Internalized stigma and self-presentation strategies of persons with psychotic and psychiatric experiences

Stigma is detrimental to persons experiencing mental distress, as it impacts on their social inclusion, quality of life, and recovery. In this article, we present the self-presentation strategies employed by persons with psychosis to manage internalized stigma. A study of the life trajectories of persons with psychosis analyzed 27 biographical interviews and identified five types of biographical trajectories. This article focuses on one biographical type, represented by six narratives. Participants placed in this biographical type struggle to portray a socially acceptable self through concealing experiences of distress and distancing the self from the psychiatric label they entail. This was achieved through several strategies, including the normalization of prior life, unwillingness to disclose psychotic experiences, unquestioning compliance with psychiatric medication, and presenting oneself as an ordinary person. Fostering more adaptive coping strategies to reduce internalized stigma may be a potential goal for psychosocial interventions.