Where does stigma come from? I’m sure there are answers and possibly more theories. I believe some stigma is the result of the assumptions we have of human behavior. To a degree in the west we believe that people have direct control over their fate and get what they deserve in life. (The Just World Hypothesis) To view poverty, hunger, oppression, illness and abuse as arbitrary is disconcerting. We have all heard the ignorant suggest that those who live in countries susceptible to famine should simply move. They assume their good fortune at being born in a democratic and wealthy nation was somehow personally determined. You are responsible for this as much as you are responsible for your height or eye colour. We like to know the cause of illness. To believe illness is indiscriminate not only goes against our worldview but it threatens our ideas of personal power and self-determination. Westerners are uncomfortable with powerlessness. Consider the lengths we go to battle male baldness. There are entire industries built to combat physical attributes. Acceptance equals defeat for some.

Westerners also value individualism. We value independence above all else. As such we assume individuals who have mental health problems can overcome their symptoms with nothing more than willpower. It’s all in your head is it not? The idea of responsibility I would argue is more pronounced in mental health than it is with physical health. We would be considered callous if we told the cancer patient to “pull up your socks.” The depressed person on the other hand is often told to snap out of it.

Is it possible that stigma is fear of a perceived threat; a threat to our person but also to our worldview. If mental illness is without cause it threatens our beliefs and elicits fear. It could be argued that as mental health consumers we are exposed to both the “flight” and “fight” responses to fear. We are avoided and segregated; even ostracized (“flight”) and we are often ridiculed (“fight”).

I am unsure of how to combat stigma but in overcoming fear, exposure is often employed. If those who have no experience with mental illness opened their hearts and minds to us they will be exposed not to a pathogen but to a human. As more people step forward, hopefully more will stand back and see us as human. As my Occupational Therapist is fond of pointing out “they” like ice cream too!