Hello everyone , I am Dr Neil Shah , I am psychiatrist and as you all know there is alot of stigma related to psychiatric illness and mental health related conditions so I have tried to present the evolution of stigma through Jean piagets stages of cognitive development
Evolution of stigma through Jean piagets cognitive development line
Though there are many dictionary definitions of stigma but if we closely examine this concept then we realise that stigma only occurs for a thing with which the evolving self is completely identified with.
As stigma is an idea , a concept, a belief , it is best to study stigma through Jean piagets pioneering work on stages of cognitive development
- A new born infant is competely identified with the physical world , there is no subject object differentiation , the child is in a state of fusion with the external environment
- sensorimotor stage - In the sensory motor stage , the infant starts to differentiate from the physical world and the subject object differentiation starts. In this stage the infant is completely identified with the physical body so for example if you take a baby who is still in the sensorimotor stage to a doctor the infant cries when someone tries to examine him physically , though he doesn’t have the ability to conceptualise his ideas what he is trying to say is don’t touch my body , there is nothing wrong with it , i am completely fine so basically he has stigma related to physical illness
3.As the child starts evolving from the sensorimotor stage( body awareness ) to the preoperational , concrete operational and formal operational stages , the self becomes identified with its psychological self that is it’s ideas , thoughts , beliefs , judgements , justifications , assumptions. By the time of adolescence the self is completely identified with the formal operational stage that is rational , logical , analytical and hypotheticodeductive thinking.Now most of the human civilization is stuck at the formal operational level of thinking .
There is a very important concept in development of any kind and evolution per se
THE SUBJECT OF THE PREVIOUS STAGE BECOMES THE OBJECT OF THE SUBJECT OF THE NEXT STAGE
In formal operational stage the subject is completely identified with this stage so it will see as an object the preceding stages - that is the sensorimotor stage , so in this stage the body and it’s physiological processes are seen as objects therefore people have no problem receiving treatment for physical ailments and no stigma just as they dont have problems getting their car repaired because they are seen as objects of awareness not as subjects through which the individual looks at the world
Majority of the psychiatric illness are thought disorders i e dysfunctions in formal operation thinking and as the self is identified with this level , any dysfunction pointed out at these thought processes is directly considered as a blow to the individuals self identity , as many patients say there is nothing wrong with me , they don’t say there is nothing wrong with my thought process so they are completely identified with their thought process so they cannot see it as an object of awareness and hence the stigma related to psychiatric illness
When the collective human consciousness evolves beyond the formal operational thinking into post formal operational thinking ( a new emerging level in the cognitive line of development ) then formal operational thinking and it’s processes will be seen as objects of awareness by the evolving self and hence can lead to a decrease in stigma regarding psychiatric illness