Tag Archives: shame

Mental Health in Small Town, USA

“There is no standard normal. Normal is subjective. There are seven billion versions of normal on this planet.”

– Matt Haig

Just some brief thoughts:

I live in a small town. Like a really small town. It’s a very conservative, small town in a very conservative part of Illinois, which is most of the state (thank God for Chicago or we would be all Red). There aren’t a lot of resources in my area for people with any type of mental health or psychiatric problems. That seems to be the case for many rural areas across the U.S.

This isn’t news. A 2020 study found that “rural residents in the USA experience significant disparities in mental health outcomes even though the prevalence of mental illness in rural and metropolitan areas is similar.”

These issues may stem from a lack of funding or a lack of understanding of these types of problems. I haven’t even heard of any recognition that May is Mental Health Awareness Month on any type in any local media in my area – not that that is surprising. I have found most people have no idea this is Mental Health Awareness Month.

That’s part of the problem. No, not recognizing May as “ours”, but by not recognizing the issue at all. I had an appointment with my psych doctor yesterday, who practices more than an hour away now. Thank God (or whoever) for Telehealth or that monthly drive would be a killer.

A study by researchers at Wake Forest School of Medicine determined one of the main causes behind the lack of resources for mental health treatment in rural areas is the surrounding shame and stigma. The belief that “I should not need help.”

“We as a society have a hard time asking for help, so it’s hard enough to ask for help [without feeling] that everybody’s going to know it,” Dennis Mohatt, vice president of the behavioral mental health program at the Western Interstate Commission for Higher Education, said. “Your neighbors don’t have a clue in a city if you’re going to go get some help. But everybody [in a small town] will know if your pickup truck is parked outside of the mental health provider’s office.”

He’s right. Fortunately, I do not fall into that category. I’m not out picketing for change or acknowledgment, but I’m far from ashamed.

Other research suggests even suicide rates are affected by the regionality of mental health services.

“There is a higher suicide mortality rate among residents of rural and nonmetropolitan areas than those living in metropolitan areas,” Ty Borders, Ph.D., said. “The discrepancy has existed for decades, and the gap has widened in recent years,”

So, why is this? I’m sure there is more than one answer, but where I live it has a lot to do with what I hope is a lack of understanding (I have to believe that, at least). Funding, too, if that can be looped into it on some real substantive basis. However, I believe it stems from a lack of understanding.

It’s also because of a weakness that gets pinned on those who suffer from any type of mental health problem or crisis. There is very much a “Suck it up and get over it!” mentality among many throughout my community. The idea that mental illness didn’t exist fifty years ago is a very prevalent one.

Poverty plays a role in this dilemma, too. How can someone expect to pay for mental health services when they can’t afford their 10-year-old’s school physical? Especially if those types of appointments are an hour away and are only open certain hours or days of the week.

According to the Rural Health Information Hub, “18.7% of individuals in nonmetropolitan areas have a mental health condition, which is about 6.5 million people. Rural residents are also more likely than urban residents to experience a serious mental illness.”

One report suggests that for every 30,000 rural Americans there is one psychiatrist. This is interesting, and it would be interesting to know how many out of those 30,000 need psychiatric help. But we’ll never get any accurate information regarding that.

So, do we need more therapists? Or is it something more serious, a more systemic issue? I don’t think there is a black or white answer. I mean, I have no real ideas that would matter. I’m just like everyone else: pointing out the flaws in the system with no real alternative measure in mind.

An Inconvenient Truth: Shame, Regret, and My Ugly Theory

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“Shame is a soul eating emotion.”

– Carl Gustav Jung

If this were of any consequence and if I were a person of any significance, this one certain belief/opinion I have regarding a specific matter I hold would most likely be considered controversial or just plain ignorant. No, it’s not political, or derogatory in any other fashion. It’s a simple idea on what some may call a “philosophical” matter, but for me, it’s really a non-issue.

It’s regarding shame and regret, and simply put I do not believe anyone can truly be ashamed of anything. This is usually where the two camps of thought get together and meet to either attack my “negativity” or speak of my stunted and simple intelligence.

Now to clarify, the emotions stemming from what I would call “genuine shame” are very real: the embarrassment, the humiliation, and all the other awkward emotions. Shame tends to take form on outward reactions.

I just don’t believe people can do something they would be ashamed of, not on a primal, base-line level anyway. What I’m trying to say is that I understand why my “belief” is not of the majority and is considered to either be arrogant or ignorant. So, I’ll at least try and explain.

According to verywellmind, shame can be described as “a feeling of embarrassment or humiliation that arises in relation to the perception of having done something dishonorable, immoral, or improper”. Although I agree that those emotions exist within us at certain times, especially after that personal sense of humiliation sets in, I think they are more so interrelated with how we feel about ourselves.

Shame, however, in the minimalist and misinterpreted way it exists, can be used as a tool for both good and bad purposes.

Arlin Cuncic, a therapist and author, writes, “Since we want to be accepted, shame is an evolutionary tool that keeps us all in check.”

I agree with that ideology, but I always go back to the idea of human nature and how something like “shame” fits on Mother Nature’s “emotional food chain”. I just don’t believe people can truly do something they are ashamed of. It’s an under-the-surface issue in which I predict semantics will play a role in the outcome of said debate.

It’s a bold statement to make, I know, but here goes: I’ve never done anything I was ashamed of, and I only say that simply because I believe human nature disallows us from doing something we would be ashamed of. I don’t doubt that the emotions tied to shame exist and are real. I feel shame is like a selfish, personal Band-Aid. Being ashamed is being humiliated after the fact. Would you do that one thing that caused you so much shame again? No. You’d stifle it and hope you have the strength to keep the lion in its cage.

Regret is an “intelligent and/or emotionl dislike for personal past acts and behavior”. One may say, “Well, what’s the difference between the words?”. There is one major difference: Shame is about personal humiliation. Regrets are about guilt. It may not seem like a big difference, but I assure you it is.

Many think the words “shame” and “regret” can be used interchangeably, but that would be incorrect. They both express different meanings. To sum it up, regret is about wrong actions, while shame is about being wrong as a person.

So, although shame and its surrounding emotions do exist, it does only in a certain context. One can feel shame and its sister emotions, but, in my opinion, we can never truly do anything we are ashamed of. It’s human nature on a primal level. Regret is the awareness that you’ve done wrong, and you feel remorse for having done it.

Below is a clear example of the differences:

Regret: I did something bad.

Shame: I am something bad.

Shame is a feeling of humiliation after having done something whereas regret is a feeling of guilt after doing something wrong.