Italian
According to the Treccani Italian language dictionary, the word stigma comes from Greek, literally meaning “puncture,” and signifies a mark, stain, indelible, or a distinguishing sign that entails the attribution of negative qualities, socially subject to discredit and disapproval.
The stigma of mental illness is the main issue delaying the request for help, leading to deferral and resistance to prescriptions, voluntary interruption, or self-administration of therapies, often inappropriate and outside of medical supervision. Mental illness is commonly perceived as a constitutional fragility that is not subject to repair or effective treatment. “Mental illness does not heal,” this is what is normally believed. Or worse, “mental illness is a vice of the mind, a social anomaly, an irreducible deviance.”
Italian laws provide that the mentally ill are not criminally liable or punishable if they commit crimes of any kind. The law explicitly refers to “mental defect, partial or total”, “inability to act”, “inability to understand and to will”.
It is clear from these premises that the “mentally ill” are considered devoid of the faculties that make a person free and responsible for what they do, think, and say. No other illness carries such “stigma.”
Within the category of “mental disorders” are included various pathological conditions, distinguished by severity, pervasiveness, persistence over time, availability, and effectiveness of treatments. However, the connotation of “mentally ill” remains a unique identifying label, with a negative value in terms of its performance and social adaptation.
The stigma is not felt by the patient suffering from mental disorders, certainly not in the same way it is felt by others. Only those who suffer or have suffered from such disorders can understand its impact in terms of subjective and intersubjective suffering, and not in terms of stigma.
The mind, with its ability to dominate and organize the time and space in which it historically exists, is an organ of the body. But it does not have a specific location for its retrieval. It is an organ with functions, many of which are still unknown, decentralized as it is present in every part of the organism and also in the space outside the body. This is why the only perspective from which we can understand how the mind functions or does not function remains currently the bio-psycho-social.
It is precisely in this tripartite representation of the mental structure, bio-psycho-social, that the deep root of stigma lies. Biological, psychological, and social aspects are all represented in that system we generically call mental health or illness. A disorder of the mind can be temporary or persistent, yet always inseparable from the context and situations. Treating mental disorders and restoring health where there is illness means intervening in a systemic complex in which the strictly medical aspect occupies a limited portion.
Stigmatized are not only individuals with mental illness nor the mental illnesses they endure. The stigma is directed at the mind, whose functions frighten us when they are hidden and inexplicable. We show the wounds of the body without shame, but we are ashamed to show the wounds of the soul. The mind with its functions is the true object of the stigma.
It is possible and necessary to overcome the stigma, accepting the principle that every individual is made up of healthy parts and unhealthy parts, and that, even in the most severe and devastating illnesses for the mind and body, there is always a healthy part with which one can and must interact. Caring for the mentally ill means highlighting and enhancing their healthy parts, accepting the humanity of their unhealthy parts, and pursuing the goal of a healing that is always possible.
