The psychological costs of marginalization

Being seen as less than has a long-standing impact on the health of an individual.

Marginalized individuals or groups often feel or are made to feel less important, less privileged, and less respected than those who hold more status, power, privilege, and opportunity in society. They may be considered outside of the ‘mainstream’ way of thinking and behaving. Marginalization includes but is not limited to caste, religion, mental health status, physical ability, socioeconomic status, sexual orientation, sex, gender identity, weight, age, and race. Being seen and treated as less than or exclusionary in some way has a long-lasting impact on the mental health of an individual. As I write about this issue, I am aware that I hold a safe distance from several aspects of marginalization, due to the privileges I have had and continue to have.

Individuals who face marginalization are also more vulnerable to the effects of stress. The prevalence of exposure to trauma is high among those that are marginalized, and coping with this stress becomes an arduous task due to the potential risk of exploitation and/or exclusion. On an emotional and psychological level, individuals can feel isolated from the social fabric of their larger communities and can feel a sense of paranoia, which is a function of how they might be perceived and treated by others. They can feel invisible, as though their concerns are not significant enough to be heard, and self-doubt and frustration are common psychological responses. Some marginalized groups are also at higher risk for suicide and self-harm.

This process of marginalization can, unfortunately, start young. Sometimes it is difficult for me to contain my horror when a 9-year-old boy in my office, who is bullied due to his weight, can rattle off a bunch of names that his peers call him because he is bigger than them in size. He is too young to understand why his friends are mean to him, but not too young to question his self-worth and feel inadequate during PE class due to the social misfit that he is made out to be on a daily basis. The good news is that he is sitting in my office, and therefore receiving the help he needs at the time that he needs it. This is not the case for many, who hide behind the shame of marginalization for years, as it goes unnoticed and ignored.

So, what needs to be done?

As you can imagine, a lot needs to be done, and listing out those action items is beyond the scope of this piece. To start with, the many systems (individuals, families, schools, offices, law and governance) that work to secure the rights of children, students, employees, and citizens, also have the responsibility of educating themselves on recognizing the many vulnerable groups, including those with mental health difficulties. This recognition can help reduce that feeling of isolation and invisibility, and those with individual differences can attempt to temper their experiences of rejection with hope and cautious optimism that someone in their immediate environment is noticing them, maybe even listening.

The worst we can do is not notice, or notice and do nothing. It's important that we try to model intersectionality, where we understand that the many aspects of an individuals’ identity including their health status, race, age, sexuality, etc., do not exist separately from each other but intersect to create a complex identity. Understanding these connections is key to being able to identify barriers to growth, better health, and opportunity, from which we can begin to develop solutions that are not one-size-fits-all.

Divya Kannan, PhD, is a clinical psychologist from Vanderbilt University in Nashville, USA, where she has spent the last several years working with adult survivors of violence. She is currently a practicing clinician in Bangalore.

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