A worldview captured in a headline

Sometimes a headline perfectly distills an aspect of the zeitgeist. That's the case with an article in Tuesday's New York Times: "'Schizophrenia' still carries a stigma. Will changing the name help?"

There are two assumptions at work here, both quite widespread in certain American circles in 2021 — and both highly questionable.

The first concerns the social significance of "stigma." Having an illness, disorder, or disability can involve considerable struggle. But how much of this difficulty is physicially intrinsic? And how much of it is a function of the negative way the disease or debility is received by society? Many have become convinced in recent years that the second problem — social stigma — is enormous and cries out for a response.

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The second assumption concerns what that response should be. Here, as often, the proposed solution is to change the way we talk about the underlying condition. If we alter the words we use — "schizophrenia" in this case — we will positively influence the way we respond emotionally to the people around us.

Neither of these assumptions is sound.

If you have schizophrenia, whatever we call it, you have a serious mental illness — one that, thankfully, can now often be treated and managed with pharmaceuticals. Some people will respond negatively to this fact about you, in most cases because of fear, much of it ill-founded and based in ignorance of the disease.

That's regrettable. But is it the primary or even an especially significant problem you face in your life? I'd suggest that in most circumstanes that could only be the case if you're fortunate enough to have benefitted from medical interventions that have tamed the worst symptoms of your illness — and that if you have thus benefitted, you could probably avoid publically announcing you have any diagnosed mental illness at all, thereby avoiding the stigma entirely. If you haven't had such good fortune, however, the physical illness is likely a more serious obstacle than other people's behavior.

As for the name itself, the Times article suggests several alternatives to "schizophrenia," including "altered perception disorder, attunement disorder, disconnectivity syndrome, integration disorder, and psychosis spectrum disorder." But why are any of these alternatives inherently less stigmatizing than "schizophrenia"? I'd suggest that they aren't, that the stigma arises from the aforementioned fear of certain characteristic behaviors of the afflicted, and that the labels we attach to those behaviors are beside the point.

Here and elsewhere, it might be a good thing to focus less on the supposed scourge of social stigma — and even less on the ostensible power of words to shape our perceptions of the world around us ("latinx," anyone?). Instead, we could devote more time, energy, and resources to addressing the underlying problems themselves.