Internalizing Stigma

by Jay Paul

 

At the end of a book I recently relished was an interview with the author. She mentions her divorce in passing with the explanation that her husband had mental illness—nothing further was said about it. I was devastated. I thought so highly of this author, and I learned that she felt so little of people like me. Giving mental illness as the only reason for a divorce is to assume that people with mental illness all make poor spouses. That’s the only way such a remark can make sense. Plenty of people with mental illness make good spouses, and plenty of neurotypicals make for poor spouses.

 

It’s called stigma.

 

A few years ago, I was talking on the phone to one of my best friends from childhood. He mentioned that his sister was seeing a difficult man “who has BIPOLAR.” He said the last word with a heap of disdain, apparently forgetting for the moment that I had been diagnosed with just that and with a condition considered even more serious. I decided not to say anything. In this moment, my friend made the mistake of equating mental illness with a lack of character.

 

It’s called stigma.

 

This stigma is reinforced by the news media. They mention that a person accused of a crime “has a history of mental illness” as if that explains the reason for the crime. The overwhelming majority of people with mental illness are nonviolent and nonthreatening. Mentioning someone’s mental illness in relation to a crime makes about as much sense as mentioning their diabetes. 

 

Thing is, most neurotypicals can be so irrational. They think they have more to fear from a person with psychosis than from one of their hate-filled fellows.

 

It wouldn’t be so bad if the stigma stayed out there, with the neurotypicals. Yes, stigma makes for difficulties with the police. Yes, we sometimes have to deal with people being afraid of us for no good reason. But the biggest part of the problem is internalizing the stigma. When the world is afraid of and hates you, part of you tends to believe it. I would be surprised to find any person with serious mental illness who doesn’t struggle with internalized stigma.

 

I know I do. I often blame myself for my diagnosis of schizoaffective, as if I willed it upon myself. I blame myself for not working full time, even though I took a low-paying, full-time job and got off disability back in 2012. I stuck it out for a while. But four years later, I was back on disability. The reasonable conclusion is that full-time work doesn’t fit my constitution. I can contribute more to this society by not working full time, taking care of myself to avoid episodes that use up resources, working part time, and doing volunteer work such as writing this blog. This is the reasonable way to think. But stigma doesn’t always allow for it. I get down on myself sometimes. And the messages aren’t being manufactured by me. They are coming from outside, from people such as the author and my friend mentioned above.

 

While one part of me internalizes the stigma, another part fights back. I insist on my worthiness. I remind myself of the good I have done. I remind myself of my successes as a writer (I publish poetry, short stories, and a novel under a different name.) I think of what I have contributed to my family’s welfare. I try to buck myself up. But it will never be enough. There is no such thing as paradise. Thoughts of my own inadequacy because of my diagnosis will always haunt me. They are awful, insidious things that pop up in moments of insecurity—right when they are least welcome.

 

Recently, I was eating on the patio of a restaurant with a friend of mine who has bipolar. I wondered what the waiter would think if he knew we both had diagnoses of serious mental illness. Would he just wish we would go away? Would he be afraid? I cringed, thinking what a nuisance I am sometimes, what an inconvenience I am to the neurotypicals and their rosy life. Of course, this was just a passing thought. I don’t thoroughly believe this. I know plenty of neurotypicals have lives as difficult if not more difficult than mine.

 

A further wrinkle for me is paranoia. Most every day I have a moment when I think of an embarrassing or slightly shameful moment from my past, sometimes the distant past, and I cringe and think, “Everybody hates me.” This thought lasts for a split second, and then I quickly rally myself by remembering that, no, everybody does not hate me. I tell myself that there is no evidence that either my family or friends hate me. It takes about 30 seconds to get back to equilibrium. Then I get on with my day.

 

Such paranoia feeds into the stigma. Although I am privileged not to conform to any of the stereotyped pictures people have of schizophrenics, I nonetheless sometimes feel as if everybody knows my diagnosis. I sometimes also feel as if my friends will shirk me for being fairly public about my diagnosis. Sure, they know I have struggled with my mental health. But seeing the details may cause them to run from me. What makes this even more acute is I have had friends disappear on me. Was it because of my mental health? I will never know. They could have just drifted away. But such severances become all the more acute when you feel that they may have been occasioned by their fear of me because of my diagnosis.

 

How do I fight back against internal stigma? I guess I try to remind myself of all the worthy things I do. I try to remind myself of my inherent worth and the inherent worth of all people. I remind myself that my friends and family would miss me if I were gone. I wish I had a magic pill I could share that would release all people from internal stigma. But that will never happen. It’s a never-ending struggle.

 

My guess is that all people suffer from insecurities and feelings of inadequacy. But these feelings get exacerbated in me, and probably in others like me, by both stigma and paranoia. Sometimes you just want to scream, “I didn’t ask to be this way!” But the fact is, I am this way. And where am I? What do I see from this position? A lot of it is very bad, but not all of it. The neural make-up I have provides me with windows onto experience that have been rarely explored in contemporary society. (I believe that acceptable knowledge stemming from what we now call psychosis was much more common before the mid 18^thcentury.) Such exploration will be difficult. There is not a good vocabulary for it. But it is what I intend to do in the weeks ahead.