DESARROLLO DE CANAL DE VENTAS

The majority of theoretical scholarship pertaining to the stigma construct identifies the work of Erving Goffman as the originating point. He codified his ideas and concepts in articles, such as “The Moral Career of a Mental Patient,” (1959), and books, Asylums: Essays on the

Social Situation of Mental Patients and Other Inmates, (1961) and Stigma, (1963). Goffman

(1961) detailed how an individual progresses from the status of “civilian” to that of a mental patient. Various discrediting marks or attributes could be stigmatized such as physical

deformities or blemished characters, for reasons which include mental illness, sexual deviance, criminality, and addiction. The stigma of race or religion was designated by Goffman as “tribal stigma.” These various physical, moral, and status differences devalued and discredited

individuals. The result, according to Goffman, was that “we exercise varieties of discrimination, through which we effectively, if often unthinkingly, reduce his life chances” (Goffman 1963:5). Theories specific to mental illness stigma include Labeling Theory and Classic Labeling, introduced by Scheff in (1966), which focused on the negative consequences of labeling,

asserting that labeling actually caused mental illness. This work led to the development of Modified Labeling Theory, the basic premise of which was that individuals are socialized in culturally specific ways that include value systems around mental illness. These systems

specifically devalue individuals who suffer from what society considers outside of the norms of acceptable behavior and are therefore mentally ill. In conceptualizing stigma, Link and Phelan emphasized that stigma is a complex construct where various elements, such as labeling,

stereotyping, and discrimination converge to create notions of “us” and “them,” so economic and political power is also being exercised (Link et al. 1989, 1997, 1999; Link and Phelan 2001, 2013; Scambler 2011).

Another theoretical development in the conceptualization of stigma was attribution theory, which purported that the etiology of mental illness was outside of an individual’s control. This premise would lead to increased sympathy toward the mentally ill and therefore diminish society’s coercive tendency towards those suffering from mental illness. However, this theory

did not prove helpful and soon gave way to essentialism and biological determinism (Corrigan et al. 2003; Phelan 2005)

Pescosolido and Martin reiterated that “stigma is conferred through labels, ‘mentally ill’ by medicine, ‘criminal’ by justice system, these produce negative stereotypes, of varying

consequence.” And thus “stigma represents the intersection of cultural differentiation, identity formation through social interaction, and social inequality” (Pescosolido and Martin 2015:93).

One barrier to seeking help for mental illness was the wish to avoid the negative consequences of being labeled and the subsequent devaluation and discrimination (Link 1987; Link et al. 1989: Kroska and Harkness 2006; Perry 2011; Pescosolido 2013). This fear was very real, with cultural ideas about the mentally ill ranging from increasing incompetence to

dangerousness (Stout, Villegas, and Jennings 2004; Wahl 1992; Wahl, Wood, and Richards 2002).

Link and Phelan (2010, 2013) identified three goals of stigmatization as exploitation, enforcement of social norms, and avoidance. They also introduced the conception of stigma power, incorporating Bourdieu’s theory of symbolic power and his ideas of “misrecognition, hidden taken for granted aspects of culture” (Link and Phelan 2014:25).

Also, those faced with stigmatization acted in various ways to resist labeling and to deflect the resultant stigma (Thoits 2011, 2015, 2016). The empirical work in Modified Labeling theory developed ideas relevant to active stigma, avoidance, and resistance (Link et al. 1989, 2002; Link, Mirotznik, and Cullen 1991; Thoits and Link 2015). This was identified as “secrecy,” concealing labeling information, providing information to dispel stereotypes,

et al. 1989, 1991). Subsequently the outright “challenging” and “distancing” was also included by Link et al. (2002).

Challenging amounted to the active and direct confrontation of deployed stigmatization, which can be identifying such behavior immediately and objecting to statements as they are expressed (Thoits 2011, 2015, 2016; Thoits and Link 2015). Distancing was the cognitive separating a person does from the stigmatized group (Thoits 2011). The outcome of the latter amounts to the individual person saying, “I’m not like them…your stereotypes of them are misapplied to me” (Link and Phelan 2013:537).

Both Classic Labeling Theory and Modified Labeling Theory had taken positions that were partially correct, and thus labeling brought both positive and negative consequences, resulting in new treatments and services on one hand, but further stigma and discrimination on the other (Link and Phelan 2013; Perry 2011; Rosenfield 1997). Both noted the paradox of labeling providing the means by which the most disadvantaged secure services and benefits, as well as how people seek to avoid and resist the resultant stigmatization (Link et al. 1989, 2002; Thoits 2011).

Goffman’s scholarship (1961) on asylums suggested that stigma is more a product of the way in which mental institutions are organized and less a result of the behaviors of people who suffer from actual mental illness (Link and Stuart 2017). Goffman was not alone in this belief, and according to Link and Stuart (2017), other scholars also attributed the stigma suffered by those with mental illness to the organization of psychiatry and mental health institutions. These scholars heralded a period of distrust towards mental illness institutions and the medical field of psychiatry (Scheff 1966; Foucault 1975; Szasz 1974). Corrigan’s work also indicated that an

actual clinical diagnosis could exacerbate negative stigma toward the mentally ill, by further implying group cohesion of the mentally ill to the general public (2007).

Through the use of grounded theory methodology and the employment of various theoretical lenses for analytic purposes, stigma can be identified, not only of mental illness but also of overall client-based perceptions around incarceration. As noted previously, Link and Phelan emphasized the convergence of various elements, such as stereotyping and creating “us” and “them” labels that facilitated a loss of status when coupled with discrimination in a power situation (Link and Phelan 2001; Scambler 2011; Wright et al. 2000).