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11. CEL > Sociology > Flashcards

Flashcards in Sociology Deck (25)
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What are social norms?

Rules which govern behaviour
They are collective
They include positive sanctions to encourage behaviour & negative sanctions to prevent behaviour
They are so widespread they are often taken for granted & invisible
Once established they can be very difficult to change


Describe culture and normality

Culture = The way of life of a particular social group ( includes language, social norms, customs, values, beliefs, rituals, manners)

What is considered normal varies culturally and across time


Sociology of pain?

How people perceive and respond to pain, both in themselves and in others, is shaped by culture.

While culture is a framework that informs individual behaviour, not everyone conforms to cultural social norms. Rigid use of generalisations can lead to cultural stereotyping & serious inaccuracies


Consequences of unhealthy messages in med school?

Don't get ill, form of weakness, supposed to be perfect, contributes to sense of failure and reluctance to seek help

Creates impossible standards & expectations

Competitive nature of medical school and comparison with peers can lead to feelings of inadequacy / not being good enough

Pain and unpleasant bodily feelings can take up a lot of our attention > affect work and learning

Start to normalise unpleasant behaviours

Those from a medical background may be reluctant to go to the doctors because
Fear of diagnosis
Accepting and normalising
Feeling like they are wasting the doctor’s time


What is the inverse care law?

The inverse care law is the principle that the availability of good medical or social care tends to vary inversely with the need of the population served.


What is medicalisation?

The process whereby human conditions and problems come to be seen as medical conditions requiring medical intervention


What is social construction?

Something ‘invented’ or ‘constructed’ by people in a particular culture or society

Critical realism: physical material reality but mediated by social context


PMS as social construction?

Women experience something in relation to their cyclical changes but this ‘something’ is mediated by culture

Our bodies are grounded in the physical but immersed in a wider social, political and economic system which mediates our experience of the body

PMS/PMDD as a site of biological, social and cognitive interaction


Lung cancer barriers to help seeking

Patients had experienced a range of health changes indicative of LC but they did not tell their GPs about these despite making use of primary care services

Symptoms were normalised: framed as normal features of lifestyle and ageing (e.g. breathlessness=unfit, getting older, overactivity, seasonal change)

Absence of pain or lump
Belief that the symptoms will go away
Intermittent symptoms
No awareness of cancer symptoms or risk
Previous benign diagnosis for symptoms


3 key barriers to help seeking?

Fear of Embarrassment
- time-water or as neurotic, especially for those with diverse mild symptoms
- Fear that even the patient’s family think the symptoms are psychosomatic
- Men view help-seeking as unmasculine
- Embarrassment of sensitive or sexual area

Fear of Stigma

Fear of Cancer
- Serious and painful symptoms, fatal incurable disease
- previous experience of cancer
- fear of unpleasant Tx
- loss of sexuality after Tx
- Shame associated with dirt & uncleanness


What is the sick role?

Defining something as condition / disease entitles you to role

Rights: not blamed for condition, exempt from normal duties

Responsibilities: seek medical help, follow medical advise and get well ASAP

Doctors typically grant the sick role


What is a narrative construction?

Typically include stories about:

- What we have done
- Who we have been in the past
- Who we are now
- What we do now
- Who we will be in the future

These stories provide a sense of continuity, coherence + purpose to our lives


Narrative vs narrative construction?

Narrative: story or account of events and experiences

Narrative Constructions:
stories we tell about our lives or biographies in order to make sense of our lives + give them meaning. These stories try to answer questions about:
- Who am I?
- What is my life about?
- Shape our identities + give our life meaning


What is biographical disruption?

The ways in which people’s lives become profoundly disrupted by trauma, chronic illness or injury.

Not only is a person’s physical body disrupted, but also, the narrative constructions or stories that have made up their biographies or lives; their sense of self or identity.


Stages in biographical disruption?

1. Disruption to a person’s body and to practical, everyday activities

2. Disruption to a person’s narrative construction or biography: their sense of self, their past and future


What is narrative reconstruction?

Following an accident or illness, our stories or narrative constructions are disrupted or disorganised and we need to tell new stories or narrative reconstructions to bring coherence and meaning back to our lives.

These new stories try to make sense of the trauma/injury/illness by explaining why it happened, why it happened to them and by determining their responsibility.
People do this by referring to their past and their future.

People Ask Why it Happened to Them, Try and determine their responsibility, look to future to give their life meaning, look to the past to explain the cause, often explore or question spirituality or religion


Biographical disruption and narrative reconstruction are profoundly influenced by....?

Available Resources:
Physical (type of injury or illness & severity)
Social (education, occupation, family, friends)
Cultural (religion)

Cultural connotations associated with the trauma, injury/illness


Concepts of narrative construction, biographical disruption & narrative reconstruction can help doctors by...

Providing an understanding of the patient’s situation (meaning, context & perspective) that may not be addressed by other methods

Improving communication skills

Encouraging a consideration of a patient’s social, psychological & spiritual needs and appropriate support for these

Providing a framework for approaching a patient’s problems + uncovering diagnostic + therapeutic options

Working with patients to develop meaningful coping strategies, including the fostering of new stories

Working with patients to consider how their past & expectations for the future prior to the trauma/accident/illness informs their current situation

Encouraging empathy & promoting understanding between doctors and patients
Suggesting or precipitating different therapeutic options


What is stigma

An attribute that is deeply discrediting

Reduces the bearer from a whole and usual person to a tainted, discounted one (Status Loss)

Excludes individuals from full social participation (Social Rejection)

Spoilt identity


Types of stigma?

Felt stigma: shame associated with the stigma and fear of being socially excluded (internalised)

Enacted stigma: actual rejection and discrimination.

Courtesy stigma
Stigma by Association: Family and friends experience stigmatisation because of their connection to the stigmatised person

Study has shown doctors hesitant to diagnose patients with conditions that have stigma attached to them


3 types of stigma?

Physical differences

Blemishes of individual character

Membership in certain social groups


4 components of stigma?

People identify and label human differences

These human differences are linked to negative attributes

Labeled individuals (“them”) are categorized as distinct from “us”

Labeled individuals experience status loss and discrimination


Why do people stigmatise?

Exploitation and domination/keeping people down

Enforcement of social norms/keeping people in

Avoidance of disease/keeping people away


How do people manage stigma?

Secrecy: concealing information that might reveal the stigmatising condition

Education: providing information to counter judgments

Withdrawal: avoiding potentially rejecting situations

Distancing: I’m not like them!

Deflecting: That’s not all of me! It’s only a small part of me

Challenging: efforts to change other people’s beliefs or behaviour


Pain central sensitisation?

Experiencing pain regularly can either:
Hypersensitive to painful stimuli
Desensitisation to pain by having learnt coping mechanisms

Memory and learning
Being bombarded with lots of information means not everything will be processed
Short and long term memory

Grief – 6 stages of grief?

Increased anxiety --> increased catastrophising and somatisation