The Gregor Effect - (from Kafka's The Metamorphis)

From Gregor Samsa - protagonist in The Metamorphosis - referring to how people respond to those with serious illness.

Refers to the relationships of patients with those around them, the ''Gregor Effect'' (first postulated by Preston (1979) more recently popularised by Howard Brody (2002)) is a reference to German author Franz Kafka's 1915 short story The Metamorphosis. In the story, the protagonist Gregor Samsa turns into an insect. His family and friends, although at times empathetic and still loving, find ways to avoid him, to distance themselves from his ''illness''. Psychologists ascribe this ''Gregor effect'' to how some view the terminally ill. The ''Gregor effect'' can make people uncomfortable, scared, and at times present a challenge to their own mortality.

The Gregor effect implies that the diagnosis of disease becomes a stigma, a mark that impinges on all other social roles and affects all other relationships and interactions.

Ronald Preston (1979) used Kafka's analogy (he referred to the impact on others of serious illness or bodily deformity as the "Gregor effect") to study the reactions of nurses caring for the chronically ill and aged. He was interested specifically in reactions to people whom he labelled "acutely ambigious" in that they are like us and yet not like us (Preston 1979:37-46).

Preston observed a range of reactions in hospital wards to people in these catagories:

• impulsive reactions (startle, flight)
• prejudiced reactions (based on preconceived social values rather than emotion)
• obscenity reactions (attempt to resolve ambiguity through identification with deformed or disabled)
• ritual separation (banishment or sequestration of the sick as a prelude to the separation of death)
• humanitarian (observor broadens perspective and expands what it is to be human to resolve the ambiguity the condition causes, embracing the patient as fully human - often can become superficial attempt to do good rather than sincere)
• spiritual transcendence (often tied to religion has a firmer basis than humanitarian to resolve ambiguity)
• normalisation (conceptualises the the sick and disabled as just like us thereby deflecting any threat)
• diversionary tactics (such as using black humour)
• induration (may develop gradually and result in diminished perception of the ambiguity (Preston 1979:47-84))

Books
Howard Brody (2002) Stories of Sickness. Oxford University Press.

Ronald Preston (1979). The dilemmas of care: social and nursing adaptations to the deformed, the disabled, and the aged.