1. Symbolic Interaction: A Theoretical Approach to Understanding Stigma & Recovery Jim Roe

2. Overview How Symbolic Interaction can be used as a contemporary method to identify ways in which Mental Health Practices inadvertently contribute towards the disabled self. Background: The Medical Model Changes in recent policy & practice Stigma Symbolic Interaction

3. The Medical Model Medical Model  Diagnosable symptoms  Expert/specialist to diagnose  Biological framework as an explanation  Expert/specialist to repair Implications - Maddux (2008)  Causes lie within the individual not environment  Understanding comes from the individual not interactions

4. However... Maddux: Illness ideology  Emphasis on weakness and sickness  Dichotomy of normal and abnormal behaviours  ‘Patient’ as a passive victim  No control – require expert attention & care Neglect for the meaning of illness  Individual  Social group

5. Focus of NHS Policy Reducing & controlling symptoms Optimal levels of autonomy & citizenship (Recovery)

6. Stigma & Labelling Significant impact on recovery  Diagnostic labelling  The abnormal individual  Perceptions of dangerousness  Social disruption  Relationship troubles  Self-stigmatisation  Perceived personal responsibility  Self worth, aspirations and capabilities

7. Symbolic Interactionism Origins in Pragmatist thought (Mead) Blumer (1969) Individuals act towards things based on meaning Meanings derived from social interaction Meanings modified through social interaction Little recent research Implicit in early sociological work by Goffman, Szasz & Rosenhan

8. The Implications Individuals’ actions, reactions and interactions central to analysis First person accounts Reflective process Observations of the processes of social interactions

9. The Benefits Focus on micro-processes Service Users and Professional Staff First person accounts Meanings Patterns of behaviour and communication Reconstruction of subjective worlds

10. The Questions What are the underlying meanings of service users’ needs, risks and potential? How are therapeutic interactions governed by these meanings? What are the effects of these interactions on the recovery process in terms of stigma and harm? What are the sources of this underlying harm?

11. In Summary Symbolic Interaction is a way to understand how the self is created and therefore understand how contemporary practices & conventions inadvertently contribute towards the disabled self.

12. Symbolic Interaction: A Theoretical Approach to Understanding Stigma & Recovery Jim Roe