Chapter Five

Identity and Illness

A. Concept of self, the emergence of a consumer culture, consumption, identity and the
body, gender, consumption and the body

Concept of Self

1. Philosophical Roots

• Descartes: "I think, therefore I am" → self as a rational, thinking subject.

• Hume: Self is not a fixed substance, but a “bundle of perceptions.”

2. Sociological Perspectives

• Charles Horton Cooley – “Looking Glass Self”

o We see ourselves as we imagine others see us.
o Self = reflection of others’ judgments.
• George Herbert Mead – Social Self
o Self develops through social interaction.
o “I” = spontaneous, individual side.
o “Me” = internalized social expectations.
• Erving Goffman – Dramaturgy
o Self is performed, like actors on a stage.
o We manage impressions depending on audience (“front stage” vs. “back stage”).

3. Psychological Perspectives

• Freud: Self divided into Id (desires), Ego (rational mediator), Superego (morality).
• Erikson: Self develops across stages of life (identity crises).

4. Postmodern & Cultural Views

• Michel Foucault: Self is shaped by power, discourse, and institutions (e.g., medicine,
sexuality).
• Bauman & Giddens: In late modernity, self is fluid, constantly constructed through
choices.
• Consumer Culture: Self expressed through lifestyle, brands, digital presence.

5. Key Features of Self

• Relational → shaped by others.

• Dynamic → changes over time and context.
 • Performative → enacted in everyday life.
• Embodied → tied to the body, looks, and health.
• Cultural → linked to norms, values, and consumption.

A short comparative chart on major thinkers’ views of the Self

Thinker Concept of Self Key Idea / Metaphor Focus

Charles
Self develops through how we Reflection of others’
Horton Looking Glass Self
imagine others perceive us judgments
Cooley
George “I” = spontaneous, individual
Interaction & role-
Herbert Social Self (I & Me) side; “Me” = internalized social
taking
Mead norms
Life is like a stage; self is
Erving Impression
Dramaturgical Self performed (“front stage” vs.
Goffman management
“back stage”)
Inner drives &
Sigmund
Psychoanalytic Self Id, Ego, Superego unconscious
Freud
processes
Self shaped by discourse, power,
Michel Disciplined/Constructed Power & social
institutions (e.g., medicine,
Foucault Self control
sexuality)
In late modernity, self is
Anthony Agency & modern
Reflexive Self continuously constructed
Giddens identity
through choices
Identity is unstable, shaped by
Zygmunt
Fluid Self consumer culture and global Postmodern fluidity
Bauman
uncertainty

• Classical (Cooley, Mead, Goffman): Self = socially constructed through interaction.

• Psychoanalytic (Freud): Self = internal psychic conflict.
• Critical (Foucault): Self = produced by power and discourse.
• Late Modern/Postmodern (Giddens, Bauman): Self = reflexive, fluid, consumer-
driven.

The self is not a fixed essence but a socially constructed, dynamic, and performative identity
that emerges from interaction, culture, and power relations.

1. Concept of Self

• The self is not fixed but socially constructed.

• Symbolic interactionists (e.g., Mead, Goffman) argue that self develops through
interaction with others.
 • In consumer society, the self is often expressed, shaped, and even fragmented through
consumption patterns.

2. Emergence of Consumer Culture

• Historically tied to industrial capitalism, mass production, and advertising (19th–20th

century).
• Consumer culture emphasizes buying not just for utility but for lifestyle, identity, and
status.
• Influenced by Baudrillard (sign-value of commodities), Veblen (conspicuous
consumption), and Bourdieu (taste, distinction).
• Globalization and digital platforms amplify consumer culture today.

3. Consumption

• No longer only about survival (food, clothing, shelter).

• It now carries symbolic meaning: what you buy signals who you are.
• Modern consumption includes experiences (travel, fitness, aesthetics) in addition to
material goods.

4. Identity and the Body

• The body becomes a site of identity construction.

• What we consume (fashion, cosmetics, fitness regimes, surgery, diet culture) inscribes
meaning onto the body.
• Featherstone & Turner: in late modernity, the body is a project—to be shaped,
disciplined, and displayed.
• Social media amplifies this, turning the body into a curated consumer object.

5. Gender, Consumption, and the Body

• Women’s bodies have historically been more regulated by consumer industries (beauty,
fashion, diet).
• Advertising perpetuates gendered ideals (slimness, youth, muscularity).
• Men increasingly targeted too (the “metrosexual,” body-building, grooming industries).
• Gender norms shape what kinds of consumption are “appropriate” or valued (e.g.,
pink/blue coding, luxury bags vs. cars).

• Self is socially constructed and expressed through consumption.

• Consumer culture links identity to lifestyle and status.
• Consumption is both material and symbolic.
• The body is a cultural canvas shaped by consumption practices.
• Gender plays a central role in directing how bodies are consumed, represented, and
disciplined.
A comparative table that maps the connections between Self, Consumption, Body, and
Gender

How It Links to Relation to

Theme Key Ideas Role of Gender
Consumption Body
Gendered
Socially Body is a expectations shape
Self-expressed through
constructed; medium to how the self is
consumer choices
Self identity is fluid “perform” presented (e.g.,
(brands, lifestyle,
and performed identity (tattoos, femininity via
taste).
(Mead, Goffman). fitness, style). beauty, masculinity
via strength).
More than utility:
Consumption Industries market
symbolic
Goods/experiences inscribes differently to men
meaning, lifestyle,
Consumption bought to display meaning onto the and women,
status
identity and belonging. body (fashion, reinforcing gender
(Baudrillard,
diet, surgery). norms.
Bourdieu).
Central to
Seen as a Consumed, modified, Female bodies often
identity—
“project” (Turner, and displayed via objectified; male
Body appearance
Featherstone); site clothing, cosmetics, bodies increasingly
becomes a social
of self-expression. and health regimes. commodified.
marker.
Gender ideals Reinforces
Cultural norms
Gendered consumer inscribed on the inequalities: women
define
Gender markets (cosmetics vs. body (slimness, judged more by
“masculine” vs.
cars, toys, colors). youth, appearance; men by
“feminine.”
muscularity). power/status.

• Self → expressed through consumption.

• Consumption → materializes on the body.
• Body → shaped differently depending on gender.

B. Effects of Illness on identity, relationship between illness and identity

Effects of Illness on identity, relationship between illness and identity are a key theme in medical
sociology.

Effects of Illness on Identity

Illness is not only a biological condition but also a social and identity-shaping experience. It
can affect:

• Self-Concept
o Serious or chronic illness disrupts a person’s sense of self (loss of independence,
work, and roles).
o Example: cancer or disability can make people feel “different” or “less
themselves.”
• Stigma & Labeling
o Goffman: illness can create a “spoiled identity.”
o Visible illnesses (e.g., skin conditions, HIV/AIDS) often carry stigma.
• Role Changes
o Talcott Parsons: “sick role” → the ill person is exempted from normal duties but
expected to seek recovery.
o Illness may shift identity from “worker/student/parent” → “patient.”
• Biographical Disruption
o Michael Bury: chronic illness disrupts life story and identity, requiring re-
negotiation.
o People may reconstruct new identities around illness (e.g., “cancer survivor”).

2. Relationship between Illness and Identity

• Illness as Identity Threat

o Illness challenges the continuity of self and identity.
o Example: loss of physical ability may conflict with one’s self-image.
• Illness as Identity Resource
o Some people embrace illness as part of identity (e.g., disability pride, mental
health advocacy).
o Online communities create shared illness identities.
• Embodiment
o Illness changes how one relates to the body (pain, fatigue, loss of control).
o The body becomes central to self-awareness.
• Social Relationships
o Illness affects roles and relationships (family, friends, workplace).
o Others may view the person primarily through the “illness lens.”

Key Theories & Thinkers

 • Goffman (1963): Stigma & spoiled identity → illness reshapes how others see us.
• Bury (1982): Biographical disruption → chronic illness alters life trajectory.
• Charmaz (1991): Loss of self → chronic illness can erode valued aspects of identity.
• Frank (1995): Illness narratives → people construct stories to rebuild identity after
illness.

A clear comparative table on how illness can act as both a threat and a resource for identity

Aspect Illness as Identity Threat Illness as Identity Resource

Loss of self, diminished sense of Rebuilding self around survivorship,
Self-Concept
normalcy (Charmaz). resilience, or advocacy.
Shift into “sick role” (Parsons) →
New valued roles, e.g., activist, peer
Social Role loss of independence, work, or
supporter, community leader.
family roles.
Pride movements (disability rights, mental
Spoiled identity (Goffman) → others
Stigma health awareness) reclaim stigma as
see the illness before the person.
strength.
Biographical disruption (Bury):
Illness narratives (Frank): telling stories
Life Narrative illness interrupts life story, creates
helps rebuild meaning and coherence.
uncertainty.
Loss of control over body, Body becomes a symbol of survival,
Body
experience of pain, fatigue, transformation, or strength (e.g., “warrior”
Relationship
limitation. metaphors).
Social Formation of supportive communities,
Risk of isolation, pity, or exclusion.
Interaction shared illness identity (online & offline).

• Threat → Illness destabilizes identity, produces stigma, disrupts roles and life story.
• Resource → Illness can also empower new identities, create solidarity, and foster
resilience.

Illness impacts identity by disrupting self-concept, altering roles, and shaping relationships. It
can both threaten identity (through stigma, loss, disruption) and reshape it (through adaptation,
survivorhood, collective identity).

C. Interplay of illness and identity-stigma and labeling theory

The interplay of illness and identity is often best understood through stigma theory (Goffman)
and labeling theory (Becker, Lemert, etc.).

1. Illness and Identity

• Illness is not only biological → it reshapes how people see themselves and how society
sees them.
• Identity can be challenged, reconstructed, or stigmatized.
• People with illness may internalize or resist labels given by society.

2. Stigma and Illness (Goffman, 1963)

• Stigma = a spoiled identity → when a condition reduces a person “from a whole and
usual person to a tainted, discounted one.”
• Types of stigma in illness:
o Visible stigma (e.g., facial disfigurement, skin disease).
o Invisible/hidden stigma (e.g., mental illness, HIV/AIDS).
• Impact on identity:
o People may feel shame, secrecy, or withdrawal.
o Illness becomes the “master status” (the dominant identity trait seen by others).

3. Labeling Theory and Illness

• Howard Becker (1963): Deviance is not inherent, it is a label applied by others.

• Edwin Lemert: Primary deviance (first act, not identity-shaping) vs. secondary deviance
(label internalized, identity altered).
• Applied to illness:
o When someone is labeled “mentally ill” or “contagious,” society treats them
differently.
o Over time, individuals may internalize the label → shaping self-concept and
behavior.

4. Interplay of Illness, Stigma, and Labeling

• Illness → attracts labels (“disabled,” “mad,” “weak”).

• Labels → lead to stigma, discrimination, exclusion.
• Stigma → threatens identity, but also may push individuals to form counter-identities
(e.g., disability pride, mental health activism).
• Identity → constantly negotiated between personal self-understanding and social
labeling.
5. Key Examples

• Mental illness → often stigmatized as “dangerous” or “unpredictable.” Label may

overshadow all other identities.
• HIV/AIDS → Strong stigma tied to morality, sexuality, and contagion fears.
• Disability → Labeled as “dependent” or “incompetent,” but disability rights movements
resist this labeling.

A clear comparative table on Stigma Theory vs. Labeling Theory in relation to illness and
identity

Labeling Theory (Becker, Lemert,

Aspect Stigma Theory (Goffman, 1963)
1960s)
Stigma = a “spoiled identity” when a Illness identity is shaped by labels society
Core Idea person is socially discredited due to applies; deviance/illness is socially
illness. constructed.
How illness marks a person as How being labeled “sick,” “mad,” or
Focus “different” and reduces them in “disabled” changes self-concept and social
others’ eyes. reactions.
Stigma arises from visible or hidden Labeling can lead to secondary deviance:
Mechanism
attributes linked to illness. the person internalizes the illness label.
Impact on Illness becomes a master status Self-identity shifts according to the label
Identity (dominates all other identities). accepted or resisted.
Stigmatized individuals may hide,
Social Labels affect interactions: others treat the
withdraw, or resist their spoiled
Interaction person through the lens of illness.
identity.
People may resist stigma through Individuals can reject, negotiate, or
Agency coping strategies or re-framing embrace labels, influencing identity
identity. reconstruction.
Person labeled “mentally ill” → may
HIV/AIDS patient seen as morally
Example internalize the label and behave
“tainted” → social exclusion.
accordingly.

• Stigma theory: focuses on the social discrediting of illness identity.

• Labeling theory: focuses on the power of social labels to construct and reshape illness
identity.

Illness and identity are deeply intertwined. Stigma (Goffman) shows how illness can spoil or
mark identity, while Labeling theory (Becker, Lemert) explains how social labels attached to
illness can reshape self-concept, either negatively (internalized stigma) or positively
(resistance, activism).
D. Identity theory, structural symbolic interaction
Identity Theory and Structural Symbolic Interactionism since both come from symbolic
interactionism but developed in different directions.

1. Identity Theory (Sheldon Stryker, 1968; Burke & Stets, 2009)

• Part of structural symbolic interactionism.

• Focuses on how roles and social structures shape identity.
• Key Ideas:
o People have multiple identities (parent, student, worker, patient, etc.).
o Identities are organized in a salience hierarchy → the more important an
identity, the more likely it guides behavior.
o Identity is tied to role expectations in society.
o When role expectations and self-identity match → stability; when they clash →
identity conflict.

Example: Someone strongly identifies as a “teacher” but becomes chronically ill → illness
challenges their teacher identity.

2. Structural Symbolic Interactionism

• Builds on Mead’s symbolic interactionism but stresses the influence of social structure.
• Core Assumptions:
o Society is a network of social positions (statuses and roles).
o Identities are linked to these positions.
o Interaction is shaped not just by micro-symbols (everyday meanings) but by
macro-structures (institutions, organizations).
• Stryker’s Identity Theory is a prime example of structural symbolic interaction.

Example: A hospital patient identity → shaped not only by how the patient sees themselves,
but also by institutional structures (doctor–patient hierarchy, medical labels).

3. Difference from Classic Symbolic Interactionism

• Classic (Mead, Blumer): Focuses on micro-level, meaning-making in everyday

interaction.
• Structural (Stryker, Burke): Adds a macro perspective → how social structure and
role expectations organize identities.

4. Application to Illness & Identity

 • Illness may cause identity disruption because:
o Roles (worker, parent, student) are interrupted.
o The new “sick role” identity may clash with valued identities.
o People re-negotiate their place within structures (family, workplace, healthcare
system).

A comparative table that contrasts Classic Symbolic Interactionism with Structural

Symbolic Interactionism (Identity Theory)

Classic Symbolic Interactionism Structural Symbolic Interactionism /

Aspect
(Mead, Blumer, Goffman) Identity Theory (Stryker, Burke, Stets)
Level of Micro-level (face-to-face interactions, Links micro (interaction) with macro
Analysis everyday meanings). (social roles, structures).
Self emerges from interaction, fluid, Self is organized into multiple role-based
View of Self
negotiated in situations. identities within social structures.
Symbols, meaning-making, looking-
Key Role identities, salience hierarchy, identity
glass self, dramaturgy, impression
Concepts commitment, identity verification.
management.
Social Seen as flexible, emergent through Seen as relatively stable: statuses and roles
Structure interaction. provide a framework for identity.
Identity Formed through shared symbols and Formed through commitment to social
Formation interpretations in interaction. roles tied to structural positions.
Identity changes when role expectations or
Change in Identity shifts with changing meanings
structures change (e.g., illness,
Identity in social interaction.
unemployment).
A person negotiates being “friendly” A person identifies as a “teacher,”
Example or “serious” depending on audience “parent,” “patient,” with one identity being
(Goffman’s dramaturgy). more salient in guiding behavior.

• Classic SI → emphasizes meaning, symbols, micro-level interaction.

• Structural SI (Identity Theory) → emphasizes roles, salience, macro-social structure
in shaping identity.

• Identity Theory (structural symbolic interaction) → identity is role-based, socially

structured, and organized by salience.
• It bridges the micro (self, meaning) and macro (roles, institutions) in understanding how
identities are formed, maintained, and disrupted.
 Identity Control Theory and Affect Control Theory, which are both developments within
symbolic interactionism and identity studies.

1. Identity Control Theory (ICT)

• Developed by Burke & Stets (2009).

• A formal theory about how people maintain their identities in everyday interaction.
• Core idea: People have identity standards (how they see themselves) and constantly
compare them to perceptions of how others see them.
• Key Process:
1. Identity Standard → internal self-view (e.g., “I am a competent teacher”).
2. Perceptions of Self → feedback from interactions (what others show about us).
3. Comparison Process → comparing self-perceptions to identity standard.
4. Identity Verification → aligning perceptions with identity standard.
5. Adjustment → changing behavior or redefining identity if mismatch persists.
• Application: Explains why people resist or adapt to identity challenges (e.g., illness,
stigma).

Example: A person who identifies as “healthy” may experience identity disruption when
diagnosed with chronic illness → they will work to verify or reconstruct that identity.

2. Affect Control Theory (ACT)

• Developed by David Heise (1979).

• Focuses on how people maintain emotional meanings in social life.
• Core idea: People act to keep their feelings about themselves and others consistent with
cultural meanings.
• Key Concepts:
o Fundamental Sentiments → culturally shared feelings about identities (good,
bad, powerful, weak).
o Transient Impressions → feelings that arise from specific situations.
o Deflection → difference between fundamental sentiments and transient
impressions → motivates action to reduce deflection.
• ACT uses a mathematical model to predict behavior in interaction based on emotional
consistency.

Example: A doctor who feels their role is “caring” will act to reduce situations where they seem
“uncaring” to maintain emotional alignment.

3. Key Differences
Aspect Identity Control Theory (ICT) Affect Control Theory (ACT)
Maintaining emotional consistency between
Maintaining consistency between
Focus cultural sentiments and situational
self-identity and perceived identity.
impressions.
Core Identity verification through Emotional meaning maintenance through
Concern interaction. action.
Cognitive → comparison and Emotional → minimizing deflection to align
Process
adjustment of identity. feelings.
Social psychology & symbolic Formal mathematical modeling of sentiments
Method
interactionist concepts. and identity.
Identity disruption and maintenance Predicting behavior in interaction based on
Application
(e.g., illness, role conflict). emotional meaning.

• ICT side (left) → shows how illness affects the identity standard, triggers perception,
comparison, and adjustments to maintain identity consistency.
• ACT side (right) → shows how illness influences transient impressions and emotional
meanings, leading to deflection and corrective action to restore emotional consistency.
• Both theories together explain how illness challenges identity and how individuals
manage both self-concept and emotional meaning in response.

• ICT → focuses on self-identity consistency.

• ACT → focuses on emotional consistency.
Both theories show how identity is actively maintained in social life, especially when
challenged (such as by illness or stigma).