Chapter 4 shows how internalized stigma often results in adaptive preferences that harm a person. When people incorporate aspects of negative stereotypes into their identity, they sometimes develop adaptive preferences by internalizing harmful social norms and beliefs embedded within these stereotypes. I show how people with mental illness often develop goals and desires that are shaped by these beliefs and social norms, which limits what they believe they are capable of, thus reducing their options for action and truncating their agency and autonomy. While adapting desires to one’s circumstances can be positive, as in positive adaptation, it is negative when it is harmful to a person. The adaptive preferences that result from this can be seen as rationality deficits that are oppressive and nonautonomous and that damage well-being and flourishing.