As psychotherapists, we use diagnoses to categorize mental illness to assist us in developing and implementing treatment plans based on current up-to-date research. A diagnosis serves as a guiding tool for treatment purposes. It is imperative for us psychotherapists to see our clients for who they are – genuine and unique human beings struggling to stay afloat in the midst of their personal storms. Clients come in struggling with issues pertaining to their mental illness with impacted relationships and consequently the burden of stigma that many endure with their diagnosis. It is helpful to unpack stigma to help you and your client understand it fully. The World Health Organization in 2001 also recognized that it is the largest barrier to treatment engagement.
Jones and colleagues outlined stigma, in it’s full scope, to have 6 dimensions that include:
- Peril – Otherwise known as dangerousness. Clients can be perceived as frightening, unpredictable and strange.
- Conceal-ability – The visibility of a mental illness which parallels with controllability. Mental illnesses that are harder to conceal are more stigmatized.
- Course – How likely the person is to recover and/or benefit from treatment
- Disruptiveness – Measures how much a mental illness effects relationships or success in society. If the mental illness is seen as less disruptive, more stable, it is less stigmatized.
- Origin – Mental illness can be either biological or genetic in origin.
- Aesthetics – Or the displeasing nature of mental illness in its social cues and perceived behaviours that fall out of the norm.
Corrigan and colleagues also categorized stigma into three further categories:
- Controllability – Where society believes that mental disorders are personally controllable and if not speak to lack of effort.
- Stability – How likely is the person with a mental illness to recover and/or benefit from treatment
- Pity- Disorders that are pitied more have less stigma associated to them.
To further read up on stigma, I recommend the article Mental Health Stigma: Society, Individuals, and the Profession by Ahmedani(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3248273/) which further breaks down stigma into societal, self and health professional origins.
Clients can easily start to feel confused, hurt and ashamed of who they are based upon how society and their close communities view their mental health diagnosis. Some clients may even feel relief to being able to put a name to their problems; however, many often feel other feelings such as guilt, grief, anger, fear, shock and denial etc.,
Here are some ways psychotherapists can assist clients to see past their diagnosis.
- First and most importantly, clients are not their diagnosis. Clients are people who happen to be dealing with a mental illness. Letting your client know that this is a piece of the puzzle and does not represent them as a whole can be impactful.
- Help clients practice self-love and be kind to themselves through empowerment, mindfulness and meditation.
- Help clients be realistic about other people perceptions. Why clients cannot control other people from reacting negatively to a client’s diagnosis, clients can themselves choose to react in a positive way. This may also mean helping the client to grieve the loss of significant people in a client’s life that have retreated since the disclosure.
- Help clients see that they can be a role model and a mental health advocate to others. Clients can achieve this by teaching others about their diagnosis, having an optimistic attitude and by staying compliant with treatment.
- Have clients write down their thoughts, concerns, questions and goals in order to make sense of their diagnosis. This can end up being a focus for your sessions.
- Encourage clients who are having difficulty adjusting to their new diagnosis join an in-person or online support group specific for their mental illness. This may allow clients to find solace in knowing that other people who are enduring the same. There may be other community resources you can refer your clients to as well.
Andrea Cashman is a registered psychotherapist in private practice who has founded Holistic Counselling Services for individual clients seeking therapy in Ottawa, Ontario. She also practices at The Ottawa Hospital as a registered nurse. Feel free to comment below or contact her at [email protected] or visit her website at www.holisticcounsellingservices.ca
*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA