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Abstract

In numerous contexts and cultures, persons with a physical deficiency such as a limp, have been perceived with negative characteristic morally and socially. We question ourselves how they influence the personal process of acceptance of the hdicap, these social representations, in which we are deeply involved, as the social beings that we are. For this we carry out a qualitative investigation, utilizing the method of analysis of the speech of the people whit a limp carried ont in interviews halfguieds with then. We find that the process of acceptance of the handicap is a "rite of passage" just as was defined by Van Gennep.

Introduction

     In different historical and cultural contexts, physical deformity has been perceived as something malignant, and both the social representations and the attitudes towards people having a physical deficiency have been negative and rejection-like. Laín Entralgo¹ affirms that along history there has been equivalence between physical and moral disorder. Aguado Díaz² maintains that throughout the times, since the most remote antiquity and in different cultural contexts, two poles in contradiction have existed regarding both the concept and the treatment of the defficiencies: an active one and a passive one. On the active pole, defficiencies were considered as natural phenomena, biological or environmental, but always modifiable by prevention or treatment. Special education programs and procedures to palliate them were designed.
     On the other case the deficiency was demonized, it was seen as a punishment, a consequence of a fault, and the deficient was abandoned, or the infanticide of the deficient was committed, or it was segregated, marginalized, discriminated and confined.
     According to Diel³ in Greek mythology, the limp symbolized the soul's deformation, the limp was a failure in the spirit, and it was the punishment for disobedience towards the Gods. In the classic Greece and Rome the infanticide or the abandonment of children with physical defects were common practices; there was a law prohibiting the raising of disabled children. The Greeks were shocked when they saw that in Egypt it was a habit to raise all the children.  On the contrary, the parents that put a child to death were condemned⁴. The limp has been considered impure by the Jews; lame people were excluded from entering the temple, "no male having a defect will present the offerings: no matter he is blind, limp, disfigured or disproportioned, or a man with a broken foot" (Lev. 21, 19)⁵.In the XVIth century, the Franciscan monk Juan de Pineda reminded the Christians the following: "The Lord in the antique Law prohibited anyone from being a priest if he had a long nose, a grown gibbosity, the eyes full of sleep, only one foot, if he was one-handed, he had scabies in his body  or malformed limbs"⁶
     Weinberg-Asher⁷ studied the attitudes towards the people with physical defects and concluded that it exists a negative stereotype of the people with physical corporal handicaps. This stereotype consists of perceiving them as less capable for the social relationships, less intelligent, less cheerful, less happy, being a less pleasant company, less nice, less relaxed, more aggressive, and more resentful. The attitudes were less unfavourable towards the situations of transitory illness and more unfavourable if the deformities were permanent. This coincides with the thesis of Goffman⁸ about the physical handicap considered, in many cultures, as a stigma that marks the handicapped as different from the others, understood as dishonourable for the invidual bearing it, being compared to a sign of moral defect and in extreme cases, being compared to an evil, dangerous or weak person.
     Making it specific, the limp is not only a medical category, but also a social and moral category; it has symbolically been built as a moral fault. We have to remember that we are social individuals and as such we build ourselves in society. For this reason it is possible to ask oneself how the people having deformities in their feet will elaborate their identity.
     The categories of thinking have an influence on what and how the world is perceived, and they do organize the guidelines of behaviour. But at the same time, the pre-existing cultural environment influences the construction of those categories. Our aim is to identify and interpret, using the speeches of the informants, the elements making up the mental representations about the process of assumption of the physical handicap; the process that makes the person accept or reject his social situation having a physical deficiency.

Methodology

     A qualitative study has been made with adult population in the city of Madrid. The contacts were made via the "Asociacion de polio y post-polio" and via some friends and common acquaintances. The work has been done with the people that accepted to participate voluntarily and selflessly. The degree of collaboration was high. The results do not have to be extrapolated to the whole population having chronic impairments on their feet. We can assume that the people that refused to be interviewed have other representations and they have built their process of acceptance of the deficiency in a different manner.
     The technique of work was the in depth half-directed interview, understood as a dialog between investigator and informant, letting the informant speak in a free manner, using his own words and talking about his issue; The informant reveals his semantic world, he categorizes his experiences being interrupted as little as possible without missing the final objective. The dialog is redirected when exhausted or driven through paths aside the aim of the research. Some basic subjects of the interviews were: the perception of the feet, the perception of the body, corporal representations, corporal aesthetic, health, family, education during the childhood, interaction with people, the relationships with the other sex, work or religion.
     Afterwards, by means of the analysis of the speech, the interviews were interpreted. The analysis and interpretation were made following Foucault⁹, when he says that it is necessary for the analysis to be deconstructed, divided into its components, dismantling the construction made by the individual. This deconstruction must be made, up to arriving to understand the relationships existing between the elements of the discourse, and also up to becoming capable of drawing the semantic axes, knowing how to interpret the metaphoric figures in order to be able then to reconstruct it based on the analysis and understanding the meaning of the words and their position.

Results

     Two models have been elaborated for the process of acceptance of their social situation according to the age at which the patients suffered the disease:

a) People affected by the malady in the early infancy, before the age of 24 months. Therefore, they become conscious of themselves and their situation perceiving already the physical handicap.
     1st stage: Static normalization. During the childhood, a "static normalization" of the perception of the social situation exists. In the childhood the messages received from society are few, especially for a child suffering health difficulties and having its family acting as a social protector ring.  They feel safe.  "The infancy, I remember..I was stuck in a hospital, I do not remember it as a big problem. I don't know, my mother used to take me to the hospital because on a certain day the girl had to have surgery, do you know what I mean? , I don't know, you are in bed, you have a plaster, and then it comes the recovery, it was normal for me". The family, being the first group of socialization, contributes with its attitude to build this "static normalization" of the situation. If within the family environment the handicap is not lived as an extraordinary fact but as an ordinary issue, the child will interiorize it as such.  "At home I was never treated differently from my brothers, neither for better nor for worse, compared with my brother, we were always together, frankly speaking there was no difference, we were always treated equally".  If the "static normalization" during the childhood is frequent, it will be frequent the idealization of that childhood as well. The idealization is done in order to make stronger the contrast with the following phase of life that is perceived as painful.  One was happy until the society broke that felicity, because it is going to be during the contact with the society that the social situation of the child will be perceived as inferior, as stigmatized, as discriminative (we are gathering Goffman's category and concept of "stigmatized" for people presenting any physical insufficiency. "A individual that could easily have been admitted in the circle of the ordinary social relationships, has such a characteristic that can call our attention and this makes us move away from him, destroying, as an effect, his rights in relation to us according to his attributes") .⁸
     2nd stage: denial-rejection. The "static normalization" accepted without questioning during the infancy begins to shatter when the person starts listening to the incoming messages from society. It is the society the one in charge of locating each individual spatially, emotionally, hierarquically and symbolically in his socially corresponding place. In this case it will be the place of the handicapped ones, that is, people with a physical defect that generate compassion-fear. All the informants agreed in defining the point in time when they became conscious about their handicap by the moment on which the society defined them as such. " I learnt that I was so [limp], when the others told me, and since then, you start to live as if you were different, as if you carried with you one more word that the rest of the people does not have; before that, you did not live it as different".
     The messages received as a result of the social interaction are the critical point of fracture of the statism that becomes then a continuum acceptance-rejection, in which they will have to move for the rest of their lives getting closer, depending on the moments and circumstances, to one pole or the other. During the first moments, they will get closer to the pole of rejection. The "static normalization" of the perception of the social situation was never questioned; the questioning arrives when the social environment shows them that their situation is not "the normal one" as it is not the usual one. The society, following its inherent tendency of organizing and controlling, categorizes the situations and the people according to its own purposes. The social tendency of making  "the usual things" equal to "the natural things", excludes and leaves out all the people and circumstances, conditions or behaviours that are outside the margins of "the most frequent", it entails a ferrous social control. The "good social order" points out that the ones who are different must be kept at the margins. But when the different ones are children, they arouse a feeling of pity because they are perceived as condemned to social failure, due to the fact that in their case social achievements will be more difficult to reach. "I remember hearing them say: poor girl, and poor one, what pity!, but at the beginning I did not understand it, I said to myself " why is she telling me this? If. because I saw myself as a normal person, Do you understand? ...But then there were times when I had rage against that kind of thoughts about me, because I lived well, in every sense. I did not do anything that the others were not doing and. but, yes I remember that". "What I do remember are the old ladies always saying poor one, poor kid, and I did not understand well what they were referring to, because I did not feel poor [laughs], and that was always shocking for me as I think we arouse more pity than we really feel for ourselves".
     The messages from society force to re-discover oneself as "poor one". They are the social parameters the ones that sentence the situation of the handicapped as different, not fitting in with his personal perception of it.
     When the personal situation arouses pity on the others, it is discovered that what was lived as "normal" in the family environment is not "normal" in the social environment. There is a fight between how things are perceived and how they should be perceived, and the denial and rejection of the new status take place. There is a distortion within the social structure, in such a way that the person is obliged not only to reallocate himself, but also, and this is the most difficult part, to re-allocate the social interactions with the others, according to his new status.
     If I am not admitted by society, it will be difficult for me to admit myself. It starts then a period of personal instability and rejection towards a society that insists on placing them in the space reserved for the handicapped -that is, they are moved away from certain common rights and duties-   without them feeling alike. In spite of that they are conscious about their situation of physical limitation for certain activities, but this cannot be a reason for social exclusion. "I remember the summers being very good, there in the village, with my cousins, for example, if we had to go by bicycle to the river, we all went, I was on the bar of the bicycle, and I knew [!!!] which one was my place". In that "I knew!" the informant describes the situation without any dramatism, with the spontaneity of knowing her own limitations. To know oneself's limitations is very different from accepting the society as the one imposing limits and putting boundaries to the personal social space. Self-knowledge is very different from bearing with social impositions. Many times, the acceptance of a situation that is socially assigned to them brings them tranquillity as they place themselves in the position expected for them to be placed in. They will only feel the deadweight of their situation when they will have to face discrimination.   

b) People whose illness was produced after having consciousness of themselves and their situation without physical deformity.
     After having lived the childhood without corporal deformities, a health problem occurs that leaves a physical deformity as a sequel. In that case the most crucial stage of the denial and rejection crisis happens when the illness takes place. Being eliminated the first phase of "static normalization", they enter directly the stage of rejection; they face that disease that has intruded on their lives in a sharp way, without permission or warning. The phase of crisis takes more time, it lasts longer, going forward and backwards, with the possibility to finish, equally, in the acceptance. "I declared myself in total rebellion towards myself and whatever affected me in my environment, I saw myself very young and in rebellion, it caught me very young, with twelve years, everything plunges on you, because you do not accept it, you do not accept it, and then it was a constant fight, but against everyone around me while I totally denied what I had; the relationships with everyone changed to bad, and then the coming back to school, the rejection of the mates, [.] because at the beginning it went very well, they sent me an enormous bear, a letter from all the school friends and so on, but the coming back was hard, this affects oneself, it affects for bad with the other children, for bad in the sense that like every child which is tough and sees a defect,[.]they went for it. We, the children, are very cruel when we are young, we are more direct".
     When she says that the evil lies in "being more direct", she means that "the bad ones" were then ones that placed her more directly in front of the reality that she, at that point, was denying and rejecting. In the middle of the phase of denial and rejection, hostile attitudes towards the person or people that make clear the non-admitted situation, are developed as a defence costume not to accept the evidence.  
     3rd stage: the acceptance. In both models, a solitary period of introspection has been passed through to get close to the pole of acceptance. The process includes a path of reflexion up to arriving to the acceptance. In the narrations of the informants it is very frequent to find the phrase "at least consciously I think so", meaning that there has been a process of active meditation up to arriving to the actual moment; when they speak about certain concepts, they are transmitting the conclusions after a reflexive process, having in mind that when the hidden subconscious becomes conscious it is because things that existed within it have been discovered. "Little by little, very slowly, it has not been very., it has been more because of my own help, inwardly, if you don't do it, no one will come for you to do it, it is inner strength more than any other thing., you have to do it, you pose it to yourself in such a way that. I don't know, it comes up little by little. when you see people, you see how you are evolving, you see that you can remain a bit more behind, you try little by little until the moment comes when I made it! , and you say it is me now!  And I have to accept what I have because there is no other option; I am not going to be embittered all my life".  This is the story of an informant on which she is describing her arrival to acceptance. It is lived as being reborn. "And you say: it is me now!" or "you say ok, this is what I have" are coincident phrases from the informants. It seems that the solitary crossing through the desert has ended.
     With the crisis situation as starting point a new identity is rebuilt, but let's analyze which other mechanisms take part in the dialectic destruction construction of the new identity. Besides the importance that they give to their own strength, there is another present element: society. It has to be witness of the process, recognize it and collaborate with it. "As you go on seeing the people, you go on changing", "It depends on how your parents, your group of friends, are dealing with it.. it has a big influence"..
     When the process ends up in the acceptance, a lucid and fruitful emotional stability has been reached. "Well, I think that you have some limitations, but up to a certain point those that you accept, I think, I am one of those who think that they can do everything, some things more slowly, better or worse, but I do it, not everyone does things well!, and not everyone in the same manner. Many times the limitations are in the head. That is why I told you before that living it with naturalness is a matter of this [pointing out the head]. because if you accept it you live comfortable with yourself and with people and you do not think they are going to look at how I walk, you know?... well, that is how I am, if they want, they will accept me, otherwise, too bad for them".
     Constructing oneself from difficulty, or from the handicap, seems to be a constant in all the people interviewed. They have rebuilt their own personal evaluation from the demolition caused by the phase of denial and rejection. The handicapped individual accepts his handicap; he understands that it is one more component, among many others, of his person. He blurs the handicap as fundamental in his person; he accepts it, not as a misfortune, but as characteristic, among others. The acceptance represents the rebellion against being an object of attitudes of compassion, but never the rejection of the reality of being handicapped. It is one more peculiarity of the person and it will be as limiting or invalidating as each person will want to consider it, independently of the objectification of the medical evaluating court. Labelling a person as invalid means, in fact, invalidating him.  "I remember the last time I went there, I went to the doctor, I had a total invalidity and they wanted to give me the absolute invalidity; and I said to them that no, that they were not going to give me the absolute invalidity being 23 years old, you see,. because then, [.] you will not make me a good-for-nothing. because this is not how I feel: good-for- nothing, and that's how it happened".  

Conclusions

     The process followed to accept the handicap clearly seems to be a "rite of passage". It consists of the three phases described by Van Gennep¹⁰ including: 1) separation, 2) limen or phase of threshold and 3) regrouping of the individual in a new status. It points out the change of position within the social structure from a stage of life to another.
     The phase of separation corresponds to the stage when the "no normal" becomes present, through the messages coming from society, in the believed social situation of "static normalization". During this first phase the person is separated, moved away, obliged to abandon his believed status; the individual is separated from his roll, he is excluded from the rights and duties that he considered to be general. This is lived as denial and rejection. The next phase of limen, of threshold, of margin, corresponds to the stage of introspection, the stage of the self-meditation that is done and must be a lonely and isolated action.  Probably it is in the threshold when our perception is bigger, because placing ourselves at the border helps us to perceive more clearly the shape, the shapes. It is certain that all of them have done a lot of introspection, and that has led them to appreciate themselves. This is the phase when they border the danger of getting blocked in this situation of threshold and remain forever in the social boundary. The key words, repeated by all the informants, which open the phase of acceptance are: "this is what we have". It is the symbolic phrase that shows off the entrance into the phase of regrouping, of adding, it is the acceptance of their new situation in the social structure, a situation that is quite stable; it is being reborn with a new identity.  The dark phase of limen has been left behind and the innocence of the childhood has come to an end, arriving to the adult life understood as emotional and cognitive maturity, as a taking of consciousness.  From this point on the concern is casted towards the exterior. It is true that it is a continuum with moments of higher acceptance or higher rejection, but always the acceptance follows the rejection and it helps to become more interested about the outside world. The relationships within the society are used as a catalyser for the acceptance, which is why, if those are avoided, the reaction is prevented and the person remains encysted in the rejection.
     I try to make clear that I am not stating the existence of a determinism "physical handicap -> creative self-reflexion -> clearer consciousness of the self-being and deeper knowledge of the society in which they have to live". I would like to remark that I have only had interviews in depth with those people that voluntarily accepted to be interviewed, and therefore, my conclusions cannot be extended to all the people having a physical handicap. They have been left apart those who answered: "I do not speak about that things", lock sentence that cancelled any trial of interview. The people that do not arrive to the phase of acceptance can remain hanged, frozen in the stage of the margin, in the liminal space and maybe those were the people that refused to be interviewed. Because they have not accepted themselves, they feel continuously as an object of evaluation and rejection as far as the society is concerned, with the consequent dissatisfaction and insecurity that this entails.
     I would not like the investigation to be read only as a positive valuation of these people. I would like the regard to be extended to the social context. The society recognizes the merit of people that develop their working activities and have a productive life; it also recognizes that a higher sensibility towards the problems of architectonic and other barriers should exist. Many times those are not correctly designed and numerous times they are not respected.  It looks like a subtle attitude to place the people with a physical handicap outside the social structure. Rationally, in our society, it is inadmissible to deny the rights of social individual to people with physical handicap; symbolically they are no given equality of rights. In the social structure they are located at the margin, where traditionally and historically they have been. Today it would be unacceptable, for example, that a politician declared in public the denial of the rights for people with handicap, his politic carrier would be ended. But, symbolically, the denial of these rights is admitted, it does not exist a consciousness of city built for everyone. Our big cities only admit healthy and young people; elders, ill people and others not having the physical capacities at full yield, are expelled from the big city and in short, they are expelled from society.
     "The society, from the public powers, does not take into account the people with physical handicaps, at all, the problem of the architectonic barriers, honestly speaking it is. those who use a walking stick, that sliding floor that the city council puts, this is the worst possibility for us, it makes you loose the balance, because we loose the balance in the sliding movements, there is a big problem with the steps, the ramps are too steep, no, there is no care".

Acknowledgements
     I would like to thank Isabel, Teresa, Ismael, María, Pepi, Emilia, José Antonio, Maribel, Laura, Miguel Angel, Pepi, Alpha, Jose Antonio, for their selfless contribution. Without them this work would not have been possible.

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