Social Stigma Theory: The Social Stigma Of Group Identity

My mother was never inclined to use therapy as an intervention and whenever it was mentioned she became very defensive. My brother followed suit by laughing it off. Many non-medical beliefs endorsed by racial/ethnic minority groups assign personal responsibility to the development of illness and may explain increased negative views held by racial/ethnic minority groups (Alvidrez, Snowden, & Kaiser 2008). The result of personal responsibility is an outside perception of weak and disabled.

Alvidrez (1999) found that in a sub-sample of 63 African Americans, 62 believed that problems should be not discussed outside the family. I can briefly remember my mother expressing that she had everything under control, everything would be fine, and home is where things work themselves out. Reflecting back now, it was her way of coaching herself into believing that she was solely responsible for things being okay and faulted herself if things did not go as planned. Looking at my past experiences growing up, I remember indirectly having a similar attitude with many things. When it came to school and work, I pushed myself very hard and never knew how to ask for help.

Williams and Williams-Morris (2000) discuss the stigma of racism as being an attack on the ego identity of its victims.

Alvidrez et al. (2008), in a sample of black mental health consumers, found that some felt they were taught early on that Blacks should be able to handle any adversity. This understanding implicates therapy as a deficit of the group identity, which is one of resilience and strength. Therapy is a seen as a failure to cope or deal with the problem effectively alluding to poor functioning. Because stigma is a barrier to receiving treatment, people of color reinforce conflicted cognitive thinking. Throughout my early stages of development, I saw help as a weakness and I personalized my shortcomings. Then I had to understand what that meant for my identity as a young black girl. I didn’t know how to make sense of my racial identity or cope with the responsibility that came with it. Alvidrez et al. (2008) described mental health consumers as having a fear of social judgment, social rejection, and discrimination. This fear of discrimination extends to feelings of being teased, laughed at, gossiped about, ostracized, and discrimination to the extent of being denied job opportunities.
Goffman (1963) described social stigma theory in three forms, but the two currently relevant are stigma of character trait and stigma of group identity.

Stigma of character trait is defined as a blemish of individual character trait. An example is having a record of a mental disorder and therefore being social deemed weak-willed. The inference comes from a social label. Stigma of the group identity is identified through relation with a larger social group such as race, religion, or a nation. All stigmas in this form are from a lineage and by definition effects all members. Alvidrez (1999) found that in a sub-sample of 63 African Americans, 62 believed that mental illness carries a

stigma.
Williams and Williams-Morris (2000) examine the historical context of these feelings through the lens of racial inferiority. They state:
“Black Clinicians have long argued that popular misconceptions, inaccuracies, and stereotypes of the psychology of African Americans could lead to the misdiagnosis of black patients. The over-diagnosis of paranoid schizophrenia and the under-diagnosis of affective disorders are the most frequent types of misdiagnoses for blacks. The differential interpretation of similar symptoms due to conscious or unconscious acceptance of negative stereotypes may be a contributing factor to misdiagnosis” (Williams & Williams-Morris, 2000, pp. 256).
This historical experience of black people being a victim to discrimination in a claimed safe space should be expected to bring a charging emotional response. There is understanding for feelings of fear, insecurity, and anger. I question what will it take to bring growth and comfort from this occurrence. There is a mistrust of mental health services within the black community due to an outstanding overt systematic portrayal of racism. Instead of preserving the memory, its used as a rationale for not seeking mental health services. This response has hindered the black experience in the mental health world. Nadeem et al. (2007) found that black women in a sample of low income women expressed that they were less likely to want care because they did not trust the mental health system to treat them fairly. This adaptive response of not trusting a mental health care system appears instantly gratifying. I imagine my mother never had these thoughts readily accessible when making these decisions; it was an automatic thought. My mom did not think about the effect it would have on my way of thinking, feeling, and being. Without telling me her deeper feelings for not going to therapy, I find it interesting that her resistance probed me to want to go more. I wanted therapy, I wanted to be able to sit and talk to someone on how to be a family and cope with issues like sibling rivalry as my brother and I are so close in age, coping with his physical illness, and coping with being raised in a single parent home. My mother’s rejection of my longing for therapy left me with feelings of ambivalence. It also unconsciously raised me to develop a “superwoman” construct, which is debilitating. Woods-Giscombe’ (2010) conducted eight focus groups with African American woman to explore the meaning of a Superwoman Schema. She found that the women characterized the superwoman schema as obligations to manifest strength, obligations to suppress emotions, resistance to being vulnerable or dependent, determination to succeed despite limited resources, and obligation to help others (Woods- Giscombe’ 2010). My superwoman construct was feeling I could do everything and more without the help of others. I would not let people in and instead would continue to say, “I got it.” Despite any feelings of being tired or overwhelmed, I still concealed myself and maintained my independence. I masked any negative feelings because vulnerability was seen as a weakness. Since therapy was not an option, I formulated an understanding that any difficulties in life I was obligated to deal with.
I never recognized the superwoman scheme as debilitating in the moment. It reinforces the idea that any mistakes are personal failures and it also disrupts the development of reciprocal meaning relationships. Continued from the research by Woods- Giscombe’ (2010), the woman described contextual factors that reinforce the dimensions of the superwoman schema: historical legacy of racial or gender stereotyping or oppression, lessons from foremothers, history of disappointment, mistreatment, abuse, and spiritual values.
Through this experience, I lost how to be a friend and how to let people in. My interpersonal connections were guarded and despite longing for connections it was easier to be distant. Alvidrez et al. (2008) talked about self-isolation as black mental health consumers actively choosing to isolate from others to avoid rejection and feelings of being flawed or weak. These feelings remained despite a lack of concrete evidence of others aligning with that perspective. While he talks about physical isolation, I think my experience was more of a mental and spiritual isolation. I thought I was protecting my peace of mind and emotional status by sheltering myself. This sheltering would later lead to heightened emotional experiences without adequate coping skills. I thought I was being resilient when in fact I was not.
My strengths and weaknesses as a therapist are correlated with my life trajectory. Choosing a field that will allow me to provide clinical services to those in need will bring forth mixed feelings related to my own story. Contrary to that idea, this field also validates my purpose. I have always seen my personal narrative as evidence that I was meant to be a psychologist. At a young age, I found myself looking for clarity and understanding as to why certain experiences were emotionally charged. Working with clients who experience similar developmental paths will be a touching reminder of my experience. A weakness that I may come across is over sensitivity to cases involving race. These cases may cloud my judgment in the diagnostic and clinical interpretation process due to my sense of relating. I must be cautious not to project my way of coping with my life onto a clinical session, overlooking pathology, or providing interpretation that is not there. Despite good intentions, it is sometimes unconscious to project your way of thinking. I will have to be conscious of my clinical interaction and thought processes. In working towards the therapeutic alliance with clients, I must be aware of not creating dynamics of dependency with the patient to reinforce the idea of me not needing my own support. I have to also be sensitive to the concepts of transference and countertransference, addressing feelings and attitudes instead of overlooking them. As my developmental experiences shape my cognitive processing and behaviors, it also affects my interpersonal connections.
As my ability to interact in interpersonal relationships has been crippled by both developmental experiences, I find as strength of being able to validate vulnerabilities to experiences that bring sad feelings. My childhood experiences created passion and purpose in my life. As a therapist I want to connect to children, teaching concepts of forgiveness and striving for hope and confidence in the face of adversities. Children should later be able to reflect on such experiences with confidence, using their testimony as evidence of real strength and resilience. Because of this, I want to be open to learning and having a sense of mastery in dynamically attending to families in crisis.
Growing up and having to cope with my little brother being diagnosed with a chronic physical illness and having to confront the stigma of being resistant to therapy left me with deficits in my emotional, social, and spiritual wellbeing. Both experiences were emotionally challenging due to the unexpectedness. Such confusing experiences left me at times without peace of mind. I have attained a greater understanding of my cognitive processing and why certain experiences can be emotionally charged. Because of my ability to reflect on my childhood, I developed a stronger desire to help children and families of today. I am empathic to children perplexed by their developmental experiences and seeking understanding on how it affects their feelings and thoughts.
While validating a patient’s early experiences, I hope to encourage resiliency. I have a powerful inclination to encourage consumers of mental health services to use their experiences as building blocks for a great testimony and even better life. I can expect that in others, because I went through it myself. Being aware of my possible shortcomings as a therapist will be the antecedent for me to strengthen the skills I do have and continue to work on my deficits.