"Whenever I go into a restaurant, I order both a chicken and an egg to see which comes first"

Tuesday, March 31, 2015

The Importance Of Stigma– Calling A Spade A Spade

The avoidance of stigma and shaming have become part of the progressive campaign for inclusiveness and diversity where all people are welcome under the big tent whether black or white, Anglo or Hispanic, gay or straight, and healthy or ill. In this extreme populist view, advocates have ignored the universal stratification of human society,and the natural tendency to be suspicious of The Other, and the importance of stigma and shaming as social regulators.

No society present or past has been completely communal and democratic. Leadership is essential for organizing groups for productive, efficient, purposeful action.  The bell curve of intelligence applies to both the Jivaro Indians in the Amazon and to Americans. Some people are smarter than others and will ascend to positions of leadership, power, and wealth.  In remote tribal communities, priests and medicine men have assumed this role. They have a canny understanding of human nature and man’s need for belief.  They have studied tribal cosmology and the links established between the gods and man. They are ambitious and know the tributes both social and economic conferred on men like them.

Jivaro Indians

In large, mature civilizations like that of India, life has always based on social stratification, religion, and a priestly class.  The caste system is based on the assumption that the only purpose of life is spiritual evolution, and that regimentation of the necessary but irrelevant aspects of life – food, sex, money, and family – allows the soul to mature and finally achieve nirvana.

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Even in highly industrialized societies, society is conservatively ordered around the modulation of human nature – not too much self-interest, territorial ambition, pursuits of wealth and power.

Anything that upsets the social order is immediately suspect.  It is no surprise that fundamentalist Christian America finds gay sex and marriage wrong because the Bible says that it is ‘an abomination’, a procreative family has been at the heart of human society since its beginnings, and that non-reproductive unions are antithetical to its integrity.

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Anyone who threatens what is perceived as the natural order is marginalized, criticized, and stigmatized.  If one is not sure how dangerous the outsider, better to keep him beyond the protective perimeter.

Modern progressives have tried to reverse these natural trends. By assuming that all people are the same and that there is no such thing as The Outsider, they have ignored consequences. The legitimate promotion of women’s rights has necessarily affected the integrity of the family. It is difficult to give children the proper attention, time, early education, and caring consistently correlated with adult maturity and success.  The equally legitimate recognition of gay rights has indirectly changed the character of marriage and family. Although a child with two loving fathers or mothers can certainly do well, he grows up in an ‘artificial’ or ‘synthetic’ (as Dolce and Gabbana have recently characterized it) family.  Playwrights since Sophocles have understood that the male-female family is the crucible for maturity.

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The mentally ill have been included within this same progressive category of diversity. The mentally ill are no different from you and me, should have the same rights, access, and freedom as anyone without stigma or shame. Severely disturbed individuals like the Alps mass murderer or school shooters who have been treated for suicidal depression, are considered to be simply ill, and no different from those suffering from cancer.  They are not put on a watch list, a no-fly sheet, or in police files.  The concern about stigmatizing all mentally ill people has kept the dangerously demented in the shadows.

A former head of CDC remarked privately in the early 80s that he had never seen a serious, virulent, infectious disease like HIV/AIDS not treated as an epidemic. It was clear from the onset where the epicenter of the disease was – in the homosexual population of San Francisco, and it may have arrived there through contact with gay prostitutes in Haiti.  Yet, the public health physician went on, HIV/AIDS because of social concern for stigma, became ‘everyone’s disease’. Financial, professional, informational resources were spread widely instead of focusing on the locus of the disease and its vectors.

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In Africa, it became clear that frequent, often random extra-marital sex was spreading HIV/AIDS. Sexual mores through much of Africa were permissive by Western standards, and serial unprotected sexual partnerships facilitated the quick and efficient spread of the virus.  Yet international health workers were not allowed to criticize the practice, for that would be culturally myopic and patronizing.  All cultural practices are morally equally according to ‘progressive’ cant, promiscuous sex included.

As a result, focus was on the use of condoms – a mechanistic solution which avoided talking about the irresponsibility of unprotected frequent sex in an HIV/AIDS environment. Most of all, no one should ever suggest that those who practiced unprotected sex were morally responsible for the deaths of others.  Avoidance of cultural stigma was considered more important that slowing the disease.

Progressives are careful not to criticize the obese.  Fat people, the say, are no different from thin ones.  They have made their own lifestyle choices and who are we to criticize them?  Medium sizes expand to large, to extra-large to XXXL.  Dolls are now made plus-sized, furniture is resized to fit the obese.  Firms like Abercrombie and Fitch and Lululemon are criticized because they have chosen to sell to a restricted market – fit men and women.

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The French know that stigma and shaming work as means of weight control. French women are thin because of longstanding and universally-respected cultural norms which favor the trim and fit.  Again, ‘progressives’ have raised concern for those many women who starve themselves to fit into petite sizes.  They have been shamed into thinness, these critics say, and fat women are stigmatized.

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No doubt there are many French women who would love to put on a few pounds; but the public health of the society as a whole benefits from the rigorously self-enforced social norm. 

In public elementary schools, inclusiveness trumps performance. To call out the intellectually slower students would be to stigmatize them and erode their self-esteem.  Instead of acknowledging their limited intelligence and forcing them to reach the highest limits of their genetic potential, they are left to languish while other, less critical skills are admired, encouraged, and announced.  One should never stigmatize these slow students.

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The point is, American society has veered far too far towards inclusiveness and diversity for its own good.  In a recent article in the New York Times (3.29.15) Judith Shulevitz writes about the the new ‘emotional fragility’. We seem afraid of our own shadows and feel the need to be protected and shielded from life’s unpleasantness.  It is less painful to assume that people are all equal rather than focus on individual delinquency, dysfunction, or anti-social behavior. We have been mollycoddled by parents and teachers who want to keep us from the truth.

Few of us however are that delicate.  We understand that targeting the schizophrenic, potentially dangerous individual is not a mass indictment of the millions with neurosis, bipolar disorder, or simple anxiety.  We are capable of having respect for gay people who want the freedom to enjoy the same rights as other Americans but also of making up our own minds about the ultimate rightness of the homosexuality, its Biblical references, or its effect on the family. We can decide for ourselves whether it is right to keep out all travelers from Sierra Leone, Liberia, and Guinea because of the raging Ebola epidemic in those countries regardless of ‘stigma’, or whether there is a better, more targeted way to protect our shores.

In other words, we should not avoid stigma at all costs; but take each new social, environmental, cultural challenge separately.  Decide whether the collective categorization of a group makes practical sense (as in the CDC Director’s observation about San Francisco) or not.

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