The Sociologists at Work feature exposes students to the importance and application of social science research.

Nancy Herman

Becoming an Ex-Crazy

Sociologist Nancy Herman (1993) was interested in how labeling can weaken a person’s self-image, create “deviant” patterns of behavior, and lead to social rejection. She was especially concerned about how former mental patients are reintegrated into society after their release from a psychiatric hospital. She decided to study ex-mental patients because her father had been an occupational therapist at a large psychiatric institute in Ontario, Canada. She spent most of her childhood and adolescence roaming the halls talking to patients. From time to time, the patients would spend Thanksgiving and Christmas with her family.

For this study, she conducted in-depth interviews with 146 former nonchronic mental patients (hospitalized in short intervals for less than two years) and 139 former chronic mental patients (hospitalized continuously for two or more years). She interviewed them in a variety of settings, such as coffee shops, malls, and their own homes. Many subjects invited her to their self-help group meetings and therapy sessions.

Herman found that these ex-patients, on release, noticed right away that friends, neighbors, coworkers, and family members were responding to them on the basis of their “mental illness” label and not on the basis of their identity prior to hospitalization. Although their treatment was complete (i.e., they were “cured” of their “illness”), others still saw them as defective. They were often made to feel like failures for not measuring up to the rest of “normal” society. As one woman put it,

When I was released, I presumed that I could resume with the “good times” once again. I was treated—I paid my dues. But I was wrong. From the first moment I set foot back onto the streets of “Wilsonville” and I tried to return to my kids . . . I learned the hard way that my kids didn’t want nothing to do with me. They were scared to let me near the grandkids—that I might do something to them. They told me this right to my face. . . . Having mental illness is like having any other illness like heart troubles, but people sure do treat you different. If you have heart troubles, you get treated, and then you come out good as new and your family still loves you. But that’s not so with mental illness . . . you come out and people treat you worse than a dog! (quoted in Herman, 1993, p. 303)

On release, some of the former patients Herman interviewed were quite open about their illness and attempted to present themselves in as “normal” a way as they could. Others became political activists who used their “ex-mental patient” label to try to dispel common myths about mental illness or to advocate for patients’ rights. But most of the former patients spent a great deal of time selectively concealing and disclosing information regarding their illness and treatment. Strategies of concealment included avoiding certain individuals, redirecting conversations so that the topic was less likely to come up, lying about their absence, and withdrawing from social interaction. Constant concern that people might “find out” created a great deal of anxiety, fear, and frustration, as described by this 56-year-old woman:

It’s a very difficult thing. It’s not easy to distinguish the good ones from the bad ones. . . . You’ve gotta figure out who you can tell about your illness and who you better not tell. It is a tremendous stress and strain that you have to live with 24 hours a day! (quoted in Herman, 1993, p. 306)

The stickiness of the “crazy” label is difficult for former mental patients. However, Herman’s research also shows that ex-patients are not powerless victims of negative societal reactions, passively accepting the deviant identity others attribute to them. Rather, they are strategists and impression managers who play active roles in transforming themselves from “abnormal” to “normal.”