A psychosocial perspective on the glossectomy experience.

This analysis of the glossectomy experience based on Goffman's concepts of the preservation of self and of stigma management suggests several helpful responses for speech-language pathologists and other clinicians. Attention to psychosocial dimensions of recovery. In the face of life-threatening illness and necessarily radical treatment, the patient and others may trivialize or overlook psychosocial needs. The importance of specific social behaviors--talking on a telephone or eating in a restaurant--can only be understood in terms of the patient's own self-definition. The psychological impact is more than frustration at lost or inadequate functioning. It may be profound grief, a response to threats to aspects of self-definition most valued by the patient. Help in the presentation and preservation of self. While helping to improve speech intelligibility by reinforcing different compensatory mechanisms, clinicians can assist with other compensations in social performance. More attention to nonverbal cues, including dress and physical appearance, may be helpful. Increased use of written communication can facilitate social interactions and reinforce the sense of linguistic competence until intelligibility and fluency are regained. From the perspective of Goffman's analyses, the individual who selectively manipulates social cues to counteract a stigma need not feel "fake." The intent of more conscious manipulations is not to invent a new self or to fool others but to preserve the integrity of the self. More information about stereotypes may help the glossectomee cope with others' inappropriate reactions and evaluate the relative importance of stigmas in different social interactions (e.g., stereotypes expressed by one's employer or family members deserve more attention than those expressed by strangers).(ABSTRACT TRUNCATED AT 250 WORDS)