The Anti-Stigma Thesaurus: Rewriting the Language of Mental Health

The Anti-Stigma Thesaurus: Rewriting the Language of Mental Health

Despite how the nursery rhyme goes, words can hurt. They can also be used to reinforce mental health stigma, particularly in crime fiction. Words are powerful - and "with great power comes great responsibility". The longevity and influence of words can be epitomised in that one quotation, first used centuries ago and popularised by a comic book adaptation. Words are the building blocks of the writer's craft. They are our weapons and our tools. We can fuss for hours over the right choice of word to fit a sentence, a tone, a character. When it comes to fighting mental health stigma, we need to choose our weapons carefully. The last time I wrote about this, I merely complained that writers should do better. This time, I'm going to do better. The following words and phrases are all in common usage but have the potential to be harmful to people with mental health problems and reinforce stigma about them. I have here presented alternatives that...
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Freudian Script: Emotionally unstable personality disorder (EUPD)

Freudian Script: Emotionally unstable personality disorder (EUPD)

Emotionally unstable personality disorder: balance, understanding and acceptance This week's Freudian Script concentrates on a mental health problem that is not often in the public eye. As opposed to correcting stereotypes about this condition, I will instead look at what emotionally unstable personality is, common stigma problems, portrayals in fiction, and how writers can consider the condition in their work. WARNING: This post contains discussion of self-harm, suicide and abuse. DISCLAIMER: Freudian Script discusses mental health problems for writers of fiction, to encourage accurate and sensitive portrayals. If you or someone you know is experiencing mental health problems, please seek help from a doctor. What is emotionally unstable personality disorder (EUPD)? Perhaps a better starting question is: what is a personality disorder?. A personality disorder is when an adult has a set of personality traits that cause problems for them in their lives. These have likely developed from difficult early life experiences and were at one time useful to help survive those situations. However, as the...
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Freudian Script: Gangs and Drugs

Freudian Script: Gangs and Drugs

Gangs and drugs - in the eyes of the public, inextricably intertwined. But what is the impact of gang lifestyle on mental health? And how do alcohol and drugs fit the picture? What is a gang? My protagonist Jason often protests that he wasn't in a gang. He ran with a group of lads who liked petty theft and doing drugs on the weekend. So, what exactly is a gang? In its 2009 report "Dying to Belong", The Centre for Social Justice identified that part of the problem of researching and tackling the negative effects of gang culture is the lack of universal definition. Therefore, they proposed a definition, which we will use for the purpose of this post: "A relatively durable, predominantly street-based group of young people who (1) see themselves (and are seen by others) as a discernible group (2) engage in a range of criminal activity and violence (3) identify with or lay claim over territory (4) have some form of identifying structural feature (5)...
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Freudian Script: Bipolar Affective Disorder

Freudian Script: Bipolar Affective Disorder

Bipolar Affective Disorder: The Fight For The Middle Ground After the revelation that Robin Williams suffered with bipolar affective disorder, a rush of articles about creatives and mental health problems sprung up all over the shop. Last week - not for the first time - a young man sat in an assessment with me and said he didn't want medication to take away his "creativity". So, now seemed like a good time to talk about what bipolar affective disorder is and what it isn't, and how Hollywood and the media often get it wrong. What is bipolar affective disorder? Also know as manic depression, bipolar affective disorder is a mental health problem consisting of cycles of two opposite moods: manic/high phases and depressive/low phases. In between episodes, people sit somewhere in a mood state that is "normal" for them - which may run slightly high or low, depending on the person. A person with "rapid cycling" disease has four or more episodes per year. Bipolar...
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Freudian Script: Psychiatrist v Therapist

Freudian Script: Psychiatrist v Therapist

"I'm going to see a shrink for therapy" - what does that actually mean? Who are you going to see and for what? What is the difference between a psychiatrist, a psychologist and a therapist? Who would win in a Psychiatrist v Therapist fight? Freudian Script is going to demystify the difference between a psychiatrist v therapist and what exactly folks mean by "therapy". What is a psychiatrist? A psychiatrist is a medical doctor who specialises in mental health. In the UK, this means going to medical school, doing at least a couple of years in different medical and surgical jobs, then specialising in psychiatry. Psychiatrists are members of the Royal College of Psychiatrists. You would visit a psychiatrist particularly for diagnosis, medication and monitoring. You may also visit them for therapy, but I will get into that later. What is a psychologist? A clinical psychologist is someone who has trained in psychology, usually to the PhD level (which means they are also called doctor!), and...
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Sticks and Stones: Mental Health Stigma and Crime Fiction

Crime fiction is entertainment. Writers' primary goal is to entertain. But what is the impact of the written word on the most vulnerable people in society? Does crime fiction contribute to mental health stigma? What is stigma? The term stigma refers to the negative stereotypes, prejudice and discrimination directed towards a group - in this case, people with mental health problems. For example, the stereotype "schizophrenics are psycho killers" may lead to attitudes like "all mental patients should be locked up" and "I don't want a nutter around my children" and actions like avoiding people with mental health problems, opposing mental health facilities in their neighbourhoods, and beating a man to death. Stigma is not just about public attitudes to mental health. People with mental health problems can direct these negative attitudes towards themselves - self-stigma: "It's my fault I'm depressed - I'm not strong enough to cope." There is also institutional or structural stigma, where organisations discriminate against individuals, such as quietly...
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Freudian Script: Inside a Psychiatric Ward

The madhouse. Loony bin. Asylum. Psychiatric wards are called many things, but what is it really like inside one? Freudian Script continues to give writers an up-close-and-personal view of mental health services in the UK and this week's post concentrates on the inside of mental health unit. History of the psychiatric ward The first "psychiatric wards" were the asylums of the 18th century. These were private houses where your relatives could send you because...well, because they felt like it, really. There was no regulation and the owners didn't ask many questions, provided you could pay. The first mental health legislation in the UK - The Madhouses Act 1774, for the legal nerds - was to regulate these houses, license and inspect them. In many ways, mental health services have moved on from this point - and in some ways they haven't. Who is admitted to a psychiatric ward? So, why do people come to a psychiatric ward? In the old days of asylums and institutionalisation,...
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INTERVIEW: Lucy V Hay on Teen Mental Health and Jasmine’s Story

For this week's Freudian Script, Lucy V Hay (aka the infamous script guru Bang2write) talks frankly about her struggles with her mental health as a teenager and how that contributed to the latest book in her THE DECISION series, JASMINE'S STORY. You drew on your personal experiences in THE DECISION: LIZZIE’S STORY to write about teen pregnancy. How did your experiences shape JASMINE’S STORY? Being popular is a huge part of growing up, especially for girls. I was not popular and I felt it every day, but I was not hugely unpopular either, so I got through school relatively unscathed... I got the usual taunts about being ugly or fat or whatever, but probably no worse than anyone else. I was very much The Outsider at school and felt very “detached” from it all, as if I was watching myself and others there. This was underlined by the fact I attended a school out of catchment where I lived; there was no...
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Freudian Script: Police and Crime

Police officers - not the most likely custodians of society's mental health. However, they are frequently called out to mental health emergencies and they play an uneasy role alongside the mental health profession in enforcing mental health law. In commemoration of National Crime Reading Month, I'm going to explore the often-complex relationship between the police, mental health professionals and people suffering from mental health problems. Please note, I am neither a lawyer nor a police officer. These examples are mostly drawn from my own experience and attempt to offer insight for writers who wish to write about these topics. Why involve the police? Several situations may require a police presence in the context of a mental health problem. A few examples include: > A disturbed man in the street, running into traffic. > A desperate woman on a bridge, threatening to jump > A 999 call from a concerned mother whose son with schizophrenia has gone missing > A woman accused of assault says the demons made her...
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Freudian Script: The Mental Health Act

So, you want to write about mental health. By checking out the previous series of Freudian Script, which concentrated on specific conditions - like depression, psychopathy and autistic spectrum disorders - the writer can get to grips with a sensitive and accurate portrayal of a mental health problem. But what about the experience of living with a mental health problem in the UK? How do mental health services function? What happens when you have an urgent problem one morning? How about at midnight? What goes on inside a mental health hospital? Who comes to see you if you can't leave the house? And what about the professionals who work in mental health? Who are they and what do they do? How do they interact with other areas of medicine, social workers, and emergency services? The next series of Freudian Script concentrates on these aspects of mental health. Because I live and work in the UK, this will focus on the British experience of mental...
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