Harmful Judgments

A couple of weeks ago, I finished reading the book by Randy Shilts, And the Band Played On, about the early years of the HIV pandemic. The book is organized by timeframes and various events occurring within those timeframes as well as around the experiences and activities of certain activists, researchers, politicians, and people afflicted with AIDS during the period of 1980-1987. It’s a fascinating read. One of the things I found most striking and disturbing was how strongly political and social forces influenced the response to the burgeoning HIV epidemic in the U.S. and elsewhere. AIDS cases began to appear during a key phase of the gay rights movement, and evidence suggests that activities occurring under the umbrella of sexual liberation may have amplified the early dissemination of the HIV, particularly in places like San Francisco, Los Angeles, and New York. Despite a growing number of gay men, heterosexual individuals, IV drug users, babies, and mothers afflicted with AIDS, President Reagan apparently did not even publicly mention AIDS until after Rock Hudson died of it in 1985. Researchers trying to seek funding to understand the causes of AIDS were stymied by a reluctance to acknowledge the problem or devote funding to it. Part of the problem here was that AIDS was seen as a disease of gay men, and in fact, an early name for AIDS was “Gay-Related Immune Deficiency” (GRID). Further, for some time, blood banks refused to screen for AIDS risk or, later (when tests were available), HIV. When movements began to promote safe sex in bathhouses, there was pushback, as this seemed to infringe on gay rights. All of these factors seemed to curtail measures (research, screening, policy, public education, etc.) that could have saved thousands, if not millions, of lives later on. What I found most troubling was the idea that, because this was seen as a gay disease, efforts to tackle it head on were lacklustre in the early days. This, I believe, is a great example of an incredibly harmful consequence of judging.

One of the key features of prejudice is judgment – either explicit judgments of others or other groups that we’re consciously aware of, or implicit judgments that operate just outside our conscious awareness. We either implicitly or explicitly judge other people or people who are apparent members of other groups as bad, deficient, morally flawed, dangerous, contagious, and so on. These judgments, in turn, affect how we take in information about others, making us more likely to see the facts that support our judgments and less likely to see the contradictory facts. If you judge someone as an “angry person,” for example, you’re much more likely to notice and remember instances where the person seems irritable or acts angrily than instances when the person is calm or expresses other emotions. You might even dismiss instances where the person is calm as exceptions. I believe a lot of people still have the image of people with borderline personality disorder (BPD) as angry, out of control, hard to treat, difficult to relate to, and so on. This can’t help but influence how (or whether) they interact with people with BPD. I think it probably also influences research, policy, and initiatives to help people with BPD. For example, extensive efforts have been made to combat stigma and educate the public on bipolar disorder, and in comparison, efforts for BPD have been vanishingly minimal, despite the similar prevalence of these disorders and the high suicide risk posed by BPD. Things are slowly changing, with increased awareness of effective treatment for BPD (e.g., DBT, mentalization based treatment, transference focused therapy, among others), research dispelling myths about the disorder, and large-scale initiatives to implement effective treatment. That said, I think we still have a long way to go. On an individual basis, we can start by reflecting on our judgments. The first step in becoming free of judgments is becoming aware of them. Step back, notice what’s going through your mind when you encounter someone you dislike or who is different from you. Notice whether some of your thoughts are judgmental. Perhaps the judgments are explicit and obvious (“good,” “bad,” etc.), or maybe you know you’re judging because you feel an automatic aversion or sense of emotional discomfort. In either case, just notice these experiences, and try to label them for what they are. Awareness is not the cure for judging, but it is an essential first step.  ~ Alexander L. Chapman Ph.D., R.Psych.