7 Ways to Stay Resilient in the Face of HIV Stigma and Discrimination

It seems impossible to escape. Hateful speeches scream from the television. Ominous threats break through into actual violence and increasing numbers of people find themselves labeled as "bad" or "the other" based on various stigmatized aspects of who they are: race, ethnicity, mental health and substance abuse concerns, disability, immigration status and health conditions including HIV/AIDS.

Stigma, a mark of disgrace or dishonor based on arbitrary characteristics, and its physical expression, discrimination, have a long, destructive history. Those of us living with HIV/AIDS are familiar with its damaging impact on our emotional and even physical safety, as well as its ability to undermine our identity and self-worth. When emotional resilience is strong, however, we become empowered to speak up and challenge this stigma. The constant accusations from television, neighbors and even family declaring that there is something wrong with us echo unnervingly with our own shadows of self-doubt and shame. Once internalized, these hateful messages no longer require any external expression to do harm. As a therapist I have heard countless clients who, having experienced stigma and discrimination, utter these same words: "I feel like damaged goods."

Ironically, most anti-stigma and anti-discrimination programs target the stigmatizer. Through education and human connection they attempt to confront mistaken beliefs and assumptions, often with positive effect. But the person who actually experiences stigma and discrimination is frequently left to deal with the resulting feelings on their own. Many turn to addictive behaviors to numb their emotional pain, some succumb to a consuming, roiling anger, while others engage in sexual compulsivity and high-risk sexual behaviors.

It can be a struggle to find helpful strategies that promote personal resilience. Here are seven tips for managing your response to stigma and discrimination in a healthy way:

1. Maintain a Strong Sense of Self

Preserving (and sometimes discovering for the first time) self-worth demands a significant amount of self-examination. It begins with introspection through which we can discover our truth and identify our strengths. This may involve finding power by defiantly reclaiming a stigmatized identity, a process exemplified by the reappropriation of the word "queer" from a term of derision to one of pride. It is important to remember that a healthy sense of self can only originate from within us. It does not derive from what we wear, the car we drive or any other external factors through which we receive validation. Relying on these ultimately undermines any resulting ego boost because, on the inside, they don't resonate with who we believe we are. The introspective process must be accompanied by self-compassion. Many of us have dealt with stigma and discrimination from an early age and, over time, have developed defenses that no longer serve us. Take an honest, gentle look at your life and make the necessary changes to move away from beliefs, behaviors and even people that don't support who you want to be.

2. Find Your Courage

It is a natural reaction to throw up defensive shields when confronted with stigma and discrimination. Finding courage at such moments may require doing the exact opposite of what your instinct for self-preservation demands. Of course, fear is a healthy reflex that protects us and personal safety must always be considered. When evaluating any course of courageous action there are various skills that help us remain firmly grounded in the process. I believe the first of these is conscious breathing. Deep, measured breaths stabilize our physiology and strengthen our ability to be proactive instead of reactive. Acts of courage, by definition, move anyone out of their comfort zone. Expect some degree of anxiety as your go through this process, but remain grounded in your personal power. It is important, at the same time, to maintain an awareness of your thoughts. Most of us will experience an automatic, negative voice that questions our self-worth and our ability and even our right to speak up. Challenge these thoughts, all the while staying in the present moment. It is easy to let our minds slip into the future or the past, but that simply distracts us from being fully engaged as we connect with our inner knowing.

3. Be Persistent

Persistently confronting stigma and discrimination requires that we maintain a strong connection to our motivation, whether that is based on challenging institutional discrimination, healing our own hurtful experiences or holding the intention that things will be different for our children. Such strong desire must be accompanied by self-discipline and productive habits, because false starts and reactive behaviors can be discouraging and rapidly undermine resolve.

4. Learn From Others

Experiencing stigma and discrimination is isolating because it triggers strong emotions such as anger, fear, depression and hopelessness. In the face of such powerful feelings many people withdraw and find themselves managing their stress on their own. No doubt, someone you know has also experienced what you are feeling. Identify role models you admire, speak with them, learn from what they have done and create ways in which you can work together.

5. Maintain Strong Connections

Healthy social connections are a powerful tool to build and maintain personal resilience. Because isolation can result from stigma and discrimination, creating such networks can be challenging. It is important to confront any residual self-doubt that keeps you from reaching out and connecting with others. The strength of a group of individuals acting as a unified force is not only a powerful challenge to stigma, it is an enormous comfort for the individual, as well. Maintaining strong social connections may be the single most important factor promoting emotional and physical health.

6. Perform Service on Behalf of Others

Discovering one's power to challenge stigma and discrimination will, of necessity, lead to some degree of self-involvement. While this is natural, it can disrupt healthy balance and perspective. For that reason, I believe service to others is an important way to maintain integrity with oneself and the larger community. The Hindu concept of seva captures this concept, referring to service performed without any expectation of result or award. Such service broadens our focus and, especially when combined with a daily practice of gratitude, can be a powerful force for personal transformation.

7. Advocate for Your Beliefs

Discovering personal power in the face of stigma and discrimination, and networking with others who share your experience, naturally lends itself to a more effective force for individual and social change. Learn about the issues, identify solutions, connect with decision makers and engage the media. Speak up for those who have not yet found their voices. In doing so you engage your healthy power in a way that benefits both you and others.

Remaining resilient when challenged by stigma and discrimination is difficult even for the strongest among us. These skills provide a pathway to such resilience, utilizing self-worth and engagement as tools for both individual and social change.

David Fawcett, Ph.D., L.C.S.W., is a substance abuse expert, certified sex therapist and clinical hypnotherapist in private practice in Ft. Lauderdale, Florida. He is the author of Lust, Men, and Meth: A Gay Man's Guide to Sex and Recovery.