The Stigma of Mental Illness

[First Published on www.Rick Thomas.com]

Unless you have been living detached from electronics in the past five years, you are well aware of the many campaigns to “destigmatize mental illness.” The American Psychiatric Association—along with Big Pharma and advocacy groups (who are largely funded by drug companies)—has presented countless “destigmatize mental illness campaigns” as altruistic efforts to help those with mental and behavioral struggles. These groups insist that society has a wrong view of and approach to those who are “abnormal”, but what is actually stigmatizing is labeling people as abnormal and setting them aside as disordered. The stigma of mental illness is really a battle over defining normalcy, categorizing people, and influencing personal identity.

While psychiatric labels are posited as helpful and necessary, many times those labels cause further damage[1] and create the very stigma advocates claim needs to be eliminated. In fact, being labeled as abnormal in itself stigmatizes individuals, since it unjustly delineates people into subjective groups. The historian Roy Porter explains,

Stigmatizing—the creation of spoiled identity—involves projecting onto an individual or group judgments as to what is inferior, repugnant, or disgraceful. It may thus translate disgusting and fears into the fearful, first by singling out difference, next by calling it inferiority, and finally by blaming ‘victims’ for their otherness. This demonizing process may be regarded as psychological driven, arising out of deep-seated and perhaps unconscious needs to order the world by demarcating self from other, as in the polarized distinctions we draw between Insiders and Outsiders, Black and White, Natives and Foreigners, Gay and Straight, Pure and Polluted, and so forth. The construction of such ‘them-and-us’ oppositions reinforces our fragile sense of self-identity and self-worth through the pathologization of pariahs.[2]

Herein rests one of the problems the secular paradigm cannot escape: to be diagnosed as mentally ill is to be categorized as abnormal. Former chair of psychiatry at Duke University and chair of the DSM-IV task force, Allen Frances, remarks:

Being “normal” and fitting in with the pack are a key to survival. Evolution has wired into human nature an uncharitable wariness and lack of compassion for those who are different and don’t satisfy tribal standards. Having a mental disorder label “marks” someone in ways that can cause much secondary harm.[3]

Former professor of psychiatry at Harvard Medical School and NIMH consultant, Peter Breggin, also comments on how labels “mark” or stigmatize people from an early age and shape their identity:

Psychiatric labeling inflicts additional humiliation and injury on already damaged children. It can rob them of all self-esteem, shatter their identity among their peers, and relegate them to inferior status in the eyes of parents and teachers. Often the stigma remains for a lifetime.[4]

Psychiatric labels that categorize people as abnormal for behaving normally are damaging and isolate people with genuine mental and emotional needs. While there is a tremendous effort on the part of secularists to remove the stigma of mental illness, the stigma exists not because of society’s perception, but because the very nature of the current construct of mental illness creates it.

Labels have a benefit, but not to the one who is labeled. For those who categorize people, labels can offer a false belief that “I’m ok and you’re not.” Porter explains,

Setting the [mentally] sick apart sustains the fantasy that we are whole. Disease diagnosis thus constitutes a powerful classificatory tool, and medicine contributes its fair share to the stigmatizing enterprise. Amongst those scapegoated and anathematized by means of this cognitive apartheid, the ‘insane’ have, of course, been conspicuous.[5]

What Porter rightly expresses is that every system that ostracizes, labels, and scapegoats others best serves those who have been granted the authority to label and categorize people.

There is also a great financial benefit for stigmatizing people. The Citizen’s Commission on Human Rights remarks,

With a seemingly altruistic agenda, the fact is the campaign to end the “stigma” of mental illness is one driven and funded by those who benefit from more and more people being labeled mentally ill—pharma, psychiatry and pharmaceutical front groups such as NAMI and CHADD to name but a few. For example, take NAMI’s campaign to stop the “stigma” and “end discrimination” against the mentally ill—the “Founding Sponsors” were Abbott Labs, Bristol-Myers Squibb, Eli Lilly, Janssen, Pfizer, Novartis, SmithKline Beecham and Wyeth-Ayerst Labs. So next time you see an ad promoting “stop the stigma” see it for what it is, a pharmaceutical marketing campaign.[6]

Labeling someone as mentally abnormal and stigmatizing them for being normal affords those in authority financial gains and a false sense of security that they are okay while others are not.

What if being labeled as mentally ill, though, is indication of normalcy and not abnormality? For example, a child’s hyperactivity is considered to be an abnormality by the APA. But hyperactivity—another word for high energy—and lack of self-control are normal in most children. Furthermore, high energy is highly sought after and does not constitute an abnormality. If no standard of normal energy is established, then why stigmatize children for having a character trait that will surely benefit them as they learn self-control?[7]

Furthermore, labels often create a self-fulfilling prophecy. By characterizing people as abnormal, mental turmoil is created where none existed before. Telling children that they are disordered and will be the rest of their lives regularly has a devastating effect on children and encourages them to fulfill expected psychiatric roles. Dr. Frances explains,

Labels can also create self-fulfilling prophecies. If you are told you are sick, you feel and act sick, and others treat you as if you are sick. The sick role can be enormously useful when someone truly is sick and needs respite and care. But the sick role can be extremely destructive when it reduces expectations, truncates ambitions, and results in a loss of personal responsibility.[8]

Psychiatric labels too often establish a new identity for the one labeled. In fact, many who are diagnosed begin to find their identity in their new label/alleged disease over any other characteristic—commonly stating that “I am bipolar, schizophrenic, or depressed . . . .” Mental health professionals try to keep the mindsets, emotions, and behaviors represented in psychiatric diagnoses from being perceived as character issues, yet those labeled regularly identify their own character by psychiatric nomenclature. Still others are self-diagnosing and creating a new type of self-fulfillment based on social narratives.[9] Psychiatrists Til Wykes and Felicity Callard explain:

Both the meanings that people attach to the feelings and behaviours they are experiencing, as well as societally sanctioned explanations for these feelings and behaviours play an important role in shaping people’s ways of embodying a psychiatric diagnosis. Consider, for example, the recent report of a new phenomenon: patients in Britain approaching psychiatrists with self-identified bipolar disorder. This suggests that, despite the ongoing and pervasive stigma attached to a “severe mental illness” diagnosis, individuals are beginning to understand as well as self-describe some of their own patterns of behaviour and emotional variability as a list of symptoms that – when gathered together – make them people “with bipolar”.[10]

Labels are sometimes helpful, but more often than not they are powerful tools to gain authority, to create dependence, to stigmatize people, and to change beliefs and identities.

As Christians, we have been given the only label and identity that provides freedom from mental turmoil. We are by God’s grace, mercy, and ransom identified in Christ and no longer the “enemy/hater of God.” Paul says in Colossians 1:21-23,

And you, who once were alienated and hostile in mind, doing evil deeds. He has now reconciled in his body of flesh by his death, in order to present you holy and blameless and above reproach before him. If indeed you continue in the faith, stable and steadfast, not shifting from the hope of the gospel that you heard, which has been proclaimed in all creation under heaven, and of which I, Paul, became a minister.

Every person’s mind is naturally hostile and alienated from God, which as Paul points out, produces bad behavior. What is typically stigmatized in mental illnesses are our common human mindsets and behaviors—both moral or amoral. We are all mentally ill (Jeremiah 17:9) apart from Christ and not just a few. Being found in Christ begins the process of restoring our minds (Philippians 2) and transforming our behavior (Romans 12:1-3).

Not only is bearing the name and having the mind of Christ positively life changing, but it also leaves no one behind. Scripture presents us all as broken and frail when compared to Christ—the perfect standard of mental health/normalcy. Having this understanding leads us to acknowledge the reality that we all have mental impairment and fragility—not just a few.

The American Psychiatric Association’s attempts to imprecisely/subjectively define mental illness in the DSM-5 as something that is “characterized by clinically significant disturbance” in mind, emotions, or behavior.[11] But Scripture declares us to all be both depraved and fragile. Add to this truth the fallen condition of the world, which is incredibly distressful, and we are a people of constant mental turmoil and impairment. In other words, we are all—not just a few—mentally ill. The renowned psychiatrist, Karl Menninger, asserted in the mid 1950s that,

Gone forever is the notion that the mentally ill person is an exception. It is now accepted that most people have some degree of mental illness at some time, and many of them have a degree of mental illness most of the time.[12]

The Dutch humanist philosopher, Desiderius Erasmus, said in 1509,

I doubt if a single individual could be found from the whole of mankind free from some form of insanity. The only difference is one of degree. A man who sees a gourd and takes it for his wife is called insane because this happens to very few people.[13]

Whether from the Biblical perspective or from the secular position, we are all in need of having our minds restored. The only way that we can destigmatize mental illness is to accept God’s view of humanity and receive a new identity through Jesus Christ.

The apostle Paul found comfort that though he was frail, his identity in Christ through grace brought him hope and freedom: “But he said to me, ‘My grace is sufficient for you, for my power is made perfect in weakness.’ Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me” (2 Corinthians 12:9). Gospel—centered thinking acknowledges our weakness and rejoices in the good news. Paul was able to accept his fragility by depending upon God’s grace. Likewise, Paul reiterates in verse 11 that we are all on the same playing field: “For I was not at all inferior to these super-apostles, even though I am nothing.” We are all on the same level; no one is inferior, and when compared to Christ, we are all nothing. Yet, in Christ, God has graciously made us priests, kings, and His sons/daughters . . . Next time someone brings up the idea of destigmatizing mental illness, graciously lead them to the gospel, which declares that we are equal—desperately needing Christ to change our minds, restore our souls, and transform our behaviors.

Notes and Citations:

[1] Allen Frances, Saving Normal: An Insider’s Revolt against Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life (New York: HarperCollins, 2013), 252.

[2] Porter, Roy. Madness: A Brief History. New York: Oxford University Press, 2002), 62-63.

[3] Frances, Saving Normal, 109.

[4] Breggin, Toxic Psychiatry (New York: St. Martin’s Press, 1991), 291.

[5] Porter, Madness, 63.

[6] Citizens Commission on Human Rights, “Psycho-Pharma Front Groups,” https://www.cchrint.org/issues/psycho-pharmaceutical-front-groups/.

[7] For further study on hyperactivity and self-control, see Daniel R. Berger II, The Truth about ADHD (Taylors, SC: Alethia International Publications, 2017).

[8] Frances, Saving Normal, 109.

[9] Diana Chan and Lester Sireling, “I want to be bipolar”: A New Phenomenon, Psychiatrist, 34, no. 3 (March 1, 2010); 103–105.

[10] Wykes and Callard, “Diagnosis.”

[11] Wykes and Callard, “Diagnosis.”

[12] Karl Menninger, The Vital Balance: The Life Process in Mental Health and Illness (New York: Viking, 1963) 33.

[13] Desiderius Erasmus, Praise of Folly (1509), chapter 38. See also Rosemarie Jarski, Words from the Wise: Over 6,000 of the Smartest Things Ever Said (Skyhorse Publishing, 2007), 312.