Must stigma be the answer?
Now that we are well into this new decade, I must broach modernity; specifically, modern American cultural considerations regarding the semantics of “schizophrenia.” My name is Robert Francis and I recently wrote a book titled On Conquering Schizophrenia: From the Desk of a Therapist and Survivor. Allow me to further clarify. I indeed wrote the book OCS; however, Robert Francis is my pen name. My true name I have chosen to keep private. Yes, it may be 2020, but in many ways modernity often reflects an antiquity, especially in regard to the specifier of schizophrenia and its associated semiotics.
I have lived with what psychiatry calls schizophrenia for 25+ years. Like most, I was diagnosed around age 22. In my early 30s, I returned to graduate school and obtained my master’s in social work in 2006. Over the course of my schizophrenia, I have been gainfully employed, for the most part. I have worked in the mental health field for some 20 years, with over 10 years spent as a post-master’s mental health talk-therapist. Currently, I work as a licensed clinical social worker (LCSW) with the geriatric population. Yet this, my literary premise, belies that fact; I am an active therapist and at the same time live with the often ominous diagnostic, paranoid schizophrenia. Given this provisional gestalt, why have I chosen to write a book, which inadvertently became a labor of love, under a pseudonym? Can the reason exude beyond an assumptive or presumptive sense of mandated personal stigma?
I perceive and attest that my schizophrenia is a persistent and formidable existential paradox. In order to cope with how I am rendered when amid its often heinous symptoms, I must self-talk quite the chatter that my perceptions, the very things that ostensibly look real and true, are in fact not real or true. I will retort to myself: “That which I perceive to be true is not.” My trials with schizophrenia have taught me that my perceptions carry no resemblance to the item we refer to as reality. De facto, I have learned that my perceptions provide me with a most unrelenting paradox. And similar to the paradoxical nature of this innate schizophrenia, the reason I chose to write under a pen name is also a paradox.
In my professional realms, I have always chosen not to disclose my mental illness. When writing my book (and this essay) therefore, using a pen name follows my preferred tradition. So can the choice of using a pen name reside in a subjective realm beyond the assumptive knee-jerk of an associated sense of cultural stigma? Yes: My reasoning is actually contrary to notions of personal stigma.
Primarily, I want to succeed based on merit, not sympathy. If I disclose my situation, then professionally, the attributional association of “the therapist with schizophrenia“ will necessarily and inevitably follow. But, I beg, this is not who I am. Rather, I am a therapist with a private medical issue and I prefer to maintain its confidentiality. In the end, for me, it boils down to a personal matter without further justification needed. Speaking its name I find superfluous.
You may think: If no stigma, why no mention? Might I be rationalizing, overcompensating for, or perhaps distorting my motives?
My answer resides in my personal reality: intrapsychically, the label known as schizophrenia has never struck me with a visceral connection to any sort of associated stigma. Its mention and symbolism induce in me no shame. Its personal attribution brings no personal angst. In fact, with the label of schizophrenia I feel a wholesome and holistic egosyntonic congruence. I suppose this outcome can be attributed to my innate disposition, or perhaps it is a simple case of good fortune.
Let us use my declarations as a type of case study (as a microcosm), following my conclusion: Stigma is foremost a personal issue. All types of stigma, be it due to schizophrenia or otherwise, first must be discerned specifically, each unto its own, rather than applied to a population in general. For some, certain words evoke stigma, while for others the exact same verbiage produces no reaction. Similar to views through a kaleidoscope, people react to the linguistic constant in varied manners and with discrete perceptions. Therefore, assumptions of stigma (perhaps based in cultural conditioning) can be unproductive and simply erroneous. When conceptualizing stigma, a priori, personal dispositions must be factored in before applications of any associated stigma pertain. In my instance, per my cogito, personality, and disposition, I am robustly copacetic with the linguistic use of “schizophrenia” as an attribute of mine. It is nothing more than a diagnostic, a descriptive veneer.
Not all the details behind the one’s social veil do we share with others, and this is a universal assertion. For me, schizophrenia comfortably resides enshrouded, but certainly not in shame. I have my secrets as you have yours. In my instance, I find “schizophrenia”, as a personal qualifier, superfluous. It is a part of my life, but it is not my identity. Thus, I choose to keep my schizophrenia private because I do not want others to confuse the two. I do not want to be the “schizophrenic therapist.“ I just want to be the “good therapist.“ I do not want to be the friend with schizophrenia, I just want to be the friend.
In many ways, personal disclosures regarding the generic term schizophrenia create a binding type of oppositional dualism. In its voiced revelation, an imposed cultural stigmata may result; but its unvoiced confidentiality, by its very avoidance, serves to reinforce that same stigma. Is it best proper, then, to stand tall and proud in one’s schizophrenia, and in such manner destigmatize its overt expression? Some may say such disclosures advance a cause. Personally, however, I have always felt it to be a most unnecessary declaration of what remains a personal and private issue. And so my lips remain pursed and my schizophrenia remains a social non-sequitur.
Make no mistake, my diatribe here certainly does not imply that others do not bear the burden of a schizophrenia stigma; I don’t wish to demean their experience. Further, for those who do feel an internalized stigma, such notions may significantly hinder recovery. And so, your choice to share or not share your experience must be assessed and addressed singularly and specifically. Because in the end, psychiatric recovery, and moving forward from debility to ability— or, better yet, transcendence— is the ultimate win in our modern age.
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.