2. Stigma & Identity Models
April 8th, 2010

3. Agenda I. Stereotypes – more examples
II. Simulations & Destigmatizing(?)
III. Stigma & the Individual
IV. Society & the “Other”
_ Hofstede
Cultural Differences
“Onion Diagram”
Douglas
Concept of Dirt
5 Ways Cultures deal with “dirt”
V. Disability Models and Artifact Example

4. Stereotype Examples Tropic Thunder
Burger King Commercial “The King’s Gone Crazy”

6. Nike Air Dri-Goat Print Ad (cir. 2000)
"Right about now you're probably asking yourself, 'How can a trail running shoe with an outer sole designed like a goat's hoof help me avoid compressing my spinal cord into a Slinky on the side of some unsuspecting conifer, thereby rendering me a drooling, misshapen non-extreme-running husk of my former self, forced to roam the earth in a motorized wheelchair with my name embossed on one of those cute little license plates you get at carnivals or state fairs, fastened to the back?”
Boycott
600 complaints within the first couple of days
Subsequent Apologies

7. Simulations & Destigmatizing(?)
Any experience with Simulations/Disability Awareness events?

8. Simulations & Destigmatizing
Several parents in Apopka, Fla., are upset over a surprise school "Holocaust" project according to a Local 6 News report. (teachers divided the school's 440 eighth-graders by last names, issuing yellow stars to those whose names begin with L–Z )

9. 8th Graders Other students were privileged,
“last names L through Z were given yellow five-pointed stars for Holocaust Remembrance Day.
Other students were privileged,
Students were forced to stand in the back of the classroom and not allowed to sit.
Were forced to go to the back of the lunch line four times by an administrator.
"They were told that they could not use the water fountains,
“if you're wearing a yellow star , you can't use this water fountain."

10. 'Daddy, the only thing I found out today is I don't want to be Jewish,‘

11. STIGMA: The “Spoiled Identity” (Interpersonal interactions management)
Goffman
STIGMA: The “Spoiled Identity”
(Interpersonal interactions management)

12. Stigma: The Experience of Disability -1966; Paul Hunt (UK)
collection of articles:
“challenged the standard preoccupation with the medical and personal 'suffering' experienced by individuals with an impairment.”
“a direct 'challenge' to commonly held societal values: 'as unfortunate, useless, different, oppressed and sick.‘”
From A Critical Condition (Chapter 12 in Hunt. P. (ed.) 1966: Stigma: The Experience of Disability, London: Geoffrey Chapman)

13. WHAT IS STIGMA’S PURPOSE?

14. Example
Susan Boyle

15. Example

16. “Drive stupid and score some kickin‘ new wheels.”
Nothing’s cooler than the day you get your drivers license. But, as soon as you start driving stupid , it’s not so cool anymore. Texting, using your iPod, racing, they all fall under the category of stupid. And dangerous. ….. Nothing kills more Utah teens than auto crashes. Not fazed? Ok, how does spending the rest of your life in a wheelchair grab you?....”

17. WHAT IS STIGMA’S PURPOSE?
Allows us to deal with: “Anticipated others with out special attention or thought.”
Who’s “IN”/Who’s “OUT”
Helps Categorize & Manage Multiple Stimuli

18. WHERE / HOW DOES STIGMA GET ITS POWER?

19. Acceptance of the Devalued State
SHAME
Acceptance of the Devalued State

20. Globalization
Specific Stigma Terms: cripple, moron, handicapped, idiot, etc
Generalize to WHOLE Person:
Expected to up hold the Generalization

21. (Don’t want to be “found out.”)
Stigma Management
I) Information control(Discreditable)
“PASSING”
(hiding the stigma)
(Don’t want to be “found out.”)
"to tell or not to tell, ….to lie or not to lie, …. to whom, when and where."

22. Passing Objective: minimize detection or disclosure
1. Conceal stigma symbols (FDR)
2. Play down the defect
3. Distancing (social, physical, emotional)

23. Can not “Hide” the Mark(s)
Stigma Management
II) Tension management (Discredited)
“Covering;” “Aggressiveness / Deviance”
(reducing its significance)
Can not “Hide” the Mark(s)
attempts to control awkward, difficult or hostile interactions with "the normals."

24. “Covering”
1. Use of devices to cover the stigma - Surgery (Only results in Record of Correcting) 2. Engage in activities from which normally be disqualified - Being President (FDR)?; One handed baseball player?; - John Hockenberry?

25. The International Center for Limb Lengthening, Sinai Hospital of Baltimore

26. Limb Lengthening Surgery
Example
Limb Lengthening Surgery

27. Tyra Banks on Asian Eyelid Surgery
Example
Tyra Banks on Asian Eyelid Surgery

28. II) Tension management (cont)
“Aggressiveness / Deviance”
“The dramatically presented preposterous explanation”
2. “The attack.”

29. Other Responses to Stigma
Attempt to Directly Correct:
1. Overcoming:
Celebrated in Modern Culture
2. Victimization: Learned Helplessness
Institutionalization Effect
3. Avoidance: Isolation
Hypervigilance; “The Stare”
4. Re-assessment: Limitations of “normals”
Disability Pride; Deaf Culture

30. Goffman: Natural History of the Stigma Experience
1. Acquiring the standpoint of normal
2. Recognize the Stigma
3. “Affiliation Cycles”
4. Group Reinforcement
5. Discovering Humanness

31. Goffman My Favorite Quote
“Each potential source of discomfort…can become something we sense he is aware of, aware that we are aware of, and even aware of our state of awareness, about his awareness…”
ALWAYS ON!

32. 1940’s What is stigmatized now that was not 60 years ago?
What was stigmatized 60 years ago that is not now?

33. Can be a very rapid process: Japanese Americans
Stigma
Can be a very rapid process: Japanese Americans
Destigmatizing:
Usually a gradual process taking years / decades
Our Culture Reinforces Stigma through it’s Obsession with Rank Orderings

34. Society & the “Other” Hofstede - 1994 Cultural Differences
“Onion Diagram”
Douglas
Concept of Dirt
5 Ways Cultures deal with “dirt”

35. Geert Hofstede’s “Onion Diagram” (1997)
Symbols
Words, clothing, hairstyles, jargon, flags, accent
Heroes
Role models with behavioral characteristics that are prized in a culture. Alive or dead, real or imaginary
sport, music, or movie stars, politicians and historical people, cartoon heroes, people from one’s own family (e.g. one’s own father or mother)
Rituals
Collective activities, ie. greetings, ceremonies
Values
The “core” of culture, implicitly learned so early in our development that we don’t even realize it
Evil vs. good, dirty vs. clean, unnatural vs. natural, ugly vs. beautiful, abnormal vs. normal, irrational vs. rational, paradoxical vs. logical
symbols
heroes
rituals
values
practices

36. Hofstede
Everybody looks at the world through their own lens, people from “other” cultures have something special about them, but what we have experienced ourselves is normal (home)
“Uncertainty Avoidance”
“…the extent to which the members of a culture feel threatened by uncertain or unknown situations”
What is different is wrong

37. Mary Douglas - Concept of Dirt
“Matter out of Place.”
How Societies Groups or Deals with
Ambiguous Margins.
Who’s in - Who’s out
Dirt is an Anomaly - A Discordant
Element
Purity & Danger: An Analysis of Concepts of Pollution and Taboo (1966)

38. Argues that ambiguity proves difficult
Culture involves classification, dirt is disorder, = breakdown of classification, boundaries are ambiguous or confused.
There no absolute form of dirt

39. 5 Ways Cultures deal with “dirt”
Reduce Ambiguity (Fuzziness of Otherness) by Creating dichotomies.
Elimination
Avoidance
Label as dangerous
Incorporating into ritual

40. 1. Reduce Ambiguity Create Dichotomies: Disabled / Non-Disabled;
Gay / Straight
Child / Adult
Male / Female

41. That which Defies Classification Especially Troublesome to Society
Transvestites, Mulattos, Part Timers, Intersex, Passers, Multiple Impairments

42. 2. Elimination Eugenics Holocaust War Prenatal Testing
Human Genome Project
Death Penalty

43. 3. Avoidance OR Strengthen dirty status
Ugly Laws
Not-In-My-Neighborhood
Special Education
Prisons
Asylums

44. 4. Label as Dangerous Bodies / Minds Out of Control Epilepsy
Hallucinations
Disturb the complex web of subtle exchanges

45. 5. Incorporate
Into Ritual: Special Olympics Charity / Telethons

46. Questions?

47. What is
Impairment?

48. Some Ways to Understand Disability
Disability Models
Some Ways to Understand Disability
Two Groupings:
The problem is the INDIVIDUAL
The problem is Society (Social Model)

49. *Some, if not most, of the time
INDIVIDUAL MODELS*
Focus is on the Individual as the Problem
- Medical Model
- Moral Model
Personal Tragedy Model
*Some, if not most, of the time
hard to separate out as distinct models

50. Medicalization of the INDIVIDUAL Body/Mind MEDICAL MODEL
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)
International Statistical Classification of Diseases and Related Health Problems (ICD)
International Classification of Functioning, Disability, and Health (ICF)

51. Michel Foucault’s analysis of “biopower”
Medical-scientific knowledge claims and solutions to the “problem” of disability (e.g. madness diagnoses).
how we conceive of the meaning of "disability“ has enormous practical, social, and legal effects, reframing and urging one conception of disability over another is deeply and fundamentally connected to power structures

52. Statistical bell curve (1835) invented in the era of efficiency, progress, eugenics
Statistics created “the tyranny of the norm,” really the ideal.
Statistician Francis Galton founded the eugenics program of eliminating deviations from the norm (in one direction only).
Before the 1700’s “Normal” did not exist in language

53. Sara Baartman, exhibited in Europe as Hottentot Venus, died 1815, dissected & displayed

54. IQ testing 1905 invented by Alfred Binet.
“abnormal” children can be educated.
1910s US psychologists corrupt this goal.
Mental testing industry.
Hereditary / Eugenics
Measure & label & institutionalize.
“Menace” to society.
Moron – imbecile – idiot scale.
By 1920, 328 institutions, with 200,000 people labeled mentally impaired.

55. From segregation to prevention of “unfit” births = the eugenics movement 1900-1940
Social costs, burden of supporting the “feebleminded” and their offspring.
vs. desirable traits = white, middle-class norms…
US sterilizes 60,000 people in institutions.

56. “Ugly Laws”
Early 1900's – 1970’s it was illegal to be "found ugly" on the streets of many American cities like Chicago, Illinois Omaha, Nebraska and Columbus, Ohio. Punishment for being caught in public ranged from incarceration to fines.
“No person who is diseased, maimed, or in any way deformed so as to be an unsightly or disgusting object is to be allowed in or on the public ways or other places in the city. If such a person exposes himself to public view, he shall be subject to a fine for each offense.” Chicago ordinance

57. Eugenics
1920 “The Permission to Destroy Life Unworthy of Life,” Germany. Karl Binding , a lawyer, & Alfred Hoche, a psychiatrist.
1927 Buck v. Bell United States Supreme Court upheld the concept of eugenic sterilization for people considered genetically "unfit." Oliver Wendell Holmes, Jr., stated: "Three generations of imbeciles are enough.“
Upheld Virginia's sterilization statute which provided for similar laws in 30 states, under which an estimated 65,000 Americans were sterilized without their own consent

58. US Set the Example
Nazi Germany -between , 375,000 people in Germany sterilized
1939 T4 program – Start of Germany’s Euthanasia program ~275,000 Disabled People murdered.

59. Medical Model? Americans with Disabilities Act – ADA 1990
(1) has a physical or mental impairment that substantially limits a major life activity,
(2) has a record of such an impairment, or
(3) is regarded as having such an impairment.

60. Evaluation of the concept of MENTAL ILLNESS
Subjective, shifting, contested assumptions/examination?
There are no objective diagnostic tests
“biomedical assumption that there are clear boundaries between diseases and between the sick and healthy.”
Psychiatric survivors movement since 1970s.
Argue that their differences are not helpfully categorized or treated as impairments.
Insiders’ POV; narratives of living with bodily/mental difference.
Sick or criminal? Problems of deinstitutionalization.
Newly invented disabilities (and treatments)
Social anxiety disorder

61. WHO, ICF 2001 Disability : outcome or result of a complex
relationship between an individual’s:
health condition
personal factors
external factors
“…retains individualistic medical notions
of disability and its causes.” P15 Disability: A Choice of Models; Barnes & Mercer

62. Example
Forrest Gump

63. Moralizing the INDIVIDUAL Body/Mind MORAL MODEL Two Parts I)Religious and Spiritual origin II) Character weakness

64. Moral Model I)Religious and Spiritual origin
Punishment from God (ie: due to displeasure)
Evil spirits (possessed)
Witchcraft
Bad Karma (did something evil in the past)
Gift from God (cross to bear, angelic)

65. Moral Model (cont.) II) Character weakness:
Examples: villains in movies, refrigerator mothers, lazy, faking, unmotivated
Medicine tends to blame individual character when cause is unknown.

66. Tragedy of the INDIVIDUAL Body/ Mind PERSONAL TRAGEDY MODEL
Disability is considered a tragedy
Society needs to take care of / protect persons with disabilities
Examples: inspiration news story, telethons, charities

67. Example
Blondie Brings Up Baby (1939)

68. SOCIAL MODEL Examining Society
Instead of disability originating within the person, disability originates from society
Disability results from society, (Ableism), and the environment:
Physical barriers
Attitudinal barriers
Political/Policy barriers

69. Social Model – Origins (Britain) Union of Physically Impaired Against Segregation
UPIAS definitions of impairment and disability, 1976:
• Impairment: Lacking part or all of a limb, or having a defective limb, organ or mechanism of the body.
• Disability: The disadvantage or restriction of activity
caused by a contemporary social organization which
takes no or little account of people who have physical
impairments and thus excludes them from participation
in the mainstream of social activities

70. SOCIAL MODEL
Many Ways to “Emphasize” what it is about Society that Creates Disability

71. Social Model Variants – UK Marxist and materialist interpretation of Society
The historical convergence of industrialization and capitalism as restricting impaired people’s access to material and social goods, which results in their economic dependency and creates the category of disability
Social Creation: Does not suggest solutions; Does not include those “successful” in Capitalist system; ideology (a social theory of disability would include impairment; social model of impairment is needed)
“…disablement is nothing to do with the body. It is a consequence of the failure of
social organization to take account of the differing needs of disabled people and remove the barriers they encounter. The schema does not, however, deny the reality of impairment nor that it is closely related to the physical body. Under this schema impairment is, in fact, nothing less than a description of the physical body.” & “`As the conditions of capitalist production changed in the twentieth century, so the labour needs of capital shifted from a mass of unskilled workers to a more limited need of skilled ones. As a result of this, the Welfare State arose as a means of ensuring the supply of skill, and in order to "pacify" the ever increasing army of the unemployed, the under-employed and the unemployable‘ & “…Vasey (1992) has already pointed out, the collectivising of experiences of impairment is a much more difficult task than collectivising the experience of disability.
‘…disabling culture’ of contemporary capitalism, they refer to an ensemble of materially-evident relations and representations, including political economic systems. Central to the materialist account is a spatio-temporal focus on changing ‘modes of production’; for example, the shift from feudal to capitalist society and the associated rise of commodity relations and exchange.
Oliver, M. 1996; ‘Exploring the Divide’, edited by Colin Barnes and Geof
Mercer, Leeds: The Disability Press, 1996, pp. 55 – 72).

72. Social Model Variants – US Society’s Culture & Attitudes
Assumes that inappropriate and discriminatory social attitudes and cultural phenomena are the central problem for people with impairments
Social Construction:
DISABILITY AND MATERIALIST
EMBODIMENT
Mike Clear and Brendan Gleeson
JOURNAL OF AUSTRALIAN POLITICAL ECONOMY No 49

73. Social Model Variants - Minority
Political based used to counter discrimination and advocate for Civil Rights – Primarily US
disABILITY identity / Pride / Culture

74. Social Model Variants – Independent Living Model (ILM)
States that current sociopolitical structures produce access barriers for and dependency in impaired people resulting in disability
is based on a consumer driven movement that fosters autonomy, self-help and the removal of societal barriers and disincentives

75. Social Model Variants – Human Variation
Universal Design
re-think design= The built environment; economic, social, cultural, and political entities including organizations that provide employment, education, health care, transportation, communication, and the full range of public services.
Human Variation:

76. Social Model Variants – Dismodern Theory
L. Davis
Sees imperfection as the norm
Normal is a fairly new term…

77. Social Model – Summary
disability is restricted activity (caused by social barriers)
2. disability is a form of social oppression
3. disability is created by categorizing bodies/minds as normal or abnormal

78. Example
Gig Harbor Wheelchair Dancer

79. Continued Seattle Times staff reporter March 31st, 2010 GIG HARBOR -
Gig Harbor dancer incorporates her wheelchair into her routine Gig Harbor dancer Andrea Jerabek incorporates her wheelchair into her routine and encourages the disabled to become dancers Integrate<! dance has grown tremendously""", 20 years, say dancers By Nancy Bartley
Seattle Times staff reporter March 31st, 2010
GIG HARBOR -
She warms up in the studio, body lithe, elastic as she stretches before the wall of mirrors_ Then the music heats up and she's balanced on one leg, the other extended_ An arm forms an arc above her head before she sweeps low, touching her wheelchair_ Then she's spinning and flying, incorporating the wheels into her pattern of dance_Andrea Jerabek's passion for the art began long ago when she was a little girl in pink tights pattering across the polished wood floor of the dance studio in New York, where she could almost forget the deformed foot that in the future would be both a curse and a blessing. She decided 10 have it amputated in 2005 eliminate the constant pain, and now uses a wheelchair or a prosthetic Ieg_Today, Jerabek, 42, and a social worker, is an ambassador for integrated dance, which often blends disabled people, their support equipment and sometimes able-bodied dancers in performance_It's an art that's grown tremendously since Mary Verdi-Fletcher of Cleveland, created The Dancing Wheels Company, believed to be the nation's first integrated dance company, 30 years ago_ Charlene Curtiss and JoAnne Petrol/founded Seattle's Light Motion Dance Company in the late 1980.

80. What About Impairment?
Initially: Social model tries to breaks the bio-medical chain of causation:
Impairment Disability
Why was this strategically important to DRM (Disability Rights Movement)?

81. (But I am Blind, Have pain, Different!)
ISSUES: While the social model redefines “disability,” it stops short of questioning the status of “impairment”
Minimizes the experience of impairments
(But I am Blind, Have pain, Different!)

82. Others: impairment should not be taken as simply a “natural state”
Some disability studies work challenges whether impairment is just biological. (Disability/Postmodernity, eds. Corker & Shakespeare).
Carol Thomas: impairments are “shaped by the interaction of biological and social factors, and are bound up with processes of socio-cultural naming.”

83. WHY CARE? How Disability Is Defined Determines What Is Measured
= Allocation Of Resources

84. EXAMPLES Social Security Disability Insurance
University of Washington Accomodations
World Bank
Oregon
In 1989, passed legislation rationing health care to all state residents who were on Medicaid.
World Bank: The Lancet in July, 1993, reported that the World Bank (WB) is now moving into first place as the global agency most influencing health policy. Since 1980 the World Bank’s involvement in heath had faced bitter criticism but this could not change its basic approach towards the health sector. WB and International Monetary Fund (IMF) had espoused Structural Adjustment Programme (SAP) with debt for the third world countries. In order to meet the requirements of debt, SAP dictates a number of measures in policy decisions in these countries.
It directs cuts in public spending on health, education and other social services.
Removal of subsidies and lifting of price controls on food and other basic commodities. Amitava Guha
Oregon: “…developed prioritized lists of condition-and-treatment pairs and then ranked these in three basic categories: essential (treatments that prevent death, such as appendectomy for appendicitis), very important (treatments for nonfatal conditions that would return a patient to a previous state of health, such as hip replacements or cornea transplants), and valuable to certain individuals (treatments for fatal or nonfatal conditions that would not extend or improve the quality of life, such as treatment for the end stages of cancer or AIDS). Condition and-treatment pairs were then ranked according to importance within each of these three basic categories.” Had to abandon strict cost-effectiveness calculations produced rankings that were counter-intuitive and seemingly absurd
In the original list, for instance, the insertion of dental caps was ranked higher than surgery for ectopic pregnancy (a condition which is fatal without surgery).
The commission developed prioritized lists of condition-and-treatment pairs and then ranked these in three basic categories: essential (treatments that prevent death, such as appendectomy for appendicitis), very important (treatments for nonfatal conditions that would return a patient to a previous state of health, such as hip replacements or cornea transplants), and valuable to certain individuals (treatments for fatal or nonfatal conditions that would not extend or improve the quality of life, such as treatment for the end stages of cancer or AIDS). Condition and-treatment pairs were then ranked according to importance within each of these three basic categories. Working with budget imperatives, the Oregon state legislature established cutoff lines on the ranked list below which no services would be covered. While this plan has followed John Stuart Mill's dictum of "the greatest good for the greatest number" by allowing Oregon to provide health care access to a larger percentage of citizens, it has raised a number of other questions: If we are to ration health care based on whether it improves quality of life rather than on biologic outcome, what method do we use to evaluate that? Do treatment prioritizations based on quality of life disadvantage the disabled? Are refusals to provide medical care based on cost-effective rankings ethical? Health Care Reform in the States by Susan Moke

85. Models – Summary Problem is the Individual Problem is with Society
Medical
Moral
Personal Tragedy
Problem is with Society
Social Model & its variants

86. Examples Lady Gaga (Youtube) YouTube – We R Society (UK)
Picture
YouTube – We R Society (UK)
Artifact Example