My Scars Are No Different Than Yours

Everyone has scars: from surgery, from itching too much when you had chicken pox, or from that time you scraped up your knee when you fell on the sidewalk when you were a child. Some people have scars that are the result of mental illness. I have many scars all over my body from self-injury: little scars, big scars, faint scars and deep and wide scars. The definition of stigma is "mark of shame or disgrace." For people with scars from cutting or suicide attempts their scars may serve as a scarlet letter, marking them with the sin of having had mental illness.
            The way that people with mental illness feel about their scars is as diverse as they are. Some are proud of their scars: they are battle wounds from a long and hard-fought struggle with mental illness, and they represent courage. Others see their scars as a chronicle of their history: the reminder of where they have been and where they are going. Some are indifferent about their scars: they are what they are and don't require any further thought. And some people are ashamed of their scars: they feel that their scars mark them as weak, broken, and sick.
            How you feel about a scar affects how you deal with it. Some people hide and cover their scars, others don't give them any thought, and still others proudly let the world see.
I have a scar on my forehead from accidentally falling down a flight of stairs as a child. I readily tell people that story, laughing about my childhood clumsiness and marveling at how well the 45 stitches healed.
            My scars from self-inflicted wounds while I was deeply depressed do not generate the same kind of conversation. Some people notice them and say nothing. Others ask, "What happened??" expecting me to have a story about a horrible accident or injury, and instead getting the explanation "I was depressed..." Which usually makes the asker feel awkward and immediately change the subject.
            I used to try to hide my scars, wearing pants in warm weather, applying supposed scar fading creams, and slathering foundation and makeup over them. But it just became too much of a hassle, and I didn't like the implication of hiding them. I was, in the past, ashamed and embarrassed of my scars. I thought they were ugly. But now I see them as simply leftover marks of my illness. I am not proud of my scars, but I am not ashamed of them either and I do not hide them, because I did nothing wrong. I was very depressed and did what I felt I had to do to survive. Self-injury is a very unhealthy coping skill and I was in a pretty desperate place to use it, but I was doing the best that I could at the time. Now I know healthier coping skills. And I AM proud that I have not done any self-injury for over 3 years now. Scars are just what’s left over when you’ve healed. My scars are no different than yours.

A Critique of Mental Health & Academia

Imagine that you are a member of a minority (perhaps you are). Now imagine that you take a college course which purports to teach all about your minority group. Imagine that this course is taught by someone who is not a member of your minority. Imagine that ALL of the textbooks assigned are written by people who are not a member of your minority. In fact, in this supposedly advanced course, you do not get to interact with or hear from a single person from the minority group it purports to teach about.

This is not an imaginary scenario. The “minority” I am referring to in this scenario is people with mental illness (although they are less of a minority than most people think). This is the reality of many college courses taught about mental illness. Sometimes there is one book assigned by a person with mental illness, as a sort of token effort. There is a social work saying that I love: “Nothing ABOUT me WITHOUT me.” People with mental illness need to be involved in education about mental illness.

This is not just an idea that I have, the fact that hearing from and interacting with real people who have experienced mental illness leaves students with a much better understanding of mental illness than the traditional way of hearing only from “experts” is actually backed up by research. One of the greatest benefits is decreasing stigma among students. A study by Mann and Himelein (2008) found that the “traditional, diagnosis-centered” approach to teaching an introductory psychology class did not result in any reduction of stigma among the students, whereas a “humanizing” approach did. They concluded that “intervention programs that include personal information about the individuals with mental illness, encourage discussion, and evoke empathy are more likely to succeed” (Mann & Himelein, 2008, p. 548). Corrigan (2005) explains, in his excellent book on stigma, that research shows that the most effective way to reduce stigma is through interaction with people with mental illness in a situation where they are equals, have common goals, and the interaction is sanctioned by those in authority. The interaction that professionals have with their clients with mental illness is NOT as equals, the professional is clearly in a position of power. Therefore, it is not a very effective type of interaction for reducing stigma. The classroom is the ideal place for stigma to be rooted out of young students before they embark on their careers! Interaction with people living with mental illness as guest speakers or educators in a course about mental illness provides interaction as equals, officially sanctioned by those in authority (the professor, department, or college), with the shared goal of educating students about people with mental illness. Every college course on mental illness should include some interaction with real, live people with mental illness. There are many ways this can be done: they could be a guest speaker, they could be invited to come answer student questions, or they could be included in class discussion or other activities.

There is no shortage of people with mental illness willing to participate in this type of interaction: for example, NAMI-MN offers free, trained volunteer speakers through the In Our Own Voice program. I emailed the Director of the MSW program I am in sharing this information with her and encouraging the inclusion of people with mental illness in relevant courses. Her response was “I want to re-iterate that in our MSW program you will be a student and in that role, it is our stance that your primary role is as learner.” I asked a psychology professor who has been very encouraging of my mental health advocacy work about how I could best educate psychology professors on how to teach about mental illness in a way that reduces stigma, and she suggested that I do a presentation at a Psychology Colloquia which the department regularly hosts. I emailed the head of the Psychology department my proposal and received no response. I am getting the feeling that educators and “experts” do not want to be told how to teach about mental illness from the likes of me, because I am merely a student. Reading books, memorizing facts, and doing clinical research is certainly valuable. But the lived experience of people with mental illness is valuable too, and it is rarely acknowledged. And if I got college credits for all of the reading and research I have done simply to better understand my own mental illness I would have a doctorate by now. We are all experts on ourselves. Please, do not teach ABOUT “my people” WITHOUT including us.