The Shackles That Bind: Breaking Free From Stigma

A Counsellor’s Story

Many that know me recognize that I am very “rah, rah, rah!” about counselling  — and I’m not being sarcastic. I have an enthusiasm for it that verges on nerdish, formed by experiences on both sides: as a counselling client and counsellor.

But it wasn’t always that way.  My early experiences of counselling were involuntary. I had a few family counselling experiences which I found awkward, weird and I was not even clear why I was there. I didn’t have much interest in going back and things fizzled out pretty quickly.

Fast forward to high school when things weren’t going so well for me. I had a nervous system in fight or flight mode almost 24/7, lived the life of an unpopular recluse at school and had a home situation that was going down fast.

It came to the school counsellor’s attention that I needed help. I never booked a session with my counsellor; the session was booked for me and I was told I had to go. I remember looking around to see whether the coast was clear in the hopes of getting to the counselling office undetected. Heart thudding, I proceeded. “Teleport me out of here,” I thought.

I got asked some probing questions about my home situation and lied in my responses. ‘Everything was fine.’ The counsellor saw my distress and sent me home with an assortment of pamphlets, one of which really stood out. It was a comic drawn in the style of Archie, a comic I loved when I was a kid.  It showed a crowd of teenagers in a school hallway, with a caption something like, “how many of these students in the crowd have an alcoholic parent?”  At that point, I freaked out. The word “alcoholic” was on the page—in plain sight! I could hear my heart in my ears and I was scared, but wanting to turn the page. When I did, what I saw were a lot of circles drawn around a lot of teens. Way more than I would have thought. I was shocked. It was a sizeable minority.

This really was my first lesson about stigma and it marked a considerable turning point about how I viewed counselling. I wasn’t gung-ho right away, but at least I was now more open. And I owe a ton of debt to my past therapists and fellow group members. In my case, counselling was life-saving.

Stigma Defined

The Oxford Dictionary describes stigma as “A mark of disgrace associated with a particular circumstance, quality, or person.” This definition led me to ponder whether it’s the counselling itself that’s stigmatized, or rather, the shame associated with the conditions that bring us to counselling. Maybe both.

External Stigma

We know that socially, some ‘circumstances, qualities or persons’ are subject to more stigma than others. We may find ourselves using generic or ‘socially acceptable’ terms to describe our mental health, out of fear that others will judge us, or out of concern for possible consequences. And such consequences, which may be overblown in our minds may actually be realistic! Bosses may be discriminatory, insurance companies may be punitive and friends may walk away. Or not.

Internal Stigma

While we have a choice around how we view ourselves, internalized stigma can still be an equally powerful force. When we self-stigmatize about our mental health or the possibility of counselling, this may be related to a number of factors including:

  • Cultural factors and expectations.
  • Family views on mental health and wellness, including attitudes about asking for help, receiving help and the discussion (or lack of discussion) of emotional problems in the family growing up.
  • Low self-esteem or confidence
  • Trust issues, particularly when there has been a history of trauma and/or when reaching out was not possible or safe.
  • Friends and significant others – whether our peers value or support asking for outside help and if any have had any previous experience doing so.
  • Views about change – viewing issues or personality traits as “fixed” and change- resistant can compound feelings of shame.

Tips for combatting stigma

  • Recognize that each person’s journey around stigma is unique. We can’f force acceptance; it is an internal process that evolves over time.
  • Social stigma is lessened over time by speaking out – internalized shame is decreased when we are less isolated and connect with trustworthy others; when society is more open about mental health and other traditionally stigmatized topics, education and understanding increase and become more mainstream.
  • Identifying safe spaces and support people is key, particularly when starting dialogue about mental health issues or counselling.
  • Practice reaching out and asking for help with people you trust. This can be a key first step.
  • Spread the discussion about mental health issues at a level you’re comfortable with: personal, community, regional, national, international. The Canadian Mental Health Association is an example of a national organization with provincial chapters that campaigns for the public to “get loud” on mental health week and runs the annual “Ride, Don’t Hide” event every June.
  • Be open and accepting when others chose to share with you. This is a time for listening, not advice, unless it is requested.
  • Mental heath professionals have a key role to play in the delivery of services – condescending attitudes towards clients and acting as if the counsellor could never be subject to personal problems is both highly stigmatizing and untrue; when this messaging comes from therapists, the impact can be particularly harmful because the counsellor is in a position of power and supposed authority.
  • Mind your assumptions – sometimes we think we know what another person is going through, especially if you’ve gone through similar circumstances. While there may be some crossover, each person’s experience is unique; we can never truly know exactly what someone else is feeling or experiencing. Being open to listening and receiving feedback when we’ve got it wrong, is a significant step towards making the world a more accepting place.