Stigma - Social and self

- [Voiceover] Social stigma is the really extreme disapproval and discrediting of an individual by society. But actually, stigma comes in two different forms. The first is social stigma, and the second is self stigma. Now, when we mention social stigma, what are we talking about? Well, social stigma can be fueled or associated with several other key concepts, and these include stereotypes, prejudices, and discrimination. One of the challenges is that the degree of overlap between stereotypes, prejudices, and discrimination, and its stigma is not entirely clear, and appears to be somewhat variable depending on the source. We commonly encounter social stigma when we are looking at conditions such as medical or mental health conditions, or other issues, such as sexual orientation, or criminality. A stigma against mental health is a major challenge. So let's try and look at that a little bit more closely in this example. In this example, many individuals may believe that the mentally ill are violent. This is an example of a stereotype, in that it involves a belief or a cognition that is generalized to a population. If this cognition subsequently leads on to a negative emotion, or a negative affect being associated with it, then this, then, would be an example of a prejudice. In our example, if I start to become scared of the mentally ill, that would be a prejudice. Finally, if, through stereotypes and prejudices, we actually have a change in our behavior, this can lead to discrimination. A discriminatory behavior would be if we are scared of the mentally ill, we may not want to live close to them, or, for example, hire them in our workplace. Social stigma, and the components of social stigma, can vary a great deal by the sociopolitical context. Sexual orientation, for example. Now that we've mentioned social stigma, let us look at self stigma. And one of the things that can happen with an individual is that they can really internalize all the negative stereotypes, prejudices, and discriminatory experiences that they have. As they internalize these negative stereotypes, prejudices, and discriminatory behaviors, they may feel rejected by society, they may feel like they need to avoid interacting with society, they may really struggle to come to grips with their condition. For example, someone who has HIV or AIDS, and really feels the social stigma may go into denial and deny to themselves that they have the condition, and not receive medical follow-up. They may also experience hits on their self-esteem, or suffer from other mental health conditions, such as depression, and then, they themselves may display behaviors that really isolate them from society, and stop them from even attempting to take part in education, vocation, thereby further isolating them. So it appears that, not only is the stigma directed from society and other groups towards an individual is important, but also the stigma that's directed by the individual towards him or herself is also important. Let us also consider studying stigma by using these concentric circles. In the middle, I'm going to label the first circle as 'self,' representing the individual who is stigmatized. The second circle shall represent the family, or the close social group. The third circle shall represent wider society, and finally, the fourth circle shall represent things external to society, but that are very important, such as the media. One thing that we should appreciate is that there are bi-directional relationships between all of these groups, such as the self and the family, the self and society, the self and the media, and also in between all of these groups, such as society and family, such as the media and society. So let's have a closer look at these groups as we peel off the concentric circles. Let's start by looking at the influence of the media. The media is a major source of stigma, because it can have depictions of various conditions as being violent, dangerous, or representing moral failings, as is commonly the case when we encounter representations of mental illness in the media, but it can also be encountered in other conditions that are depicted in the media, such as HIV and AIDS, obesity, and people who have substance use problems. A useful intervention at this point is the development of guidelines for journalists to try and decrease the amount of stigma that is present in the media, and there's several different sets of guidelines and suggestions in order to do this. And when we mention media, we know that social media is also a huge component. Now, let's move on to society. Society is also very important, because this is where the interactions between the self and society involve things like education, employment, health care. Stigmatizing views by employers, by health care providers, can really diminish the access of individuals to earning an income, to getting the proper level of health care, to even turning up for a screening, getting follow-up, and an important intervention at this point is the use of legislation and anti-discrimination laws. Now, let's consider the family. Now, the interesting thing here, is that the family can not only be shunned by society, if they have somebody with a stigmatizing condition, but the family may also shun the individual themselves. In this example, we may often see somebody in the family who has a stigmatizing condition to be hidden, kept away from the family, to really be isolated, and almost kept as a secret within the family. So if we look at our concentric circles, the family can be stigmatized by society, but can also stigmatize the individual, so this also may be detrimental to personal or intimate relationships. So at this point, interventions such as therapy and education are also very important. Finally, we reach the very core of the structure, which is the individual with the condition, or the self. And in this case, we know that all these different interactions, media, society, and the family, the individual can internalize a lot of this different stigma, and that can lead to them avoiding situations, denying the existence of their condition, suffering from mental health conditions, and no longer really participating in society. Useful interventions at this point would be to educate the patient, to give them access to resources, support groups, and these resources would really help them to understand that they're not alone.