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Stigma And Mental Illness


CSI doesn't provide a real balanced view of those with mental illnesses

One of the best parts of speaking at the Pacer Symposium was that I got to meet and hear two other wonderful speakers. Dr. David Golbloom gave a talk on the stigma of mental illness that gave me a lot to think about. Today I want to share the gist of it with you, particularly some of the questions he asked us to think about.

If the presentation gets archived I will post a link to it. It was worth hearing.

This man was so smart that he made the word erudite seem inadequate. Here are some of the points he made.

Physical illness makes heros

He asked us of an experiment where subjects were taken into a room and asked to leave their political correctness behind. During a timed interval they were asked to shout out as many words as possible to describe someone with a mental illness.

The results were predictable to him. Lunatic. Crazy. Sick. Twisted. Schizo. Nuts, etc.

When a similar group was asked to perform the same exercise describing a victim of cancer, the results were words like:

Brave. Courageous. Tough. Perservering.

Very interesting. It suggested that someone with a severe physical illness was someone to be admired,while someone with a mental illness or disordered was someone to be feared. Someone stigmatized.

Are you still you?

Dr. Goldbloom suggested that much of the stigmatization of those with mental illnesses is rooted in fear. He used this example:

“If your leg breaks, you are still you. But if your mind breaks…are you still you?”

I worked as a job coach for a year. I was horribly unqualified, just like all of the other workers there who were making $10 an hour. We were basically drivers for people with disabilities. I personally worked with people whose conditions ranged from severe cerebral palsy to extreme adult onset schizophrenia.

My job was to try to help them find jobs they could interview for, help them prep, take them to the interviews, and if they were able to land a job, to work with their supervisors to make reasonable accommodations and help them succeed.

I won’t lie. I was extremely unnerved by some of the conversations I had with the people with schizophrenia. Many of them were articulate and intelligent, and could describe their alternate realities to you in as much eloquence and detail as anyone can describe anything.

They just weren’t real, and I never knew exactly what part I was playing in their worlds. For instance, once I went to check on a client who had been doing quite well. I was told that he had bonded with me and looked forward to my visits. I had no idea if this was true, but it was nice to hear.

I walked in and said hi to him while he was on the job. He turned and swung a lunch tray at me with all the force he could. He screamed “You f***** my girlfriend!”

1) This was not true. I hadn’t.

2) He didn’t have a girlfriend, but on that morning, he was somewhere else in his mind, and I had wronged him grievously.

On that morning at least, from where I was standing, he was not the person I had worked with. From then on, uncertainty loomed behind every interaction we had. I could never quite feel that he wasn’t about to hit me. I never again felt like I knew what he was thinking.

It wasn’t his fault. That was the mind he had. It wasn’t my fault for being unsettled by it and not wanting to be attacked. I know that there is a balance. That there are tools to help professionals deal with that and to know the signs. We weren’t professionals.

Violence and mental illness

“If it bleeds, it leads.” If you follow the news, you probably believe this. Horrific, violent acts saturate the media. If you didn’t know any better, you might think that every single child gets kidnapped at least once, it is impossible to go on a date without getting kidnapped and assaulted, everyone’s next door neighbor is simply waiting for the right moment to visit in the night…

Dr. Goldbloom stated that CSI is the most-watched program in the world, between its current and syndicated episodes. “What does CSI teach us about people with mental illness? Monsters to be feared.”

I did not catch the study Dr. Goldbloom cited, but I wrote down the numbers.

“If you could snap your fingers and eliminate all violent crimes that were the result of a mental illness you would still have 96% of the crimes left to deal with in the United States and Canada. This is an incorrect starting point, but nobody seems to know that. Television and the news are not helping disabuse us of that notion.”

If you are interested in a more in-depth (and more humorous) look at what currently passes for the news cycle, I highly recommend Drew Curtis’s book It’s Not News, It’s Fark.

A few more thoughts

I can’t imagine how frustrating it must be to serve effectively as an advocate for those with mental illnesses. Saying it’s an uphill battle doesn’t really do it justice.

I would predict that in any given day at work at the public library, I deal with 20 people with a diagnosed mental illness. Most are homeless, most are willing to talk about it openly, and most feel that there is no help for them. Many have told me that they are aware that their behavior frightens people at times.

What a challenge on both sides. They can’t snap their fingers and reverse their conditions, and their advocates can’t simply go around and tell everyone not to be scared of behaviors that can actually be quite frightening.

I would love to hear thoughts or different perspectives on this, particularly if you, a loved one, or your profession are involved with mental illnesses.


Brains need strength training, just like bodies.

Comments on this entry are closed.

  • Jeanette Swalberg August 12, 2011, 9:21 am

    …and those 20 folks you helped probably equaled four percent of the folks you assisted that day…lol

    Seriously though, I can believe these numbers. I think if you did an unofficial study of library patrons throughout the library system you would find this ratio is pretty accurate. You might find yourself assisting a larger number of patrons with mental illnesses, but then the patronage of your library is much larger than one of the “outlying” branches.

    The lesson here is that mental illness affects everyone, and because there isn’t a cast, or a “cancer hat”, we don’t know that some assistance may be needed. Just look at the recent stories in the news about tragic interactions between police officers and mentally ill individuals. While I don’t have any answers, this is definitely The Topic of our (and our children’s) generation.

  • Heather August 12, 2011, 9:50 am

    As someone who suffers from depression, and as someone who was married to a depressive whose friend was also a schizophrenic, I know what you’re dealing with there in your library. I found the best way to handle episodes was to try and talk to them, try some logic, and keep telling them to take their medication if they were being treated chemically for something. Personally, I don’t watch stuff like CSI or SVU or Law & Order (or as I call it, Long & Boring). I don’t like the way they protray poor people, black people, Italian people, or any other minority that Hollyweird tries to criminalize just because they aren’t white middle-aged bald guys who run things. I’m pretty much anti-Hollyweird. Paris Hilton and her ilk do nothing for me, other than make me angry. Guys like Pavel, however, now they ROCK!

  • Emily August 12, 2011, 6:54 pm

    I really loved this post.

    As a girl who has battled her fair share of both physical and mental illnesses, I can attest that one doesn’t make you more heroic than the other.

    I have an extreme form of dysautonomia, and I spent 8 months of my life in a wheelchair- not being able to stand up for more than about 10-12 seconds without fainting. Not to mention the years that I have spent going in and out of the hospital, trying to find a cure.

    I have also battled anorexia nervosa. I can’t even begin to explain how terrible it is to have your mind tell you how awful of a person you are on a daily basis. In all honesty, I actually think that anorexia is worse than dysautonomia, because your mind tricks you into thinking that it is something that you want.

    This all being said, I’m very open about my battles with dysautonomia; I’ve volunteered for multiple organizations and told my story to a lot of people in attempts to spread awareness. People usually respond to my story with “wow, you’re such an inspiration” or “you are so strong and optimistic.”

    However, I’m not open with my struggle with anorexia. In actual fact, anorexia nervosa affects less than 1% of the population, but its portrayed as some selfish cry for attention amongst vain teenage girls. You’re not strong for battling anorexia, instead you’re stupid; why wouldn’t you just eat!?

    Lately I’ve been trying to be open and honest about both of my illnesses. Neither is more noble than the other, and they are both something I didn’t ask for. It’s not my fault that I got dysautomia, just like it’s not my fault that I got anorexia. There really shouldn’t be a stigma.

    • Josh Hanagarne August 14, 2011, 8:47 pm

      Thanks Emily. I’m happy you’re making progress. Good luck with everything.

  • ummati August 13, 2011, 11:06 am

    Hi Josh,
    I find your blogs very interesting.

    In the last 5 years of my life (i am 26 now), unknown to me, i developed a serious, life disturbing, and life threatening mental disorder.

    Its a relatively unknown form of Obsessive Compulsive Disorder, known as Primarily Obsessional OCD (PO OCD)

    In it a person is unable to control the repeated coming of violent, blasphemous and sexual thoughts. Think i must be sick person? Thats ok :).. thats what i thought for a long time.

    Anyways, they’ll keep on coming repeatedly in a flash in your mind, over and over again. The more they worry you, the more you loath and hate them, the more you fight them, the more they will come.

    PO OCD is triggered by stress and not by being a sexually sick person. Its onset is gradual, happening once in a week/month for a few hours and is finally triggered by stressful event that causes PO OCD to become full blown, a constant 24/7 nightmare.

    It brings along with it depression, anxiety and stress, perhaps for this reason alone that your normal sane mind has turned into a nightmare so obscene that you think that you are worst of humanity walking on earth.

    I am practicing muslim, praise be to God for it.

    Reciting the Quran, praying five times a day, attending religious events, talking to my mother, father, my sister and brother became a nightmare. Every waking moment was filled with such thoughts.

    For 5 years i believed that i was a horrible and sinning person. For 5 years i tried very very hard to block those thoughts but nothing worked.

    I was a normal college student. An above average student. I used to be full of life, confident and vibrant. (Praise be to God, after being cured i am full of life now, full of dreams, goals that i want to achieve, i am alive again 🙂 )

    The nightmare in my mind crippled me in a way that person without a mental disorder can’t imagine.

    The thing with primarily obsession OCD is that unlike mental illnesses schizophrenia, anorexia, other forms of OCD which involve actions like checking, hoarding things, which usually lead to certain abnormal behavior, in PO OCD its all in the mind. So family members, friends, colleagues are usually absolutely clueless.

    But in Primarily Obessional OCD, there are no apparent sign of madness, of mental illness. Outwardly the person seems normal, just constantly down and out. There are no hallucinations, no voilent urges to act or commit any of those acts. There is a deep and disturbing dislike for those thoughts and those actions.

    PO OCD is all about silent suffering, silently dying inside without your parents even know what a nightmare your child is having. A nightmare that doesn’t end when your eyes wake up in the morning. Its perpetual pain, suffering, depression, anxiety, and stress. All in the mind.

    And with no one to tell you that what you have is mental disorder and that its completely curable, praise be to God, the Merciful.

    Even if you sense that something that its not your fault, that something abnormal is happening to you, its nature is so shameful that you won’t even tell anyone the cause.

    Can you imagine a person telling his or her father that when i talk to you for a minute my mind is flashed with a thought of your throat being cut? Or something sexually appropriated? No. You can’t. The pain is too great.

    People with primary obessional OCD are not a danger to others, but they can become a danger to themselves!

    The level of depression and stress at having such thoughts always in the mind can destroy a person and make them think that there is no way out and consider suicide.

    The worse thing that a person can do (and which everyone with PO OCD does until they know PO OCD and understand it ) is to say that its their fault. That they must be sick in some way that they had those thoughts.

    Please let me tell you, its not. These thoughts are not in their control. They suffer every day at being unable to control these thoughts.

    They feel no joy at the sexual thoughts, the religious, or the blasphemous, its just a pain that keeps on growing.

    To anyone out there.

    OCD is completely curable disorder.

    I am completely cured in sense that OCD as an active agent is not a part of my life.

    The first most important step to being cured was to know that it wasn’t my fault!

    Just like someone develops liver failure, heart failure, cancer, so too a part of my mind can started to malfunction.

    Mental disorders are a reality just in the same way physical disorders are a reality. And just like a person can not cure himself of diabetes without understanding the disease, the cure, taking the cure and then ensuring preventive measure, so too you must first accept that you (if you have one) have a mental disorder and then:>>

    Go to psychologist. Understand you disease. Work with your doctor.

    Recognize that something is malfunctioning, recognize the correct cause of the problem. Work on that cause.

    Its simple. Recognize the problem. Once you know the problem, now you can work on finding the solution.

    The real trouble comes in the case of self denial and stigma attached to mental disorder, you probably won’t go to a psychiatrist until you see absolutely NO way out, and you are left with no choice but accept that something is seriously wrong, and that self-denial despite shame, is not going to take me any where.

    Don’t risk your beautiful at the thought of shame of telling your psychiatrist whats the problem. If you do, you are brave person, and you be proud of yourself!

    OCD is a life long disorder, BUT if a person deals with it, it CAN be controlled and KEPT at bay for your ENTIRE life, God willing.

    The TRICK is to understand the monster. To KNOW how to tame it, and to KNOW what unleashes it.

    YOU are NOT the monster, its a mental disorder.

    The taming lies in the cognitive understanding that its not your fault. Take your medication. Don’t fight your thoughts. When you know that you are not responsible for them, treat them as they deserve: not worth your notice. Let them come and go. When you don’t give something attention, it will fade away.

    Thats the nature of OCD, the more you fight, the more those thoughts would come, they are not worth the fight.

    Understand your human mind, you can’t stop a sudden thought from coming. Once its there you can decide how to deal with it. The choice is in whether to take stress or not.

    If you take stress and fight it, it would turn into a vicious self- amplifying cycle.

    If you tell yourself that i know that this is not my fault, its a mental illness, and let it go, it will fade away.

    Stress can bring it back complete, fullblown. I know techniques to help me deal with it such that after a few hours those OCD symptoms go away. My success, if God wills, in dealing with OCD will depend on my success in becoming very good in handling stress in my life.

    I have 3 books on OCD which i read to make sure that i work on my weaknesses such as an inability to handle stress. I feel no fear, but a sense of confidence, that now i whats the problem. Previously there was just darkness and confusion. And now, praise be to God, i know what wrong, and i can go about setting it right! 🙂

    To anyone out there, reading this comment, who wants help or advice. I am not professional psychologist, but i am human being who went through a painful experience, and perhaps if what you suspect are dealing with is PO OCD, i might be able to give you support.

    If thats the case, please contact me at abd.wa.ummati@gmail.com

    Remember, you are worth a joyous life, you are worth making it through any dark tunnel that you enter. Don’t ever give up. You are worth it, and PO OCD is not.

    Josh, this comment was meant to be comment, sorry i got emotional, but i really want to help, because most likely people with PO OCD are not even going to accept they have PO OCD or take help until matters become extreme.

    Please don’t do that. Its really not your fault. Seek treatment, you WILL be cured, God willing.

    • Josh Hanagarne August 14, 2011, 8:47 pm

      No problem, I hope someone gets something out of what you said.

  • Casey (North and Clark) August 15, 2011, 8:33 am
  • Susan Garvey August 15, 2011, 9:05 am


    Thank you so much for your post today. I’m a person who suffers from chronic depression, something that’s plagued me for most of my life, but was diagnosed about 19 years ago. About 3 years ago, I hit the worst low ever and this was during a time when I was on regular medication, seeing a therapist – all the things that should have helped. Although I didn’t consider suicide at the time, I knew that if things persisted the way were, it was something definitely in the not-too-distant future because life held no hope for something better.

    I remember feeling so lonely and misunderstood because there is very little support or understanding of even a “routine” mental illness like chronic depression and how devastating and difficult it can be to go through just the most simple day to day matters. I ended up being on disability for about two months while attending a day program, something I lovingly call “depression day camp.” While I was supported quite well by my therapist and the counselors in the program, but for my kids,no one else knew. We mentally ill people try very hard to hide our problems from other people. In fact, not being able to ask for help was part of my problem.

    To make a long story short, I felt very frustrated and saddened by the fact that if I had an outward, identifiable illness, I would have been supported like crazy – people bringing dinners, helping me out, sending me cards, making supportive phone calls. Instead, I soldiered on alone for the most part and that loneliness, isolation and lack of caring just adds to the problem.

    I’m doing better now, have learned that “this too shall pass” but have never really gotten over the resentment that I feel I have to “hide” my illness from most of the world, but for a select few or people I pay to listen.

    Thanks for letting me vent and for bringing this information to light.

  • Tammy August 22, 2011, 4:08 am

    I wish there were more informational shows on tv educating the public on mental diseases and disorders instead of ” the crazy side kick” or the ” crazy nemesis”. It really doesn’t help with the already poor idea people have of mental illness. Because it is ” all in my head” so to speak. Many people treat it as something that can just be turned off like a bad thought and the sufferer is in control or can control it if they wanted to.
    I am a LONG time agoraphobic. Im listed as severe. I’ve not left my home in approx 12 years with the exclusions of a few outtings here and there but only with my good friend or my husband. I dont feel secure or safe with anyone else ( i do have a dependant borderline personality disorder). I was in treatment with a psychologist for cognitive therapy for YEARS as well as psychiatric treatment and HEAVILY medicated (which seemed to be the only course they deemed fit for me with the panic attacks being so severe associated with the agoraphobia) mind you being medicated to the point of being awake less than 8 hours a day SUCKED especially as a parent of a teenage child at the point i developed the agoraphobia and panic attacks. For the most part i am completely fine, coherent, myself so to speak
    (when im in my own home). But when introduced to new people i get anxious and babble ( im frequently labeled as scatter brained or an airhead. I do have a college degree but people would never realize it im sure lol). I am able to visit my siblings, nieces, nephew and my parents on “good days” with my husband and i say im not well when its a particularly tough day. During a rather hard time bordering suicidal i reached out to my family for help ( for the first time ever letting them see the “real” me) and that was the WORST mistake of my life. Now they wont speak to me, they gossip behind my back about how ” crazy” i am. I’ve been told to just get over it already! Its all in your head! Having mental illness is the loneliest thing to endure. Ive had many conversations with my husband about the same things you stated in your article. How can my brain being sick be any different from being sick of the body. I never ASKED to be this way so why do i get treated like i WANT to be sick? the highlight of this whole illness and the most beautiful words ever spoken to me since this all started. After a lengthy anxiety attack ( it lasted well over a day non stop) My psychologist had me to the local hospital ( it has a psych er wing) he called ahead so they would be waiting for me to give me something ( more or less antihistimine type meds). As the nurse was leaving my exam room after initial exams she peeked her head in and said 3 words. I swear it felt so AMAZING just to hear it especially from a psych nurse. ” You’re not crazy”, then she smiled and headed off to hand the info to the doctor! That was nearly 10 years ago and to this day that is the best thing ANYONE has ever said to me.

    As for the question Am i still me? Well for the most part i am still me on good days. Im happy, goofy, silly, articulate, loving. On bad days i am still me. Its just trapped inside i feel it there it just cant get out. Sometimes when the bad moments or bad day ends its just an embarrassing fog or dream fragmented in my mind. Its like coming out of a deep dark tunnel and everything becomes louder, more vivid more clear like coming out of anesthetic then you know its going to be ok.