Elevator in abandoned building covered in grafiti

PSYCHOLOGICAL & SPIRITUAL THERAPY: Beware of labels that erroneously pathologize people

Last updated: April 9th, 2019

[su_panel background=”#d5c38b” color=”#000000″ border=”0px none #ffffff” shadow=”0px 0px 0px #ffffff”]In our new weekly Psychological & Spiritual Therapy column, therapist Jack Surguy is offering professional advice to The Mindful Word readers for all those questions and problems you have wanted to discuss with someone qualified and caring.

If you would like Jack to assist you in any areas of your life and relationships, fill out this form. He will respond to your questions through this column, normally published every Tuesday.

QUESTION

Hi Jack,

I avoid using elevators. I’ve been trapped in elevators a few times in my life and since I live in developing countries, the technology isn’t so reliable so I tend to think avoiding them is a good thing. But sometimes I find myself lugging 40 kg up six flights of stairs in 40 degree heat, which isn’t all that convenient either.

On the one hand, I see the fear as irrational because most elevators work just fine and in most cases, if they break down they’ll start working again soon enough.

On the other hand there are some that don’t work, and some buildings are sketchy, so I don’t know if there’s even someone around to fix the problem or if they’d even care that there’s someone stuck in the elevator. I don’t like enclosed places and I don’t even like to be inside buildings as I spend most of my day outdoors. I just live with buildings when I have to, but I neither like them nor do I feel I really belong in them.

I still use elevators sometimes. If the building is modern, I’ll use one without much concern. Is this fear a phobia I should just get over or rational/useful?

Thanks,

Kiva, 39

ANSWER

Hello Kiva,

Thank you for your question. I chose your question this week because it’ll allow me to address a couple of different issues that I believe are pertinent to the current culture in which we find ourselves.

In your question, you ask whether or not what you’re experiencing is a phobia, or if you need to just get over your issues with elevators. Well, let’s start out by defining what a phobia is and what it’s not.

What is a phobia?

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), the following criteria must be met for someone to be diagnosed with a phobia:

  • Marked and out of proportion fear within an environmental or situational context to the presence or anticipation of a specific object or situation.
  • Exposure to the phobic stimulus provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed panic attack.
  • The person recognizes that the fear is out of proportion.
  • The phobic situation is avoided or else is endured with intense anxiety or distress.
  • The avoidance, anxious anticipation or distress in the feared situation interferes significantly with the person’s normal routine, occupation (or academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
  • Symptoms must be present for at least six months.

From what you described in your question, it doesn’t sound like you meet the criteria for having a phobia of elevators. In fact, it sounds like you have very rational and valid reasons for avoiding elevators in many circumstances.

Furthermore, it’s very important for you to know that having a dislike for using elevators doesn’t mean you have a phobia, either. To have a phobia, you must have a marked and out-of-proportion fear of elevators. Disliking something doesn’t meet this criterion. So to answer your question Kiva, I would say no, you don’t have a phobia, and due to some of the circumstances you described in your question, it’s not something you necessarily need to get over.

Buzzwords and labels

So what are the other issues to which I alluded at the beginning? There are several buzzwords many people are probably familiar with that I’d like to address. These buzzwords include homophobia, xenophobia, and Islamophobia. These labels are often ascribed to individuals who are against, object to, or protest homosexuality, people from other countries, or the religion of Islam.

Labelling people with these terms, in my opinion, actually does more harm than good for those seeking to ensure equal treatment under the law for all people. Furthermore, labelling people is also harmful to those who may object to or protest certain behaviours, beliefs, or activities for reasons not based on irrational or out of proportion fear.

Consider the following example. On the website for the American Society for Public Administration, PATimes, author Alexander Dawoody states the following about a newcomer to America:

If the newcomer, for example, is from a country or region that has produced an intense political event that is still stressing, that person may be prioritized by xenophobia as hate target number one simply for guilt by regional association with the generating region of such tension…. The ranking in hate, of course, has no rationalization or systematic functional operation. It is produced uncoordinated and spontaneously by individuals who use institutional setting and organizational behavior to give voice to their paranoia…. The only reward is psychological. Because of this, xenophobia is a state of mind and a form of illness [emphasis added] that differs from classic racism.

I found these statements to be very misinformed, and honestly disturbing in some aspects.

I’m assuming that when the author writes, “an intense political event that is still stressing,” he’s referring to an act of terrorism. Essentially what the author is arguing is that if a certain group of people declare war on another nation, and then commit acts of terrorism against the people of that nation, or other people who are associated with that nation, being cautious or wary of individuals from that group of people in regard to terrorist acts is wrong and a form of illness.

How is this argument damaging?

When we examine the criteria required for a phobia to be diagnosed, being cautious or wary of certain individuals doesn’t necessarily mean that this fear is out of proportion within a particular environmental or situational context. The argument put forth by PATimes is damaging in the following ways:

  • It erroneously, and I argue, maliciously pathologizes people who simply have opposing or contending viewpoints based on rational and logical thought. This labels the opposition as “ill,” which suggests that their concerns or objections shouldn’t and can’t be seriously considered.
  • It creates animosity and further division between people.
  • It fails to distinguish between those who may have safety concerns about foreigners, those who may hate and despise foreigners, and those who may actually have a fear of foreigners. In fact, when the term xenophobia is used, it isn’t actually referring to a fear of other people dissimilar to oneself, but is actually referring to hatred, which isn’t even a component of a phobia.

It’s very important for people to be aware of these issues. Like Kiva, people may, at times, assume that they or other people around them might have a “mental illness” when that’s simply not the case.

Pathologizing normal human behaviour and responses can be very damaging. Mental health terminology is currently being hijacked by people who have no understanding of or training in mental health. Even worse, some individuals within the mental health field have also used this label-centred terminology. When it’s used in a manner that’s socially, psychologically and morally irresponsible, we all suffer as a society.

What does this have to do with mindfulness?

Mindfulness is much more than sitting on a pillow feeling calm and having feelings of well-being. To be mindful is also to be aware of the ways in which some individuals may seek to deceive or manipulate us, or plant false beliefs or narratives into our perspectives.

Most of the instructions on mindfulness came to us from the teachings of Shakyamuni, also known as Siddhartha Gautama or the Buddha. The Buddha taught us that part of mindfulness training is to root out false beliefs because they lead to further ignorance. Once this ignorance takes hold, people can actually become more prone to violence and behaviours that cause further harm.

Therefore, part of our mindfulness practice should consist of critically analyzing the information we’re being presented with as “truth.” In doing this, we can all become more capable of helping people like Kiva understand that there’s not something wrong with them just because they prefer the outdoors to modern buildings and houses.


image via Pixabay
  1. This was interesting to read because I also avoid some elevators for some of the same reasons, and I don’t enjoy being in them, even though I’ve never had a panic attack in one. I don’t mind buildings, but I don’t like those little windowless bathrooms like the ones you find in some gas stations. I did get stuck in a small bathroom with just a tiny window once, since the door got caught on the thick carpet somehow, and I had to throw my body weight against the door (breaking off some trim in the process) to get out! There was also another time in which I accidentally went into a storage room instead of a bathroom in a gas station, and the door locked behind me. Luckily an employee quickly came to the “rescue.”

  2. I don’t have a problem with elevators as there is always a crack where light or air can get in. But I am the same with windowless rooms. I cannot stay in a room without a window. There are many hotels in Asia that do not have windows. I also need to have my window open, if even just a tiny bit. I need to have fresh air. Have problems in countries where ice is the norm for many months.

  3. Hotels without windows?! I don’t think I’ve been in one of those, but I’m mostly in Canadian hotels. The window of the bathroom I was stuck in was only about the size of a laptop, though, not big enough for me to crawl through but I suppose I could have stuck my head out and yelled into the street if throwing myself at the door hadn’t worked. 😛

    1. It’s interesting, I’ve been in windowless rooms and those rooms in Asia that have the latch on the outside with bars on the windows, essentially turning it into a jail cell if someone were to put a padlock on it while you’re inside, and I’m fine with both of them. I think the thing with elevators for me is that they’re so small and there’s no way out if between floors (the door can be pried open if at a floor) and it seems oxygen is limited. Rooms are big enough and there always seems to be a way out if one tries hard enough to get out. I’d imagine a door will eventually break if it gets smashed hard enough.

      1. Yeah, the fact that there’s no way out if between floors bothers me too. I dislike elevators less when I’m the only one in there or I’m with only two or three people than if I’m with 3+ people, I guess because it seems like there’s less space and air with that many.

  4. Thanks for the response Jack. It prompted me to ponder the problems within the mental health field. Language really does have such an impact that is unappreciated. I agree, people throw terms around so loosely without really analyzing their meaning that we’re diluting our language and causing harm as a result. Thankfully more people are getting into mindfulness at the same time.

    1. Yeah, like “Oh wow, I’m so OCD since I arrange my socks according to colour,” or “That’s such a schizophrenic idea.” I also witnessed an acquaintance being called schizophrenic on social media when they obviously weren’t, they seemed maybe depressed but not schizophrenic in the least.

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