1. 1 Stigma & Dirt DISABILITY & SOCIETY: Introduction to Disability Studies Oct 10, 2006 Week 3, Session 4

2. 2 Mental “Illness” At the start of the 20th century there were only a dozen recognized mental illnesses. By 1952 there were 192 and the Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition (DSM-IV) today lists 374.20th centuryDiagnostic and Statistical Manual of Mental Disorder, Fourth Edition

3. 3 DSM-IV definition: “Although this manual provides a classification of mental disorders, it must be admitted that no definition adequately specifies precise boundaries for the concept of ‘mental disorder.’”

4. 4 DSM-IVDSM-IV : Oppositional Defiant Disorder: 313.81 If a child's problem behaviors involve a pattern of defiant, angry, antagonistic, hostile, irritable, or vindictive - this mental disorder of childhood may be diagnosed. These children may blame others for their problems.irritablemental disorder Diagnostic criteria: A. A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present:  (1) often loses temper  (2) often argues with adults  (3) often actively defies or refuses to comply with adults' requests or rules  (4) often deliberately annoys people  (5) often blames others for his or her mistakes or misbehavior

5. 5 DSM-IVDSM-IV : Oppositional Defiant Disorder:  (6) is often touchy or easily annoyed by others  (7) is often angry and resentful  (8) is often spiteful or vindictive  Note: Consider a criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level.  B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.  C. The behaviors do not occur exclusively during the course of a Psychotic or Mood Disorder.  Reprinted from the Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994 American Psychiatric Association

6. 6 20 th C US history: medical model to normalize, segregate, create dependency  See historian Paul Longmore, Why I Burned My Book  Warehousing since 1850s Mental “illness”: By 1850, 55 asylums - ~ 45,000 ''known insane persons” by 1900, 328 institutions - ~ 200,000 patients (1930 shock therapy, lobotomy; 1952 drug Thorazine)  peaked in 1955 at ~ 560,000

7. 7 Columbus Ohio State Hospital – Until the Pentagon – Largest Building

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9. 9 In 1936, Walter Freeman performed his first lobotomy operation. Inserting an ordinary ice pick above each eye of a patient with only local anesthetic, drive it through the thin bone with a light tap of a mallet, swish the pick back and forth like a windshield wiper and - a formerly difficult patient is now passive. Used it for everything - psychosis to depression to neurosis to criminality. He developed assembly line lobotomies, going from one patient to the next with his gold- plated ice pick. Between 1939 and 1951, over 18,000 lobotomies were performed in the US, and many more in other countries. It was often used on convicts, and in Japan, it was recommended for use on “difficult” children. The old USSR banned it back in the 1940s on moral grounds! In the 1950s protests began. The general statistics = ~ a third of lobotomy patients improved, a third stayed the same, and the last third actually got worse! Francis Farmer, an eccentric actress, was committed to Western State hospital. Rosemary Kennedy, sister to John, Robert, and Edward Kennedy, was given a lobotomy when her father complained about the mildly retarded girl’s embarrassing new interest in boys. Her father never informed the rest of the family about what he had done. She lived out her life in a Wisconsin institution and died January 7, 2005, at the age of 86. Her sister, Eunice Kennedy Shriver, founded the Special Olympics in her honor in 1968.

10. 10 Life Magazine "Bedlam 1946" Philadelphia State Hospital, known as Byberry, originally built in 1912. Byberry has been investigated so many times that in 1987, an 18-member task force decided to close the hospital in the interest of the patients. The hospital officially closed its doors in 1990. http://www.abandonedasylum.com/psh1.html http://www.abandonedasylum.com/psh1.html

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12. 12 "Bedlam 1946" by Albert Q. Maisel, Life Magazine (5/6/46)

13. 13 Byberry: "Four hundred patients were herded into this barn-like dayroom intended for only 80. There were only a few benches; most of the men had to stand all day or sit on the splintery floor. There was no supervised recreation, no occupational therapy.. Only two attendants were on this ward; at least 10 were needed." (the Shame of the States, Albert Deutsch)

14. 14 This is the bed-jammed corridor of Ward N-7, for female patients, at Bellevue Hospital as sketched by Eric Godal immediately after a personal tour in the summer of 1947. City Hospitals Commissioner, Edward M. Bernecker, refused permission to take photographs inside the hospital, so Godal sketched this drawing. (the Shame of the States)

15. 15 "Bedlam 1946" by Albert Q. Maisel, Life Magazine (5/6/46)

16. 16 "Bedlam 1946" by Albert Q. Maisel, Life Magazine (5/6/46)

17. 17 "Bedlam 1946" by Albert Q. Maisel, Life Magazine (5/6/46)

18. 18 Time Line (cont) 1952 Thorazine – 1 st Major Psych Drug 1950s-1970s Deinstitutionalization State Institutions 1972 The appalling conditions at Willowbrook State School in New York City for people with developmental disabilities are exposed as the result of a television broadcast by Geraldo Rivera from the facility. (POP ~5,700)

19. 19 PERSONAL TRAGEDY

20. 20 I. Stigma & the Individual Stigma Power Stigma Management  Discreditable - information control  Discredited - tension management -(Simulations)- II. Society & the “Other” Douglas  Concept of Dirt  5 Ways Cultures deal with “dirt”

21. 21 STIGMA: STIGMA: The “Spoiled Identity” Viewed Less Than Fully Human WHY STUDY STIGMA?

22. 22 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

23. 23 Questions?? Does Human Society always requires an “Other”? How Is the “Other” Determined? How Can “Othering” be Challenged? How is being a DP Different from Other Minority Groups?

24. 24 WHERE / HOW DOES STIGMA GET IT’S POWER? Acceptance of the Devalued State = SHAME

25. 25 Goffman cripple, moron, handicapped, idiot, Specific Stigma Terms: cripple, moron, handicapped, idiot, etc Generalize to WHOLE Person: Expected to up hold the Generalization

26. 26 Goffman: Stigma Management Discreditable: information control- ("to tell or not to tell, ….to lie or not to lie, …. to whom, when and where." ) Discredited: tension management – (attempts to control awkward, difficult or hostile interactions with "the normals.")

27. 27 Discreditable (Management of Information) Passing: Objective: minimize detection or disclosure (FDR)  1. Conceal stigma symbols  2. Play down the defect  3. Distancing (social, physical, emotional)

28. 28 Discredited (Management of Tension) 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; One handed baseball player Aggressiveness / Deviance  1. “The dramatically presented preposterous explanation”  2. “The attack.”

29. 29 The International Center for Limb Lengthening, Sinai Hospital of Baltimore

30. 30 Other Responses to Stigma Attempt to Directly Correct 1. Overcoming:  Celebrated in Modern Culture 2. Victimization: Learned Helplessness 3. Avoidence: Isolation / Passing  Hypervigilance; “The Stare” 4. Re-assessment: Limitations of “normals”  Disability Pride; Deaf Culture

31. 31 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

32. 32 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!

33. 33 Gill: Differences from Other Minority Groups 1. Public perceptions of Disabled People- a confusing mix of conflicting emotions  Fear, Pity, Charity, Disgust 2. Stigma can be superficially linked to impairments 3. Lack of “Safe Havens“ 4. Socialized as “normal” Gill, “Divided Understandings,” Handbook of Disability Studies, Albretch, et al 2000

34. 34 What is Stigmatized =Reflection of Society

35. 35 EXAMPLES  What is stigmatized now that was not 60 years ago?  What was stigmatized 60 years ago that is not now?

36. 36 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

37. 37 Simulations

38. 38 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 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 ) http://www.local6.com/news/8345157/detail.html

39. 39 'Daddy, the only thing I found out today is I don't want to be Jewish,‘ http://www.local6.com/news/8345157/detail.html

40. 40 Douglas 1966 Concept of Dirt / “Matter out of Place.” How Societies Groups or Deals with Ambiguous Margins. Dirt is an Anomaly - A DiscordantElement Purity & Danger: An Analysis of Concepts of Pollution and Taboo (1966)

41. 41 Douglas 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

42. 42 Douglas 5 Ways Cultures deal with “dirt”: 1.Reduce Ambiguity (Fuzziness of Otherness) by Creating dichotomies. 2.Elimination. 3.Avoidance 4.Label as dangerous. 5.Incorporating into ritual.

43. 43 1. Reduce Ambiguity Create Dichotomies: Disabled / Non-Disabled; Gay / Straight Child / Adult That which Defies Classification Especially Troublesome to Society: Transvestites, Mulattos, Part Timers, Passers, Multiple Impairments

44. 44 2. Elimination Eugenics Holocaust War Prenatal Testing Human Genome Project Death Penalty

45. 45 3. Avoidance OR Strengthen dirty status: Ugly Laws Not-In-My-Neighborhood Special Education Suburban Flight Prisons Asylums

46. 46 4. Label as Dangerous Bodies / Minds Out of Control Epilepsy Hallucinations Disturb the complex web of subtle exchanges

47. 47 5. Incorporate Into Ritual Special Olympics Charity / Telethons

48. 48 Summary I. Stigma & the Individual Stigma Power Stigma Management  Discreditable - information control  Discredited - tension management -(Simulations)- II. Society & the “Other” Douglas  Concept of Dirt  5 Ways Cultures deal with “dirt”