HOUGHTON — Stigma remains one of the biggest barriers to treatment of mental illnesses and disorders, particularly in the United States.

There are many sources of stigma. It can come from society in general, but it can also come from the health care industry and even family members of those requiring treatment and services.

An Aug. 3, 2016, report titled “Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change,” published by the National Library of Medicine (https://www.ncbi.nlm.nih.gov/books/NBK384923/) states in part that:

“People with substance use disorders, in particular, are viewed by the public as weak-willed, although evidence shows that they are as likely to adhere to treatment as people with other chronic medical conditions, such as hypertension or diabetes.

“Unfortunately, and in spite of efforts to educate the public, this misperception has increased over time, according to the findings from national surveys in 1996 and 2006.

“Media portrayals of people with untreated and symptomatic substance use disorders, rather than depictions of those on a path to recovery, may be a factor in maintaining or increasing negative stereotypes and stigmatizing attitudes and beliefs about people with substance use disorders.”

The pressure from stigma surrounding mental health issues can come from family, friends, coworkers and society on a broader level, according to an article published by Medical News Today titled “What is mental health stigma.” (https://www.medicalnewstoday.com/articles/mental-health-stigma)

Groups can also politicize stigma. It can prevent people living with mental illness from getting help, fitting into society and leading happy and comfortable lives.

For many people in recovery from substance use disorder, family estrangement can make continued recovery from addiction or other mental illness far more difficult.

Karl Pillemer, Ph.D., a professor of human development at Cornell University who studies marriage and families, wrote an article titled “Why is estrangement so painful?” (https://www.psychologytoday.com/us/blog/lessons-loving/202011/why-is-estrangement-so-painful) that details the impacts of estrangement on mental health.

Research identifies four threats of estrangement to mental health, according to a Nov. 20, 2020, article on Psychology Today’s website.

The biologically based process of attachment has enormous effects over a person’s entire lifespan, Pillemer wrote.

“People to whom we have lifelong attachments serve as a secure base when we are in trouble, protecting us when needed physically or psychologically,” he stated. “Because of the intensity of these early attachment experiences, we continue to want family members to provide comfort and support when we need it. When these bonds break, we can experience profound emotional reactions.”

Pillemer went on to state that losing someone — in this case through estrangement — activates what psychologists call the attachment system.

A family member’s absence can cause grief about the loss of the relationship due to the long-term attachment bonds that had been previously formed.

Because family members are specific, irreplaceable individuals, attachment leads to feelings of separation anxiety, yearning for the relationship, and disruptions in the estranged person’s other social relationships.

The bonding that occurred over years of childhood can make the person who is estranged from their family members feel deeply insecure about the loss.

That is one of the main reasons why estrangement matters so much to so many people.

Pillemer further wrote that losses involving social rejection have especially damaging effects. Rejection is especially stressful because human beings have a fundamental drive toward social inclusion and belonging.

“Being rejected threatens our evaluations of ourselves, causing us to feel worthless and even lowering our self-esteem,” Pillemer wrote. “The double whammy of a threat to self-esteem and a lack of ability to control the situation make social rejection one of the most harmful things we experience.”

Estrangement can also lead to feelings of uncertainty, according to Pillemer.

“Research shows that we are made uncomfortable by situations in which we are stuck in ambiguity with limited information to guide us,” he wrote. “The lack of clarity freezes the process of grieving, blocks coping and hinders decision-making. So it is with estrangement, when the person is physically absent but psychologically often intensely present.”

For individuals on the receiving end of estrangement, he explains, the ambiguity compounds the other threats, making the stressful effects chronic and risking repeated rejection.

Pillemer concluded his article by saying the chronic stress of a family rift can wear the estranged down and affect his or her other relationships.

He advised people not to hesitate to get professional help. Many of the respondents in his studies found counseling to be transformative in either coping with the estrangement or working toward reconciliation, he said.

Professionals who work with individuals and families need to be aware that estrangement is a powerful underlying cause of psychological distress and should be prepared to address it with their clients, he further advised.

“As I learned in my studies, few people willingly talk about family rifts, but they form a dominating presence in many of their lives.”