A dictionary definition of stigma is: mark of disgrace; stain on character. So it’s an inherently shameful thing. Also, it goes right to the core of a person, implying a basic character flaw. Character comes close to a person’s core identity. So one can see just how damaging stigma is!
Stigma is based on prejudice, or in other words, pre-judging. The dictionary defines prejudice as an opinion formed without fair examination of facts; bias. It is obviously wrong, dangerous, and harmful to form an opinion about someone or a group of people without knowing the facts about them or their condition.
Stigma is steeped in ignorance and judgement, and has a tangled system of longstanding historical roots. Unfortunately it is prevalent worldwide. The toll that it takes on individuals is enormous, from causing denial and not seeking help or not accepting treatment, to the suffering from a psychiatric problem being multiplied by shame and isolation. The good news is that through increased awareness, programs, and increased openness, stigma regarding psychiatric problems has lessened, and is continuing to lessen. Anyone can be part of the solution to the problem when they are ready to be.
IGNORANCE
We say that stigma is steeped in ignorance because it is based on false ideas such as: that someone with a psychiatric problem is weak, different, abnormal, crazy, is to blame for his problem, or is somehow less acceptable or should be looked down upon/judged. These ideas are often held at unconscious levels to varying extents, even if people know them to be false at a comscious level. Because stigma is so prevalent, it usually affects the individual himself, those around him, and society in general.
THE TRUTH
The truth, which is an antidote to stigma, is that psychiatric illnesses are legitimate illnesses like any other illness. Like other illnesses, the sufferer does not choose the illness, and deserves compassion not judgement. These illnesses are very common, and can affect all kinds of people with all sorts of strenghs, including high levels of intelligence, creativity, strong wills, highly empathetic and so on. In other words, they can affect anybody. The causes of psychiatric illnesses are multifactorial. To a greater or lesser degree, genetic predisposition is a factor. Another factor is past unresolved trauma, which just refers to upsetting events or, circumstances that never got resolved and thus affect one’s view of themselves, others, and the world. And then, of course, present stressful circumstances are also a factor.
The other important truth to keep in mind is that NOBODY is perfect, physically or psychologically. Everyone is prone to catching a cold, developing an illness, and everyone has psychological issues causing them to get ungrounded and upset, and take things personally, or develop a psychiatric illness. There is a continuum from only rarely and briefly getting upset, as is apparently the case with the Dalai Lama, to those with severe psychiatric illness, where for example, fears can become so magnified that the become beliefs, and the person loses touch with reality. Everyone lies somewhere along the continuum at any one time.
Everyone has their own unique set of strengths and weaknesses, and nobody is superior or inferior to anyone else, or has more inherant worth as a human being than another. Nobody out of complete freedom would choose to suffer from a physical or psychiatric illness, and those who do suffer deserve compassion, not judgement.
Because we all have “egos” as humans, we all have a tendency to judge, both ourselves and others. Judgement is a product of the ego, which in its insecurity, seeks to elevate itself above others in order to feel better about itself in comparison. The lierating truth is that everyone is acceptable and loveable witzh all their imperfections. Truly believing this gives us security and takes away the need to judge. Judgement is also fed by ignorance (not understanding or knowing) and fear. Of course judgement can be easily learned from a judgmental family, community, or culture.
A TRAGEDY
Living in a culture that stigmatizes psychiatric illnesses, it is particularly poignant and tragic when, for example, a person with depression, is affected by the stigma, and mostly sees himself as an unacceptable depressed person, losing sight of his identity and the rest of all that he is. Unfortunately, this is a scenario that I encounter all too often. The illnesses themselves often cause more negative feelings such as fear, worry, guilt, shame, self-judgement, feeling inferior, and not good enough. So people already immersed ithese feelings are especially prone to fall prey to stigma, thus judging and rejecting themselves, and losing sight of who they really are. A condition that already causes so much suffering thus results in the suffering being compounded further by the stigma.
A woman I am working with who is much better than she was, continues to suffer greatly with social isolation for the past five years. All of this is because of the shame of the stigma of her past illness, which we are now working on.
Certain cultures or subgroups within a culture have stronger stigma about psychiatric illnesses, making it even harder for the individual who is suffering. For example, just yesterday I met a young physician from Jordan who was telling me that even in the present, psychiatric illnesses are generally perceived as shameful and unacceptable. So when a young woman was referred to a psychiatrist, it was a devastating thing for everyone in the family, despite her parents being physicians . It would have been easier if she had had advanced cancer, which is seen as a legitimate illness! So something is very wrong there.
WHAT CAN BE DONE
With each person truly believing the truth: that psychiatric illnesses are legitimate illnesses with a biological basis and that they can affect anybody, that the sufferer is not to blame and deserves compassion, not judgement, that they are not signs of weakness nor cause for shame, stigma is weakened. The truth is important for everyone, whether they are a sufferer, or know someone who is, or not. The greater the lack of understanding, the greater the magnitude of the stigma. Likewise the greater the understanding, the less the stigma. As people come to believe the truth, they will become more open about discussing the topic in a matter-of-fact way. Less shame leads to less secrecy, and less secrecy leads to less shame. When I see clients who are struggling with stigma, I routinely tell them about my family history and personal history of depression, which they find reassuring. Openness and grounded communication about the topic helps people feel less alone, and more compassion rather than judgement for sufferers. There are subgroups within society where there isn’t a stigma, and where people safely share their experiences with each other. The more you talk openly about the topic, the more you are helping to combat this ugly destructive phenomenon of stigma.
Educational programs and campaigns, both in schools and outside of them, including ads, can be helpful to educate, raise awareness, and promote dialogue. Stigma for psychiatric illnesses has decreased significantly over the years, yet there is still a long long way to go. I urge you to be part of the solution. The more people who talk openly about this very common problem, the faster this horrible problem will diminish.
Wisdom for living well 