Stigma

Jargonizing the Stigma Concept:

Stigma is a mysterious external process that becomes internal that all message receivers face. Though stigma works in many different ways, I think it is particularly astounding and deceptive that it is not considered part of the definition of all forms of schizophrenia disorders. In my mind including it in the definition is a way of acknowledging and respecting that part of the negative outcome for those who suffer is the way society and our culture defines and treats the phenomenon of special messages. Acknowledging the role of stigma suggests that the outcomes of people becoming resigned to isolate, to sit and smoke all day in a board and care setting, is not only the result of their internal choice or abilities but the systemic interplay of individuals and the community that surrounds them.

For example, having myself transitioned from being treated like a hard-working, conscientious social worker who inspired social change, to a mental patient who needed to be locked on a ward for my own safety, I know that the power of this concept first hand. The transformation was profound! Suddenly my strengths were no longer defined by me. As I walked in circles on the floor to maintain my need for exercise, the only strength my psychiatric nurse gave me was that my family, in spite of all the hurt that I had experienced over the past fifteen years, was good family support. Two years later stigma still dogged me as a deli worker who worked under the constant threat of being fired. Now, fifteen years later, in spite of the fact that that I have a house, a wife, and a job where I am appreciated, I still battle with a sense of being slandered and rejected while my work remains unacknowledged. While I have not let stigma ruin me, I work with people who are extremely undervalued who are fighting the same demon. I write notes that diminish their efforts so the organization I work for can get paid.

In jargonizing this construct I want to consider that stigma starts in the message receivers’ mind long before the special message and divergent view constructs.  Stigma starts with a subjective perspective or preconceived notion of what words like: “crazy,” “mad,”  “psychosis,” or “schizophrenia” means. It needs to be remembered that the minute one enters into a message crisis unconscious stigma pounds and punishes.

Early impressions are the foundation around which stigma takes root. For me, it was the librarian in my third grade who first introduced me to the concept of “schizophrenia” in a pamphlet. I have come to best see those early impressions as lies regarding incurable brain disorder that is very rare. At the time subsequent interfacing did a lot to diminish my sense of humanity for those who suffer with this. It was somehow okay to throw them away because there was nothing that could be done. Oh, for sure it was sad, kind of like when someone dies in an earthquake.

But having this early impression reinforced persistently through early experiences in hospitals for eating disorders, in Abnormal Psychology text books in college that used misleading twin studies, and as a young professional in the mental health field did a lot to make me feel punished when I received the diagnosis. None of the trauma that I had been through mattered, only that early impression of what the “disease” was.

Early impressions of “psychosis” for those who have parents who struggle from it are going to be very different. Targeted abuse from symptoms or the outside world may result in innocent suffering and form a starkly different impression. Likewise, individuals who grow up in rural, urban, or differently zoned areas than I, where mentally ill people are housed or warehoused, are likely to develop very differing impressions of mental health in very different sets of circumstances. They may not be so book focused.  They may have more or less humanity in them. Nevertheless, I would argue that early impressions start a process of hurt and misunderstanding in many individuals’ experience.

Through this and the next chapter, I will approach stigma as though it is potentially false notions of dominance that distort the rational world and prevent the individual from using their strengths in a meaningful manner.

It’s arguable that stigma comes from the same social processes initiated by the formation of the “state” that empower some to dominate others. Social order of all sorts depends on distorted vision: how else do we all accept the fact that slaving peasants in Uganda make brand name shoes for pennies an hour, while famous endorsers who make them cool, make millions per a few seconds.  It is the justification of illogical, unreal, oppressive and perhaps even selfish reality. For people high up in the social order, stigma serves a real purpose. It is real and many would argue part of reality. But for the people in hacienda camps, their beauty and strengths might wither and disappear and that is not real. At least we could thank and honor them for allowing us to be where we are at. But in reality, the haves are the ones who hate the have-nots because of stigma.

Meanwhile, on a more personal level, for the individual cast out of their community, I believe stigma universally erodes the individuals’ genuine strengths and mandates unfair, submissive roles that are culturally-defined and that can in some cases erode the potential for self-actualization.  Here I am speaking directly about individuals in the mental health system, the industry that exacerbates wounds and defines messages in ways that barely makes sense: amplifying the myth of eugenics and denying the roles of trauma and spirituality. As I will review in chapter eighteen on mad diversity, suddenly there are dominant hereditary eugenic beliefs and myths that justify internment camp conditions, and message receivers feel controlled like a marionette by massive coils of knotted message experience and stigma shaken by corrupted powers above.

Oddly, in institutions it is often people with heightened views of stigma that message receivers have to be in relationship with to get out; they become obliged to utilize elementary social skills and R+R tasks to make friends with, rather than overthrow the oppressor; social skills that may under-estimate their true abilities that may be committed just shine on with ultimate plans to escape. Indeed sometimes the only way to escape from bondage is to take denial (the Nile) down-stream in fake-it-till-you-make-it style.  If the message receiver does not utilize denial and social skills they run the risk of staying stuck or traveling up the river into permanent warehousing.

Stigma Driving the Double Bind and Brain Damage:

Stigma and social sanctions work together in a way that makes it impossible for a message receiver to act without facing some form of punishment.  In my training, I learned that this concept was coined by anthropologist Gregory Bateson as being a “double bind.” I believe that double bind circumstances become inherent in institutions, families, and just about any social group in which power is operant. Even well run, non-punitive message groups run the risk of the “double bind” when they are backed by a system of punishment. In spite of my best efforts, I have seen this happen to individuals and bear responsibility for that even when I have done what I can to prevent it.

Hence, I am going to take a minute to explain how the “double bind” fits into the special message definitions. Recall how special messages stir up emotions that cause the message receiver to sleuth, creating streams of divergent views that soothe. In this process, the message receiver can: 1) rationally test out the divergent views sleuthing for more evidence; 2) give in and act as though the divergent views are true, committing retaliation reactions; or 3) distract from the emotion by completing R+R tasks. The first two options clearly lead to punishment. First, sleuthing will increase the special message phenomenon (which can be traumatic in many cases) until the message receiver reacts and reacts stronger. Second, retaliation reactions inevitably lead to social punishment unless the message process is understood and allowances are made. In both cases stigma further advances and exacerbates social sanctions. But with R+R tasks there is a way out! This I have argued.

But here I want to consider the way that stigma inherently can interrupt this option. If stigma is an inaccurate definition of the problem that steals identity, the able bodied message receiver does what they can to complete R+R tasks for hours, years, or in many cases decades. However, stigma functions to undermine the acknowledgement of such success. Stigma says there is still a process that is going on that impacts and gets in the way. Stigma sniffs out this process, shines a light on it, and confronts it. Stigma wants the message receiver to stop denying that they are different. It seeks to undermine characteristics of the success. It seeks to demonstrate that if the special messages weren’t present, the work could be even better. Stigma wants the message receiver to pay more attention to the problem in order to eradicate it. Stigma actually believes that there is something wrong with the message receiver, not different. Stigma will use the first opportunity to criticize and diminish the message experience.

Think about it! The first thing message receivers are taught when they commit retaliation reactions is that they will have to be put in a hospital and have help forced on them until they settle down. They are put in a holding setting where they may be more limited in terms of R+R tasks they can complete. Then slowly, they are taught that when they behave better, or at least pass through the holding period that they can have R+R tasks back in very basic and limited manners.

I would argue that this process discourages R+R tasks and social relationships in severe manners. Unless a message receiver is exceedingly well, it is upsetting to see their abilities talked to like they don’t exist. A message receiver needs to be able to dummy-down and not let the ridiculous nature of what is going on impact their sense of self.  They cannot do this if they are told this is treatment.  In my opinion, they may be able to do this if they are taught that it is punishment.

Message receiver’s need to know about the “double bind” and choose to work with the staff who are committed to eradicate it.

Stigma as a Multifaceted Mechanism of Oppression:

In giving stigma a clear role in the message process, it is so important to acknowledge that stigma about “psychosis” is only a part of a much larger picture. Message receivers are only a part of the much wider inhumane human process. I’d consider any reality that is hidden in the history books, any genocide, in which graphic and violent details that the mainstream conspires to hide to be a potential origin. Classified documents and other undocumented conspiracies, are examples. But I’d also argue that behind any legitimized genocide, or institutionalization process, there are many means of subtle social oppression; with each, stigma against groups of people is legitimized.

In considering stigmatic mechanisms of oppression, I want to classify two types. First, those second generation mechanisms that get formerly recognized by an intellectual community that seeks to reduce them, but whose work may remain irrelevant to some in the mainstream; factors such as: race, class, gender, veteran status; immigration status, sexual orientation, ableism. Second, first generation mechanisms that are not formerly recognized, in which the oppression is so raw and fresh that it does not get formally observed.  First generation oppressions may be addressed and limited to some extent through law. However, first generation oppressions keep them alive and well. First generation oppressions may be more cloaked and painted as though they are due to weakness of character, but they are all distorted, oppressive mechanisms through which social order is maintained nonetheless. They may be outlawed and blamed on the victims. They are the means of war on the poor. Examples of first generation oppressions are: educationism, gangsterism, legal justicism, creditism, nimbyism, job historyism, nepotism, traumatism, addictsism, mental disorderism, schizophrenificationism, co-occurringism.

While clearly this first and second generation divide is imperfect, the point I like to make is that those people who can get one label with the most first and second generation stereotypes associated with them in the eyes of the mainstream win. Shifts in laws and cultural changes that are happening now may involve moving the second generation issues down to first generation issues. I’d argue that any kind of institutionalization is the result of multiple layers or isms.

In my opinion, the little popularized field of social psychology with studies that prove elements of “the labeling theory” reveals that mainstream opinion can help make a stereotyped reality or oppression more likely to come true. In my admittedly uneducated opinion, social psychology is key to understanding stigma. Thus, according to labeling theory a subject gets a felony and becomes a “criminal” and regardless of their silenced stance on the role of gangsterism or valid sense of morals, they get traumatically pushed into all or nothing criminal behavior because of the box on the employment application.  Additionally a body who has any sort of altered state, becomes a “schizophrenic” and gets treated as though neurotransmitters are disrupted so forcefully that my brain really does swell and need neurotransmitter disruption due to trauma. But if a white psychiatrist has empathy for the schizophrenic they may become bipolarized if they hide what is going on with them. But, if they are black and bipolar, forget it! Even individuals who are bipolarized will suffer the punishment of the schizophrenic. And finally there is the soldier/hero who regardless of their background, level of support at home, or knowledge of covert intelligence or violence and loss they got exposed to, either stays hero or becomes defective and prone to suicide.  In other words the stigma of a word has a lot to do with the way the body and mind respond, the decisions a stigmatized person makes and the outcome of their life and health.

Author: Tim Dreby

I am an award-winning author and practicing psychotherapist

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