The Stigma of Mental Health in the African American Community

The Stigma of Mental Health in the African American Community

Let's Talk Mental Health

Caroline Stewart MSN, RN

Hello everyone, this is my 1st official blog post. I thought this topic would be a great for discussion because it’s so controversial. Before I dive into it, just a little information about myself, I have been a psychiatric nurse for almost 5 years. I have a Master’s Degree in Nursing and have cared for patients aged 4 to 102 all in mental health, behavioral health, psychiatry, whatever you like to call it. Although to some may seem like a short time in the field, I have learned so much and experienced more.  I love working in mental health, it’s a field of medicine that requires a “grey” thinking mindset.  I have grown passionately about mental health and caring for this vulnerable patient population. Next to mental health nursing, my love is education. I’ve had my hand in the education pot as well working, part-time…

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Dissociative Identity Disorder: Anger and Shame

Art by Rob Goldstein
Found on Pinterest

I assume my DID is more clearly visible on social media, but even in Second Life,
when some of the alternates logged in with separate accounts and avatars,
most people assumed I was really good at role play.

Most of my friends describe me as talented, bright, positive, passionate, and

But I’m also depressed, impulsive, sometimes self-destructive, suicidal, and self

I experience depression as if it is a separate self because it feels as if I see the
world through another man’s eyes.

This depressed self impulsively acted out when we  were younger.

He usually wound up in crisis clinics and on psych units.

We’re older and better at coping when the depressed self comes out;
but coping takes so much energy there is little left for anything else.

When I tell people I am symptomatic what I mean is that I have all
the symptoms of a dissociative disorder combined with the symptoms
of major depression.

Art by Rob Goldstein
Symptoms Dissociative Disorders
Art by Rob Goldstein
Symptoms of Major Depression

The depressive loss of concentration makes the memory loss of DID more confusing.

Shame is what I feel when I lose an area of competence.

I know that I am able to write under a deadline but not now.

I know that I can write a competent review but not now.

I know that I can collaborate on projects but not now.

What I don’t understand at my core is why I can’t do those things now.

Art by Rob Goldstein
Found on Pinterest

And when I sense our culture’s denial of mental illness in my interactions with
friends who mean well the shame merges with rage.

The misconceptions and lies about people with mental illnesses insinuate
themselves into our lives and becomes a given.

A given is a misconception that people unconsciously accept as maybe true.

It’s a given that all people who are homeless either:

A: Drank themselves onto the streets.

B: Chose to live on the streets.

C: Both A and B

The number of people who comfort themselves with the ‘they deserve it’
choice of C: must be huge because all social conventions are collective
and volitional.

We collectively incarcerate and execute gays until we collectively figure
out that we’re wrong; and even then there is no guarantee that the forces
of ignorance won’t convince us to go back to collectively incarcerating
and executing gays.

So it is a century after Dorothea Dix we brutalize the mentally ill with
lethal neglect and homelessness.

Just as we collectively agreed to build institutions to house and safeguard
the mentally ill we now collectively agree to starve them to death on the

By what mechanism do we do this?

We do it by denying the truth of chronic mental illness.

We pretend that people with broken brains will always choose treatment
when it’s offered, even though one of the primary symptoms of
serious mental illness is denial.

These quotes are perfect examples of the kinds of attitudes that
make life miserable for people with chronic mental illness.

I found them on Pinterest by running a search for Mental Illness:

Art by Rob Goldstein
Found on Pinterest

I’m to change that I’m broken by denying the truth of it?

I’m broken.

I didn’t beak myself.

I’m sick of starting over.

I’m sick of living in pain.

How do I ‘rediscover’ someone I never knew?

Art by Rob Goldstein
Found on Pinterest

My illness places me at the mercy of a political movement that defines my life as useless
because I am mentally ill. This movement wants me to die.

As examples I refer you the thousands of seriously ill people rotting on our streets and in our prisons.

Yes, I have strength and courage. I’d also like to have access to treatment and rehabilitation.

Art by7 Rob Goldstein
Found on Pinterest

I love Thoreau but I don’t think he had chronic mental illness in mind when he wrote that.

I’m not disturbed by my imperfections; I’m disturbed by the symptoms of a Complex Post Traumatic Stress Disorder brought on by the repeated physical and sexual assaults I experienced as a child.

Imperfections are not listed in the DSM 5.

Art by Rob Goldstein
Found on Pinterest


The idea here is that people with mental illnesses are gifted in ways that
should make us feel better about it.

Yes, I’m creative.

But I’d rather be working; which brings us back to shame.

I am gay, ideologically feminist, and believe that gender identity is fluid.

I am also a male raised to be straight in a culture that punishes ‘weak’ men.

I have internalized the message that losing command of my emotional life is
shameful and weak.

When my illness prevents me from using my mind I suffer a lifetime
of internalized self-hatred and shame.

Art by Rob Goldstein
Nothing Seems Real

(c) Rob Goldstein 2016

All images found on Pinterest




Inside Dissociative Identity Disorder: Rich Man Poor Man

I’ve begun to follow the blogs of other people with Dissociative Identity Disorder.

Refractory Ramblings From The Darkside



Life as a Committee

I don’t know what my own DID looks like but I can see the whole person
in the fragments of self-expression on these other blogs.

Where my DID differs is the way my alternates evolved after they
found Second Life.

When the first alternate joined Second Life in 2009 the others quickly followed.

Each of them evolved socially and each wanted time in SL with its own circle of friends.

Some members knew the different alternates but few people believed that I had DID.

That was in part due to the fact that I didn’t believe I had DID either.

When I fully realized in 2011 that my life as a functioning adult was over I became desperate and angry and in my rage I blamed all of Second Life.

In that regard I really am only human: fear makes people behave irrationally.

I was terrified.

I’m five years healthier now and no longer feel like a helpless victim.

My task is to learn how to use SL in ways that enhance my life and to
respect the dangers in VR that are unique to people with DID.

Art by Rob Goldstein
Rich Man

I am of two class groups

The rich man remembers High School in Queens, walks through Forest Hills, classes in art and music and going to the zoo with his Grandmother.

Art by Rob Goldstein
A Day at the Zoo

The poor man calls himself white trash.

He only remembers the poverty of the housing projects, the ignorance of his neighbors and the shame of illiteracy.

Art by Rob Goldstein
Poor Man

All of my alternates are divided by two.

Each alternate in our system has an alternate that looks and behaves as if it has only known poverty.

Art by Rob Goldstein
Alt 7

This division by class means that every period of prosperity is followed by a period of poverty.

In my 20’s I’d find a job that paid well and six months later need to be hospitalized..

It looked like I had bi-polar illness.

As I aged each new self had a little more skill.

Rob studied literature.

Matthew studied computers.

Robert is still learning photography and social media.

The goal of my DID is invisibility.

I become invisible in most social settings by fitting in.

When Matthew emerged in the 1990’s he had better social skills and access to the knowledge we had acquired in New Haven.

He first worked in IT and then shifted to mental health.

He gained access to what we knew about psycho-dynamic treatment principles and he went to work in the mental health system.

Matthew’s identity is organized around the Catholic principles of liberation theology which gives him a sense of passion as an advocate.

Art by Rob Goldstein

The alternates in my system are also united in their love for our partner.

We succeeded in building a life worth living and if we had not aged past 50
we might have remained stable.

Some men with DID get worse as they age because they feel more vulnerable.

I’m one of them.

I fell apart again when I turned 58.

People with a mental illness must learn how to cope with the effects of disruptive symptoms, the social stigma induced by the symptoms and the stress of living in a country that seems to have collectively lost its mind.

This is not the first time that the modern civilized world
has gazed into the abyss.

The problem is that we may not survive to get another chance.

I’m a rational man with a mental illness in an irrational world.

I don’t understand why we can’t have a national history lesson and just accept the fact that we made a mistake in 1980.

Unregulated capitalism is a failure and destructive to the common good.

I don’t understand why our nation has to disintegrate to figure out
that we need to re-regulate capitalism.

I don’t understand why people shut themselves off from fact and
make themselves toxic with hate.

I don’t understand repeatedly falling for the same lies decade after decade.

It’s 2016 and we are still investigating bogus Clinton scandals.

In 1992 it was Whitewater.

As an abuse survivor, I look at American politics and see a mob of racist adults hurling stones at black children the day my South Carolina grammar school was desegregated.

I see the man who called me a kike and kicked me in the stomach when my body was five.

So I read these words in Salon today I felt afraid:

For a generation, gun advocates have defended the right to bear arms as a check against tyranny, and for just as long liberals have dismissed this as a melodramatic talking point. But what if we take them at their word, and accept that it is possible we are witnessing the opening phase of a still-inchoate violent uprising by a broad class of Americans, who, ignored politically, bypassed economically, and dismissed socially, are beginning to take matters into their own hands?

What if, in other words, Donald Trump isn’t an aberration created by the miscalculations of party elite, but the political expression of a much deeper, and more dangerous, frustration among a very large, well-armed segment of our population? What if Trump isn’t a proto-Mussolini, but rather a regrettably short finger in the dike holding back a flood of white violence and anger this country hasn’t seen since the long economic boom of the 1950s and ’60s helped put an end to the Jim Crow era?

One way or another, we’re going to find out soon. Trump made headlines when he suggested his supporters would riot if he were denied the nomination despite his lead in the delegate count. Even if we are spared that spectacle, the Trump era will almost certainly come to an end by November. And then we will be left with the naked fact of his followers, too few in number to effect meaningful change on their own, too numerous for the rest of us to ignore, too angry to sit still for long.


I know these people.

Part of me was raised by them and Bobby has let me see his memories.

They dehumanize the people they hate.

For people driven by hate and fear killing a Jew or a Gay man or a
Liberal is no different from shooting an animal.

Bobby thinks that their leadership in Congress won’t pass
gun restrictions because they will resort to violence if Hillary
Clinton wins.

Trump has already called for violence should he lose the GOP

Why wouldn’t he do the same for the general election?

That’s how Bobby and I see it and I pray that we’re wrong.

But I don’t think we are.

I sometimes think that it’s better to just live in my delusions.

Rg 2016