Illness, and then shame

It is curious how illness – whether mental of physical – is often associated with shame in our western culture. I have experienced it myself related to chronic fatigue. There is a shame around lack of energy, not being as social or engaged as I normally would be, not being able to do as much or what I normally would do, and so on. It is as if I am not only responsible, but somehow morally at fault.

It doesn’t fit my conscious view, of course, which is why it is so obviously an attitude I have absorbed from our culture. (This is not different from the rest of my views. Most of them are directly absorbed from culture, whether it is from mainstream culture, subcultures, or the cultures of specific traditions and philosophies. If one is not, then it is at least strongly flavored by these existing views. And it is easier to notice this when there is a poor fit between my conscious view, and a view I have absorbed influencing how I interpret and feel about something.)

For me, the shame is relatively mild and I am aware of it, so it is usually not a big deal. But a conversation yesterday reminded me that it is quite common. (A friend of mine has fatigue related to thyroid problems.)

So what can be done about it? At an individual level, we can educate ourselves about the causes of the illness (genetic, environment, in the case of chronic fatigue – most likely virus.) We can share our experiences with friends and family, and people in a similar situation. And we can  inquire into our beliefs around it, and find what is more honest for us. At a community or social level, we can do the same: education, conversation, shared inquiry into beliefs, attitudes and underlying assumptions.

Some beliefs that come up for me: I shouldn’t be sick. I should have more energy. I shouldn’t be a burden to others. My life would be better if I had more energy. My mind should be clearer. My mind shouldn’t be fuzzy. I should be able to eat what I want. My body is a limitation for me. My body fails me.

Another question is why did it come about? What are the historical reasons for experiencing shame around illness?

We live in an individualistic culture, so it makes sense to emphasize causes at that level. Perhaps from Christianity, health and illness has taken on moral meaning. And in our modern society, there has been a strong emphasis on how personal lifestyle is related to health and illness.

Combined, it means that health is seen as mainly our personal responsibility. If we are not healthy, it may be our own fault. And that a “moral” weakness – lack of willpower or control – is behind it.

There is of course some truth to this. Lifestyle does have a strong impact on our health, and it is important for each of us to take responsibility for our own health.

But other influences are often far more important, such as genetics and our physical and social environment. And lifestyle itself is strongly influenced by genetics and our physical and social environment. Very little of it comes down to purely individual causes, if we can say there are any at all.

Our health may be impacted by clear immediate causes, or a combination of many, and each of these in turn have infinite causes.

So as a society, it makes sense to emphasize how we can organize ourselves to create the conditions for improved health and well-being. In relating to others, it makes sense to emphasize non-person causes when we make value or moral judgments, and sometimes also encourage changes in the social or physical environment, or lifestyle. And in relating to ourselves, we can do the same, and also take responsibility for our own health in terms of what we are able to change, including our environment and our diet, sleep, exercise and so on.

It seems obvious. But somewhere in us, it may not be so obvious. We may still experience and act from unexamined beliefs, absorbed from our culture.


– illness, then shame
— shame for mental illness, and also physical illness – what can do about + why?
— what can do: inquiry, learn about the causes, share with others etc.
— why: individualistic culture (individual causes, so individual blame), moral judgment (must have done something wrong)

In my case, the chronic fatigue most likely came through a viral infection (mono) combined with stress, which may then have created good conditions for another virus to flourish.

And genetics and our physical and social environment has a big impact on how well we are able to make lifestyle changes, far more than ideas of “willpower” or similar individual-based causes.

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