Inward Enquiry and Self Stigma

Rev. Master Olwen is a female monk now based at Throssel Hole Buddhist Abbey. She has read all the content on this blog and has expressed that she looks forward to seeing more as it comes out. 

Although expressing that she does not feel at all qualified to speak on depression or psychosis from a personal experiential point of view, Rev. Olwen has made some comments which she is happy to be shared on this blog.

From her experience as a teacher she said: “...for us as meditation teachers it seems important to not come to blanket conclusions about whether or not it is good to encourage or recommend people to learn to meditate who may currently have depression or whatever”.

Rather than taking a specific intellectual or theoretical position on “Zen and mental illness”, Rev. Olwen commented that: “It seems it is all so much bigger and wider on the ground of the totality of our being and that aligning with "ideas about" whatever it is... is rather to restrict "reality" or rather bend it and push it into a small self-imposed frame”.

In a similar vein she said: “I think it could be valuable to follow up the area of how people think and feel about what they experience as "depression" or "psychosis"...” 

It is this area, of how people think and feel about these experiences that we shall explore here.

Many of us who have been labeled with “mental illness” might be troubled by what mental health workers call “self-stigma”. This self-stigma ultimately consists of our thoughts and feelings which can diminish our “self-esteem” and “self-efficacy”. It can result in the “why try” effect and impact on our life goals (Corrigan, et al. 2009). In other words, following the way we think and feel about the depression or psychosis we experience, we may think we can’t do certain things and may miss out on doing the things that are important to us.


Geoff, who is recuperating after a recent discharge from hospital, has had a number of psychotic episodes in the past. He is now back in his flat, but he feels conditioned to believe that he will always have mental health issues. 

He recognises that he already has low self esteem and he says that knowing that an employer could recruit someone who hasn't got a Mental Health problem means he feels completely demotivated. 

A member of staff working with him in the community commented: "It's almost as if a lie repeated hundreds of times becomes the truth - simply because he heard his condition mentioned over and over as an obstacle, he is now trapped in this state of seeing nowhere beyond his Mental Health diagnosis".

There are lots of negative stereotypes about psychosis and mental illness. With self-stigma, these stereotypes are taken a step further. Self-stigma comprises three steps:

1)   Awareness of the stereotype (e.g. “People who have been psychotic are unwanted”)

2)   Agreement with it (e.g. “So I guess I’m unwanted by other people”)

3)   Applying it to one’s self (e.g. “There’s no point in applying for that job – they’re not going to want me”)

Because of self-stigma it can be easy to be dissuaded from pursuing the kind of opportunities that are fundamental to achieving our life goals, but stigma also exists “out there”. The charity Rethink Mental Illness, reports that research by The Mental Health Foundation, found that 47% of people who had experienced mental distress said that they had experienced discrimination in the workplace, and 37% had experienced discrimination when seeking employment.

Fortunately I have never had long periods of unemployment and I have always been honest about my past admission to hospital with psychosis. Larger employers usually have an Occupational Health department, and within the past few years, when I met an Occupational Health doctor, I explained that I had worked for many years in various environments known to be stressful, and with no relapse of psychotic symptoms. I explained to the Occupational Health doctor that I did not feel that my past episode(s) of psychosis were even relevant any longer, but the doctor told me in no uncertain terms: “You have a history of psychosis and will always have a history of psychosis whether you like it or not”.

When I was told this by the doctor I felt affronted, even wronged. What he said was true; yet how I think and feel about this fact is another matter. There is a place for reducing stigma and breaking down negative stereotypes in the world, but we may also need to examine our own self-stigma. At the very least, we can start by being aware of stereotypes without agreeing with them and applying them to ourselves.

Rev. Master Olwen, although making clear that she does not feel at all qualified to speak on the matter, has suggested inward enquiry: “into the conditioning and this culture's assumptions and approach that one has soaked up”. She suggests that this inward enquiry might “relieve some of the suffering that arises from that form of conditioned reaction”, and she adds that often one may be completely unaware of this conditioning “until one has a way into deepening the enquiring/sitting with process”.

The way we think and feel about what we experience as "depression" or "psychosis" may be an area for inward enquiry. 

Those of us with a history of psychosis, depression or whatever, may not intentionally or even consciously “self-stigmatize”, but we have, no doubt, soaked up this culture’s assumptions about what that history (however recent or distant) might mean, and our reactions will be conditioned by that. 

Whilst inward enquiry into this conditioning may relieve some suffering, Rev. Olwen continues to point out that “...one cannot generalise, and people really have to essentially trust their own process.”






Note: You may also be interested in Manasa Ayurveda - a traditional Buddhist Ayurvedic approach to mental health and wellbeing, now being introduced in the West...