self-stigma

...some patients resist the diagnosis of a post-traumatic disorder. They may feel stigmatized by any psychiatric diagnosis or wish to deny their condition out of a sense of pride. Some people feel that acknowledging psychological harm grants a moral victory to the perpetrator, in a way that acknowledging physical harm does not.

Of course, I should have known the kids would pop out in the atmosphere of Roberta's office. That's what they do when Alice is under stress. They see a gap in the space-time continuum and slip through like beams of light through a prism changing form and direction. We had got into the habit in recent weeks of starting our sessions with that marble and stick game called Ker-Plunk, which Billy liked. There were times when I caught myself entering the office with a teddy that Samuel had taken from the toy cupboard outside. Roberta told me that on a couple of occasions I had shot her with the plastic gun and once, as Samuel, I had climbed down from the high-tech chairs, rolled into a ball in the corner and just cried. 'This is embarrassing,' I admitted. 'It doesn't have to be.''It doesn't have to be, but it is,' I said.The thing is. I never knew when the 'others' were going to come out. I only discovered that one had been out when I lost time or found myself in the midst of some wacky occupation _ finger-painting like a five-year-old, cutting my arms, wandering from shops with unwanted, unpaid-for clutter.In her reserved way, Roberta described the kids as an elaborate defence mechanism. As a child, I had blocked out my memories in order not to dwell on anything painful or uncertain. Even as a teenager, I had allowed the bizarre and terrifying to seem normal because the alternative would have upset the fiction of my loving little nuclear family.I made a mental note to look up defence mechanisms, something we had touched on in psychology.

Admitting the need for help may also compound the survivor's sense of defeat. The therapists Inger Agger and Soren Jensen, who work with political refugees, describe the case of K, a torture survivor with severe post-traumatic symptoms who adamantly insisted that he had no psychological problems: "K...did not understand why he was to talk with a therapist. His problems were medical: the reason why he did not sleep at night was due to the pain in his legs and feet. He was asked by the therapist...about his political background, and K told him that he was a Marxist and that he had read about Freud and he did not believe in any of that stuff: how could his pain go away by talking to a therapist?

Public stigma Stereotype Negative belief about a group (e.g., dangerousness, incompetence, character weakness)Prejudice Agreement with belief and/or negative emotional reaction (e.g., anger, fear)Discrimination Behavior response to prejudice (e.g., avoidance, withhold employment and housing opportunities, withhold help)Self-stigma Stereotype Negative belief about the self (e.g., character weakness, incompetence)Prejudice Agreement with belief, negative emotional reaction (e.g., low self-esteem, low self-efficacy)Discrimination Behavior response to prejudice (e.g., fails to pursue work and housing opportunities)Understanding the impact of stigma on people with mental illness. World Psychiatry. Feb 2002; 1(1): 16_20.PMCID: PMC1489832

According to Hoge and colleagues (2007), the key to reducing stigma is to present mental health care as a routine aspect of health care, similar to getting a check up or an X-ray. Soldiers need to understand that stress reactions-difficulty sleeping, reliving incidents in your mind, and emotional detachment-are common and expected after combat... The soldier should be told that wherever they go, they should remember that what they're feeling is "normal and it's nothing to be ashamed of.

In talking with people that have experienced it, I learned that PTSD is something that a person in a position of authority sometimes thinks they__e not supposed to have. They don__ always have an avenue to personally address it or even discuss it.

Self-stigma refers to the state in which a person with mental illness has come to internalize the negative attitudes about mental illness and turns them against him- or herself.

~~You are not alone~~ No, really. Literally. Maybe you have always known (or suspected) this. Maybe this news is shocking, baffling, dismaying, even unbelievable to you. Despite what you might believe or may have been told about yourself, you are not just 'moody'. Nor are you crazy or defective or possessed. You have what is commonly called 'multiple personalities'.

By developing a contaminated, stigmatized identity, the child victim takes the evil of the abuser into herself and thereby preserves her primary attachments to her parents. Because the inner sense of badness preserves a relationship, it is not readily given up even after the abuse has stopped; rather, it becomes a stable part of the child's personality structure.