• Mental illness and stigmatization


    (Note: This week’s piece has been written by guest columnist Soong Phoon.)

    Mental illness was formerly perceived and interpreted as “madness.” But what is “madness” really? Don’t we all go a little ‘crazy’ at some point in our lives? Don’t we all get a little “sick” at some point? Don’t we all get a “disease” during our lives? It’s inevitable, because we are all subjects that inhabit a vulnerable and variable human body. I deliberately use these politically incorrect terms, because it’s important to interrogate the binary opposition of “normality” and “abnormality,” which perversely, still seems to persist.

    I am bipolar. I was discharged from a psychiatric unit exactly four weeks ago, after an eight month and one day admission in ICU. I was admitted following a suicide attempt, having been profoundly depressed and what “they” (the medical community) defined as psychotic, treatment resistant depression due to the rigidity of my fixation on suicide. I received 36 treatments of ECT (Electroconvulsive Therapy—yes, they still use it, but it is very different; safe, controlled, nothing like the way it is depicted in films and one of the most effective treatments for depression), 22 infusions of ketamine (Special K!) and was trialed on a truckload of various medications. Having said that, why does it feel like I just “came out?” It could be attributed to the fact that the first four sentences were all statements beginning with “I”—sheer narcissism?—or; it could be due to the fact that there is still an immense, all pervasive stigmatization and shame surrounding the entire spectrum of diseases that are categorized as “Mental Illness.”

    Why is this the case? How are depression, schizophrenia, borderline personality disorder, psychosis—the list goes on and on—different from leukemia, asthma, the measles and pulmonary heart disease? Why are afflictions that impact the brain, essentially a chemical imbalance, so stigmatized? Isn’t the brain a part of the body? The separation between mind and body was a Cartesian construct from the 17th century and a foundational development in Western philosophy. But in response to that distinction, which absurdly continues to exist in the public eye, why is there no stigma surrounding disorders like Parkinson’s and dementia, which also affect the central nervous system? In fact, the term “dementia” is derived from the Latin “demens,” which translates to ”insane, mad, out of one’s mind.”

    So many questions, so few answers. The only explanation I can think of is that mental illness manifests itself behaviorally, rather than physically, which can be more difficult for those observing and on the receiving end of this behavior to process. But, in response to that, Alzheimer’s also has behavioral symptoms, such as irritability, delusions and unwarranted suspicion. Problematically, the symptoms of illnesses like schizophrenia can be hallucination, hearing voices and incoherent speech. Mostly anyone would just say: “whatta psycho!” But these are neurological problems, occurring in the brain, which I shall continue to insist, is part of the body. These behavioral expressions of a mental state require empathy, understanding and most importantly, education. In my very first depressive episode at the age of 13, perhaps my sudden introversion, lethargy, and refusal to leave my room seemed “weird” and “inexplicable” to some people, especially my parents. Apparently, I just looked “dead-eyed.” The worst part of this, was that I was at Disneyland; the “Happiest Place On Earth!”

    Formerly, I was under the impression that depression was quite mainstream, accepted and understood. A New Zealand celebrity, Charlotte Dawson, who struggled with depression, recently took her own life. Only three days later, an appalling article, which attributed her suicide to the affliction of excessive vanity, was irresponsibly written by Deborah Hill Cone in an accusatory, second person mode of address. The article itself, published in the national newspaper, as well as some of the commenters, demonstrate the incapacity of many to understand and empathize with the intense despair, sorrow and anguish that those suffering from depression experience. Instead, it operates to trivialize a legitimate illness, perpetuates the stigma and systemic discrimination surrounding mental disorder and explains the shame that many feel for having a clinically diagnosed illness. It demonstrates the role that the media oftentimes plays in intensifying the stigmatization and stereotypes associated with mental illness; particularly, films like One Flew Over the Cuckoo’s Nest and Girl, Interrupted immediately come to mind. Don’t get me wrong; a few of these movies are great. But in the psychiatric ward, I encountered numerous patients that kept their ailment a “secret,” because “people just don’t understand.” Some people do, some people don’t. But everyone should.

    In Madness and Civilization, Foucault examines the history of madness, suggesting that the “mad person” was an invention of the Age of Enlightenment that legitimized the incarceration of individuals that society deemed “undesirable.” The medical gaze, the media, and some segments of the public continue to judge those that exhibit behavioral problems, as “unacceptable” in the same way. Stigma arises from discrimination, from condemnation, from intolerance and an absence of empathy and compassion. It is an exclusionary practice.

    Why is this done? Why do those that stigmatize the behavior of the “mentally ill” do so? Foucault also examines the odd distinction between “unreason” and “madness.” Isn’t stigmatization a mode of unreasonable behavior? And thus yet another mode of undesirable behavior? And if it is undesirable, according to Foucault, doesn’t that make it a mode of “madness” in itself? In psychoanalytic terms, those that stigmatize are engaging in self-soothing; a type of autoerotic regression that aggressively projects itself onto the “sick” out of fear, and isn’t that an inherently sick act?

    Perhaps stigmatizers themselves should be confined and educated. Foucault himself was critiqued and experienced exclusionary behavior as a homosexual, when homosexuality was perceived as an “illness.”

    Foucault writes: “People know what they do; frequently they know why they do what they do; but what they don’t know is what what they do does.” Ultimately, the question is; what kind of humans do we want to be?

    Soong Phoon is an MA graduate n English Literature from the University of Auckland, NZ and is a broadcaster on 95bfm.com

    Nicole Del Rosario CuUnjieng is a PhD Student in Southeast Asian and International History at Yale University


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    1 Comment

    1. Patricia Teoh Kim Seing on

      Congratulations to Soong Phoon for “speaking up” in this article. Its a way to weed out stigmatizing mental illness patients and those who have recovered. Lack of knowledge or understanding is one of the main causes of stigmatization.