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Against the stigma: How mentally ill people can overcome their shame

Against the stigma: How mentally ill people can overcome their shame

Those who suffer from depression or anxiety disorders are often ashamed – and hide their psychological suffering. Shame has an important function, but it can also harm us. A study provides indications of how to deal well with emotions.

“I have depression” – a phrase that hardly anyone says easily these days. Despite increasing public education, mental illness still carries many stigmas.

It’s just a lot easier to explain a broken leg than to refer to an ailment that is invisible to other people. According to an epidemiological study, 18 million people in Germany alone are mentally ill.

To put the whole thing in perspective: within a year, in purely numerical terms, every inhabitant in North Rhine-Westphalia suffers from a mental illness. Accordingly, an entire federal state would then be faced with the question: How do I deal with my mental illness? Often, out of shame and fear of exclusion, those affected decide to settle the whole thing with themselves.

Assumptions about mental illness

Professor Nicolas Rüsch, Senior Physician at the Clinic for Psychiatry and Psychotherapy at the University of Ulm at the District Hospital in Günzburg, has written the book “The Stigma of Mental Illness”. In an interview with “Psychologie Heute” he explains the plight of the mentally ill as follows: “Those affected can lose their social status and are no longer taken seriously. They are labeled and therefore often perceived and treated as different.”

According to a study by the University of Vienna, people with complex clinical pictures such as schizophrenia in particular have to struggle with stigmata. The research team interviewed those affected in 27 countries about their experiences of discrimination.

The result: 47 percent of the participants experienced discrimination in their circle of friends, 27 percent in the work context. So it is hardly surprising that 72 percent of those questioned concealed their diagnosis out of fear and shame.

Stigmata make life even more difficult for those affected and often ensure that the course of the disease is negatively influenced. Because: It can be incredibly helpful to share with others.

It could be quite a while before our society is free of prejudices – if that is even possible. Fortunately, there are ways for people with mental illness to overcome the shame that society’s stigma creates.

Study: This helps against internalized shame

But what helps against the so-called internalized – i.e. internalized – shame? A research team from Australia’s Macquarie University in Sydney also asked itself this question.

So the working group led by Professor Susanne Norder has summarized all the studies that have been published on the subject so far, 16 in total. Each of the research papers looked at treatment options for shame in people with mental illness.

However, the chosen approaches were very different. From two to 16 sessions, from individual to group therapy and from art therapy to acceptance therapy, everything was included. In summarizing all the results, the Australian researchers have now been able to work out the most successful methods.

At the forefront is commitment therapy, which is primarily about dealing with shame in a mindful and non-judgmental manner. But exercises to increase self-compassion, education about how shame develops and creative therapy approaches have also shown to be effective.

Overall, however, the effects were only “small to medium”. In addition, according to the scientists, further treatment strategies are therefore needed that “relate to findings of emotion psychology on the development of shame”.

Why are we actually ashamed?

The findings from Australia show that we are not helpless at the mercy of shame. This is good news for all of us, because shame is an emotion that doesn’t just affect people with mental illness. Who does not know the blush that rises in your face when something embarrassing happens to you or you make a verbal mistake.

Basically, we feel ashamed when we experience something that we consider socially unacceptable. The uncomfortable feeling of being exposed in front of the assembled team arises when something gnaws at our privacy. The result: we make ourselves small, both physically and mentally, and would literally like to sink into the ground.

Why shame is also a good thing

A reaction that is nothing negative at first – and in case of doubt even makes us more approachable. At least that’s what psychologist Matthew Feinberg from the University of California at Berkeley found out in a study. Accordingly, people who obviously feel shame appear to be more trustworthy, sympathetic and more generous.

Apart from that, shame also has a sense for ourselves: it shows us the limits of our intimacy and ensures that we do not cross the boundaries of others lightly.

The whole thing becomes problematic when shame becomes chronic – as is the case for many people with mental illnesses. Those affected then have the constant feeling of not being good enough and of not being able to live up to society’s expectations. It is not for nothing that there are people who are ashamed because they do not correspond to the common ideal of beauty.

Sometimes it goes so far that shame casts a dark shadow over our own lives and prevents us from going about our normal everyday lives. In this context, there is often an increased tendency to feel guilty. For people with mental illnesses in particular, this is associated with a high level of psychological strain. But the same applies to everyone else: shame can be a burden.

Overcoming shame, is that possible?

If you often suffer from feelings of shame, you can first ask yourself what exactly the cause of the shame is. We often just accept the unpleasant feeling and adapt our behavior directly. It can help to ask ourselves whether, rationally speaking, the shameful situation is really as bad as it feels, or whether we would have judged the same situation differently with a good friend. Most of the time we’re just so harsh on ourselves.

It can also help to imagine the worst-case scenario. What’s the worst that can happen? Most of the time we imagine unrealistic scenarios, which then make us feel ashamed. The reality is usually not that scary in the beginning.

Another tip against feelings of shame: accept your rough edges. Yes, that’s easier said than done. But it’s like this: each of us has quirks and each of us has made a fool of ourselves at one point or another. So next time something awkward happens to you, just smile and move on!

Admittedly, the tip only helps people with mental illnesses to a limited extent. Anyone who has to deal with social prejudices often experiences a very intense form of shame. Because often those affected have internalized the stigmata themselves before they become ill themselves. But here, too, it can help to come to terms with yourself. Anyone who succeeds in doing this will at some point no longer be ashamed to say in public: “I have depression.”

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Source: Stern

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