Concealed Stigmas and What Science Tells Us About Our Need for Support

Concealed Stigmas and What Science Tells Us About Our Need for Support

By Elizabeth Stewart

Elizabeth Stewart is Family Drug Support Aotearoa New Zealand’s guest contributor. She is a health professional with an interest in personality psychology.

Some things we choose to share with our family/whanau, friends, and acquaintances. Such things may include: our successes, family members’ successes, holiday plans and even just small everyday matters. Some things we cannot easily share, because there may be a stigma attached to them.

A stigma is a sort of secret which causes us shame and makes us want to conceal or hide it. This is called a “concealed stigma”. So maybe you have a concealed stigma—so far so good—why would it not just be an excellent idea to keep such details to yourself, end of story?

Humans are extremely social. It is suggested that this may be why we have such a large brain-to-body ratio, compared to other animals: Purely for social concerns! We can understand how others are feeling by listening to what they say, but we can also interpret the distress of others just by observing tiny fleeting facial expressions. It takes quite a lot of effort for humans to attempt to keep secrets. While our mouth may say one thing, our faces may tell another story. This can confuse and worry those around us. It can become hard to keep hiding these secrets from people.

When we conceal a stigma, we must think about everything we say, and remember who knows the “secret” and who doesn’t. We may worry what will happen if someone we are hiding our secret from, finds out the secret anyway. It is very easy to underestimate just how many other thousands of people are also concealing the same stigma and distress.

One interesting article by John E. Pachankis2 discusses the downsides of concealing any type of stigma. Many different stigmas are discussed. Pachankis talks about the way a person’s thinking may be altered if they are bearing the burden of concealing a stigma. People may start to notice things relating to the stigma everywhere; in the newspaper, on the television, seemingly everywhere they look. Concerns about being “discovered” may be constantly on the person’s mind. The person affected may become preoccupied, hypervigilant and even suspicious when the innocent mention of things which may be related to the stigma or its concealment are discussed. This in turn may result in shame, anxiety, depression, and even hostility being felt.

In normal circumstances these feelings may be relieved by talking with others who may help us “put things in perspective” and tell us the truth: that alcohol and other drug issues extend to all areas of New Zealand society from the high to the low and everywhere in between, and that, in fact they also have a brother/daughter/father/uncle, or otherwise, with exactly the same problem. When someone else is told they are often glad you mentioned it, because keeping their own stigma concealed, is affecting so many areas of their life too.

Unfortunately, life being what it is, it may become easier to just avoid socialising and instead isolate oneself, which negatively impacts relationships and friendships, and whanau/family functioning. When people are not able to discuss their concealed stigma, the stigma can even cause people to downgrade the way they value themselves, and can make them see themselves differently, even viewing themselves as a “lower quality person” despite this not being true. This unfortunate and entirely inaccurate self-assessment is reported to be a side-effect of concealing virtually any stigma you care to name, including having a whanau/family member with alcohol or other drug misuse.

Because a “concealed stigma” is by nature concealed, finding others with the same concealed stigma is usually difficult. This is where a support group may be useful. It can be particularly good to see and talk to other “normal” people who are experiencing the same issues. This is called “feedback”, and this may be very helpful for all areas of functioning. Feelings of isolation may be relieved, and there is likely to be a decrease in social avoidance3, depression, shame, and anxiety, and even the frequency of intrusive thoughts regarding the concealed stigma. One of the most important improvements is likely to be that the closed loop of: worry→upset→social isolation→feeling negative about oneself→increased worry, is broken.

Coming out about a concealed stigma to carefully selected people, is predicted to bring great relief, and enable one to build coping4 and resilience5. A support group is a great place to meet with others in a safe, confidential situation. Telling one’s story, and hearing the story of others, can be very helpful. You may then reflect on the experiences of others, to help inform your own decisions. You may need to take some tissues: it may be a huge relief to finally feel ‘normal’ again and be able to share your feelings with others who understand the challenges you are facing. Sharing what you have learned during your own journey supporting your whanau/family member or friend who is using alcohol or other drugs, is likely to benefit others on their journey. Hopefully a focus on self-care will be offered.

A final word comes from another interesting article by the personality and social psychologists Deborrah E. S. Frable, Linda Platt, and Steve Hoey6. These scientists advise that the way to lift “self esteem and mood” and reduce “negative cultural messages” related to a concealed stigma, is to associate with people sharing the same stigma. These researchers found that those hiding a stigma experienced much lower self-esteem, self-regard, social confidence, self-ratings of physical appearance and physical abilities, and even slightly lower confidence in their academic abilities than people with a stigma which was not concealed. People concealing a stigma rated higher for levels of anxiety, depression, and hostility, than those with a stigma which was not concealed.

The advantages of attending a support group were found to be many: when associating with those sharing the same concealed stigma as oneself, self-esteem was significantly higher, anxiety was significantly lower, and depression was also significantly lower among members of groups sharing concealed stigmas. It was suggested that these benefits arise because one stops feeling so alone with the hidden stigma, and ceases feeling like the “only one”. Mostly these authors suggest, that by meeting similar others, we are reassured that we are OK too.

Elizabeth Stewart is Family Drug Support Aotearoa New Zealand’s guest contributor. She is a health professional with an interest in personality psychology.

The Stepping Stones Programme, located under Courses and Events on this website could be an great starting place to build coping and resilience as outlined in the article above. Register on line.


1 stigmas: a mark of shame, disgrace, or embarrassment associated with a person

2 Pachankis, J. E. (2007). The psychological implications of concealing a stigma: A cognitive-affective-behavioral model. Psychological Bulletin, 133(2), 328–345. doi:10.1037/0033-2909.133.2.328

3 social avoidance: may include not seeing your friends, avoiding socialising, isolating yourself somewhat

4 coping: managing stressful circumstances successfully

5 resilience: the capacity to recover from difficulties and possessing a certain ‘toughness’ and optimism

6 Frable, D. E. S., Platt, L., & Hoey, S. (1998). Concealable stigmas and positive self-perceptions: Feeling better around similar others. Journal of Personality and Social Psychology, 74(4), 909−922.