A recent study published in the Review of General Psychology surveys existing research on the nature and effect of dehumanization in healthcare contexts. This includes both self-dehumanization, or self-objectification, and other-dehumanization. The review analyzes both participant examples of dehumanization, such as students and healthcare professionals, as well as document examples, such as newspaper and magazine articles. The majority of studies explored self-dehumanization, which was linked to higher anxiety and depressive symptoms, disordered eating, and other negative symptoms.
āAlthough such health-related dehumanization processes may occur both in everyday informal situations and in formal medical contexts where health care is a central activity, this topic has gained much attention in the latter. In medical contexts, where it has been described as endemic and multidetermined, dehumanization violates patientsā rights to autonomy and informed decision-making and is seen as one of the key drivers of inequitable health treatments and poorer clinical outcomes,ā explain authors Eva Diniz, SĆ³nia F. Bernandes, and Paula Castro.
The concern with dehumanization in mental healthcare dates back to humanistic psychologistsā criticisms of behaviorist psychology in the mid-twentieth century when humanists argued that behaviorism saw the individual as a machine rather than an experiencing, āwholeā person.
The debate continues, with many criticizing the DSM and psychiatry for their use for ādehumanizing labels,ā and others arguing that the medical model reduces empathy. Research suggests that empathy is a predictive factor in positive mental health outcomes.
The current study is a broad review of dehumanization in healthcare. This ranges from self-dehumanization and self-objectification to other-dehumanization, as well as from metaphors used in dehumanization processes to the different effects that dehumanization can have on individuals.
A total of 59 relevant articles were included in the review, from an original number of 3,229. The majority of the studies were connected in Anglo-Saxon countries, with most focusing on self-objectification among young adult women. Much of the following research relies on Fredrickson and Robertsās āSelf-objectification theory,ā accounting for how women internalize oppressive social understandings and behaviors.
Fifteen of the studies analyzed dehumanizing metaphors in healthcare settings. Some individuals used metaphors to describe their bodies as, for example, a ātime bombā in reference to chronic illness and a āsuspicious machineā in reference to their ability to achieve a successful pregnancy. Women viewing their bodies as āsexual objectsā was also common. These metaphors seemed to be associated with a distancing from the individualsā own experiences and emotions.
People with infectious diseases such as HIV often viewed themselves as ādirtyā or ācontaminated,ā reducing themselves to stigmatizing characteristics of the conditions. Overweight individuals felt like they had āa second-class bodyā and reflected social stigmas around things like laziness and lack of agency, i.e., being a ācouch potato.ā
Nine studies explored metaphors related to other-dehumanization. Healthcare professionals referred to pregnant womenās bodies as āfaulty machines,ā which needed constant supervision. āTranssexualā individualsā bodies were objectified as being either āoperativeā or āpreoperative.ā Magazines often framed womenās bodies as sexual objects as well, encouraging them toward being white, young, and thin, while emphasizing passivity and an instrumental understanding of their bodies.
Several studies (n=49) explored the predictors, mediators, moderators, and outcomes of dehumanization. Students with lower āperspective-takingā skills and āempathic concernā failed more often to view individuals as uniquely human. Psychiatrists and psychologists, who believed in a genetic as opposed to a psycho-environmental basis for mental illness, perceived less uniquely human emotions in patients, such as comfort or disappointment.
When patients were understood to have their own unique thoughts and to be able to plan and make choices, they were viewed as more human than when their āmental illnessā was the overarching frame for how they were perceived. Lower socioeconomic-status patients were especially likely to be dehumanized in this way.
Nurses with a high emotional commitment to their organization and patients showed a stronger denial of uniquely human qualities, which was also associated with lower rates of burnout and distress. The same was true of healthcare professionals with high rates of direct contact with patients, suggesting that dehumanization may be a coping mechanism for some individuals. Non-healthcare individuals, however, were more likely to seek psychological help treatment if they viewed themselves as uniquely human.
āIn sum, this set of studies showed that patientsā dehumanization seems to be protective of professionalsā mental health, decreasing stress, and burnout, whereas being a victim of dehumanization leads patients to poorer medical adherence and mental health.ā
The authors report several situational factors affecting self-objectification. When young adolescent and young adult women were enrolled in yoga and mindfulness meditation classes, there was a decrease in self-objectification after eight weeks. On the other hand, when young adult women joined an exercise class that emphasized physical appearance as the primary goal, the participants showed an increase in self-objectification.
The same study showed that when a different exercise class emphasized health reasons, self-objectification decreased. Women who worked in sexually objectifying job environments reported higher self-objectification as well as higher rates of depression and lower job satisfaction.
Self-objectification was found by the authors to be associated with more anxiety and depressive symptoms, lower self-esteem, fewer social involvements, lower well-being overall, and more self-harm behaviors. Negative body evaluation was another consequence. Eating disorders, as well, were more common among those who engaged in self-objectification. This association was buffered by self-compassion, but not spirituality/religiousness.
In terms of physical health, self-objectification was associated with lower rates of exercise in public places, to avoid further sexual objectification by the āmale gaze.ā On the other hand, self-objectifying women more often engaged in extreme exercise activities and extreme dieting, to the point of unhealthiness. This was true for pregnant women, as well. Furthermore, women high in self-objectification engaged in riskier sexual and reproductive health behaviors, such as not attending medical appointments and not using contraception as much. Attitudes toward menstruation and breastfeeding were also negatively affected.
The authors note that much of the data was focused on students and laypeople, rather than extensively studying dehumanization among healthcare professionals. Additionally, much of the research did not take into account broader social factors such as SES, focusing instead of decontextualized individuals. These individuals were frequently young adult white females, which makes generalization difficult. The research literature would also have been improved by including the perspectives of both the victims and actors involved in dehumanization, rather than a more passive analysis, according to the authors.
They argue that more research is needed on other-dehumanization, different forms of self-dehumanization such as the effects of different bodily metaphors, and mediating social and economic factors.
Limitations to the review article itself were also identified. Keyword searches used were broad and may have missed more specific topics such as ābodyweightā and āeating disorder.ā The authors also focused on āeverydayā dehumanization and meaning-making, as opposed to pathological/clinical issues such as burnout and compassion fatigue.
The authors conclude:
āOverall, current research depicts a whole range of psychosocial processes of dehumanization and their interconnectivity not only in formal health contexts but also in everyday interactions, bridging some of the gaps left by health service research. Being an emerging field of research, there is a call for a broad and more contextualized understanding of self- and other-dehumanization on formal health-related contexts and beyond, as an important stepping stone to tackle current inequalities in health.ā
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Diniz, E., Bernardes, S. F., & Castro, P. (2019). Self- and other-dehumanization processes in health-related contexts: A critical review of the literature. Review of General Psychology, 23(4), 475-495. (Link)
I really like the fact that we ‘study’ how dehumanizing people might have negative outcomes. I wonder how long this study takes? Probably as long as the ‘bullying’ studies. Now we just have to figure out which words or actions are dehumanizing, and replace them, but not the attitudes. That will work out just fine. There, another study completed, off to the next one.
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Yeah, surprising outcome, isn’t it? Who could have guessed that dehumanizing conditions caused people emotional distress and upset? Sure glad we have Scientists to figure out these difficult questions for us!
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Since dehumanizers/bullies are also liars and do not respond to logic and reason, and fighting them only escalates things and drags the entire collective down, then what are the options? Some are not in position to walk away, for whatever reason. Some can, and fear doing so, for a variety of reasons.
Somewhere, there has to be some kind of systemic transformation here if social change is going to occur in any way, shape or form. Otherwise, dehumanizing begets dehumanizing begets dehumanizing, aka generational abuse. How can this end? Better to pass along good things to the next generations, not this same ol’ shit.
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I agree with you all. Another waste of tax payer dollars, I guess needed to help properly re-educate our delusional “mental health” workers, by researching into the blatantly obvious. It’s a shame our “mental health” workers have less than zero common sense.
āIn sum, this set of studies showed that patientsā dehumanization seems to be protective of professionalsā mental health, decreasing stress, and burnout, whereas being a victim of dehumanization leads patients to poorer medical adherence and mental health.ā
Partially true, once my family’s medical records were handed over by decent nurses in my PCP’s office, and I read the staggeringly dehumanizing and depersonalizing opinions of my former psychiatrist, I was appalled. So appalled that I first confronted him politely, which terrified him, and prompted him to try to “re-educate” my husband, which he failed in doing. So we had to leave that child rape covering up psychiatrist.
Although I did find weaning off the last of the psychiatric drugs was largely beneficial to my “mental health,” not detrimental. Despite the drug withdrawal induced “super sensitivity manic psychosis,” which largely functioned as an awakening to my dreams, and resulted in a born again type story. Which, for a Christian woman, isn’t a bad thing.
The next part of this blog largely seems to be a discussion of how the male psychologists and psychiatrists can control the free women of America. “… This association was buffered by self-compassion, but not spirituality/religiousness.” I disagree with the “mental health” workers’ equating “spirituality/religiousness.”
Because they are two completely different things today. Spirituality is about belief in the Holy Spirit, and about a God who will bring about a better world for all. Belief in the paternalistic mainstream religions today, is belief in the DSM “bible,” because our mainstream religions bought into your BS paternalistic, child abuse profiteering, DSM belief system long ago.
https://www.indybay.org/newsitems/2019/01/23/18820633.php?fbclid=IwAR2-cgZPcEvbz7yFqMuUwneIuaqGleGiOzackY4N2sPeVXolwmEga5iKxdo
https://www.madinamerica.com/2016/04/heal-for-life/
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Convincing people (and all around them) that they’re broken machines, incapable of rational thought, ethical behavior or responsible decisions can be dehumanizing and lead them to view themselves as mere objects.
Wow!
The authors were Castro, Diniz and Bernandes. Maybe Dr. Obvious was a ghost writer.
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This excellent 12 minute TEDtalk addresses dehumanizing via gaslighting and offers concrete suggestions for how to deal with a gaslighter–
https://www.youtube.com/watch?v=v4P2Qwh1QCU
Gaslighting is when a person or community makes a person question their own personal reality and therefore, their sanity. Seems to be the very foundation of the mh industry, their reason for being. It’s what they do. It stands to reason that people’s health would deteriorate under such circumstances, as would quality of life. Keeps the negative self-doubting voices not only alive and well, but also strong and in charge.
I believe this is the root cause of mind/body/spirit instability and lack of wellness, under ANY circumstances. I also think it’s really important to recognize and reject anything or anyone that makes you question your own state of mind and being, and your perception of your own life experience. That’s an unequivocal violation of personal boundaries, negation of self-agency, and pure crazy-making abuse.
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