Re-framing Stigma: Felt and Enacted Stigma and Challenges to the Sociology of Chronic and Disabling Conditions

Abstract

This paper comprises a re-examination of the concept of stigma as applied to health and illness. It takes as its point of departure the author's hidden distress model of epilepsy posited in the 1980s. This model is outlined and subject to critique under the headings of conceptual decisions, theoretical context, and biographical impact. It is argued that although the model retains partial validity, its principal weaknesses are its neglect of important sociological questions more commonly posed since its formulation. An examination of these questions is followed by a consideration of stigma relations oriented towards a re-framing of stigma more appropriate for a changed, and changing, social world. A core contention is that interactionist theories of deviance and stigma alike focused almost exclusively on institutional and symbolic orders and paid scant attention to social structures and axes of power. The paper concludes with a provisional re-working of the hidden distress model of epilepsy that takes account of this contention.