Internalizing stigma

I used to be much more open about having a psychiatric condition.

My mother has been on medication for as long as I can remember. Her psychiatrist was a household name throughout my childhood and adolescence. (Whether we viewed her as a benevolent or malevolent figure, the psychiatrist was there, like a relative one alternately loves and hates.) My father also went through a couple episodes of major depression and briefly took an antidepressant. They both talked openly about these things. So when I had my breakdown at 15, I did not have any sense that seeing a therapist and taking medication was something to be ashamed of.

I quickly learned differently. Even some of my friends, a group of misfits with problems of their own, reacted negatively. I also learned that some people in my own family, outside the immediate circle of my sister and parents, were not understanding.

One incident particularly sticks in my mind. I remarked to my favorite teacher that I was going to ask my therapist something, and I will never forget the look of shock that came over his face. Why it was so shocking to him, I still don’t understand. But I immediately internalized that look. I was duly ashamed of myself. How could I have been so stupid? How could I have thought that was OK to talk about? Why did I have so little understanding of social norms?

That was the day I learned not to mention psychotherapy unless the person I was talking to confessed to it first. Even if I learned that a friend was seeing someone, I was careful about how much I told them. I learned that an occasional generic depressive episode was more acceptable than long-standing mood instability. I learned not to talk about intergenerational trauma or self-injury or delusions. I went to college. I got a job. I developed better impulse control in public. I learned how to appear to others as a normal, sane, functioning individual (which is different from actually being a normal, sane, functioning individual). And every time I messed up, every time I let something slip, I internalized the other person’s reaction: the awkward silence, the shock, the condescension.

But then something interesting happened. My son was born, and I discovered that when I mentioned his birth defect to people, they reacted exactly the same way. Even though it was a purely physical condition they could see for themselves, my speaking openly about it made them uncomfortable. They scowled. They fell silent. They looked away.

I now understand, after years of surging self-hatred every time I recalled the high-school incident, that my teacher’s reaction was formed by social prejudice and that I had no reason to be ashamed. I understand this intellectually, and yet I feel uncomfortable writing about it even on an anonymous blog. The social process that tells us what is acceptable and what’s not, that pushes madness and sickness and just plain difference underground, that makes so many people unwilling to seek help, is very effective. Emotionally, I haven’t overcome that internalized stigma.


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