Biology and stigma

We wish to offer a brief response to the article by Drs Angermeyer and Matschinger (2005) entitled ‘Casual beliefs and attitudes to people with schizophrenia’.

Underlying all forms of discrimination, including psychiatric stigmatisation, is an exaggerated attribution of ‘other-ness’ to certain individuals or groups, so that there is an assumption (made by the discriminator) of the existence of fundamental differences between himself and ‘the other’. Be it in the area of criminology, race, morality or mental health, this myth is further reinforced by the use of historically and culturally determined dichotomous constructs such as good/evil, citizen/alien, sane/insane and normal/pathological. The association of a biological marker with any stigmatised group acts as a signifier, further emphasising that group's distinctiveness. Previous attempts to elucidate biological markers in criminals and in certain ethnic groups have served only to etch this mistaken notion of fundamental difference a little deeper in the mind of the discriminator and, in doing so, to reinforce prejudice. We believe that the findings of Angermeyer & Matschinger may be partly explained through a similar effect following the promulgation of a biological theory of schizophrenia.

Cognitive-behavioural therapists address this myth of difference as a therapeutic strategy when working with people with psychosis by emphasising the continuity of symptoms across the range from those designated as ‘sick’ to ‘normal’ (Kingdon & Turkington, 1994). We believe that the extension of such an approach in the wider treatment of society could have a powerful role to play in the ongoing campaign against psychiatric stigmatisation. The origins of our current unsatisfactory conceptualisation of mentally ill people as being separated from ‘normal people’ by an absolute and fundamental boundary are often attributed to the Kraepelinian model. We welcome then the predictions made by Craddock & Owen (2005) of the imminent demise of this in favour of a newer, hopefully less iatrogenic paradigm.