The Stigma Process: Part 2
Posted by Tammy Daily
In the first part of this discussion, I argued that there are some unfortunate but normal ways in which people think about their social worlds that allow the development and maintenance of negative attitudes about people with mental illness to arise. Now we need to walk through how this plays itself out.
1. I have a category called “crazy” or “mentally ill”. When my youngest daughter was about to start kindergarten (I believe she was 5), I showed her a cartoon image of a person with the wild eyes and unkempt hair characteristic of the “crazy” stereotype. I asked her to tell me about the man in the picture. She said he was “cuckoo”. We form these categories very early and elaborate on them often.
2. I define that category based on general beliefs and attitudes about the people inhabiting the category thus creating a stereotype . I ask students on the first day of Movies & Madness to tell me the first words that come to mind when I say “mentally ill person”. They typically come up with some combination of the following: crazy, wild, nuts, out of control, dirty, homeless, violent, unreliable, unkempt, unstable, etc.
3. The images used to create my stereotype are largely based on what I have seen on TV and in film. I mentioned in the last post that there was a set of traits commonly associated with mental illness (unpredictable, dangerous, incompetent, childlike, blameworthy, untreatable, and contagious all of which add up to being far less than fully human). Researchers (e.g., Otto Wahl and colleagues) have found that these traits are typical of television characters who are presented as having a mental illness. When I ask students where they have learned what they know about mental illness, they agree that television is still their major source of information. The vast majority have never given the accuracy of such images much thought.
4. I use my stereotype to predict what others in the category will be like and how they will behave. If the stereotype for “mentally ill person” is unpredictable, dangerous, incompetent, childlike, blameworthy, untreatable, and contagious and I’ve just seen a person I think might belong in that category, what predictions am I most likely to make? Let’s say that I go to work and a gossipy coworker leans in my office door and whispers, “Did you hear about the new hire? I just heard she spent time in treatment and that’s why she was out of work for so long.” My eyebrows go up and I say, “Oh, really?” thinking that I won’t be swayed by such malicious gossip. Later in the day, I see the new person slam down her phone in frustration. How am I most likely to perceive and interpret that act?
5. I will notice and remember examples of people who fit my stereotype but not those who do not. When I ask my students to tell me the last time they heard a story about a person with a mental illness, almost without exception, they tell me about a salacious crime that was reported in the local or national press. While my local newspaper (which I read every day with near religious fervor) is very supportive of NAMI and mental health issues, reports of crimes which are extraordinary frequently come with a descriptor such as “had a history of mental health problems”. This gives the reader a weirdly comforting explanation (“people who do things like that aren’t like me; they are mentally ill”). Even when people who happen to also have a mental illness succeed, their accomplishments are often missed or discounted if they are reported at all.
6. I will tend to make internal/stable attributions about the causes of the behavior I see in individuals that fit in the “mentally ill” category. I had a speaker on campus who was a person with bipolar disorder. He walked constantly as he spoke. This behavior was immediately attributed to his being manic by many in the audience. I can’t lecture without walking and using my hands but, since I’m not readily placed in the “mentally ill” category, my behavior is not attributed to the possession of a mental illness but rather to an overt attempt to keep them interested or to being nervous that day. Neither are stable attributes inherent to me. They are things I can presumably turn off at will (actually, I can’t). If those behaviors are attributed to internal traits, they would tend to be innocuous ones (e.g., energetic).
7. When my negative stereotype is activated, I experience fear, anger, pity, and/or disgust. Go back to the workplace example. I see my new coworker slam down the phone. Given that the seed about the person’s alleged hospitalization has been planted, I am more likely to be alarmed by that sight than I would be otherwise. In fact, it may make me quite nervous.
8. These emotions will then prompt a stigmatizing response (e.g., discrimination, avoidance, coercion, or neglect). If seeing my new coworker prompts me to feel nervousness or even fear, what are the chances that I will knock on the door and ask if there is anything I can do to help? The odds are long. More likely, I will head straight for my gossipy colleague’s office and report what I have seen. Is it any wonder that people don’t disclose their mental illness status?
In Part 3, I will discuss how to mindfully reshape this process using controlled rather than automatic processing.