To the Heart of the Matter, Part II: Perceptions of Public and Personal Stigma

By
-
107
180

In 2014, a couple of researchers published an article on the topic of perceived stigma in the public and personal domain.  The authors noted that, to date, “no studies have examined perceptions or misperceptions of how the study participants themselves would be treated by the general public for seeking treatment for mental health concerns” and also analyzed specific factors (e.g., mental health symptoms, demographics) that might be connected to the perceptions.

A couple of terms must be defined before considering the findings, and extending a conversation started in my initial installment of this series.  Public stigma is characterized as “the degree to which the general public holds negative views and discriminates against a specific group [in this case, those with mental health difficulties].”  Personal stigma captures “how one actually would view and treat others themselves.”  That being said, research uncovered a number of interesting results.  Initially it was found that perceived public stigma was rated at a significantly higher level than personal stigma.  On the topic of personal stigma, 93% indicated “disagreement” that they themselves would view someone with mental health difficulties negatively while 0.8% “agreed” they would have a negative view of such individuals.  9 out of 10 raters indicated that those with mental health issues should not feel embarrassed, worry about their reputation, or see themselves as weak or think less of themselves in this situation.

Certain factors were significantly correlated with these findings.  Individuals who reported higher levels of anxiety themselves were more likely to rate increased public stigma.  A more negative view of mental health treatment by the rater was also associated with heightened perceptions of public stigma.  In regards to personal stigma, men of Asian descent were more likely to acknowledge increased personal stigma (i.e., looking at the person in a negative way) while like with public stigma, an increased negative view of mental health treatment was associated with higher personal stigma levels.  Also, differences between a rater’s perception of public vs. personal stigma were associated with the following factors:  female gender and increased anxiety/depression scores of the raters.  In other words, females who were depressed/anxious tended to report a greater discrepancy between personal and public stigma than other raters, most likely with heightened public stigma reported (as noted prior).

Overall, the researchers found that raters endorsed much more elevated perceptions of public vs. personal stigma.  In many ways, the raters seemed to say that while they felt the public often judged people with mental health problems differently, personally they would rarely or never do so.  The authors concluded, with much further discussion of mitigating factors, that the “general consensus towards mental health treatment may not be as negative as one believes.”

Before further discussion around these conclusions can ensue, it is critical that we look at all the factors that may have influenced or distorted the data in any manner, and which may have resulted in a perception of reality than may not be accurate.  The first is the social desirability factor, which in this case would potentially lead raters to answer in ways that preserve their own sense of integrity and positive image.  It is understandable that many might be leery about acknowledging their own negative attitudes towards others, even though the research was done confidentially.  Secondly, participants were college students.  Arguments can be made that 1) they are especially prone to the social desirability bias, and 2) do not represent a larger sample of individuals who have truly struggled with mental health issues, although certainly some in the sample did.  Third, the nature of the statements that were answered and how this influenced raters should also be considered.  For example, Pair 1 included the following statements regarding public vs. personal stigma, respectively:  “It would be too embarrassing” versus “They should feel embarrassed.”  Most of us reading this would likely feel uneasy ever asserting that someone should feel embarrassed (even if we felt this way), especially given circumstances with which they may not have been responsible (e.g., childhood abuse).  Fourth, there is a big difference between what we say we would do (or think) versus what actually occurs.  A huge body of research exists that indicates our unconscious behaviors may reveal stereotypes or discrimination that our conscious selves would deny.  Certainly, this is not an exhaustive list of possible influential or misleading agents, but it is a beginning.  I encourage others to provide comments about potential explanations that might alter findings that I have not included.

That being said, there is one final possibility even if the strength of the findings is compromised to a certain degree.  It is the one with which researchers concluded, which indicates that public perception of mental health stigma does not entirely reflect a reality that exists.  Many of you reading this that have experienced truly negative reactions from others (due to mental health concerns and/or treatment) may be angered or offended by this proposition.  However, no one (especially myself) is saying that stigma is not a serious concern that doesn’t need to be addressed.  It is.  Although in some ways I do feel that people can seek out treatment with less apprehension today than decades ago, there is no doubt that many still experience negative reactions (intentionally or unintentionally) from what others perceive in them.

Still, I feel that this is an important discussion that has long since been neglected when the topic of stigma arises.  As I said before, I do not believe (like almost anything else that exists in humanity) that stigma is entirely a one-way street.  In fact, when it is described this way, I feel that it does a disservice to both the person accused of stigmatizing and the person who feels stigmatized.  It has a way of widening a gap that needs to be shrunken and further fortifying an us vs. them mentality that needs to be bridged and destroyed.  Practically speaking, what often happens is that two groups of people who probably really need to talk and get to know, and respect, and maybe even love each other end up avoiding and despising each other instead.  I am not trying to be pollyannaish or unrealistic about this topic.  I am not suggesting that some people, no matter what the circumstances, may not hold to negative, discriminating beliefs.  But I do believe that division and unilateralism, in action, word, or belief, never leads to real progress.

Over the years, I have had many opportunities to confront my own explicit and implicit biases, and they almost always seem to happen when I finally get to know someone for who they are.  As a young mental health technician working on an adolescent unit just out of undergrad, I remember so often hearing about the reports of individuals as they were coming onto the floor.  What happened over and over again was that when I would finally meet them, and get to know them, they would almost never live up to the reputation that preceded them; more importantly, I started to see them as the person they were and the struggles that had led them to me. I started to recognize the similarities we shared even if our stories sounded very different.  And I found that I could not help but empathize and care for them, and see the value that each person had to me, our society, and our Divine Creator.

But when a real, empathetic human experience does not occur in some manner, individuals in all positions feel disconnected.  I think this happens often when the term “stigma” is thrown out as if the case is closed and no further discussion ensues.  Certainly many times the “offender” may have actually done something to discriminate or disrespect an individual with mental health difficulties; however, it is just as reasonable to assume that sometimes, a stigmatizing act may not be what it seems, just like a bump in a hallway may either be accidental or malicious – no matter what we think.  This idea coincides with the researchers’ findings that increased anxiety and depressive symptoms intensifies a perception of public stigma.  It is not surprising in that we all know that when we are feeling down or anxious we are often more likely to perceive a negative side in others than when we are feeling well.

As civil rights activists were planning the Montgomery Bus Boycott (as detailed in the Pulitzer Prize winning book Bearing the Cross), there was a clear sense that although activists were working against the injustices of bigotry and segregation, they also had to be particularly acute to the mistakes and misattributions of their own, as they knew that this might derail an otherwise noble undertaking.  Whether this was illegal or violent behavior, or misinformation or misperceptions put forth, leaders of the civil rights movement knew that they must acknowledge where they might have gone wrong (in deed or thought) so that right could be done.  So it seems, too, for the movement to provide the utmost care, respect, and love for anyone dealing with mental health challenges.  Everyone needs to go truth-seeking if “we shall overcome.”

***

Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

RELATED ARTICLESMORE FROM AUTHOR

107 COMMENTS

  1. James, I think this article’s idea is basically correct. Most people are probably not as judgmental or negative about others who are suffering (with “mental illness” labels), in actual practice (personal stigma) as we sometimes fear them to be (public stigma).

    A similar phenomenon occurs in the news media where the 5% of awful things happening in the world get plastered all over the newspapers and media shows, while the large majority of good, benign, constructive happenings in people’s daily lives are ignored. That is why I read http://www.goodnewsnetwork.org now instead of watching cable news because the mainstream media it is so distorted and discouraging.

    I am confident that people given mental illness labels, especially those labeled “borderline”, “psychotic”, “schizophrenic”, “bipolar”, are especially attuned to the public stigma image while not realizing that it may not reflect how most people act and think in practice. Due to abuse and neglect, people with these labels often experience primitive psychological splitting where they view things in only all-good or (more usually) all-bad terms. They are exquisitely attuned to possible negative perceptions of others, while being relatively unreceptive to positive loving perceptions, and tend to overinflate negative ideas while not realizing the degree of their distortions.

    Lastly, in the US especially a complicating factor of stigma is that “mental illness stigma” is often viewed in reference to the delusional idea that the stigma is against people who “have a brain illness.” So the destigmatization process is then imagined to be the following: we are discriminating against people who have brain illnesses called schizophrenia, bipolar, depression; we would never do this for people with heart disease or diabetes, and we need to get rid of the stigma by viewing the mental illness labeled people as having an illness like any other.

    Of course this is just bullshit – the brain disease scam which serves the existing system of coercion, overdrugging, and lack of taking responsibility for looking at difficult emotions and one’s own contributions to people’s problems. The “destigmatization of mental illness” only produces more pessimism, hopelessness, and stigma because it communicates that a person cannot fully recover and has a life long illness they have no power over. It’s a lie. We have a lot of research now showing how damaging the destigmatization of mental illness stigma is:

    https://theconversation.com/blame-it-on-biology-how-explanations-of-mental-illness-influence-treatment-48578

    http://www.madinamerica.com/2015/12/70079/

    http://recoveryfromschizophrenia.org/2012/07/its-not-just-the-drugs-misinformation-used-to-push-drugs-can-also-make-mental-problems-worse/

    http://theicarusproject.net/sites/default/files/files/read_prejudice_schizophrenia_biol_stigma.pdf

    http://www.uw-anxietylab.com/uploads/7/6/0/4/7604142/chemical_imbalance_test_brat.pdf

    A lot of people misunderstand “stigma reduction” to be about reducing negativity toward individuals who they delusionally believe to have a brain disease. They just don’t realize they are only making it harder, on aggregate, for this group of people – who actually don’t have brain diseases – to find salvation and deliverance. Probably the majority of the American public think and act like ignorant sheep in this regard, swallowing whole the lies about mental illness being a biological illness. To me this is a more important issue – how stigma is structured and understood relative to biological/genetic models – than almost anything else.

    • BPD, you make a ton of great points, most of which I agree and some of which I will attempt to further flesh out in the next installment about how I think we should treat others that struggle in any domain, physical, psychological, or otherwise. I definitely understand what you mentioned about how destigmatization efforts can backfire as it implies (or clearly indicates) that these individuals are impaired for good instead of recognizing that we all have a capacity for renewal and positive growth. The only thing counter I would say to you and others who hold the beliefs regarding destigmatization efforts (and you alluded to this) is that many people do have good intentions (albeit misguided) and care about others, and are not part of a larger conspiracy that is sometimes put forth here on MIA. They really want to treat people well, but a combination of fear, misinformation, and their own challenges may lead the results to be less than desired.

      Thank you for your time and thoughts.

      jim

  2. Beautiful exploration of a complex and highly personal subject, James. Our perception of ourselves certainly does drive our reality, imo, so when we eschew negative projections and refuse to identify with them, regardless of how aggressive and systemic they become, then I believe we are taking the necessary steps toward a sense of personal agency and freedom, which to my mind, is where we find well-being and inner peace.

    I like to discern stigma by saying there is an ego side to it and there is a practical side. While I was going through the mh system, the stigma which I encountered, which could be quite thick and brutal, temporarily undermined my ability to make a living and extended my period of ‘disability.’ It was all politics, that is for sure.

    It had nothing to do with ‘hurting my feelings,’ even though it felt more like vicious gossip more than any kind of fair and neutral professional assessment. In fact, I was extremely successful with clients. They, however, had another agenda, so this is where we clashed.

    But it was admittedly extremely annoying, distracting, and downright crazy-making to listen to projection after projection, personally unfounded and all based on stereotypes and myths, as a way to malign my character and try to make me feel some kind of shame, to which they did not succeed, that’s not part of my make-up and I had absolutely nothing to feel ashamed about, far from it. I’d been healing by leaps and bounds and it showed.

    I was vindicated in legal mediation, but my employability was completely compromised. That’s what happens when you challenge the status quo–blatant stigma, totally political, intended to cause ‘shame.’

    I would not accept the view of me they were dishing out, so I continued my training and began a healing and teaching practice that continues busily today. Plus, my experiences with all of this led me to make a film about stigma in the mental health system, which changed my life. I’d like to think this is because I would not in the slightest buy into their fictitious (stigmatizing) version of who I am, and stuck to what I knew about myself.

    When we observe others without experiencing what they have experienced, then we are bound to project, that would be natural. I’m not sure why some people continue to insist that they project negatively onto others, however, rather than with respect, neutrality, curiosity, and affirmation, but they do. I don’t know how to stop that from happening, not sure anyone can. People are enraged, cynical, and fearful, and that’s the way it is right now, until people wake up and heal.

    But we can know the truth about ourselves and be firm in that, and this will render stigma completely powerless. Our true nature always wins out over the fiction of who we are, projected onto us by others. That’s how I busted through an extremely stigmatizing, second-class making environment and found my life again, on my terms, mirrored only by my own heart, spirit, and experiences.

    Wishing you a peaceful New Years, James. Thanks for your extremely thought-provoking work, you know I enjoy your angle on things, and I resonate with the spiritual essence of your work.

    Peace to all in the New Year.

  3. I must say I found it to be those who advocate belief in, and financially benefit from, the DSM disorders – the psychiatrists, mainstream doctors, religious leaders, government officials, police, insurance workers, judges, and lawyers – who tend to stigmatize, be disrespectful to, and actually break laws against, those with DSM labels.

    But none of my friends or neighbors were rude or discourteous to me while I was being made “psychotic,” via drug induced anticholinergic intoxication syndrome / “bipolar.” And, when I finally told my friends about how doctors and my ex-pastor intentionally poisoned me to cover up prior easily recognized iatrogenesis and the sexual abuse of my child, all those I’ve told about these deplorable “professional” crimes were appalled at the “professionals.” And the “professionals” get really embarrassed about their co-workers behavior, too.

  4. Hi there,

    I don’t really believe in “mental illness”. But, I definitely support the idea of a reasonable approach within human rights activism, even against prejudice.

    I’d say I’ve witnessed quite a bit of stigma or attempts to take advantage, mostly in the non psychiatric medical environment. Medical people don’t like being contradicted in terms of diagnosis I think because mental health medicine is so insecure.

  5. Hi,

    Good article, thank you.

    In my experience, those who were most blatantly prejudiced towards me, were (ironically) MH practitioners, Psychiatrists, Clinical Psychologists, Nurses, Social Worker, Assistants and Cleaners in hospital settings. Examples being:
    – telling someone that all and any traumatic events they have been through, are not relevant, what’s wrong with me, is my brain chemistry;
    – to add insult to injury of the above, the only reason i can’t see this is because I am “ill” (“poor insight”)
    – telling someone they have a (fictitious) physiological illness for which they have to take drugs for the long term if not the rest of their life (i.e. hopelessness…you are permanently broken)
    – oh, not to mention the taking away of their human rights, and terrifying people inpatient…

    If that’s not stigma, I don’t know what is…and these are the people who are there to “help”….

    In stark contrast, friends and colleagues I have generally found to be extremely sympathetic and kind.

  6. Hi James – a very thoughtful piece. Stigma in “mental health” is a topic talked and written about much, these days.

    I am in Australia and here, “Mental Health Week” is very heavily promoted and supported by many government and not for profit organisations with the aim of “reducing the stigma of mental health”. Yet – all to often I’m left wondering – does no-one even notice the inherent stigma in the terms “”mental” health and/or illness” – in and of themselves?

    In using these terms, we are still buying in to the old separation of mind/brain and body myth – the dualism that even so much work over several decades now in fields as apparently “purely scientific” as developmental neurobiology has clearly shown to be an utter myth, as well as the bio-psychiatric model of “mental illness” as a “brain disease”.

    It’s well known in many areas now (though still promoted to the general public by government and psychiatric organisations) that the “chemical imbalance theory” of depression and possibly all “mental illness” is a lie (though I acknowledge that in some instances the influence of genetic and pre-disposing physical vulnerabilities can be a much greater factor than in others). We, as human beings, have feelings and emotions. In examining the criteria for diagnosis for just about any so-called “mental disorder” in that diagnostic bible, the DSM, just about all criteria that need to be met for diagnosis of so-called “mental illness” refer to ongoing difficulties in managing a particular feeling/emotion. Much research is now showing that even those symptoms that have been labelled as ‘psychotic’, such as hearing voices, hallucinations, derealisation etc, may in fact at times be more strongly correlated with factors such as dissociation and past experiences of trauma and abuse and so, are more likely to be varying defences in managing emotions that are ‘unmanageable’ – rather than “illness” (mental or otherwise).

    Are our feelings and emotions “mental”? Any person will know that the emotions they feel are felt not just in the brain but also in the body. Neurobiological research has repeatedly confirmed the links between the brain, nervous system, endocrine system and immune system functioning (amongst others), as well as confirming that our capacity to manage our feelings is primarily influenced by factors external to ourselves such as interpersonal relationships and stress.

    What this means is that yes, there are times when we can be reduced to not being able to function as well as this modern society, which emphasises the need to be “happy and productive”, requires of it’s good enough citizens. It also means that to be overwhelmed by our emotions is just as disabling physically in the body, as well as “mentally”, as being overwhelmed by a virus to which the body responds with a high fever. Labelling those who are overwhelmed in this context by their very real feelings and emotions as “mentally – yet not physically or environmentally – ill”, while I understand the need to overcome the “just get over it” attitude, is still inherently stigmatising of itself.

    I don’t pretend to have an answer to this labelling conundrum but, feel it is one that at least needs airing. To acknowledge in public that one is “mentally ill”, possibly at least partially because of the push to de-stigmatise and educate that people can not “just get over it”, carries with it associations of permanent disability, thus making the person appear unreliable as an employee or even friend and acquaintance. As you highlight, it takes a deeper personal relationship to begin to see past these surface stigmatising labels and understand that the person is real and experiencing things that are not strange and scary but in fact, quite understandable, yet at the same time a person does need extra consideration and concessions and can not live up to societal expectations to be “happy and productive enough”.

    But, might not the whole of society be better served by learning that humans are fallible beings who can not function at 100% effeciency in any and all circumstances and conditions, and that when things get too tough, we do need the help and support of others around us to manage our feelings. We are and need to be connected to those around us so survive those times when our emotions and feelings become overwhelming. That our environments matter, that our own personal feelings matter and we both need and deserve help. That in many instances it might just be our societal expectations that are unrealistic – not that some individuals are “mentally ill”.

    Sure, this would be a paradigm shift of enormous proportions but, as with the de-bunking of the biological brain illness model of mental illness in the first place, the momentum can build and these moves can and do happen. And in the end, who really feels good about perceiving themselves as “mental”?

    • does no-one even notice the inherent stigma in the terms “”mental” health and/or illness” – in and of themselves?

      Exactly.

      The next thing I think we need to work on in terms of our anti-psychiatry consciousness-raising is recognizing that not only is the term “mental illness” an oxymoron of sorts, but that it is falling into the same trap to implicitly accept that there is an “it” which needs to be redefined, if not as “mental illness” then as something else.

      It seems pretty clear to me that when people react to significant events in their lives, traumatic or otherwise, in ways which are inexplicable to others, the outward behavioral manifestations of such will different in different people. Seemingly similar behavioral patterns are labeled as “symptoms” of “illnesses” but the meaning of the behavior is completely different from person to person. There are no valid “categories” here because the significance of any behavior is unique to the individual. So when I say “there’s no ‘it’ there” I mean that we do not need to find a more “accurate” substitute term for “schizophrenia”; we need to change our compulsion to categorize human thought, feeling and behavior as something that is consistent, scientifically definable or predictable. (This is the part that seems to bug mainstream liberals who want to replace religion and philosophy with “hard” science.)

    • Thank you for identifying the inherent stigma in the false terms describing mental distress; I consider the proper term to be “emotional distress” from painfully distressful experiences. Emotions become difficult to manage when distressful experiences become too painful and too difficult to manage; emotions are expressions of experiences of well-being or distress. The brain is resilient and operates properly most of the time; neurologists are involved when there are brain problems.

      Best wishes, Steve

      PS- It is difficult to understand the experiences of other; I do not believe that there is a genetic pre-disposition to react to distress beyond a history of personal experiences.

      • I have often used “emotional distress” as a “substitute” term. But even here we are ignoring that some people, for example those labeled “manic” (at least prior to the “bipolar” label), are not necessarily feeling distressed at all, but are “unacceptably” driven, inspired, talkative or on a creative tear. If anyone is feeling distressed it is the people around them.

        • I believe that “emotional distress” better describes “mental distress” and is inclusive of people whose behaviors are labeled “manic.” I believe that manic behaviors are “driven” by a desperate search for relief from intense emotional pain (from painfully distressful experiences). It is now coupled with depression because it describes behaviors that desperately seek relief from the hopelessness of depression. A perceived solution to extremely painful hopelessness creates a superficial happiness and intense motivation. Unfortunately, solutions to extreme hopelessness are rarely produced in a short enough period of time to provide the desired relief. Manic episodes are distressful for family and friends who believe that the “solution” appears desperate and unlikely.

          Best wishes, Steve

          • Yeah well you’re doing pretty much what I was talking about, i.e. identifying a particular behavioral/personality characteristic, which could be reflective of any number of disparate influences, as “manic,” then generalizing about this self-constructed category of people you’ve created. Some people have streaks of proclivity followed by periods of inactivity and withdrawal; it’s just how they are. This includes some of the world’s most creative people throughout history.

            Others who are not “distressed” include those who are in the midst of spiritual or other revelatory experiences.

          • Old head,

            I agree terms like “mania,” “psychosis,” and all the DSM psychiatric terminology, are just theorized ways of defining normal human reactions to evil, essentially.

            And I do claim my drug withdrawal induced experience was one which I felt, at the time, was one inspired by “God speed.” But the psychiarists claimed my amazing experience was due to “mania.”

            But since none of the psychiatrists have yet to actually prove God doesn’t exist, I guess you’re right, I shouldn’t call my amazing spiritual journey “mania,” nor “psychosis.” It was, as I initially theorized, a spiritual journey.

        • As one who was made “manic” twice, via drug withdrawal induced super sensitivity manic psychosis, but who never really suffered from depression, just disgust at the medical / religious betrayal of my family, then utter disgust at the almost unfathomable in scope iatrogenic crimes being perpetrated against humanity, especially so many children, by today’s “mental health” industry. And a psychologist I spoke with recently agreed disgust is not depression.

          I do agree with Steve that mania can result from a search for relief from, at a minimum, extreme injustice, if not intense emotional pain. And I agree, “emotional distress” is a much more accurate descriptor than “mental illness.”

          Although, I also somewhat agree with Kallena, it’s possible extreme injustices, like wars, do seemingly create multi-generational mental or emotional problems. I see the WWII “greatest generation” raising the most fiscally irresponcible and ethically immoral “me generation.” Although these people’s fiscal irresponsibility and lack of ethics does seem to be due to a likely improper child rearing environment, rather than genetics.

          So I guess, I doubt Kallena’s eugenics theory, but I don’t claim to understand a knowledge of everything about the human experience, like today’s psychiatrists. But I do believe the psychiatric industry absolutely attacks families who believe in their “life long, incurable, genetic mental illness” theories, to perpetuate their eugenics theology, thus they create a “cycle of abuse” of certain families.

          Protecting my children from such potential psychiatric eugenics deluded defamation was why I needed to research medicine, so I could medically prove my “bipolar,” was actually the psychiatric drug induced anticholinergic toxidrome, not some scientifically invalid “lifelong, incurable, genetic mental illness.”

          • Oh, and I too was one in the midst of a “spiritual journey,” which again qualified me as one who was not “distressed” by my drug withdrawal induced super sensitive manic psychosis. It was a really cool awakening to my dreams, which implied we as humanity are to collectively evolve, rather than allow today’s psychiatric industry to maintain the current unjust status quo.

          • I do agree with Steve that mania can result from a search for relief from, at a minimum, extreme injustice, if not intense emotional pain.

            “Mania” is used as a medical/psychiatric term in most cases so it is good to avoid, even if that’s not one’s personal understanding, just to avoid confusion. My main point though was that while whatever behavior we’re talking about at the moment may be a strategy for avoiding emotional suffering, it is not always such. Again, this sort of generalization is what leads to such catch-all notions as “mental illness.” Anyway, I’m just being picky.

          • Hi Someone else –

            very interested in where from my posted comments you find any indication that I have a “eugenics theory”?

            Personally, I believe that everyone is unique and experiences can’t be generalised. What can be discovered and somewhat generalised though is what types and degrees of experiences have what impacts on people in what kinds of ways. You mention the effects of wars – the impacts of such events on both individuals and whole societies have been studied in many ways so there’s no need to simply believe or not believe whether such extreme traumas can have fundamental and lasting impacts that can or can’t be ‘passed on’ – we know they can.

            Where or whether this gets to eugenics though I don’t understand in the least. Everyone still, intergenerational trauma or not, has to travel their own personal journey and discover for themselves if they believe it is spiritual or otherwise.

            Language is always a problematic issue in any discussion of these sorts of issues. We are limited in the words we have available to describe any experience yet, how one person interprets that word may be different based on their own history and experience to how another may interpret and use that same word – whether they are words used as psychiatric labels or not.

        • It easily becomes difficult to discuss behaviors and experiences with a vocabulary that supports the medical model; I do not define thoughts and behaviors as “manic” if the person is comfortable with them.

          The current narrative is about a medical problem from a “mental” disorder; I believe that a more truthful narrative is about a social welfare problem of painful emotional suffering from distressful experiences.

          Best wishes, Steve

      • Thanks Steve.

        I agree that “emotional distress” is a much more accurate and appropriate term, though language itself can be very difficult and reductionist of any and all human experience. Unfortunately, we do have to try to find the best words possible to manage to communicate what we wish.

        Everyone’s own experience is unique, but re the potential for genetic pre-disposition to react to distress beyond ones own history of personal experience and context, I’d include here the fact that trauma can in fact alter the genome and thus, this altered genome is then be passed on to future generations. This then amplifies any pre-disposition a person may have to suffer unmanageable emotional distress and adds to the potential for the “cycle of abuse”.

    • Kallena, you said this:

      “But, might not the whole of society be better served by learning that humans are fallible beings who can not function at 100% effeciency in any and all circumstances and conditions, and that when things get too tough, we do need the help and support of others around us to manage our feelings. We are and need to be connected to those around us so survive those times when our emotions and feelings become overwhelming. That our environments matter, that our own personal feelings matter and we both need and deserve help.”

      What you said encompasses a massive volumes of faith and psychology at its best. When all of us start to let go of our pride and realize that we are not independent beings, but interdependent people, the world suddenly has potential it did not before. The process can be brutal, but the results can be beautiful if we take this to heart. One of the best things about being a psychologist is understanding full well that so many things that people think they struggle with alone are actually the things that so many struggle with together, without even knowing it. I will address how we take this understanding and move to a more authentic place in the next installment.

      JFS

  7. Some really great points were brought up, and would say one of the big ones is the divide this has created. Also the problem with self stigma. If a person is feeling bad about themselves, talking about stigma will probably only make them feel worse, and make people who are either unsympathetic more engaged, and people who feel like tjheir trying to understand defensive. I however think the worry about how they could be perceived plays a big part. That could be hard to be avoided though. However, many did report self stigma, which in itself is a problem. I wouldn’t exclude where they may be being stigmatized, however wonder what’s being done to address their own self stigma. I, would hope that they would be able to see some good in themselves.

    I don’t know if the word stigma though in itself is all to helpful. I think perhaps that’s one thing that could help this situation a little more. I would say people having self doubt, or experiencing a lack of compassion, or negative feedback. This is pretty relatable to everyone, and think the important thing is to actually talk about the problem. Self doubt, and reviving lack of compassion is something everyone knows to some degre. That’s something they can relate to. I think telling people they should make more of an effort to be more understanding, and compassionate, would be a lot more useful, than saying you should stop stigmatizeing people. Who could honestly look at themselves, and say I’m always completely understanding, and compassionate, and it would not be possible? The problem with self doubt might be harder, although everyone has it to some degre, and think the best way would be to help them find what’s good about themselves, and others also experience self doubt. There are many things that could be done, however both of these things are complex. I think a big part would be realizing that everyone experiences all of these things.

    I think the points you made about the reports of patients are also an important factor, as they are often based on what’s wrong. The same goes with evaluations. A person can internalize, but like you said about your pataints, they often don’t live up to them. I would say that is a huge factor, as well. To a degree, these are often how people labeled mentally ill are perceived publicly, and people may to degree wonder, or believe some of these things.

    However, this is important that it be talked about in this specific way. The most important thing I believe you brought up is it’s not that clear cut. While I don’t agree with all the conclusions, and ideas, and overall views on mental health, think this can at least point to something more than the endless back and forth, about stigma. The idea, where people must either be fixing, or berating someone.

  8. Nothing is more irritating to me than the notion of “stigma.” First random people are dehumanized by being given disease labels by the mental health industry, officially defining them not only as “other” but as damaged goods, then when other people absorb these attitudes and respond as they might be expected to — i.e. by holding the person with the mysterious “disease” at arms length in case it’s catching — they are accused of harboring “stigma.” Then the psychiatrized are supposed to care about these ignorant attitudes of ignorant people, who could easily have been in the same diagnostic boat had they encountered psychiatry at the wrong moment in their lives? Fuck that. There’s a simple solution — stay away from people who talk about “mental health.”

  9. I don’t like the word “stigma”. My dislike stems from the word origin as much as anything else. The word arose from the practice of branding or marking slaves and criminals. I’d prefer to think that any mental patient brand I might have received has long worn away. I find those words prejudice and discrimination, that came out of the civil rights struggle, much more useful. So far as I know, “mental health” is not said to have a “stigma”, although a “stigma” is attributed to “mental illness”. I don’t think we are “helping” people by encouraging them to pursue mental patient as a career. In many cases, in fact, the mental patient career choice stands in the way of eliminating prejudice and discrimination. People work as a rule; mental patients, not so much. I read something on a CCHR website once that stated that a person was “mentally ill” until the insurance ran out. I think there is a lot of truth in that statement. Once we had a mental patients’ liberation movement, and although it may have been superseded by a mental patients’ movement, as far as I’m concerned, it’s still a mental patients’ liberation movement.

    • I don’t think we are “helping” people by encouraging them to pursue mental patient as a career. In many cases, in fact, the mental patient career choice stands in the way of eliminating prejudice and discrimination.

      Yep. If you’re going to define yourself as weak, sickly and weird people will pick up on your own projections and treat you that way.

        • Not much for the word ‘stigma’ but I see you have no problem in blatanatly stigmatizing others. If anything is going to get in the way of progress, it is all this damning judgment, based purely on speculation, toward psychaitric survivors of your particular choosing. Looking in the mirror is always a great place to start if you really want to create change.

          • Thanks, Alex, but just the same, I see no reason to seek “help”, and I wouldn’t have that “help” imposed on me against my will and wishes either. As for “stigma”, if I scrutinize myself in the mirror I’m still OK, that is, no “stigma”. I can’t seem to find those “bad genes” if I look for them. I’m biased though, I have to admit that. If anybody wants “stigma”, they can have it. I hear it comes with “mental health” treatment. Uh, “mental illness” so-called, too. It’s hard to find any “stigma” in a clean bill of health.

          • I don’t have a problem, in other words, bucking the trend no matter how popular a pastime “mental ill health” has become of late. Can’t speak for others, that’s just me. I’m not overly nostalgic either.

          • Disability is physical or it is not disability.

            When I was first committed to the hospital there were people there who’d thought they’d found paradise because they’d never have to work again. You also had those who were called institutionalized due to their “learned helplessness” after the length of their stays. I don’t count myself among either category.

            I’m not a snake oil salesman, and I don’t subscribe to any philosophy or religion of invalidism. There is, at the present time, little attempt to scientifically separate physical disability from phony disability. Perhaps science should make some small endeavor to do so.

          • Frank, what you say about others is merely projection on your part, you can’t know what goes on with another person, especially if your projections are laden with judgments, as they seem to be here, by what you express. We can only know ourselves.

            That’s exactly what is wrong with current ‘mental health care,’ at the core–they assume and project their personal and subjective reality onto others, and call it ‘truth,’ while all the while it is pure judgment. That’s why the field is a fiasco, it’s all based on conjecture, speculation, and dualistic projections. There is no truth here, just meaningless babble–lucrative for some, draining for others.

          • Disability is physical or it is not disability.

            I get your drift in terms of trying to be consistent but I don’t know if there’s a direct analogy between this and, say, recognizing that since “mental illness” is not physical “it” is not illness.

            For example, say both of someone’s parents tragically die in a train wreck, and they are too emotionally blown away to go to work the next day — wouldn’t it be sort of quibbling to argue about whether they “can’t” or “won’t” work?

          • Alex, my experience is of being locked up against my will and wishes, that is, forced treatment. I’m not, and I wasn’t, seeking treatment. I had no choice in the matter, and then it was just a matter of playing the game. I did what was expected of me. If I didn’t, I wouldn’t have gotten discharged. I’m glad to be out of it. “Chronic mental illness”, as far as I’m concerned, is a joke. I don’t want to spend my life in treatment, and as that is a real option, I don’t spend my life in treatment. I’m not into the mental health racket at all really. It’s just not for me. I worry about people, projection or no projection, who think it is for them. Endless consumption of mental health services can be an endless drag. “Needy” can get, after all, excessive.

            OldHead, I don’t think it’s quibbling at all to distinguish “can’t work” from “won’t work.” Biggest distinction, “won’t work” CAN work. We may no longer have a work ethic, but if we did have a work ethic, then it assumes a certain amount of importance. As far as I know robotics hasn’t advanced so far that robots are taking care of all our needs yet. We get called “broken”, okay, but, frankly, some of us aren’t “broken”, that is, some of us are fully capable of doing a day’s labor. Some of us, in fact, don’t mind putting out a little. Nothing wrong with that.

          • Frank,

            It can be very difficult to impossible to work when one is experiencing constant hyper-vigilance, or dissociation, or panic attacks, or feelings of persecution, or voices, or suicidality, or any number of other experiences that get talked about on MiA. The fact that these experiences are not usually caused by medical conditions does not mean that they are not real or that they are not serious. This is not to mention the disabling harm done by psychiatric “treatments,” though that might perhaps qualify as “physical” in your notion of disability (or maybe not).

            In any event, I reject the medical model of disability anyway, so there’s no contradiction. The social model makes a lot more sense to me.

            http://www.scope.org.uk/about-us/our-brand/social-model-of-disability

            As an aside, way to champion the Protestant work ethic (i.e tool to enslave the working class) and capitalist labor markets!

          • Frank, we’re in agreement about many basic things. I don’t believe in the ‘chronic mental illness’ racket, either. To me, that is exactly what I’m calling dangerous stigma (yes, I know it’s the word du jour, but personally, I feel it covers it well–at the very least, we’re talking about negative false conclusions which lead to no choices for the individual, whilst being marginalized).

            Based on that false assumptions, a lot of bad decisions are made by all parties concerned and end up creating this reality of ‘chronic something or other’ when it needn’t be, there are so many options for how we address our issues and the effect that life has on us.

            Psychiatry and the mental health field, in general, would not be an option for me, either, based on its past failures with me which led me down a very dark road, like others describe.

            While the effects of such a vampire-like system in the name of ‘health care’ does concern me regarding our society in general, I’m not sure I can afford to worry about others, until they contact me to help them make the transition from ‘mental patient’ to free citizen. That’s a big internal leap, which is the path I took, to get out of all that. I was deeply embroiled in the system, until I finally woke up to what it was all about, in reality. That’s when I began to shift my perspective about how we create our own reality, and this is what freed me completely.

            In the meantime, everyone has their path to take, however that occurs. Our choices lie in how we respond to that which we cannot change in the moment, and once we own that, then we can actually create the change we want, overall.

            The mh field perceives people so dualistically and is so extremely class conscious on top of it. I think this field is a dinosaur at this point. There are so many ways to heal and grow, if that’s what one desires. This is a matter of keeping up with the times. The internet, especially YouTube, is filled with a plethora of ways in which to approach our lives, always in process. Lots and lots and lots to explore, above and beyond any of this “mental health” stuff…

          • Well, usually those psychotic breaks plus take place when one is relatively young. I’d say close to the time when one is going through the transition between adolescence and adulthood. Sometimes earlier. At a point when such could, in fact, be marked down to folly and inexperience. Should one not be able to recovery eventually, with that great healer of all healers, time, I guess that leaves the non-recovery movement. I’d rather recover, that is, wise up myself. I know many, many people have the “mental illness” excuse. I don’t have that excuse, and I don’t need anyone to sell it to me either. We’re stuck with this perennial problem regarding why some people don’t get over it, and the rest of the population do get over it. Alright. I’ve got an easy solution. It’s called ‘over it.’

            I take it you’re saying, “UpRising”, that you’re a member of the idle rich. So be it. If you can afford not to work, you don’t have to do so. Meanwhile, the rest of us are busy trying to figure out a way to get from point A to point B. Sometimes it helps to be going somewhere.

          • No Frank, actually you are busy telling everyone that people who cannot work because of mental/emotional problems are frauds who don’t deserve social support.

            I’ll ignore the rest of your non-response, except to note that I never said anything about the experiences I listed necessarily being permanent.

          • Frank, what you say speaks to me, too. I think if you add just a bit of compassion in place of the judgment which I feel kind of drips from your comments, then I think you’d be right on in every respect. Why so hard on others? That’s a lot of work.

          • Yo Frank, I didn’t make a clear distinction between “can’t” & “won’t”; I asked you whether you thought there was a meaningful distinction in the specific example I mentioned (about the sudden death of one’s parents); you didn’t answer that yet so my response is in limbo. Anyway I started a fresh thread on this a couple comments down.

        • Wrong, UpRising. We, or rather OldHead, made a distinction between those who “can’t work” and those who “won’t work”, and I went along with it. Making the determination you make, that this certain population “can’t work”, is a determination for science to make, not me. I’m certainly not for abusing people. Nor am I for excusing people.

          Okay. If the experiences you mention aren’t permanent in all cases then someone gets over them. That much I can agree with you on.

          • Much of what is called disability in psychiatry has to do with excessive and unnecessary drugging. I don’t think even that excuses a person from throwing hay-bails into the back of a pickup. There are many moral evasions people can make about all sorts of things. I was noting once how this Fountain House model “club house” somewhere had 900 members. If those 900 members did some real work rather than pretend work they could really get some things done. I’m thinking in terms of building schools and clinics and that kind of thing. “Club houses” are primarily about “rehabilitation”, that is, pretend work, and not real work. Were this not the case, you have more schools, clinics, affordable housing, or you name it. I know about a “club house” that had a yard work program going that it had to can because of Social Security Disability requirements. There’s your disability, and it’s not actually disability, it’s bureaucracy.

          • “Much of what is called disability in psychiatry has to do with excessive and unnecessary drugging. I don’t think even that excuses a person from throwing hay-bails into the back of a pickup.”

            It would be totally unreasonable to expect a person to throw hay or anything of the like while dealing with the myriad pitfalls of psychiatric drugging and withdrawal. It is, indeed, extremely disabling, and it can be excruciatingly painful and disorienting for a long period of time.

            The problem is that healing can be a needle in a haystack. Healing requires focus, discipline, and also rest. Core changes need to happen, and space and time are needed for that to happen.

            Many of us are trying really hard to make this information more accessible and available, naysayers aside. Fortunately, it’s reaching people now that they’ve run out of traditional mainstream options.

            Perspective really matters here, without judgment. That’s the only way we’re going to break the cycle of abuse and unreasonable expectations, which inevitably lead to hopelessness. New perspectives generate hope.

          • I do think drugging can seriously impair a person’s ability, as well as impede or stymie progress towards stability. This is why there needs to be paradigm change across the board. Drugs are the reality though, and people often don’t realize how devastating their effects can actually be.

            Long-term the patient does best who has not been introduced to the drug-taking regimen. Convincing mental health professionals, and family members, that their loved one doesn’t need a drug to function acceptably. Even the idea of getting psychiatrists to lower the dosages, and to taper patients off heavy duty chemicals. Now there you have a challenge.

          • Granted, but my focus continues to be on judgment toward vs. compassion for others, regardless of where they are in the moment. I believe that’s on topic for this particular blog, and vital to a sound society–which, indeed, we are far from having. Still, it has to start somewhere, can be anywhere anytime.

            That’s mostly what I’m wanting to emphasize at this time, so I’ll stop here. I appreciate the dialogue, Frank, and what you’ve shared. For me, the paradigm shift is about focusing inward rather than outward, as the way to create change.

          • For me, the paradigm shift is about focusing inward rather than outward, as the way to create change

            Choosing one over the other is erroneous. Do people argue over whether yin or yang is superior?

          • “Choosing one over the other is erroneous.”

            It’s not about choosing, it’s about integrating. What we perceive outside of ourselves is the direct result of our inner world. It is a projection, always. That’s the nature of our personal reality, how energy works. Ask anyone who understands energy, it is a common study these days, all over the internet.

            We live in a multi-dimensional universe, we are multi-dimensional beings. New perspective, new paradigm, radical change.

            “Do people argue over whether yin or yang is superior?”

            One aspect is not superior over another, they work in unison, integrated. Each one has a specific frequency and set of characteristics, which work together as complementary frequencies, for the purpose of creating–either in harmony or not.

            When not in harmony, there is imbalance leading to chaos, and something needs to be corrected. There are many ways to correct an imbalance, based on the unique particulars of a situation.

    • Frank, you said the following:

      Disability is physical or it is not disability.

      Getting away from the politics, psychiatric backlash, and the connotation of the word itself, I will simple offer this thought that I wholeheartedly believe until proven otherwise:

      People can and do struggle in all primary domains, whether is be psychological, physical, social, or spiritual. Struggles in these domains can and do lead to impairing circumstances that are contrary to what people themselves desire. Impairing circumstances lead to the need to seek help from various places, including professions such as mine. Professionals such as mine, although flawed in many ways, often do attempt to assist individuals to assume a level of functioning that they deeply desire, not necessarily one that is artificially constructed by societal norms or expectations. Ultimately, people do desire to feel/be healthy, happy, and harmonious when all is said.

      Whatever way this is all defined often, in my perspective, misconstrues the obvious point. People that are struggling often need other people to help them, even though the person seeking the help and the person giving it are fallible, as noted in the prior post. Being too harsh towards either, and assuming them to groups that might be despised or despising the groups that might be used to define them, is not a way towards progress.

      Just a few simple thoughts. Appreciate your willingness to weigh in.

      jim

      • Hi James – it’s been a pleasure to finally see you come in and post again, bringing some sense of coherency to what had become a tedious tit for tat type thread clogging my inbox. First time I posted here on MiA (though I’ve followed the page for a fair while) and wasn’t quite expecting it to be like this.

        Re this comment from Frank that “disability is physical or it’s not disability”, I agree with your response to it but, would also like to query: How can we even separate out what is physical and what is not? Does “physical” mean it has to be visible to another person? If so, then yes. Many things we struggle with aren’t physical. Another way of separating out these domains is by the origin of their cause -as you indicate: psychological, social or spiritual.

        But – these domains in which we struggle – the psychological, social and spiritual – are experienced as emotions and feelings and these are, in fact, physical entities/changes/processes occurring in the body and, despite these not being able to be seen from the outside without extremely high-tech hormonal and chemical analyses, the feelings and emotions in our bodies can and do cause physical responses that can be utterly overwhelming and unmanageable.

        So, on that level, I’d suggest that to attempt to separate “physical disability and struggle” from “non-physical disability and struggle” is spurious in the first place and it’s obvious, as you say, that all people need help from others who must also be fallible, whatever the cause of their suffering.

        Looking forward to your next instalment.

      • Hi Kallena,

        You noted the following question/thoughts:

        How can we even separate out what is physical and what is not? Does “physical” mean it has to be visible to another person? If so, then yes. Many things we struggle with aren’t physical. Another way of separating out these domains is by the origin of their cause -as you indicate: psychological, social or spiritual.

        I agree that at some level all of our attempts to categorize are artificial and inaccurate to a certain degree, for one obvious reason: we are one person, one body, one mind, etc… That being said, though, what I would say (as you discussed somewhat) is appropriate is for us to describe the different expressions of our one being – i.e., physical, social, psychological, and spiritual. Someone throwing a ball obviously is seen as a physical expression although we know full well that it involves psychological and potentially social underpinnings. The thoughts we have are obviously described as a psychological phenomenon even though we all know that physical, spiritual, and social aspects can have an effect on them. So, yes, their is an artificiality to all of this, but in saying this (unlike how others might feel), I don’t necessarily think that we should throw out any means of expression/categorization simply because it doesn’t perfectly reflect a true reality that exists. If we continued to take this route, we might find ourselves one day unable to speak to each other because we are so hamstrung (or tongue tied might be a better word) with imperfect nature of the words that we are using (and our fear that they might offend someone) that we no longer feel free to speak authentically in the way we are ultimately called. Words mean something–what we do with them means more.

        More to come…

        • Hi James –

          agree with you that words and so, some means of categorisation are important. Without them we can’t communicate anything at all and I think from what you write we are in agreement overall on this.

          What I was attempting to emphasise was purely in reference to the original comment you referred to here that “disability is physical or it is not a disability”, though I possibly did not do so too clearly (maybe illustrating the difficulty with use of words and labels sometimes). So, my emphasis was not so much that phenomena in all these realms involve psychological underpinnings (which they must), but that all actually involve the physical, bodily realm.

          Experiences in all these realms, no matter their origin, are felt as emotions/feelings in our bodies – which are actual experiences of altered bodily states – changes in hormonal functioning, neurochemical balance, balance of the nervous system etc. These bodily changes at levels too deep to see are the basis of all our feelings – good and bad and so are physical ‘abilities’. Or, if the experience of our resulting emotions (and thoughts) becomes too overwhelming, the physiological changes in our bodies can be no less physical and a ‘disability’ (to again use some words that I don’t like) than to break a leg.

          So, to label an experience as “purely psychological” or purely spiritual or social and therefore any ‘disability’, even if it can’t be easily seen as physical as ‘not physical ‘is in fact, a misnomer. Despite this, I most certainly do not believe that we should ignore all means of classification of these experiences as the use of different words to describe them can, while on one level being reductionist and dualistic, also express and give meaning, which is essential.

          • I like your comment, Kallena, and agree overall with what you say. However, this one phrase caught my attention–

            “Without them [words] we can’t communicate anything at all…”

            I feel that words are a mere fraction of our communication– that our behaviors, actions, emotions, facial expressions communicate a great deal with no words at all. Silent films are a good example of this, for one. Music communicates a great deal without necessarily having lyrics. Avoiding, ignoring, shunning–also very strong communication using no words.

            Many people can’t speak and can communicate a great deal with no words. I think we feel this level of communication much more powerfully than words. We all feel it, then it becomes a matter of interpreting, and learning an individual’s personal wordless ‘language.’

            Different people can use the exact same words and mean completely opposite things–being direct vs. being sarcastic, for example. Again, we feel the energy more than hear the words, and as a result, we associate the words with certain feelings, and this can be divergent among people.

            We all interpret, associate, and give our own meaning. Again, not with words, but with the energy with which we speak them and hear them–or not. Flipping someone off has a very definite vibration that is felt by the person getting flipped off. Plenty of communication happening there.

            To me, this is important when talking about such issues as stigma and discrimination. Most often, these are extremely powerfully communicated with no words whatsoever. In such environment, one can feel it, doesn’t have to be spoken directly. In fact, discrimination is most often beyond language, and communicated solely by how people are treated. Discrimination is about behavior, and that communicates everything.

          • Hi Alex –

            not sure if this is coming up as a reply to your comment to me as the format for some reason doesn’t look as though it is allowing me to reply to you – but leaves this looking as if I’m ‘replying to myself’.

            Thanks for highlighting that phrase in what I wrote: “Without them [words] we can’t communicate anything at all…”.

            You are right. I was hasty in my response with that phrase. I agree with what you write that a very great deal of communication is non-verbal, and especially that it is experienced on a “feeling level”. That this level of communication can in fact be a lot more intense than words alone.

            It is how we feel and experience our interactions with others and the world around us that gives them meaning – not the words used in those interactions alone as that phrase implied. Yes, often people use the same words yet attribute opposing meanings to them and most definitely, especially when discussing an issue such as “stigma”, it is behaviours that in fact speak louder than words.

            Words are necessary when we are attempting to understand one another’s opinions and perspectives and are attempting to communicate. As here – re-phrasing and checking – are these “words being used as I understand you to be using them” is in a format such as this, the only way to reach some degree of clarity re we are communicating similar views and reaching any consensus of understanding or not.

            Thank you again – I agree with the points you highlight.

          • Thanks for clarifying, Kallena. I think what you’re describing with regard to reframing and checking it out is actually really *great* communication, responsible.

            In general, I’ve noticed that we do tend to make a lot of assumptions without checking it out, which I feel is what creates the stigma in the first place. When we assume without going for absolute clarity, then we wind up projecting, and it tends to not be a very positive projection. (Shoot first, ask questions later–or worse yet, ask no questions at all, just shoot).

            I really like what you’re offering here, good stuff!

    • According to this interpretation of “stigma,” the only people who stigmatize are psychiatrists and others able and willing to brand people for life with “mental illness” labels. I’m surprised they don’t actually tattoo or brand our labels in our foreheads.

      It might come back to bite them in the butt, however, when the DSM6 comes out and all their favorite imaginary diseases are renamed and re-categorized by popular vote.

  10. I disagree with the study; stigmas are generally considered harmful and a “mental health” stigma is generally considered the worse. I assume that the study did not focus on employers where stigmas are most problematic. The stigma is also perceived differently depending upon whether emotional suffering from painfully distressful experiences is erroneously defined as a brain or mental “disorder.” The stigma of “mental health concerns” appears less harmful to people who consider the DSM to be a valid document. Most people erroneously assume that mental distress expresses a biological failing because of difficulty imaging their experiences becoming a living nightmare. More importantly, it is difficult to imagine distressful experiences becoming extremely distressful and the related emotional pain becoming constant, excruciating pain.

    A little told story is the effect of the false stigma on suicides. Most people who kill themselves refuse professional assistance because the false stigma of a “mental disorder” would worsen their plight.

  11. I enjoyed the article and think that the point that we need further discussion is very important. To label something in modern society is to accept it and justify taking no further action to change it.

    I do think that stigma” is a cliché’ term promoted by those who can benefit most from it (NAMI and the NIMH for example). I also think the study falls very short in using a college body as a cross section of population. I think that among different economic levels and cultural groups ideas about “mental illness” are different.

    The term “mental illness” promotes much misunderstanding as it is an umbrella term that really describes nothing. It is all experiences lumped into one heading that serves to foster nothing but confusion. Though those who experience the extreme distress of what would be “psychosis” and those who experience “depression” are both suffering, the term is meant to disable everyone equally and dehumanize at the same rate. Chemical imbalance stupidity is also meant to accomplish the same thing and make a fully human being less than by removing any hope of moving beyond the struggle. There is also not a snowballs chance of individuality in the mire. The DSM is glorified name calling and bullying by a politically and economically sanctioned industry. The system exists as it does to create a new generation to control. The worst attitudes against those who seek “help” comes from the helpers who cannot see individuals but only “illnesses” in a bible of social conformity (DSM). The ironic thing is that if they looked among the pages they would find themselves there.

    • I agree, including the last sentence. My PCP was paranoid of a non-existent, but potential, malpractice suit – so she projected her paranoia onto me, and defamed me as “paranoid schizophrenic.”

      I went for a second opinion to a therapist, who was manic and paranoid about covering up the abuse of my child for her pastor and friends – so she projected her own manic obsessions onto me, and defamed me as “bipolar.” And I learned later that therapist was also a depressed divorcée with a mentally ill child, thus apparently dispised generally happy women (I was in denial of the child abuse initially) – so she also projected her own depression onto me, and defamed me as “depression caused by self,” based upon lies from the child molesters.

      I found dealing with doctors who projected their own “mental illnesses” onto me, to be quite an insane experience. But I think it’s important for people to know we do have the depressed, manic, and paranoid people working within the medical profession now – and these “mentally ill” doctors do project their own “mental illnesses” onto their patients – for reasons of malpractice suit prevention and child abuse cover ups (greed / criminal behavior). What a shame the medical community is not intelligent enough to spot the “mentally ill” within their own ranks, however, and to the contrary, tries to murder patients to cover up the crimes and iatrogenesis of these “mentally ill” doctors instead.

    • Squash, all good comments.

      The blotting out of individuality by grouping people’s reactions to unique circumstances based on outward behavior is a key component of psychiatric totalitarianism. It is particularly disappointing that so many people who consider themselves to be “progressive” buy into this; in doing so they are lending credence to those on the right who portray socialism as a state of mindless conformity sans individuality.

  12. Hi James, I always enjoy reading your work.

    You ask for comment about the weakness of the study done by Pedersen and Paves. Personally I feel that at this level of analysis, what is being examined is methodology which has little if anything to do with actual human beings. Drawing on the ideas of Goffman’s “Encounters” and “traffic” (I think Hannerz) this is like looking at one street corner, and saying this is every street corner, everyday. I think we want patterns to emerge, and at times force them to appear out of need.
    I must admit, I’ve been wanting to ask you if you think Nebudchadnesser II was suffering from lycanthropy? And was he better left to live with the delusion that he was a King (oh wait he was lol) and eat grass? Or should there have been an ‘intervention’?
    What I can say from personal experience is that ‘stigma’, whatever that may be, disappeared completely when I knew I loved the person I was looking at. Might be something in that.

    Take care and thank you
    Boans

  13. This is to continue the stuff about ability/disability, “work” etc.

    I put “work” in quotes because all work is not the same in terms of its social value. Different types of work have different social, moral and ethical connotations. Under capitalism the only work which is considered real work is that which ultimately adds to the system’s coffers, not necessarily that which meets one’s own needs (other than eking out survival wages). The archetypical example is Marx’s shoe factory worker who can’t afford the shoes he works to produce in mass quantities every day. This is known as “alienated” labor, which is the essence of labor under capitalism. What alienated labor leads to is — surprise — an alienated population, living for no other reason than to perpetuate the profits of capitalists (in the current day read this as corporations). This describes what most people do today for “work,” and is praised as an indication of one’s character, sense of responsibility, etc. — even working for a pharmaceutical company or other corporation which pollutes the planet, props up the war machine, etc. This is what’s known as a contradiction. So the question is, what moral imperative or “work ethic” is involved one way or the other so far as one’s participation in this system?

    On the other hand, it is also work when I repair my roof, paint my living room, write a letter to the newspaper or drive a friend to the dentist; on a larger scale it takes lots of people doing lots of work to organize an anti-psychiatry movement. And while all these things may contribute far more to the collective good than working at McDonalds, they are not considered to be “real” work under capitalism because there’s no profit involved.

    While it would not spell the end of capitalism (good news to some) a guaranteed annual income would be an excellent step on the road to social equality. Switzerland will be voting this year on implementing a system in which every citizen, however “abled,” would receive a basic income of $2,800 per month. Other countries are discussing this as well. Once implemented such a system would go a long way towards ending the sort of situation we’re discussing here with people quarreling over crumbs.

      • This is why Frank’s musings above, on what constitutes “real” work, make no sense to me at all. Nor does his prattling about “work ethic.”

        And how does it make sense to oppose psychiatry because of its disabling “treatments” and then to say that recipients of said “treatments” are not actually disabled (if only temporarily)?

        (That’s not to let Frank off the hook for his blatant albeist bigotry against those who cannot toil due to various mental/emotional states. People who cannot toil because of disabling mental/emotional problems should not be forced to starve or freeze to death for lack of social support.)

        • The burden of proof is not on me, Uprising. Assertion proves nothing. I don’t exist in order to confirm another person’s feelings about purposeful activity. People can be impaired by substance abuse, and when I say substance abuse I am including psychiatric substance abuse. You’re blaming me for “blatant ableist bigotry”. “Ableist or disableist”, I don’t think we have a reliable method for determining who is or isn’t “able.” What’s more, he or she who can do is “able.” I’m not out to deprive anybody who can make an honest living of the opportunity for doing so. I’m just saying there is a reason why The Little Engine That Could wasn’t titled The Little Engine That Couldn’t. Sometimes it seems like a number of people in treatment for psychiatric labels never soaked up the message contained in The Little Engine That Could. I simply think that the benefits of repeating nursery school into perpetuity because one didn’t grasp that message over rated.

          • Just because we don’t have a reliable method of determining who is able and who isn’t doesn’t mean that there are people who are unable to function. And why are you assuming across the board that people who are currently unable aren’t trying to regain their abilities?

          • We’re getting into some real philosophy here, aren’t we? What, for example, is the function of a person? I imagine there are very many people who wouldn’t be able to agree on the subject. Then again, when we do have the function of a person down, are the people who can’t manage it authentic or pretending? I imagine there are many careers, and I’m going to spare myself by not mentioning any of them by name, that the world could easily do without. That some people aren’t working in one or another of them is just as well.

          • Not sure if this is going in the right place, but this is for Frank’s 1:32 comment. I am not understanding why you are so intent on proving who is really disabled and who is faking it. We probably never will have a way of knowing definitively, so this seems like a wasted discussion. As someone who has also had physical problems that greatly impaired my functioning at one point, where there was hard physical evidence of a problem (e.g., lab/mri abnormalities) but no readily agreed upon diagnosis (thus there was an assumption that I must be “fine”), these distinctions seems sort of absurd.

            Disability isn’t exactly a glorious lifestyle, so I don’t think you have to worry about a mass exodus of functioning people turning their lives upside down. I just think it is inhumane to ignore suffering, and there are definitely people who are “unable” who are suffering that would have a much better chance of regaining function with social support. I feel we should support them and not spend so much energy asking them to “prove” their disability.

          • I’m not a “customer” of “mental health services.” I’m neither playing the “mental illness” card nor the “mental disability” card. I recognize that there can be very real survival reasons for doing so. I think I said at one point that “disability is physical or it isn’t disability.” I stand by that saying.

            Now whether we are talking about physical disability or something else is another thing entirely. I’m not selling “mental illness”. I’m not selling any corresponding “mental health treatment.” I think there is an excess of that in the world now, and I want nothing to do with it. If you need the “mental health” system, fine. I leave it to you. I don’t need it, thank you. I can do alright without it. Please, don’t force me and everybody else, the remaining 75 % of the population, to be a “customer” of “mental health services.” I’m happy right where I am, thank you.

          • Surviving and Thriving,

            I guess you didn’t get the memo that to question or criticize Frank’s Reaganesque views on work and disability means that you must also be promoting psychiatry and especially forced psychiatry. Because tomato.

          • Frank, the question isn’t really about whether you think someone “needs the mental health system”. Most of us here think its BS. What I am questioning (and I think others too), is why you seem to have so little compassion for those with mental health problems that impair their ability to function.

            I am someone who has had both physical and mental disabilities and is working my tail off to get myself back to my former functioning (actually work wise, I am relatively normal, though that has required patience, understanding, and accomodation from others at several points ). Your argument that physical disability is somehow more valid really doesn’t hold water. Physical disability can be just as hard to “prove”. Some physical diseases like lupus take on average 3 years to diagnose from the first onset of symptoms. Is the person just supposed to rot until they get a diagnosis?

            I do not consider mental illness a traditional illness (because I view most of it as a normal response to abnormal environmental conditions ), but regardless, someone in those states can be just as impaired as someone with physical illness, no matter how many times they chant the Little Engine that Could. Also, you are ignoring that undiagnosed physical illness is often misdiagnosed as mental illness.

          • Frank, the question isn’t really about whether you think someone “needs the mental health system”. Most of us here think its BS. What I am questioning (and I think others too), is why you seem to have so little compassion for those with mental health problems that impair their ability to function.

            You are saying a number of contradictory things here. If the “mental health system” is BS, and one doesn’t need BS, then one doesn’t need the “mental health” system. I would presume that if there are “those with mental health problems that impair their ability to function” the “mental health” system can’t be all BS. The “mental health” system now has the concept of anosognosia with which to imply that anybody who rejects such treatment is impaired. Talk about BS.

            I didn’t say that physical disability was easy to prove. I said that “mental disability” isn’t really a valid category for me. People can, and are, disabled by psychiatric treatment. That’s physical. “Brain damage” is disabling. Physical ill health associated with metabolic syndrome, too. “Bad” thoughts aren’t disabling. My compassion is limited when disability, in this sense, can be prevented and avoided. Once the damage is done though, the damage is done.

            Diagnosed physical conditions can be a problem, only that problem is not, and never will be, “mental illness.” People can “I think I can’t” to their heart’s exasperation. I’m still glad some of them can, “I think I can” all the way to contentment. If failure is written into the script, there’s an easy solution, change scripts. As far as it goes, psychiatrists are cynical enough. I’m not the person to endorse their negative prognoses.

            I guess you didn’t get the memo that to question or criticize Frank’s Reaganesque views on work and disability means that you must also be promoting psychiatry and especially forced psychiatry. Because tomato.

            There is something to be said for not funding an atrocity. No less a luminary than R.D. Laing pointed out how much Ronald Reagan had done against forced psychiatry by closing the big asylums. Now you’ve got E. Fuller Torrey blaming people labeled “mentally ill” in the criminal justice system on Ronald Reagan. I see Reagan in much better light today than I did when he was in the White House. Criminalization is not the answer, but then I don’t think criminalization was Reagan’s answer either. Because boomerang.

          • Fair enough, Frank. Evidently, “Reaganesque” was not the right word for the occasion. I can think of lots of other words too, but I’ll leave them to your imagination.

          • I don’t see any contraction. I’m saying that the current system to “help” people who have suffered abuse, have undiagnosed physical illness causing emotional problems, etc is rubbish and often does more harm than good. Saying they are in real pain has nothing to do with mental health “treatment” being effective in relieving that pain. What is often effective in helping them is COMMUNITY support, not medical support.

            Also, I get your frustration at the preventability of mental health “treatment” induced disability but why is your lack of compassion directed towards those who received the treatment, sometimes against their will? Seems your lack of compassion should be directed elsewhere.

            I am also saying several of the arguments made against mental health being an legitimate disability could be easily applied to physical illness. Your arguments assume physical illness is easy to prove, and the reality is that it often isn’t. Also, your mentality of The Little Engine That Could could be applied to them too. They could just “deal” with physical pain,limp around if necessary. How is that any different than telling someone suicidal to just suck it up and find a way to deal?

          • Yes, community support beats “medical” support, but that distinction often isn’t being made. I see more benefit in leaving the system than I do in “consuming” the system. Without community support, I imagine one could end up falling back into the system. I not against people helping people. Only when that help is beneficial, and not harm masquerading as benefit. In “mental health” you get a lot of harm masquerading as benefit.

            I would address my compassion to human beings but without the professional jargon. The jargon goes along with those laws that would reverse the age of consent. I prefer to hang onto my age of consent (i.e. human, citizen, legal) rights, and as long as I am not being committed by a kangaroo court of mental health law, I hang onto those rights.

            I’m absolutely opposed to mental health system expansion. The great “mental illness” epidemic we are currently undergoing is something we don’t need. The mental health system is “broken” only in so far as people expect it to prevent violence. It isn’t “broken” at all. It works all too well. You’ve got a very large rate of people with “mental illness” labels because it does work so well. We’d be a lot better off if it was “broken.”

          • The very arguments you are using are the same arguments they’ve been using to expand the mental health system since the mid-seventeenth century, and the “mental illness” numbers during this time have only gone in only one direction, and that direction is up. The numbers are only going to go in the other direction when the system starts leaving people alone, and that’s not what the system was designed to do. Having people rely on that system more and more and more only keeps it going.

          • You can twist arguments as you like to support pretty much any cause you like. Regardless if they are being misused, people with mental health issues deserve and often need community support. Though many manage to bounce back on their own, many also don’t get to a good level of functionality.

            In other cultures, family and community support during difficult emotional times is more of a norm. For example, in some cultures, a new mom is expected to rest and her family takes care of a baby in the period immediately after giving birth for about a month or so- they recognize that is a difficult time (baby blues) and family/community is generally expected to be more involved in helping raise the child.

          • “People with mental health issues” is pretty much a bill of goods. I’m not selling psychiatry, psychology, or social work. I’m not selling “mental health issues” as you put it. The vultures from social services don’t have me as rotting clientele.

            We were talking “function” before. That’s psychiatric jargon really. The DSM-IV, I believe the DSM-5 has changed it a little, had a 100 point or so Global Assessment of Functioning GAF scale to measure functionality. 100 was no symptoms, and 1 – 10 major danger to self and others. Thing is, if a shrink scored you low on this GAF scale he’d probably give you lots of drugs and a poor prognosis. If you bought the bill of goods, that leaves you with lots of drugs and a poor prognosis. If not, you don’t talk about your poor “dysfunction”. That’s shrink-talk, and shrink-talk may work for you, but it doesn’t work for many of us.

            I don’t think anybody needs to be in bondage to the mental patient role. I see that role as a role that can drag a person down into an early grave. However popular a role it has gotten to be, I think there are more preferable roles to play in real life, with accent on the real. Chief Bromden, if you’ve ever read or seen One Flew Over the Cuckoo’s Nest, knew. He escapes the Cuckoo’s Nest in the end.

          • Frank, go ahead and obsess about my jargon, you seem to ignore the greater message. I just believe in showing compassion and support towards people who are going through tough times (insert any word that you think is more appropriate).

          • Well, since you put it that way, so do I. I just don’t think that’s the kind of thing people get out of Mad-Houses as a general rule. Further more, I kind a think of a barn raising as a more productive matter than a pity party. If you’re talking more barn raising and less pity parties, I could see it. Yes, definitely.

          • The Mental Illness Makers will do everything they can–not counting drugs–to keep you helpless and dependent on hand-outs and THEIR SERVICES of course.

            I finally realized it was bologna sauce when after 2 decades of meds compliance, therapy and other nonsense my life still stunk!

            Lots of you on this site think wanting to work, have a family and a decent reputation in the community are silly goals. Nevertheless, many Americans have these goals and should be allowed to pursue them if they so desire.

            Psychiatry will do its best to make sure none of your dreams or goals ever come true. Because they see us as nonhuman they think we don’t want or need what “real people” do.

  14. This is why I’m a “psychiatric survivor movement” of one. And it’s been extremely effective. Otherwise, with multiple members, it is clearly fragmented due to an ocean of stigma (damning judgment). Sadly, I believe we all know where this originates. To me, that is the heart of the matter.

  15. Why do we continue to say “stigma”? It’s prejudice. Are we simply afraid to say that? Just because discrimination towards the mentally ill is socially acceptable does not make it any less destructive.
    I will openly admit I am biased having experienced severe and dehumanizing stigma in my life. However, “stigma” is not a one way street. It just isn’t as simple as just perception either. Just turn on the television, and you can’t miss the steady stream of negative associations with mental illness. It’s all around us all the time, so while some “stigma” may be perceived, it’s not just simple perception. Just as much as the media’s misinformation has shaped public assumptions and fear towards those with mental illness, it also shapes the way we view ourselves and feeds the underlying fear of being mistreated.