mental health debate: the stigma of stigma

the following is a transcript of an email conversation with harold mayo, a mental health advocate from florida. harold is critical of talk of stigma in relationship with mental illness. this criticism arose in connection with the press release for mental health camp.  in the following you will see that in the exchange, i directed most of my efforts towards understanding harold’s point of view. i don’t agree with all ore even many of his points but will leave that to another post. what’s important here, i think, is to entertain the dialogue (even if it seems a bit like a debate right now). i am very interested in hearing what you have to say.

harold: to prolong the concept of “stigma,” CAMH is employing it as a marketing tool (MHA here in the US, other groups elsewhere.) it is a powerful tool, stereotyping. it has worked against many people. jews, women who survive rape, in my country people of african origin, and mental illnesses. why we purchase this “product” is difficult to assess. why we promote it is even more difficult to assess.

isabella: in order to ascertain whether i understand you correctly, when you say product, would it be almost like a brand? in that vein, we could say that CMHA (that’s who we’re talking about here, not CAMH, which is another organization) is not “selling” say, heinz ketchup, it’s selling the idea/concept of stigma. correct?

yes i believe CAMH is using negative marketing as a tool to get themselves attention, reinforcing negatives instead of providing us with positives, as “black is beautiful” did. “CAMH can care for you so long as we can keep you a position to be cared for,” is the model.

yes “stigma” is being marketed as a brand. name me another medical issue that employs this marketing tool. michael j. fox does not employ it. i am aware of no medical condition that does, outside this one it has no marketing value. where claims of “stigma” against women continues to be a marketing practice, where women are diminished and where men are in total control, it continues its effectiveness. where not, it does not.

the women’s movement here refuted the assignation “stigma” to women who survived rape, they forced us to look at realities it hid, the violence, the crime, the criminal. they did not ask us to reduce or diminish it, they forced us to end our marketing practice against them, to stop. we did. it is a model worth emulating. mental health must do the same. the model has been established, it is being ignored.

isabella: why would CMHA want to prolong/sell the idea of stigma? (to keep itself in the business, perhaps, just like some social service agencies are referred to as “poverty pimps”?)

yes. examining the structure of cults, no CAMH is not strictly a “cult,” one easily observes this practice: “you are flawed, i do not like that you are seen as flawed, you ought not be seen as flawed, i will protect you.” constantly reinforcing the “flaw,” while claiming to oppose it, is a pandora’s box syndrome: i let loose the negative terms, no one can recover them and put them back in the box.

harold: are you perhaps also saying that by keeping up the talk about stigma, the act of stereotyping is perpetuated? (“those” people with mental illnesses, for example?)

yes. “those people” is the ultimate goal of any prejudice. we, “them.” how many ways we express “those people” is what i examine in the media every day.”the” mentally ill, that generic, is one. it is the most useful to any marketing campaign, it establishes the logo. “the” jews did, “the” blacks did. “the” mentally ill does. it is the house brand, the one with the generic label on the can.

isabella: i would say that mental illness is still not something that people enjoy talking about, to put it mildly.

do not interpret “people” to mean all people. i cannot dispute your use of the modifier “enjoy.” we do not “enjoy” speaking about many illnesses. nonetheless we do. i do not know your age, but i recall very clearly not talking about breast cancer. my head says it was not the cancer that was the issue, but the mention of “breast.” now we speak about it, without hesitation. and we have made progress in addressing it because of our speech. and “many” of us, “some” is a better descriptor, enjoy speaking about it, if only to assure people it is a topic one needs to discuss. as a mental health editor, i edited a great many people talking about it (mostly talking poorly.) as a retiree, i address many instances of people talking about mental illnesses. i address them in education, government, and the media.

isabella: can you explain more why it (assigning a “stigma”) is an affront?

ask the jews who survived it in nazi europe. ask any african american in the us, south africa. i generally speak very directly, please do not be offended by: do you realize how naive a question yours is? that is the power of well marketed social contracts, it preserves naiveté, while doing its harm. how many women did i insult with my jokes about rape, how many african americans did i insult through my inactions? how many women? how many people in high places dealing with a person a mental illness will not come forward because of the marketing? i hid for about three years after my first institutionalization, and then realized that was what was “expected” of me. from that day i became a vocal advocate.

i appreciate many very successful people are still in hiding because of the marketing, and the number of people purchasing that product. they skew public perception by hiding. as it is an affront to any woman who has survived the violence of sexual assault to argue that she is “marked,” it is an affront to suggest that i am.

harold: “according to CAMH” rings soundly my ears alongside “according to bigots” stigma surrounds jews, “according to,” here one must now say, “some men,” stigma surrounds rape… this “according to” is a red flag i note wherever it occurs, and from whomever, university, government, private and public voices.

isabella: i don’t understand what you’re saying there. it vaguely sounds to me like you’re implying that we’re talking about authority wrongly used, but – well, that’s just a shot in the dark. can you tell me more?

harold: yes, it is authority wrongly used. “black is beautiful” is rightly used,” ” i am woman hear me roar” is authority rightly used, and note the “roar,” simply speaking was not enough. so long as the focus of any group is negative, it is authority wrongly used. “impart knowledge positively ” is authority rightly used.

harold: we [people with mental illness] are as accepted in the community as any other people.

isabella: that is not my experience. just a little example: most of the time, when i say that i cannot do a certain task or that i need to do things differently because of my at times fragile mental health, i don’t meet what i would consider “normal” reactions such as, “oh, right” or “interesting, tell me more”, etc. i usually meet stony silence.

harold: that is your experience, it is anecdotal and certainly (sometimes) true for you, it is not “we,” do not expand your experience to that of everyone. that is CAMH’s marketing tool, “the negative is the only reality.” it is but one reality. it is the promoted reality.

when the marketing changes, your response and the response to you will. (i am sure it has.) so, market yourself better. you are a product, market yourself. you are doing it very well in your letter.

here is an example from my life: i wanted to learn computer skills, went to of the library and asked for help. within seconds i recognized how limited my abilities were and i began crying and hurriedly left. slowly i picked up some skills, but working in public brings out my weaknesses. a few months ago i returned and failed again. i went to my wife, a librarian there, and told her the librarian was not helping me. she said, “tell her what you need, she cannot help you until you do. she cannot offer you an accommodation if you do not describe it.” i then asked a librarian to sign me in on a computer, because i was afraid i could not follow the steps the library has in place. she did. i asked her to give me a computer isolated from those in use, she did. market your needs, they are yours.

harold: illness does not discriminate as words do,

isabella: i don’ t understand.

harold: illnesses strike all people, they do not select among people by imposed labels or prejudices. that is why we are as likely successful individuals as the “product” CAMH markets with their language. language is the repository of a society’s prejudices, recognized it can be stopped. marketing is often so thorough it is not recognized. marketing is often so insistent, in law, education, government, social intercourse, media, it cannot be overcome, ergo: “we shall overcome.”

harold: while the broad stereotype entertains, it does not inform.

isabella: i guess i don’t understand the connection between talking about what we perceive as the real problem of stigma or discrimination (when i say “we”, i should disclose that i am on the board of the CMHA vancouver/burnaby branch) on the one hand and stereotype on the other

what you perceive as the “real” problem does not make it the real problem. (were blacks here “slaves” or were they people held by us in slavery?)

you have been successfully “marketed” about what the problem is: “it is you, your illness.” it is not you, it is “them,” they who are doing the marketing. “they” are not the actual problem, the “marketing” “they” have internalized is. when the “marketing” of women changed, the response to the marketing allowed for change. when the “marketing” of CAMH changes, it will allow for change, too.

harold: we do not encourage those changes with negations, we encourage them with positive act, word and thought.

isabella: oh, that sounds interesting! tell me more! what’s a better way of doing this?

harold: “black is beautiful.” present positively. remove all negative language, adhere to the practice of positive representation. advocacy for represents issues positively, advocacy against represents them negatively. assess each and every word, sentence, phrase for its presented view. if it is negative you are defeating your claimed cause, you are allying with those against you.

isabella: are you saying that agencies like CMHA are intending to harm people with mental illness?

harold: i am, resoundingly.

as i intended to harm women, as i intended to harm african americans. responding to a “truth” i wholly believed, i intended harm. people on the receiving end of that harm were harmed.

i will leave you with these anecdotes about one of the founders of this nation, thomas jefferson:

1. he believed wholly that his grandchildren should read, and read with them every evening, that they did, a noble goal.
2. he believed wholly that the people, children and grandchildren he held in slavery should not, and proscribed them from learning, a now ignoble goal.
3. he believed wholly that men should receive a university education and founded one, a noble goal.
4. and he believed wholly that women should not, a now ignoble goal.

CAMH has many ignoble goals. like jefferson’s, they are intentional. in jefferson’s time there were few here who marketed goals contrary to his. but they existed. there were many in other countries who marketed goals contrary to his, who had no such ignoble intentions, for they were never marketed there.

communication being instant today, there is no longer excuse for ignoble goals.

your turn now, dear readers.  what do you think?

5 thoughts on “mental health debate: the stigma of stigma

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  2. Evan

    His point (put in so many words and in different ways) seems to be that to draw attention to something is to legitimise/prolong it.

    I do think this can be true. I don’t think it applies in this instance. He may be someone who believes one should only look on the bright side. (I think this is dangerous – leading to ‘the return of the repressed’ to coin a phrase.)

    Looking forward to seeing your response. Thanks for opening up dialogue about this.

  3. Raul

    I saw his communications and I don’t think he actually made an effort to engage in dialogue (he seemed forceful and so absolutely sure that he was right and you were wrong that I’m not sure why you entertained his request to post this).

    I respect your decision to post it (this is, after all, your blog), but I am not really sure how open he is to dialogue, and thus, the value of the discussion with him.

  4. isabella mori

    raul – well, *i* like engaging in dialogue, and will jump on all kinds of opportunities to do so 🙂

    there have been others who have said that it is not helpful to speak of “the stigma of mental illness”, that it is better to speak of “discrimination against people with mental illness”. i’m not sure whether that’s something that would be ok with harold, but one way to look at it would be to say that there is nothing stigmatizing about mental illness per se, that the problem actually lies in people who feel afraid of mental illness.

    whatever is going on here, once again it speaks to the power of language, and how important it is for us to respect it.

  5. Susan Low

    Frankly I found a lot of Harold’s comments a bit indecipherable, so I’m impressed you stuck in there with it.

    One thing that the message of “stigma” or “discrimination” does is set up an “us” and “them” divide which I think is inflated. It seems like there is some hard line in the sand between people who have mental illness and those who do not… and heaven forbid that *I* ever end up being one of those unfortunates who cross that line. (For the record, I’ve already gone there and come back a few times).

    I’d rather see CMHA focus on the incredible normality of mental illness – it is SO common in our society and it does not stop people from being high achievers, beloved family members and friends, and satisfied people. The harm lies not in the mental illness but in a systematic blindness to the mental illness.

    I’d rather speak of inspiration and opening minds than focus on how *awful* it is to be discriminated against.

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