There are nothing like lightbulb jokes in the operating room to make you plume your feathers.  The other day, my nurse “enlightened” me with them.

How many psychiatrists does it take to change a lightbulb?  One, but the lightbulb has to be willing to change.

How many surgeons does it take to change a lightbulb?  One, because while he holds it, the world revolves around him.

How many nurses does it take to change a lightbulb?  If it’s during shift change, no one will touch it.

That is as far as we got, but please share yours, especially if related to psychiatry :).

Lightbulb jokes are common, clean, dirty, and fairly ageless. It does not take the brightest lightbulb in the room (Teehee!) to know that they are so because they capitalize on stereotypes.  Stereotypes, likewise, are widespread, and fairly ageless.  Even in something as objective as brain disease. i.e., The brain is carbon matter, a human organ, mushy grey stuff. The brain gets sick like any other part of the body, human organ, and people bits. Brain gets diseased, people behave and feel diseased.

A primary care physician’s assistant, “PA,” was sharing with me the other day about how she deals with stereotypes when she approaches patients who need treatment toward brain health.

I tell them about all the executives and professionals who get treatment ‘because the stress gets to them and they have nervous breakdowns.’  Then they don’t feel so bad about accepting treatment because they associate themselves with these successful people.

Stereotypes can be positive, negative, or neutral.  Everyone has them.  We clinicians, patients, grocers, those who want nothing to do with medical care, and even executives and other professionals (smile) have them.  But what, in dealing with stereotypes, is friendly to Me?  It starts there.  With Me, one little, or largely valued Me.

We stereotype ourselves and maybe that is why we stereotype others.  For example, this struggle of what to call illness of the brain is common, widespread, and fairly ageless. A Menninger Clinic blogger wrote eloquently about it recently, “Does reframing mental illnesses as brain disorders reduce stigma? by JON G. ALLEN, PHD.”  Most pithy, I thought was this,

…we should be skeptical of the view that regarding psychological problems as brain disorders will abolish stigma. Although the disease model decreases blame, this shift comes with a cost: It increases pessimism about recovery and might also contribute to perceived dangerousness.

I have never forgotten the Spiral Dynamics idea that in the magical level of consciousness, there is a sense of being disempowered. “Perceive dangerousness” is magical. Behind negative stereotypes, there is magical thinking.  We give over what is not to be given and take what is not to be taken.  We have fear.  We feel victimized.  We lose what is freely our own.  Disempowerment is terrifying. There is a lot more stigma out there than there is information but giving stigma and/or negative stereotypes power is our own choice.

A fellow blogger wrote to me how he approaches it,

Change brain illness to mental illness. Our problems really are brain illness from physical dysfunction but I can accept that my psyche is sick easier than my brain is sick.

Stereotypes may scare us but they can also inspire.  It is up to the individual, to Me, how to respond.  As in lightbulb jokes, we who are targeted by stereotypes can take pride in them.  They are not the same as “stigma” although there is overlap when negative.  Stereotypes can be neutral or even something to be proud of.

How many psychiatrists does it take to change a light bulb? None–the light bulb will change when it’s ready.

How many psychiatrists does it take to change a lightbulb? None. It’s their job to help people find their way in dark places!