“Stigma” is a prominent concept in the mental health community, and probably rightly so. It refers to a sense otherness, an experience of judgment and prejudice, and a feeling of isolated loneliness that results from the judgment.
It’s not merely a perceived concept; rather, it’s very tangible and real. A great many people who experience mental illness or mental health challenges report the loss of friendships, jobs, and other such life things critical to well-being.
I co-facilitate a NAMI Connection support group, and the topic of stigma is a popular discussion. I myself have experienced it. I’ve lost a couple of friendships when said friends were uncomfortable with my diagnosis of bipolar disorder, and I had negative responses from an employer that resulted in a distinct lack of employment. To be sure, when I was dealing with a traumatic brain injury and the diagnosis of bipolar 1 disorder, I couldn’t work. The employer was very supportive about the TBI and wanted me to return when ready, but when the employer learned that I was in a behavioral health rather than a “regular” hospital and was diagnosed with a mental illness, I was unwelcome and even told that I couldn’t be trusted. This was not based on any changed behavior or reliability on my part but instead on the perception of mental illness on their part. That is what stigma means.
Yes. That is stigma. Stigma is real. Stigma is bullying. It leaves a foul taste in the mouths of those who speak of it, and it is toxic. To have toxicity means to poison those exposed to the substance—or in this case, the concept. People are hurt by stigma. However, perhaps “stigma” is toxic in another way, too.
I recently engaged in a twitter conversation, limited to 140-character exchanges yet very meaningful, discussing the frustrating aspects of “stigma.” While stigma is indeed real and undeniable, are mental health organizations doing people a disservice by continuing to focus so much on it? When the cry is constantly, “Fight stigma!” is positive change actively promoted?
“Fight stigma” is a battle cry. In a battle, there are enemies. The enemies try to destroy each other. The people who perpetuate stigma by judging and ostracizing are being destructive. People with mental illness who are trying to just live life like everyone else meet barrier after barrier. But the anti-stigma campaigns are doing battle, too. “Fight stigma.” “Boo to the people who judge.” Okay. Fine. But then what? Do we want to stay and fight, or do we want to move forward?
Believe me. I’m not brushing off stigma and it’s countering as unimportant. It is important. Currently, there are too many conversations like this one, extracted from the novel Leave of Absence:
When William said nothing further, Rod continued, “I know I’ve said this before, but it really sucks that this happened to her. You guys don’t deserve this. I hope they can help her. She hasn’t been the same for nearly two years, and that’s a shame. She used to be such a great person.”
Used to be a great person? For a moment, William was speechless. He knew Rod didn’t mean to be hurtful, but his comments stung. When he spoke, his voice was tinged with hurt and anger. “What the hell does that mean?”
“Hey, no need to get pissed. I didn’t mean anything by it. She’s still Penelope and all, but just, well, you know…” Rod trailed off and made a vague gesture.
“No. I don’t know.”
“Come on. Schizophrenia…” Rod trailed off again, as if that single word said it all.
“I don’t know what you’re getting at. Why don’t you enlighten me?” William challenged.
“It’s gotta freak you out, man. It would freak anyone out. Doesn’t she think that aliens are going to abduct her, or that the CIA is out to get her or something like that? Aren’t you scared? People with schizophrenia are unpredictable and violent. What if voices tell her to kill you, William? You go to sleep one night, and she sneaks into the kitchen, grabs a knife, and stabs you or something.”
Stereotypes abound, and they hurt. This description of schizophrenia is as common as it is incorrect. Here, the stigma against mental illness destroyed a friendship. Things need to change. But is crying “stigma” alone going to bring the needed changes?
Perhaps it’s time to expand the stigma-fighting campaigns that exist. Stating that stigma needs to stop (and yes, it does) might not be enough. Perhaps more important than saying that stigma needs to stop is asserting that understanding needs to begin. Perhaps the Look Me in the Eye campaign, a movement to break down barriers between people, could be a positive model. Rather than calling for an end to the stigma against people with developmental and intellectual disabilities, this campaign calls for increased understanding and improved relationships.
Is being rooted in a fight against stigma preventing forward movement? Personally, rather than telling someone to stop stigmatizing me, I’d like to give them a way to do it. I’d like to teach people what given mental illnesses are and are not as well as to show them how to look at each other’s heart. Should we continue the battle cry of “Stop stigma,” or would it be better to beckon, “See me for who I really am?”
What are your thoughts on stigma? Feel free to join a dialogue by leaving a comment.