COGNITIVE AND BEHAVIORAL PRACTICE 5, 199-200, 1998

Series Introduction: Stigma

Patrick W. Corrigan University of Chicago Center for Psychiatric Rehabilitation

Severe mental illnesses like schizophrenia strike wath a double-edged sword. On one hand, persons struggle wath a biological disease that causes psychosis, negative symptoms, and social disabilities. These symptoms and disabilities pre- vent persons from achieving many of the social roles and corresponding life goals that define adul thood in Western culture: living independently, obtaining competitive jobs, developing long-standing relationships, and earning substan- tial income.

On the other hand, societal reaction to severe mental illness can be equally devastating. The pubhc's negative attitudes about severe mental illness, and their discriminatory behawor toward those with psychiatric disability, also limit social opportunities and corresponding goals. Landlords are unlikely to rent apartments, employers do not want to hire, and neighbors wish to avoid "dan- gerous ex-mental patients." The stigma and discrimination p romoted by society can be as harmful to the person as the disabilities caused by the disease.

Recogmzing society's role in worsening the outcome of severe mental illness has special significance for a behavior therapy of schizophrenia. Practitioners need to continue skills training, incentive therapies, behavioral family therapy, and other strategies that assist persons in learning social and coping skills to manage disease and disability. However, the impact of stigma and discrimina- tion on mental illnesses suggests an additional target for behavior therapy Re- searchers and practitioners need to identify behavioral interventions that help persons with severe psychiatric disability deal with stigma. We also must identify social change strategies that will alter how the public views mental illness and in- teracts with persons challenged by these disorders. This series summarizes both

199 107%7229/98/199-20051 00/0 Copyright 1998 by Assoclanon for Advancement of Behawor Therapy

All rights of reproducnon m any form reserved

200 COR~IGAN

approaches to stigma: what the person might do to diminish the impact of dis- crimination and what advocates might do to diminish the stereotyping behav- iors of society.

In the first article, Patrick Corrigan reviews ways in which stigma and discrim- ination impact severe mental illness. He then uses this review to set up a model for a behavior therapy of stigma. Robert Lundin follows with personal remarks about the impact of psychiatric stigma. Mr. Lundin has suffered from manic- depression, and society's reacuon to manic-depression, for more than 15 years. He writes about his experiences with stigma and ways he has learned to deal with discrimination.

The behavior therapy of stigma and discrimination modeled by Dr. Corrigan yields three targets. (1) Behavior therapists might help persons with severe mental illness learn skills to cope with societal bigotry. Paul Holmes and Philip River review some of these strategies in their article; for example, teaching a person to whom and when to disclose a history of mental illness. (2) Behavior therapists provide strategies that empower persons with mental illness in the pursuit of their life goals. Empowered consumers are viewed as the polar oppo- site of stigmatized patients. Faith Dickerson provides a cognitive behavioral analysis of empowerment . She then reviews behavioral strategies that foster em- powerment. (3) Behavioral technology needs to change societal attitudes about mental illness. Erik Mayville and David Penn review cognitive behavioral strate- gies that might assist the public in adopung less stigmatizing attitudes and in abandoning sugmatizing practices.