There’s a scene in the novel Leave of Absence in which Penelope and Oliver, patients in a behavioral health hospital, are waiting for a group session to start. Because of her schizophrenia, Penelope feels as though she doesn’t even fit in in a behavioral health center:
“When they entered the room, some participants stared and others blatantly averted their gaze. As usual, Oliver and Penelope sat in the back of the room. Other people came in, but not a single person sat next to them, and the chairs on either side of them remained empty. Penelope leaned toward Oliver and whispered, “I wonder if people just hate me or if they’re afraid they might catch what I have. It’s been like this for almost two years. Do you see why I can’t do this to William? I don’t want him to be shunned by the world because of me. It feels really awful, and I can’t do that to him.” She looked down at her hands and picked at her nails.”
This shunning that devastates her is known as stigma. Stigma’s impact is hurtful; in a poll, a high percentage of people indicated that they would rather not associate in various ways with someone who has a mental illness. The numbers are shocking. What, though, do they actually mean for someone experiencing mental illness?
It’s very easy to hear the word stigma and understand that it implies negative judgment against a group of people (in this particular case, it’s against people with mental illness). But it’s not always easy to verbalize the implications of stigma. What happens to someone who faces stigma?
With stigma, someone is judged negatively. No one ever likes to be judged negatively, of course. Who among us hopes for a really harsh performance evaluation at work? Stigma, though goes deeper than this. A bad review at work is based on things someone does. Stigma is based on a personal trait. Stigma, then, is based on who someone is.
This type of judgement actually perpetuates the stigma and stereotypes against people experiencing mental illness. This type of judgment is a form of prejudice (of pre-judging). It’s looking at only one aspect of a person rather than at the whole picture. It’s seeing mental illness rather than the whole person who’s experiencing it. This is what a person facing stigma “hears” (if not through direct words, through actions like when no one would sit by Penelope in the above scene): You are different. You are strange. You aren’t good enough to hire. You aren’t good enough to hang out with. You are worthless. You. Are. Mental Illness.
You are mental illness. See how this idea intensifies stigma and prejudice? You are “schizophrenic.” “You are bipolar.” You. Are. Crazy.
You are the flu? No. You have the flu. You are asthma? No. You have asthma. You are depression? No. You have depression. (Or even better, you are experiencing depression. Wording it this way further removes it from one’s identity and reinforces that any mental illness is, like asthma, something a person has to deal with rather than who someone is.)
When someone is criticized for something he/she did, he/she might feel embarrassed. When someone is criticized for who he/she is, he/she feels shame. Shame is a feeling of worthlessness. Shame is painful. Stigma leads to shame and can create isolation, loneliness, and self-loathing.
Think back, for a moment, to middle school (or, depending on your age, to junior high; for me it was junior high). For most of us, being different meant the risk of ostracism, and committing a social faux pas (which involved even the slightest deviation from “normal” behavior) resulted in at best a bit of ridicule and a worst downright bullying. It’s an awful experience. I have never heard anyone say that if, given a chance, they’d go back and do middle school all over again. Most people I’ve talked to (yes, I have conversations like this) say emphatically that noting would be worth experiencing the nightmare of middle school ever again. The reason for this is not because of the rigorous academic coursework. It’s not because of the cafeteria food (although I’m sure that the lunches aren’t really missed). It’s because of the judgment of the other students. Middle school is a time when kids feel scrutinized constantly for every little thing and bullied for any deviation from the norm.
Luckily, many people no longer experience the stress and fear of harassment that happens in middle school. Those human beings, though, who experience mental illness and face the stigma associated with it, perpetually live in middle school.