Breaking the cycle of shame: addressing parental self-stigma in adolescent psychiatry
- Kristina Mišeikytė
- 22 hours ago
- 4 min read
Parents of adolescents hospitalized in a psychiatric ward inevitably face the stigma associated with mental disorders. First, when experiencing external stigma from others, parents begin to feel blamed and socially shamed for their child’s mental disorder, often being labeled as incompetent parents. The prevailing view is that parents whose children have been diagnosed with mental disorders such as attention deficit hyperactivity disorder, anxiety, and especially social phobia, or depression, are viewed by society as if these disorders are not serious illnesses, but rather a sign of the child’s weakness resulting from poor parenting. It should be noted that parents whose adolescents are hospitalized in a psychiatric ward may also face professional stigma, which manifests as a stigmatizing attitude toward such parents on the part of healthcare professionals, which also affects their self-esteem, the need to distance themselves, and a delay in seeking help for the adolescent’s further treatment.
The process of parental self-stigmatization begins with the perception of external stigma, as parents confront societal stereotypes about mental health disorders: accusations of poor parenting, incompetence, and social isolation. This leads to doubting one’s parenting competence and self-blame, thinking, “I must have done something wrong.” As these parental doubts are internalized—because they increasingly believe in stigmatizing attitudes—their self-esteem diminishes, and shame sets in. In other words, this is an internalized sense of self-deprecation; as it intensifies, emotional distress arises, associated with depression, anxiety, feelings of guilt, and psychological exhaustion, all of which significantly impact the parents’ relationship with the adolescent and family dynamics. It is worth noting that parents’ self-stigmatization regarding their adolescents’ mental disorders manifests on three levels: the cognitive level, where they view themselves as weak and incapable of properly raising their child; emotional, where they feel shame and guilt; and behavioral, where they may conceal the fact that their child has a mental disorder and fail to seek the necessary help for the child’s treatment.
Shame is considered the emotional core of self-stigmatization among parents of adolescents hospitalized in psychiatric wards. The consequences are severe, as both life experience and scientific research show that parental self-stigmatization is associated with stress, depression, anxiety, reduced self-esteem, and self-worth, while identified symptoms of depression and anxiety are associated with feelings of sadness, guilt, shame, and fear. These factors weaken parents’ ability to mentalize—that is, their ability to recognize and distinguish their own mental states from those of adolescents, to understand them, to reflect their feelings, and to respond to inappropriate behavior; it becomes more difficult to maintain emotional balance, and thus everyday parenting situations are experienced as even more stressful. Without timely support for parents, their psychological state becomes one of the main factors leading to the rehospitalization of adolescents in psychiatric wards, and the rehospitalization of adolescents, in turn, affects the parents’ psychological state. This creates a vicious cycle from which there is no escape unless parents seek help for their own psychological state.
Strategies for overcoming stigma become crucial. These include various parent support groups and all therapeutic interventions focused on shame, which help identify and become aware of the sources of shame, share one’s own stories of shame in a safe environment, and help build resilience against feelings of shame. In other words, for parents whose children are hospitalized in a psychiatric ward, it is important to experience a compassionate group, to learn about the impact of interpersonal experiences that trigger fear and shame on identity, and to gradually reestablish a connection with their own identity, strengthening it by sharing stories of shame. It is worth noting that the transition from shame to guilt is an important part of the parents’ adaptation process; this is explained by the fact that attempting to constructively resolve conflicts and difficulties is a sign of guilt, not shame, because it is guilt that allows one to move forward and to effect change, whereas shame signifies stagnation, a state of being stuck.
All forms of art therapy, and especially art therapy, can help reduce parents’ self-stigmatization. For over a year now, the Children’s and Adolescent Psychiatry Department of the Psychiatric Branch at the Republican Klaipėda Hospital has been running a supportive art therapy group for parents, which is part of a comprehensive support program for the child and is also aimed at helping parents overcome self-stigmatization. In this supportive art therapy group, parents share their stories of shame, experience a sense of community, and express their feelings—especially shame, which is difficult to put into words—through creativity. This way of engaging in the therapeutic process gives them a sense of control and empowerment, while symbolic expression allows them to reveal and express complex inner content and overcome avoidance mechanisms. In the creative process itself, parents can experience creative joy, relaxation, and empowerment through being in the here and now, which strengthens self-esteem and reduces emotional stagnation, while also strengthening emotional autonomy, while maintaining space for self-awareness and exploration, which helps strengthen identity development. Self-reflection in art therapy can be less threatening, yet allows for a deeper understanding of one’s emotions, as the artwork helps reflect the inner “I” through depicted symbols. In other words, art therapy can be the first step in helping parents get to know themselves better, overcome the stigma of mental disorders and self-stigmatization, and, through creative activity, break free from stereotypical views of psychological help, while also encouraging parents to begin attending individual psychotherapy, because the difficulties and crises experienced by adolescents are most often related not only to what is happening in their current lives, but also to the traumas their parents experienced in their own childhoods. □
