Written by Hannah Dang with support from the DAC team.
In his classic sociological text on stigma, Erving Goffman wrote “The Greeks . . . originated the term stigma to refer to bodily signs designed to expose something unusual and bad about the moral status of the signifier. The signs were cut or burnt into the body and advertised that the bearer was a slave, a criminal, or a traitor – a blemished person, ritually polluted, to be avoided” (133). Since the Ancient Greeks, we have learned the true perpetrator of the pollution riddling our world is stigma itself.
Tuning in on February 9th of 2023, UConn’s Institute for Collaboration on Health, Intervention, and Policy (InCHIP) was proud to welcome Professor Lawrence Yang, a Ph.D. Professor and Vice Chair at New York University’s (NYU) Department of Social and Behavioral Sciences, for his lecture, “[The] Stigma of Health Conditions in the Global Context: Applying the ‘What Matters Most’ Approach to Mental Illness, HIV, and Cancer Stigma.” As an Associate Director of the Global Center for Implementation Science and Founding Director of the Global Mental Health and Stigma Program at NYU, Yang’s presentation covered the consequences of a community’s culture concerning the threatening effects of stigma in a transformative society. To analyze the stigmatization of psychosis spectrum disorder (PSD), human immunodeficiency virus (HIV), and breast cancer, Professor Yang specifically uses studies based on bilingual Chinese people from the Fujian Province on China’s mainland and people from Botswana.
Starting with mental health, Professor Yang shared his research regarding what Chinese communities value and its connection to the stigmatization of mental health awareness. According to Yang, Chinese groups mainly have four values:
- Renqing: the core dynamic of reciprocity, understanding, and maintaining relationships
- Guanxi: the social exchange networks and access to resources (social and material)
- Lian (which translates to face): to uphold reciprocal obligations to lead one to lay claim to ‘full adult’ status or ‘full personhood’
- Perpetuation of one’s lineage
Yang then claimed if a person who struggles with their mental health continues to uphold their community’s values, the person would not “lose mianzi (social status)” or “lose lian (being a decent human being).” The importance of mental health was iterated in a study with Chinese patients who were diagnosed with psychosis spectrum disorder, a type of disorder that causes patients to experience delusions, hallucinations, negative behavior, and other psychotic symptoms (Perrota). Upon interviewing the patients, Professor Yang concluded that culture can shape and protect against stigma.
Professor Yang then went on to analyze gender roles from a Botswana perspective. To this day, medical specialists aim to provide free and accessible HIV treatment to the people of Botswana; however, the “stigma of HIV [greatly contributes] to ART non-adherence.” ART (antiretroviral therapy) is the treatment used for suppressing or stopping retroviruses, including HIV that causes AIDS (acquired immune deficiency syndrome) (RxList). Thirty-eight individuals, men and women living with and without HIV, in Gaborone, Botswana were interviewed. In the context of cultural and gendered inequality in Botswana and the Social Security Administration (SSA), it has led to a disproportionate amount of blame and stigma towards women due to conceptions of “promiscuity and immorality.” Because women are consistently blamed for contracting HIV and spreading it to their partners, Professor Yang explained “women are forced to choose between the physical death or social death.” However, if a woman is proven to be fulfilling her maternal duty as a mother to her children, it would be a case in which culture mitigates stigma. Harmful stigmatization led to the intervention of “What Matters Most (WMM),” a program to assist pregnant women coping with HIV and breast cancer stigma in regards to seeking accessibility to ART and mastectomies. The program also resisted stereotypes of promiscuity and promoted safe disclosures.
As a representative of the Disability and Access Collective (DAC), I attended Professor Lawrence Yang’s presentation in hopes of better understanding the negative consequences of stigmatization in various cultures. I thoroughly enjoyed his presentation, but I wished he narrowed his objective to focus on how a person’s culture severely affects their mental health because his study focused on a patient who was not burdened by his culture despite his psychosis. I do believe it is important that a person’s culture is not to be blamed for ruining a person’s psyche. Specifically, it is people who normalize stigmatization and ostracize others due to their mental illnesses who are most, or more, at fault.
Not only that, although Professor Yang made an effort to include breast cancer, another stigmatized disease, in his lecture, breast cancer was not as equally represented as psychosis and HIV/AIDS. As for the women in Botswana who undergo heavy scrutiny in comparison to their male counterparts, I’m glad Professor Yang addressed their mistreatment and unequal double standards in their Botswana community.
Overall, I have high hopes for the future. If the steps iterated above are already being taken to this extent to relieve the influence of stigmatization, then addressing mental health, viruses, diseases, or other afflictions won’t be as restrictive anymore. As Lerita M. Coleman Brown said in “Stigma: An Enigma Demystified,” “although the process can be fraught with pain and difficulty, stigmatized people who manage to reject the perceptions of themselves as inferior often come away with greater inner strength” (154).
Works Cited
“Medical Definition of ART (Antiretroviral Therapy).” Edited by Charles Patrick David, RxList, RxList Incorporate, 29 Mar. 2021, http://www.rxlist.com/art_antiretroviral_therapy/definition.htm.
Perrotta, Giulio. “Psychotic Spectrum Disorders: Definitions, Classifications, Neural Correlates and Clinical Profiles.” Annals of Psychiatry and Treatment, Peertechz Publications Incorporate, 31 Dec. 2020, http://www.peertechzpublications.com/articles/APT-4-123.php.
The Investopedia Team. “Social Security Administration (SSA): What It Is and How It Works.” Edited by David Kindness and Suzanne Kvilhaug, Investopedia, Dotdash Meredith, 6 Feb. 2023, http://www.investopedia.com/terms/s/ssa.asp.
Yang, Lawrence. “InCHIP Lecture: Stigma of Health Conditions in the Global Context.” YouTube, UConn’s Institute for Collaboration on Health, Intervention, and Policy , 9 Feb. 2023, youtube.com/live/EoeUN7LDdJk.
Written by Erving Goffman, 1922-1982; in The Disability Studies Reader. The Disability Studies Reader (Fifth Edition) (New York, NY: Routledge (Publisher), 2017, originally published 1997), [133]-144.
Written by Lerita M. Coleman Brown, fl. 2017; in The Disability Studies Reader. The Disability Studies Reader (Fifth Edition) (New York, NY: Routledge (Publisher), 2017, originally published 1997), [145]-159.
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