In his book, Stigma, Goffman (1963) insinuates that those dominating society, or the majority, establish categorizations of what is normal; those people that fail to meet normative attributions set by society are often discounted and discredited. These non-normative attributes constitute what is referred to as “stigma” (Goffman, 1963, p. 3). Goffman (1963) states that stigma is” an attribute that is deeply discrediting, but it should be seen that a language of relationships, not attributes, is really needed” ( p.3).
In Strategic Interaction Goffman (1969) suggests that in everyday life, individuals must interact with and through other individuals in pursuit of fulfilling their own needs and interests. Depending on the party, or person, individuals might be confronted with help or harm contingent upon the circumstance; this requires of individuals to orient themselves to their surroundings and exercise their own unique capacities (Goffman, 1969). Thus insinuating that before one orients to situational circumstances, they must consider information being provided to them by the other person (Goffman, 1969). These interactions differ for stigmatized people as they are often confronted with disrespect and disregard (Goffman, 1963). Goffman (1963) states that “the presence of normals is likely to reinforce this split between self-demands and self” (p.7). A vast number of Americans are diagnosed with a physical or mental disability each year, which is then compounded by their daily encounters with stigma due to societal denominations of “normality”. According to the U.S. Census Bureau (2010), approximately 56.7 billion Americans identify as having any disability. Of that number, 38.3 million identify as having a severe disability and 12.3 million of them aged six and older require assistance with activities of daily living (ADLs) and independent activities of daily living (IADLs) (U.S. Census Bureau, 2010). Millions of Americans are forced to orient to the dominant members of society, while also coping with the unique challenges associated with their disability. Specific to mental health, 48.3 million Americans experience mental illness in any given year due to a variety of factors; nearly 10 million adults live with a severe mental illness (National Alliance of Mental Illness (NAMI), 2015). Alarmingly 60% of adults living with mental illness did not receive treatment; many of them are over-represented in the prison population or living homeless without adequate resources (NAMI, 2015). Suicide is the tenth leading cause of death for American adults and research shows that 90% of people having completed suicide suffered from some sort of mental illness (NAMI, 2015). Childhood prevalence of mental illness is also incredibly prominent in the United States and research shows that 50% of lifetime cases begin by the age of 14 (NAMI, 2015). Approximately one in five children live with a mental illness and 20% of that population suffer from a severe mental illness. The average delay between onset of symptoms and therapeutic treatment, when it does occur, is roughly 10 years (NAMI, 2015). This creates an American dilemma as 50% of youth living with mental illness drop out of school and 70% are involved in the juvenile justice system (NAMI, 2015). Disturbingly, suicide is the second leading cause of death for youth over the age of 10 and 90% of those youth had a mental illness (NAMI, 2015). I cannot understand the stigmatized nature of disability both as a human being reading the aforementioned stats and as a social worker. I can speak to the unrelenting strength, creativity, ingenuity, and resilience of people living with disabilities as a youth therapist and in the past, a psychiatric social worker that served adults. The best way for me to confront stigma associated with persons having a disability is to tell a few stories. Names will be changed or withheld in order to protect the confidentiality of clients and friends who inspired me through our acquaintance. As a sophomore in college, I established a dear friendship with a young man who suddenly became blind during his freshman year of college due to a very rare disease. Imaginably, his entire world was shaken and he dropped out of college although he had achieved a perfect SAT score; he relinquished his dreams of becoming an engineer. He was forced to adjust and orient himself to society as a new being without the ability of sight. Although this friend is now someone I simply and gratefully meet in passing along the streets of Pittsburgh (this break in friendship, unfortunately, was initiated when I started a new job), he was a protective and motivating force for me as an undergraduate student. He was more aware and in tune to our surroundings than me and shared that understanding. This friend has now obtained a degree, hosts a local radio show, and leads liberal political movements in Pittsburgh. His sensitivity to people, life, and ability to fight against societal injustice despite his physical disability, continues to inspire me to do and be better. My very first client as a budding social worker in 2008, was a three year old child who had suffered a major stroke at the age of six months. When I first met him, he could only speak a few words and no sentences. However, he had this unrelenting energy and desire to live and grow, probably apparent since the day of his birth. Through him, I learned the power of play. He would teach me how to communicate through games, running at the playground, jokes, and pretending to be superheroes. His family taught me the power of unconditional love and support. By the time I left him due to a promotion, he was able to speak in sentences. He grew and got stronger, better, and more lively each day. His exuberance for life was evident in every activity despite all odds. Another client, who I always refer to as Grace when speaking of her to students, taught me how to move forward more so than any other being I have had the pleasure of meeting. This girl was five when I first started working with her and to this day is the most severely abused and traumatized person I have ever encountered. She was so severely physically abused by scalding water that she wears permanent scars on her face. She was also sexually abused and resilient enough to report the abuse twice while involved in child protective services. She was hospitalized psychiatrically at the age of six. Initially and understandably, this young girl would throw tantrums at school. Chairs, desks, artwork, etc. would fly around the classroom. However, in her kindergarten class she was introduced to Pete the Cat through a Youtube video. Her life motto then became “I’m just going to keep walking along singing my song” like Pete the Cat. After being placed in a stable and safe foster home, she got better. Like my previous client, we would play, and she would heal. Every session we would sing and dance to Pete the Cat. She made so much progress and met all of her therapeutic goals that she no longer needed me as her therapist. I make sure to teach my students her motto, “I’m just going to keep walking along singing my song”. I refer to her as Grace because she taught me grace. The last client I will write about not only possesses the perfected smile, but also resides in its essence. He lives with autism in such a beautiful manner, words cannot adequately describe the joy this child brings to the world. From him, I learned the power of and wisdom associated with imagination. I remember clearly one session a few years ago where we were reading a biography about Dr. Martin Luther King Jr. After learning about Dr. King, this client was shocked that at one time in history he and I could not play together or eat at the same restaurant. He said to me, “Dr. King must have imagined a better world and that’s how he made it better. Now it’s okay for us to play because of him”. I wish I would have written down all of my client’s wise sayings because they were inspirational and resonated from a place of pure imagination. These are only a few of the many resounding stories of strength recounting the lives of people living with disabilities that I encountered personally and also early on in my professional career. Truly, I could write a story about each of my many clients from the past 7+ years, but time and space disallows such an endeavor. I will, however, suggest that we as a society re-think how we treat those people living with disabilities. Instead of stigmatizing those already faced with a magnitude of environmental and physiological challenges, we should rather, view them as muses. Within these people lies innate abilities to withstand harsh circumstances. Most importantly people living with disabilities are people distinctive because of their resilience. I will repeat something I said in a previous blog, “Differences are courageous”. Instead of discounting those that are different because of disability, we should count them as the strongest people possessing the highest levels of adaptability. We as a society must remember that being different requires courage instead of attacking those that are different, we should instead commemorate their strength. References: http://www.census.gov/prod/2012pubs/p70-131.pdf https://www.nami.org/NAMI/media/NAMI-Media/Infographics/GeneralMHFacts.pdf https://www.nami.org/NAMI/media/NAMI-Media/Infographics/ChildrenMHFacts10-26-15.pdf Goffman, E. (1963). Stigma; notes on the management of spoiled identity. Englewood Cliffs, N.J.: Prentice-Hall. Goffman, E. (1969). Strategic interaction. Philadelphia: University of Pennsylvania Press.
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