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SILENCE, SHAME, AND STIGMA: ALIVE AND WELL

Posted Sep 14 2009 9:50am
As recently as 20 years ago, cancer was seldom talked about within families or among friends. At best, a person diagnosed with cancer was referred to as someone having “the big C.” Just saying the word cancer carried with it the fear of its being contagious. Mental illness, I’m sadder to admit, carries an even worse stigma, one that keeps many people in denial, living with shame, suffering from guilt, and immobilized to seek help – even today – when help is available.

In the 1940s and 50s when I grew up with a mother who suffered from Major Depressive Disorder, I knew that: “Whenever Mother wasn’t herself, Father drew the blinds shut to prevent people from seeing in, but the turbulence that followed her from room to room weighed heavily upon each of us.” (Chapter 12, FOUR ROOMS, UPSTAIRS: A PSYCHOTHERAPIST’S JOURNEY INTO AND BEYOND HER MOTHER’S MENTAL ILLNESS). I knew that before the age of ten and as a psychotherapist, wife, mother and grandmother, I know now that no one ever benefits from pretending to shut the world out or from shutting themselves inside pretending others don’t know that they’re there.


In large part, I am writing this blog in response to a recent topic addressed by Lynn Harris’s in “WEDNESDAY’S WOMAN.” In it, she identifies a problem she feels is prevalent in many marriages: the difficulty of MEN AND MONEY. She cautions women about the necessity to be in charge of their own assets and implies that women are frequently at the mercy of men who equate money with power, who spend or over-spend secretly, even at the expense of their family’s well-being. She goes on,half-jokingly, to suggest that it is also not a good idea to marry anyone who is “bi-polar” (a condition formerly referred to as manic depression) and for that she received questions about why she said it as well as slack for having said it.

I think she did us all a favor by bringing the issue out into the open. The issue as I see it is not merely the importance for couples to discuss how they relate to money before they commit to marriage. Whether one is stingy or spends beyond one’s means is not the root problem, though it may, in fact cause many problems. The real issue is understanding how they manage life, in general: how they problem solve, how much they are willing and/or able to share in daily household responsibilities, and whether or not they are serious about a commitment to having children and then being an active participant in their development. Not least of all, each partner must be willing to be honest about how he or she copes with any psychological or physical illnesses each may have.

What’s important is not to avoid marrying anyone (as one writer seemed concerned about doing) because he or she has an admitted diagnosis for a known condition but rather to be fully aware of the ramifications of that condition and how it will effect the couple and any children they may choose to have. Also, it’s of utmost importance to know whether any person with a known "condition" is being treated and whether or not he has been compliant when medications were prescribed as being a part of the treatment plan.

I recall an inspiring article in the New York Times, Sunday, August 16th, in which the groom admitted to having Tourettes’ Syndrome after only a few dates. He felt himself falling in love and wished to spare himself and the woman from any unnecessary grief should she wish to walk away. Clearly, she was already smitten and learned how to best accept and adjust to his problem. He was receiving proper treatment and was compliant with his medications.

Referring back to Lynn's article, a reader expressed concern about confronting her fiancé with the possibility of his being bi-polar. During times when he was feeling beyond enthusiastic, she felt it was all too easy to go along for the ride. Yet, given his alleged history of erratic spending and symptoms of grandiosity,Harris is correct in cautioning the woman in such a case and describing her predicament as being one when "a woman’s pocket book is at risk!”

The bottom line is that none of us is perfect. There isn’t a family that doesn’t have a skeleton or two in its closet. Yet, a healthy relationship must be one in which honesty is a primary priority, for honesty and loyalty are the best prescriptions for sustaining respect and love in any relationship.

And though I could spend pages describing the signs and symptoms of most psychiatric disorders – from the various stages of depression and anxiety, obsessive-compulsive disorders, the various chemical and non chemical addictions to cases of schizophrenia and then some, I think it best for now to simply say that I am happy to respond to any specific concerns you may have and will then suggest treatment modalities as well as professional health care providers who can best assist you.

I suppose I would like to end where I began: Stigmas still abound and as long as we recognize behaviors that seem to be outside the norm in our children, adolescents, young adults or seniors, if we do not offer our unconditional love to those who need special care or take a pro-active position in attempting to have them diagnosed and treated, then we remain part of the problem and certainly do not contribute toward any solution.

Whatever the fear is today that still prevents some people from educating themselves, it certainly is akin to shame, and speaks to a deep-seated need to prevent oneself or one’s family from being judged by others as being less than perfect. Well, guess what? While some families do suffer far greater ills than others, and the term “dysfunctional family” is over-used and bandied about too freely, that doesn’t mean that other families are perfect or that perfection is what one should strive to attain. Receiving the help necessary to move beyond personal and profoundly damaging trauma is, however, as necessary as treating diabetes or heart disease. Taking pills or injections and/or being in therapy for a broken leg, a broken heart or a broken mind will only make us stronger and healthier and help those who love us to lead healthier lives, as well.

In a recent conversation I had with my brother in-law, a retired and dearly beloved neurologist, he expressed regretting the fact that throughout most of his career the internet was not available to his patients. Symptoms that could easily be found with a touch of ones fingers could have spared many from coming to his office too late to receive proper care or the best care. And we both agreed that despite the fact that not all information on the internet is accurate, checking it out and becoming an educated patient makes for a better doctor and, ultimately, a healthier society.

Here’s to finding your voice (should you need to do so); living without shame (about that which is is not in your control); and leaving stigmas behind you (as that is where they surely belong)!

With best wishes for a healthy and fulfilling week ~
Linda
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