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professionalstuff · 4 years ago

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REGENERATIVE LEADERSHIP

Regenerative Leadership is the process of aligning one’s own way of being, one’s actions, ways of communicating and being in relationship with the wider pattern of life’s evolutionary journey towards increasing complexity and coherence with in the nested wholeness of community, ecosystems biosphere and Universe we participate in. (Wahl, 2019) Many leaders have termed regenerative to provide an alternative to the notion of sustainability which many of leaders featured here indicate has become insufficient to describe what needs to be done, economically, socially and environmentally if we are to ensure a flourishing world for present and future generations.

Simply expressed before we can live in a sustainable society, locally and globally, we must undergo profound paradigm shift like those that have allowed us throughout the ages to divest ourselves of beliefs that could no longer explain reality, that no longer worked for us, to seek out and adopt a more satisfactory new set of beliefs. (Kuhn, 1962)

According to Brown (2006), it is not quite suitable for the leaders to rely on the traditional approaches to leadership in finding better alternatives to solve existing problems.

THEORETICAL BACKGROUND

Regenerative leaders are meant to have dynamic capabilities. Dynamic capabilities have been defined as the capacity to renew competencies to achieve congruence with the changing business environment by ‘adapting, integrating, and reconfigurating internal and external organizational skills, resources and functional experiences. (Teece, Pisano and Shuen, 1997). ‘Dynamic capability is defined as the capacity of an organisation to purposefully create, extend or modify its resource base.’ (Helfal, 2007). To qualify as a dynamic capability, a capability not only needs to change the resource base, but it also needs to be embedded in the firm, and ultimately be repeatable. (Helfat, Peteraf, 2003)

However, dynamic capabilities are argued to comprise of four main process: reconfiguration, leveraging, learning and integration. (Bowman, Ambrosini, 2003) Reconfiguration refers to the transformation and recombination of assets and resources, example, the consolidation of manufacturing resources that often occurs because of an acquisition. Leveraging refers to the replication of a process or system that is operating in one area of a firm into another are, or extending a resource by deploying it into a new domain for instance applying an existing brand to a new set of products. As a dynamic capability, learning allows tasks to be performed more effectively and efficiently, often as an outcome of experimentation and permits reflection on failure and success. Finally, integration refers to the ability of the firm to integrate and coordinate its assets and resources, resulting in the emergence of a new resource base.

When current dynamic capabilities are perceived to be insufficient to impact appropriately upon a firm’s resource base the dynamic capabilities themselves needs to be renewed. In other words, the firm needs to change the way it purposefully creates, extends, or modifies its resource base. (Helfat, 2007). In these circumstances a firm needs a set of dynamic capabilities to act upon the extant set of currently embedded dynamic capabilities, thus allowing it to change its resource base in new ways. These regenerative dynamic capabilities allow the firm to move away from previous change practices towards new dynamic capabilities. Regenerative dynamic capabilities are likely to be deployed by firms whose managers perceive that the environment is turbulent, where external changes are non-linear and discontinuous. (D’Aveni, 1994)

In essence, the leadership challenges of sustainability are contained in the need to balance complex and sometimes conflicting demands for economically, socially and environmentally sustainable solutions which require skills and behaviors that have gone unrecognized or have not been necessary in more stable organisational and social environments. (Ferdig, 2007)

The sustainability leaders create opportunities for people to come together and generate their own answers- to explore, to learn, and to devise a realistic course of action it addresses sustainability challenges. Instead of giving direction, sustainability leaders develop and implement actions in collaboration with others, modifying them as needed to adapt to unforeseen changes in the environment over time sustainability leaders recognize that the experience of change itself, and the dissonance it creates, fuels new thinking, discoveries, and innovations that can revitalize organisations. Furthermore, (Ferdig 2007) indicates that sustainability leaders make the notion of sustainability personally relevant, grounding action in a personal ethic that reaches beyond self-interest. They recognize that all of us can co-create the future through individual ways seeing, understanding, interacting, and doing. Sustainability leaders are informed, aware, realistic, courageous, and personally hopeful in ways that genuinely attract others to business of living collaboratively. From this perspective, it is impossible to define sustainability leadership as purposeful action driven from a position of enlightened self-interest, where benefiting others and the planet means the same as benefiting oneself. (Capra 2002)

Sustainability can be defined as the ability of natural and social systems to continue along what they are doing indefinitely, whereas sustainable development is the process that is undertaken so that sustainability may be achieved. (Attkisson 2008)

Regenerative leadership sits at the very core of what the organisations of today, and more importantly tomorrow, will need to rely on to thrive. (Nicklin 2020)

REGNERATIVE LEADERSHIP FRAMEWORK

The Regenerative Leadership Framework emerged from the findings of structured interviews conducted with 24 highly successful sustainability leaders in the field of business, education, and community development. The research methodology applied was the constant comparative method of qualitative analysis known as grounded theory. (Glaser and Strauss, 1967)

The study was conducted among terminal cancer patients. The major premise of the method is to allow theory to emerge from the data, rather than seeking to confirm a hypothesis, as in the scientific method. Though this may appear to contradict the scientific method, it ensures that the research bias is minimized, providing for objective findings to be extracted from the data. Among the most exiting findings was the overall correlation of leadership styles across the 3 domains of business, education, and community. While each of the approaches to sustainability of the 24 leaders were nuanced towards the most central aspect of their specific field, whether economic, environmental or social there was a surprising commonality in how they defined sustainability, how they came to perceive themselves in the context of sustainability and sustainable development, and how this influenced their leadership behavior. In the sequence of interviews, for example the majority the respondents shared the basic definition of sustainability, often used interchangeably with sustainable development, of the well-known Brandt Land Commission Report of 1987, which considers this to be the “development that meets the needs of the present without compromising the ability of future generations to meet their own needs” (World Commission on environment and development, 1987)

The regenerative leadership constructs aggregated in the 4 quadrants may be broadly conceptualized as follows:

Quadrant 1 (Individual Interior/Subjective)

Facilitating access to the source of personal purpose and emerging self.

Quadrant 2 (Individual Exterior/Objective)

Connecting with others through keen observation and deep listening.

Quadrant 3 (Collective Interior/Subjective)

Eliciting collective purpose through generative conversation

Quadrant 4 (Collective Exterior/Objective)

Engaging in collective action through third-order change and back carting to strategize and prototype the best possible solutions to emerging futures.

The framework is completed by 3 additional visuals:

1) The horizontal field of engagement and emerging consciousness

2) The indirect regenerative leadership path represented by the infinity symbol; and

3) The 2 semi-circular arrows surrounding the framework that symbolise the collaborative heterarchical leadership style that is necessary for successful management within and across multiple systems and organisations for sustainability to be made possible.

CURRENT LEADERS AND REGENERATIVE LEADRSHIP

For several leaders today, many of whom were trained in a previous era of leadership thinking, this more to more emotionally intelligent, empathetically influenced and regeneratively-led business is infinitely difficult to grasp. When there was a same conversation with a millennial leader, however, they understand intrinsically that this move is not an option. It is what 21st century business, and certainly business post COVID-19 crisis, is already poised to be founded on.

“It will be in this driving of awareness surrounding the role of regenerative leadership, which systematically puts empathy at the core of organisations that we can build-and rebuild. Business and human resilience will provide impactful organisational results”.

Regenerative Business enriches life. It enriches us our customers, and the wider stakeholder ecosystem. Regenerative Business transforms our role and purpose, from a “what’s-in-it-for me” approach to a mindset of collaboration, co creativity and contribution.

“Seeking inspiration in the natural world, the principles in regenerative leadership provide a framework for a more inspired path forward in business and life” (Gellert 2020)

KEY CHANGES THAT CAN BE MADE THROUGH REGENERATIVE LEADERSHIP

Despite of these stressful times organisational functions can be made more purposeful, creative, agile, and wiser. There are 2 pathways to be considered:

1) Chooses fear and degeneration.

2) Chooses life and regeneration.

The exact idea is that the systematic challenges we face relate to a need for an inner awakening within our collective and individual psyche. The ultimate act of leadership is guiding ourselves, our teams, and social systems through real transformation.

Shyji Saji George

MBA student.

#university of bedfordshire

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illusteresa · 5 years ago

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Methodology

From Pragmatism to Piracy

I must start by stating that I had never done research as a means to an end within my practice before. I had always gone with my gut or accumulated knowledge as a process towards a final outcome. Blinded by my own random thoughts, I had no notion whatsoever of the insights the research could provide to a creative designer/illustrator. I believed fiction and innovation had to be all new things and that there was no gaining from whatever was already done since it was indeed already done. I found out I was extremely wrong as soon as I began.

My method starts with reflective research. I found that it always begins with an emotion, a doubt or an impacting visual that triggered me in some way - just like in the creative process - followed by thorough objective research or an attempt to improve an issue I might have encountered (Mainemelis, 2002). After such I go back to reflecting on my findings.

My objective research allowed me to understand my focus subjects, helped to inform my search with quality texts from reliable and viable sources such as academic books and peer-reviewed articles. This objective search also showed proofs to my reflection, it defended my point of view and, sometimes, it even changed my view of certain subjects with the provided knowledge. It made sure that whatever I was writing about was not biased or incorrect since there were random things I used to believe in when I was young and now I question all of it till proof is given.

I have little use of subjective research since I made no extensive interviews nor any enquiries. I noted responses to my work for one of my blog posts because they were the focus of the experiment and the rest of the subjectivity within the posts is more reflective and critical.

In terms of reliability I focus on peer-reviewed texts as I believe they are at the top of the hierarchic chain of quality references due to their trustworthy content. However, when I gathered subjective research such as in the “Visual Irony” post, I asked colleagues, friends and family members for their insights knowing how their education, culture and beliefs would bias their responses. Opinions could easily vary but, as a designer, the public’s take on what is produced is a must for it to be effective.

From my recent reading on research methods, I found out I’ve leaned towards the grounded theory method by gathering theoretical sampling. This because, just like Glaser and Strauss in the sixties, when a problem would arise, I would gather the evidence from what is directly there by questioning its content in order to prove a point and find a solution to it (Bell & Waters, 2018). New data would always test my ideas in order to add to or break my theory. Once the solution was found, I would distance myself in order to see its faults since it is my belief that the best tool we have rests in our brains, in reflecting on the issues that we stumble upon.

On the other hand I believe I could have gone deeper as I acknowledge that by being critical and reflective I don’t do as much objective research as I think I should in order to support my theories. There is, also, a lack of originality in terms of research methods in my opinion.

Being very introspective, I found reflection to accompany me everywhere I went and in whatever I researched, either for visual inspiration or for when I stumbled upon situations that intrigue me. I used subjectivity when describing the feelings that I experienced so I could show the idea behind most posts as I wanted the reader to feel what I felt. I inspect my research in the end of each post where I relate the objective research I gathered to final concluding thoughts. Nevertheless I do not examine my argumentation’s effectiveness since I would lean towards overthinking and auto-validation until now.

Some of my posts have books defending their subject that might not be considered by all researchers since they might be mirroring my own opinion specifically. Even though I mention the contrasting thoughts on the studied subjects, I lack the consideration of other researchers views when referencing.

Leaving out most of the visual experimentation was my biggest foul provided that my master bases itself on visual language as a priority.

I am, though, limited by my interests, my understanding of only four languages (some articles I might only get access as a pdf of a scanned version where there is no way to translate it) and my education and formulate most conclusions based on my experience since it is my belief that, as I said in the “The Growth of an Idea” post, our actions are connected to us as rational beings since most of our research route’s choices depend on our gut, knowledge or personal taste.

Now, I like to think of my method as an adventure. A journey where I jump on my imaginary boat filled with tools in order to gain knowledge. I stumbled upon some obstacles in the way, gathered more tools and kept drawing my way. I might not even know to where it will lead me. In this sea of research the aim might be reaching land or finding a treasure but I ultimately believe that the richness we end up achieving comes from the whole experience of roaming this ocean of research.

To conclude, I trust it wasn’t only the research itself but the research methods that made me grow as an illustrator and designer opening paths I never knew before.

References:

Bell, J. & Waters, S. (2018) Doing your Research Project: a Guide for First-time Researchers, Open University Press

Mainemelis, C. (2002) “Time and Timelessness: Creativity in (and out of) the Temporal Dimension.” Creativity Research Journal. [Online] 14 (2). pp.227-238. https://www.tandfonline.com/doi/pdf/10.1207/S15326934CRJ1402_9?needAccess=true [Accessed: 21st November]

#methodology #methods #reflection

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hofculctr · 3 years ago

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Hofstra University

The Department of Music

presents the

Hofstra Chamber Orchestra and Hofstra Symphony Orchestra with Adam Glaser, Music Director, performing “Symphonic Dances.”

Norman Dello Joio: Choreography: Three Dances for String Orchestra ; Ottorino Respighi: Ancient Airs and Dances, Suite No. 3; Carl Maria von Weber (orch. Berlioz): Invitation to the Dance, op. 65; Johann and Joseph Strauss: Pizzicato Polka; Edvard Grieg: Symphonic Dances, Op. 64

Friday, November 12, 8 p.m. Toni and Martin Sossnoff Theater, John Cranford Adams Playhouse, South Campus Admission is FREE and open to the public. Advance Registration required. More info and to RSVP visit http://tiny.cc/9cfluz

ALL GUESTS (Hofstra students, faculty and staff, as well as visitors) that attend a Hofstra University-sponsored indoor event must be fully vaccinated. Evidence of vaccination will be required at time of entry with Hofstra Pride Pass or proof of vaccination and government ID. Masks covering over your mouth and nose, must be worn at ALL indoor events on campus.

#Hofstra #Music

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legendarypeanuttriumph · 5 years ago

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Observación participante.

El siguiente reporte es del capítulo dos, titulado LA OBSERVACIÓN PARTICIPANTE. PREPARACIÓN DEL TRABAJO DE CAMPO, del libro Introducción a los métodos cualitativos de investigación de los autores S.J. Taylor y R. Bogdan.

Este capítulo es una orientación sobre qué decisiones que tomar antes de realizar la observación participante. Este capítulo consta de ocho acápites.

En el primer acápite titulado DISEÑO DE LA INVESTIGACIÓN los autores señalan algunas particularidades del diseño de la observación participante.

En el segundo acápite titulado SELECCIÓN DE ESCENARIOS los autores brevemente establecen como elegir el escenario de investigación ideal.

En el tercer acápite titulado ACCESO A LAS ORGANIZACIONES hacen los autores algunas recomendaciones para acceder a investigar organizaciones.

En el cuarto acápite titulado ACCESO A LOS ESCENARIOS PÚBLICOS Y CUASI PÚBLICOS, Taylor & Bogdan abordan algunas sugerencias para la investigación en lugares públicos.

El quinto acápite ACCESO A ESCENARIOS PRIVADOS trata sobre como establecer contacto a escenarios privados.

El sexto acápite ¿QUÉ SE LES DICE A PORTEROS E INFORMANTES? trata sobre como comunicar los intereses investigativos de forma efectiva a informantes y porteros sin obstaculizar la investigación.

El séptimo acápite RECOLECCIÓN DE DATOS. En este acápite se examina la importancia de formular notas de campo de forma detallada.

El octavo y último acápite es titulado INVESTIGACIÓN ENCUBIERTA aquí los autores aluden al criterio de una variedad de científicos sociales, así como también sus propias opiniones sobre la investigación encubierta.

Primer acápite

A diferencia de otros métodos de investigación, la observación participante se caracteriza por su flexibilidad, su enfoque constantemente evoluciona.

Aunque lo conveniente es realizar la observación participante sin preconceptos específicos, siempre existen interrogantes previas a la investigación de campo. Estas interrogantes las dividen los autores en dos categorías: sustanciales y teóricas. Las categorías sustanciales se refieren a interrogantes relacionadas con ''problemas específicos en un particular tipo de escenario'', y las categorías teóricas se refieren a ''problemas sociológicos básicos, tales como la socialización, la desviación y el control social.''

Ambas categorías están interconectadas, debido a que un ''buen estudio cualitativo combina una compresión en profundidad del escenario particular estudiado con intelecciones teóricas generales que trascienden ese tipo particular de escenario.''

Indican que no es sensato aferrase a ningún interés teórico, así como tampoco a ningún escenario, es preferente que se investigue los fenómenos tal y como emergen, y si se encuentra particularmente interesado en cuestiones teóricas, estar dispuesto a cambiar de escenario. Indican que ''Todos los escenarios son intrínsecamente interesantes y sucinta importantes cuestiones teóricas.''

Los autores opinan que ''en el momento en que los observadores participantes inician un estudio con interrogantes e intereses investigativos generales, por lo común no predefinen la naturaleza y número de los casos -escenarios o informantes- que habrán de estudiar.''

Cuando de investigaciones cuantitativas se trata, ''los investigadores seleccionan los casos sobre la base de las probabilidades estadísticas''. El muestreo al azar tiene como objetivo ''asegurar la representatividad de los casos estudiados respecto de una población mayor en la cual está interesado el investigador.''

Similar a este muestreo estadístico, en investigaciones cualitativas, se define la muestra sobre una base que evoluciona conforme el estudio avanza.

Referente a esto, los autores aluden a un concepto formulado por los sociólogos Glaser y Strauss denominado muestreo teórico, este es un procedimiento que consiste en seleccionar ''casos adicionales a estudiar de acuerdo con el potencial para el desarrollo de nuevas intelecciones o para el refinamiento y la expansión de las ya adquiridas.'' Es gracias a este procedimiento es posible comprobar ''si los descubrimientos de un escenario son aplicables a otros, y en qué medida. De acuerdo con Glaser y Strauss, el investigador debería llevar a un rendimiento máximo la variación de casos adicionales seleccionados para ampliar la aplicabilidad de las intelecciones teóricas.''

Segundo acápite

Consideran los autores que un escenario ideal, es donde el investigador: 1) tiene fácil acceso, 2) logra establecer rapport y, 3) le es posible recoger datos pertinentes a su investigación.

Enfatizan la importancia de la paciencia para elegir un escenario, ya que, por lo general, las cosas progresan lentamente.

Sugieren que el investigador evite escenarios en los que exista una cercanía personal o profesional, estiman que ''cuando más próximo se está a algo, más difícil resulta desarrollar la perspectiva crítica necesaria para conducir una investigación consistente.''

Tercer acápite

Cuanto de organizaciones se trata, el investigador obtendrá acceso por medio de porteros. Estos son agentes con alta responsabilidad, con estatus o alto rango.

Es pertinente que el investigador no proyecte que proporcionara inconvenientes o molestias en la estructura de la organización. Debido a que el acceso a las corporaciones y a grandes organizaciones es particularmente difícil, existen varias tácticas de introducción a los que los autores aluden: (1) El enfoque directo; (2) por medio de una red de contactos, y; (3) por la puerta trasera.

Es probable que existan tensiones entre los distintos niveles de jerarquía en una organización, por lo que, si el interés investigativo radica en los niveles inferiores, es preferible que el investigador mantenga considerable distancia de los porteros una vez que se haya obtenido acceso. También existe la posibilidad de que los porteros asignen a los investigadores informes de sus observaciones, es frecuente que estos solo le brinden al portero información muy general.

El hecho de puede existir un lapso significativo entre el acceso al escenario y la iniciación de la observación, o que en ocasiones no se consienta el acceso al investigador, son algunas de las adversidades que los autores consideran importante tener en cuenta en el diseño de la investigación.

Cuarto acápite

Cuando el investigador se encuentra en escenarios públicos (parques, edificios gubernamentales, aeropuertos, estaciones ferroviarias, playas y etcétera) o semipúblicos (establecimientos privados como, bares, restaurantes, teatros, negocios, etcétera), los autores aluden a Steven Prus, quien sugiere ubicarse en los puntos de mucha acción. Es decir, aproximarse a las personas y emprender una conversación casual.

Los autores advierten de la importancia de ''asumir un rol aceptable'' cuando el investigador permanecerá en lugar por un tiempo determinado. Aconsejan, ''Identifíquese antes de que la gente comience a dudar de sus intenciones, en especial si está en envuelta en actividades ilegales o marginales.''

Quinto acápite

En cuanto a escenarios privados, Taylor y Bogdan establecen que la técnica para ''lograr acceso a escenarios y situaciones privados es análoga a la del entrevistador para ubicar informantes. Tanto a los escenarios como los individuos hay que encontrarlos; el consentimiento para el estudio debe ser negociado con cada individuo.''

Los autores describen una técnica para ganar acceso a escenarios privados denominada bola de nieve, esta consiste en ganar la confianza de una pequeña red de personas y que estas nos introduzcan a más, y así, paulatinamente se construya una red de contactos.

Taylor y Bogdan establecen que existen cuatro tácticas por donde comenzar.

En primera instancia comenzar a averiguar con contactos personales.

Segundo, que el investigador se comprometa con la comunidad que quiere estudiar.

En tercer lugar, concurrir los mismos establecimientos y organizaciones sociales que el sujeto de estudio.

Y cuarta, el hacer uso de la publicidad.

Sexto acápite

Determinan los autores que no es conveniente explicar con detalle los pormenores relativos a la investigación o la fidelidad con la que se hará la recolección de información.

Señalan que el investigador debe ser ''veraz, pero vago e impreciso.'' Nunca engañar deliberadamente, pero tampoco hacer sentir al sujeto demasiado observado para no inhibir su comportamiento.

Una forma efectiva sería argumentar que el investigador no se encuentra especialmente interesado en esa organización o personas específicas. Los autores arguyen que en todas las investigaciones ''los intereses del investigador abarcan más que un escenario particular''.

Frecuentemente los porteros poseen cierta aprensión a la investigación por temor a las consecuencias de los descubrimientos, o por temor a que la investigación consista de métodos intrusivos que perturbe de algún modo el escenario, por lo que es común que los porteros demanden elaboras explicaciones sobre la metodología, o expresen preguntas críticas sobre el diseño de investigación y quieran establecer ciertas garantías (pactos).

Aconsejan los autores, que los investigadores anticipen estas problemáticas y tengan respuestas preparadas, ''bastará con una consideración superficial e imprecisa de los métodos de investigación cualitativos, la teoría fundamentada, etcétera.''

Séptimo acápite

De manera muy breve los autores indican que durante el proceso de lograr el ingreso a un escenario es importante llevar de forma detallada un control de observaciones ya que estas al final, por más triviales que parezcan, proveerán al investigador de valiosa información.

Expresan los autores, ''El proceso de obtener acceso a un escenario también facilita la compresión del modo en que las personas se relacionan entre sí y tratan a otros.''

Octavo acápite

En cuanto a la investigación encubierta, los autores indican que esta ''suscita graves problemas éticos''.

Hay científicos sociales como Jack Douglas que consideran que el engaño es parte de la cotidianeidad, por lo que no es vital ser franco con el informante. Por el contrario, antropólogos como James Spradley, defienden el ''derecho a no ser investigado'' de las personas.

Otros como Norman K. Denzin opinan que el propio investigador debe tener la plena libertad de suscribirse a las conductas éticas que encuentre oportunas.

Por último, están los que opinan que el fin justifica los medios, y si los resultados de la investigación proveerán de beneficios a la sociedad, es lícito no ser del todo veraz. Los autores son de este criterio, aunque si bien, no abogan por el engaño abierto con el simple objetivo de cumplir con alguna obligación o ambición académica, reconocen que existe una escasez de investigaciones a grupos que concentran poder, y establecen que ''estudiar de modo encubierto los grupos poderosos puede resultar recompensatorio*''.

Al finalizar, los autores también aluden al hecho de que toda investigación guarda cierta deshonestidad, el investigador nunca es completamente veraz debido a que no es posible explicar el proceso de investigación al sujeto de estudio, ya sea por su cualidad abstracta que exige de un análisis imperioso o, por la cualidad emergente de la investigación que no provee al investigador de resultados claros inmediatos.

En conclusión, este capítulo aborda las cuestiones fundamentales de tomar en cuenta a priori a la observación participante, desde la conexión con nuestros sujetos de estudio como la selección de escenarios.

Bibliografía:

Taylor, S.J. Y R. Bogdan. ''La observación participante. Preparación del trabajo de campo'' Introducción a los métodos cualitativos de investigación. Edit. Paidos Basica, España, 2000, pp. 31-49

#2019 #Observación participante #S. J. Taylor #R. Bogdan #Métodos y Técnicas de Investigación Antropológica

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robwilsonimages · 5 years ago

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Grounded Theory and Photography

Robert Wilson

Blog Post 3

4th November 2019

For my MA Photography project, I am considering the use of Grounded Theory as a research methodology that I can apply to my photographic data collection and analysis. Before I can implement this research paradigm, it is important to consider its suitability for use in a photographic project. This article will examine how a photography project can generate a theory which demonstrates the potential of Grounded Theory for the medium.

Robert Frank’s The Americans: the creation of a theory of place in photography

Grounded Theory is a qualitative research methodology that was first revealed to academia by Barney Glaser and Anselm Strauss in their ground-breaking work The Discovery of Grounded Theory (1967). Strauss’s successor and collaborator Juliet Corbin summarises Grounded Theory as

‘… a form of research the purpose of which is to construct theory from data. The methodology is carried out through a set of data gathering and analytic procedures. Procedures should be used flexibly and reflect the analytic task at hand. Researchers can’t pick and choose among the procedures deciding to use some and discard others. It is the flexible use of procedures that lead to the development of rich and dense theory that fits the data and that offers insight and solutions to the issues and problems of participants.’ (Corbin, 2017)

Whilst Grounded Theory was originally used in nursing studies, it has now become widely applied across academic disciplines. This article will explore the appropriateness of Grounded Theory as a framework for photographic research. It will not provide cases of photographers using Grounded Theory as there is no explicit evidence in the literature that photographers have consciously applied the paradigm but will illustrate its suitability for photography by showing how artists can built theories within their work. To do this, we will examine the clearest and most well-known example of a photographer creating a theory – Robert Frank’s The Americans (2008).

The Americans and its Theory of America

Frank’s The Americans (2008), first published in 1958, was not initially popular, and the majority of reviews were critical. Yet, it has come to be regarded as a seminal work of documentary photography. Uniquely at the time, the work was not solely about aesthetics or creating a single narrative but constructed a theory of America. The book is not an ode to American, but is,

‘…ambiguous, destabilized, ‘moving’ photography that engages the viewer in a dialogical process rather than transmitting a ready-made story with its pre-packaged values and assumptions.’ (Campbell, 2003, p. 214)

The book turns a critical eye on America and that America is, most particularly, one of flags, of automobiles, jukeboxes, and religion, and of racism. It must be noted that Frank’s theory of America does extend beyond the three features above, but for the necessity of brevity, this article will focus on these alone. For greater exploration, the reader is encouraged to engage with The Americans itself as well as Robert Frank's 'The Americans': The Art of Documentary Photography (Day, 2011).

Flags

Robert Frank - Parade – Hoboken, New Jersey (1955/56)

The Stars and Stripes is central to the arrangement of the book (Day, 2011, pp. 71-76). They are the placeholders that begin each new ‘chapter’ (p. 71). In each of the images that feature the flag, the people present are subordinate to it. For example, in the opening image of the book Parade – Hoboken, New Jersey, Day notes that the women in the image are

‘… marginalized, cramped into the corners of the composition. They appear no more important in the image’s visual hierarchy than the wall which divides them. These women are fitted into this block not because it suits them or is a desirable residence, but because there is nowhere else they can go.’ (p. 72)

As we proceed through the book, the flags continue to appear. For example, in Fourth of July – Jay, New York, a tattered flag overshadows a party, yet the participants are seemingly unaware of its presence. In the last image to feature a flag, the amusing Political rally – Chicago (the second image in the book to carry the name), the bandsman is subsumed by his sousaphone: the instrument dominates and his identity is hidden (pp. 75-76). In Frank’s America, flags are a constant theme, and even if the responses of those featured in the images are not consistent (p. 76), the people themselves are always of secondary importance.

Automobiles, Jukeboxes and Religion

Frank’s America has three religions: Christianity, jukeboxes and cars. Christianity, represented by crosses both real and implied, features throughout the book. Juxtaposed against this are both the automobiles, which are not new, but are ‘older models, junked cars, or accidents on the side of the road’ (Mortenson, 2014, p. 425), and the jukeboxes which serves as altars for people of every background. The country worships before all three.

Robert Frank – Political Rally – Chicago (1955/56)

Political Rally – Chicago (the first image to carry the name) is the first of the implied crosses to feature. The figure, with arms spread wide and high, appears almost crucified on the cross formed by the window above. His expression is either triumphant or a grimace of pain. Halfway down his chest is a black patch. This maybe shadow but appears more like a stain. Was this the entry point for his Spear of Destiny?

This image and Jehovah’s Witness- Los Angeles feature implied crosses, but the work also features multiple ‘real’ crosses. Christianity is the overriding faith in the book, but Frank shows that it is not the only faith.

Robert Frank – Covered Car – Long Beach, California (1955/56)

In Covered Car – Long Beach, California, the anonymous car has become the altar in the church of the automobile. As Day (2011, p. 62) points out,

‘The photograph depicts a car covered in a cloth. The cloth appears to be silk, perhaps a parachute or something similar. The richly adorned car stands between two palm trees, which create the impression of a portico. The car thus becomes an altar, complete with altar cloth.’

For the rest of the work, the automobile is a frequent feature. It is a constant facet of everyday life in The Americans. Its variety of appearance include as a simple mode of transport, at a funeral, as an intrusion, as a place to sit during a movie, and finally as a place of rest in the final image of the book. The presence of the car cannot be escaped and it is an inclusive faith. However, only one other image consecrates the automobile as overtly as Covered Car – Long Beach, California, and that is St. Francis, gas station, and city hall – Los Angeles.

Robert Frank – St. Francis, gas station, and city hall – Los Angeles

Here, the statue, which Frank names as St. Francis,

‘…preaches directly across a deserted highway, into the sun. … St Francis is famous for his sermon to the birds. … Here he preaches to an audience of automobiles.’ (p. 88)

The cars appear, flock like, crammed between the two buildings waiting on every word. By being blessed or preached to by St. Francis, the image inescapably marks the cars as part of America’s religion.

Robert Frank – Bar – New York City (1955/56)

In Bar – New York City, the jukebox glows ethereally as if beckoning converts with a mystic light. Day (p. 143) describes it as ‘a modern-day Gabriel trumpeting in song the arrival of a new age’ and notes that the figures present in the bar seem to take little notice of its radiance. This jukebox wants to convert more to its cause even if, as in this image, few are listening.

However, in images such as Candy Store – New York City, the jukebox, like the car in Covered Car – Long Beach, California, becomes an altar. This time surrounded by young people who informally worship at it. Like the car, the jukebox is inclusive in its conversion of followers. This is illustrated effectively by Café – Beaufort, South Carolina. Here, a small African American baby is sprawled face first on the edge of a large cushion. The child is dwarfed by an enormous jukebox which seems to watch over the child in a protective, almost angelic fashion. Despite the child’s potential exclusion, on account of its ethnicity, from much of what 1950s America has to offer, the jukebox is there for him or her regardless of background.

Belief and its paraphernalia, conventional or otherwise, is a consistent theme of Frank’s America. It is one of the key theories that underpin The Americans as a critical description of 1950s America.

Racism

Whilst racism is frequently alluded to in the book, one images confronts it directly. That picture is both the book’s cover and arguable its most well-known. It is Trolley – New Orleans.

Robert Frank - Trolley – New Orleans (1955/56)

The message of segregation is clear in this picture of a racially divided America. The white passengers are in the front and the black passengers the back. They are separated by a divide. However, the image offers us more than a simple reading. As Sturken and Cartwright (2009, pp. 19-20) note,

‘It is as if the trolley itself represents the passage of history… The trolley riders seem to be held for one frozen, pivotal moment within the vehicle, a group of strangers thrown together to journey down the same road that would become so crucial to American history…’

This analysis can be taken further still. In the centre of the picture, we see two children, innocent of expression; it is they who are necessarily the central focus of the image. It is the minds of children that are to become the battleground. If the children cannot be persuaded of the folly of racism and segregation, then America’s future is a bleak one.

Racism is also seen in a wider but less overt context than segregation in the South in the image San Francisco.

Robert Frank - San Francisco (1955/56)

In this image, Frank surprises and photographs a black couple relaxing above an apparently wealthy white-washed suburb. However, they are separated from it excluded from the gleaming buildings and affluence. Professor Maurice Berger, writing in the New York Times notes that,

‘Rather than a neutral observer, Mr. Frank looms over them, an active, unseen participant — a surrogate for the intimidating whiteness that shadowed the lives of black Americans, no matter how liberal their environment.’ (2015)

It is clear from these two images as well as others in the book that the racism of mid-1950s America is an integral feature of Frank’s theory. Whilst is never again confronted so overtly as in Trolley – New Orleans, it is a constant theme.

The Connection to Grounded Theory

Grounded Theory did not exist as a research paradigm when Robert Frank was completing his work on The Americans. If it had existed, we can be confident that Frank would been neither aware nor interested in its potential as a photographic research tool as his great project was not an academic exercise. However, this does not obviate the realisation that he created a theory of America in his work. His theory is individual and subjective, but, nonetheless, it is a theory.

Since its creation Grounded Theory has consistently shown that it can be an effective method of generating theory in research. Additionally, it is axiomatic that qualitative research methods in general are subjective in nature. Therefore, if we accept that a body of photographic work can generate theory, and Frank’s work suggests the truth of this, it seems entirely appropriate to accept that Grounded Theory can be used a method of theory generation for a photographic research project.

References

Berger, M. (2015). The New York Times. [Online] Available at: https://lens.blogs.nytimes.com/2015/01/15/robert-frank-telling-it-like-it-was/ [Accessed 6 11 2019].

Campbell, N. (2003). 'The look of hope or the look of sadness': Robert Frank's dialogical vision. Comparative American Studies An International Journal, 1(2), pp. 204-221.

Corbin, J. (2017). Grounded Theory. The Journal of Positive Psychology, 12(3), pp. 301-302.

Day, J. (2011). Robert Frank's 'The Americans' The Art of Documentary Photography. Kindle ed. Bristol: Intellect.

Frank, R. (2008). The Americans. 11 ed. Gottingen: Steidl .

Glaser, B. & S., S. A. (1967). The Discovery of Grounded Theory. 1st ed. Chicago: Aldine.

Mortenson, E. (2014). The Ghost of Humanism: Rethinking the Subjective Turn in Postwar American Photography. History of Photography, 38(4), pp. 418-434.

Sturken, M. & Cartwright, L. (2009). Practices of Looking: An Introduction to Visual Culture. 2nd ed. New York: Oxford University Press.

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Difference Between Grounded Theory and Ethnography Difference Between Grounded Theory and Ethnography Definition Grounded theory and ethnography are two qualitative research methodologies. Grounded theory, developed by Barney Glaser and Anselm Strauss, is a methodology that involves developing theory through the analysis of data.

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Juniper publishers-Aging In Grace and the Effects of Social Isolation on the Elderly Population

Abstract

Our conception, birth and developmental processes are as a result of human cooperation which establishes a necessity of our dependence on others for success, personal progress and well-being. Without this cooperation our full growth into adulthood will be grossly hampered. This article will discuss such cooperation and confirm the reality that we are summed by the contributions made in our lives by people we have been privileged to encounter in our journey of life.

It identifies successful aging or aging in grace within a framework of factors and conditions that encourage the potential development of the 'untapped reserves' of the elderly population. It is also aims at demonstrating how social isolation is a problem in the general wellbeing of the elderly population and "social death” as a devaluation of the humanity of others and of the human person in general. Finally, it recommends social support systems as imperative in promoting general well-being among older adults.

Introduction

In the light of our collective cynicism and stereotyping of aging and the elderly—elderly people are sick, elderly people are ugly, elderly people are obsolete, the question arises: is there any hope to age in grace or successfully, and experience some kind of tranquility and happiness in the process, and what would that entail? Aging in grace, graceful aging, successful aging, optimal aging, positive aging, productive aging, active aging, adaptive aging, or aging well, are all ideas without universally accepted definitions. A focus on aging includes concepts such as health, life satisfaction and quality of life and genetic, biomedical, behavioral and social factors.

Aging in Grace and Other Nuances

The terms aging in grace, graceful, successful, positive or optimal aging are usually used interchangeably, but, according to many gerontologists these terms focus on life-style choices that promote quality aging, and therefore minimize age-related problem. The term successful aging was made popular by Rowe and Kahn [1] in order to describe quality aging well into old age. Aging in grace is one of the ways of describing the other ways of growing old happily, successfully and normally, or the average aging development as assessed on any measure and with any age definition, and pathological aging, which incorporates acute or chronic disease that hampers a normal aging pattern and accelerates decline. Many people, view aging as 'something to be denied or concealed', but aging in grace and successful aging have to do with 'aging well' which is not the same as 'not aging at all'.

Successful aging is no longer an oxymoron but a reality. Nevertheless, a standard or uniform definition for successful aging still does not exist. Part of the problem in defining the term is a lack of consensus on what aging is, when it starts, and finding general criteria for success, since social and cultural values both play a role in the definitions [2]. Successful aging can be defined as the process of promoting gains and preventing losses through a process called 'Selection, Optimization and Compensation' (SOC). An inclusive definition of successful aging necessitates a value-based, systemic, and an ecological perspective. Both subjective and objective indicators need to be considered within a given cultural context with its particular contents and ecological demands. The solution according to Rowe and Kahn [1] is thus to use various subjective and objective criteria for successful aging, focusing on individual variability within a given culture.

Successful aging is the result of the interaction between an aging individual within his or her society over the life span, and can also be described as the process of 'adaptive competence'with regard to the challenges of later life, using both internal and external resources. Since dynamics in society influence the aging process, successful aging is not solely an inherent quality of an aging person. There is a bidirectional relationship between an aging individual's adaptive competence and the developmental tasks of society. Successful agers appear to fare well on developmental tasks. There does not seem to be clear scientific agreement on a definition of developmental tasks, but Featherman et al. [3] describe them as sequences of tasks over the life course whose satisfactory performance not only is important for the person's sense of competence and esteem in the community, but also serves as preparation for the future. Developmental tasks require using one's cognitive, emotional and behavioral skills to manage one’s life circumstances. Examples of adaptive competence include gathering social support, maintaining independence as far as possible and adjusting well to retirement. Featherman et al. [3] are of the opinion that as aging progresses, ill-structured tasks out-number well-structured tasks. Well-structured tasks are sometimes defined as problems with standard solutions or techniques, and ill-structured tasks as more ambiguous problems with relative solutions. Reflective planners tend to fare better in retirement because of their accumulated expertise in solving ill-structured problems.

I. With Rowe and Kahn, we identify three key aspects in successful aging

i. preventing disease and disability as far as possible, inter alia through good lifestyle choices,

ii. continuing with mental and physical exercise throughout the life span, and

iii. Keeping up an active life-style, by being productive and by fostering strong social relationships.

This identification was based on the 10-year MacArthur study involving a multi-disciplinary team of professionals that wanted to answer three questions:

i. the meaning of successful aging,

ii. what can be done to age successfully, and

iii. What changes are necessary in American society to facilitate successful aging.

This equally helped with a paradigm shift away from conceptualizing aging as more focused on disease and disability, to a more hopeful approach. However, research confirms that few very old people (older than 90 years) age successfully. Thus, the concept aging in grace, Ihenetu [2] suggests is more 'comprehensive' than successful aging, because aging in grace focuses on 'quality of life and a sense of well-being' despite age- related decline or ill health. Successful aging for some researches is an idealized term that is not necessarily in accordance with the present reality of aging, due to the fact that restrictive factors such as ageism, affordable housing, adequate income and quality healthcare are not taken into consideration. On the other hand, the value of successful aging lies in understanding that an individual can contribute to aging well, for example through specific activities or life-style choices. Nevertheless, few elderly people fit neatly into the categories of successful, normal or pathological aging for all capabilities and suggests that one should maximize successful aging in the capabilities one can control as early in life as possible, employing preventive measures to delay age-related decline for as long as possible.

Social Death and Social Isolation Among The Elderly Population

With the advance of science and modernity, the meaning and understanding of death has been evolving. Death can be defined on a variety of different levels but most people define death as a physical event in which there is a cessation of all bodily functions including beating of the heart. Some in the medical field will broaden this to include 'clinical' or 'biological' death. The 'social death’ phrase evolved and relates to those who die in a social sense consequent to degeneration of the brain or disease, which limits interaction with those around them.

The first available presentation of social death came from Glaser and Strauss (1966), during a discussion of 'hopelessly comatose’ patients, these authors describe their receipt of 'nonperson treatment from hospital personnel when talking freely about things that would matter to the conscious patient. They said that socially he is already dead, though his body remains biologically alive. They also describe some 'senile patients' as 'socially dead as if they were hopelessly comatose’ in the eyes of the families who consign them to institutions and thereafter fail to visit. Some individuals according to Ihenetu [4] regard certain health challenges as a result illness or old age as a social death in which the person is no more connected to society and is dying a little at a time with no hope for recovery. A person's true worth does not diminish as a result of certain health challenges, it becomes an assault for a system of society to diminish and devalue the humanity of others as socially dead or insignificant based on the condition of life.

It is important to debate the idea as to whether elderly persons who are faced with the challenges of old age can be considered socially dead because how they are perceived would directly correspond to how they are cared for and valued in society. A good place to start would be to ask the question; what it is that makes an individual into a whole person? What is it that would allow one to say that an individual has a worthwhile life or life of value? The perception of social death may have some correlation to anticipatory grief that precedes the impending death of an elderly patient. What this means is that the caregiver or family member who is in the position of contributing to the social life of the individual might have given up long before exhausting every available opportunity to communicate. Labeling someone as socially dead is a serious allegation. In essence, it is the end of an individual's social existence. It might even be considered as a self-fulfilling prophecy that could speed up actual physical death. Social death occurs when a person is treated as a corpse although he or she is still clinically and biologically alive. For instance, this is much like allowing someone who was brought into a hospital in a near death state to remain on the stretcher overnight for the fear of unnecessarily having to dirty a bed. Social death does not always lead to biological death nor is it a definite concept.

A survey by Pat Robertson (2011) which referred to Alzheimer’s patients as socially dead, 100% of the responses received from surveys sent out to caregivers show otherwise. When specifically asked if those with Alzheimer's are to be considered socially dead, here below are some of the responses received from caregivers: "Absolutely not; each time my father saw me I could see a twinkle in his sad blue eyes. He did not know my name but he called me pretty’. Another said, 'Not at all - we still can enjoy church; sing and he still goes to Sunday school but does not recall anything except the Lord 's Prayer” To the same question, a Hospice Medical Director writes 'No, because they are still relational to the family to which they belong. They interact with loved ones even until death.' Another doctor who specializes in geriatrics notes, "In those with advanced dementia though the interaction/conversation may be basic or repetitive, they can still interact and thus are not socially dead.” A palliative care doctor said, "I believe they are far from socially dead. Although they may not be able to verbalize, they do communicate in other ways - why can’t people see it?”

Self-perceived social death occurs when an individual accepts the notion that he or she is as good as dead. When a patient is given a terminal diagnosis, it can be a cause to precipitate such thought. However Kastenbaum [5] is of the view that social death must be defined situationally. In particular, it is a situation in which there is absence of those behaviors which we would expect to be directed towards a living person and the presence of behaviors we would expect when dealing with a deceased or non-existent person. Thus, although an individual may be potentially responsive and desperately seeking recognition and interaction, that individual will by this definition be socially dead if others cease to acknowledge his or her continued existence. Consequently, it is paramount to get this right. Non-cognitive or elderly persons should never be looked upon as those who cease to have continued existence [4].

On the other hand, when we look at social isolation among elderly adults, we discover that there are so many researches on the effects of isolation on children and young adults, but only a few on the effect of isolation on the elderly. However, the human need for social connection does not fade away among the elderly, which is to say, the elderly have the need for social connections. Decline of social connection is considered one of the various interrelated factors which compose well-being among the elderly. Hence, it is necessary and important to deepen the knowledge about social isolation among the elderly. According to some authors, social isolation is a subject concerned with the objective characteristics of a situation and refers to the absence of relationships with other people, that is to say, they believe that persons with a very small number of meaningful ties are socially isolated, (ibid.,35).

Meanwhile, Ihenetu [4] enumerated five attributes of social isolation as: number of contacts, feeling of belonging, fulfilling relationships, engagement and quality of network members. Consequently, even loneliness, depression symptoms and their temporal connection are not attributes of social isolation, but those concepts can be causes of being socially isolated. Therefore, lack of a sense of social belonging, lack of social contacts, lack of fulfilling and quality relationships, psychological barriers, physical barriers, low financial/resource exchange and a prohibitive environment can be possible reasons leading to social isolation.

Turning to the effects of being socially isolated, it has been associated with increased vascular resistance, elevated blood pressure, impaired sleep, altered immunity, alcoholism, progression of dementia, obesity and poorer physical health. In other words, socially isolated individuals have a higher possibility of suffering from health issues. Also, drinking, falls, depressive symptoms, cognitive decline and poor outcome after stroke, nutritional risk, increased rates of re-hospitalization, loneliness and alteration in the family process were are also specific effects of social isolation. These truly existing negative effects prove that social isolation has a far-reaching impact on elderly well-being.

Its effects on the elderly well-being are phenomenona which cannot be ignored. The socially isolated elderly persons are among the risk group for myriad other negative health consequences, such as poor nutrition, cognitive decline and heavy alcohol consumption. Therefore, social isolation has a non-ignorable influence on elderly well-being [4]. It is more prevalent in older adults due to diminished vitality and health. In other words, diminished vitality and health are direct causes for being socially isolated among the elderly. Simultaneously, vitality and health are considered a vital dimension of elderly well-being. In sum, the relevance between elderly well-being and isolation is arising from interaction.

Isolation

Working Definition

'Belonging' is a multi-dimensional social construct of relatedness to persons, places, or things, and is fundamental to personality and social well-being. If belonging is connectedness, then social isolation is the distancing of an individual, psychologically or physically, or both, from his or her network of desired or needed relationships with other persons. Therefore, social isolation is a loss of place within one’s group(s). The isolation may be voluntary or involuntary. In cognitively intact persons, social isolation can be identified as such by the isolate.

Some researches portray social isolation as typically accompanied by feelings related to loss or marginality. Apartness or aloneness, often described as solitude, may also be a part of the concept of social isolation, in that it is a distancing from one's network, but this state may be accom¬panied by more positive feelings and is often vol-untarily initiated by the isolate. Some researchers debate whether apartness should be included in, or distinguished as a separate concept from, social isolation. Social isolation as we can see has several definitions and distinc¬tions, dependent upon empirical research and the stance of the observer.

When Isolation Becomes A Problem

Social isolation ranges from the voluntary isolate who seeks disengagement from social intercourse for a variety of reasons, to those whose isolation is involuntary or imposed by others. Privacy or being alone, if actively chosen, has the potential for enhancing the human psyche. On the other hand, involuntary social isolation occurs when an individual's demand for social contacts or communications exceeds the human or situa¬tional capability of others. Involuntary isola¬tion is negatively viewed because the outcomes are the dissolution of social exchanges and the support they provide for the individual or their support system(s). Some persons, such as those with cognitive deficits, may not understand their involuntary isolation, but their parent, spouse, or significant other may indeed understand that involuntary social isolation can have a negative and profound impact on the caregiver and care recipient.

When social isolation is experienced neg¬atively by an individual or his or her significant other, it becomes a problem that requires man¬agement. In fact, according to much of the liter¬ature, only physical functional disability ranks with social isolation in its impact on the patient and the patient’s social support network (family, friends, fellow workers, and so forth). Therefore, social isolation is one of the two most important aspects of chronic illness to be managed in the plan of care.

The Nature and Distinctions of Social Isolation

Social isolation is viewed from the perspective of the number, frequency, and quality of con¬tacts; the longevity or durability of these contacts; and the negativism attributed to the isolation felt by the individual involved. Social isolation has been the subject of the humanities for hundreds of years. Who has not heard of John Donne's excla-mation, 'No man is an island', or, conversely, the philosophy of existentialism— that humans are ultimately alone? Yet the concept of social isola¬tion has been systematically researched during only the last 50 years. Unlike some existential¬ists and social scientists, healthcare professionals, with their problem-oriented, clinical approach, tend to regard social isolation as negative rather than positive,(ibid.). However, isolation can occur at four layers of the social concept. The outermost social layer is community, where one feels integrated or isolated from the larger social structure. Next is the layer of organi¬zation (work, schools, churches), followed by a layer closer to the person, that is, confidantes (friends, family, significant others). Finally, the innermost• layer is that of the person, who has the personality, the intellectual ability, or the senses with which to apprehend and interpret relationships.

In the healthcare literature, the primary focus is on the clinical dyad, so the examination of social isolation tends to be confined to the levels of con¬fidante and person, and extended only to the orga¬nization and community for single clients, one at a time. For the healthcare professional, the most likely relationships are bound to expectations of individually centered reciprocity, mutuality, car¬ing, and responsibility. On the other hand, health policy literature tends to focus on the reciprocity of community and organizations to populations of individuals, and so it deals with collective social isolation. At the level of the clinical dyad, four patterns of social isolation or interaction have been identified; although these were originally formulated with older adults in mind, they can be analogized easily to younger persons by making them age-relative:

a. Persons who have been integrated into social groups throughout their lifetime.

b. The 'early isolate’ which was isolated as an adult but is relatively active in old age

c. The 'recent isolate' who was active’ in early adulthood but is not in old age.

d. The 'lifelong isolate' whose life’ is one of isolation.

Normally there are feelings that isolation brings which are often characterized by boredom and marginality or exclusion. Boredom occurs because of the lack validation of one's work or daily routines; therefore, these tasks become only busy work. Marginality is the sense of being excluded from desired networks or groups. Other feelings ascribed to social isola-tion include loneliness, anger, despair, sadness, frustration, or, in some cases, relief.

Progressions In Social Isolation

Regardless of how social isolation occurs, the result is that basic needs for authentic intimacy remain unmet. Typically this is perceived as alien¬ating or unpleasant, and the social isolation that occurs can lead to depression, loneliness, or other social and cognitive impairments that then exacerbate the isolation. Several predisposing reasons for social isolation have been proposed: status-altering physical disabilities or illnesses; frailties associated with advanced age or developmental delays; personality or neurologic disorders; and environmental constraints, which often refer to physical surroundings but are also interpreted by some to include diminished personal or material resources.

A typical course of isolation that evolves as an ill¬ness or disability becomes more apparent is the change in social network relationships. Friends or families begin to withdraw from the isolated individual or the individual from them. This process may be slow or subtle, as with individuals with arthritis, or it may be rapid, as with the person with AIDS. Unfortunately, the process of isolation may not be based on accurate or rational information. Individuals with serious chronic illnesses come to perceive themselves as different from others and outside the mainstream of ordinary life. This perception of being different may be shared by others, who may then reject them, their disability, and their differences. Part of this sense of being different can stem from the ongoing demands of the illness. For example, social relationships are interrupted because fam¬ilies and friends cannot adjust the .erratic treatment to acceptable social activities. From such real events, or from social perceptions, social isolation can occur, either as a process or as an outcome.

Individuals with chronic illness often face their own mortality more explicitly than do others. Even if death does not frighten those with chronic illness, it frequently frightens those in their social networks, which leads to guilt, and can lead to strained silences and withdrawal. For those who lack this social support, social isolation is not merely a metaphor for death but can hasten it.

Possible Causes

The list to the possible causes of social isolation is endless. Retirement, death of a spouse or significant other, health problems and even reduced income can create situations where one becomes separated from social contacts. The key, however, is how the elderly person and caregivers choose to respond to these changes because the responses can make the difference in creating a positive or negative result.

Social isolation can develop when living at home causes a lack of communication with others. This results in the elderly person feeling lonely due to the loss of contact or companionship, as well as a deficit of close and genuine communication with others. It also can be the self-perception of being alone even when one is in the company of other people. We discuss the impact of these few:

A. Stigma: Social isolation may occur as one effect of stigma. Many persons will risk anonymity rather than expose themselves to a judgmental audience. Because chronic illnesses can be stigmatizing, the concern about the possibility of revealing a discredited or discreditable self can slow or paralyze social interaction. In a study examining chronic sorrow in HIV-positive patients, stigma created social isolation. Therefore, social roles and the robustness of network support affect social isolation. The individual with chronic illness or their families grapple with how much information about the diagnosis they should share, with whom, and when. If the illness is manageable or reasonably invisible, its presence may be hidden from all but a select few, often for years. Parents of children with chronic illnesses often manage stressful encounters and uncertainty by disguising, withholding, or limiting information to other, an action that may add to limiting their social network.

For example as siblings of children with infectious disease deal with the isolation of their brother or sister, they became vulnerable to being socially isolated themselves. Social isolation not only burdens those with chronic illness, it also extends into fam¬ily dynamics and requires the healthcare profes¬sional to consider how the family manages. Nurses must explicitly plan for the isolation in families with children who are chronically ill. Thus, with social isolation being a burden for the family, it requires the healthcare professional to consider how. The family manages the illness and the isolation. Where the stigmatized disability is quite obvious, as in the visibility of burn scars or the odor of colitis, the person who is chronically ill might venture only within small circles of under¬standing individuals. Where employment is possible, it will often be work that does not require many social interactions, such as night work or jobs within protected environments (sheltered workshops, home offices). Regardless of what serves as reminders of the disability, the disability is incorporated into the isolates sense of self; that is, it becomes part of his or her social and personal identity.

B. Social Rules: Any weakening or diminishment of relationships or social roles might produce social isolation for individuals or their significant others. Those who lose family, friends, and associated position and power are inclined to feelings of rejection, worthlessness, and loss of self-esteem. These feelings become magnified by the person's culture if that culture values community. An example of social isolation of both caregiver and care recipient occurred in a situation of a woman whose husband had Alzheimer’s disease. The cou¬ple had been confined for more than 2 year? In an apartment in a large city, from which her confused husband frequently wandered. Her comment, "I'm not like a wife and not like a single person either," reflected their dwindling social network and her loss of wifely privileges but not obligations. This ambiguity is common to many whose spouses are incapacitated. Moreover, after a spouse dies, the widow or widower often grieves as much for the loss of the role of a married person as for the loss of the spouse.

The loss of social roles can occur as a result of illness or disability, social changes throughout the life span (e.g., in school groups, with career moves, or in un accepting communities), marital dissolution (through death or divorce), or secondary to ostracism incurred by membership in a• "Wrong" group. The loss of social roles and the resultant isolation of the individual have been useful analytic devices in the examination of issues of the aged, the widowed, the physically impaired, or in psychopathology.

C. Age: Old age with its possible many losses of physical and psychological health, social roles, mobility, eco¬nomic status and physical living arrangements, can contribute to decreasing social networks and increasing isolation. This will become even more of an issue as the numbers of older adults are expected to increase arithmetically and proportionately in the next two decades. The prevalence of social isolation in older adults has been approximated now to be at 2-20% and even as high as 35% in assisted-living arrangements [4].

Social isolation has been linked with con¬fusion, particularly in older adults with chronic illness. But when the socially isolated are also immobilized, the combination of isolation and immobilization can lead to greater impairments, such as perceptual and behavioral changes (e.g., confusion, noncompliance, or time distortions). Physical barriers (such as physical plant designs) or architectural features (such as heavy doors) also contribute to social isolation or home-boundedness. All of these limits contribute to social isolation in ways that motivation alone cannot eas¬ily overcome.

Social isolation has been shown to be a serious health risk for older adults, with studies indicating a relationship between allcause mortality, coronary disease, and cognitive impairments. In a converse finding, older adults with extensive social networks were protected against dementia. And, as described earlier, although low social engagement may not be a form of social isolation per se, it is a psychological isolator and thus a risk factor in social isolation. For example, depressive symptoms in older adults were shown to be decreased by social inte-gration. Isolated older adults were shown to have increased risk for coronary heart disease, and death related to congestive heart failure was predicted by social isolation. Similarly, post-stroke outcomes, for exam¬ple, strokes, myocardial infarction, or death, were predicted by pre-stroke isolation.

The extent and nature of a, social network from local to community, and integrated to contained, as well as the positive; or negative nature of the social relationships in the social network, impact health as well as social isolation. In fact, the quality of the social relationship may have more impact than the number of ties, which suggests that a few solid relationships may be more beneficial than many ties of poor quality.

Social Isolation and Well-being

Generally discussions on well-being both the best methods for achieving it and whether or not it is an appropriate goal of human activity, have been frequent throughout history. It is known that health status and personality are the most important predictors of well-being. In consideration of the relationship between health status and age, studies show that overall dysfunction comes along with the aging process. However, it can also be influenced by the quality of life especially of social isolation and loneliness. In order to understand better wellbeing in the elderly, We shall analyze the meaning of well-being, the relationship between well-being and elderly and well-being with other predictors in order to find out if they are mutually contradictory [4].

In the contemporary policy and practice, Well-being has become a high profile issue. Rather than talking just about 'improving health' we are more likely to read about 'improving health and wellbeing', and similarly, the notion of 'welfare' is now accompanied by 'well-being': as well as 'doing well', the aim should be to 'be well.' Well-being has been associated with 'happiness', with 'quality of life’ or 'life satisfaction'. And sometimes it is talked about as 'subjective well-being’ or 'mental well-being.' So the idea of well-being involves how we feel about ourselves and our lives, rather than how our lives might be assessed by others [4].

In relation to elderly people and others who use social care services, the importance of 'activity' or 'healthy lifestyles' are highlighted as factors that contribute to quality of life, wellbeing and remaining independent. This is also based on the idea of 'choice'- which we can benefit from choosing how we live our lives and what services or supports will help us do so.

Psychologically, well-being is considered as a vital dimension of the elderly person’s quality of life. Psychological well-being is generated by two dimensions which are absence of depression and emotional loneliness; and presence of happiness, life satisfaction, feeling of security, and plans for the future. An individual will be high in psychological well-being to the degree in which positives affect or predominate over negatives. On the other hand, when negative effects are in a dominant position, the individual will be low in well-being. That is to say, to gain subjective well-being, pleasure usually predominates over pain in one's life experiences.

It not surprising therefore, that some elderly people have talked about the significance of all kinds of relationships to their well-being. These included relationships with families, friends, neighbors, service providers, and also for some at least, the nature of casual encounters with strangers at bus stops, at the checkout counter of supermarkets and elsewhere. People feel a sense of security knowing a neighbour is looking out for them, and the opportunity to have a chat and cup of tea can help if someone feels isolated. The opportunity to strike up conversations in public spaces can also help people who have limited social contact to feel connected, particularly if families are rarely seen and friends have died. Losing friends can also mean losing the chance to share memories and some people suggested that, not only is it hard to make new friends in old age, 'new friends’ do not carry the history that 'old friends’ do. So that when people join in activities in the hope that they may develop new connections, this may not always positively contribute to a sense of well-being.

Friendships are important at any age. The older people we interviewed talked about how friends contributed to well-being through offers of practical help, sustaining connections with their past, and also by enabling them to give back and contribute to the well-being of others. Family relationships can be a source of support, security, joy and pleasure. They can also enable older people to contribute to others' well-being; not only caring for partners, grandchildren or other relatives, but offering their knowledge and experience (e.g. of places they have visited, journeys they have made) for the benefit of younger people starting out on exploring the world. Two way learning and support (e.g. grandchildren helping them use the internet) helps older people feel they are involved in reciprocal relationships, helps them feel valued, stay in touch with the world and maintain their sense of identity.

Social support in isolation

Social support was initially defined by taking cognizance of the number of friends an individual has; but this definition has been extended to include the person's satisfaction with the support that is rendered. Social support could include esteem support, whereby a person's self-esteem is boosted by other people, informational support that includes information provided by other people, and social companionship, which consists of support rendered by means of activities. Finally, instrument support involves a form of physical assistance. Social support has also been defined by some authors as any input that can further the goals of the receiver. Social support can be tangible, including provision of physical resources that can be beneficial to the individual in some way, or psychological, that assists the individual in developing emotional well-being Social support can also be explained as the specific people or community resources to which an individual turns for emotional and instrumental assistance. While social support could be defined as the active participation of significant others in the caregiver's efforts to manage stress, caregivers can easily become isolated from social support as a result of their confinement and responsibilities, which places them increasingly at risk for stress-related illnesses. Both the caregiver's as well as the patient's quality of life can be adversely affected, as social support is important for coping and satisfies the need for attachment, a feeling of self-worth, stress relief, and so on. However, social support is generally defined as any action that is to the advantage of the receiver of such support.

Categories of Social Support

There are six criteria of social support that researchers have used to measure the level of overall social support available for the specific person or situation [2]. First, they would look at the amount of attachment provided from a lover or spouse. Second, measuring the level of social integration that the individuals involved with, it usually comes from a group of people or friends. Third, the assurance of worth from others such as positive reinforcement that could inspires and boosts the self-esteem. The fourth criterion is the reliable alliance support that provided from others, which means that the individual knows they can depend on receiving support from family members whenever it was needed. Fifth, the guidance of assurances of support given to the individual from a higher figure of person such as a teacher or parent, the last criterion is the opportunity for nurturance. It means the person would get some social enhancement by having children of their own and providing a nurturing experience.

Two other major categories of social support have also been identified [4], tangible support, which may include physical resources that could be beneficial to the receiver; and psychological support, which assists the receiver in developing beneficial affective or emotional states. Psychological support helps a person to feel more content (or to feel better). It is clear that social support from family and friends have an important role to play in assisting a person to translate intentions into health behaviours, while the absence of social support can have a detrimental effect on the individual’s overall health. Social support can also consist of support from individuals such as friends, family members, neighbors, co-workers, professionals and acquaintances. All types of support have been found to be beneficial in helping individuals to cope during a serious illness. There is enough evidence to suggest that in general people who receive support enjoy better health than those who do not receive such support.

Therapeutic effects of social support

Social support is one of most important factors in predicting the physical health and general well-being of everyone, ranging from children through older adults. The absence of social support shows some disadvantages among the impacted individuals. In most cases, it can predict the deterioration of physical and mental health among the victims. A regular social support is a determining factor in successfully overcoming life stress. It significantly predicts the individual's ability to cope with stress. Knowing that they are valued by others is an important psychological factor in helping them to forget the negative aspects of their lives, and thinking more positively about their environment. It not only helps improve elderly person’s wellbeing, it affects the immune system as well. Thus, it becomes a major factor in preventing negative symptoms such as depression and anxiety from developing. Social support and physical health are two very important factors that help the overall well-being of an elderly person. A general theory that has been drawn from many researches over the past few decades postulate that social support essentially predicts the outcome of physical and mental health for everyone.

Studies have equally shown that social support can effectively reduce psychological distress during stressful circumstances. In addition to providing psychosocial benefits, it appears to reduce the likelihood of illness and to speed up recovery from illness. It is clear therefore that social support helps individuals to obtain a more positive outlook on life, increases self-esteem and resistance to illnesses, and encourages people to engage in more positive, health-promoting behaviours. The form of it received can play an important role. For example, if someone needs emotional support and receives only tangible support, it can further add to the person's frustration and stress. Studies have shown that immuno-suppression may be reduced by social support, which confirms the notion that social support promotes health in general [6]. It also indicates that people with a high quantity and sometimes a high quality of social relationships have lower mortality rates. Social support appears to help people to effectively resist illnesses and minimize complications from serious medical conditions.

Its regular provision essentially predicts the outcome of elderly adults' general health condition. Inadequate social support at any time would predict that elderly adults will develop depressive symptoms over time. Elderly adults would be able to ignore the negative effects in their lives with help and reinforcement from others. This is considered a psychological effect. A lack in the availability of social support would likely make the individuals notice their daily hassles and life stressors much more clearly. This step could accelerate the deteriorating effect of their physical and mental health [7].

Conclusion

There is evidence that social experience is very essential in predicting successful aging and well-being for everyone, ranging from childhood through older adults [8]. After a few decades of studies, researchers have finally gained some understanding about the relationship between social support, successful aging and well-being. Nonetheless, some areas of research still face some problems because they sometimes focus on one population, ignoring the generalization rules for using the random samples to generalize the result to a whole population [4].

The continuity of research on the effects of social isolation and the relationship between social support and general wellbeing of elderly population will enable us to understand better the effects of good social support toward physical and mental health, along with a general well-being. Many studies have shown that if a high level of social support becomes available to the elderly population, it will benefit their overall health in a long run. The importance of social support implies to everyone in our society, ranging from young childhood through older adulthood. The providers of social support can be anyone in society who brings positive environment and reinforcement to the individuals, especially from their family members. This article is optimistic that we can have a dramatic impact on the success or failure in aging, and that there is the possibility of continued growth and development in the later years. Not only physical well-being will be improved, but also emotional and spiritual well-being, when retirement and 'aging in place' become the best stage of all instead of an indirect isolation.

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omg-chronoscontracter · 8 years ago

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From Sick Role to Health Role

Perhaps one of the most widely cited roles from Talcott Parsons (1964) is his notion of the ‘sick role’. The sick role, as much as it sounds basic, assumes that somebody is sick for a temporary period of time. Whilst this maybe the case, we are now living in contemporary times globally and therefore the sick role is becoming outdated with more chronic conditions. Perhaps, one could argue that the sick role has become a ‘health role’ of individuals, where things are now chronic?

Perhaps we could muse over these thoughts regarding the state of current society, with a rising aging population, an increase in comorbidities and a larger stretch financially and with resources within the health system (DoH, 2009). This does not look to decrease, but rather the system looks to become more stretched and fractured than ever before. With the rise of a health role and the diminishing sick role, acute illness is seen to soon disappear due to patient empowerment, new ways to manage the self and marketisation of the current health system (Bury, 1997).

With the previous sentence in mind, does being sick within the sick role still hold the same meanings and if it does, would we consider illness as a social deviance in a system that aims to normalise and institutionalise? Has the sick role become another out of date term? What happens when people surpass the sick role? These are the kinds of questions I am looking to answer in this piece.

What is the Sick Role within a Capitalist Economy?

According to Parsons (1964), health is defined as;

“the state of optimum capacity of an individual for the effective performance of the roles and tasks for which he has been socialised”.

Some may refer to this in the medical field as a balance called ‘homeostasis’, which is the bodies ability to maintain equilibrium in order to function at a normal capacity. For example, when we are ill the bodies fights the illness and after a few days we feel better. We become restored to a normal function and obtain a ‘healthy’ status. The performance mentioned above refers to the activities of the everyday, the normal routines that we do as individuals to maintain our daily lives and responsibilities, such as going to work an earning a living. There are limits to what can be called a ‘homeostatic approach’ (Clancy and McVicar, 2009), when the body faces a challenge where it is not possible to return the body back to its ‘normal function’, that is it aims to restore homeostasis through different bodily mechanisms. Such examples could include people who suffer from chronic obstructive pulmonary disease (COPD), strokes, brain damage and myocardial infarction. The body learns to cope normally in new ways. This point is important and will only be touched upon as this is the discussion of a future piece looking towards the idea of remission society and the postmodern reclaiming of the body.

Health is vital within the capitalist structure of society as it provides the basis for “valued achievements” and moral valued, often seen in terms of economic gain (too who is another debate for the lefties and the righties) (Gerhardy, 1989). One key institutionalised vision of health is the way in which it can impede on educational achievements, upward mobility and ultimately competition within a competitive labour market. According to theories of meritocracy, these values blossom within education and health, in essence, can impede this and affect individuals. Gallagher (1976) refers to health as an adaptive value that allows one to achieve their goals through optimum performance.

The way people enter sickness within society is of pivotal importance, as this can shape and define their social role and peoples perception that matters which shouldn’t. One could refer to such a Parsonian theory of sickness and society as a psychosomatic one due to its ability to disrupt normality and cause a withdrawal from everyday practices (Heidarnia and Heidarnia, 2016). I am not here to discuss the form of abuse or potential enjoyment, from for example constant pain, but it is worth considering within the context of defining the sick role as seen shortly.

Within illness, people are undermined by their bodies through a somewhat natural process. If a person is unable to meet the societal goals expected from them, they can become caught up in burn out. For those who enter the sick role, perhaps the start of the role, is that sickness is not a fault of the individual and therefore we should disarm far right impositions and ideologies of laziness and purposeful sickness through bad choices. I understand that this can become blurred, for example a constant smoker who then becomes ill with COPD. I should make it clear that I am not referring to somatic illness, where some would argue that you have to fight for.

Ultimately, the sick role aims to bridge a gap between the incapability to conform to societies norms and regulations in the face of illness (Varul, 2010). One key definition is ‘moratorium of reciprocity’, which introduces the sick roles second key defining feature, where people are to suspend all daily duties and activities. In basic terms, the sick role forces conformity to a role unable to socialise and conform to a normal healthy role. Such an example could be seen in calling in sick from work when you are not well in order to firstly rest and secondly, to protect others from getting whatever it is you have. One could use a metaphorical idea that people are to remove themselves away from the world of the healthy in order to recover from ill health. People do not just become sick, they become ‘disturbing elements of the system’, the healthy system (Parsons, 1987). Your role is to protect others. As history has shown countless times, society, the country and capitalism becomes transformed into a metaphorical figure that needs protection. To potential put others at risk will harm the economic system that requires workers to work.

It should always be remembered that the body is both a biological and social entity (Shilling, 2002). The physiological and social are affected by ill health. This can lead to regression, an anomie of the self. With modern day medicine and health expertise existing everywhere, people are not able to successfully treat and diagnose themselves. Perhaps one can refer to this as an anomie of the body. Gerhardt (1991) refers to a childlike dependency, where we an asymmetrical relationship is required to be formed, regardless of how temporarily. The final obligation to fulfil the requirements of the sick role is to enter an asymmetrical relationship with a ‘physician’ in order to get help with the issue they are currently experiencing. For Parsons (1951);

‘the burdens the physician asks his patients and their families assume on his advice are often very severe’.

Whilst people are in an asymmetrical relationship, one based on power, people are not consumers, they cannot pick and choose what to do and when to do it. People are not seen to have the rationality enough to make themselves well. It is not a game of preferences.

So then, in summary, the sick role is an institutional and obligatory role within society. It has three core conditions;

1. Sickness is not the result of the person but a ‘natural’ incapability of the body.

2. People are to withdraw from their daily tasks and obligations during this acute phase of ill health. This is to protect others and to allow people to recover from their current ill health.

3. Finally, the person is to seek advise from an experienced ‘physician’.

Whilst this idea is interesting, roles are changing. Some would call for Parsons ‘sick role’ to be made obsolete with the current societal climate. With the face of chronic illness glaring us deeply, the definition of ‘physician’ is fluid, the obligations and societal conformity and institutionalisation are not so clear cut and people are having to adapt in ways that make them cope and form a new equilibrium with themselves and others. I will refer to this, as some have previously suggested, as a ‘health role’, where people do not just recover and some will find new strategies to cope.

Is the Sick Role Outdated?

Since the 1970’s, a specific attention to chronic illness has been highlighted, due to their untenable character and their ability to more so than not exclude illness (Freidson, 1970; Segall, 1976). What we have seen is a massive attention to chronic conditions that far surpass the basic principles of the sick role. One could argue that since people are no longer able to recover from the sick role the a new role must take its place, one I shall demonstrate to be the ‘health role’ which requires governmentality, self governance and identity bonding and adaptation. Parsons attempts to make a defence of his sick role even in the face of such opposition;

‘recovery is the obvserse of the process of deterioration of health, that is, level of capacities and in many of these chronic situations tendencies to such deterioration can be held in check by the proper medically prescribed measures based on sound diagnostic knowledge.’

(Parsons, 1978)

I believed that Parsons lived in a time where the impacts of such chronic conditions were only just coming into fruition through medical and public understanding. What becomes clear, especially if hindsight was a skill to be used, is that there are crises and outbursts of ill health in the everyday lives of individuals. These ‘crises’ become a part of the individuals ability to cope and to maintained a normal mechanism of control (Varul). Being chronically ill is part of the individual with the potential ‘lurking around every corner’ (Strauss and Glaser, 1975). The cycle of patient-practitioner relationship does not end but becomes a tool for monitoring and progress (Frank, 1995).

Varul argues that with the extension of the medical control exerted, there is a correlation with diminished autonomy and this in turn diminishes the concept of the sick role under a change of circumstance. People may never be able to withhold ‘social competence’ as people live with permanently disabling issues and challenges (Paterson and Hughes, 1990). There is one benefit to this. The more disruptive a condition then the more flexible a person has to be with how they adapt and evolve within the societal normalisation (Cangulhem, 1988). If the sick role argues that the obligation to do what is right is tied to protecting others through removing oneself from normal obligations, the health role would argue that people must become immersed in their new role, merits and values of the given society. If this does not occur then anomie can set in from society and a ‘loss of self could occur’ (Charmaz, 1983).

To regain the sense of self, the values required to fit into a capitalist society, requires direct and indirect participation within a reciprocal cycle of exchange. To maintain this, Parsons attempts to make another defense of the sick role within chronic times;

‘commitment to the attempt to recover a state of health or in the case of chronic illnesses or threats of illness to account regimens of management that will minimize current impairment of teleonomic capacity and future risks that the actual or presumptive illness may entail.’

(Parsons, 1978).

If this is true then does an individual take on not only a new role and new job? Does this desire to regain a full capacity and direction become the persons own full time job? Whilst these questions can be asked, perhaps paradoxically the health role becomes caught up between the everyday lives from which they live and the sick role they believed they once had. One cannot play a health role without obeying expectations of the sick role. How does one act ‘normalised’ in a society full of expectations when the body of the sufferer can no longer act as it former healthy self (Radley, 1994)?

As shall be explored in an upcoming blog piece on the ‘remission society’, people have chronic conditions that need a voice, a narrative to give the body attention (Frank, 1995). The moral obligation lies to some extreme with the moral obligation to say ill health is not nice but at the same time remembering they are carrying their ‘own luggage’ which has to be transformed for the new self and body that exists (Frank, 1995). Within Frank’s (1995) ‘remission society’, people hold 2 passports, one to the land of health and one to the land of illness and these lands are entwined. You never know when you will go to one or the other. One will always be in ‘remission’, one will always live in fear of ill health and one is always at arms against the rest of society. People are torn between the health role and the society conformity. If people are chronically ill then self-surveillance occurs, management of ‘crises events’ and routine observations of the condition become the norm. At the same time, people are meant to perform as normal as possible within the society in which they live. As Varul quotes;

‘Regaining legitimacy by minimizing unreciprocated dependency (Charmaz, 1983; Williams, 1993) is a central motive in the reorganizing efforts towards a new normality’.

Ultimately, people are learning to manage their new selves and become more autonomous. Mol and Law (2004) can make a good example of such things. In their work on hypoglycaemia, they discuss the condition and how people adapt and learn to accept it as part of them;

It may be: ‘measured as a blood sugar level below 3.5 mmol/; felt as sweating, shivering or an overall sense of discomfort; countered as something that responds to eating sugar; avoided out of fear of coma or, worse, death; while it is also produced as a negative trade-off of postponing long term complications. Done in all these ways, hypoglycaemia is all these things’.

(Mol & Law: 2004)

People begin with close monitoring with a health practitioner and as the condition grows and the individual learns more about it, they learn to manage it. People ar able to restore their autonomy and learn how to speak of their body in new ways. Again, this will be something I pick up on in my ‘remission society’ post. But ultimately, people are given more free rain with their illness. They manage and care for themselves without having to be lead like a dog on the leash, or perhaps, they can be seen as the dog running independently of from the leash.

Ofcourse the health role is not the only critique of Parsons sick role. Williams (2005) higglights some of these issues. One of the big critiques is the notion of cultural relativism. The values of health are not all the same, the issue is not a shared valued universally. Notions of competitiveness and capitalism may not always appear apparent in all societies and this should not be the blanket argument as proposed by a sick role theory of the self. As Frank (1995) argues, whilst important the asymmetrical relationship is not a relationship of dependency. People learn to speak of health and come to understand their bodies once again in their own language. As the above quote used from Mol and Law (2004) demonstrates, people learn when there is something wrong. People are not alienated through medical expertise and confusing language but learn to formulate things in their own words. Heidarnia and Heidarnia (2016) argue that some people do not contribute as much, such as those in very old age. Should we just exclude the past experiences of contribution? Or should we remove them from a theory of capitalism and health altogether? This question is to big for a blog nearing its end.

Summary

The sick role has become outdated with the rise of chronic conditions. But, for those who adopt the approach of a health role, they are still bound by certain elements of the sick role. Society has expectations of the people within it and they aim to instil norms and values. The idea that everything is tied to a capitalist notion of society may apply to western societies, but it is not universal. People learn to be empowered whilst adopting the health role and have reduced reliance upon the medical field and expertise. This chronic illness paradigm becomes both a moral and individual one. Perhaps, I could leave with the work of Michel Foucault and consider whether the health role is an exemplar of governmentality, of biopolitics and what Foucault deems as the ‘technology of the self’.

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