What is stigma? And how does it change a person’s mental health and quality of life? In today’s Psych Central Podcast, Gabe talks with anthropologists Alex Brewis and Amber Wutich about the deeply dehumanizing impact of stigma in culture. Whether it’s your mental health diagnosis, your neighborhood, your hasten or your inability to meet society’s standards in some way, stigma is alive and well in today’s world. People even tend to stigmatize themselves, intensifying their suffer.
Why are parties so quick to label? And how does stigma feign mental health treatment? Tune into the show for an in-depth look at how humen tend to label others( and themselves) — often without even thinking about it.
Alexandra Brewis( Slade) is a President’s Professor and Founding Director of the Center for Global Health at ASU.
Trained as an anthropologist, Alex’s award is currently concentrates on how stigma, poverty, gender and other forms of social and economic exclusion and marginalization figure our health and human biology. With a long career of resulting mixed-method community-based field research at multiple sites across the globe, much of her current investigate brings together large and diverse units, addressing such challenges as water insecurity, improving development project design and monitoring, and appropriately adapted anti-obesity acts.
At ASU, Brewis Slade coachs world-wide state and anthropology. She is an American Association for the Advancement of Science( AAAS) friend and currently helps as president of the Human Biology Association. As an administrator at ASU, she founded the Center for Global Health in 2006 and served as Director of the School of Human Evolution and Social Change( 2010 -2 017) and Associate Vice President for Social Sciences( 2014 -2 017 ). She currently provides as President of the Human Biology Association.
Professor Brewis received a doctorate in anthropology from University of Arizona( 1992) and was an Andrew W Mellon Foundation postdoctoral person in demography at Brown University. Before joining ASU in 2005, she coached at University of Auckland and University of Georgia.
Amber Wutich is a President’s Professor of Anthropology and Director of the Center for Global Health at Arizona State University. Her two decades of community-based fieldwork are concerned with how inequitable and unjust resource institutes affect people’s well-being, specially under conditions of poverty. An expert on irrigate insecurity and mental health, she aims the Global Ethnohydrology Study, a cross-cultural study of water lore and management. Wutich maintains longstanding ties in her discipline locates in Paraguay and Bolivia, and succeeds a tactical confederation between la Universidad Catolica-Itapua( Paraguay) and ASU. An ethnographer and methodologist with over 100 peer-reviewed pamphlets, Wutich edits the gazette Field Methods and coauthored Analyzing Qualitative Data: Systematic Approachings( 2016, SAGE ). Her teaching has been recognized with allotments such as Carnegie CASE Arizona Professor of the Year. Wutich has raised over $34 million in study stores, as part of collaborative research teams, from the National Science Foundation, USDA, and other funders. Wutich’s latest record, coauthored with Dr. Alexandra Brewis, is Lazy, Crazy, and Disgusting: Stigma and the Undoing of Global Health( 2019, Johns Hopkins University Press ).
About The Psych Central Podcast Host
Gabe Howard is an award-winning writer and loudspeaker who lives with bipolar disorder. He is the author of the popular bible, Mental Illness is an Asshole and other Observations, available from Amazon; ratified imitates are too accessible directly from the author . To understanding of Gabe, please visit his website, gabehoward.com.
Computer Generated Transcript for’ Alex Brewis& Amber Wutich- Lazy, Crazy, and Disgusting’ Episode
Editor’s Note: Please be mindful that this transcript has been computer engendered and therefore may contain mistakes and grammar flaws. Thank you.
Announcer: You’re listening to the Psych Central Podcast, where guest professionals in the areas of psychology and mental health share thought-provoking information using plain, daily communication. Here’s your emcee, Gabe Howard.
Gabe Howard: Hello, everybody, and welcome to this week’s episode of the Psych Central Podcast. Calling into the reveal today “were having” Alex Brewis and Amber Wutich, both anthropologists and President’s Professors at Arizona State University where Alex founded, and Amber now targets the Center for Global Health. Their most recent book together is Lazy, Crazy, and Disgusting: Stigma and the Undoing of Global Health. Alex and Amber, welcome to the show.
Alexandra Brewis, Ph.D .: Thank you.
Amber Wutich, Ph.D .: Thank you.
Gabe Howard: Well, I am really excited to be here because your work focuses on three issues of world state endeavors, cleanlines( or “disgusting” ), obesity( which is “lazy”) and my own personal favorite mental illness,( which is “crazy”) and trying to tie those things together so well. It’s difficult, right? But there’s stigma everywhere. And mental illness is just like any other aspect of health when it comes to being stigmatized in this manner.
Amber Wutich, Ph.D .: It is, and mental health is one of the stigmatizing phenomenon that we understand best. And it is therefore genuinely helps us think about other questions that are less well understood.
Gabe Howard: One of the things that’s become fascinating to me since I started doing this show and started working in patient advocacy is when I first get started, I are of the view that exclusively hard-handed stop only mental illness was labelled, that if you had any other illness or state or a malady, you were treated with caring and respect. And nobody was judgmental. And that the only reason people were “ve been meaning to” me because of my bipolar diagnosis is because people didn’t like the mentally ill. And as I started to get more and more involved and fill great beings like the two of you, I has recognized that. Oh, my. It seems like any health provision is stigmatized.
Alexandra Brewis, Ph.D .: Yes. So we went through a lot of different aspects of stigma. But what seems to be the case is that conditions that are chronic and don’t have an easy cure have often been those that are a focus of stigma. Because those descriptions can affix and kind of stay attached. And part of the stigma is the disease itself isn’t readily and entirely treatable in the way that, you know, for example, a cold is self restriction. To having a cold is not going to be nearly as labelled as having leprosy or other conditions that have various kinds of crept in as becoming very stigmatized over duration. Often it’s positions that are associated with some panic and often that comes from not knowing exactly what the causes are, exactly how to fix it. Those tend to be the conditions that become stigmatized.
Gabe Howard: When we’re talking about stigma, let’s define the word. What accurately is stigma?
Alexandra Brewis, Ph.D .: Well, stigma in relation to health is when the condition that you have comes to define your name in a negative way because of the judgments that are placed on that. And the thing that’s particular about stigma is it’s also then used as a road to push parties down and out, to marginalize them, to deny them. So stigma is the disease, plus the negative arbitration, plus the social rejection that comes from that.
Gabe Howard: In many actions, that just sounds a great deal like discrimination. How does stigma differ from discrimination?
Alexandra Brewis, Ph.D .: So one course that stigma becomes prove is as discrimination. So discrimination, is one type of stigma, a stigma where people act on those negative arbitrations to treat someone worse than they would otherwise. Whether it’s disavowing them employment, disavowing them with health care. But the difference is that stigma can take many forms. So while discrimination is basically an play-act stigma, people can feel stigma and be influenced by it without someone overtly acting on a negative judgment.
Gabe Howard: I think that we can all agree that whether it’s stigma or discrimination, it’s really analyse parties less than they are. It’s looking at them and deciding, hey, you’re not as good as other parties. Is that a fair sort of analogy or assessment of stigma?
Alexandra Brewis, Ph.D .: Yes, it’s a process of removing people’s humanity, of a process of devaluing them as social beings. So that’s exactly what it is.
Gabe Howard: Obviously, when we’re talking about state controversies, it’s hard enough to be sick, right like that in and of itself is difficult and being stigmatized, that in and of itself is difficult. And when you threw the two together, this just is problematic. And that kind of contributes me to my next question. How does this stigma subvert mental health treatment?
Amber Wutich, Ph.D .: There are so many styles that stigma subverts mental health treatment. One important thing to understand is that stigma can actually cause mental ill health. So people who are frequently brutalized or propagandized out or down in culture can develop anxiety. They can develop depression. So that’s right off the bat. In addition to that, for countless people, the accomplishments of being stigmatized by a mental health care provider is actually worse than addressing the manifestations of mental health. So they would rather continue untreated than actually seeking out care from a provider. Beyond that, we know that stigma depresses investment in mental health research and treatment. So the quality of care available to parties is less because of stigma. We know that it can undermine the efficacy of care. So, beings may not receive care that’s as good as they might if they didn’t have a stigmatized ailment. And then a really important thing for people is that if they have a labelled mental health condition, they are to be able to receive less social support from people around them. And that can really impede their improvement.
Gabe Howard: One of the things that’s fascinating to me about being a mental health advocate is the idea that it simply happens to a certain type of person. You had a bad upbringing. Your mothers were bad. A parcel of trash inspects. Your mother didn’t love you enough or there’s just so much misinformation that swims around. But a good deal of parties guess these things are true. Does the amount of stigma of mental health conditions contribute to parties reputing some of these far fetched beliefs about mental illness and mental health questions?
Alexandra Brewis, Ph.D .: So I think it’s almost the inverse. I think that people’s minds about these types of causes of illness that is often used to drive stigma. So if people be suggested that illness are because the family fails or the person or persons flunks, they’re more likely to stigmatize that state. So a good example of that that we see now is rising stigma against obesity. Is that when people believe that parties advantage a great deal of heavines because of moral miss, like, you know, for example, overweight children’s parents are good parents, then that actually tends to elevate and give them more stigma towards the condition.
Amber Wutich, Ph.D .: But an essential part of stigmatization is othering. And it’s a way of making a distinction between myself and other people who have this health. Right? And so this idea that the source of the stigmatized requirement is different, is something that not everyone events, is part of this othering process as well.
Gabe Howard: One of the things that was mesmerizing to me in your bible, Lazy, Crazy, and Disgusting, is about how health professionals might unwittingly create additional stigma through their efforts to help people. Can you hold us an example and talk about that for a few moments? Because I think that numerous beings only interpret health professionals as good and helpful. It’s interesting that they can have any negative repercussion in the way that they’re working. So I exactly found that completely fascinating.
Alexandra Brewis, Ph.D .: A good example we have in our record of that is we have health professionals who on the whole, are just really motivated by the desire to do good in their task. Now, we don’t want to gives the impression that the health profession is full of people who are actively stigmatizing purposefully.
Gabe Howard: Of route not, it’s like an unintended upshot, right?
Alexandra Brewis, Ph.D .: Yes. So in the book, we go through the case of sanitation involvements that really operation stigma as a route to prompt behaviour modify. So by making use of certain cleanlines demeanors like outdoor defecation outraging and stigmatized, they’re working hard to push parties to choice and patient demeanor in ways that fulfill public health objectives, right? Which is better sanitation, better health, less infectious disease. So the goals and targets itself is good. But in doing that, what it seems to be doing that we see as anthropologists is that on the grind, they actually are also creating new pockets of stigma that can be very damaging for the people that they focus on with, you are aware, when it comes to sanitation and dimensions of the people that can’t afford to build bathrooms, can’t open to buy soap, and the other things now that they’re expected to have as a result of the involvement. So I think that’s one really good example of how the best available aims can derail. If parties don’t understand how stigma really works on the foot.
Amber Wutich, Ph.D .: And thinking about mental health specifically, I do think it’s important to point to mental health care professionals as one of the groups of care providers that really sincerely understands how shattering stigma can be and makes an enormous effort to destigmatize care. But there are certain variants of mental health treatment which is something we look the persistent negative impacts of stigma. And one good example is an opiate treatment. So for people who have opiate addiction, we know that there is often an excessive emphasis placed on their own efforts. And if they relapse very often, they are believed to label as a result , not just by their social networks, but too even by their care providers. And we know that that flesh of care is not consistent with the best aftermaths for opiate therapy. And this is so much the event that sometimes people with opiate addiction are not counseled to consider medication. They’re just told that they need to make more of an effort in certain treatment programs. And so I think that’s a really good example of the way that stigma can be damaging in mental health treatment.
Alexandra Brewis, Ph.D .: And another example that’s quite different is the observation that mental health treatment professionals are often stigmatized within the profession because they are seen as working with patients that are less desirable, that are less easy to treat. So you see this with a lot of clinicians that choose to work with labelled status is because they themselves become devalued within the profession.
Gabe Howard: We’re going to stair away for a minute and then we’ll be right back.
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Gabe Howard: And we’re back discussing mental health stigma with Professors Alex Brewis and Amber Wutich. This is slightly off topic. But to your point, one of the tropes that you hear about often is that mental health professionals are just as crazy as their patients. They got into it because they wanted to diagnose themselves or they got into it because they wanted to diagnose a family member, whereas this doesn’t exist elsewhere. An oncologist isn’t seen as somebody who has cancer or knows someone with cancer. They’re just somebody who went into a specialty for any number of reasons. Is this something that you’re seeing in your work as well, that simply all mental health professionals are labelled?
Amber Wutich, Ph.D .: That isn’t something we specifically investigated in our own part, although we do see in the literature indications that the stigmatization of some mental health professionals. And I think that’s a process that you’ve described is a really good example of how these negative rulings accrue to people who are in a stigmatized social position.
Gabe Howard: I can certainly accompany where if somebody tells you, hey, you need to see a mental health professional and you’re thinking to pop culture and you’re thinking to all of these, only everything that we’ve seen about mental health professionals in the favourite media, in movies or even in journals, we may think, oh, yeah, they’re just crazy beings that are, you know, pushing capsules or are they just want to talk about it. And that doesn’t work and they’re nuts. It’s a really easy way to dismiss something that you probably previously don’t want to do. And I say that you don’t want to do it , not because it’s mental health, but because who wants to go to the doctor? And that’s sort of what you’re talking about with stigma. Right. It’s this acces to easily dismiss something rather than truly think about it and consider its merits.
Alexandra Brewis, Ph.D .: One of the big challenges was stigma is, and probably the most damaging form, is self stigma, when you take on the label and you begin to believe it yourself. So if you think that you show those negative qualities that have been placed on the condition because you have it, that’s obviously going to be not wanting a diagnosis in the first place or wanting to seek treatment, because the awfully play of doing that gives you into that category that you already concurred is a denigrated list. That’s why ego stigma is by far the most damaging form of stigma that there is.
Gabe Howard: That’s something that I hadn’t even thought about. But you’re right. Because who wants to be fill in the space? It’s scary enough living with the illness, but declaring all of these things to yourself. And then, as you mentioned earlier, admitting this is something that others. This can be very, very difficult. Thank you so much for saying that. I really, actually appreciate it.
Amber Wutich, Ph.D .: It is true that it can be incredibly difficult to come to the realization that you have a labelled requirement and that by striving medication, you may need to spawn that more public. But one of the things that Alex and I found in our research and genuinely believe is that of all the ways that people have tried to destigmatize certain health conditions. Probably the most powerful is that when people with a condition become activists and speak to society , not only about the behavior that the stigma is impacting them, but also the path that we should modify our society, that is a really fantastically gallant number and has amazing efficacy. So that’s the flip side, that once parties get past the stigma and move into a place of contacting out to others be used to help, it can really transform the way that they impact the world positively.
Gabe Howard: I could not agree with you more. As somebody who lives with mental illness, I believe that speaking about it honestly, genuinely, certainly helps people. And the amount of support and encouragement that I’ve been given is its own form of, I don’t know, it feels like a big hug whenever I get the nice e-mails. And that helps me maintain my my mental health issues topics as well. So thank you. I actually have known that. And I hope anybody listening will either was talking about themselves or foster their friends and family and loved ones to speak out as well.
Amber Wutich, Ph.D .: That’s true, and this podcast was a good example of a room that you’re impacting the very broad discourse around these issues and actually curing a good deal of people.
Gabe Howard: Thank you. Thank you. One of the key points of your record is that mental conditions like depression might themselves be created or worsened by stigma. We tend to think of stigma as something that happens after the diagnosis. We don’t think of it as something that induces a diagnosis. And the pattern that mesmerized me “the worlds largest” that you grant is how stigma around the neighborhood where you live could worsen your recession. And there was a study on this, if I’m not mistaken. Can you talk about that for a moment?
Amber Wutich, Ph.D .: Absolutely. We did a study a few years ago, and to understand it, I think it’s helpful to have a little bit of background about Phoenix. So Phoenix, like countless enormous municipalities in the US, has a section that has a very long history of racism and discrimination. And so beings were forced to live in this neighborhood. It had inferior services. It has a history going back at least 100 years. And so to this day, this place carries that scene of a stigmatized locate. There are other vicinities in our municipal that have similar statistics in terms of poverty or infrastructure or crime. They’re really no different than this vicinity. But they don’t carry that same stigmatized name. So we conducted interviews with beings in the stigmatized vicinity and a same place “thats really not” labelled and found that people living in the stigmatized place had worse mental health issues composes than parties in a same neighborhood “thats really not” labelled. And so we concluded that precisely living in a situate that had this discoloured name, could negatively affect people’s mental health. And “theres a lot of” other people who come at this question using different methods or different ways that have come to same judgments. And we know that living with a stigmatized situation and living in a stigmatized situation, all of these things increase the stress that someone is experiencing and suffering. Very traumatic situations can increase the likelihood of parties having evidences of distres and depression.
Gabe Howard: And I actually is of the view that logically that obligates ability. If every day you wake up and somebody is telling you that you are bad because of the residence that “youre living in” or who your parents are or the neighborhood or the domain or your job, that’s going to have an impact, right? We all know that positivity has an impact. If you’re well affection and well supported, you tend to think more positively, have better mental health issues, be more stable. So the reverse would have to be true, right? If you’re incessantly told that you’re bad, you’re going to start to feel bad.
Amber Wutich, Ph.D .: That’s exactly right. And I think it’s important to note that because we live in a society where it’s very easy for parties to, for example, have a lot of medical monies and end up bankrupt or being dislodged from their homes, the conditions that induce extreme stress and negative mental health outcomes can really happen to any of us.
Alexandra Brewis, Ph.D .: And they’re different in every social setting. So, for example, I worked for several years on a small island in Micronesia on issues of infertility. And there it was very, very important to duos to have children, to continue family tradition, for legacy. And you would see that the most distressing, the most depressing social condition that parties could have there, above all others was being unable to have children. So it’s very contextual in terms of what is depressing for beings around stigma. Stigma tends to be focused on what are the things that civilization quality “the worlds largest”. So in some ways, when you look at the stigma, you actually too verify the patterns and the specific characteristics of depression that comes with that is really actually you can see what civilization appraises. From the perspective of mental health, mental health is going to be most challenging in national societies when the values that people are aspiring to, things like self control, and some of these other things that are associated with good mental health.
Gabe Howard: I can’t expressed appreciation for both enough for being now, we’re almost out of time, but I have one question that I want to ask about your university exertion, because one of the things that we hear about so often is that young people are struggling with mental health issues topics. And you’re both professors. You’re at one of the most important public universities in the United States. You teach and you instructor a lot of undergraduates. Can you discuss why mental health issues concerns are so prominent on campuses and maybe a little bit about what can be done to assist?
Amber Wutich, Ph.D .: Absolutely. Well, if you think about the experience that students in universities they’re having. I think it’s pretty obvious to everyone why they are experiencing a lot of stress. And many of them have elevated experiencing of nervousnes, hollow. So many of them are living away from home. So they’re experiencing a severance in their social support system. Quite often they’re taking on debt or they’re working variou errands. So is not simply do they have fiscal stresses, but they have very little time to rest. They are probably not participating in healthy eating and practise the room that they did when they lived at home with their families. And all of these things can contribute to evidences of feeling and sadnes. So when I learn undergraduates fairly early in the class, I often put up on the board a list of mental health screeners and cause them know what the evidences of increased likelihood of tension and dimple are and give them a little lecture about how common and ordinary “its all for” beings to experience anxiety and dimple in college and tell them know that we have free resources and that everybody should establish with the mental health care provider if they are experiencing some of the indications of feeling and hollow. So I feel like that’s important because first of all, they may not have been encouraged to seek mental health care in the past. That are likely to be the first time someone is telling them that it’s okay to do that. Too by opening up a discussion in the class. The happening is, the rates are very high. Almost ever, a handful of students “re saying”, yes, I’m experiencing this. Yes, I was just going to our mental health clinic. This is what it was like. And so it opens up a gossip and certainly converts people’s experience from feeling like it’s something they’re agony alone to a shared event that they can all address and move forward with together.
Gabe Howard: Alex and Amber, thank you so much for all the work that you do. Thank you for being now. How can our listeners find you?
Alexandra Brewis, Ph.D .: We are both on social media in various ways. So we blog at Psychology Today. Our blog is called Diagnosis Human and we both have websites. AlexBrewis.org and AmberWutich.org.
Amber Wutich, Ph.D .: And we’re on Twitter.
Alexandra Brewis, Ph.D .: We are on Twitter. You are more on Twitter than I am.
Amber Wutich, Ph.D .: So @AWutich and?
Alexandra Brewis, Ph.D .: and @brewis_alex.
Amber Wutich, Ph.D .: On Twitter.
Gabe Howard: Wonderful. And where can folks get your volume?
Alexandra Brewis, Ph.D .: Probably the most wonderful thing is Amazon.com.
Amber Wutich, Ph.D .: And our publisher is Johns Hopkins University Press.
Alexandra Brewis, Ph.D .: And if you come to our Web site, there’s a deduction code on there for purchase diaries through Johns Hopkins directly.
Gabe Howard: Wonderful. Thank you again so much for being here and listen up, everybody, here’s what I need you to do. Wherever you downloaded this podcast, please squander your words and tell people why you liked it. Don’t be afraid to share us on social media. Email us about or, you know, etch us out on a little placard and walk up and down your street and say, hey, the Psych Central Podcast is awesome. And recollect, you can get one week of free, handy, cheap, private online advise anytime, anywhere, simply by call BetterHelp.com/ PsychCentral. We will see everybody next week.
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