The Stigma Surrounding Mental Illness: History and Recent Perspectives

Introduction

Historically, a variety of ancient cultures such as Greek, Indian, Egyptian, Hebrew and Chinese etc. have deduced various theories surrounding the occurrence and treatment of Mental Illness and it often revolved around 3 major explanations-  supernatural, biological and later came in the psychological explanation.

Well known philosophers of antiquity, such as Plato and Hippocrates, also voiced their stance for the humane treatment of individuals with psychological complications, which in turn opened doors for discussions in the sphere of psychoanalytic thought.

But in the present scenario, we still commonly find individuals with mental health issues suffering. Due to the societal prejudices around  their illness, which is often fueled by misguided & antediluvian beliefs regarding the causations of such mental health problems such as spiritual possession, wrongdoing in past life etc.

The stigma surrounding mental illness builds due to the gross generalization & appalling representation of such serious issues in the media, often depicting people suffering from such problems as violent, dangerous, disabled and sometimes even of the criminal mindset.

What is Stigma? 

The Stigma Surrounding Mental Illness: History and Recent Perspectives

Stigmatization, often perceived as a recent phenomenon, has a long-standing history. The word stigma comes from the ancient Greek practice of tattooing a slave as a mark of their lower status and to curtail their mobility.

Later on, stigmatization in the modern age took on to a new definition referring to individuals suffering from mental health issues whose mobility was often curtailed in likeness with the ancient greek slave, often chained, shunned and on rare occasions even put to death. 

A firm belief which plays a significant role in the lives of discounted individuals in the society suffering from psychological issues in many countries of the world such as India, Middle East, South Korea, is rooted in the misguided spiritual burden of a person – the God’s anger towards the individual suffering from a mental health issue and the fear that association with such an individual would lead to a similar fate.

The tension between the religion, tradition, spirituality and science continue to shape the concepts of mental illness and the impression of individuals suffering from it. Studies have also shown that Koreans due to the Korean culture based on Confucianism where the reputation of the family is of paramount importance and is always placed before the needs of an individual leads to an individual in being unwilling in seeking treatment for mental health issues. Moreover, as suggested by Korean doctors that Confucian culture emphasizes individual will and self-discipline which further creates a social prejudice against seeking help in mental health problems.

Ancient to Middle Ages 

As mentioned earlier, we find various early civilizations which have explored the themes of mental health problems. They often swore by elaborate rituals followed by offerings and incantations to treat individuals. In addition, these civilizations also pinned their hopes on sorcerers, mystics, priests and other healers to attend such problems.

We also come across the practice of trephining or trepanning through the evidence obtained from the Neolithic burial site in France, which involved chipping a hole in the individual’s skull to let out evil spirits, which continued in some isolated parts of Africa till 1900, since it was believed that the individual suffering from mental health issues was possessed by an evil spirit.  

Ancient Greeks also with their thoroughgoing belief in spirits and the supernatural elements, attributed the changes in the behaviour of various Gods as responsible for causing changes in the human world, therefore, such changes could also explain one’s state of illness. Proper conduct, they believed was rewarded with divine protection whereas unscrupulous human comportment was punished with illness.

Greek priests called the Asclepios followed the God of medicine and healing, Asclepius. Since people believed that Asclepius healed the individuals in their dreams while they were asleep, thus the practice to sleep in Asclepion Temples was very common. Also, the Asclepion Temples at Kos and Epidaurus display plaques given by grateful patients. A well-known symbol of Asclepius medicine known today is the caduceus carried by Hermes, serving as a reference to the use of snakes in healing practices of ancient greeks.

The Stigma Surrounding Mental Illness: Healing Santuary Greece
Healing Sanctuary Greece

Owing to their contact with the Greek culture, Romans imbibed the Greek ideas on mental health. Asclepiades discarded Hippocrates’s humoral theory and suggested remedies from restoring mental health by the introduction of changes in diet, patterns of exercise along with drug and music therapy which he believed was important to maintain ‘psychogenic equilibrium.’

The Greek theories on mental health were also assimilated into the Arabic culture with a greater bend towards religious thought. Like the Greeks, they also found the meaning behind some profoundly mentioned mental disorders such as melancholia, mania, delusions etc in spiritual and mystical theories. Whereas other issues related to mental health such as anxiety, rage and depression were believed to be caused by the possession of the body by a djinn which led to attempts to exorcise the djinn by torturous means by beating the individual or shock therapy.

Classical Greek thought hailed the ideas of naturalism – laws of nature govern our world as opposed to Gods and demons determining human fate based on past life wrongdoing. Aclmaeon asserted that the brain was the organ of thought, not the heart. He theorized that the mental activity originated in the CNS by tracking down the ascending nerves from the body to the brain and also applied this to determine the treatments for these mental health issues.

The focus of mental illness theories went from physiology to spirituality during the European Middle Ages. With the spread of Christianity, the idea of sin dominated, and the psychotherapists of that period became priests rather than physicians. Christian doctors embraced certain long-held beliefs of the  Greeks and Romans, as treatment turned on astrology, alchemy, theology, magic rites and exorcism.

Into the bargain, early modern Europe, into the period of enlightenment no longer saw mental health issues any different from the physical ones and it also didn’t involve moral responsibility. But it did encounter individuals suffering from mental health issues as victims of witch hunts. Also, these individuals were often seen as wild animals, therefore, harsh treatments time and time again were used such as restraint in chains to calm the beastly passions.

Whereas the Egyptians considered issues such as depression and dementia and physical diseases alike, as suggested in their description in the Papyrus called the Book of Hearts.

Ayurveda 

The Stigma Surrounding Mental Illness: Ayurveda

Indian and Greek polytheistic cultures had much in common, therefore, in Indian ancient culture, we find the basis of mental illness and healing in the moral and spiritual considerations of an individual but owing to the nuances of the language and oral tradition these ideas often turned out to be misinterpreted. Such imperceptive distortions gave rise to beliefs that the external causes of a mental illness were grounded in the sins committed by the patients either in a current or previous life and the symptoms varied depending upon the spirits that were offended by the individual. 

The ancient and Traditional System of Medicine in India is called Ayurveda, the term is formed by combining two words “Ayu” meaning life and “Veda”meaning knowledge. The Graha Chikitsa is also known as the Bhoot Vidya in Ashtang Ayurveda deals with psychiatry, involving the study of emotional and psychological disorders. 

Ayurveda also attributes the imbalance of Tridoshas- Vata, Pitta, Kapha, for the psychological disturbances of the human mind such as Vatonmad — similar to schizophrenia, Pittonmad — similar to mania, Kaphonmad — similar to depression, and Tridoshonmad — Depression. It suggests that these emotional toxins called the doshas which accumulate in mind if not drained out of the body in a stipulated duration of time can lead to various chronic mental health issues such as anxiety, insomnia and depression.

Traditional Chinese Medicine (TCM)

The Stigma Surrounding Mental Illness: Traditional Chinese Medicine
Traditional Chinese Medicine

Psychological reasoning in China developed contemporarily alongside Indian, Roman & Greek thought. According to Chinese theory, five phases constituted the conditions of imbalance between Yin and Yang. Mental impairment, according to the Chinese interpretation, is thus regarded as inconsistency of the yin and yang since ideal health arises from harmony with nature. The imbalance was the mechanism that drove the theory of psychosis with the earliest recorded instance of mental illness in ancient China dating back to 1100 B.C. The Chinese psychiatry in the 17th century came to include forms of restlessness, anxiety, delirium, insomnia etc.

The Traditional Chinese Medicine prescribed the use of herbs, acupuncture, exercise and emotional therapy in the treatment of mental disorders after the identification of symptom complexes by analysis involving 4 stages – observation, listening, inquiry and feeling the pulse.

The 21st century 

The Stigma Surrounding Mental Illness: World Health Organization

The World Health Organization (WHO) states, There is no health without mental health; but it certainly isn’t the case for most societies across the world since the stigma surrounding mental illness stands ubiquitous. 

In India where the what- will- people say mentality continues to perpetuate the tone-deaf attitude and denial towards mental health issues. The lack of awareness and victim shaming has stooped so low that a survey done by The Live Love Laugh Foundation revealed that 60% of respondents agreed with the statement that mentally unhealthy people should “have their groups” so that healthy people are not “contaminated,” while the same number also believed that “lack of self-discipline and willpower” was also one of the contributing factors causing mental illness. The stigma surrounding the mental health problem is so deep that several people lose their reputation at work and sometimes even their jobs, therefore justifying their unwillingness to seek professional help.

Various scholars such as Goffman were very critical of mental hospitals because these further increased stigmatization instead of enabling patients to lead normal lives. The study of psychology in  this day and age is helping us evaluate our own beliefs and prejudices against the individuals suffering from mental health issues. Though the studies are far more elaborate than before, the application of these findings and the creation of awareness on their basis still lacks in most societies. 

Liked this piece? Also read: Warning: Don’t Take Your Thoughts Too Seriously!

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One thought

  1. If there’s anyone on the outside looking in to someone wth mental helth issues or seems to just be pacing along with stoicism, a series that really belted out to me is ‘After Life’ with ricky Gervais.

    The Stigma that comes with mental health I feel is that it’s something thats broken and needs to be repaired fast. fast repairs lead to weakness in the efforts. Everyone deals with everything differently but everyone wether they know it or not has an end goal, to feel normal. After Life literally tackles every hurdle wiht blunt force and does it well. makes you realise the little things really do matter and make big leaps in the realistation that someone can come to terms and take a handle on their mental health.

    This post has been a good read, a lot of the points highlighted I’ve read and taken on board after a bit of a struggle years ago and I can honestly say, Routine, focusing on health and small goals has really adjusted my reality.

    Thanks Ashna!

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