“Serious mental illness strikes with a two-edged sword. On one side are the symptoms, distress, and disability that hamper people pursuing personal goals. On the other is stigma: the social injustice many people labeled mentally ill experience that can be equally challenging for achieving one’s aspirations (Corrigan and Bink 2016).”
The first and widest of the barriers blocking adolescents from accessing mental healthcare is the social stigma against mental illness. Depression, especially in adolescents, has been societally misunderstood, mischaracterized, and misinterpreted for decades. But to understand how so many suffering teens are being silenced and dismissed–with labels like “hormonal” or “spoiled” sealing their lips–we first have to understand what stigma is and how it affects human behavior.
So, in this first installment of my two-part feature, we are going to ask:
“What exactly is social stigma–and how does it shape the way people present themselves? Can it change who they are inside?”
Strangely enough, to answer these questions, we first have to head to a theater.
Welcome to Goffman’s Theater!
In his seminal work The Presentation of Self in Everyday Life, renowned sociologist Erving Goffman explains the dynamics behind an individual’s interactions with society by using an extensive theatrical analogy. Also called “dramaturgical analysis,” this method compares an individual to an actor onstage performing in front of an audience.
Individual-society interactions are, in many ways, a performance. The actor presents a fictional narrative to the audience, and the audience tries to make sense of that narrative by picking out, interpreting, and analyzing parts of the act. At the same time, the actor also watches the audience. Onstage, where the spotlight is shining, the individual presents positive or desired impressions of his or herself. Here, the actor holds a “virtual identity.” Backstage, behind the curtains, the individual keeps a separate and private identity distinct from the one that he or she presents to the audience. Here, the actor holds his or her “actual identity.”
Social stigma is the devaluing of certain social characteristics. According to Goffman, there are three types of such characteristics: physical differences, differences in personal traits, and “tribal stigmas.” Stigma against people with mental illnesses fall under the second category. (We are going to discuss the specifics of mental illness stigma in detail next week, but for now, let’s stick to the big picture.) When the audience disgraces or distorts a certain trait, such as having a mental illness, one’s “virtual identity” becomes separated from one’s “actual identity.” A gaping schism forms–and the individual now faces a challenge. The actor must respond; the show must go on.
So what does that response look like? According to Goffman, individuals often try to dispose of their stigmatized or “spoiled” identities by concealing them. They drag it backstage, behind the curtains, where no one will find it. This tendency becomes especially problematic, however, in individuals suffering from or at risk of mental illness; what they dragged backstage could be slowly wearing away at their ability to feel happy, fulfilled, or willed to live. It needs treatment. It needs the eyes of a psychiatrist or a guidance counselor or a family member or a doctor or a friend. It needs mental healthcare.
Next issue, we will expand on the real-life implications of this “spoiled” identity effect, and what it means for depressed teens facing social stigma in the US. But until next time, enjoy the intermission!