Wednesday, July 15, 2020

Reinforcing Stigma in Unexpected Ways


Do we perpetuate the stigma against those with mental illness by trying to normalize or speak more gently of mental disorders?

Language is powerful. The words we use to define things greatly influence how we feel about them. Can safe words result in damage to the people we’re trying to help?


I’m in a group at church working to make the church more open to and accepting of people with mental illness and the people who support them. I was asked to present with another congregant on language.

In the discussion with the larger group the topic turned to whether we should speak to mental illness or defer to words like mental wellness or mental health challenges. People were concerned about being judgmental or biased against people by labeling them as “ill.”

But that’s just what we are.

Bipolar disorder and other serious mental disorders are illnesses. They’re medically based and treated with prescription medication and other medical therapies. Just like any physical illness for which one visits a doctor.

I’m afraid that when we try to make the world feel safer for those with mental illness by using what we think are more accepting words to describe them we actually make the world less friendly for those with severe mental illness. Because by using safe words we sanitize things so much that the person who doesn’t feel challenged, but instead feels desperately ill, the person who can’t think of wellness because their life has been decimated by symptoms of psychosis, is driven deeper into a darker place since no one wants to accept them as ill.

We don’t say everyone has stomach aches so I understand your stomach cancer and speak of digestive wellness. We shouldn’t say everyone has challenging moods so I understand your bipolar disorder and speak of mental wellness.

I understand that safer language is well-meaning, but it can make the person who seeks help feel even more misunderstood and alienated because no one seems able to deal with the fact that they are sick and desperately need help.

Bipolar disorder is not normal. We shouldn’t try to normalize it. Let’s call it what it is and treat it.
Wellness is for stress and diet and fitness and workplace productivity programs. Severe mental illnesses are different. We shouldn’t ignore that difference or try to define it away.

Challenges for me include making the mortgage payment because my wife just lost her job and reaching a sack of rice on the top shelf because I am short. Suicidal, psychotic mixed episodes are not challenges. They are medical emergencies that require hospitalization.

Part of the desire to use safer language is that mental illnesses like bipolar disorder are terribly over-diagnosed. The worried well who need a little help coping don’t want to identify with the person on the street or in prison, even though they share the same diagnosis. So for the worried well we develop safer language so they don’t feel like one of them.

Obviously, this distinction behind the emergence of safer language only makes the person who is truly disabled feel less accepted by and more distant from normal, well-functioning society.

As we try to normalize the language around mental illness we reinforce the stigma that there is something terribly wrong with those who suffer from mental illness. If we don’t even feel comfortable using honest words, the thing we describe must be really terrible after all.

If you can’t call something what it is you must be afraid of it. You must avoid it. That’s stigma.

My partner in the presentation felt strongly about this. The group decided to stick to the words mental illness. We believe this will make the church a safer place for people who deal with mental illness because we’re not trying to hide anything. We’re willing to open up and confront the truth.

Words matter. Let’s use honest ones, not compensatory or avoidance ones. Mental illness is OK. It’s treatable. People with it can live positive, productive lives. We shouldn’t try to hide it behind words that make those who don’t have it feel better.

This post originally appeared on my blog "Getting Older With Bipolar."


My book Resilience: Handling Anxiety in a Time of Crisis is available wherever books are sold.

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