Recently, while doing some research, I came across a couple of articles with celebrities who spoke out about the various mental health issues they have had or are struggling with. Celebrities have been more vocal about mental health and the stigmas associated with them. Coupled with the efforts of every day clinicians who work to spread awareness as well as the licensing boards and associations, such as the American Counseling Association (ACA) and American Psychological Association (APA), the understanding and importance of taking care of our mental health has spread significantly.
At about age 10 when I decided that I wanted to be a therapist, mental health was completely foreign to everyone I knew, even to the point where I just stopped sharing what I wanted to become. Even while in undergraduate and graduate school, when I did share with some individuals, the consensus was that I was going to deal with “those crazy people”. I guess in a sense, I was also one of “those crazy people” for even considering this kind of career. For me, I experienced therapy at a young age and it had a profound impact on me; to the point, that once it ended, I had a clear view of what I wanted to do as a career. At a young age, I recognized the importance of this field of study. I did not consider who the clients would be or what their issues would be; I just knew that I could help them. I am sure that for many clinicians, the decision came whether through personal contact or through working with families and friends who experienced mental health issues, or through the need to help others. It is quite amazing to me that over two decades later, I still get statements such as the above. This only emphasizes to me that there is still much more work to be done. I am thrilled that progress has been ongoing and I can have conversations with people, and some recognize that mental health is important. However, there is much more work to be done so that people do not feel that they have to have severe issues to seek help.
Mind vs. Body
Modern medicine has taught us that much of the happenings in our bodies is done automatically. On any given day, we are not aware of how many breaths we took, how our bodies functioned, or how many thoughts we had during the day. Yet, it is so easy to dismiss the importance of our brains. Most people only think about their brains when a medical doctor advices of an issue with the brain. At that point, we are still only focused on just this one thing about the brain. Medicine has shown us that the brain takes care of us without us every considering how to take care of the brain and ensure that it functions optimally. The brain manages the functions in our bodies 24/7, 365 days of the year. So why is it that it is so easy for us to go to the doctor the moment we experience any physical pain but when there is an issue with our mind, we consider it a weakness to seek help for something as complex as the mind? While the brain is a physical organ that can be tested and checked, the same does not apply for the mind.
In my own experience, I have met clients who came very reluctantly to therapy – whether a parent bringing a child or an adult being forced by a third party – and upon further conversation, it becomes clear that some of their unwillingness to participate in therapy is based on misconceptions based in stigmas. They feel that they appear weak and are in need of someone to fix them; they feel that their existing environments will now only view them as ‘severely sick’ because it is only crazy people that go to therapy. The extent of misconceptions about therapy can feel overwhelming. Patrick Corrigan and Amy Watson’s article in the World Psychiatry journal, February 2002, issue 1 noted that although stigmas and stereotypes affect all kinds of illnesses, public opinion seems to dislike individuals with psychiatric disabilities than individuals with other conditions. This may be because mental illness has been linked to social problems such as drug addiction and prostitution, according to Corrigan and Watson.
Another interesting thing I have discovered about misconceptions about therapy is that people do not understand the point of it. I recently spoke with a potential client who wanted to understand what the difference in speaking to a therapist was as opposed to speaking to a close friend. This was a question I had not heard in a long time; for a minute, I was taken aback that this was still an issue in today’s society. Stereotypes and stigmas affect our worldviews and have direct impacts on what we consider acceptable and unacceptable. In our current society, mental health illnesses are still viewed as taboo unfortunately.
Stigmas help societies to identify groups that have been deemed as less than in some particular way and they do not fit in with the societal norms. They are used to ostracize individuals that others have deemed as being of lesser value, and oftentimes – because of human need to belong to social groups – we tend to fall in line with the consensus so that we too do not become ostracized. Mental illness carries with it the association of shame and weakness and is perpetuated by the stigmas attached to it. The history of mental health seems to be ignored now in our current society. However, I believe that the social stigmas assigned to mental health illness still traces back to the days of asylums and deplorable treatments provided to people with severe mental health problems. We only have to watch the TV in present times to see examples of patients being strapped to beds and force-fed medicines and various kinds of severe treatments to recognize that these ideas and thoughts are thoroughly embedded in the fabric of our societies. One thing I have learnt about the American culture is that the general assumption seems to be that if something is not talked about, then it either does not exist or it is not much of a problem; this couldn’t be the furthest thing from the truth. Margarita Tartakovsky talked about the conditions of the early mental health asylum in The Birth of the Mental Asylum in the World of Psychology blog; she highlighted the importance of Dorothea Dix who worked to reform mental health and the way that patients were treated.
The idea still permeates our societies today, especially in some cultures, that having a mental illness makes the individual weak and useless, and of lesser value because others feel that they cannot contribute anything of value to society. These individuals are viewed solely as the sum total of their mental illnesses. Corrigan and Watson emphasized that people with serious mental illnesses struggle with symptoms of their diseases and also, they struggle with the stereotypes and stigmas attached to these same illnesses. Hence, their struggle is two-fold. An important point by Corrigan and Watson is that the stigma itself is also two-fold. The public stigma is the general population’s reaction to people with mental health issues; then there is the self-stigma which is the stigma that people with the illnesses have against themselves.
As clinicians, we have to be cognizant of these stigmas when we work with our clients. Oftentimes, we are aware of what the public feel about mental illnesses. But do we take the time to examine the clients’ thoughts and views on themselves with these illnesses? Especially for clients who have received recent diagnoses, their experiences are very different from clients who have been living with mental health issues for much of their lives. We have to help clients recognize that stigmas perpetuate fear and a lack of knowledge. Stigmas give people the chance to make assumptions and judgements about others without any factual information. Stigmas offer a short and quick way to assign people to boxes so that we can feel safe and secure in our own worlds. Corrigan and Watson specified that prejudice leads to discrimination which people with mental illness often experience from families, friends, employers, and other social infrastructures. We must explore these dynamics with our clients to determine the extent to which they experience these negative effects in their lives. We also have to empower them by helping them to recognize the stigmas and stereotypes they themselves enforce in their own lives. These personal stigmas are even more far-reaching and much more embedded because the clients may not even know they are there. The clients, in a sense have subjected their own internal powers to the power of the stereotypes and stigmas.
As counselors, we must take on the role of advocates for our professions, not only in our agencies and offices but in everyday conversations and with people we meet on a daily basis. We never know who we can help in everyday passing conversations. Since becoming a counselor, I have learnt that the role of advocacy is ongoing. I hear passing remarks about the uselessness of therapy, the confusion over all the various professional titles, and even within the professional community, there is disparity between the professions. There are more than enough reasons why people should not seek help to safeguard their minds. Society teaches us that protecting our physical and emotional health are extremely different concepts. Even within the counseling field, much of the history is medically based. The wellness model is a relatively new idea that strives to teach us the importance of a holistic approach to health. Our aim should be to be healthy, physically, mentally, emotionally, and spiritually. So once again, we must be advocates in our communities for the importance of our minds.
Charmaine Perry is a counselor who works mostly with adults and couples in central New Jersey. Her passion is mental health and writing and finding ways to incorporate these two fields to advocate for mental health services for African and Caribbean Americans.