When Western researchers started positing this theory, thanks to new technology allowing them to map brain functioning and DNA, they thought it would help decrease stigma toward the mentally ill, by removing the sufferer from blame. If “mental illness” is due to some inherent physiological abnormality, then society can’t blame a person’s behavior or inability to achieve full recovery on things like character weakness or life choices, so the thinking went.
Unfortunately, the opposite occurred. Research conducted throughout the globe has shown that over the past four decades, in regions where the biomedical model has gained ascendance, negative attitudes toward the mentally ill have actually significantly increased, including heightened public fear of the mentally ill and greater social ostracism. Why? Because the implication underlying the biomedical model is that of a person whose brain is so permanently broken and abnormal he or she is always unstable, unpredictable, unhealthy, and dangerous, Watters explained.
In other words, the biomedical model doesn’t allow for the more accepting view Kimwana’s family had: of a daughter who fluctuated in and out of periods of health (normalcy) and suffering. Wrote professor Sheila Mehta of Auburn University, who has conducted studies and experiments on how the biomedical view influences Westerners’ perception of mental illness: “We may actually treat people more harshly when their problem is described in disease terms… We say we are being kind but our actions suggest otherwise… Viewing those with mental disorders as diseased sets them apart and may lead to our perceiving them as… almost a different species.”
Watters may not have realized his observation about how central a role culture’s naming and defining of an illness plays in individuals’ prognosis was touching on a field of recent research known as “labeling theory.” It grew out of postmodern and feminist lines of social psychological research that started being explored in the 20th century, pioneered by such academics as Erving Goffman, Charles Horton Cooley, Carol Gilligan, Herbert Blumer and Thomas Szasz. These researchers developed theories like symbolic interactionism and social constructionism that proposed new ideas about how people develop a sense of self, and where “mental health” falls into that. Szasz, the famous father of anti-psychiatry, denounced the labeling of mental disorders, calling it a political act by those in power: An attempt to exert social control over people who threatened them by branding nonconformists with a “spoiled identity.” One well-known example of this is how early women suffragists were accused of suffering from “nervesickness” and other mental ailments in the 19th century by men who opposed their fight for civil rights. Szasz suggested describing people with “mental disorders” as struggling with “problems in living” instead.
In the past decade, new research in labeling theory has revealed troubling evidence that the way we name and define mental disorders in Western psychology can cause even more harm than the illness itself. The aforementioned Patrick Corrigan and Petra Kleinman, for example, have demonstrated the stigma the mentally ill experience from psychiatric labeling is often internalized, causing low self-esteem, self-prejudice and feelings of worthlessness. Anthony Taylor and Palmer Reg Orovwuje’s studies have found the rejection and humiliation the psychiatrically impaired experience is so strong it amounts to a “second illness.” A landmark study by Jo Phelan, Bruce Link and colleagues, in the 1980’s, showed that simply being labeled as chronically “mentally ill” had twice as large an impact on an individual’s income and employment than the actual symptoms themselves.
Labeling theorists say what happens is, the term “mentally ill” becomes in effect a person’s “master status,” leading to a self-fulfilling prophecy in which the person buys into the label and starts to limit him or herself by socially isolating, ceasing to apply for jobs, and conforming to additional expectations associated with their label. A viscous cycle ensues that ironically only ends up fueling psychiatric practitioners’ belief they correctly nailed the person’s alleged “mental illness” in the first place. The label and its stigma, therefore – not the alleged disorder – is what ends up sustaining the illness, according to these researchers.
After reading stuff like this, I start to wonder, am I inherently wired to hate myself, to constantly interpret my life in comparison to others’ negatively, as those close to me say – or is it actually the other way around. Is it perhaps Western psychology’s form of diagnosis and labeling – and the entrenched, societal stigma it’s left in the American mindset in its wake – actually, that has taught me to hate myself as much as I do?
That biological reductionism counterintuitively exacerbates stereotypes about the mentally ill – even by practitioners themselves – has certainly proven true for me. The countless treatment providers who’ve tried to “fix” me over the past decade have, for the most part, blindly embraced the gene/brain abnormality theory. And while I have no doubt they mean well, and they try to make clients like me feel better by saying things like “it’s not our fault” – the way they’ve treated me in practice has done nothing but exacerbate my “internalized stigma.” Always, when I’ve struggled at a certain point while in a treatment center, or months after discharge relapsed yet again, practitioners have never stopped to consider whether the problem perhaps has more to do with them, not me. Whether their failure to see me as a culturally-embedded person – rather than an illness – and reconsider their treatment approach as a result, might be a problem. On the contrary, they continued to prescribe me the same regimented, authoritarian, debasing and outmoded form of treatment they’ve been prescribing – in their cookie cutter approach – to eating disorder patients, no matter what their age or background, for years.
Despite having attended several residential and day treatment programs over the past decade, and doing every fu—ing thing – no matter how humiliating or traumatizing it’s been – these programs have asked of me, it’s never worked. And invariably the