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3. Modified labelling theory- Bruce Link and colleagues (1989) | 🧿 Sociology UPSC Optional 🧿

3. Modified labelling theory- Bruce Link and colleagues (1989) conducted several studies which point to the influence that labelling can have on mental patients. Through these studies, taking place in 1987, 1989, and 1997, Link advanced a "modified labelling theory" indicating that expectations of labelling can have a largely negative effect, that these expectations often cause patients to withdraw from society, and that those labelled as having a mental disorder are constantly being rejected from society in seemingly minor ways but that, when taken as a whole, all of these small slights can drastically alter their self-concepts. They come to both anticipate and perceive negative societal reactions to them, and this potentially damages their quality of life.

Modified labelling theory has been described as a "sophisticated social-psychological model of 'why labels matter.'" In 2000, results from a prospective two-year study of patients discharged from a mental hospital (in the context of deinstitutionalization) showed that stigma was a powerful and persistent force in their lives, and that experiences of social rejection were a persistent source of social stress. Efforts to cope with labels, such as not telling anyone, educating people about mental distress/disorder, and withdrawing from stigmatizing situations, could result in further social isolation and reinforce negative self-concepts. Sometimes an identity as a low self-esteem minority in society would be accepted. The stigma was associated with diminished motivation and ability to "make it in mainstream society" and with "a state of social and psychological vulnerability to prolonged and recurrent problems". There was an up-and-down pattern in self-esteem, however, and it was suggested that, rather than simply gradual erosion of self-worth and increasing self-deprecating tendencies, people were sometimes managing, but struggling, to maintain consistent feelings of self-worth. Ultimately, "a cadre of patients had developed an entrenched, negative view of themselves, and their experiences of rejection appear to be a key element in the construction of these self-related feelings" and "hostile neighbourhoods may not only affect their self-concept but may also ultimately impact the patient's mental health status and how successful they are

4. Erving Goffman - Goffman's book Stigma: Notes on the Management of Spoiled Identity (1963) examines how to protect their identities when they depart from approved standards of behaviour or appearance, people manage impressions of themselves, mainly through concealment. Stigma pertains to the shame a person may feel when he or she fails to meet other people's standards, and to the fear of being discredited—which causes the person not to reveal his or her shortcomings. Thus a person with a criminal record may simply withhold that information for fear of judgment by whomever that person happens to encounter. Erving Goffman coined the term "Total Institution" for mental hospitals and similar places which took over and confined a person's whole life. Goffman placed psychiatric hospitals in the same category as concentration camps, prisons, military organizations, orphanages, and monasteries. In his book Asylums Goffman describes how the institutionalisation process socialises people into the role of a good patient, someone "dull, harmless and inconspicuous"; in turn, it reinforces notions of chronicity in severe mental illness. The Rosenhan experiment of 1973 demonstrated the difficulty of distinguishing sane patients from insane patients.

His most popular books include The Presentation of Self in Everyday Life, Interaction Ritual, and Frame Analysis.

His most important contribution to labelling theory, however, was Stigma: Notes on the Management of Spoiled Identity published in 1963. Unlike other authors who examined the process of adopting a deviant identity, Goffman explored the ways people managed that identity and controlled information about it.