Sunday, 30 March 2014

Flavours of stigma

So in my dissociation post the other day I alluded to the idea that people's reaction to mental health conditions could be different depending on the condition itself. There are many misconceptions that people have about the subject as a whole, but often certain ones seem to be trotted out more in connection to certain conditions. Often the overlap, in a sort of Venn diagram of discrimination, and some conditions seem to come in for flack from every which way. Obviously this is just me rambling about my personal thoughts, but I like to categorise and put things in order. So here are a few of what I consider to be the more common ways of thinking about mental health.

1. Diminishing, belittling, invalidating- think about phrases such as 'you just need to...' or 'when I'm sad I...' or 'pull yourself together'. This is tricky, because often these things come from a very well-meaning place, people are trying to help. They are built largely on the assumption that depression equates to sadness or anxiety to worrying. The assumption that they know exactly how you feel. This can be hard to deal with, you want to acknowledge that people are trying to help and be grateful for that....but it's difficukt when they've so titally misunderstood everything about how much it hurts and how difficult it makes life. Anxiety and depression are most often subject to this kind of thinking, particularly when the condition is new.

2. Annoyance, frustration, anger- pretty much an extension of the above, the language becomes 'just get a grip already' and 'we all have bad days you've just got to deal with it' and 'I've had enough of this now'. Because, lets be honest, it's hard work caring for someone who's ill, even if we were talking physical illness. And when people don't know the details or the reality of a condition, which is so often the case with mh, it can be very hard for them to grasp why you're not behaving as you 'should'. Mental health is not a logical thing, it's not something you can argue,  or bribe, or persuade someone out of. And trying leads to hurt and anger and pain on both sides. Depression and anxiety can fall here again, particularly if it's more enduring, but also disorders such as OCD or eating disorders and body dysmorphia and similar.

3. Suspicion, judging, accusing- this is 'attention-seeking' territory, where 'you just like the drama' or you're 'manipulative' or 'holding a personal pity party' or similar. Often it can seem this way, partucularly when behaviours or extravagent displays of emotion are involved. Often people are not in control of how they're behaving, or are too desperate to care...maybe they feel they have no choice or maybe their behaviour is misread entirely. Sometimes our own feelings and preconceptions get in the way of our perception of others- in our anger we can accuse an upset person of 'turning on the waterworks', for example, when crying is a natural human response. Conditions such as BPD/EUPD come under fire from this sort of thinking. Behaviours such as self harm. Even suicide attempts/ suicidal thoughts.

1, 2 and 3 can be lumped together in some ways in that they all work on the basic assumption that the individual has a choice about their illness....they choose to be ill and choose to remain ill and therefore they must want it in some way and are consequently selfish.

4. Fear- my fourth catch all group. Technically there is fear involved in most judgements we make but I'm thinking less of worry and more of 'omg stay away from me'. The assumption that 'mental people' are dangerous ir violent or volatile. That desire to lock people up and throw away the key because they shouldn't be around 'normail people'. Often thought processes followed by people with no knowledge of mh at all or towards conditions where perception of reality is in question. Schizophrenia, DID (not the same as schizophrenia), psychosis, mania.

Ironically the fact that people think individuals have a choice or control over their condition is one of the driving forces in this type of stigma!

Like I said at the beginning, mh can't be split down and categorised so simply, many things will fit in more than one box, or need a box all of their own. One thing you may have noticed in the list though us the fact that most all of these are based on misinformation and lack of knowledge. Education and understanding can make a massive difference. X