Marketing the Damaged Self:
The Construction of Identity in
Advertisements Directed Towards
People with HIV/AIDS
Rodney H. Jones
Department of English
City University of Hong Kong
Journal of Sociolinguistics 1 (3):
393-418
Perhaps more than any other group in
recent history, people with AIDS have witnessed themselves defined.
Sociologists, linguists and cultural critics have traced the various identities
of PWA’s presented in media, health discourse and statements of public policy
from a variety of different philosophical and theoretical positions. Sontag
(1989), Alcorn (1988) and Ross (1989), examining metaphors common in AIDS discourse,
point out that images of war, poverty, deviance and criminality operate to
identify people with AIDS as the other, foreign invaders, predators, and
enemies of ‘normal’ society. Brandt (1988), drawing on the work of the
sociologist Erving Goffman (1963), notes that popular images of people with
HIV/AIDS often invoke a ‘triple stigma’: the biological mark of illness, the
‘blemish of individual character, and the ‘tribal stigma’ of being associated
with groups already ‘assumed to be particularly prone to infection’
(homosexuals, IV drug users, and prostitutes). Other critics like Plummer
(1988), Goldstein (1991) and Lupton (1994) observe that the construction of
identity of PWA’s in the media is often organized within contradictory
discourses in which an amoral medical model for AIDS exists beside a
morally charged stigma model, and people affected by it take on the
opposing roles of innocent victim and guilty agent. Emphasizing
the ‘political stakes’ involved in such construction, Plummer (1987) writes:
A whole gallery of folk devils have been
introduced--the sex crazed gay, the dirty drug abuser, the filthy whore, the
blood drinking voodoo-driven black--side by side with a gallery of
‘innocents’--the hemophiliacs, the blood transfusion ‘victim’, the new born
child, even the ‘heterosexual’. All of this has served to illustrate the ways
in which so called ‘deviance’ or ‘stigma’ comes to mark out the moral
boundaries of a particular culture and establish either a degree of closure on
a particular social order or provide room for some innovations and change.
(45-6)
The majority of the studies mentioned
above, however, focus on discourse directed towards the uninfected (the
proverbial ‘general population’). In fact, it is to a large degree though the
discursive construction of the reader as someone not having AIDS that the
isolation and stigmatization of those with AIDS in such discourses is
facilitated. There is, however, a large body of discursive activity emerging
from within the ‘AIDS community’ itself which has received relatively less
critical attention, discourses which seek to reclaim and reconstruct the
identity of PWA’s ‘in their own name’. Community based AIDS Service
Organizations and the People Living with AIDS movement have increasingly become
‘vehicles for socializing people into a new paradigm--a new understanding of
the meaning and organization of AIDS’ (Patton 1989:115). This paradigm is as
much linguistic as it is social or political (Callen 1990, Crimp 1988). The
very first sentences of the founding statement of the People with AIDS
Coalition, for example, presents what is essentially a linguistic argument,
focusing on how labeling helps to shape social practice and human
relationships:
We condemn attempts to label us as
"victims," which implies defeat, and we are only occasionally
"patients", which implies passivity and helplessness, and dependence
upon others. We are "people with AIDS". (PWA Coalition 1987:148)
As the number of infected ‘survivors’
grows, so does the amount of discourse directed towards this infected
community, from educational materials offering PWA’s advice on dealing with
their situation, to commercial discourse offering goods and services to the
increasingly lucrative ‘AIDS market’. This new ‘insider’ discourse has provided
PWA’s with a whole new range of identities that contend with the spectacle of
AIDS presented in the news media of hopeless, helpless victims, bereft of
sensuality and eroticism, marked by the stigmatized signs of terminal illness.
These new images instead portray PWA’s as healthy ‘survivors’, ’empowered’,
heroic, even athletic individuals battling against disease, death and
discrimination. Harris (1995) noting the prevalence of this ‘sanitized’ version
of AIDS in popular gay magazines, suggests that such representations push AIDS
discourse from optimism into the realm of ‘fantasy’:
The most conspicuous omission (in these
publications is) images of people with AIDS. Pictures of wasted bodies would
scare advertisers and destroy the giddy mood of these magazines. In an
interview with the late filmmaker Derek Jarman, Genre took the unusual
step of omitting photographs of the director altogether...Even Poz, the
magazine devoted to those living with HIV, avoids photographs of diseased
pariahs and instead showcases HIV-positive athletes with ruddy, gym-buffed
physiques. (53)
The
currency of such identities is such that they have even emerged in commercial
discourses outside of the ‘AIDS industry’, as, for example in a recent Nike
commercial featuring an HIV positive marathon runner.
This paper examines the ways identity
is constructed in advertisements which explicitly direct their messages towards
people with AIDS (or those who have tested positive for HIV) in magazines
published for the American gay community. In it I argue that these images are
not entirely positive, and that even when PWA’s are positioned as the talked
to rather than the talked about, similar patterns of stigmatization
evident in mainstream media continue to be enacted in subtler and potentially
more damaging ways.
Selling AIDS
Politicians and the media have spent
considerable time and energy reminding us of the devastating cost of AIDS to
individuals, governments and the medical and insurance industries. Few,
however, have focused attention on the profits the crisis has generated.
Medical researchers and practitioners, pharmaceutical manufacturers, insurance
companies, educators, government bureaucrats, publishers, thousands of
non-governmental organizations and their employees, and critics who write
papers like this, all combine to constitute a burgeoning band of ‘AIDS
profiteers’ whose number in some places may even exceed the number of people
actually dealing with AIDS or HIV seropositivity.
While not wishing to disparage the
charitable motivations of and valuable contributions made by many members of
the above groups, it would be ingenuous to ignore the money that has also been
made. In most Western, capitalist economies, people with HIV/AIDS and their
friends and family members are increasingly seen as an important new ‘niche’
market, the size of which by nearly all estimations is bound to grow
considerably in the foreseeable future. Refuting Watney’s (1989) view that the
cultural agenda of AIDS constructs PWA’s as ‘disposable’, Erni (1992) suggests
that the ‘body of the infected’ is central to the power struggle within medical
discourse and so constitutes a significant ‘techno-political investment’ for
the medical community. Similarly, as the number ‘healthy’ infected bodies
grows, they gain a new importance as consumers with a particularly persistent
set of needs to be exploited. Any analysis of how PWA’s are constructed and
positioned in advertising, therefore, must first take into account the emerging
‘market identity’ of PWA’s, one which in America at least is inextricably bound
with the rapidly evolving ‘market identity’ of young, gay men1.
The advertisements gathered for this
study came from two popular magazines targeting the American gay and lesbian
community (The Advocate and Genre) and one particularly geared
towards people with HIV and HIV related illness (Poz), monitored over a
period of seven months (February to August, 1995). Fifty different
advertisements offering goods and services explicitly for HIV positive readers
were collected (Appendix). Many of the ads appeared repeatedly in numerous
issues of all three magazines.
In one sense, the magazines are themselves statements of identity.
They proclaim that their readers constitute a cohesive and identifiable group
worthy of the advertising revenue necessary to produce a slick, ‘upmarket’
periodical. Bronski (1984:147), tracing the transformation of the Advocate from
a ‘political’ organ to a more commercial venture, attributes to it a
significant role in the ‘marketing of gay culture’ in the seventies and
eighties, much of which consisted of attracting advertising by portraying gay
men as affluent and materialistic consumers, a ‘dream market’.
This selling of gay identity is even
more obvious in the new breed of ‘upbeat, glossy gay magazines’ (Harris 1995)
like Genre, which aggressively pursue big ticket advertising by trading
in stereotypes and questionable statistics about the power of the ‘pink dollar’2
to portray their readership as wealthy, stylish and status-seeking. The market
identity driving the social construction of PWA’s in these advertisements must
be located in the context of the already constructed ‘gay consumer’ -- a white,
male urban professional, well-educated, image conscious, style conscious and
unburdened by the expenses of supporting a traditional family. The presence of
HIV seropositivty adds to the equation two further characteristics of the
‘ideal consumer’: health-conscious and ‘desperate’. That the presence of HIV or
AIDS is becoming increasingly seen as an important feature of the ‘gay market’
is evidenced by the sheer number of ads targeting people with HIV/AIDS in these
publications. In a typical issue of The Advocate, for example, more than
half of the quarter to full page ads are explicitly directed towards PWA’s.
A survey of the goods and services
offered in these ads says as much about the particular constellation of needs
experienced by people living with HIV/AIDS in the political and economic matrix
of the United States (where medicine is almost completely privatized) as it
does about identity values. Nearly three quarters of the ads (31 out of 50)
advertise services associated with viatical settlements (the selling of
life insurance policies by the terminally ill)3 , revealing the
market perception (and the social reality) that living with AIDS in the United
States is not just a medical challenge, but a considerable financial one as
well. Other goods and services advertised include drugs and nutritional
supplements (8 occurrences) pharmacies and pharmaceutical services (5
occurrences), recovery centers, water purifiers, and even a company that sends
Christmas and birthday cards to clients’ friends and relatives after the
clients have died.
An initial examination at the
portrayals of PWA’s in these ads confirms Harris’s (1995) observations: people
with HIV/AIDS are represented as spectacles of health, possessing immaculate,
athletic bodies which communicate both strength and sensuality. A vast majority
of the ads feature healthy, handsome, smiling young men either in ‘erotic’ or
‘semi-erotic’ poses (1-4, 34, 49) or in ‘outdoorsy,’ ‘sporty’ settings, often
in the company of supportive friends or loyal pets. Advera (36, 37, 38), a
powdered nutritional supplement, presents the reader with images of ruddy PWA’s
cheerfully climbing mountains or jogging along the beach underneath quotations
like: ‘For people like me who have AIDS, there’s a nutritional product that can
help us increase our energy and improve the quality of our lives’ (37). A tan,
chiseled model in a lumberjack shirt holding a collie in his arms gives a
similar testimonial for Marional, an appetite stimulant, whose ad pre-empts any
doubts that might arise from such an idyllic representation by a footnote:
‘*Person depicted is a model who is HIV positive.’ Ability Life Trust (23), a
viatical settlements company, takes this image to it’s extreme, portraying the
PWA as a bulging Charles Atlas type holding up a globe which is surrounded by
the words: HIV Positive? You Can Have the Whole World in Your Hands’ (Figure
1).
In contrast to the widespread
pessimism evident in more mainstream scientific and media discourse on AIDS4
, the ads are pervaded by a spirit of optimism. PWA’s are told that they have
choices, options, hopes; they are invited to dream, imagine, and, most of all,
take control of their own fate. ‘Today my T-cell count fell below 500,’ a
confident looking young professional tells us in an ad for Life Partners, Inc.
(11), ‘And I feel fine.’ These positive images, however, are not entirely
benign. Along with this sunny optimism, the ads also invoke, sometimes only
subtly, its opposite, the shadow of disease and death. Images of health and wealth
are held up against a background of other possibilities: wasting, helplessness
and financial ruin. There is always the hovering admission that ‘eventually
I’ll need long term medical care’ (11), the tacit, or even baldly stated notion
that ‘Facing a life threatening disease is the worst of all problems’ (8).
Often the dark side lies in the presuppositions that underlie apparently
friendly remarks: ‘No one should make you feel like you have too long too live’
(7) (as if people around you might be doing just that). Other ads invoke stigma
through hyperbole, by portraying such an impossible standard of health, success
and power, that they even more forcefully remind the PWA of what he does not
have (see for example 23, 36, 37, 38, 40).
In some ads this contradictory
discourse is particularly striking, with images of health and empowerment
directly juxtaposed with images of despair and helplessness. Page &
Associates (3, 4), for example, places the determined face of what might be a
runner in the starting blocks next to a young, waifish nude curled into the
fetal position. In others the contradiction arises in the form of puns or double
entendres which resonate in both positive and negative directions, some
fairly bordering on gallows humor. The reminder that ‘Mom is waiting for your
call’ offered by Mail Order Meds (44) is likely to have complex and disturbing
connotations for a young HIV+ gay man who may be dealing with his family
members’ reactions or possible reactions to his illness or sexuality. The reassurance
that a viatical company can ‘open a whole new window of opportunity’ (1)
reminds the reader of both ‘the window period’ (the period of time shortly
after infection during which HIV is transmittable but undetectable with
anti-body testing) and ‘opportunistic infections’, both common parlance in
HIV/AIDS discourse. The promise of another viatical company that there are ‘‘No
hidden clauses, no anonymous owners, no secret partners’ (12), revives the
discourse of ‘hidden threat’ so prevalent in media and educational
presentations of AIDS. And the news that ‘Barry’s feeling better longer without
MAC’ (39) might more immediately conjure up the absence or death of a lover or
friend rather than, as the fine print informs us, the absence of Mycobacterium
Avium Complex.
Still other ads manifest this
paradoxical discourse through ‘a pattern of alternation at the level of the
sentence’ (Fairclough 1992:115). In the following passage, for example,
statements of hope (‘pretty well’, ‘dreaming of my next exotic vacation’) are
alternated with statements of despair (‘vision declined’, ‘worrying about
health insurance, disability and life insurance’), with the advertiser
presented at the end of the paragraph as an agent for the reconciliation of
these contradictory discourses:
For me, my life was far from perfect but by
most standards things for me looked like they were going pretty well, except
for being HIV+. As I slowly developed AIDS,my vision declined & I was forced
to go on permanent disability. I went from dreaming of my next exotic vacation
to worrying about health insurance, disability and life insurance. That’s when
I came in contact with Dedicated Resources. (30)
Similarly, other ads create binary
oppositions through the mixture of conflicting registers, as in the slogan, ‘Money can lift spirits. It can buy
dreams. It can provide the best medical care.’ (24), in which the registers of
money and medicine are mixed with a more ‘metaphysical’ register of ‘spirits’
and ‘dreams’, and uneasy marriage as the result flies in the face of the one of
the most fundamental principles in most ‘spiritual’ discourses, the idea that
‘money cannot buy happiness.’
The presence of diverse and even
contradictory discourses in texts is, of course, not unusual. Bakhtin (1986)
has pointed out that texts not only draw upon meanings and conventions of other
texts, but also often mix such meanings and conventions in ironic or
paradoxical ways. Lee (1992:136) claims that ‘texts are typically the site of
contestation between conflicting perspectives,’ and Fairclough (1992:116) has
specifically detailed the ambiguous nature of much modern advertising discourse
that attempts to bring together the conflicting demands of ‘telling and selling’.
Competing perspectives are also a common feature of much of the popular and
medical discourse about AIDS, especially that which focuses on cure and
treatment. Erni (1992:41-2), for example, in his critique of the politics of
AIDS treatment, sees the construction of the ‘end of AIDS’ as ‘located in the
strategic articulation between two contradictory discourses: a discourse of
impossibility and a discourse of possibility,’ with ‘the discourse
of impossibility emphasiz(ing) uncertainty and skepticism, (and) the discourse
of possibility bespeak(ing) hope and excesses.’
A significant aspect of such
‘competing discourses’, says Lee (1992), is not just that they present
conflicting perspectives, but that they construct for the readers conflicting
roles, what he calls ‘social formations’. ‘The concept of social formation,’ he
writes, ‘is linked to the process of perception in the sense that particular
phenomenon may have quite a different appearance for the same individual when
viewed from the standpoint of different social formations in which he or she
participates’ (145). Fairclough (1992:115) also notes how conflicting
discourses within texts position readers in ‘contradictory ways.’ The effect of
the paradoxical perspectives seen in these ads, therefore, can best be
understood through the examination of the contradictory ‘identities’ which they
invite their readers to assume and the relationship these contradictory
identities have to the already ambiguous position PWA’s inhabit in the larger
social context.
Display and the construction of the ‘damaged’ identity
Discourse analysts have increasing
focused their attention on how advertisements and other public discourse
construct what Fairclough (1989) calls the ideal subject and Kress (1985)
calls the discursively constructed reading position. Discourse, says
Fairclough (1992:64), constructs both ‘social identities’ and ‘social
relationships between people’ in the ‘subject positions’ it makes available.
Scholars in communication and advertising have made similar observations.
Vestergaard and Schroder (1985), for example, examine how advertisements put
forth rules of behavioral normalcy which reflect and reinforce existing
power relations in society. Goldman (1992) claims that ads create identity by
transforming the readers’ hopes, fears and values into commodity signs,
thus making the consumer himself a commodity. Scollon (1995) questions the
emphasis on a single ‘idealized reader’, and (1997) suggests that public
discourse creates multiple identities for the receiver through ranges of choice
enacted within a series of overlapping frames, each creating a dimension of the
receiver’s relationship with the discourse and its author. Others, like (Cook
1992), similarly see ads as heteroglossic and dialogic, operating by
positioning sender and receiver in particular relationships with multiple but
limited role possibilities. All of these perspectives point to the notion that
the ‘meaning’ of ads lies not just in the ‘message’, but in the range of
relationships enacted in the ad between the sender and the receiver, and the
roles the reader is invited to perform within each of these multiple
relationships.
Goffman (1976) in Gender
Advertisements suggests a concept that underlies the above points of view,
the idea that advertisement works chiefly though the ritual creation not of
ideal readers, but of ideal relationships, relationships that have their roots
in everyday interaction. Goffman calls this mechanism display and
defines it as the tendency for people to present to each other at strategic
moments ‘gestural pictures’ of the nature of their relationship in particular
and of their shared assumptions about human nature in general. For Goffman,
advertising creates a public means for putting forth these ritualized
representations of ‘appropriate’ relationships, a kind of social portraiture
in which ‘the individual is given an opportunity to face directly a
representation, a somewhat iconic expression, a mock-up of what he is supposed
to hold dear, a presentation of the supposed ordering of his existence’ (1). In
ads, as in all communication, display ‘provide(s) evidence of the actor’s
alignment ...(which) establish(es) the terms of the contact...(and) the mode or
style or formula for the dealings that are to ensue among the individuals in
the situation’ (1).
This perspective suggests that in
order to understand the contradictory identities presented in ads directed
towards people with HIV/AIDS, we must look to the relationships constructed
within these images and between the authors of the ads and their targets, and
how these relationships invoke or draw upon already constructed ‘appropriate’
relationships in the everyday life of the PWA. In another work, Stigma (1963),
Goffman describes the processes of identity management participated in by
individuals who for one reason or another are ‘marked’ by society as abnormal.
The situation of the stigmatized, Goffman points out, is fundamentally
paradoxical, ‘in that society tells him he is a member of the wider group, but
that he is also different in some degree, and that it would be foolish to deny
this difference’ (123). Everybody, regardless of whether or not they are
stigmatized, must juggle the demands of two distinct identities in public life,
the self they display to others (virtual identity), and the ‘secret
self’ which is hidden from others (actual identity). For Goffman, the
plight of the stigmatized ‘constitutes a special discrepancy between virtual
social identity and actual social identity’ (3). In cases where an individual’s
stigma is not immediately apparent (as with many HIV positive people), identity
management in everyday life is often facilitated through the mechanism of passing
in which the ‘discreditable’ self is hidden within an envelope of virtual
identity (Figure 2).
In
other circumstances, however, when the individual’s stigma is more difficult to
conceal, or in dealings with people who share a degree of intimacy with the
stigmatized, the ‘abnormal’ person must depend on others to assist him in the
management of these contradictory identities. Those who play this special role
in the lives of the stigmatized are referred to by Goffman as the wise,
‘insiders’ or confidants who, by virtue of their knowledge and closeness to the
stigmatized, hold the power to facilitate (or disrupt) the mechanism of passing,
to act as ‘mediators’
between
the stigmatized’s virtual and actual identities (Figure 3).
The same tension between conflicting
identities which plays itself out in the everyday lives of PWA’s can be seen
enacted in the discursive construction of the disease and those affected by it,
a narrative, which, ‘mobilize(s) the image of the war between the self and the
not self’ (Erni 1992:47). The paradoxical presentation of identity in ads
directed towards people with HIV/AIDS can therefore be seen in the larger social
context of stigma management; by simultaneously invoking a virtual identity
of health and ‘normality’ and an actual identity of disease and
deviance, the advertisers position themselves in the role of the wise,
thus clothing themselves with the aura of intimacy and authority enjoyed by
those who play similar roles in the PWA’s actual life: friends, lovers,
counselors and health professionals. The positioning of the advertiser (or
product) as a mediator between fact and fantasy, between who the reader is and
who he would like to be, is in fact quite typical in advertising. Cook
(1992:137) offers many instances in advertising, especially in that targeted at
women, in which the product acts as a mediator between public and private
selves and ‘promises reconciliation between apparently rival claims’. This
positioning, however, takes on special significance in ads directed towards
PWA’s because of the stigmatization and challenges in identity management they
already face in the larger social context, for by exploiting and displaying
these rival identities of the stigmatized and offering to mediate between them,
the authors reinforce the very process of stigmatization which they promise to
relieve.
The advertisers make the position of the
wise available to themselves both by peopling the ads with images of
individuals who normally play such a role in the real lives of people with
AIDS, friends and family members (12, 19, 26, 44), lovers (10, 14, 34, 38) and
health care professionals (41, 43, 50), and by themselves reenacting the
discourse of involvement common to such individuals. Linguistic
strategies of involvement, Scollon and Scollon (1995:36-7) point out,
‘uphold a commonly created view of the world’ and emphasize the reader’s ‘right
and need to be considered a normal, contributing or supporting member of
society.’ Such strategies include: noticing
or attending to the reader
‘We
focus on you, your needs’ (28)
exaggerating interest, approval, sympathy
‘You deserve the best life
possible’ (28)
‘You’ll be treated with the respect, dignity and attention you’re
entitled to.’ (7)
claiming in-group membership
‘Being the only gay owned and
operated company providing this service, we
understand your needs and frustrations just a little bit better than our competition.’
(3)
claiming a common point of view, opinions, attitude or
knowledge
‘I’ve
been through the process.’ (17)
‘Nobody knows what you’re going through better than us.’ (25)
being optimistic
‘Distant lands to see. Goals
to achieve. Spirit to rejuvenate.’ (5)
and
using the reader’s language or dialect, in the form of ‘buzz words’
associated with the ‘gay rights’ movement like ‘Pride’, ‘Dignity’, ‘Affirmative
Lifestyles’, as well as the movement’s symbols, like the inverted pink
triangle.
Again, such strategies are common in advertising as authors
attempt to create an atmosphere of trust and intimacy. When directed towards
the stigmatized, however, these strategies construct not just intimacy but also
a particular kind of power relationship between the author and the reader, as
the advertisers take on the mantle of the wise upon whom the stigmatized
is dependent for successful identity management.
Identity values and the template of the American ‘normal’
Within this pattern of stigma
management, advertisers construct, therefore, not a single identity for the
PWA, but dual identities, a virtual self, consisting of identity values
which the reader is meant to emulate if he hopes to be regarded as ‘normal’, and,
more indirectly, an actual self, which undermines the possibility
of ‘normality’. Both of these identities are fictions, the virtual identity presenting
an unobtainable standard of physical and psychological well-being, and the actual
identity invoking society’s worst suspicions about the PWA, and the
reader’s worst fears about himself, an identity which in truth is no more
‘actual’ than the paradigm of health and happiness behind which it hides. Thus
the ads simultaneously offer and deny the possibility of passing. In
order to understand how this occurs and the identity values enacted within this
pattern, it is necessary to take into account the cultural notions of self and
communication of the society within which the ads were produced, to ask: What
does it mean to be ‘normal’ in America, and how is the ‘normal’ self expressed
through communication? The ‘normal’ the PWA is meant to ‘pass as’ must be
measured against the template of the ‘American normal’.
Carbaugh (1988), in his analysis of
‘personhood’ and American communication in the discourse of Donahue,
observes a constellation of identity values and rules of interaction that
function in American public discourse. Among these are the notions that the
self is an ‘individual’ contained within the body which inherently possesses
‘dignity’ and ‘the right to choose’. The appropriate way in which this self is
enacted is through the public exercise of options and expression of individual
opinions and personality within a framework of mutual respect. Failure to
exercise options and express individuality are seen as a kind of
dysfunctionality, a loss of selfhood.
Other scholars, like Scollon and
Scollon (1995) and S. Scollon (1993), also see the conception of self as
closely related to conceptions of communication, in particular those expressed
in the ideology of the Utilitarian Discourse System. Communication
within this discourse system, they observe, is regarded as a tool for solving
problems, with high value being placed on information, objectivity, directness
and logical positivist thinking. They further claim that the emphasis on
information and control in American communication is related to a worldview
which is individualistic, goal oriented, and pragmatic.
Not surprisingly, similar symbols for
personhood and rules of interaction are emphasized in the ads as appropriate
identity values for the PWA to emulate. Invocation of these values, however,
within the framework of stigmatization and the discrepancy between virtual and
actual identities, is problematic, as they celebrate the very features
of selfhood and means of expressing it that are typically denied to people with
HIV/AIDS.
Exercising Options
The
notion that selfhood is measured by the number of options an individual possesses
and the power he has to exercise those options is a particularly salient
feature in many of the ads. ‘Don’t wait,’ the reader is urged, ‘Exercise your
options’ (23). ‘You should be completely aware of all your options’ (12)
another ad advises. The ‘right to choose’ is seen as a fundamental feature of
the normal self, and inability to display and exercise this right is seen as a
failure to take responsibility for discovering the options that naturally
exist. ‘Opportunities always exist’, the PWA is told, ‘Let Neuma help you
discover yours’ (31). Put in these terms, the diminishing options that
inevitably accompany serious illness are presented to the PWA as a threat to
his ‘selfhood’. The solution, of course, is to construct an appropriate virtual
self by ‘choosing’ to patronize the goods or services of the advertiser. The
good or service becomes a way for the reader to regain selfhood as the
advertiser ‘open(s) a whole new window of opportunity’ (1).
There is, however, a darker side to this ‘discourse of options’.
Carbaugh (1988) reminds us that options are almost invariably accompanied by a
number of assumptions which act as constraints to the exercise of options, in
particular, the assumption of accountability. ‘Each individual must
assume the responsibility for all of his or her actions, and, at another more
basic level, persons in public must conceive of their lives and actions as
individual matters of rights and choice’ (58). The invocation of ‘personal
responsibility’ is a particularly common feature in popular media’s portrayals
of PWA’s which treat those in certain groups (hemophiliacs, infants) as
‘innocent victims’, and those in other groups (homosexuals, IV drug users) as
somehow responsible for their condition, guilty agents in their own and others’
destruction. In the context of the ads, the position of choice the reader is
invited to take up implies also a position of responsibility which not only
asks the PWA to take responsibility for dealing with his situation (‘you’ve got
to get tough’ (3)), but also subtly implies that he bears responsibility for
his own infection and ‘self-destructive behavior’ (49). AIDS itself becomes a
matter of choice.
The Code of Dignity
The ‘code of dignity’ so stressed by
Carbaugh (1994) in his studies of cultural values in American communication, is
also a salient feature of the ads. The advertisers promise ‘The cash you need
and the dignity you deserve’ (27), that ‘Dignity is a right you will maintain’
(29), and that ‘You’ll be treated with the respect, dignity and attention
you’re entitled to’ (7). One ad even quotes Donahue, the very source of
most of Carbaugh’s observations:
‘The
final months of a person’s life are lived with the dignity of not going broke.’
Phil Donahue, The Donahue
Show, December, 1992 (2)
Tied up with this ‘code of dignity’,
however, are the demands of uniqueness, ‘to know how one’s necessities,
abilities and capacities differ from others,’ and authenticity, ‘to be
forthcoming and expressive about oneself, to coalesce one’s outer actions with
one’s inner thoughts and feelings’ (Carbaugh 1994:176), demands problematic for
the PWA caught within the discourse of stigma management constructed by the
ads. The very uniqueness he is asked to celebrate is the feature that robs him
of ‘appropriate’ selfhood, making him into a member of a stigmatized group, a
diseased body, a ‘damaged’ self. Perhaps the most painful paradox of all in the
ads is the emphasis on self-expression as a central feature of ‘personhood’.
They are full of people with HIV/AIDS displaying their seropositivity and
claiming it publicly as part of their identity, sometimes as models portraying
themselves as PWA’s with ‘special needs’, and sometimes through the
confessional voice of actual testimonials:
Hi, my name is Andrei and I am living and
dealing with AIDS in all of its ramifications.
I guess I’m pretty much in the same situation as many of you.
Andrei
Kraminsky/HIV+ 8 Yrs. (30)
In
the same breath, however, the ads emphasize to the reader that he may not have
the same opportunities for self-expression as Andrei Kraminsky and his ilk,
constructing alongside the ‘code of dignity’ a ‘code of secrecy’:
‘Confidentiality is assured.’ (16)
‘For the Money You Need and the
Confidentiality You Deserve.’ (32)
‘Strict Confidentiality’ (21)
‘Your call will be confidential’ (26)
‘(we) will not release confidential
information’ (32)
‘All orders are shipped overnight in
plain, unmarked boxes’ (45)
This
tension between the demand for public enactment of the self and the need to conceal
one’s identity goes to the very heart of what Goffman calls the ‘paradoxical
situation of the stigmatized,’ as the enactment of self serves to remind the
reader of the constraints on such enactment. Carbaugh writes:
There is an irony built into the...discourse
of dignity. It consists of a general dynamic: the common meanings made when
coding conversation this way are highly individualized and liberating, while
the forms and moral status of those very meanings are largely collectivized and
constraining. (1994:177)
For
the stigmatized, public enactment of the self amounts to an act of ‘disclosure’
or ‘confession’, an act which Foucault (1981) points out invariably involves
unequal power relationships: while confession seemingly ‘exonerates, redeems
and purifies (the confessor); unburdens him of his wrongs; liberates him and
promises him salvation’ (62), what it actually does is draw the confessor more
into a position of being dominated. Gamson (1996), discussing the affects of
the public enactment of gay and lesbian identity on daytime television, notes
the feelings of ambivalence experienced by the stigmatized in witnessing
‘himself’ publicly displayed:
For lesbians, gay men, bisexuals, drag
queens, transsexuals--and combinations
thereof--watching daytime television
has got to be spooky. Suddenly there are renditions of you, chattering away in
a system that otherwise ignores or steals your voice at every turn. (80)
This
ambivalence is enhanced in the case of the PWA who must invariably view such
displays against the possible consequences of disclosure in his individual
situation. Again, the advertisers present a ‘solution’ to the dilemma, offering
to mediate between the demands of self-enactment and the demands of secrecy by
simultaneously putting forth a surrogate to enact the ‘AIDS identity’ and
promising the reader that his own confidentiality will be protected.
Knowledge = Power
Along with the identity values
Carbaugh sees as characteristic of American notions of ‘personhood’, the ads
also reinforce communication values inherent in what the Scollons (1995) refer
to as the Utilitarian Discourse System, in particular the emphasis
placed on ‘knowledge’ and information. Borrowing the style of medical,
educational and counseling discourses, the advertisers give the impression that
the purpose of their advertisements is not to sell, but to provide information,
creating what Fairclough (1992:115) has observed in other advertisements as an
emerging discursive ‘hybrid’ of information and publicity. Several of the ads
are embellished with technical jargon, complicated scientific discourses on
drug contraindications, precautions and interactions (40), and optimistic
positivist assertions like, ‘Getting (your immune system) to work better is a
matter of fundamental cellular biology’ (34, 35). Even ads for financial
services use the style of medical discourse:
‘More and more, people surviving with
AIDS are selling their life
insurance for relief from one of AIDS
most common symptoms...stress. (3)
‘We know from experience that selling
a life insurance policy can
reduce financial stress and help you
gain additional control over your life. (14)
‘Our
purpose is to eliminate or reduce the financial stress associated with the
physical stress of terminal illness.’ (27)
Some of the ads are presented in the
form of newsletters, clothing their claims as facts. An ad for Mail Order Meds
(45), for instance, which consists almost entirely of a newspaper style article
on the relationship between nutrition and HIV infection, blends advice on
preventing AIDS-related wasting almost seamlessly with information on
nutritional products available through the company. Similarly, an ad for
Pacific Oaks Medical Group masquerades as an issue of Healthcare News,
with every ‘news item’ from concerns about TB to the promise seen in research
on protease inhibitors invariably related to services available through the
group. ‘I am more informed regarding healthcare decisions than ever before,’
says a smiling PWA featured in the ad, ‘Thanks Pacific Oaks.’
‘Knowledge’ is portrayed in the ads as
an essential tool for the successful enactment of the virtual identity--’Knowledge
is Power’ (13)--and the advertisers are thus elevated to the status of
‘professionals’-- possessors of knowledge. Erni (1992) points out that the
metaphor: Knowledge=Cure is central in media and medical discourses on curing
and preventing AIDS, and that this metaphor resonates in different (and
sometimes damaging) ways for different readers. For the uninfected, it implies
knowledge of the ‘deviant’ identities of potential ‘carriers’. For the
infected, it implies culpability (for not knowing enough not to have gotten
infected in the first place) and the hope of ‘redemption’ through the
information made available to him (for a price) from the ‘AIDS industry’.
Failing to purchase this knowledge is seen as irresponsible, an act of willful
ignorance whose consequence is no less than death. The political consequences
of such readings are an invitation to the uninfected to discriminate, and an
invitation to the infected to feel guilty and dependent on society and the
medical community’s ‘undeserved sympathy.’ A similar dynamic plays itself out
in these advertisements. By so persistently offering ‘knowledge’, the
advertisers construct the reader as ‘lacking knowledge’. Readers are repeatedly
put in the position of having to ask: ‘ask your care team about ONDROX’ (50),
‘See your doctor immediately and ask if MARINOL is right for you’ (40), ‘To
learn more, call 1-800-RX B4 MAC’ (39). Theirs is a discourse of questions.
Even these questions, however, are co-opted by the advertisers, who readily
advise readers on which questions are ‘important’ and which are not: ‘Twelve
Questions You Need To Ask Before Selling Your Life Insurance Policy.’ (12),
‘The answers to these and other important questions in this new booklet.’ (13).
Fighting Stress
One final, and perhaps most disturbing
aspect of some of these ads is the way they resurrect metaphors of war and
struggle already elucidated by Alcorn (1988) Sontag (1989) and others,
metaphors that, according to Scollon and Scollon (1995), also arise from
conceptions of the self and communication contained within the Utilitarian
Discourse System, which emphasize ‘control’ and aggression and give rise to
what is known as ‘Type A Behavior Syndrome’ (Friedman & Rosenman 1974). One
prominent feature of the virtual identity presented in many of the ads
is exactly this type of behavior:
‘We’re the company that helps people
gain control of their lives financially’ (1)
‘Relief fast. You want it, you’ve got
it. But you’ve got to get tough.’ (3)
‘Fight back...Now more than ever,
surviving with AIDS takes aggressive
financial planning.’ (4)
‘Take Control.’ (12)
‘Living with HIV is a challenge.’ (31)
‘Advera can play a key role in your
fight to maintain your weight’ (36)
‘Weigh In and Fight HIV Infection.’
(45)
The
metaphor of living as a ‘fight’ or ‘challenge’ not only invokes the possibility
that the PWA may be ‘defeated’ (a disturbing reminder of actual identity),
it also puts him at war with himself. As Sontag (1989) has told us, the line
between ‘virus as enemy’ and the infected body as enemy blurs in the discourse
of ‘fighting AIDS’. Furthermore, one cannot help but wonder about the effect
such an aggressive, control-oriented approach might have on an individual with
clear medical reasons to avoid stress--the idea of ‘fighting stress’ seems an
oxymoron.
Conclusion
Professional and ‘in-group’ presentations
of stigmatized individuals, Goffman (1963:109-111) notes, present the
stigmatized with a ‘code of behavior’ regarding the appropriate ways of ‘facing
up to’ his problem, desirable patterns of revealing and concealing and ‘recipes
for an appropriate attitude regarding the self.’ ‘To fail to adhere to the code
is to be a self-deluded, misguided person,’ he writes, ‘to succeed is to be
both real and worthy.’
The display of identity in
advertisements directed towards people with HIV/AIDS provides an example of
such a ‘code of behavior’. This display teaches the reader what identity values
he should hold dear in order to participate in the world of the ‘normal’. At
the same time, however, it reminds him that such participation is a kind of
fragile ruse--that true ‘normality’ is impossible. Far from liberating the
reader from the negative stereotypes of the mainstream media, the images in
these ads actually reinforce them by presenting virtual and actual identities
through a series of binary oppositions (Table 1). The creation of the
‘idealized’ self--healthy, empowered and possessing options is intertwined with
and dependent upon the creation of it’s opposite, a ‘damaged’ self--diseased,
powerless, guilty of both ignorance and moral failing-- fulfilling in fact, all
of the worst indictments of the less generous popular press.
Neither of these identities are
‘realistic’ portrayals of or helpful models for people with HIV/AIDS. They
merely fuel the already powerful pattern of stigmatization existing in the
larger social frame.
I do not mean to suggest that this
mechanism of stigmatization is unique to ads targeting PWA’s. In fact, many
media texts manifest similar dualistic tensions in such areas of power versus
solidarity, and negative versus positive perspectives (Kress 1986), and similar
stigmatizing positionings and constructions can be seen in much advertising
discourse -- ads for beauty aids, for example, which operate not just by
presenting a standard of beauty but by widening the circle of ‘ugliness’ open
to stigmatization. It is hoped that the approach put forth in this paper can
illuminate not just how patterns of stigmatization arise and operate in the
discourse of AIDS, but how such patterns also may occur in other areas of
public discourse, and how they are used to reinforce ideologies and power
relationships within societies, for, as Goffman notes:
stigma involves not so much a set of concrete
individuals who can be separated
into two piles, the stigmatized and
the normal, but a pervasive two role social
process in which every individual
participates in both roles, at least in some
connections and in some phases in life.
The normal and the stigmatized are
not persons but rather perspectives.
(1963:137-8)
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Appendix
Advertisements Directed at People with HIV/AIDS
(from The Advocate, Genre and Poz, Feb. to Aug. 1995)
|
No. |
Company |
Description |
Slogan |
|
1 |
Page &
Associates (viatical settlements) |
b/w seated
male nude, black background |
terminally
ill...there are options |
|
2 |
Page &
Associates |
color
seated male nude |
Now, Selling
Your Life Insurance Puts More Then Just Money In Your Pocket |
|
3 |
Page &
Associates |
b/w half
male face, small color seated male nude, black background |
relief
fast. we promise. |
|
4 |
Page &
Associates |
b/w half
male face, small color seated male nude, black background |
fight
back... |
|
5 |
Legacy
Benefits Corporation (viatical settlements) |
white page,
text in black box |
Distant
lands to see. Goals to achieve. Spirits to rejuvenate. |
|
6 |
American
Life Resources (viatical settlements) |
suit lapel
with red ribbon |
RED RIBBONS
COVER THE HEART BUT NOT THE EXPENSES. |
|
7 |
Life
Entitlements Corp. (viatical settlements) |
b/w
drawing: male profile looking down country road |
If you’re
terminally ill, no one should make you feel like you have too long to live. |
|
8 |
Viaticus
(viatical settlements) |
small b/w
picture of young male against white background |
Facing a
Life Threatening Illness is the Worst of all Problems |
|
9 |
Life
Partners Inc. (viatical settlements) |
text in
light blue rectangle in blue marble background |
Come To The
Source/ Strength
and Experience Stability
and Efficiency/ Be certain
of your financial decision. |
|
10 |
Life
Partners Inc. |
small blue
tint pictures of threshold of suburban home/ two young bearded men in kitchen |
Imagine... |
|
11 |
Life
Partners Inc. |
sepia tint
picture of young man in cardigan and glasses, confident, thoughtful
expression |
"Today
my T-cell count fell below 500" |
|
12 |
National Viator
Representatives Inc. (viatical settlement advisor) |
b/w picture
of seven adult figures of varying ages (6 males, 1 female) in family portrait
posture with dog in middle |
"WE’RE
THE PEOPLE WHO DON’T THINK YOU SHOULD SELL YOUR LIFE INSURANCE POLICY BY
FLIPPING THROUGH A MAGAZINE" |
|
13 |
National
Viator Representatives Inc. |
picture of
booklet: All the Questions You Need to Ask Before Selling Your Life Insurance |
KNOWLEDGE
IS POWER. |
|
14 |
Individual Benefits (viatical settlements |