Stigma and Social Control
Most people would identify stigma as a significant problem for their relative with a mental illness and for the family in general. Effects on the individual can include a lowered self-esteem, difficulty making and maintaining friendships, job difficulties, and reluctance to tell others about their illness. Family members often speak of lowered self esteem and damaged relationships.
What exactly is stigma? There are many definitions out there but we have chosen the following as one to guide our discussions: "Stigma exists when elements of labeling, stereotyping, separating, status loss, and discrimination co-occur in a power situation that allows these processes to unfold" (Link, Phelan, 2001, p. 382).The word "stigma" is Greek in origin and referenced the practice branding criminals and slaves by making a permanent mark in their skin. It was a label- a way of setting them apart.For people with Bipolar or many other mental illnesses, it is the stigma and the controls put in their life because of it that may in fact have a stronger impact on their lives than the illness itself. In a study done by Canadian Mental Health Association it was found that high percentages of respondents stated that the following were impaired due to stigma: social and family relationships, employment, housing, inclusion in their community, self-esteem . Due to beliefs that are held by the public, all these areas in someone's life could be affected or ultimately, controlled.
There are terms out there for stigma on family members and friends of those with a mental illness as stigma is not something that only affects the person that has the illness. “Courtesy stigma” and “associative stigma” are both terms that are commonly seen in the literature.
Here are some general things to think about as you are reading through the questions below and as you are supporting your loved one, yourself and other people in your family in dealing with stigma.
What are the main sources of stigma? We see all around us things that lead to the stigmatization of people with a mental illness. From movies and tv shows about a murderer with a mental illness, to media talking about crimes committed by people with mental illness, to terms like "crazy" and "funny farm". We also see side effects of medications that people are on that cause people to behave in ways they wouldn't otherwise- such as pacing or smacking lips- which the public sees as symptoms of the illness but really they are side effects of the medications.
What can be done to support your family member through the stigma? Many families have reported that facts about mental illness, having the chance to interact with other families with a family member with a mental illness, family support,friend support, finding a doctor who both your family member and you are comfortable with and who respects you, are all things that help deal with the stigma.
What can be done to fight stigma? Unfortunately we all know that stigma still exists and there is no magical cure for getting rid of it. Any approach needs to be multifaceted and multilevel. All the mechanisms that lead to stigma need to be addressed but issues at an individual and at a system level also need to be considered. Ultimately the approach also needs to address the cause of stigma. This can be done by changing the strong beliefs and attitudes of powerful groups that lead to all the outcomes of stigma or it needs to change it so these powerful groups no longer have the power they do so make their beliefs the dominantly held ones. Either change the thinking of these powerful groups or take away their power. This may be easier said than done.
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