The Words that permit prejudice and stigma
Introduction
Many of the words that we use to describe human suffering simply do not work. They don’t work, because they label people as being different. And, they don’t work because they make people more frightened of those who are depressed or psychotic. And, when people are frightened they become more prejudiced.
I don’t want people to be frightened. So, what do we do?
Downstream Problems
Stigma in mental health, which is the felt experience of on-going judgement, inferiority and exclusion, is a downstream problem. It starts when people with more power think they know what is best and when they stop listening to those who need their help. It starts when they restrict people’s freedoms by taking control for the lives.
Mainstream Psychiatry does more harm than good
Psychiatry uses words like mental illness, disease, disorder and symptoms. At first glance, these words may seem harmless, but they don’t bring people together. When you believe in a biological cause of human suffering you are suspicious and you keep people at a distance. And people feel frightened.
Healthcare is meant to help you
Healthcare is not meant to frighten you. It is meant to help you. Its job is to take care of you. But too many people are told they need to take prescribed drugs that will fix their brains. And, they are not warned about the terrible side-effects and the long-term damage that it can cause.
When you visit a Doctor, you expect to be able to trust them. You expect to get help so you can be a better parent, to advance in your career and to enjoy hanging out with your friends. Unfortunately, psychiatric medication often robs you of these freedoms. So, what do we do?
The Facts Don’t Work
I’ve made mistakes. These are the same mistakes that many liberals make. I present the facts and I expect that other people will be immediately convinced to change their attitudes. How can you ignore the facts right? But the facts don’t work either. In this post-truth world, the actual facts can only be heard by other liberals who already think the same as me.
World Views
Facts on their own are useless in changing people’s minds. Your mind has a filter and you naturally look for evidence that supports your own world view. This is why Trump supporters believe anything he says. Your filter also dismisses anything that doesn’t support your world view. In fact, facts that dispute your world view only strengthen your world view.
Conservatives speak to values not facts
Conservatives have cottoned on to something that liberals don’t understand. They speak to values not facts. And they are organised. They are winning!
In the last 60 years, conservatives have been successful in changing people’s attitude. They have shifted people’s world views to the right and they have changed what is important to them. Instead of building communities that help all of society, people are pursuing self-interest.
Conservatives have done this by organising themselves. Big business owns many of the biggest selling newspapers and they donate vast amounts of money to the conservative political parties.
The world’s wealth is being soaked up by fewer and fewer people. Health inequalities also get bigger as the gap between the rich and the poor widens. Suffering increases leaving the way for conservative healthcare to move in and start giving people drugs to fix them. But they do more harm than good.
Conservatives are winning, because they are organised and they speak to values not facts.
Don’t call them stupid
Conservative Morality
Liberals think that conservatives are immoral or stupid. The truth is they just have a different morality. They have a Strict Father Morality.
The Strict Father morality takes the view that families need a strict father to discipline their children. They believe that children are naturally bad and that they need to be taught to be good through punishment. By punishing them, they’ll learn how to behave and how to become self-reliant.
They believe in a natural order organised in a hierarchy. God above man, man above woman, parents above children. They also believe in whites above non-whites, heterosexuals above homosexuals, rich above poor and strong above weak.
They believe that life has winners and it has losers. You are a winner if you’ve learned self-control and you are a loser if you have not. Therefore, if you are suffering economically, socially or with your health it is your fault. They believe that if you look after yourself effectively, then everyone will prosper.
The Liberal Progressive Morality
Liberals believe in something different. They believe in a Nurturant Parent Morality, which sees mothers and fathers as responsible for protecting and empathising with their children. They believe that children are inherently good, but they need care and guidance to get on in the world.
Nurturant parents invest in protections for people. They believe that if you protect people, then you make the world fairer and more equal. They believe that you can make people and the world better by investing in a strong public sector. With a strong infrastructure, education system, healthcare and economy, people are free to prosper.
The Centre
These are the extremes. Many people are more complex than this and often have a mixture of these moralities. They hold parts of both. For example, you might be nurturant at home and conservative at work. You might want a compassionate teacher for your children, but you think taxes on business should be minimised.
When you are organised then you can influence the way people think. The way people think is controlled by what they read, by politics and by the organisations that exert power in society. These are the ones with the most money and the most power.
Present the facts 2nd and the moral frame first
Thankfully, cognitive neuroscience, linguistics and contextual behavioural science are teaching us how we can win back influence.
We need to connect with what people care about. And we need to use our own language to describe it. When we use conservative language, we strengthen the position of the conservative. Saying their words are wrong, only reminds people of what they have said. When we use bio-medical language to describe human suffering, we give strength to the strict father morality of mainstream psychiatry and big pharma.
The facts are important. They are incredibly important. But they do not change attitudes unless they are presented within a new frame. The frame needs to speak to what people care about. When you talk about what you care about, set the frame first and present the facts second.
Win over people by speaking to their hearts and minds
A new frame – Gentle & Brave Health care
Tony Biglan wrote a book about building a world that is more nurturing. And this starts with empathy. You can get closer to people when you take their perspective. You can avoid conflict when you remain respectful no matter what other people say or do.
When we are gentle, people feel less frightened. This is what I want mental health care to look like. When I focus on being gentle, I listen to what you are telling me. And, when I am being gentle, I am open to my own emotions so that I can tune in to what you need. When someone is gentle with me, I feel safe.
Help a person to feel safe
Safety is the base you need to take purposeful risks. Taking risks that make your life better requires you to be brave. So, our healthcare needs to be both gentle and brave. Help a person to feel safe and then help them to step outside their comfort zone. Help them to invest in their own wellbeing so that they can prosper.
There are times in my life where I have been neither gentle nor brave. And, it didn’t work. It left me stuck and it left me miserable. But one day, I found my courage and I started to build better relationships. I started to make wiser choices and my confidence grew.
We need to be organised
I didn’t do it alone. I had a family and friends that were there for me. Their support gave me strength and steered me in the right direction. And this is what we all need to change people’s attitudes, to change the culture and to change the system in our health care.
We need to be organised and we need to speak to people’s values. So when you meet a family member, friend or work colleague who thinks conservatively, talk to them about being gentle and being brave. Get them to talk about when they’ve looked after people and when they’ve protected people. When you do that you activate their empathy and you turn off their self-interest.
Stay clear of their frames and their language. You don’t want to activate the strict father morality in them. Even when you are arguing against what they’re saying, use your own language. Speak of how gentle and brave health care gives people the freedom to become more independent.
When you’re debating, view it like you’re dancing. Get crystal clear about what you believe and repeat it loud. Repeat it again and again, because you’ll strengthen the caring frame in their mind.
Say it simply. We need gentle and brave healthcare. Stigma is a downstream problem borne out of prejudice and fear. Be gentle and people will feel less frightened. Be brave, and you can prosper.
- Define your position and learn it well so you can grab people’s attention when you talk about it.
- Connect with the parts of people that are nurturing and bring that alive
- Organise and unite by partnering up.
- Debate like you’re dancing and always frame 1st…be passionate and show conviction.
Exploring Effective Therapy for Depression in Birmingham