Psychiatry in Denial

The popular conception of biology obscures the origins of poor mental health.  We’re blinded by notions of genetics and brain chemistry to the reality that our reactions are decontextualised and the blame for ill-health is placed on those, some of whom have already been blamed from birth, by a science that has simply got it wrong.

People with mental health conditions, treated by psychiatry, are subjected to a biological idea that hasn’t got that much to back it up: even research into twins which seemingly supports clinical psychiatry’s theories has been called into question. Real world causality is taken out of the equation as people with mental health diagnoses are placed in a social void where behaviour is judged without adequate consideration being paid to environmental factors.

One of the main talking therapies, Cognitive Behavioural Therapy (CBT), makes a similar mistake, asking people to change their thinking to change their approach to their environment and in so doing change the environment itself, without highlighting how unhealthy that environment can be to people with a diagnosis.

I believe that mental ill-health is socially influenced and its etiology is intergenerational.  Poor thinking, communication and interpersonal skills can be passed on from generation to generation, which leaves many unfortunate enough to come under a triggering set of events unable to cope, leading to a diagnosis of mental ill-health.  Research into the effect of our environment on our brain chemistry shows how important context can be.  Compound the issue across generations and the rest can pretty much write itself. Families fuck you up, goes the saying, but telling people this is a minefield. It’s difficult to imagine psychiatrists having the courage and the tact to be able to address the problem head-on.

But this isn’t a blame game.  When a baby’s born, the parents are not given much in the way of support and guidance.  You’re pretty much left to your own devices and the support of family and friends, support which can be misguided and problematic.  Again, this isn’t a blame game, more a wish that parents get more support and better guidance to stop the rot, especially in families that function poorly.  Wider afield, inequality is known to have a detrimental effect on people.  This also needs to change, so that we not only need to tackle the problem at an individual level, but at a societal one, also. To be on the receiving end of the social implications of a psychiatric diagnosis can be a nightmare for people, with many saying that these implications are more damaging than their symptoms.

Not only is our culture ignorant of the issues, it’s also historically prejudiced.  This can lead to the scenario that service users not only face prejudice from the wider society, but also from themselves, often putting people off seeking support and, if they do get it, impeding their recovery. Social media gives people a chance to address all this by diminishing the role of the mainstream mass media, challenging the dominant view of mental health and enabling people to build relationships with others in a way that lets them get a more realistic and positive message across.  The hope has to be that greater inclusion – meaningful inclusion – is possible with the right approach.

However, I think that just using social media is not enough.  We need to improve our own thinking along with our communication and interpersonal skills.  We need to know the context of our diagnoses and the treatment we currently receive.  We need to not only be well-versed about our own lives, but about the world around us in order to make a convincing case whenever the opportunity arises. Social media will almost certainly influence how medicine is done, with a less top-down approach from psychiatry.  Unfortunately, Britain’s main healthcare provider – the NHS – is slow at changing and I expect many in the psychiatric profession to resist the kind of changes being mooted by advocates of social media.  In other words, don’t expect a revolution to happen tomorrow.

Saying all that, it looks like change is coming in the years ahead, in no small part thanks to the existence of social media.  It needs to, but it also needs people to abandon their fears about revealing their diagnosis – to come out and advocate for improvements in the lives of the diagnosed so that when the next generation of mental health service users enter that first meeting with a psychiatrist, they don’t face the same pain many people in contemporary society face.


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