"The only thing shameful about mental illness is the stigma
attached to it." - Lindsay Holmes
A while ago I had a familiar experience. At the Please Touch Museum in Philadelphia, I ran into a South Asian Indian ("desi") family, who had driven down from New Jersey to the museum for their three-year old's birthday. We started talking and our conversation reached the inevitable "so what do you do?" I found out that the husband and wife both worked in IT. When it was my turn to answer, I hesitated.
I am a Clinical Psychologist. I do psychotherapy, psychological assessments, lead therapy groups and conduct evaluations for patients struggling with mental health issues. I work with individuals and families dealing with depression, anxiety, mania, hallucinations, delusions, post-traumatic stress disorder, personality disorders, substance abuse, suicidal thoughts, other self-injurious behaviors, relationship issues, adjustment issues and the task of finding self-knowledge, meaning and purpose in their lives. I work with children, some as young as four years old, to help them successfully overcome present challenges so that these do not build up and result in full-fledged disorders later on. I also teach and do research, mostly related to mental health issues.
I answered that I was a researcher. It was not a thought-through statement. Just the first thing I could come up with in my hesitation. I had a feeling of short-changing myself even as I said it but it had already been said. Later that day, I reflected on why my gut reaction had been to portray myself as a "scientist," which of course, I am, but not a "practitioner," which I am as well. With most Americans, I do not usually hesitate to present the practitioner side of my professional identity. I realized that in this exchange, my South Asian roots had played a significant part. Many a times when I have introduced myself as a psychologist, I have often observed an alarm reaction from South Asian acquaintances. There is a noticeable discomfort, as if a family secret had been revealed, or that the secrets are now threatened by the mere presence of a therapist. The mention of psychology is considered better avoided. Their hesitations are similar to mine, they come from the same place.
Growing up in India, it was not difficult to see the shame of mental illness. The stigma of mental illness casts a net wide and deep. As it is a society driven by family reputation, members of families commonly hide their own symptoms of mental illness or of their family members. Denial is the default coping mechanism. There is a strict demarcation between "normal" and "mental", and nobody in their right mind would allow any identification with the latter. Statements such as "mad or what?", or in Hindi "paagal hai kya?" and derivations thereof are common parlance. And if a little "mad" is a problem, then a lot is a disaster. The treatment of severe mental illness is abysmal and the outcomes for those suffering from it are horrendous, The problem itself is not acknowledged, therefore never solved.
South Asian culture is hardly unique in having stigmatizing attitudes towards mental illness. Western culture tends to have greater individual stigma based on the concepts of independence and self-determination. Other cultures exhibit greater social stigma towards mental illness. However, this is not a litany of any culture, it is a reflection on my experience within these two cultures and the questions that emerge from that. What can we all do to change our default attitudes towards mental illness? It is quite a task to eradicate the stigma of mental illness from a culture but we can all take small steps. For my part, I decided to make the conscious effort to always introduce myself as a clinical psychologist in the future. I hope that people at the other end of that introduction can examine their attitudes towards the "mad," "paagal" or "mental" people, and those who work with them, and respond not with labels and stigma but with tolerance and acceptance.
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