Everyone starts to perceive him or herself through past experiences. Education, and learning new languages, were the most dominant forces that formed my personal life, giving a shape to my values, needs, goals, beliefs, attitudes, and feelings. In addition, my experiences working as a volunteer in several situations near Palestine and Jordan taught me a great deal. Looking back at these experiences helps me to recognize how the behavior of other people may have influenced me. However, I have always thought of myself as being an open person, so I felt that learning from other’s experiences and choices could help me to change my world. As a social worker, working with individuals and communities who have been stereotyped and stigmatized, and learning about the responses of individuals and groups and their experiences and negative attitudes, has given me some insight into how people’s behaviors shape their own realities.
When I worked with low-income families (inter-groups) in Philadelphia, I helped them to find affordable housing. Most of my clients had mental health problems like depression or Post Traumatic Stress Disorder (PTSD). The major problem that shaped their experiences was stigma. By stigma, I mean a situation in which an individual with a given attribute is deeply discredited by the society and thus is rejected as a result of that attribute (and see Goffman, 1963). My clients were mostly African-American and Latino immigrants to the US. Having experienced racial discrimination, they felt stigmatized, and, their resulting behavior only tended to make their situation worse.
In the middle of the nineteenth century in the United States (US), many people suffered from mental illness. Most of the psychiatrists identified the causes of these mental illnesses and deviant behaviors as related to fear of poverty, religious anxiety, loss of property, racism, prejudice, and also the fear of war (Rothman, 2006. p.111). Before the emancipation of the slaves in the south, the slave owners would burn or cut the body of the slave to indicate ownership. These are now called “stigma signs” indicating the status of a discredited individual like a slave and criminal. Such “stigma signs” created a sense that such inter-groups were marginal to the dominant group of the larger society, creating fertile grounds for stereotyping and prejudice (Goffman, 1963).
My previous and current experiences working with mentally ill clients broadened my ability to analyze the main internal impacts of stigma that revolve around expectation of rejections and stigmatization and internalized stigma. The labeling theory explains how people internalize their negative experiences of mental disease which may lead to further rejection, isolation, withdrawn behavior, anxiety, and shame. In the US, people with mental illness have internalized the negative representation of mental diseases characteristic the American culture, which leads them to feel stigmatized and increases their feeling of rejection.
In 1999, I volunteered in an organization in Ramallah called Jabal El-Nejma (Star Mountain) which attempted to rehabilitate Palestinian children with Downs Syndrome. It is well known that most people treat individuals with Downs Syndrome like animals (Radio voice of peace, 2007); the children with whom I worked were very aware of how they were treated, so they felt stigmatized. It was difficult for me to reduce their feeling of being stigmatized, and of course, it was especially difficult because I was working with handicapped, mentally retarded children. These children were primarily affected by the general oppression of the Israeli occupation experienced by Palestinian society.In particular, the blockades, the “security wall”, and other travel restrictions imposed by Israel have generally impacted Palestinian children negatively. These restrictions made it very difficult for the children to come to Jabal El-Nejma, further isolating them from their support network. Internalizing the general negative responses to the travel restrictions, has led these children to demean their sense of their own self-worth, and thus their ability to function within their society. The negative self image that these children had of themselves was further amplified by the way in which people treated them like animals. For example, there was one case in Hebron, in which the parents locked their mentally retarded son in a small room because there were ashamed, and did not want people to know about him.
In 2002, also in Ramallah, where sidewalks and municipal parks still bear the scars of the invasion by Israel, I served as a counselor for handicapped, mentally retarded children in the inner city Amari refugee camp. By facilitating cultural, sporting, and other recreational activities for the children, I helped to teach them life skills for the present and for their future. The parents of these children felt the pain of loss and the discrimination against them because of the stigma of being refugees. Working with these children helped me to better understand the phenomenon of suffering from stigma. This was perhaps my most challenging and eye-opening volunteer experience. I observed how local Palestinians perceived and treated incoming Palestinian refugees who had fled from cities (like Ramla and Lydd) within Israel.
From 2004 to 2006, I worked in the Ministry of Women’s Affairs of the Palestinian Authority on cases of “Honor Crimes.” An honor crime is the practice of killing girls and women who are perceived to have defiled a family’s honor by allegedly engaging in sexual activity or other improprieties before marriage or outside of marriage. These women are stigmatized by their society as deviant, and are then threatened by their family and society. What was called “deviant” behavior that justified killing, eventually expanded to include transgressions that are not initiated by the girl herself, including rape, incest, sexual abuse, and even rumors of such sexual behavior.
In traditional Palestinian society, as in many Arab societies, the honor of the family is strongly tied to the chastity of its daughters (Emery, 2007). A woman’s activities are closely monitored by her family. Her virginity is considered their responsibility; she is dominated by men during her entire life, first by her father and her brothers, then by her husband, and finally by her sons. When a woman’s chastity is questioned, even if she is really innocent because she was raped or the rumors prove unsubstantiated, she is shamed, and her family is shamed with her. “Her shame” is considered to compromise the whole extended family. As long as she is around, it would be difficult to arrange marriages for her unwed sisters, and her male relatives will be scorned – so they eliminate her by killing her.
My own educational experience, influenced by dramatic events, naturally awakened in me an awareness of the problems of Oppression and Stigmatization. I have realized that oppression and stigmatization lead to dehumanization, both for the oppressed and also for the oppressors.In the case of my family, ethnic discrimination, oppression, and the ills of military occupation drove my father from Palestine to Jordan in 1970. I was born in Amman, Jordan in 1979. While I was a child, I remember that my father was imprisoned several times for one to three years each time.
Although my father was weakened by the oppression that he felt both as a refugee and as a prisoner, he still maintained his ability to support his family. Though he did not want to remain a refugee in Jordan, he feared returning from Jordan to Palestine. This fear was created by his experience in prison when he was repeatedly told that he would never have his freedom again and never be able to return home. I believe that my father’s inner strength has sprung from the very oppression that he has experienced, through which he learned to his maintain his humanity. What my father learned from his experience in prison and afterwards was similar to my own educational experiences.
When I was 10 years old, I transferred to a public school closer to our refugee camp in Amman, Jordan. My experience of the educational practices in this school illustrates how Palestinian refugees experienced the stigma of being refugees in Jordan. Most of my teachers were Jordanian, who represented the policies of the host country (Jordan). In our classes, Palestinian refugee students had to follow the strict Jordanian regulations. Every morning, we had to sing the Jordanian national anthem, which reminded us daily that we were refugees not in our own land. We were not allowed to argue or criticize the materials presented in our lessons; we always had to listen to what the teachers said without offering any feedback and certainly without arguing. If we had disobeyed any of teachers’ regulations, we would have been expelled from class. Thus, we were exposed to a stigma process that lead us to feel insecure and rejected.
This experience affected both my own perception of “myself”, that is my own self-image, and also my perception of “the others,” that is the Jordanians. This process of labeling myself as a refugee and my teachers and classmates as inhospitable Jordanians, linked with the negative stereotypes that I experienced of my teachers and the Jordanian society, resulted in my feeling labeled as different from the rest of the society in which we were living (Goffman, 1963). These experiences can influence us powerfully, because such acts not only result in a loss of our social status, but also stimulate feelings deeply connected to the stigmatizing attribute within us. As a result, my parents and I felt dehumanized, disempowered, and disrespected.
At both the micro and the mezzo levels, social workers must address stigmas in their assessments and in their on-going work. They must address the process of stigma internalization, and help their clients to build skills in stigma rejection and self advocacy. Of course, they should also support and encourage individuals who have successfully overcome internalized stigma. Education is one of the most important interventions that might reduce stigma, including leading protests and increasing contacts among people while working with community. Social Workers can cooperate with community leaders to protest against and to suppress the negative attitudes towards people who are mentally ill or have been otherwise stigmatized. Education can be an effective tool for changing attitudes; indeed, targeting the fear of violence in these people has been particularly effective. These interventions could be effected by establishing community education programs for the general public as well as for targeted groups (including the media, local leaders, students, and employers). Moreover, an effort should be made to create opportunities, like structured dialogues and community service projects, to facilitate social contacts between stigmatized individuals and members of the community at large.
At the macro level, it is possible to address the problems of stigma through policy changes and through research. In terms of policy, social workers can function as partners to movements for Civil Rights, and Gay and Lesbian Rights, and so on, and to support political leaders in an effort to enhance the social capital and the political power of stigmatized people. Research could be designed to effectively assess the long term effects of the stigma on individuals and the resilience of communities. Individual resilience is the ability of stigmatized individual to regain and maintain a feeling of self-worth. Community resilience is the ability of a full community to accept people who were initially seen as stigmatized (Shih, 2004). I suggest that through research, we may find effective interventions for decreasing stigma and increasing the levels of acceptance in the community, thus fostering both individual and community resilience.