Stigma and Self-Compassion in Digital Stories By People Living with Mental Illness

Background/Purpose: The purpose of my research is to explore how people with mental illness experience stigmatization from society and internalize those messages. SAMHSA recognizes the importance of self-disclosure for recovery from mental illness and for reducing the stigma associated with it. The National Alliance for Mental Illness (NAMI) provides a means for such disclosure through their “Share Your Story” initiative whereby people may publish their personal stories on the internet. Self-compassion is nonjudgmental recognition of oneself as part of humanity and the common human experience. Given that stigma is a process of social devaluation that leads to experiencing a sense of shame and social isolation, self-compassion appears to be a fitting antidote. Research questions: How is social stigma and internalized stigma experienced in the stories? How is self-compassion experienced in the stories?

Methods: A qualitative review was conducted of all NAMI stories (N=365) published before March 2020, the start of the pandemic. The purpose was to examine stories by people who self-disclosed a mental health condition, therefore stories by others were excluded. Atlas.ti software was used to assist the researcher to organize the data and prioritize transparency of process; attach comments and reflections to quotations; code the documents; maintain a research diary; create a codebook, generate visual displays and reports. A second observer reviewed the stories and coding to establish inter-rater reliability.

Results: According to the stories, social stigmatization still exists; much of this process is silent and mental health is not safe to talk about. The following myths/stereotypes were referenced in the stories: Mental illness is not real; mental illness is weakness; suicide is selfish; depression is lazy; anxiety is an attention seeking tactic; some disorders more stigmatized than others; and terrorists are people with mental illness. Some stories attributed stigmatizing beliefs to other intersections of identity. Internalized stigma is still a barrier to receiving treatment, despite recovery-oriented healthcare movement in full swing. When a person receives a psychiatric diagnosis, it signals a change in social status to suddenly having a stigmatized social identity. Like other invisible stigmatized identities, such as sexual orientation, many people with mental illness choose to ‘stay in the closet.’ Internalized stigma by law enforcement, military officers and veterans fear being perceived as weak by peers or losing the privilege of carrying a service weapon.

Self-compassion in this population is maintained through self-care behaviors, psychiatric treatment, and medication compliance that is not always accompanied by, nor preceded by thoughts of kindness, common humanity, or mindfulness as the psychometric construct in prior research portends. Compassion for others is repeatedly cited as the unique gift and strength among people with mental illness.

Conclusions/Implications: The NAMI stories reveal that despite being protected by the Americans with Disabilities Act, people with mental illness continue to suffer from societal stigma and internalized stigma. There has been progress, but with that has come growing pains and backlash that mirror the gay rights movement. Due to cognitive distortion, the maintenance of self-compassion in this population must come from a body-mind connection.