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Free download from www.hsrcpress.ac.zadeveloping the self-concept. A positive self-concept is a prerequisite for anindividual’s personal happiness and daily functioning.According to symbolic interactionistic theory, the self is established,maintained and altered in interaction with others. Other persons’ reactions willaffect the self-concept. Specifically the amount of respect and concern thatsignificant others show to a person will be perceived by him as a measure ofhis own worth, 6 while devaluing judgments expressed by others will affect themaintenance of his self-esteem. An important goal of the study was therefore todetermine whether the nature of the interaction during medical encounters atthe centre was threatening to the self-images of the elderly patients.Symbolic interactionistic theory also allows for the conceptualisation of thesocial situation within which the action takes place. 7 This perspective considersthat behaviour can only be understood when viewed in its whole context. Theterm “definition of the situation” implies that a situation is not only as it existsin its verifiable form, but also as it seems to exist (Timasheff, Theodorson1976: 170). 8 Interaction between individuals thus takes place in specificsituations to which they bring interpretations which are their definitions of thesituations. These definitions then direct the interaction process and constitutethe reality of the actor.Goffman’s (1959) concept of the “presentation of the self” refers to how actorsattempt to present themselves in the best possible way. 9 In constructinginterpretations of particular social situations, individuals in effect seek to“manage” the image of themselves that they give to others. If the selves thatare presented are negatively evaluated, the self-images of the persons becomedegraded.Several themes common in symbolic interactionist theories had particularrelevance for the study. These were (i) the emergence of the self in interactionwith others (the study was based on the perceived value judgments of “others”at the centre by the subjects of themselves); (ii) the interaction process (withinmedical encounters) being a potentially emergent event, and (iii) theperspective always returning to that of the actor (the acting elderly patient).Symbolic interactionism thus provided a humanistic theoretical perspective forthe investigation and firmly grounded it within a qualitative framework. 10Instead of viewing the elderly patients as mere responding organisms, theperspective afforded a more social-psychological approach to their experientialstates, giving the perspective of the elderly individuals primary importance. Italso posited a fundamental link between patients and the social structure at thecentre which rested on the role of symbolic and common meanings. Theperspective thus permitted an expanded treatment of how elderly patients arelinked to, shaped by and in turn create this social structure.203