It depends: The difference between stigma and wisdom

As an academic, I cherish debate and reflection. Of course, it is one thing to be challenged by someone who may have some reservations about my views about the mind-body debate or my thoughts about when and where the Habs will bring home cup number 25. To be questioned on your personal beliefs takes us to a whole new level.When the woman who currently occupies a large portion of my heart read my last entry, she posed the following hypothetical: “If, when we first met, I told you that I was suffering from bipolar disorder, would we still be together now?” (Just to set the record straight, this was a “what if” question, she is not bipolar).

Two days after the blog was published, I ran into Hélène Laberge, who skillfully manages multiple roles here at the Douglas, not the least of which is the head of our occupational therapy department. Following a heart-felt exchange of pleasantries, she looked at me with her special, inquisitive look of disbelief and asked: “Would you really marry someone with a mental illness?”

I must confess that my initial, reflexive response to both questions was “No!”. I wasn’t at all pleased with this knee-jerk response; it seemed like I was guilty of nurturing the same “holier-then-thou” attitude that I chastised others for holding. On further reflections, however, I realized that my true answer was: “It depends.” For those of you thinking this is the ultimate in fence-sitting, allow me to expand.

If I met someone who was doing nothing to try to improve their condition, then I wouldn’t commit myself to a fully intimate relationship. If I met someone who was currently taking medication for their problem, was committed to taking the medication AND (note the emphasis here) was currently an active participant in psychotherapy or a support group, then I would use the same criteria for compatibility that I would use with any one else, common interests, likes, dislikes, and yes, physical attraction. Why? Because the research shows overwhelmingly that a combination of pharmaco- and psychotherapy is the best form of intervention. And if someone is doing their best to overcome the demons that we all have (to varying degrees, of course), then I am open to a deeper exploration of future possibilities.

There is one interpretive problem with the Canadian Medical Association survey on attitudes towards mental health: it does not permit us to compare our attitudes towards the mentally ill with our attitudes towards people with other kinds of illness. How many Canadians (or other nationalities for that matter) would consider a relationship with someone suffering from HIV-AIDS? What about diabetes, heart disease, arthritis, chronic back-ache, Chron’s disease or asthma?

Would I run away from someone suffering from AIDS? Not necessarily. I’d want to know whether that person was currently taking medication for their problem, was committed to taking the medication AND was currently an active participant in psychotherapy or a support group (Sound familiar?). Then I’d want to know more about the person.
Why would I want to know if a potential mate suffers from arthritis? Because it could, in theory, limit the things we are able to do together. No, not just the horizontal Mambo, but bikes rides, walks in the forest on a frosty winter’s day, floating among the clouds in a hot-air balloon. I’d like the information so that I could compare these restrictions with the distinctive benefits and advantages that the individual has to offer.

And if we decide not to commit to a relationship (be it romantic or friendly) because we feel there is no compatibility, that’s not prejudicial. Nor would it classify as stigmatization. Stigma and prejudice are born of ignorance and misinformation; if you make the effort to acquire the necessary knowledge to be able to judge the person AS A PERSON, if your choice is educated, then it’s not stigma.

Same is true for our reactions to the mentally ill: If we ostracize someone simply on the basis of a diagnosis, well that’s stigma. If we take the time to learn exactly what bipolar disorder is, what can be done about it, how the disorder manifests itself in the individual, and whether or not the person is doing something about it, well, that’s just being wise.

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Posted in Human, Mental health.

Posted on 25 Aug 2008

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