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First, by treating the "illness" as a physical condition, the physician legitimatizes the "sick" person's qualification for exemption from normal role responsibilities. For one thing, the resident prisoner is temporarily exempt from being handled as a rebel.
Second, the "sick" person is viewed as the victim of a condition to be changed rather than a possessor of defective attitudes. To the extent that his physical effects of his self-mutilation is the center of medical attention, the prisoner gains relief from the pressures of previous personality-oriented relationships with prison officials when his "defective attitudes" were the focus of concern.
Third, qualification for the "sick role" provides a number of secondary gains, such as removal from an undesirable locale to the hospital or physical removal from threatening inmates.
SOCIAL STATUS AND SELF-INJURY
However, inmates also differ in the status positions they occupy within the social structure of the prison. The dependent personalities, inmates who fear other prisoners, and victims of mental turmoil are more likely to mutilate themselves than most prisoners because they have low status as prisoners and low status among prisoners. Their low tolerance of stress is aggravated because of their failure to gain access to inmate social structure which provides the protection and the subterranean means of gaining privileges and gratification barred by official rules.
Usually, inmates skilled in manipulation or prone to aggressive hostility against official restrictions would not engage in self-injuries. Their acceptance within the inmate social system usually provides them with means of gaining their purposes without such drastic and risky measures. But, on occasion, these inmates are in situations where their usual strategies are not effective or where the circumstances require emergency responses. Then their status in the inmate social system no longer provides benefits and innovative measures are required. Self-mutilation is one form of innovation.
anticipate discussion to follow, we find two sociological types (Rebels and Manipulators),
are most prone to be committed to the values of the inmate system and to utilize
self-injury for purposes consistent with those values. The Rebels are less skillful
usually than the Manipulators in perverting the official prison system to serve
their personal goals. The former is more likely to employ self-injuries in a rather
blatant and aggressive fashion, The other four sociological types operate essentially
outside the bounds of the inmate social system. They have relatively low status
in the inmate social system in addition to the low position in the official system
which they share with all prisoners. Because of their low status in the inmate
social system, their self-mutilations are less likely to represent art innovative
strategy used by Rebels and Manipulators to supplement less drastic manipulative
devices usually effective in achieving secondary gain.
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