On Mental Health and Stigma

The Madness of Stigmas

Stigmas have the same nature as gas, or fear, they fill whatever space is made available to them. Almost everything about mental health still has a huge pink elephant of a stigma going on. I don’t care how we face it down, but if we are really going to tackle it, front on, then we have to. I will adopt any effective method going. Writing about some of the most common themes coming up as I practice seems one way. This first post is about one of the most common anxiety triggers that comes up during sessions, particularly with patients and clients under 30.

Flesh and the Internet

I would be more at ease if I was not working with a young girl who had tried to hang herself because of what her ‘friends’ wrote about her on-line. I would also like not to be one of the moderators on a media forum where the bullying got so bad that intervention became necessary—and the irony: it is a site for international peace discussions. Many sessions would be far less embarrassing for some younger patients if I did not have to define, very carefully, the difference between Internet pornography and what it is like to have real, human sex. And I would rather not have almost been evicted from where I work in India because of some crazy fabrications about me on a particularly over-loaded social network.

I would also rather not have had to put ‘I’ so many times in that paragraph, but there is something about the nature of the Internet that has created what seems to be a new kind of tribalism that demands personal proof of everything.

Except that it is not new, this particular variety of created community.

Here is the paradox of the Internet: it is a great leap forward, but there is little that is new, fantastic, or modern about it. Really it is just a very old-fashioned idea that has had a ‘pimp my ride’ technology makeover. What the Internet does is, in many ways, fabulously retro. It is a worldwide version of the apron-waist high fences that separated terraced houses in so many cluttered mid-twentieth century European cities. Every day, as women went about their lives and laundry lines, they leant across the fences and chattered. They bitched, cried, laughed, and went away feeling unburdened, or at the very least giggling about some heinous street gossip, usually involving a condom hanging out of next door’s dog’s mouth, or variations on that sort of theme. In addition to this it is also the ether form of the factory gate, the working men’s club, school playground, campus common room, hospital waiting room, the bus you catch, the train you take, your local cafe?, your favourite pub or bar—it is anywhere and everywhere that you connect with people, except that there are no people.

When we click off a call, jump out of a chat-room, or any other kind of ‘instant’ forum, we are usually alone again, except that we feel even more alone. There is no-one to wave to across the low fence, no shy smile across the crowded tube, no shoulder to sway against on the way back from the pub after the half pint too far, no quietly supportive hand in the hospital waiting room. We are neurologically designed to respond to human warmth, to touch, and yet here we are, entrapped in a medium that stimulates our brain to think we are

in some form of intimacy, but without the vital component—human contact. The result is that when we click off the sense of aloneness is heightened, the anxiety of isolation increased, the chances of compulsive behaviour exacerbated, and depression becomes darker, the urge to click back on-line even greater.

And so we have teenagers in suicidal despair, and grown men and women behaving like drunk teenagers. Meanwhile the various security systems, national or otherwise, try to work out how to respond to the wave of unresolved human emotion that pours out across the ether, without the powerful holding pattern of human touch to control the excesses of those emotions.

There is a lot of dialogue in play about how we should behave on-line. Quite a lot of it steers fast into the realm of the absurd as people claim human rights abuses, if and when their right to scream abuse on Internet forums is challenged.

Effective dialogue is based on truth. This is how psychotherapy works – a relationship based on trust wherein someone can speak the truth about themselves, knowing that everything that is said is confidential. The Internet is the opposite of this, but it requires its own code of truth to curb some of the violence being spread across it, and some of the violence that results from what people find on-line.

Imagine if we only put on-line what we were prepared to say to someone face-to-face and sober? This is often suggested, but it is usually presented as an almost throw-away idea, too simple, or even simplistic to be followed.

Just as there is both simplicity and enormity to breathing…but that is for another day and another post.

So, in short summary, intimacy is created and shored up by human contact, by tenderness and touch. The Internet cannot do this, and we need to stop pretending that it can.