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What is shame? The painful feeling of humiliation or distress that comes from the sense of being or doing a dishonorable, ridiculous, or immodest thing; the feeling that we are less than, unbefitting, or undesirable.
What causes shame in mental disorders? History, education, culture, the disease model of mental healthcare, mental health stigma (MHS), and correlated self-image.
Why we should not be ashamed. History is crude and inconsistent, culture is misinformed, the disease model is exploitive and archaic, and MHS is generated and sustained by prejudice, ignorance, and discrimination based on misinformation and disinformation.
What are disorders and discomforts? We all have them. They limit or interfere with our life activities and impact our emotional wellbeing and quality of life. They distance us from our optimum functioning – from being the best that we can be. The difference is in severity. A disorder is a diagnosable condition that the disease model of mental healthcare labels a mental illness or disorder. Discomfort does not rise to the level of diagnosability but is physiologically disruptive, nonetheless. How did we become disordered and discomforted? Childhood disturbance, heredity, the normal vicissitudes of life, and the universal drive towards meaning, purpose, and identity.
It’s a simple but salient maxim: we are not accountable for the cards we have been dealt; we are responsible for how we play the hand we have been given. We were infected in adolescence due to heredity or for some childhood disturbance(s). We did not make it happen; it happened to us. We are, however, responsible for doing something about it. We are the captains of our ship. Recovery programs can provide the tools and techniques, but the onus of recovery is on the individual.
Carl Goldberg described shame as”feeling ridiculous, embarrassed, humiliated, chagrined, mortified, shy, reticent, painfully self-conscious, inferior, and inadequate.” There are many aspects and degrees of shame; volumes have been written about the types of shame and its complexities. Shame is painful, incapacitating, and uncontrollable. Shame makes us feel powerless, inferior, acutely diminished, and worthless.
Shame makes us want to escape, to become invisible. It elicits self-defensive reactions that can make us feel inadequate or become hostile and aggressive. Shame is unavoidable and impacts every aspect of the human experience.
Shame is not all bad; it alerts us to our irresponsible and irrational actions. Shame can be revealing, cathartic, and motivational, broadening self-awareness, and promoting emotional and spiritual growth.
We are all disordered to some extent; it is a natural part of human development. A disorder is evidence of our humanness. Our disorder is not selective, but a universal and undiscriminating condition, impacting every type of individual. Social anxiety disorder, for example, is not the consequence of childhood behavior but is driven by a combination of genetic and environmental factors. In either case, it is not our fault. While behavior over our lifetime can impact the severity, the origins of disorder happen in childhood. It is not a mental affliction but impacting and impacted by the simultaneous mutual interaction of mind, body, spirit, and emotions. Forget what we have been taught by the disease model of mental health and influenced by associated stigma. We are not our disorder; we are individuals with a disorder. We are not the sum of what’s wrong with us, but the aggregation of our character strengths, virtues, and attributes.
So why do we feel shame? Because mental illness is historically denigrating and culturally feared and scorned – beliefs perpetuated by the disease model of mental health and reinforced by mental health stigma. These influence our self-image, generating feelings of inadequacy and undesirability.
The disease model of mental health focuses on what is wrong with us. It labels us by our diagnosis, and we cease to be an individual. We are lumped with others similarly diagnosed, labeled as schizophrenics, paranoids, depressive persons, or nervous wrecks. We are stereotyped by the most descriptive symptoms and characteristics of our disorder using terms utilized by the unreliable Diagnostic and Statistical Manual of Mental Disorders (e.g., incapable, deceitful, unempathetic, manipulative, irresponsible). Then we are branded as personifications of that stereotype.
Mental Health Stigma is the hostile expression of the abject undesirability of an individual impacted by a disorder. Studies show that aversion to mental illness is socially hard-wired. Society considers the disordered unpredictable, undesirable, and dangerous. The public wants to distance itself and isolate us because of its deep-rooted fear and realization of its own susceptibility. The stigma or branding does not need to be valid or accurate; it just has to be believable. Its purpose is to separate us from the rest of society.
What are the factors or attributes in MHS? Mental health stigma is formed and facilitated by ignorance (misinformation), prejudice (fear), and discrimination (false superiority). Stigma supports and is supported by public opinion, media misrepresentation, the mental healthcare industry, and the disease model of mental health.
The media stereotypes anyone with a disorder as an unpredictable, hysterical, and dangerous schizophrenic. Half of the news stories on mental illness allude to violence. A person with a mental illness is either a homicidal maniac, autistic, or antisocial.
Healthcare professionals are often undertrained and inflexible. We know how our disorder impacts our emotional wellbeing and quality of life far better than our doctors. Clinicians deal with 31 similar and comorbid disorders, over 400 schools of psychotherapy, multiple treatment programs, and an ever-increasing plethora of medications. Utilizing a one-size-fits-all approach to recovery is the normal course of action.
The mental healthcare community is drowning in pessimism. There is evidence to indicate the problem is endemic in the medical health community and universally systemic, which means that it impacts us personally, and the current disease model is the culprit.
Clients report instances where staff members are rude or dismissive. Complaints include coercive measures, excessive wait times, paternalistic or demeaning attitudes, one-size-fits-all treatment programs, medications with undesirable side effects, and stigmatizing language.
The ‘defective’ or disease emphasis has been the overriding psychiatric perspective for over a century. By the 1952 publication of the first DSM, the focus had drifted from pathology (the science of the causes and effects of disorder) to pathography (the breakdown of our psychological shortfalls, categorizing them to facilitate diagnosis). Pathography focuses on a deficit, disease model of human behavior. Which disorder poses the most threat? What behaviors contribute to the disorder? Are we contagious? What sort of person has a mental illness? It is these attributions that form public opinion, stigma, and our self-beliefs and image.
The disease model and the DSM’s diagnostic system are under increasing scrutiny for their misdiagnoses, constant criteria revisions, symptom comorbidity, one-size-fits-all recovery programs, and general negativity. The Wellness Model of mental health focuses on our character strengths and virtues that generate the motivation, persistence, and perseverance to recover. A battle is not won by focusing on incompetence and weakness; it is won by knowing and utilizing our strengths and attributes. That is how we recover―with pride and self-reliance and determination―with the awareness of our capabilities.
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WHY IS YOUR SUPPORT SO IMPORTANT? ReChanneling develops and implements programs to (1) moderate symptoms of emotional dysfunction and (2) pursue personal goals and objectives – harnessing our intrinsic aptitude for extraordinary living. Our paradigmatic approach targets the personality through empathy, collaboration, and program integration utilizing scientific and clinically practical methods including proactive neuroplasticity, cognitive-behavioral modification, positive psychology, and techniques designed to reinvigorate self-esteem. All donations support scholarships for groups, workshops, and practicums.