"Fear of Showing Weakness"
Posted on December 3, 2017 2:39 am MST, by Louise Underdahl
Fear of showing weakness
According to Abraham Verghese, MD, professor of medicine at Stanford and author of The Tennis Partner, physician unhappiness often leads to suicide (Erickson, 2017). In the United States, an estimated 300-400 physicians commit suicide each year (Stone, 2017). As Verghese attested, every year it takes three medical school classes to replace the physicians who committed suicide (Erickson, 2017). Verghese's friend and colleage wrestled with addiction but failed to seek help; as Verghese observed: “There’s a fear of showing weakness" (Erickson, 2017, para. 6). Physician reluctance to enlist help has been attributed to the stigma attached to seeking professional help. Physicians fear losing their job, license, or malpractice insurance (Stone, 2017, para. 18).
How might this situation be remedied?
Erickson, M. (2017, October 17). Good leadership, self-compassion key to tackling physician burnout. Stanford Medicine News. Retrieved from https://med.stanford.edu/news/all-news/2017/10/good-leadership-self-comp...
Stone, M. (2017, November 10). Fighting physician burnout at the organizational level. American Association of Physician Leadership. Retrieved from https://news.physicianleaders.org/fighting-physician-burnout-at-the-orga...
Thank you for bringing this topic to our attention and asking for us to consider prevention. Sadly, the anticipatory stigma associated with disclosure is not false. Across all sectors, fear of loss precipitates disclosure. Loss of status, income, custody of a child, professional licensure, and more are discriminatory realities experienced every day. Stigma is a social label carrying extraordinary power. Fueled by lack of knowledge regarding mental illness, prejudicial attitudes take hold and discriminatory behavior evolves, even against ourselves. If our knowledge of mental illness (mental health literacy) is lacking, we are more likely to create and hold negative beliefs about our own mental health. Over time the negative cognitive assumptions can cause us to discriminate against ourselves--such as the physician avoiding treatment.
What we know is that suicidality can be mitigated through access to mental health care, but that accessing the care can be more frightening than attempting to live with ongoing thoughts of harming oneself--a horrific paradox. Despite public health campaigns, the incidence rates of suicide remain high.
Thornicroft and colleagues (2007; 2009) have begun to explain that, similar to what we experienced with HIV/AIDS, the best prevention to stigmatizing behavior, is knowing someone in our family or first-degree social circles (friends, close co-workers) who is 'out'. Through our relationship with other, stigma dissolves, our literacy increases, our prejudicial attitudes shift, and our discriminatory behavior is diminished.
A topic near and dear to my research interests, your post reminded me of just how far we have to go. Thank you for helping to fight this fight!
Thornicroft, G., Rose, D., & Kassam, A. (2007). Discrimination in health care against people with mental illness. International review of psychiatry, 19(2), 113-122.
Thornicroft, G., Brohan, E., Rose, D., Sartorius, N., Leese, M., & INDIGO Study Group. (2009). Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. The Lancet, 373(9661), 408-415.