d.For example, imagine an American client who has just been diagnosed with BorderlinePersonality Disorder, a diagnosis that is very highly stigmatized in the United States.e.How do you think a client receiving this diagnosis would feel if they were told they have apersonality disorder and that it is very hard to treat?f.What if the diagnosis were explained as a mental illness related to trauma and adversechildhood events? Instead of focusing on it being difficult to treat, they are told that it maytake time, but psychotherapy can be effective in helping them manage their symptomsLet’s consider the case of Abel again, this time focusing on stigma.CASE STUDYa.Mental illness is highly stigmatized in Abel's culture. In fact, where he's from in Ethiopia,depression is not a socially acceptable condition – it's not even a term Abel was familiar withgrowing up.b.Abel has avoided discussing his feelings of helplessness with his family, and he also refusesto share these feelings with Jenna. He’s afraid it’s a sign of weakness. He instead focuses onfatigue, difficulty concentrating, and forgetfulness.c.Although he blames these symptoms on old age, his children, who are aware of thedominant U.S. understandings of mental illness, suspect Abel is experiencing depressionsince Abel’s physician found no medical causes for his complaints.d.Jenna understands that Abel will likely not make emotional complaints. In fact, she realizeshe may not experience depression as a mental or emotional state of being at all, the waymany Americans do. But because Jenna is aware of different idioms of distress and thecultural stigma around mental illness, she is still able to recognize his signs of depression.She also recognizes Abel’s grief over the loss of his wife and leaving his home, and shediscusses this grief with him as a prelude to discussing depression.
