Session 5: Shadows of Stigma and Anti-Stigma Initiatives
Session 5: Shadows of Stigma and Anti-Stigma Initiatives
Chair: Alexander Dunst
“Madness” and “Brain Disorders”: Stigma and Disability
Christian Perring
Dowling College, New York, USA
Modern psychiatry has moved away from the language of madness, referring to particular disorders such as schizophrenia, and general types of disorders such as psychoses. The justification for this move is that it is both more scientific and less stigmatizing. Furthermore, groups such as NAMI and other official bodies representing the mentally ill also discourage the use of terms such as ‘madness.’ Indeed, NAMI and many other groups want to move away from all talk of “mental illness,” and replace it with talk of brain disorders. Yet the general public continues to use terms such as ‘mad,’ ‘crazy,’ and ‘loony,’ in disparaging ways. Of particular importance has been the “Mad Pride” movement which, echoing the tactics of the Black Power movement, the Feminist movement and the Gay Rights movement of earlier decades, has tried to reclaim the old language of madness, attempting to reverse the stigma of the formerly pejorative words. I compare these two approaches to fight the stigma attached to madness, evaluating their success, and discussing the advantages and disadvantages of the different approaches. The sanitized language of ‘mental’ or ‘brain’ disorder is more socially acceptable and is less confrontational. It also fits well with the aims of the ‘Big Pharma’ and the corporate world. ‘Mad Pride’ is more subversive with respect to the social structure, challenging assumptions of normality and appropriate behavior. This approach requires solidarity among people with mental illnesses, as it did in the earlier movements mentioned above, but it is especially difficult for ‘the mad’ to organize politically. There might be room for greater alliance with disability rights activists who have similar aims of challenging assumptions of current social structure and normality with its ambivalent stance towards medical solutions to internal dysfunctions. I end by outlining the overlap between Mad Pride and the Disability movement.
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What’s in a Name? – Women’s Resistance to the Diagnosis of Borderline Personality Disorder
Tammi Walker
The University of Bradford, Centre for Psychology Studies, Bradford, United Kingdom
Borderline Personality Disorder (BPD) is characterised by impulsivity, severely reactive mood swings, unstable interpersonal relationships, hostility, chronic feelings of emptiness and a tendency to self-harm (Morrison, 2001). In the United Kingdom the prevalence of BPD has been estimated at 1-2% of the general population, 10% of psychiatric outpatients and 15-20% of inpatients (Skodol et al, 2002). With regard to gender, BPD is predominately diagnosed in women (75%) (NICE, 2007) and many of these women may harm or threaten to harm themselves by engaging in self-harming behaviour (Nehls, 1999). The BPD diagnosis has been associated with negative connotations by the mental health arena and professionals often state that they find working therapeutically with this group of service users rather difficult and challenging. However, little is known about how the women react to being given the BPD diagnosis. The aim of this paper is to present women’s narrative accounts who have discovered that they had been diagnosed with BPD by the psychiatric profession. It will explore how the women resist and challenge this discursively constructed diagnostic category and how they struggle to accept it as their diagnosis.
State-Made Madness: Official Knowledge, (Anti)Stigma and the Work of the Mental Health Commission of Canada
Kimberley White
Law and Society, York University, Toronto, Canada
In this paper I interrogate both the nature and broader social/cultural effects of state knowledges of “mental illness” through an analysis of the objectives and organization of the Mental Health Commission of Canada (MHCC). In particular, I examine the form, content and meaning of a national anti-stigma/discrimination campaign recently launched by the MHCC to ‘correct’ public misperceptions about “those living with mental illness.” This interdisciplinary study of the MHCC highlights the very powerful ways in which official knowledges shape, and are shaped by, broader cultural and historical representations of madness, insanity, mental disorder and/or mental illness.
The political rhetoric of the MHCC clearly seeks to promote a social justice mandate – to bring those living with mental illness “out of the shadows” and into full citizenship. I argue, however, that in adopting a strict corporate governance model to identify specific problem sites, involve stakeholders and create targeted cost/time/resource efficient solutions, initiatives such as the anti-stigma campaign are more likely to affirm than destabilize the dominant representation of madness as a disease, and of mental illness as a national (social, political and economic) problem.
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How Society Potentially Contributes to the Development and Maintenance of Mental Illness: A Systems Approach to a Community Survey on the First National Anti-Stigma Campaign in Cairo, Egypt
Nahed Khairy
Department of Psychiatry, Kasr Al Ainy Faculty of Medicine, Cairo University, Egypt
The need to categorize and assign to a group is universal. It is both economical to the human brain and comforting. If done on reductionistic basis, however, the danger of generating a too homogenous, standardized human species evolves and stereotypes get transferred from generation to another. Cultures determine the range of accepted deviation from the norms, sometimes labeling the deviation as creative if the product is desirable, other times, giving pejorative terms according to the impact of that deviation. The Egyptian culture has two apparently contradictory approaches to deviant behavior: tolerance of psychotic behavior if docile and integratable into the matrix of every day life (either urban or rural) and harsh oppression, including mockery and ostrasization to any behavior that is antisocial on any point of the continuum of antisocial behavior: The slightest challenge of strongly held social beliefs is considered antisocial and is met with such oppression.
This community survey was conducted following a prime -time airing of two clips aiming to modify attitudes towards those who behave differently from the norms. Three thousand participants from the urban and /or urbanized Egyptian society representing all age groups, gender and education were interviewed on one to one basis. The questionnaire conducted contained four sections: profiling of the participant, questions related directly to the messages of the educational clips, questions related to personal beliefs and finally a stimulus card containing seven images to detect the implicit concept of mental illness that the participant holds. A synthesis of the analysis of the results is done in light of a systems approach including proposing schemata that are at play within societies that stigmatize deviation from the norms, including well deserved rejection to the violent and dangerous but also including those whose behaviors challenge obsolete but still standing beliefs. The interplay between society’s schemata and the deviants schemata is proposed within that context.
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