People with mental illness or addiction often quickly face stigma, or a negative label or judgment. This often complicates the recovery process and makes it difficult to talk about it. Fortunately, there are things you can do to counter this as a loved one and as a practitioner. Our therapist Brian Gerrits gives tips on how to make this negotiable.
Stigma creates anxiety and loneliness
"Clients often worry that they can't get rid of the diagnosis and stigma," says Brian Gerrits, a therapist at U-center. "Social fears are especially high. The fear of being rejected, not belonging or being excluded. From that fear, people withdraw, or isolate. This often leads to neglect of the person himself and the environment. Often unemployment is also a problem and the social network is smaller or less strong. Consequently, relationships with the social network are short-lived or very poor. When the consequences of stigma become so great, people start avoiding professional help and often feel hopeless, resulting in depression and even suicidality. Avoiding help increases the problems even more, creating self-stigma and starting that negative spiral all over again. Clients then more often make statements such as "you see, I can't do it," "I am not worth it," or even "I am the problem" or "I am to blame."
Quote
I see the diagnosis more as scaffolding to provide good care to the client, but the client himself is not his diagnosis.
Brian Gerrits, therapist at U-center
Tips for healthcare professionals: avoid stigma in your treatment
As a treatment provider and a loved one of someone with a mental illness or addiction, it is important to be aware of the influence of stigma. According to Brian, there are several things you can do to combat this in everyday life and during your treatment.
1. Be aware of how you communicate
As a professional or loved one, be aware of how you communicate verbally and non-verbally with the client. Classification according to the DSM-V is required by many health insurance companies, but do you also use that diagnosis in communicating to the client in this way? Or do you give a description of the diagnosis? Find a middle ground that feels right for the client.
2. Act from the client's perspective
Do not act from a medical model with biases, but act from the client himself. What does the client experience and feel? Do not talk about the client, but from the client's perspective. Let the client decide what will be discussed in the session or which interventions he wants to do together.
3. Make it negotiable
Discuss the topic of stigma during treatment. Does the client experience stigma and/or self-stigma? What impact does the diagnosis or treatment have? How does he or she and those around him or her feel about it?
4. Diagnoses are never fixed for life
Often clients have received a diagnosis at some point in the past and it still seems fixed. People and patterns change. Over months or years, a previous diagnosis may be history. Monitoring clients and re-examining them is important in this regard.
5. Try to understand his/her behavior
Try to understand the function and meaning of behaviors in your client or loved one. Why does a client self-mutilate? For attention or is it to still be able to feel something? Automutilation can have so many functions. For example, why does your client or loved one do this? What is the reason in him or her for this behavior?
6. Be "just people," not just practitioners
Normalize behavior and in addition to your role as a practitioner, just be human by sharing personal experiences or normalizing behavior. I sometimes say to clients, "I sometimes have negative thoughts about myself or I sometimes feel insecure. The only difference is that you are stuck in this or you want to become stronger in this. You may be stronger in other situations than I am".
7. Bring clients together
Sharing experiences and feelings with people with the same or different mental health symptoms can provide recognition and acknowledgement of feelings, thoughts and functional or dysfunctional patterns.
8. Talk to each other about stigmatizing.
If you hear someone say something that contributes to the stigma of a particular diagnosis name it. Also discuss the risks of stigma and be aware of the impact of certain comments.
9. Discuss the pros and cons of being open about the diagnosis
Take stock with the client on the benefits and drawbacks of discussing the mental illness or diagnosis with the outside world. Does it increase understanding and control relapse? Or does it only create feelings of exclusion?
How do you deal with stigma in your work at U-center?
"A stigma actually gets in the way of recovery. Sometimes even if the client is already getting help and has been pigeonholed. That's exactly what we don't do at U-center. We focus on what the client can do and how he can make himself stronger or the psychological symptoms smaller," Brian said.
At U-center, we look not only at the diagnosis, but also at the person. This starts from the very first day in the clinic, where clients start in a group of clients with different problems. "Despite the differences, clients still discover a lot of recognition and familiarity with each other," Brian says. "Clients are not put in a separate group or pigeonhole with only clients with anxiety disorder, addiction or personality issues. They also have sessions every day that relate to the person as a whole. Both social factors, biological factors and psychological factors are woven into various sessions. One treatment contact is body-centered, another treatment contact is focused on medication reduction, and yet another treatment contact is focused on trauma processing or changes in thinking, acting and feeling. I often see the diagnosis as scaffolding to provide good care to the client, but the client himself is not his diagnosis. I also make that clear during treatment."