Peter Bates ~ Dirt, Disgust, and Denial

Bates, P. (2012)”Wash and brush up?”, Mental Health and Social Inclusion, Vol. 16, Iss. 2, pp. 97-102. http://dx.doi.org/10.1108/20428301211232522

Peter Bates ~ Dirt, Disgust, and Denial

In opening a conversation about how to work with people who are dirty and unwashed, it is unsettling to raise the subject of the human disgust response. All our liberal inclinations are alerted to a possible violation of the principle of non-judgemental respect and we are ready to defend smelly people we have known from insult and misunderstanding. Perhaps, in raising the topic, I will become disgusting.

At some point, I guess we have all been troubled by the sights, sounds and smells we encounter on rare occasions in working with people who are losing the battle for daily survival. Whether it is unpleasant body odour, verminous hair or seeping wounds, a glimpse into someone’s mouthful of half-chewed food, a spillage of bodily waste or an admission of repugnant behaviour towards others – we all have found a trigger that fires up the human disgust response. It shapes our interactions and so we should understand it and ourselves if we are to work successfully with others. Denial is no solution.

Research as shown that three threats  – pathogen, sexual  and moral – universally trigger a characteristic facial expression as well as withdrawal, shuddering,  immune strength and nausea. These responses protect us from disease, reproductive risk and collapse into anarchy and the death of the tribe that would inevitably follow.  By the same logic, strangers evoke disgust, as they may bring unfamiliar diseases, while women respond more strongly than men, as they have to be disgusted enough for both themselves and their children.

The disgust response starts early – giving a 14 month old child a new toy, along with a 15 second ‘disgust message’ leads to the toy being avoided for an hour or more. It also generalises beyond the stimulus itself. Disabled individuals activate similar responses to those with contagious diseases, even when the observer is explicitly aware that they are neither sick nor contagious. The presence of a disgusting smell in the interview room results in people making more severe moral judgements, reduces the amount of money that they will pay for certain things, and strengthens their resolve to use a condom in future sexual activities.

So how do mental health workers deal with all their reactions when faced with a smelly, dirty or disgusting person? Disgust is plastic, as shown by the upscaling of negative responses to obesity in recent years and also by the positive learning shown by children who discover that vegetables, olives and wine are delightful. Of course, it may be that all mental health workers have already eliminated this unbecoming disgust response from their repertoire – but I fear not. Meanwhile, the primitive blend of fear and fascination that forms human disgust is itself deeply moral, as, like the birds, we set aside our own need for survival in order to give a warning cry and save the flock. Thus there is a way to take care of our own needs whilst prioritising those of others and reaching for the goal of respecting, understanding and supporting the person who troubles us.