Shame

What am I most ashamed of? Not of my diagnosis of bipolar disorder, that’s actually reasonably respectable – which is probably why I don’t find it easy to believe. But shame wraps a tight cloak around us all, one that feeds itself and whispers that no-one must know. 

What is it that fosters shame? Is it a sense of the ridiculous, as well as the bad? Or cultural judgement, a feeling that we have fallen short of society’s norms? The worry that even your closest friend will recoil slightly? The fear (when depressed) that you are bad and doomed to hell, a hell in which you don’t even believe? The embarrassment when you’ve behaved ridiculously, or said something stupid?

I was ashamed when I became a psychiatric patient – probably more of that than of any subsequent diagnosis, or of actually being unwell. This was not all my own doing, but also came from the way people (even my family) talked of psychiatric patients, and the way notes were not kept, given the apparent risk to my medical career. The shame of being an in-patient was acute – you could smell the relief on other people that this had happened to me, not to them or their families. I don’t blame them, I would have felt the same.

Strangely, there is even some of this when asked what you do. I usually say I’m a doctor, then they ask if I’m a GP, and I say no, a psychiatrist. Then there is often a short pause before they ask me if I am analysing them. Things can get worse if I mention that I’m an addiction psychiatrist, particularly if beverages are flowing freely. 

The hospital where I work has a jaded look that is at odds with the more acute services. When I show patients where I work I usually apologise for the surroundings, while expounding the merits and kindness of my colleagues. I do feel a bit ashamed though, but much better that way round.

When I was younger I was ashamed of all sorts of things – perhaps part of growing up. I was very ashamed of my English accent, and I was ashamed of my name, Rebecca (a bit posh then – fortunately my mother didn’t call me Miranda like she’d threatened to). I was ashamed of being short and bad at sports, and I was ashamed of developing boobs. I think I walked for an entire year with my shoulders hunched forward. I was very ashamed that I didn’t listen to pop music, and that I can’t dance.

Then the thing happened of which I was and am most ashamed – in my early twenties I had a termination of pregnancy. I couldn’t tell anyone. And yet, all around me there must have been other young women experiencing the same. Abortion is something which is easily available, a path you can almost feel compelled to tread when you have become accidentally pregnant. And yet it remains silently and morally criticised. I feel great admiration for those who have taken the other route of continuing their pregnancies, and continuing shame that I did not. Our society lets it happen but doesn’t condone it, an uncomfortable combination.

I would sooner talk to people of my psychiatric problems than of that – not always easy, but maybe I feel less ashamed now of my illness, which I suppose is progress of a kind. But mental illness has all its own little pockets of shame and stigma. Self-harm to me feels shameful, and far less easy to talk of than other manifestations. I feel sympathy for others, but for myself – well, I have no excuse, and see it as a behaviour, over which I should exercise more control. I have written before of borderline (emotionally unstable) personality disorder, which I consider to be a particularly stigmatising diagnosis. I cringe to think of my own relief that my psychiatrists have stuck to a mood disorder in my case, largely because it highlights my own prejudices and beliefs. Manipulation and behaviour are often raised in psychiatry, as being deliberate on the part of the patient and as such often condemned. I think my behaviour was quite poor at times when I was ill – refusing to talk to people, getting angry – but does this make me a bad person? The concept of personal responsibility is an odd one. I believe, deep down, that everything is shaped by biology followed by experience, and thus people have little choice as regards their behaviour and actions. It doesn’t mean that I don’t get irritated by people, and it doesn’t mean that things can’t change – but it does take away some of the blame, and hence the shame.

I remain ashamed of my psychiatric illness, and the fact that I have to take psychiatric medication. So many people have opinions regarding mental health that it’s very hard not to be affected by all these diverse ideas, and to doubt one’s own beliefs. I think it’s been a lot easier for me now that most people know, now that they don’t just have to wonder, or ask in whispers. There are many people finding their way by coming out about all sorts of issues often perceived as shameful, not just mental illness. I suppose that what seems sad is that they have to do this. Their stories will still be interesting, and no-one should have to feel ashamed. I feel shame and anxiety that I am about to post this, but I will, just the same.