Shame and Stigma

A good friend recently recommended this book to me: I Thought It Was Just Me (but it isn’t) by Brené Brown.  It was rocking her world.  In fact, she was loving it so much that she was sending me quotes from the book throughout the day, and I was finding myself wanting to read more.  Brown’s book is about shame and developing shame resilience.  She is, in fact, one of only a handful of people who has dedicated her academic career to research around shame and its effect on the brain, body, relationships, gender, and communities at large.  My interest was piqued to say the least.  I bought the book.

I’m going to recommend it to all of you.  And, in the spirit of that famous 1970s Faberge shampoo television commercial of old (but not that old), I’m going to suggest that you read it and then recommend it to your friends.

Shame is not a hot topic at cocktail parties although if someone brought up the topic next to me I would stay and chat.  According to Brown, most people run from it and dislike discussing it.  I am not one of those people.  I want to talk about shame.  What is shame? After years of listening to stories and doing research, this is Brown’s definition, and I think it’s a good one:

Shame is the intensely painful feeling or experience of believing we are flawed and therefore unworthy of acceptance and belonging.

She describes shame ever so correctly as a “full-contact emotion” meaning that we feel shame both emotionally and viscerally.  You know when you’ve been shamed.  Whether you feel it in your stomach or your chest or feel yourself suddenly sinking into that familiar emotional prison where the guard says, “You deserved that,” shame punishes from the inside out and the outside in.  It puts you in a double bind so that no matter what you do, you cannot win.  Or, at least, that’s how it feels.

Shame is at the core of the stigma associated with mental illness.  Brown’s definition of shame describes the existential experience of many people who have encountered stigma.  There’s only a certain level of “crazy” that is socially acceptable around these parts.  If anyone exceeds that? Well then, something must be wrong with them! Shun them and drive them out of town! Surprisingly, there are many ways to shun and alienate people who are viewed to be flawed and unworthy of acceptance and belonging.  This is why stigma is so dangerous.  One’s personal shame is often based in a perception that just might be false.  We feel like we are flawed and therefore unworthy, but this feeling originates in us.  Stigma originates outside of us and reinforces the feelings of shame that come from within.  We, therefore, stop questioning the validity of our shame responses because parts of our community are validating our shame for us! The logical step is then to believe that our shame is true; we must be innately flawed and unworthy of acceptance and belonging.  What’s next then? Action urges.  People usually begin to act on their feelings reinforced by stigma if they do not have a stronger message coming into their lives from somewhere else.  This is a not a healthy place to be.

Brown recounted a story about a young woman named Allison whose mother hanged herself.  She was an adolescent at the time of her mother’s suicide.  Allison recalled that her community rejected her.  Everyone began to pull away from her and her grieving father.  She lost her friends.  She and her father were shunned as if her mother’s suicide was a virus that could be passed on.  A big scarlet S was plastered to their chests–SUICIDE.  The intensity of the shame that was poured out upon this young woman and her father was crippling.  Eventually, her father died, and she reported feeling relieved because she never had to return to her hometown again.  She never again had to be known as the girl whose mother hanged herself.

Reading this story didn’t exactly hit a nerve for me, but I felt it in a raw sort of way.  I had two grandparents who died by suicide as you, my readers, know.  My mother has struggled with depression for most of her life, and she has tried to commit suicide many times.  There was an occasion when I was 14 in which she was almost successful.  In a very dramatic fashion, she was removed from our home in full view of the Trinity, the Heavenly Host, the entire country club association, and Vera the neighborhood gossiping hen.  I just stood there thinking, “How long will it take for the entire state of Texas to find out that my mother just tried to blow her head off?” Vera sidled up to me sweetly and cooed at me in her treacly voice, “Oh honey, I am so sorry! Now, tell me what happened exactly?”  There it was.  The phone calls started coming in within 24 hours.  She moved fast.  Veronica’s parents wouldn’t let me come over anymore.  Kathy’s parents wouldn’t let her come to my house, and I couldn’t go there either.  Kerri’s parents wouldn’t even let her call me.  I spent that entire summer socially isolated and alone.  In other words, I spent the summer at my stepfather’s mother’s house.  She was Lithuanian, mean, and made me embroider doilies all….summer…long.  This is one shade of stigma from an external point of view.  The internalized experience might be something like this: “No one wants you around because of your mother.”  This is a fairly accurate experience for many people who have mental illness in their family.  This is one reason why many families keep mental illness a secret which only perpetuates and feeds shame.  They don’t seek out much needed supports and interventions because they are legitimately fearful that they will lose their social support structures.  I did.

A similar thing happened to us after Grace’s first psychotic episode.  She lost most of her friends save one, and I lost friends, too–one in particular.  She has still never called me and does not respond to any attempted contact.  Apparently, schizophrenia spectrum disorders are catchy! The natural response to this is retaliation.  There is a self-righteous anger that comes to the surface.  We want to take out our metaphorical bats and go have “a talk” with the people who shamed and victimized vulnerable people.  I want to share something very important that Brown notes:

“…if we are going to understand shame, we must not only seek to understand Allison’s experiences, but the reactions of those around her. We can’t simply “shift shame” from Allison to her “insensitive neighbors.” Shaming her neighbors and friends would be equally destructive. Second, we have to dig deep and be honest about how we might react as a neighbor or friend. If I came home from work and saw an ambulance and police cars surrounding a neighbor’s house, I’d immediately patch into the neighborhood phone tree to find out what happened. I might not walk over and stand around gawking, because I’d like to believe I’m above that— or at least I’d want my neighbors to think I’m above it. Instead, I’d call someone who had walked over, which is probably worse. Unless I was extremely aware of what I was doing and I was consciously working not to gossip, I would probably be equally guilty of talking about it, speculating why, wondering about the details and drawing false conclusions. I can just hear conversations where we’re saying things like “I knew something wasn’t right over there” or “You know, one day I saw her . . .” I might even make assumptions about the mental stability of Allison’s father or about Allison herself following such a traumatic event. I might become uncomfortable letting my daughter play at her house. In other words, I might become exactly what I hated and, at first, refused to understand. Why? Because I’m a terrible person like Allison’s teachers, neighbors and friends? No— it’s because I’m human and situations like that can throw us into our own fear, anxiety, grief and, sometimes, even into our own shame. And to alleviate those overwhelming feelings, we seek connection with others— sometimes in incredibly hurtful and destructive ways, like gossiping and excluding others.  If we really want to get at the heart of the beast, we have to understand more than what it feels like to experience shame. We need to understand when and why we are the most likely to engage in shaming behaviors toward others, how we can develop our resilience to shame and how we can consciously make the effort not to shame others…Our level of resilience to shame is not dependent solely on our ability to recognize these behaviors and emotions in ourselves, but also on our ability to build connections with others. These connections require us to understand what we share in common when it comes to shame.”

And, there it is.  People who are often on the other side of our shaming experiences are human beings, too, seeking out connection to alleviate their own painful internal responses. The way in which they go about it can often be very hurtful, but shame shifting is as destructive as applying stigma.

What is Brown really saying here? The only real cure for shame and stigma is empathy.  Perspective-taking.  And, it has to flow both ways.  The real burner here is that someone has to show empathy first.  Who do you suppose is going to do that? The neighborhood associations who storm city hall in order to prevent a day treatment program from being built near them? Likely not.  Reactionary behavior like that is indicative of fear.  We still live in an age where people believe that schizophrenia is dissociative identity disorder which, to me, is just laughable.  Nonetheless, it’s true.

Clearly, I don’t have all the answers or even one great one.  I do see, however, that shame shifting, responding in anger, and blaming behavior only perpetuate the cycle of stigma in our culture.  I suspect that it will take a great deal of patient empathy and painstaking education over time as well as a willingness to listen to people air out their fears in order to begin to address and eventually lift the shadow of stigma associated with mental illness from our culture.

Anger is easy.  Empathy, on the other hand, is not, but someone has to take the road less traveled if the culture is going to shift.