the mental health condition (Link & Phelan 2001, p. 375). The individual feels ashamed and very emotionally hurt. Even so, there are some ways that these prejudiced individuals use to cope.
Stigma can make an individual hungry or upset and it can still result in misunderstanding from the public with regard to this medical condition. Stigma is putting a mark on an individual with mental illness as in this context (Link & Phelan 2001, p. 377). Therefore any stereotyping, calling of names, creating some divisions and excluding from some groups based on their condition amounts to discrimination and therefore stigmatization.
It has been observed that while people may not find it easy to mock a person suffering from some form of disease like breast cancers, they easily tend to ridicule mentally ill people often and they find it very funny. Stigma against the men tally sick versus the physically handicapped is evident.
The term mental illness itself is an indication that the medical condition is not in the physical body but the brain. Therefore some people do not take it as a legitimate condition therefore they do not regard is on the same level as the physical illness. Rather they look at it as a choice by an individual based on their actions.
The sick people are blamed for allowing the condition in their heads. In reality, the problem is caused by very complex factors and in most cases they range from the combination of genetics, the physiology make up of the person and the life experiences. Most of these conditions are beyond the control of the individuals.
To survive these prejudice, the stigmatized individual resort to a number of options that help them to survive and eliminated the stigma. Some people usually accept the label as being called ‘Psycho’ or ‘loony’ or any other label for that matter (Heitzeg 1996, p. 350).
As a result they adopt to live with these negative names and they are accepted in the society as insane people and hence they feel the stigma is reduced. Many people choose this alternative so as to reduce the rejection in the society or to try and reduce discrimination (Heitzeg 1996, p. 350). This tactic draws less attention to them and they survive the world.
Goffman suggest that the stigmatized individuals could respond to the same situation in different ways. The response is based on individual beliefs. Some could even act in certain ways to show stigmatization by the mere fact that they believe they have a problem (Oetzel et al. 2006, p. 117).
Some people could even try to pass or to conceal their problem from other people and the society at large so that they appear to be ‘normal’. Other people on the other hand, some people could attempt top “cover” or reduce the significance of the condition they are facing (Williams & Healy 2001, p. 112).
There are some cases where the stigmatized persons choose to reject the discrimination from the society especially the negative discrimination and then they redefine the discrimination in a positive way (Williams & Healy 2001, p. 112). They in turn show pride and show off the stigma to be seen by everyone instead of hiding their condition from the public.
For instance, a person who has ever suffered from mental illness and is now stigmatized by the idea that once crazy always crazy could take up a more activist role by leading and organisation that fights for the rights of mentally ill people (Heitzeg 1996, p. 356).
Or on the other hand such an individual can take up the role of educating the public concerning the condition by giving presentations to the community, various organizations and so on. This education strategy can help the society to understand the condition better and how to deal with the condition. As a result, they can be able to provide more supportive roles (Heitzeg 1996, p. 356).
Being labelled is a problem in the society especially when the society makes the label to be a very negative condition. The label affects socialization of the people and they get social isolation to a point that they can even fail to find marriage partners in life. The stigmatized individuals tend to keep away from the active societal participation so that they do not expose they deficiencies (Thompson et al. 2004, p. 530).
As a result, they are often passive community or society members and they can silently suffer the stereotyping or the discriminatory behaviour. For instance, many theories on how people relate show that their relationships only come from or are instigated by physical and other external factors of which individual have no control over. Sometimes the impact of illness can affect crucial bodily function like reducing the sexual functioning when the individual perceive that they will always face rejection (Hinshaw & Stier 2008 p. 371).
Stigmatized individuals are able to develop survival strategies which include adaptation where they intentionally withdraw from other people so that they can protect themselves from situations that can cause identity threats (Phillips et al. 2002, p. 492). People suffering from mental illnesses on average have been found to also suffer depression and very low self esteem compared to the normal population. Because of isolation, they also suffer lack of social skills of which they can develop good relationships with others (Satche, 2000, p. 32).
Many people suffering mental illness often manifest by showing misplaced or irrational fear of others. Because of the problems, these people are not able to maintain relationships, they isolate themselves, they cannot easily adapt to change and they suffer emotionally progressively. However, those who adapt positively to the condition, they are able to overcome the stigma and become even prominent people and educators and activists. They grow their self esteem and get empowered by being mentally ill.
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