Mental Health Discourse: Taboo or Stigma?
Ffion Brown (Manchester Metropolitan University): I am a 2nd year PhD student researching how public perceptions of gender and mental health influence the way men linguistically construct their experiences with mental illness.
While there has been an increase in awareness on mental health in recent years, discourse related to mental health, especially mental illness, continues to draw upon taboo or stereotypical language in media representations (e.g. Simmie & Nines, 2002; Corrigan, 2004; Atanasova et al., 2019). This suggests that mental health discourse remains to be taboo within society and it is worth considering why that is and how reproductions of discourse continue to contribute to that taboo.
An aspect to mental health literature that will be discussed here is the relationship between the terms ‘taboo’ and ‘stigma’, both of which are prevalent in linguistic and medical examples of literature when discussing the more social contexts of mental health research. However, there is a tendency in the literature to use these terms almost interchangeably, highlighting that their use in this context is ambiguous and demonstrating a need to distinguish between them. Therefore, how are we able to understand this distinction in mental health discourse if their usage seems to be similar?
Firstly, taboo is defined in the dictionary as ‘a practice that is prohibited or restricted by social or religious custom’ (Taboo, n.d.), although it is suggested that taboo can also be abstract and refer to many ideas at any one time (Jay, 2009). This could lead to more taboos being imposed by society, allowing the concept of taboo to be extended to mental health discourse due to how it has been reproduced by the public. Secondly, stigma as a concept follows a similar negative pattern as taboo, although it tends to be used more as a feeling towards a person who is ‘discredited’ from other society members (Goffman, 1986: p.20). Further to this, the dictionary definition goes so far as stating that stigma is ‘a mark of shame’, (Stigma, n.d.) indicating something or somebody as being shameful. It is this fear of being signalled as different, or stigmatised, that impacts how someone would engage with relevant services and possibly result in uncertainty amongst members of the public due to a lack of information (Corrigan, 2004).
Given that the two concepts are related to one another, how then does stigma become taboo and vice versa? Hudson and Okhuysen (2014) posit that it is through social stigma that society can identify what is taboo, learned ‘through the socialization of speech practices’ (Jay, 2009) and the implementation of social sanction. One way in which social sanctions allow for the continued existence of mental health being taboo is the perceived reactions from others in society. This is where feelings of stigma come into play with the concept of taboo, hinting at the idea that through indulging in taboo practice or taboo discussions can lead to being signalled as different or ‘undesired’ (Goffman, 1986, p.11) to one’s peers. As a consequence, feelings of stigma could result in less service participation and less public discussions of mental illness, allowing for more negative stereotypes and imagery to come to fruition with no dispute.
While they do seem to be used interchangeably in the literature, if we take everything into consideration, ‘taboo’ and ‘stigma’ are two different concepts that work in conjunction with one another where taboo relates to a restricted practice or discourse and stigma is how that taboo is felt amongst society members. Yet, how can we identify this distinction in public representations of mental health discourse?
One crucial element of identifying why mental health is taboo in discourse is by exploring what types of representation take precedence within media reproductions. Corrigan, Markowitz & Watson (2004) indicate that ‘when the news media portray a group in a negative light, they propagate prejudice and discrimination’ (p.483). Referring back to a fear of being signalled as different (Corrigan, 2004) this can be applied to multiple types of discourse, including mental health as a way of introducing stigma. By negatively framing certain topics, society members become afraid of being viewed in the same way and therefore restrict themselves and others from being associated with that topic and thus contributing to the taboo concept.
Stuart (2005) states that ‘negative news stories grew at a faster pace’ (p.25) in comparison to positive stories when dealing with mental health as a topic. This means that as a taboo concept, mental health discourse will continue to be referred to as such and it would be difficult to overcome that when negative imagery is consumed more often than the positive. This is especially the case when stereotypical language of violence and incompetence is argued to be a cause for feelings of stigma amongst those who suffer from mental illness (Abdullah & Brown, 2011).
Ffion Brown, PhD student, Manchester Metropolitan University
Abdullah, T., & Brown, T.L. (2011). Mental illness stigma and ethnocultural beliefs, values, and norms: An integrative review. Clinical Psychology Review, 31(6), 934-948. DOI: 10.1016/j.cpr.2011.05.003
Atanasova, D., Koteyko, N., Brown, B., & Crawford, P. (2019). Representations of mental health and arts participation in the national and local British press, 2007-2015. Health, 23(1), 3-20. DOI: 10.1177/136345931
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Corrigan, P.W., Markowitz, F.E., & Watson, A.C. (2004). Structural levels of mental illness stigma and discrimination. Schizophrenia Bulletin, 30(3), 481-491.
Goffman, E., & Goffman, E. (1986). Stigma : Notes on the management of spoiled identity. Retrieved from https://ebookcentral.proquest.com
Hudson, B.A., & Okhuysen, G.A. (2014). Taboo topics: Structural barriers to the study of organizational stigma. Journal of Management Inquiry, 23(3), 242-253. DOI: 10.1177/1056492613517510
Jay, T. (2009). The utility and ubiquity of taboo words. Perspectives on Psychological Science, 4(2), 153-161. DOI: 10.1111/j.1745-6924.2009.01115.x
Stigma. (n.d.). In Merriam-Webster online dictionary. Retrieved from https://www.merriam-webster.com/dictionary/stigma
Simmie, S. & Nunes, J. (2002). The last taboo : A survival guide to mental health care in Canada. Toronto: McClelland & Stewart Ltd.
Stuart, H. (2005). Fighting stigma and discrimination is fighting for mental health. Canadian Public Policy, 31(22), 22-28.
Taboo. (n.d.). In Lexico powered by Oxford’s online dictionary. Retrieved from https://www.lexico.com/definition/taboo