Shame and stigma: the silent barrier to help
As a psychologist I often see that people do not get stuck on their complaint, but on the shame about it. 'What will they think of me?' keeps more people out of the consulting room than the complaint itself. In this article I want to make that silent barrier visible: how stigma works, why it can weigh extra within family and culture, and above all, how to break the silence.
What stigma really is
Stigma is a negative label: the idea that there is something 'wrong' with people with psychological complaints, that they would be weak, dangerous or unreliable. Those prejudices live in society, often out of ignorance, and they are tough, even though little of it is true.
We roughly distinguish two forms. Public stigma is the judgement of the outside world. Self-stigma is what happens when you start to believe those judgements about yourself: 'I really am weak, it is my own fault, I amount to nothing.' It is precisely that second form that is often the most paralysing.
Because the public judgement you can sometimes escape, but the judgement you pass on yourself you carry everywhere. Do you recognise that strict voice that says you should not make such a fuss?
How self-stigma raises the barrier
Self-stigma works as a double burden. On top of your complaints comes the judgement that you should not have those complaints. You feel not only anxious or low, but also ashamed and guilty about it. Two weights instead of one.
That has direct consequences. People with a lot of self-stigma postpone help or do not seek it at all, withdraw, and hide how they really are. That way they keep struggling alone unnecessarily long, while help is available.
The painful irony: shame whispers that you have to solve it yourself to prove you are not weak, while it is precisely that staying alone that worsens the complaints. Asking for help is not capitulation; it is one of the bravest and most sensible things you can do.
The taboo within family and culture
Shame is never separate from the world in which you grew up. In some families and communities there is a big taboo on psychological complaints. Sometimes out of fear of gossip or loss of face, sometimes because there are simply no words for it, sometimes because 'pushing through' and 'not complaining' count as virtues.
Added to that is the fear that you would shame not only yourself, but your whole family. 'What will people say?' is then no trifle, but a real social burden. In a community where honour and mutual ties weigh heavily, that can make seeking help extra difficult.
This is not a reproach to those cultures; every community has its own sensitivities. But it does make clear why 'just seeking help' is much harder for one person than for another. And it is exactly why culturally sensitive care, care that understands your context, is so important.
The price of silence
Silence feels safe, but it has a price. Whoever hides their complaints either seeks no help later, becomes isolated, and misses the support that could have made the difference. Complaints that smoulder in silence rarely get better by themselves; more often they grow.
Moreover, silence keeps the stigma itself going. As long as no one talks about it, it seems as if it happens to almost no one, while psychological complaints are in fact extremely common. Almost everyone deals with them at some point, themselves or in their close circle.
Every time someone breaks the silence, the barrier for the next person becomes a little lower. Talking is therefore not only good for yourself, it is also a small gift to everyone else who is struggling.
Psychological complaints are not a character flaw
Let us set straight a persistent misunderstanding: a depression, anxiety disorder or trauma is not a sign of a weak character, lack of willpower or failure. They are conditions, with biological, psychological and social causes, that can happen to anyone, including strong, successful, caring people.
You would not reproach someone with diabetes or a broken leg for making a fuss either. With psychological complaints that still happens too often, and the worst is that we reproach ourselves. That judgement is not only unjust, it actively stands in the way of recovery.
Try to hear the language you use towards yourself as if it were about a good friend. Would you say to him 'don't make such a fuss'? Probably not. You deserve that same gentleness.
How to break the shame
Breaking shame begins small: by saying it out loud once, to one safe person. Someone you trust, a friend, a family member, your GP. You do not have to tell your whole story at once; 'I'm actually not doing so well' is enough to start.
Often the feared reaction turns out to be far less bad. Many people react with relief and recognition ('I thought I was the only one'), or tell about their own struggle. And if someone does react without understanding, that says more about their ignorance than about you.
It also helps to remind yourself that seeking help is confidential. Care providers have a duty of confidentiality; what you share stays within the walls of the consulting room. So you can practise talking in an environment that has been made safe for it.
How we try to lower that barrier
At AndersGGZ we are keenly aware of that silent barrier. That is why we work in a culturally sensitive way and where possible in your own language, involve loved ones if you want, and try to create an atmosphere in which you do not have to explain or defend who you are or where you come from.
Because feeling seen in your whole context, including your background and the shame that can come with it, is no side issue. It is often exactly what someone needs to dare to take the step and to stay.
Have you been doubting for a while whether you will seek help, and is shame holding you back? Then this may be your sign. A first conversation obliges you to nothing, except that it breaks the silence. And that is often the hardest, and most important, part.
Sources
- Samen Sterk Zonder Stigma — Over stigma en destigmatisering
- Samen Sterk Zonder Stigma — Aanpakken van zelfstigma
- MIND — informatie en steun bij psychische klachten
This article is informative and does not replace personal advice from a care provider. In doubt, or do you have questions about your own situation? Feel free to contact us.
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