S208

Week 1
4 April 2007

Janet Shim

Course Theme
 meanings and interpretations of the illness experience, and the actions that ensue from that

Background
 C. Wright Mills – individual experiences are inevitably/continuously shaped by and can only
be made sense of in terms of the larger society/context in which that person is living. so
there will be constant interaction between biography/everyday life of the person and the
unfolding broader history/context of the society. so the point of the sociological imagination
is to try to understand what those linkages are. ascribes a very different approach to
health/disease/illness than the biomedical model. it’s saying the entire experience of an
illness is much more than these symptoms.
 symbolic interactionism

Central Issues
 how health and illness are conceptualized and defined
 we pay more attention to certain kinds of diseases
 certain diseases much more legitimated
 process by which diseases are legitimated
 definitions of health vs. illness and their relation to one another
 social construction is all about definition, something we do in interaction/conversation with
one another. individual and collective conceptions of what entities mean
 dialogue between theory and empirical work
 breaking down traditional binaries (science as objective discovery of the truth vs. science is
actually a particular way of looking at things, and we attribute particular significance to it)

Blumer, Herbert. 1969. Symbolic Interactionism: Perspective and Method. Berkeley: University
of California Press. Pp. 1-21.
 John: people developing meanings from interaction with other people; in the absence of
interaction, we can develop meaning on our own
 how does one develop meaning on their own?
 John: pivots on sense of self-identity
 Alyssa: self as an object
 what does it mean to treat one’s self as an object?
 Alyssa: meanings you attach to what you do
 John: p. 12 – “The notion of oneself as an object fits into the earlier discussion of objects.
Like other objects, the self-object emerges from the process of social interaction in which
other people are defining a person to himself.”
 SI is a specific kind of social psychology. sociologists have a very different definition of
social psychology than do psychologists. grew out of philosophical tradition of pragmatism.
 idea that self is very important in the pragmatist view of the world. notion (Cooley) of the
looking-glass self. you can look into a mirror and see yourself the way others see you. this
becomes a metaphor for how one’s sense of self is the pivot for social interaction. ongoing
conversation between self as subject and self as object.. self as I see it, and self as others see
me. becomes difficult to distinguish object-self from subject-self
 what is social about the self – this impact of society upon individual sense of self – is not so
much (in the pragmatist tradition) a determinative outcome; it’s not simply top-down, and we
aren’t simply being molded. what’s social about it is that we always have to take note of
what the governing social patterns are, regardless of whether we choose to follow them.
 3 basic tenets of SI:
 1. humans act toward things based on the meanings those things have for them
• (in contrast with other theoretical notions that meaning is intrinsic to an object)
• it’s the importance of the act. (prevailing question: how is action social? (socially
motivated, etc.) first premise SI says it comes out of meanings we assign to
situations/objects/other people.
• even though this process may unfold regularly, in fact it’s still
unfolding/contingent/emergent
 2. meanings of things are derived/arise from social interaction
• the act/process of recognizing what’s happening.. whether more implicit or
explicit, you’re continually taking note of what’s occurring in the world around
you. it’s not just that the self is receptor for all of these things and you
automatically reproduce them; it’s that you take note of them – it’s an active
process.
• one of the ideas about SI is that the reality that matters to us is not the totality of
things in our environment. the reality that matters to us is what we take notice of,
what we deem to be important/legitimate, that attract our attention for some
reason. cognitively, we can’t take note of everything in our environment; we are
selective, and part of that is socially patterned. what’s interesting about thinking
about health and illness in this context is that you can look at health and illness
experiences in ways that haven’t been done before. premise of 3rd tenet of SI.
• prescriptive vs. descriptive agenda
 3. renegotiation of meanings; meanings can be revised. but this has to happen in social
interaction.
• this is how new diseases actually arise (here’s something we haven’t noticed
before, we have to take notice)
• part of the reason Goffman studied stigma and how social institutions and
societies treat/think about stigma is in part prescriptive; he argued it does a huge
disservice in its reproduction
 Goffman splits actual social identity from virtual social identity, but for most interactionists,
it’s just the self

 Parsons’ structural functionalism – universalistic functional imperatives

 a task of sociologists was to identify the linkages between these different social systems
 because he defined the project of sociology in that way, it becomes a much more packed
explanation for why society is the way it is (much more top-down approach to sociology,
how societies are constructed)
 the other thing that was going on in sociology around this time (mid-20th century) is that it
was trying to scientize itself (societies/individuals act in fairly predictable ways)
 there was also the much more psychological approach of stimuli and outcome
 the interactionists were in dialogue on both the theoretical and empirical levels
 theoretical: society actually built up. classroom interactions a microcosm of the building
up we see in society. what we do here is a socially patterned way of conducting a class,
but our doing this is also the perpetuation of that pattern. much more cumulative
conceptualization of society.
 Beth: does SI theory address motive? why people do what they do?
 question of why people ask the way they do goes back to first premise. we act the
way we do b/c of the meanings we ascribe to the situation, to the other actors who are
in that situation with you. it is circuitous – action presupposes meaning presupposes
action.
 the dialogue with other sociological approaches (which are about inputs leading to
outputs) .. part of the critique of SI is that it doesn’t deal sufficiently with power. not
that SI is not able to (patterned ways tend to reproduce themselves.. could be a way of
grappling with issue of power)
 rather than looking to attributes of actors as determinative of outcome, SI suggests
you still have to look at process to understand how actions/power are reproduced
 (looking-glass self – imagined conversation with imagined others)
 a lot of people in this tradition say that it’s not that SI couldn’t handle issues of
power; you can inject issues of power and inequality. certain meanings are far more
accepted/dominant. in the process of negotiating or revising meanings, it’s not an
even playing field. historically, the argument is that they weren’t handled. since their
emphasis was on building up a theory and a literature that counteracted this top-down
view of society, their emphasis – and perhaps overemphasis – was on how things
were contingent, emerging, and unfolding. and it’s in that overemphasis where issues
of power perhaps got lost.
 Krista: Leigh Starr all about power
 Beth T.: medicine still stuck in Parsons’ sick role
 and it’s not just medicine. you hear a lot re: the sick role in dominant ideologies re:
working to get better.
 structural functionalism is a particular theory about how the world works. it is
closely aligned with the notion that social science can be scientific and that
sociological research should be positivistic. the positivist tradition of doing research
leads much more toward quantitative methodologies. SI, in being focused on
meanings and interpretations, is interested in a different kind of data. Parsons, when
he writing the bulk of his data, was relying somewhat on others’ empirical work, but
he was primarily a theoretician. he acknowledged his theory wasn’t about capturing
reality as it actually happens. its utility is as a sensitizing way of understanding
(raising certain questions regarding) what happens empirically.
Charmaz, Kathy and Virginia Olesen. 1997. “Ethnographic research in medical sociology: its
foci and distinctive contributions.” Sociological Research and Methods 25(4): 452-94.
Davis, Fred. 1963. Passage Through Crisis: Polio Victims and Their Families. New York:
Bobbs-Merrill Co. Pp. 3-13, 137-64, and 167-79.
 where do you actually see the illustrations of some of these concepts?
 Beth: in the polio piece, each person is there in the same interaction, but each has a very
different perspective. the meaning of their disease didn’t change till they went home
 Davis brings up fairly early on this concept of emergence. what is this, and how is this a
uniquely interactionist perspective? (p. 10)
 he talks about the improvisation that’s required. this is something you’ll see reflected in the
Strauss. everyone does some form of work. work/task: new info/problem; what do we make
of it, and what do we have to do about it? this improvisation contributes to determining those
actions that are taken. actions not predetermined. through this problem-solving, taking note
of new things in the situation.. that is how the trajectory comes to be. cumulative building up
process. never do the “facts” of the situation dictate what the outcome of that situation is
going to be; it’s the meanings attributed that tell you how the situation unfolds
 issues of self and identity
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 maintenance of non-sick self
 it’s not just the identity of the person with polio, it’s the identity of the family, and the family
life they’ve constructed together
 moral evaluation / moralizing blame attached to children who remained more severely
impaired than other children
 be careful about not trying to psychologize when we’re talking about the relationships
between parents and their children
 one of the things the interactionist tradition advocates in its emphasis on meaning (people
construct different meanings).. it became a big project sociologically to figure out what
patients were thinking, and what interpretations they had. attributions of meaning to polio,
disability, that led to / shaped the kinds of actions they took toward their children. issues of
cooperation/compliance with medical professions. laypeople may not have same kinds of
meaning that medical professionals do.

Williams, Simon. 1987. “Goffman, interactionism and the management of stigma in everyday
life.” Pp. 134-64 in Sociological Theory and Medical Sociology, edited by Graham
Scambler. New York: Tavistock.
 making the linkage between the meaning of the stigma and the actions one takes toward the
stigma and the consequences of that action for one’s interactions with others.. what are the
interactional dilemmas that follow from the strategy of passing?
 you have to keep it up
 issue of managing information
 John: kind of information people manage is determined by the social setting
 people who do not reveal they have higher education, depending on where they are working
 Goffman emphasizes that everybody is already discreditable; everyone engaged in managing
info about ourselves, presenting sides of ourselves that are particularly desirable/acceptable.
 whole issue of stigma and discreditability and information management are issues for all of
us.
 Kim: reminds me of adolescence.
 Kim: people who don’t appear to be disabled being accosted about parking in handicapped
spots
 the social cost, psychological and individual costs of trying to pass all the time, because of
the significant stakes of disclosure
 courtesy stigma – if you associate w/ someone who is associated w/ stigma, it brings up issue
of legitimacy, visibility, invisibility
 passing = attempt to hide a minimally visible or invisible stigma.
 covering = truly interactional work that one has to undertake to make the normal feel as
comfortable as s/he can, and for the normal to pretend the stigma doesn’t exist
 the interactional dilemma revolves around an awkward interaction (with no socially
accepted way, at least from vantage point of normals)
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