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Mental Illness and Shame

By February 9, 2018May 18th, 2019No Comments

Why are America’s streets filled with the homeless, instead of its attics?

Not so many years ago, family members who had psychological problems were considered a shame to the family and were often hidden away from friends and the public in back wards. Any husband had the right, in fact, to sign his wife into a permanent ward without her consent and even to order ECT.

While medication began to be developed to control symptoms of anxiety and depression in the 1960’s, known colloquially as “mother’s little helpers,” along about the 1970’s, creative therapies were introduced that became popular among hippies and other middle class adventurers in certain urban locales, especially in California. These included encounter groups, Primal Scream Therapy, Rebirth, EST, and the introduction of paradoxical family therapy largely at Veterans Administration hospitals.

Although these approaches did not spread to the general populace, they did have their effect in the development of feminist therapy, narrative and cognitive behavioral therapies.These therapies began to deal in the normal problems of living, such as depression, domestic violence, sexual harassment and confused thought processes. They were no longer considered shameful, but useful and even necessary in the increasingly complex world in which we lived.

During the Vietnam War, the idea of PTSD replaced the earlier “shell shock.” Eventually PTSD was recognized as a disorder “PTSD, or post-traumatic stress disorder, is an anxiety problem that develops in some people after extremely traumatic events, such as combat, crime, an accident or natural disaster. People with PTSD may relive the event via intrusive memories, flashbacks and nightmares; avoid anything that reminds them of the trauma; and have anxious feelings they didn’t have before that are so intense their lives are disrupted.”

As with other diagnoses, this one was promoted by advocates of the Veterans Administration for men returning from war, thus the “Post.” Many well-known feminists who believed it applied to assault, rape, etc., insisted on participating and I myself alleged that it could only be “post” if the wars were over and that this term did not exactly apply to women who were still living in the daily wars2. Ultimately they prevailed. Yet so did the government, in perhaps an unintentional way.

This non-pathological diagnosis took off and is liberally applied now to all sorts of trauma. Unfortunately, this has had the effect of scarcely developing new and creative therapies, but providing a plethora of Masters-level licenses for private practice instead of the promised treatment programs. In this way, psychotherapy became a middle class pursuit and veterans and other drug addicts and psychotic patients can even today be seen living in the streets of the United States. The shame is now all of ours.


1. Encyclopedia of Psychology

2. Kaschak, E. (1992), Engendered Lives: A New Psychology of Women’s Experience

This article was originally published in Psychology Today.

Ellyn Kaschak

Ellyn Kaschak

Ellyn Kaschak, Ph.D. is an internationally acclaimed and award-winning psychologist, author and teacher. She is well-known as a speaker, workshop leader, human rights advocate and a public intellectual.