Nowadays, much attention is paid to the notion of self, especially in health care providing institutions. A great number of patients, especially those who obtain disability care, suffer from depressions, exclusion and segregation. These feelings are formed by the surrounding environment and by themselves. The current work investigates how this issue was considered by Erving Goffman and Michel Foucault in order to provide deep understanding of their ideas by comparing and contrasting them.

Erving Goffman and His Ideas

Erving Goffman is the Canadian sociologist who made the considerable contribution into the social science and study of the human nature in the 20th century (Barsky 1994, p.95). The formation of Goffman’s ideas was based on the works of Tom Burns, Emile Durkheim, Sigmund Freud, and other notable philosophers (Barsky 1994, p.95). He is widely recognized for studying of symbolic interaction, sociology of everyday life, framing of experience (i.e. social organization) and social construction of self. In addition, he paid much attention to the analysis of stigmas and total institutions. The current essay will be focused on his ideas concerning stigma, identity, institutionalization and disability care in the modern society (Barsky 1994, p.95).

Erving Goffman provided the following definition of stigma: “the phenomenon whereby an individual with an attribute which is deeply discredited by his/her society is rejected as a result of the attribute; stigma is a process by which the reaction of others spoils normal identity” (Goffman 1986, p. 34). The person with a stigma is not considered to be a common (Albrecht et al. 2001, p.67). Hence, this person suffers from discrimination and other actions, which reduce his life chances from the side of “common” members of the society (Goffman 1986, p. 45). This situation can be also described as cutting off from the society (Manning 1992, p.89). It facilitates the individual with stigma to respond to the social discrimination by defensive cowering or hostile bravado (Goffman 1986, p. 67). At the same time, it should be noted that, as per Goffman’s understanding, stigma represents the language of relationships between various individuals but not the set of attributes because individuals from a similar stigma category tend to unite in special groups for the protection of their interests and reflection of their ideas (Goffman 1986, p. 78).

The process of stigmatization is brightly reflected in modern health care providing institutions because people with certain illnesses can feel rejection from the side of other (healthy) members of the society. An obvious example is patients with HIV/AIDS as “when a disease label is attached to a person, the very label itself has the power to “spoil the sufferer’s identity”; both personal and social” (Healthy Knowledge 2011). Goffman noted that the social stigma is based on the labelling process. It can be caused by social reaction, i.e. discriminatory experience (“enacted stigma”), and even by imagined social rejection that can have a negative influence on patient’s self-identity (“felt stigma”) (Healthy Knowledge 2011). The situation is even sharper in the case of rendering of disability care. It is notable that both abled and disabled patients are influenced by felt stigma because “’the stigmatised individual may be able to hide the discrediting attribute from others but cannot do so from him or herself’” (Healthy Knowledge 2011). However, disabled individuals cannot avoid enacted stigma by moving to another place where they can feel themselves less stigmatized. In their book Caring for People with Learning Disabilities, Ian Peate and Debra Fears (2006) applied Goffman’s works to the modern disability care. They noted that Erving Goffman used the term “insititualization” to show the way, in which patients became depersonalized by the system of health care providing institutions and health care providers. The sociologist determined a set of various features, which defined the “insititualization” (Smith 2006, p.109). These features are the following: block treatment, depressonalization, rigid, and inflexible system of social detachment and care between the staff and patients (Goffman 1961, p.101). Hence, patients with disabilities feel exclusion, segregation and abuse for the long-term period (Peate & Fearns 2006, p.76).

Additional attention should be paid to the concept of “courtesy stigma” described by Erving Goffman (1963) in his work Stigma: Notes on the management of a spoiled identity. He identified this phenomenon as “tendency of stigma to spread from a stigmatised individual to his close connections” (Goffman 1986, p.30). In her work Disability and stigma: an unequal life. Speech & Language Therapy in Practice, Sarah Earle (2003) provided the real-life example of this concept: the relatives and carers of patients with Alzheimer usually feel shame and embarrassment (Earle 2003, p.22).
In addition, it should be noted that Erving Goffman focused on the management of stigmatizing marks rather than on their resistance (Trvino 2003, p.73). Such a micro-social focus created the background for sharp criticism of Goffman’s ideas because the idea of stigmatization was considered as “articulated, apolitical and divorced from the social processes” (Farrugia 2009, p.1015). The interrelation between social processes and stigma was discussed in the works of Michel Foucault whose ideas are closely connected with Goffman’s.

Michel Foucault and His Ideas

Michael Foucault is a French philosopher and social theorists who described relationships between knowledge and power and their application by various social institutions for controlling people (Foucault 1982, p.780). The current essay will focus on the description of his ideas concerning personal identity, stigmatization and the role of institutions in the modern social life.
It is notable that Michael Foucault provided the dual meaning of the term “subject”. This meaning depends on the disabled person and the surrounding environment. On the one hand, being the subject means being controlled and dependent from someone else; on the other hand, it implies being tied to someone’s identity by means of self-knowledge and conscience (Tremain 2005, p.87). The philosopher relates both senses to the reflection of power and models, through which individuals were transformed into subjects (Tremain 2005, p.88). Michael Foucault considered institutions as the methods of obtaining advantage by some group of individuals (i.e. confer powers to themselves) by changing some relationships and self-perceptions (Michel-Foucault 2010).

In his work, David Farrugia (2009) noted that Michael Foucault put the emphasis on the structural aspects of the stigmatization.The philosopher identified connections between knowledge and power and argued that the power is reflected “through the construction of embodied subjectivity” (Farrugia 2009, p.1016). Hence, the social control is realized inside the various institutions governed by professionals (such as hospitals, rehabilitation institutions). The subjectivity is created by the constitution of subjects as knowable. Various technologies are used for actualization and performance of this subjectivity. This idea is more thoroughly explained by Shelley Tremain (2005) who investigated the treatment of disabled individuals. The author noted that during the past two centuries the well-being of the general population was secured by the special apparatus which created, classified, controlled and even managed social anomalies, by which people were divided from others and objectivized as uncommon (Tremain 2005, p.88). This idea is based on Foucault’s understanding that the exiting practices of division and classification act as the means of individualization of people. Hence, the necessity to increase power is reflected in the creation of the numerous nursing homes and incarcerating of people there (Tremain 2005, p.87).

Foucault considered power as the fundamentally repressive thing, in which one social group reigns over the other (Tremain, 2005, p.87). This reigning is reflected in the creation of the illusion that some people are prediscursive, or natural, antecedent (impairment) (Tremain 2005, p.87). This illusion justifies the governmental practices directed on the control of one group of people over the other group of people. Along with that, such illusion can be easily created in the health care providing institutions, which perform treatment of people with disabilities. Being put in the environment of constant pressure and reflection of power, the patients consider themselves as subjects. In addition, health care providers and healthy people influenced by the system and the created illusions perceive these patients as subjects.

It should be noted that Foucault did not deny the existence of mental disorder (Varga 2015, p.64). The philosopher just resisted the idea that there should be a defined separation between mental disorder and normal experience (Varga 2015, p.64). He stood in opposition to making any “normative judgements about the correct point on this continuum at which to fix the boundaries of mental disorder” (Varga 2015, p.64).

Comparing and Contrasting of Ideas Presented by Erving Goffman and Michel Foucault

As it was stated above, this essay provides analysis and comparison of ideas of Erving Goffman and Michel Foucault concerning the work of various institutions, which are connected with the disability care and self-identification of people who suffer from various disability diseases. It is notable that the ideas of these philosophers have similar backgrounds. However, they are developed in various directions and explain the phenomenon of stigmatization differently.

Both Erving Goffman and Michel Foucault highlight the fact that identity of the individual and personal stigmatization is based on two features. The first feature is the perception of the individual by other members of the society. Erving Goffman called this feature “enacted stigma” while Michel Foucault described it as subjectivization by someone else. This means that both philosophers agreed that the surrounding environment has the considerable influence on the personal identity. The second feature refers to the imagined social rejection, i.e. how the individual considers social attitudes to himself or herself. Erving Goffman named this self-identification feature “felt stigma”, and Michel Foucault described it as a personal tie to the existing identity by self-conscience. Consequently, both philosophers recognize that the individual himself plays a great role in the personal stigmatization. This understanding is rather relevant for the consideration of the issue of stigma of disabled patients because it shows that this issue is caused by both self-perceptions and social attitudes to these individuals.

Erving Goffman even laid emphasis on this statement by providing the idea that people with similar stigmas can join in one group, i.e. form some sort of the society where they are treated as equal. Michel Foucault agreed that people with similar stigma can represent one joint social group that is influenced by other social group (common members of the society).

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Additionally, it should be noted that both philosophers pointed to the great role of healthcare providing institutions in sharpening of the rejection of individuals with various disabilities. The existing system of health care where patients feel themselves as uncommon members of the society increases their feeling of exclusion and segregation. Goffman stated that in such institutions, “the organization of life is deliberately designed to strip the inmate of his or her self-image and replace it with one more acceptable to the ethos of the institution” (Jones et al. 2011, p.83). Michel Foucault even stressed that this system was created for planting of this feeling. Special separation of common and uncommon (i.e. disabled) groups of individuals is necessary for strengthening the power and the influence of the first group over the second one. This means that both Erving Goffman and Michel Foucault agree that in the modern society, disability care sharpens the issue of social rejection of patients by their depressionalization and exclusion based on social attitudes and their self-identity because they are considered to be uncommon.

Along with that, both philosophers highlighted the great influence of the way of interaction between individuals on the formation of the self-identity. Erving Goffman described this phenomenon as interactional footing (Hauser 2005, p.36). He considered conversation between individuals as some kind of reflection of their own frames, schemes and attitudes. In addition, the socialist noted that individuals adapt the way they participate in listening and speaking to interaction on the basis of the consideration of their own position and the position of interactor (Marks 2012, p.16). He noted the following: “footing is the alignment we take up to ourselves and the others present as expressed in the way we manage the production or reception of an utterance” (Marks 2012, p.16). Erving Goffman also showed that footing can be shifted because of the changes of the alignments and attitudes. In her work, Annie R. Marks (2012) stated that “the shift in footing is noteworthy because it demonstrates the power”. This idea was further developed by Michel Foucault. He noted that the knowledge and the power are reflected through the language. Hence, one social group can create an illusion of separation from other social group by means of discourse through the number of procedures: so called “discursive practices” (thinking, writing and speaking) act as producers and inhibitors for designation of choices and exclusions (Hook 2001, p.531). The way of interaction has the considerable influence on the formation of relationships between the carer and the disabled person in the modern society because it has particular language forms and reflects the rejection of the patient by the society and by himself or herself.

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However, there are some contrast in ideas presented by Erving Goffman and thoughts provided by Michel Foucault. While the Canadian philosopher focused on management of stigmatizing marks and the ways, in which people are constituted in mutual interactions, French philosopher directed his investigations on the interrelation between social processes (power and knowledge) and stigma through local circumstances and practices. This means that Goffman is considered to be “bottom-up” micro-theorist while Foucault represents “top-down” macro-theorists (Jacobsen 2010, p.16). As per doctrine developed by Erving Goffman, social stigma is based on labelling process while Michel Foucault in his studies stressed the fact that individual’s identity is formed by the intends of one social group to increase its power and influence on the other social group by intensification of the separation between them. This power is reflected in the creation of the illusion of diversity between the groups. In the modern society, particularly in institutions providing care to disabled patients, this power is reflected in the total control of health care providers and carers (for example, family members) of all the actions and environment of patients.

The current essay provides the general description of ideas of Erving Goffman and Michel Foucault in regard to institutialization of the society and personal stigma identity of people who obtain disability care. It is notable that both philosophers have similar visions on numerous matters. First of all, Erving Goffman and Michel Foucault recognized that stigmatization is formed under the influence of attitudes of social members and self-esteem. The attitudes and self-perceptions are reflected through the language. Along with that, both philosophers agree that people with similar stigma can join in one group for reflection and protection of their interests. Erving Goffman and Michel Foucault also noted that modern health care providing institutions have the considerable negative effect on patients because they increase rejection of these people by the society and themselves. However, there are some contrast in ideas of Canadian philosopher and French social theorist. While Erving Goffman focused on management of stigmatizing, Michel Foucault studied the interrelation between social processes. The first one noted that social stigma is based on labeling process while Michel Foucault stressed that individual’s identity is formed by intends of one social group to strengthen its influence on the other social group by escalating the separation between them.

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