Stigma-- Our Secret Social Virus

The American Psychiatric Assn. is meeting in San Francisco this week, and the theme of the conference is “Overcoming Stigma.” It is an important topic not only for the mentally ill and those who treat them, but for all of us. In the time it takes for you to read this, more people than you could imagine will be stigmatized--possibly for life.

Many who carry a stigma are people who would not usually be thought of as having one. But consider stigma as a way of regarding people as different and to justify treating them differently. The following examples have in common the tendency to evoke in us either fear, pity, horror or scorn--and trigger a reaction of avoidance: a suicide attempt; a cancer or AIDS diagnosis; rape or child abuse; racial or religious harassment; divorce; bankruptcy; a denied job promotion; physical or mental disabilities; homelessness, or public revelation of the “skeletons in the closet” of a prominent person.

Because of a difference that is out of their control, these people are convicted of disturbing the norm and sentenced to a stigmatized existence. They are categorized and then pushed away or disregarded. Eventually, the disconnection drives them to feel alien, and then they begin to push away the people who have pushed them away, which just adds to their isolation.

Stigma keeps them at arm’s length and keeps them psychologically less contagious to the rest of us. Stigma will allow us to put people into a “thing” category so we don’t have to think about them or treat them as people; it legitimizes our dealing with them as other than human.

What are we to do, since it is not a matter of who the stigmatized are, but when each of us will inevitably join their ranks? Shall we wait and hope to outrun it? Shall we deny that it is even a problem?

Perhaps we could try to prevent stigma from adding alienation to those already injured. We maintain stigma through a vigilant, empathic ignorance--a steadfast refusal to see the world through another’s eyes, to see their fear, frustration, hurt. In fact, we will do anything to keep from looking even deeper into their eyes for fear of being pulled into their world. We’ll pay to avoid it. Or perhaps we’ll try to deflect the problem by focusing on the helpers (like psychiatrists or social workers) and finding a way to discredit them as exploiters on ego trips, or neurotic do-gooders.

Why do we feel the need to stigmatize? Because we are afraid of seeing our own “there but for the grace of God” vulnerability. If we can maintain our view of these people as different, we feel reassured that their traumas and tragedies will never happen to us.

Stigma can only be reduced by empathy and compassion. You cannot feel fear and animosity while feeling empathy and compassion. It is impossible to see another’s point of view, feel his or her feelings and at the same time harbor fear or hate. You can’t identify with and alienate at the same moment. You can’t rush empathy or compassion. You can’t look into the eyes of someone who is dying, abused or homeless and ask, “How bad does it get?” and then turn away.

How can we nurture in us the desire to empathize with our fellow human being? We are so reward-oriented, but what could possibly be the payoff here?

Part of the answer could be the neurotic dilemma that operates in many of us. We feel entitled to a good life that inside we feel we don’t deserve. Why don’t we deserve it? Because in an effort to get what we want, we cut corners. And we don’t stop at taking advantage of opportunity--we take advantage of people in order to get our way. But way down in the goodness of our souls, we know we have done something wrong. We feel ashamed and undeserving.

But when we give to others, when we listen to others, when we put ourselves out for others, when we give more than we take and when we don’t shortchange the world that has given us life--it is then that we earn, gain and deserve happiness and peace of mind. And happiness and peace of mind are the big payoffs.