The making of a doctormedical self and group of belonging
Clare Gerada, Zaid Al-Najjar in Beneath the White Coat, 2020
The psychiatrist Max Henderson and his colleagues interviewed doctors who were on long-term sick leave due to physical and mental health issues.9 The main themes that emerged from their interviews was the importance of their working identity and feelings of emptiness when not at work. Being on sick leave was associated with a fundamental change in this identity, one which they perceived as ‘humiliating, shameful and isolating’. When unwell and unable to work, doctors tend to blame themselves. This in turn can further worsen self-esteem and create a vicious cycle where the doctor needs work to improve their self-esteem but cannot work. Viewing themselves as a failure becomes the new identity, exacerbated by perceived negative views from colleagues. Once unwell, sick doctors feel excluded from their group of belonging (medicine). Self-stigma describes the phenomenon whereby people adopt and internalise external social stigma, experiencing loss of self-esteem and self-efficacy.10–12 Overall, feelings of failure becomes a generalised self-perception rather than specific to the loss of the work role, and the experience of being a doctor away from work culminates in an internalised, altered sense of self. Of course, not all doctors behave in this manner. Some accept the sick role when needed, seek and adhere to the advice of others and are model patients. Sadly, though, in my experience of now overseeing the care of more than 10,000 mentally ill doctors, most find it difficult to accept they are unwell and leave it until they are in crisis before seeking help.
Traversing infertility
Chinmay Murali, Sathyaraj Venkatesan in Infertility Comics and Graphic Medicine, 2021
Experience of infertility is often chaotic and leaves on the sufferer a permanent ontological scar that mediates her everyday realities. As such, the crisis of infertility is experienced “not simply as the physical dysfunction of the mechanistic body, but as the disorder of the body, self and world” (Toombs 1988, 202). The condition engenders in the suffering subject complex affective states: grief and depression, anger, guilt, shock or denial, and anxiety (Schetter and Lobel 1991, 30). These emotions are also exacerbated by the sense of loss of control over the present and the future (33). The physical and psychological ordeals of infertility disrupt women’s self-identity in multiple ways. Specifically, childless women “go through a process of ‘taking on’ an identity of ‘self’ as infertile” (Roudsari et al. 2014, 114). Again, the gendered realities of childlessness alienate the subject from her idealised imaginings of the self and affect her self-esteem through a sense of failure, loss, and inadequacy. The social stigma surrounding the condition engenders self-doubt and self-loathing in the subject.
Culture and health
Laeth Sari Nasir, Arwa K Abdul-Haq in Caring for Arab Patients, 2018
There is a lot of social stigma against psychiatric illness. The family should understand that everyone is vulnerable to psychiatric illness, and that depression is very common and is curable with counseling and perhaps medication. Like other physical diseases, it can be treated without permanently affecting the person’s identity. The family can be informed about what to expect and what they can do to support their daughter. They should not assume that it is due to a “lack of faith” or that there is something or someone specific who is to blame. For example, the mother should not think that she is a bad parent because her daughter has depression. They can be educated that spiritual and religious counsel can be sought in addition to medical treatment.
Personal Narratives of Mental Illness: From Hostage to Survivor
Published in Issues in Mental Health Nursing, 2023
Luciana White, Leanne Staniford
Despite being so prevalent in society, mental health issues are still represented negatively in different types of media, generating feelings of rejection towards the mentally ill (Klin & Lemish, 2008) and interfering with social integration. These representations have also been associated with prejudice, social and self-stigma (Atanasova et al., 2019; Klin & Lemish, 2008; Stuart, 2006; Wahl, 2004). Social stigma is defined by the reaction of the public towards a stigmatised group. According to the widely cited definition produced by Goffman (2009), stigma refers to an “attribute that is deeply discrediting” (p. 3). Link and Phelan (2001) further developed the concept by identifying key components, that together, create stigma. These components go from the recognition of differences and labelling of people, to the association of the labelled people with undesirable attributes. This association is guided by dominant cultural ideology. Subsequently, labelled people are categorised, experiencing loss of social status and discrimination, which in turn lead to unfavourable outcomes. In short, social stigma is a mark that devaluates individuals and affects them adversely (Tsao et al., 2008), bringing consequences such as social isolation, poor health care, decreased job opportunities and inadequate housing (Corrigan & Watson, 2002).
The Current Socio-Political Climate and Psychological Distress Among Transgender People
Published in Issues in Mental Health Nursing, 2018
Jacquelyn H. Flaskerud, Janna Lesser
A study published in 2013 sought to assess the relationship between minority stress, mental health, and potential mediating factors in a large, community-based, geographically diverse sample of the transgender population in the U.S. (Bockting et al., 2013). The researchers recruited through the Internet a sample of 1093 male-to-female and female-to-male transgender persons, stratified by gender. Participants completed an online survey that included standardized measures of mental health. Guided by the minority stress model, the investigators evaluated associations between stigma and mental health and tested whether indicators of resilience (family support, peer support, identity pride) moderated these associations (Bockting et al., 2013). Respondents had a high prevalence of clinical depression (44.1%), anxiety (33.2%), and somatization (27.5%). Social stigma was positively associated with psychological distress. Peer support (from other transgender people) moderated this relationship as did encouragement from families. There were few differences based on gender identity. The researchers concluded that their findings supported the minority stress model and made recommendations for prevention of psychological distress in transgender people (Bockting et al., 2013).
Attitudes toward Help-Seeking for Sexual Problems among College Women
Published in The Journal of Sex Research, 2023
Kenneth J. Parnell, Douglas A. Spiker, Tiana A.K. Johnson, Mackenzie B. May
Researchers have commonly examined two types of stigma: social stigma and self-stigma. Social stigma associated with seeking professional help refers to the perception that those who seek professional help are in some way socially undesirable or flawed (Vogel et al., 2006). Self-stigma is the internalization of a society’s stigmatizing views toward those who seek help (Vogel et al., 2006), and has repeatedly been shown to be an important barrier to seeking professional help (e.g., Corrigan & Rao, 2012; Vogel et al., 2006). College students from countries across the world have indicated self-stigma is a limiting factor in help-seeking more broadly (Vogel et al., 2017). Self-stigma has been explored within the TPB framework as well as other models and has been found to be negatively associated with help-seeking beliefs among women and college students (Lin et al., 2017; Shea et al., 2017). Several studies have found evidence that stigma mediates the relationship between cultural values, such as adherence to gender norms, and attitudes towards help seeking (Choi & Miller, 2014; 2014; Shea et al., 2017; Spiker et al., 2019).
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