As a child on the playground, did you ever find yourself responding to a slight by chanting, “sticks and stones may break my bones, but words can never hurt me”? Wouldn’t it be nice if that childish retort were really true? In reality, words can hurt. And in the world of addiction recovery and mental health, certain words or phrases can also perpetuate negative stereotypes and contribute to a stigma that keeps people from getting help.
Stigma: What It Is, Why It Persists
We’ve made great strides in understanding substance use disorders (SUD) and mental health issues, but we still have a long way to go to stamp out stigma altogether. It starts with education, because at its root, stigma is usually based on a lack of understanding or fear. Then you add in misleading media representations that reinforce incorrect stereotypes of mental illness, and it becomes easy to see why the problem persists.
Even though public education campaigns have helped to ensure that the general population today has a better understanding of mental illness as a legitimate disorder, we still have a long way to go when it comes to compassion. According to the American Psychiatric Association, a review of studies on stigma shows that while the public may accept the medical or genetic nature of a mental health disorder and the need for treatment, many people still have a negative view of those with mental illness. And stigma’s negative impact isn’t confined to mental illness sufferers alone. It’s reach also stretches to family and other loved ones who support them. It’s the same when it comes to addiction stigma.
A Lack of Understanding + Misinformation = Continued Stigma
When you consider the prevalence of content out there and the amount of time we spend each day consuming information, we should have a better understanding of mental illness and addiction. With so much information, though, it can be hard to find the helpful facts among all the distracting noise.
Without accurate info — or with too much info to sift through — we can easily fall prey to misinformation. Ideas like depression is a weakness (“why can’t you just snap out of it?”), anxiety is all in your head (“mind over matter!”), or that certain mental illnesses make someone dangerous reinforce the stigma around mental health. When people don’t feel comfortable discussing their mental health issues, we lose the opportunity to learn, and the cycle of misinformation and misunderstanding continues.
The Three Different Types of Stigmas
It turns out stigma isn’t so simple to identify as it might seem. Whether you’re talking about a negative response to mental illness or the stigma of addiction, researchers actually break it down into three distinct areas or types, each with their own identifying factors: public stigma, self-stigma and structural stigma.
So, what’s the difference?
- Public stigma is focused outward, centering around the negative or discriminatory attitudes and feelings other people may have about mental illness.
- Self-stigma, understandably, is turned inward. It encompasses the negative feelings and internalized shame that those with mental illness have about their own condition.
- Structural stigma looks beyond self and community to policies and procedures of both public and private institutions that limit opportunities for those with mental illness — whether intentional or unintentional
Words Matter
Language is powerful, particularly when it comes to topics like mental illness and substance use disorders. The professional community has continued to develop a preferred language within addiction recovery. At The Blanchard institute, we don’t use the word “relapse,” instead opting for “recurrence.” It may seem like a minor distinction, but words really do matter. By using the proper clinical term, we’re reminded that substance use disorder is a recognized disorder, not a weakness or moral failing.
Of course, using clinical terms isn’t always appropriate. The trend of tossing around clinical terms in a non-clinical way has become commonplace in our current culture. Saying things like, “I’m so OCD!” because you like things tidy diminishes the seriousness of this very real mental illness. Other terms, like “addict” or even the seemingly more positive “recovering addict,” carry a negative connotation for most people, contributing to the stigma around addiction.
Stigmatizing language examples:
- Substance abuse/drug abuse (instead use substance use disorder)
- Drug habit (instead use addiction)
- Substance abuser (instead use person with a substance use disorder)
- Drug abuser (instead use person with a substance use disorder)
- Addict (instead use person with a substance use disorder)
- Alcoholic (instead use person with a substance use disorder)
- Drunk (instead use person with a substance use disorder)
- Junkie (instead use person with a substance use disorder)
- Clean (instead use in recovery)
- Clean drug test (instead use negative toxicology results)
SOURCE: John Hopkins Medicine
Person First, Condition Second
According to the National Council for Mental Wellbeing, by using person-first and non-stigmatizing language, providers can reduce the continuation of stigma and negative bias, which can influence how people think and talk about substance use. While it may sound complicated, person-first language emphasizes the person rather than their diagnosis, which helps remove stigma. It’s the difference between labeling someone a “substance abuser” or “addict” rather than “a person with a substance use disorder” or “an addicted individual.” This approach creates a non-judgmental environment for positive interactions, safe discussions and better outcomes, says the National Council for Mental Wellbeing.
Person-first language examples:
- Person with a substance use disorder (rather than drug addict or alcoholic)
- Person with a disability (rather than the disabled or handicapped)
- Person with a mental health condition (rather than mentally ill)
- Child with autism (rather than autistic child)
Remember, the goal is to describe who the person is, not just a disorder or condition they have.
Continuing to expand the use of correct terminology matters because stigmatizing language can cause stereotyping and fear of people with SUDs, lead to discriminatory actions against a person struggling with substance use, and may result in shame that reduces an individual’s willingness to seek treatment, It can also negatively impact a health care provider’s perception of people with an SUD and the care they provide.
Our Changing Views on Mental Illness
The modern mental health field is relatively new, with disorders and diagnoses continuing to evolve along with our understanding and new research. Historically, as with substance use disorders, mental illness was viewed by many as a moral failing or weakness. Some even made a spiritual or supernatural connection, attributing someone’s struggle to a lack of faith or unwillingness to change. Today, we wouldn’t think of using negative terms like “junkie,” but from the 1960s-80s, it was commonplace.
While the language we use to discuss these conditions has evolved, the emotions we feel about them hasn’t completely caught up. When it comes to mental illness, we may have changed our terminology, but a show of emotion still makes many of us uncomfortable. We don’t always have the courage to explore our own emotions, so someone else’s inability to control emotions can leave us at a loss for words. It may be understandable, but the result is often that someone with a mental health disorder is left dealing with guilt, shame and ostracization — all in addition to their ongoing condition. This makes reducing mental stigma particularly challenging.
Let’s Keep Talking About Mental Health and Addiction
We still have a long way to go, but we are making progress. In a study reported in the Journal of American Medicine, public stigma toward mental health issues like depression, schizophrenia and alcohol dependence was found to have significantly decreased between 1996 and 2006. In the two-decade span, researchers saw improvements in public beliefs about the causes of schizophrenia and alcohol dependence and noted decreased rejection for depression. And we’ve had two more decades to make progress since that study was completed. Events like Recovery Month in the United States, Recovery Day in Canada, and The Blanchard Institute’s own annual Recovery Awareness Day event help to increase awareness.
As we continue to understand these disorders, hear more about the stages of addiction recovery, and see growth around the treatment of mental health, the language and stigma continues to change, and we can break the stigma of addiction and mental illness.
Recovery is Possible
Mental health issues and substance use disorders may seem insurmountable to those dealing with them, but today more than ever before, help and healing are possible. Recovery from addiction is happening every day. At The Blanchard Institute, our evidence-based gender-specific approach provides holistic addiction treatment, a mental health program, detox, recovery management and more. To learn more about our programs in Charlotte and Cornelius, North Carolina, contact our team today.