14 Othering, marginalisation and pathways to exclusion in health
An important part of our understanding of social exclusion is that, rather than a dichotomy of included or excluded, there is recognition of long-term processes, grounded in social dynamics and individual experiences. One of these processes is ‘othering’: marginalisation through being ‘the other’. This chapter explores othering and illustrates how it can operate it multiple ways with both positive and negative eﬀects (and indeed aﬀects), acting as an inclusionary process in some circumstances and an exclusionary one in other circumstances. We explore othering in both inter-and intra-personal terms. We begin by oﬀering a brief overview of the concept of othering, and the
related notion of stigma. The process of othering is then explored in a number of diﬀerent ways. First of all we examine how stigma, secrets and dissociation act as exclusionary othering processes for victims of abuse. We then turn to look at othering and the self in health protective decision-making, exploring how candidacy acts as an inclusionary process in breast screening. The ﬁnal section explores some more general implications in terms of othering, health, and inclusive health care practices.