Tuesday, 5 August 2014

another @rcpsych stigma piece 'Too similar, too different: the paradoxical dualism of psychiatric stigma'

'Too similar, too different: the paradoxical dualism of psychiatric stigma' by Tania Louise Gergel, King's College London, Psychiatric Bulletin, August 2014:
 

Abstract:
"Challenges to psychiatric stigma fall between a rock and a hard place. Decreasing one prejudice may inadvertently increase another. Emphasising similarities between mental illness and ‘ordinary’ experience to escape the fear-related prejudices associated with the imagined ‘otherness’ of persons with mental illness risks conclusions that mental illness indicates moral weakness and the loss of any benefits of a medical model. An emphasis on illness and difference from normal experience risks a response of fear of the alien. Thus, a ‘likeness-based’ and ‘unlikeness-based’ conception of psychiatric stigma can lead to prejudices stemming from paradoxically opposing assumptions about mental illness. This may create a troubling impasse for anti-stigma campaigns."

Snippets:
"Challenges to psychiatric stigma fall between a rock and a hard place. Decreasing one prejudice may inadvertently increase another.  Emphasising similarities between mental illness and ‘ordinary’ experience to escape the fear-related prejudices associated with the imagined ‘otherness’ of persons with mental illness risks conclusions that mental illness indicates moral weakness and the loss of any benefits of a medical model.  An emphasis on illness and difference from normal experience risks a response of fear of the alien.  Thus, a ‘likeness-based’ and ‘unlikeness-based’ conception of psychiatric stigma can lead to prejudices stemming from paradoxically opposing assumptions about mental illness. This may create a troubling impasse for anti-stigma campaigns."

"The root of attitudes such as blame may lie in stigma based on another equally disturbing view, which we might term likeness-based stigma and which stems from the idea of similarity and a view of mental illness as infirmity of character rather than legitimate illness. Whereas unlikeness-based prejudice suggests that mental illness is a defect in the very qualities which define a normal human being, likeness-based stigma implies a problem that is moral rather than substantive or biological - that those with mental illness share the same biological and environmental factors as others, but lack the strength of character to deal with them."

"it is hard to imagine a psychiatric intervention underpinned by a more neurological model than psychiatric neurosurgery"

Read complete article


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