Degradation Ceremonies-still my favourite lesson

As an undergrad Harold Garfinkel’s 1956 paper ‘Conditions of Successful Degradation Ceremonies’ captivated me. He talks about the court process as a ceremony that converts, through costume and custom, a person’s identity from free citizen, to prisoner or criminal.

This is important as a Health Social Worker, reinforced for me during  recent hospital admission. The western medical system, takes a person, lays them horizontally, takes off their clothes  replacing them with an open backed gown, and putson  a plastic bracelet with their name and a number on it. This process is conducted by people in a hierarchy of clothing designating their power within the hospital system.  One’s  identity is converted to ‘patient’.

During ‘grand rounds’ when I was standing near my allocated bed the young doctor invited me to get back into bed so they could begin their discussion. I invited her to proceed with me standing.

Standing against this stripping of individuality and status is an empowerment project for health social workers. I’m not suggesting anything radical. Refer to the people we work with as, the people we work with, not as ‘clients’ or ‘patients’. It’s why we sit adjacent to people rather than behind a desk, and why we  dress well but with attention to the socio-economic status of the people we are involved with.

In Community Health, people are still subjected to systems and processed; call centres, assessments, and waiting rooms. When we meet them it’s in an  environment foreign for them, in which they are relatively powerless and  likely to feel ill at ease.  Warmth, respect, and co-creating plans can make a situation that means  meeting with a social worker can be an experience that builds self respect and engenders hope.

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