In a previous post (Sometimes the problem is…ME?), I suggested that the problem of stigma and mental illness doesn’t reside entirely in society, but that part of the problem – much more subject to our control – is the part that resides within ourselves: self-stigma.
An interesting point, in principle perhaps, but does this insight really help anyone?
In cognitive behavior therapy, one thing we know is that intellectual understanding is only one step in the change process. We must also go about the hard work of actually transitioning to new, more functional, attitudes and behaviors. What might that work consist of?
Research collaborators from Indiana, New York and Israel have some ideas. In a study described recently in a report from the University of Haifa, people with a variety of severe psychiatric disorders were provided with a new and innovative therapeutic experience called “narrative enhancement cognitive behavioral therapy.” It consists of 22 sessions devoted specifically to modifying negative beliefs and attitudes about mental illness that have been internalized from society. When compared afterwards with people with similar disorders who had not participated in the program, participants manifested reduced self-stigma and higher self-esteem.
Is this a surprising result? Of course not. Stigmatizing attitudes about mental illness or anything else tend to change when brought to light and addressed (consider how attitudes about breast cancer and AIDS have changed over the years). Self-stigma is no different.
Our attitudes about ourselves are not facts etched in stone; they are stories we tell ourselves (“narratives”), stories that can be rewritten.
What is surprising about this report is that it is so novel. Although it is only a simple pilot study, it is being reported as big news; and so it is. It is also long overdue, considering that the technology for this intervention has been around for at least 30 years.
Let us applaud these researchers (not to mention the National Institute of Mental Health, which funded the study) and hope that this is the start of something much bigger.