A Fighter For The Better Use Of Language

One of the voices most vehement in his opposition to the use of the word “stigma”, when it comes to dealing with people who have experienced the mental health system first hand, is that of Harold A. Maio. It was, therefore, refreshing to see his words in print featured in an opinion piece on the United Kingdom’s Guardian, headed aptly, We no longer talk about ‘the’ Jews. So why do we talk about ‘the’ mentally ill?

Presently popular worldwide is “the” mentally ill, a replica of “the” Jews. It is seldom recognised. In 2008 all nine US supreme court justices agreed “the” mentally ill existed. I shuddered; the US went silent. The entire country went dark and did not notice. An alley expression had reached the height of the US supreme court and journalism fell silent, neither seeing it, nor wanting to. Not just in the US, but worldwide. It is one of the prejudices I track worldwide on the net. I respond to each example.

If you follow stories in the media where the word “stigma” comes up in reference to people who have known mental health treatment, you will often find Harold Maio has written a sharply critical letter to the editor. It would certainly be helpful if more people took the time to chastise editors and journalists for their shortcomings in this fashion, and for this shortcoming in particular.

I trace one other prejudice on the net: “stigma”. It is closely related to the first. Once one has diminished a group to a “the”, one then claims for them a “stigma”, a “they”, a difference, eventually a deficiency. Establishing an “us” is one of the primary tools of prejudice, resulting in a “them”.

I’ve never liked the word “stigma” used in such instances either seeing it as a highly prejudicial word. As it means “a mark of disgrace” you start with a perceptual problem, you’ve identified the members of this set of individuals as set apart somehow from the rest of the population. In such instances, it becomes easier to ignore the common humanity that unites people, and it becomes harder to come to the conclusion that we are them, too, and they are us.

When I objected to the use of this word during a teleconference of psychiatric survivors and mental health consumers I was happy to find that most of those at the event were in agreement with my objection. They had a different reason for objecting though, and their reason was that it was a term they felt had been co-opted by people who didn’t share their aims and objectives. This word that might once have been their word at one time, was no longer seen as their word. It had become then, for these people who had been through the mental health system, a word that was used by a “them” against the “us” they represented.

The outcome of forced mental health treatment is usually not a very good one. The damage that is done to one is financial and social as well as possibly emotional. This socio-economic double whammy illustrates that the problem is systemic. While ex-slaves were promised 40 acres and a mule before the end of the American civil war, a promise the government renigged on, mental health patients are promised next to nothing on discharge from an institution.

Ignorance of the disruption that involuntary treatment entails is itself an example of prejudice in my view. Let us return to the example of propertyless ex-slaves, one thing they could count on was poverty. The predicament most recently discharged mental patients find themselves facing is similar. Add to this precarious state, just as with black people in this country, you have a group of people facing a great deal of prejudice. This prejudice contributes to making efforts to reenter the fold, so to speak, and move upward such a challenging, often self-defeating, undertaking.

I haven’t read it suggested that there is a “stigma” attached to mental health. People labeled “mentally ill” have recovered from the label. This word “stigma” is often used to refer to the way people treat people for whom recovery is thought to be beyond reach. This presumption, in itself, is an example of prejudice. There is a great deal of fatalism at work in this perspective. It is my feeling that when a person has received a psychiatric label, improvement should be the expectation. Resignation is, all too often, the tact encouraged by professionals who have failed their clientelle, and by a system that is too often based on managing symptoms rather than recovering stability.

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21 Responses

  1. Bravo. I have been an enthusiastic and passionate acolyte of Harold Maio and his work on “the language of respect” and his painstaking crusade to educate the media and the medical profession against the use of what I call the “S” word and all his linguistic truths.

    There is no “stigma” ~ only prejudice, discrimination, fear and ignorance.

    Thank you for posting about his work. Harold is tireless in his campaign and he is most worthy of this attention. The more you can spread his words, the better.

    We tend to internal our “labels” and the damage is almost irreparable.

    Thank you.

    Sandy

    • Will,

      I notice my comment is not yet up. That’s fine. I hope you can accept that the word stigma, as it is used today, is not helpful. It brands those of us who live and struggle with mental illnesses and any mental health issues. Those who have the “stigma” are those who do the branding, more than those who are branded. It is unjust, unfair and it sets up a “them and us” dynamic which is harmful and hurtful.

      s

      • “Stigma” is a word that is acceptable to drug companies, organizations that don’t have service users best interests at heart, and medical model mental health staff. Usually it is used in instances where the most people think they are trying to do is change attitudes. In practice, if you look at studies on the subject, campaigns to erase “stigma” usually have the opposite effect to the one intended. These campaigns often increase the very thing they claim to be trying to eliminate. The manufacture of this “us” and “them” dichotomy that you mention is definitely at work here. The implication is that people impacted by the mental health system “can’t help themselves”. On top of this, the view is that they are a vulnerable population who can’t speak for themselves, and, therefore, they must have other people speak for them. It is not true that they cannot speak for themselves as they have been doing so for years. The civil rights struggle for African Americans that took place in the 1950s and 1960s knew that the problem for them was prejudice, and that the beginnings of a solution could only be found in legislation. We’re not dealing with “stigma” here, we’re dealing with prejudice, and the most effective way to change the situation, and eventually attitudes, is going to be through legislation, too.

    • The “S” word, I like it, and so true.

  2. Also, sorry about the salutation. I had someone else in mind when writ ing to you. It makes no difference to the message. I cannot stress enough that if we replace the word “stigma” with ignorance, fear, prejudice and discrimination, albeit unwieldy, things may change for us.

    s

    • No problem. The name is Frank, and I agree. The word “stigma”, or “mark of disgrace”, comes out of “ignorance, fear, prejudice and discrimination”. This “mark”, if you are not talking paper trail, is also invisible. It only exists in people’s minds. It doesn’t exist in the world. So much for “stigma” then. Ignorance, fear, prejudice and discrimination exist in the world. We change people’s minds by changing the world. Thank you for your comment.

  3. stigma /stig·ma/ (stig´mah) pl. stigmas, stig´mata [Gr.]
    1. any mental or physical mark or peculiarity that aids in identification or diagnosis of a condition.
    2. a mark, spot, or pore on the surface of an organ or organism.
    3. follicular s.
    4. a distinguishing personal trait that is perceived as or actually is physically, socially, or psychologically disadvantageous.
    5. in the plural, purpuric or hemorrhagic lesions of the hands and/or feet, resembling crucifixion wounds.stig´malstigmat´ic

    Well, if it was good enough for Jesus..

    • Jesus, if you remember, was nailed to a cross. Most people prefer
      more comfortable means of transport, Saint G.M.

      • I’ll chuck this in here.

        My favorite Jesus story (apart from those of my own) is Scorsesi’s “Last Temptation Of Christ”.

        In it (the story), Jesus takes himself and things very seriously. Throws himself down on the ground, yells in the street, and stuff like that. But then they had been invaded by Romans and they were treated capriciously and often cruelly. Jesus works for the Roman police to build crucifixes and assists at the execution of crucifixion. He builds crosses and sometimes hammers nails into the condemned. (Check out Jesus wielding a hammer and spraying blood on his face.)

        His childhood buddy Judas is horrified but because he is pious does not kill Jesus.

        If you haven’t seen the movie it’s worth two or three viewings. The book, written in about 1960 by Nikolas Kosantstakis (?sp) is something else. I could also recommend “The Gospel According to Jesus Christ” by Jose Saramago.

        Why am I interested in this shit?

        Because the stories are fascinating even as works of fiction. But I’m doubly fascinated that they are taken as fact . It makes the stories even better. And then quadruply horrified that I live with a bunch of morons that pander to this fiction being taken as a religion. And then octuply horrified that they be taken as some kind of “moral fact”. ( BTW I think the “lig” in “religion” means to tie things or to make sense.)

        But yet again why is it relevant?

        Because that’s the way people are, or at least have been bred from stock that have within their genetic code the ability to be stupid.w

  4. This is something that needs tackling in schools, other educational facilities, the workplace, churches, and within the media. So much of the information we ingest is from the latter; the Internet, television, movies, newspapers and magazines feed us with some much of our information.
    The “stigma” of being a member of “the mentally ill” is certainly perpetuated by journalists using these terms. They roll them out because they haven’t been challenged sufficiently over their usage.
    Perhaps it is time to campaign for legislation with regards to promoting terminology that is inclusive and defined by people who experience, let’s say for example, “diverse cognition”.
    It is a gradual thing to change terminology and it will take effort to change it.
    The internalisation of these out-of-date terms by people who experience diverse cognition is a difficult one for people to live with and it forces them to feel separate and “marked” (as defined above).
    These words are difficult to shake but we have to start somewhere, and that somewhere is by coming up with alternative terminology that individuals who experience diverse cognition are comfortable with.
    In the same ways we have tackled sexism, racism, and homophobia, we must now tackle the prejudice against people who experience diverse cognition.

    • …”people who experience diverse cognition”? People are diverse, I will give you that, but I don’t know that there are any effective ways to gauge cognition. Why don’t we scrap the diverse cognition idea, and just call ’em people? That way we get rid of any “us” versus “them” dichotomy in the process.

  5. Actually, I think the whole lot should go. Anything that begins with “psych”, for starters. Words that begin with “psych” can strike the fear of God into people, before one even begins with the rest.

    psychiatry
    1846, from Fr. psychiatrie, from M.L. psychiatria, lit. “a healing of the soul,” from Gk. psykhe- “mind” (see psyche) + iatreia “healing, care.” Psychiatrist first recorded 1890; the older name was mad-doctor (1703).

    Not much “healing of the soul” going on in psychiatry. Perhaps we could take a more epistemological approach.

    Definitions of “psychology” are pretty level but given the “stigma” that “psych” has attached to it, maybe psychology and psychotherapy could be subsumed by neurotherapy, which has none.

    “Mental” could be replaced with: cog·ni·tion (kg-nshn)
    n.
    1. The mental process of knowing, including aspects such as awareness, perception, reasoning, and judgment.
    2. That which comes to be known, as through perception, reasoning, or intuition; knowledge.

    [Middle English cognicioun, from Latin cogniti, cognitin-, from cognitus, past participle of cognscere, to learn : co-, intensive pref.; see co- + gnscere, to know; see gn- in Indo-European roots.]

    It is really diverse cognition that we are talking about when we talk about “mental health problems”; a differing understanding of the world that, when it becomes painful in one way or another, needs addressing.

    I think that diverse cognition ought to be respected. People who see the world in a different way should not be mis-treated for that. If they are in pain then we should help them. If they are not in pain and are doing no harm, then we should leave them alone. It is nobody else’s job to make it their business how another person lives.

    I would be interested to see what new ideas other people have.

    • I don’t see a lot of good coming of rewriting the dictionary. Words have their meanings, and those meanings had an origin. The further and further you get away that origin, the more the word has taken on a meaning other than the intended one.

      We use language to communicate. When we cannot say what we mean because the language we’d use to say it with is no longer valid, we cannot communicate.

  6. There is no physical proof of an illness, if there is, it is not mental illness.
    “stigma” is the whole point of psychiatry.
    The psychiatric label is a fancy way of insulting people, an insult from a person of the elite , a Doctor .

    For example , a doctor can’t say to the patient “You are a glutton, you eat too much in comparison to the work you do”. The doctor has to say that the patients overeating is out of their control , like the patient claims it is. This is an example of voluntary psychiatry, both the patient and the doctor want a scientific disease to explain the animal instinct of enjoying eating food.

    When the doctor imposes the label/insult against the patients wishes, that’s involuntary psychiatry.

    Without the stigma, there is nothing separating the “normal” from the “ill”.

    • I agree on many points, Mark. I agree with you that the labels they apply to people are insults, and that they are insulting. I don’t agree on the use of the word “stigma”. A “stigma” was originally a brand used to identify a slave or a criminal. If there is any brand these days, it’s invisible, and more than that, it’s entirely in the mind of the other.

      If there is any place where the word “stigma” does apply, it’s to the paper trail, to the record of hospitalization. This record is being used, for one thing, to take away people’s second amendment rights. This record is also being used to discredit their word in court cases, and in other situations. Tell me, who is talking about burning hospital records!?

      The problem here is that the word “stigma” is not being used to do anything about these breaches of citizenship rights. The word “stigma” is being used, in the negative, to drum up funding for mental health programs. These mental health programs are often disempowering and marginalizing in themselves. What I’m trying to say here is that many of these “anti-stigma” campaigns are actually counter-productive and self-defeating. They tend, in fact, to produce an effect opposite to the one intended. Studies, if you read the literature, have shown this to be true.

      Discrimination is something we can do something about. Prejudice is a word that people, even politicians, understand. These anti-“stigma” campaigns are about avoiding the real issues of discrimination and prejudice, issues that require pro-active legislation. It’s not enough to just change peoples minds, you have to change the situations people are in. We are dealing with great power and economic disparities, and lessening those disparities can be the only actions that will make a real difference in the long run.

  7. “I don’t see a lot of good coming of rewriting the dictionary. Words have their meanings, and those meanings had an origin. The further and further you get away that origin, the more the word has taken on a meaning other than the intended one.

    That’s the point. We want to get away from the existing language by examining what we really want to say. People would benefit from choosing their own definitions and not having them chosen for them.

    “We use language to communicate. When we cannot say what we mean because the language we’d use to say it with is no longer valid, we cannot communicate.”

    That’s the point. One would no longer be able to communicate the definitions currently in existence.

    • Alright, G.M. I’ve just got a couple of objections to scrapping the mother tongue altogether as you suggest.

      We want to get away from the existing language by examining what we really want to say.

      We?

      I would suggest instead that people examine what they really want to say by using the existing language. They wouldn’t have the words to examine what they really wanted to say without an existing language.

      People would benefit from choosing their own definitions and not having them chosen for them.

      You’ve just created a veritable tower of babel out of one language, and I don’t see any benefit what-so-ever in doing so.

      That’s the point. One would no longer be able to communicate the definitions currently in existence.

      Much as with old and middle English, I don’t find myself so much at home in future English. I’d rather, in fact, for utilitarian and communication purposes, restrict myself to “the definitions currently in existence.”

  8. This all starts with looking at the terms “the mentally ill” and the word “stigma”. The supposedly “mentally ill” are people, end of story. What I am saying is that it is people themselves who can choose to define themselves and that if they are not happy with the definitions that other people direct towards them, then there is room within our existing shared language to define themselves in other ways of their choosing.

    You make the assumption that people who are labelled by other people do not want to give themselves any definition of their own choosing. That is arrogant. Maybe people want to speak up and say that they experience something differently and maybe they want to give that a name. It is not up to you, me, or anybody else to put our own judgement upon that.

    I did not suggest, as you say, that we scrap the mother tongue. What are you talking about? You know very well that I do not mean that. I am looking at the existing terminology rather, because that is what we are discussing here, and showing that it is, indeed, laced with stigma, as is the word itself.

    I have noticed that you regularly say exactly the same thing as I have just said whilst positioning yourself as if you are making an opposing argument.
    For example:
    Me:
    “We want to get away from the existing language by examining what we really want to say.”
    You:
    “I would suggest instead that people examine what they really want to say by using the existing language. They wouldn’t have the words to examine what they really wanted to say without an existing language.”
    Either you are just looking for an argument where there isn’t one or you need to look up “language” in the dictionary if you are having difficulty in understanding my use of the word.

    Then I am looking at the alternatives. Things that people might want to say about their experiences in words that aptly describe them but that do not have heavily laden meanings that suggest there is something wrong with seeing the world in a different way.
    To say that one has “diverse cognition” is simply an example of the use of our existing language to come up with a term that fulfils the criteria I set out for myself as described here. It gets us away from the accepted language we are discussing; the accepted language that we – yes, “we” – all appear to find objectionable here.

    To discuss the Tower of Babel demands a religious and etiological examination to determine whether one purports a classical or contemporary significance. It would appear you are taking a traditional view, so I shall say that I have not created a “Tower of Babel”, I seek to confound it, as God did. He makes for a good example, don’t you think?

    Have you forgotten what you have written about Harold Maio? You present material here that says one thing yet you express the opposite elsewhere on this site by using terms like “nutjobs” and “adult kindergarten shirkers”. I have not taken these terms out of context and I find them as prejudicial as the terms “the mentally ill” and “stigma”. You certainly mean it when you say you are going to restrict yourself to the definitions currently in existence, don’t you?

    Your comments about “future English” are irrelevant to what I am saying because I have not suggested making up new words, just using the ones we have in a kinder and more constructive manner. Why don’t you give it a whirl sometime?

    • “Redefining” is a subject I haven’t tackled yet, but there sure is a need for doing so. SAMHSA would, with a little help from its clientelle, “redefine” recovery. I wouldn’t “redefine” recovery because the people behind the dictionary did a perfectly good job at defining it in the first place. “Redefining” is often a matter of obscuring matters. I see no need for it, not when I am relaying the truth anyway.

      I don’t speak for others. I don’t speak for others because they can speak for themselves. I speak on my own behalf as a survivor of psychiatric mistreatment. I can speak with others, but I can’t speak for them. I am deeply suspicious of people who would speak for other people. We share a voice when we’re in the choir together; otherwise, it’s differing voices saying differing things. I’m okay with that.

      “Kinder and contructive” are two different things. Kinder, as you can see, might clash with my sense of realism upon occasion. Some “constructive” use of words is suggested because some people want one to “saccharine coat” the bad. I’d just as soon see the bad destroyed.

  9. Hmm. You do have a tendency to contradict yourself on this topic.

    Yes, you are right; the dictionary definition of recovery is just fine for the most part. I do question who gets to define what is a “normal state” although.

    The defining or redefining I am talking about starts with a look at the word or phrase in question to determine what is actually being said. I think that some terms currently in use are unhealthy because their definitions tend to be quite condemning.

    Finding new terms that are flexible and do not categorise people harmfully is something I believe is worth pursuing wholeheartedly. It is not about “obscuring matters”, it is about people enabling themselves to speak about what is troubling them with definitions that suit them.

    You laud Maio’s raising the issue of language on the one hand then on the other you blow the argument to pieces with a desire to stick with the old terms to the point of abuse.

    You say you are “relaying the truth”, but you are relaying the truth as you perceive it through your bias against anyone ever having a real mental illness. The terminology you use at times is exactly the kind of terminology that Maio is saying we should move away from, and I could not agree more. Some of the things you say are offensive to people who do suffer with mental health problems. That they are not offensive to you because you consider yourself only branded mentally ill when not is evident.

    You certainly do speak for others when you assume that everyone is solely a victims of the system like yourself. In doing so, you do no favours for people who are true sufferers of mental illness. I entered this site by accident and found you doing the very thing that you say makes you suspicious. I challenged it, and here I am challenging it again. I have no issue with speaking up for those who perhaps do not feel up to speaking up for themselves right now.

    Kindness and realism are not mutually exclusive; kind is not far removed from constructive. It is not applying a “saccharine coat” to something “bad” when you use language more constructively. You are not going to destroy mental illness without destroying people who suffer from mental illness, and that takes you directly to eugenics; a discussion for another day.

    Things take time to change, and it is better to make a start than it is to quibble endlessly over what has been.

    I see the comments got mixed up above so have just read the coomments about my Jesus remark. I shall point it out for everyone the next time I use irony.

    Saint G.M. out.

  10. Correction:

    I see the posts got mixed up above so have just read the comments about my Jesus remark.

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