How to fight against stigma and auto-stigma of persons diagnosed with psychosis? Presentation of the treatment of psychotic disorders in two social contexts

  • Jasna J. Veljković University of Belgrade, Faculty of Political Sciences, Department of Social Work and Social Policy, Belgrade (Serbia)
Keywords: psychodrama, role, mental illness, stigma, auto–stigmа

Abstract


In this paper, we discuss the possibility of applying the psychodrama method in dealing with the stigmatized group of people with psychotic disorders. Despite many advances in pharmacy and psychotherapy, it is true that in the Western world there is still a marked stigma and discrimination against psychiatric patients. Our research question was whether the outcome could be different if the treatment of patients was performed in a manner different from that which is common in Western psychiatric practice? To answer this question, we describe the treatment and treatment outcomes for psychosis patients in Africa, and then outline how to reduce stigma and auto-stigma through psychodrama. The theoretical basis for this is Moreno’s theory of roles as well as various theoretical views on the possibilities of the psychotherapy of psychoses. This “step-by-step” treatment has been shown to lead to learning new and more appropriate patterns of behavior, acquiring previously unpracticed social roles, and ultimately to increasing self-esteem, much like African psychotherapy. The final outcome of both approaches is similar to each other by the rituals they use and the permissions they give to patients to be authentic in their illness – without imposing “normality” from expert positions, low relapse rates, high social functionality and low self-stigma. It can be concluded that by considering the importance of social-psychological, sociological as well as socio-cultural aspects of mental disorders, it can significantly contribute to reducing discrimination and stigmatization of mentally ill people.

Author Biography

Jasna J. Veljković, University of Belgrade, Faculty of Political Sciences, Department of Social Work and Social Policy, Belgrade (Serbia)

Odeljenje za socijalni rad i socijalnu politiku, vanredni profesor

References

Bauman, А. Е. (2007).Stigmatization, social distance and exclusion because of mental illness: The individual with mental illness as a ‘stranger’. International review of Psychiatry, 19 (2), 131–135.

Bion,W. R. (1961). Experience in Groups. London. Tavistock Publications

Bion,W. R. (1962). Theory of thinking. Inter. Journ. of Psyhoanaly, 43, 306–310.

Blatner, A. (2000). Foundations of Psychodrama. NY: Springer Publishing Co.

Blatner, A. (2005).Morenian Approaches: Recognizing Psychodrama’s Many Facets. Available at https://www.fepto.com/publications-projects/articles/morenian-approaches-byadam-blatner

Buber, M. (1967). You and me. Beograd: Vuk Karadzić [In Serbian]

Buizza, C.et all. (2007). The stigma of schizophrenia from patients’ and relatives’ view: A pilot study in an Italian rehabilitation residential care unit. Clin. Pract. Epidemiol. Mental Health 3, 23. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2173890/.

Biksegn, A., Alem., E.,Tenaw,Y. (2018). Internalized Stigma among Patients with Mental Illness Attending Psychiatric Follow-Up at Dilla University Referral Hospital, Southern Ethiopia.Psychiatry Journal ,Volume 2018. Article ID 1987581, https://doi.org/10.1155/2018/1987581

Đuric, Z., Veljković, J.,Tomić., M. (2004). Psychodrama. Zagreb: Alinea.[In Croatian]

Corbière, M., Samson, E., Villotti,P., Pelletier, J. F. (2012). Strategies to Fight Stigma toward People with Mental Disorders: Perspectives from Different Stakeholders. The Scientific World Journal. Vol. 2012. Article ID 516358. http://dx.doi.org/10.1100/2012/516358

Goffman, E. (2009). Stigma. Notes on the Menagement of Spoiled Identity. Novi Sad: Meditteran Publishing [In Serbian]

Federn, P. (1943). Ego-psychology and the Psychoses.New York: Basic Books.

Freud, S. (2003). Rat man. Beogrаd: Čigoja štampa. [In Serbian]

Foucault, M. (1988). Madness and civilization: A history of insanity in the age of reason. NY: Vintage

Klein, M. (1975). Notes of some schizoid mechanisms, 2nd.ed. In M. Klein, Envy and Gratitute, 236–248. London: Hogarth Press

Klein, M. (1950). Contribution to Psycho Analysis 1921–1945. London: The Hogarth Press LTD

Kecmanović, D. (1989). Sociology and psychiatry. In: D. Kecmanovic (ed) Psychiatry, 1st part, 394–408. Beograd: Medicinska knjiga; Zagreb: Svijetlost [In Serbo-Croatian]

Moreno, J. L. (1945). Psychodramatic Treatment of Psychoses. NY: Beacon House

Moreno, J. L. (1972). Psychodrama, vol. 1. NY: Beacon House

Мoreno, J. L. (1977).Who Shall Survive? Foundations of Sociometry, Group Psychotherapy, and Sociodrama. NY: Beacon House

Moreno, J. L. (1975): Psychodrama: Foundations of Psychotherpy, Vol 2. 2nd ed. Beacon NY: Beacon House

Moreno, J. L. (1961). The role concept, a bridge between psychiatry and sociology. American Journal of Psychiatry, 118 (6), 518–523.

Moreno, J. L. (1971). Words of the Father. New York: Beacon House

Мoss, R. H. (1982) .Copping with acute crisis. In: J. Million, C.Green and R. Meagher (eds). Handbook of Clinical Health. New York:Plenum.

Madu, S. N., Baguma, P. K., Pritz, A. (eds). African traditional healing, psychoterapeutic investigations. Kampala (Uganda): Access Communications Ltd.

Jones, M. (1953). The Therapeutic Community: A New Treatment Method in Psychiatry. New York: Basic Books.

Krueger,. R. (2011).Why learning to play is important: an up-to-date “Disoder –Specific Psychotherapy” for People with Psychosis according to Moreno. (This was a lecture given on August 29, 2009, at the IAGP congress in Rome. Posted on Adam Blatner’s website with the author’s permission, 6/30/2011). Available at https://www.blatner.com/adam/pdntbk/psychosiskruger09.html

Ljubičić, M., Dragišić Labaš, S., Nastasić, P. (2013). Student’s attitudes on person suffering from psychological malfunctions: addition to stereotype researche. Alcoholism, 49(2), 85–100.

Оgden, Т. (1992).Projective Identification and Psychotherapeutic Technique. London: Maresfield Library.

Rosenfeld, H. (1965). Psychotic states: A Psychoanalytic Approach. London: The Hogarth Press.

Stuart, H. (2004). Stigma and work, Healthcare Papers, 5 (2), 100–111

Sullivan, H. S. (1974). Schizophrenia as a Human Process. New York: N.N.Norton.

Štrkalj-Ivezić, S., Jendričko,T., Pisk, Z., Martić-Biočina, S.(2014). Therapeutic Community. Soc. psihijat., 42 (3), 172 – 179 [In Croatian]

Štajner,T., Kondić, K, Vlajković, J. (1998). I listen to you, understand you, accept you. Non-diredtive psychotherapy of Carl Rogres. Beograd:I.P.Žarko Albulj. [In Serbian]

Veljković, J., Đurić, Z. (1997). Application of Psychodrama in a work with psychoticpatients. Engrami, 19, (1–2), 95–103. [In Serbian]

Veljković, J. (2007). Psychodrama as an integrative approach in improving the Life Quality in psychotic disorders and populations at risk. Doctoral dissertation. Beograd: Institut za multidisciplinarne studije Univerziteta u Beogradu. [In Serbian]

Veljković, J.(2014). Psychodrama changes. Beograd: ZadužbinaAndrejević [In Serbian]

Veljković, J.(2015). Application of psychodrama in integration of self in adolescents. Sociologija, 57 (2), 314–330. [In Serbian]

Veljković, J. (ed) (2018). Through Labyrinth of Psychodrama. Beograd: Centar za primenjenu psihologiju. [In Serbian]

Published
2020/03/31
Section
Original scientific paper