Stigma of Mental Illness
The Role of the Faith Community
(Presented at the 2003 NAMI Oregon Convention)
by: Gunnar Christiansen, M.D.
I always listen closely to the introduction to see if I hear any new information about myself. What defines us? Are we what we have done, or what we have not done? Are we what we were, or what we hope to be? Are we what others think we are? Are we what we do, or are we the reason that we do something? Are we who we are in spite of, or because of some one or some thing? Are we a "work in progress?" Who are we anyway?
One thing for sure, if we are afflicted by an illness or disorder, we are not the defect. Whether we are tall, short or medium, whether we are black, white or in between, whether we are shapely or pleasantly plump, we are all persons. We are all an equal part of God's creation.
God has allowed mental illness to exist in our world, but defining someone by the fact that he or she has developed such a disorder is a creation of man, not God. Scripture tells us that God created us in his image. It does not say that he created "schizophrenics" and "manic-depressives." These unfortunate terms used for descriptive purposes are marks of stigma that lead to discrimination.
"To make a difference in treatment or favor on a basis other than individual merit" is one of the definitions for discrimination given in Webster's dictionary. Unfortunately this is what is happening more often than not in our nation and world today.
Those of us in this room appreciate that each of us has unique talents, regardless of whether or not we have a mental illness. Unfortunately, however, far too many of those outside of this room seem oblivious to this fact.
This lack of understanding leads to a situation in which everyone loses. Those with a mental illness are robbed of an opportunity to have an environment, which encourages their participation, and society is robbed of the opportunity to fully benefit from the talents of those with these "no fault disorders."
However, I am reluctant to throw too many stones at others. Prior to our son becoming ill with paranoid schizophrenia, neither my eyes nor my heart were open. I did not fully appreciate the challenges faced by those with a mental illness. I believe I had sympathy, but my lack of understanding prevented me from having empathy, which is necessary before a meaningful response will happen. My lack of action played a role in the continuation of the stigma and discrimination of mental illness.
Should the Faith Community be involved in the fight against stigma? If so what role should it play? I suggest to you that it should play the leading role, but does it have the will to do so?
The answer to this last question can be influenced significantly by us, especially the vast majority of us who are part of the Faith Community. We are at least partially responsible for whatever actions and lack of actions that we attribute to it.
In order for the Faith Community to assume a significant role, a paradigm shift is needed. It appears that this change of focus will not occur, however, until those of us that are affected by mental illness become the catalyst for this change. Our combined advocacy has the potential of getting the Faith Community, as a whole, to accept ministry to, with and from those with a mental illness as a central part rather than just a peripheral part of its mission.
Don't be discouraged if, at times, it seems that your advocacy in your place of worship is not particularly successful. When I get that feeling, I refer to a quote by Robert Louis Stevenson that I saw on the packaging of a loaf of bread, "Don't judge your day by the harvest you reap, but by the seeds you plant."
So what should we attempt to do as one person among many? How can we influence our fellow Christians, Muslims, Jews, Buddhists, Sikhs and those of other faiths. What is the first step?
In my advocacy, I find that looking for direction in scripture is basic to the development of an effective response. I believe God has a significant message for us in the Book of Joshua 6: 13 & 23.
"The seven priests carrying the seven trumpets went forward, marching before the ark of the Lord ….."
"When the trumpets sounded, the people shouted, and at the sound of the trumpet, when the people gave a loud shout, the wall collapsed ….."
New International Version
"The Walls Came Tumbling Down"
It is time for us to convince the Faith Community that it should join us in leading all of society on a march. It is time for us to shout and blow our horns. The wall of stigma of mental illness must come down.
For the 90% of us who do not have a serious mental illness, the wall is invisible. But those with one of these disorders can see it clearly.
A proper response by our nation to the challenges faced by those affected by mental illness involves more than just what happens in our legislature and in our medical research laboratories. Even if we are successful in passing every law that we feel is indicated and develop the very best possible medications, we will still have the significant challenge of stigma.
Society places a great deal of emphasis on the importance of giving medication to those with hallucinations and delusions in order to return them to reality, but gives little consideration to the world of stigma and discrimination to which they are returned. Perhaps rather than having the question, "Doesn't God care?," it would be more fitting to have the question, "Don't we care?"
Webster's dictionary defines stigma as a mark or brand indicating shame or discredit. The stigma of mental illness makes an invisible mark, but it goes much deeper than any brand with even the hottest of irons.
No one jokes about someone having cancer or any other illness. Why do we persistently see it happening to those with a mental illness?
Why is it so rare to see someone with a mental illness portrayed as a hero and/or recognized for positive contributions to society in movies, television shows or novels? Is there really only John Nash who deserves recognition?
We are faced with a formidable struggle. Our opponent is ubiquitous. It seems to be everywhere all at the same time. It is clever. It gets people to expand its effect without their even realizing that they are doing it.
It's ingenious. It affects people's ability to make an accurate assessment of others. As mentioned, instead of judging others by who they are and what they are doing, they judge on the basis of what illness or disability that they might have.
It influences people in such a way that they become insensitive to the effect that their comments and actions might have on others. It deceives people into feeling that they somehow elevate themselves by belittling others.
It effectively puts glasses on people that distort their vision. It prevents them from seeing that we are all created equal and that we all have the right for the pursuit of happiness.
It utilizes fear to further its cause.
Regardless of how daunting our opponent appears to be, we have good reason to believe that we can be victorious. Our opponent is evil and can be defeated.
We are not alone in the battle. We have an ally and we could not have a better one. With God's help, we can cause the wall of stigma to come tumbling down.
We are also huge in numbers. The Faith Community's troops are widespread. We are everywhere. We can be clever and ingenious as well.
We can provide glasses for others that will clear their vision and enable them to see that each person is considered special by God.
We can defeat unwarranted fear through education. Attitudes can be changed. Perceptions can be cleared up.
But to win the battle, we must do more than just talk. We must march, blow our trumpets and march again.
As we prepare for this battle, as we focus on possible solutions to our challenge, we must first carefully assess if we are part of the problem. I believe that Jesus' admonition to us in Luke 6:41 is worthy our attention, "Why do you look at the speck of sawdust in your brother's eye and pay no attention to the log in your own."
An area that demands our immediate attention is the problem of silence. I would like to share with you a poem that I received from Louise G. Fisher of Raleigh, North Carolina, which speaks to this issue.
The Hush of Mental Illness
Hush! Say the families.
We'd be embarrassed for others to know.
Hush! Say the siblings.
We'd rather die than let anyone know.
Hush! Says the minister.
Someone might feel uncomfortable, you know.
Hush! Say the deacons.
We look after the physically sick, you know.
Hush! Say some church members.
I don't want anyone to know about me or my relatives, you know.
Hush! Say some government leaders.
There's not enough money to go around, you know.
Hush! Says society.
Cause we already don't want to know, you know.
Stigma produces silence. Silence allows stigma to go on unabated. We do need more than talk to stop stigma, but it would be a huge step toward its elimination if the voices of those affected by mental illness could be heard.
I am not suggesting that it is wrong, if some want to keep their illness or the illness of a family member a secret. Often, when they do have the courage to talk to someone, rather than receiving support they are shunned. Rather than being understood, they are misunderstood. Rather than being asked, "What can I do to help?, they are offered inadequate, simplistic solutions for extremely complicated problems. Rather than receiving love, they might lose an opportunity to develop a close relationship with someone who is important to them. They might even find themselves excluded from relating with members of their own family. The job of a schoolteacher might be put in jeopardy, if it became known that he or she had schizophrenia or manic depression.
Parents that would like to advocate concerning the illness of a son or daughter might be requested by him or her to not to let it be known that he or she has one of these disorders.
Even though secrecy is understandable, I urge those who are affected by mental illness to avoid the attempt to carry the load alone. The load is too heavy. It is OK to ask for help. Doing so is not a sign of weakness. A trusted friend and particularly one that is a clergy person, as well, can be and usually is of immense help.
Unfortunately silence does have consequences. When we do not go to our clergy person, we allow stigma to be the winner. Our clergy person is not educated by us and we miss an opportunity for spiritual support.
I am thankful for the advocacy of those that do feel comfortable in disclosing such personal information to the general public. Nevertheless, I do not wish to contribute guilt to someone that desires to remain silent and already has a heavy burden.
It seems that avoidance by individuals and families to reveal the existence of mental illness in their lives is often justified, but we as a nation should feel awful about this apparent necessity.
It is amazing how many people who have a mental illness or have it in their family sit in lonely silence until they hear someone like us tell our story. It may only be privately to us that they reveal the existence of mental illness in their life, but it is a start in their releasing this burden and a significant step in their healing process. It is in our own congregations that we have the best opportunity to have such a personal touch with those that have been silenced by stigma.
Even though we may be more prone to look at our inadequacies rather than at our attributes, we must be careful not to overlook the power of being a role model. Our witnessing tells those that may be sitting in silence that they are not alone. They will see that others have survived. By openly stating the burden that the existence of mental illness and its stigma has had on our lives, we assist those in silence to understand that there is a legitimate reason for feelings of insecurity in a world that is not being fair.
Our story is powerful whether we are a family member or have one of these disorders ourselves. When we combine it with giving the positive message that there is no shame in having a mental illness, we demonstrate that we refuse to be dominated by stigma. Those that have found stigma to be overwhelming and have sought refuge in isolation can be strengthened through our willingness to fight back.
Stigma is not just something that is around us. It is not just external. It can also penetrate our psyche. It can be internalized. For those with a mental illness, it can lead to feelings of inadequacy. Its effect is similar to what happens to a child who is constantly berated by parents and/or peers. It is very difficult to accept the fact that one is OK, if constantly told that he or she is not. As a result, it is not surprising that a person might end up accepting the opinion of others as his or her own.
This result can be reversed, however, by helping those with a mental illness realize that they are so special that their opinion of themselves need not be altered by the unjustified attitude of others.We can praise their accomplishments and provide opportunities for them to show their capabilities to themselves and others. Where better for this to happen than in our places of worship.
Providing those with a mental illness opportunities to serve others voluntarily or as an employee is particularly helpful. The complexity of the work should be geared to the level of capability of each individual. For some it may be necessary to start with something that is not stressful and is on a part time basis. Others are extremely capable and only need the chance to show their worth.
Participation in meaningful activities can enable one to recognize that he or she can be someone who helps others instead of someone who needs help. I have been advised repeatedly by those with a mental illness that volunteering and/or employment have been major factors in rebuilding their self-esteem and confidence.
Elevated self-esteem and self-confidence will not eliminate stigma but will empower a person to more effectively resist the effects of stigma. This empowerment could be happening throughout the Faith Community, and would be happening, if ministry to, with and from those with a mental illness was central to the mission of each congregation.
The most powerful antidote for the internal effects of stigma and discrimination is spiritual strength. Reinforcement of the conviction that God loves us and is with us even in our most difficult times is of utmost importance.
Spiritual strength will diminish, however, unless it is constantly nurtured through giving and receiving loving care in our relationships with others. Thus it is of major importance that each of us attempt to develop a welcome and spiritually nourishing environment for those affected by mental illness in our own place of worship.
For those of you who are interested, I have placed copies of an article that I have written concerning the steps that are needed in establishing ministry to, with and from those with a mental illness on a table at the back of the room. We also have other helpful free items, such as video and audio tapes, at our FaithNet NAMI table in the exhibit area.
The word religion is derived from the Latin word "Relixio." "Lixio" is translated as ligament or connection. I believe it is fair to think of religion as a means of reconnection with God.
Scripture repeatedly tells us that God wants us to come to him. He wants us in his presence. He wants us to have a place of refuge. He wants us to have a sanctuary. He wants us to have peace. He also wants his voice of love and compassion to be heard and he wants us to do the talking just as he directed Moses as it is recorded in Exodus 4: 11 & 12:
"Now go, and I will be with your mouth
and teach you what you are to speak"
David makes it clear in Psalm 37 that God wants to aid us in advocating for that which is just.:
"Commit your way to the Lord;
trust in him and he will do this:
He will make your righteousness
shine like the dawn,
the justice of your cause like
the noonday sun."
Who are we? For sure we are all special. First and foremost we are persons that have a spiritual base through which God has offered to enter our lives with love and strength. We are persons that have the ability to perceive not only our needs, but also the needs of others. We are persons that are able to respond to these needs in a helpful manner.
What a wonderful gift it is to be able to give a helpful response to someone in need. When we combine the words "able" and "response," however, we see that there is a "catch" to this gift. We are responsible. We are our brother's keeper.
By utilizing the power offered to us by God, we could awaken the "Sleeping Giant," the Faith Community. We could do so by picking up our trumpets, marching, blowing our horns and shouting. We could be and must be the alarm clock.
Unless we accept this challenge, unless we accept this opportunity, unless we accept this responsibility, I believe the vast majority of our congregations will go on sleeping and stigma will continue to flourish. Without the active involvement of the Faith Community, NAMI may be able to trim the branches of stigma, but it is extremely unlikely that we will be able to destroy its roots. With persistence and prayer, however, I am convinced that the Faith Community will awaken and join us in our march and when it does there will be a loud shout and the wall of stigma will come tumbling down.
Thank you very much.