Friday, September 19, 2014

cognitive behavioral stigma

If my self-esteem is a bit lacking at times, maybe it has something to do with how others seem to view my situation.  Most are a pretty far cry from enlightened on the subject of mental health, but especially during my formative adolescent years, people were pretty hard on me.

Given how little was known about my condition, it's somewhat understandable.  I was not behaving in a healthy way, and no one understood why.  It makes some fairly obvious sense to attempt to correct that behaviour, right?  Even making sure to get it through my head how very wrong I was to insist on being the way I was?

There's even a whole school of psychology devoted to the idea that mental health can be remedied by healthier thoughts and behaviours.  Certainly, there's a measure of indisputable truth to that, but its limits and dangerous side-effects tend to be ignored.  Of course, it can seem incredibly harmless.  Just smile more, you'll feel better.  Think more positive thoughts, engage in more positive activities.  How could any of that be bad?

It's bad when you think it's a real solution, for serious underlying problems that are not going to be solved that easily.  It can create a dynamic of stigma, where the person who fails to follow such advice, or even just fails to find success in it, becomes at fault for that.  It risks blaming the victim for being responsible for their own plight.  Even when there's a degree of truth to that responsibility, anyone who actually cares, might want to consider treading carefully when going there.. or at the very least, try to be sympathetic when said advice doesn't exactly pan out.

So much of how the mind works is still beyond the scope of modern medical science, but that's not really much of an excuse for ignoring the harm that good intentions can cause.  Before it was even considered how pituitary function might play into mental health, it was clear that I had serious problems, and no one had any idea how to help me.

Now that it's better understood, and I've done my best to highlight that as a very likely contributor, at the very least, it makes even less sense to point out my behavioral issues.  Granted, to an observer, it sure looks like the problem is that I don't do anything, but whatever the cause, that has a whole lot to do with the crippling mental conditions I've been trying to navigate my entire life..  Even after all this, I still feel like I'm locked away in an invisible prison no one really believes in.

Take away this crushing weight, and of course my behaviour will change.  I sure as hell don't like living this way, but an emphasis on changing behavior would be putting the cart before the horse.  It's an understandable attitude, but its just not very realistic, exposes a lack of sympathy for the gravity of what I'm actually dealing with, and reinforces blame, when I'm already pathologically prone to blaming myself.

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