When Boy George first burst onto the scene in the eighties, I had an adolescent crush on him of the sort you get when you’re an adolescent. Didn’t last long. As soon as I found out he was a man AND gay, I was devastated. That was my crush on Boy George.
I suppose an option (though there are none, it seems) is to just confine me to my bedroom for the rest of my days, so I can make speeches about nothing in particular, but it’s an option. Good story, like. Could say ‘and there he goes, the man who turned his back on The Real Thing’. And you can interpret that any way you fucking like. And that. That, too.
Things are going okay. Of course, as everyone knew, my environment would be made as tough as possible for some reason or another – possibly meds, who knows? I’ve decided to not bother going out and about for the foreseeable future. There’s little point. There’ll be the usual stuff around town – an increase in stimulus, then someone, somewhere expecting some sort of response that will bring peace and joy to the world. Not for me, ta. It’s a recipe for disaster every time and I can’t be bothered with it, to be honest. I’ll just carry on at home for the time being – where, hopefully there won’t be a drastic decline in my mental condition – so that, if the time ever comes, I’ll be able to drive down town without the complications that usually take place, escalating matters to the point that my driving becomes unreliable. Best to stop driving now.
Everyone’s obsessed. Of course they are. The amount of resources, etc., mean that it’d be a miracle if people weren’t obsessed. And, sure enough, other people’s obsessions have got to become mine, somehow. Doesn’t matter how much I don’t give a shit. There is no choice whatsoever. Be that as it may. Right now, I couldn’t give a shit, but with the usual druggings, psychological pressures and so on, it may only be a matter of time before – what do you know – I’m dragged into a hospital or put on meds or both, with that being used as evidence for the necessity of meds for me in the future, too.
Seems to me that people need me on meds more than I need to be on meds, meaning that I need to be on meds because everyone needs me to be on meds. Well, if anyone needs to be on meds, it ain’t me, but I’m sure something can be arranged.
Meanwhile, the days flow from one to the other. They do, when you’re in your middle age. Me and Mom are getting along better than we have for years and that’s down to us and no-one else. Mind you, I can’t rule that out. Every time I come off meds, everyone knows I’ve been engineered into that, too. Well, that’s the way it is.
So, I’m getting along with things, reading books the authorities have written, while they try to engineer the environment around that, too. Never satisfied. I’m getting something from those books, though. Some of it may be reliable, some of it may not be. Quite interesting, trying to figure out what’s what with them, though I could be doing much more interesting and enjoyable stuff with my time. Then again, there’s not a lot I can do these days surrounded by Obsession Central.
If there’s a independent therapist you can all go to to help deal with these issues, I hope you can resolve them and mighty quick. I’m really, really bored.
On Monday, I went to psychiatric services to see my psychiatrist and break the news to him that I’d come off a neuroleptic, gradually, over nearly a year, and that I intended to withdraw from a ‘mood-stabilizer’ similarly. It was obvious that the hospital had got wind of something when I got there but, instead of relating this to me and expressing any concerns they may have had so we could discuss them, the type of odd and counter-productive behaviour I have had to put up with over a 14 year involvement with psychiatric services continued, with the patient disempowered in a process keeping them outside of knowledge. That failed approach has already been planned for way in advance of recent times. I know that. Psychiatric services know that. But they will use that to act against me, too. The world could and should be a far simpler place. And all this for what? Whatever issues services have, they should have very little, if anything, to do with me. That they probably can’t see that speaks volumes for their approach down the years.
In a letter I’ll include at the end of this post, I spell out a few things that may lead to a move from the medical model, which faces impressive and widespread calls for significant reform even within psychiatry, to a social approach to mental well-being. However, in the letter, I call for psychiatric services to not escalate matters, as they have a pattern of having done for years, but have an open mind and give an alternative approach a good chance of success. It already seems like that will not be allowed to happen, for whatever side issues there are, which I’m barred from even discussing, and which few people who aren’t aware of the stunts that get played would believe. They are basically designed to engineer mental distress to a degree which is meant to necessitate a medical approach, with no room for alternatives ultimately allowed.
I will say one thing, which seems to go beyond the realms of credibility, though that’s the way it’s supposed to be seen: during my last spell in hospital, the Consultant Psychiatrist there blatantly lied to a tribunal which is supposed to act as a safeguard for me. That’s illegal. Or it would be if the tribunal was little more than a show trial, a mock-up, the outcome of which had clearly been decided in advance, which is why I refused to attend another ‘safeguard’, which was a hospital managers meeting at Worcester Royal Hospital. Tip of the iceberg, a lot happens when psychiatry gets carried away, as any institution which can impose meaning, power and a preordained agenda, without safeguards or access to human rights, unless those rights square with psychiatry and fall within a psychiatric framework, based on the dominant medical model. You don’t believe me? You’re not meant to. That’s the beauty of it.
There’s not a lot I can do. Despite the fact that I know that medication is a detrimental long-term strategy, and my well-being does not require it, if precedent is anything to go by, my environment will become so difficult to deal with that I will be forced onto the medical model, which will then – yet again – be used as ‘evidence’ for the long-term ‘need’ for a medical approach. As my last admission to hospital demonstrated, it is almost certain that there is not a lot services will not do to try to accomplish this, with the prospect of engineering an embittered, disempowered individual who knows that he lacks fundamental freedoms which everyone should be entitled to. Sounds bizarre – entirely unbelievable – but I have enough to go on to rationally conclude that. And it’s almost certain that there is nothing anyone else can do about it, either.
Letter to my Consultant Psychiatrist
9 September 2014
Dear Dr S,
Firstly, thank you for your flexibility during my appointment with you yesterday. I had been, in retrospect, overly concerned about how you might react to what I had to say, but I was reassured that you took such a considered approach to the encounter.
You raised the issue of whether, if my health deteriorates to an extent you believe necessitates anti-psychotics, I would take Quetiapine. I tried to be non-committal, not only because I don’t think anti-psychotics are the long-term answer and want to find a better, workable solution to the cycle of long-term medicine followed by withdrawal, but also because of wanting to deal with any issues as they arise, if they do. I have to admit too, though, that my initial reaction was to be opposed to any anti-psychotics at all.
However, though there have been many things I have been doing since my last admission to hospital to address my psychological and social approach to things, which I think bodes well, especially if built upon, there are naturally going to be concerns based on precedent, not least the severity my condition has reached at times. So, after considering this, it is clear that you need to prepare for the worst as one of the potential outcomes of my proposed gradual withdrawal from medication and hopes to shift to a more social approach to my care. Therefore, it is only fair to be cooperative on this and try to find a solution with you. From what I understand, anti-psychotics can be beneficial in the short-term to avert the worst of a psychotic episode or to recover from one, though there is also evidence of the benefits of this being only short-term for people with my diagnosis. Therefore, if you are open to it, I would welcome discussing with you the available medications and strategy so you can implement a plan in the event that things turn for the worst and what the full options are beyond that. I am more than happy to include the use of an anti-psychotic in that, while wanting to keep our options open as to which one would be the most appropriate in light of the above. Your concern may be that this could impede the benefits of a long-term medicinal approach, but even if that was the case, working towards this proposal is more flexible by adjusting around precedent, providing necessary safeguards and keeping our options open.
I also want to give you some additional feedback about the appointment, which I offer in the hope that you will find it useful. As I have mentioned, your flexibility was very encouraging, but your concerns were, too, as they demonstrated that you will keep a close eye on things and try to prepare for any negative eventualities. A disappointment was that you seemed to be completely uninterested in social approaches to mental health, as these are the approaches I have always ultimately considered more viable for me, all things considered, and have some interesting advocates within the psychiatric profession as well as outside of it. Although I would not wish to offend you by trying to tell you how to conduct yourself professionally, I have to hope that, as my clinician, you would be more open to such approaches, increasing the options in your clinical toolkit and, therefore, those readily accessible to me. In appearing to be so uninterested, that may lead to a situation where, while your aim is clearly to act in the interests of my health, you could unwittingly reduce the chances of their success in favouring the medical model of psychiatry to the exclusion of all other options, while a social approach is also in the interests of my health and may eventually prove to be more beneficial. You might never know if you are reluctant to explore the option, which would be a pity, not only for me personally but, I think, for you professionally.
Another concern was your unwillingness to prescribe tranquilizers. I understand that they can be addictive, but I think on the basis of my general approach to medicine, you can trust that, on PRN, I would not abuse them or remotely risk addiction. Moreover, my experience has been that psychosis emerges after a prolonged period of intense stress, which builds up over time, often initially from quite insignificant moments. That can be external stresses or internal ones. Regarding external stresses, my home life is better now than it has been since even my first involvement with psychiatric services. This is down to basic common sense as well as social approaches I have learned and applied, though I am at the very early stages of looking in to these approaches. For example, my mother and I have openly and rationally discussed our stressors and overall relationship and why we think it has deteriorated at times, implementing numerous improvements. That has led to a greater understanding between us and an everyday life that is healthy and enjoyable. My extended social life could be improved, but that is also without stresses, as I do what a lot of people do these days and make use of technology to keep in contact with numerous people, many of whom act as a support network when needed. Overall, my home and wider social life are as good as I can expect and hope them to be. I’m content with both.
Internal stressors are another matter. Again, though, because I find that psychosis tends to emerge from prolonged, intense stress, via a poor response to environmental events that go unresolved, I believe a tranquilizer could be effective at times. Of course, it would not be as effective as an anti-psychotic if psychotic thinking were to emerge, especially if this was an exclusively internal process, but as I have mentioned, I am sure you will now be able to plan for that. However, a tranquilizer may be a viable option to offset at a very early stage relatively minor stress so it does not lead to something significantly more problematic. As my body adjusts to changes in its chemical composition, there are naturally going to be times that are stressful, but which are not necessarily psychotic in nature. For example, if there is an increase in dopamine receptors following withdrawal from a medication, if that withdrawal is handled in a measured way, the changes and response should be less dramatic, though still delicate, because of potential changes in thinking. Though I think both positions can be argued quite easily – that you could use anti-psychotics or tranquilizers for this – the information I am going on suggests it is just as valid to say that tranquilizers can help with this process, allowing for moments of calmness and reflection which can assist and even extend the integrity of the personality at crucial times. This should, in theory, allow the body and mind to make its adjustments gradually and adaptably, without unnecessary extremes.
Because I also spend a lot of times indoors, I sometimes get mild cabin fever, which I’m accustomed to managing and which doesn’t last long, but during this time of withdrawal, a tranquilizer may occasionally be beneficial. Unfortunately, we did not develop this discussion, so I could not clarify my stance and get your specific feedback on issues around tranquilizers. I think a concern for us both is that a deterioration in terms of my mental state – whether triggered externally or internally – could quite easily have a knock-on effect at home. Personally, I cannot see that, now, though I also cannot rule it out, so, although it may turn out to be unnecessary, had we developed some strategy around this yesterday, I would have been a lot happier and I hope it would have assured you in some ways, too.
A socially-based approach could make a significant difference in outcomes, rather than what I am concerned may happen, with existing support avenues doing little more than wait for a time to medicate, having prematurely dismissed the support I am requesting, without even trying. Despite undergoing Relate counselling that has proved very helpful in the long-term, however, similar approaches have never been followed up by any of the psychiatric services I have been involved with, which I think has been a great pity.
This may be down to some of the ideas in services towards me. During my last hospital admission, a senior nurse said that I am ‘a danger to men, women and children,’ when he became frustrated that he could not give valid reasons as to why it seemed I was being denied my rights. The Consultant at the hospital, also had a sense of urgency in stating that ‘there is something in you’. Both, of course, are unscientific, but have to have come from somewhere, but not from any potential or internal bug I possess. Now, not only is this a long time ago for me to have accepted that it is not really relevant to my everyday living, but I am old enough to know the difference between form and content, appreciating that what people say does not always equate to what they mean, but these are strange things to say, regardless of whether they were believed, especially in their extremity. That services may actually hold such views and concerns like them has never been addressed and, although they should realistically have nothing to do with me, may be a reason why there is a problematic and detrimental reaction to what I am suggesting. The additional, wider concern should also be that if such claims, which often lack the processes to be openly discussed and resolved, are being made on a frequent basis to vulnerable and suggestible people, such people face the danger of internalising them or taking them to heart, whereby they could raise not only their risk level but also complications for their mental state.
So, although we are on our way to implementing safeguards in case my mental state deteriorates, I think it is also wise to consider how the relationship between me and psychiatric services has often been one of escalating rather than de-escalating matters, especially during medication withdrawals, with services sometimes seeming to see this as appropriate in terms of care to get me back on medication, when far simpler strategies could be more effective if that possibility were seriously entertained. Because the dynamics of the typical relationship between a psychiatrist and their patient differs substantially to that between talking therapist and a client, it may be helpful if we think about why my approach to psychiatry is sometimes seen as problematic. The latter relationship is more appropriate to me because it’s less a process of judgement within a hierarchy, more a discussion, leading to rational solutions, fully taking into account the views, perspective and intentions of the client in a more modern, egalitarian and empowering environment. So, maybe instead of this being seen as a problem between me and psychiatry, it would be more productive to consider and work around what I have thought all along and even requested at the start of my involvement with services: that the design and methods of the talking and social approaches have always been more appropriate for me and my well-being, as they fit in with my personal history and philosophy. If that conflicts with the view of services, then I suggest we have lacked something significant somewhere along the line. So, although I know you find it difficult to relate to how I approach you because of your perspective, I hope you can appreciate that it can be the same for me from mine, but also that it’s not a measure of disrespect by any standards or a battle of wills, but more a question of the inappropriateness of the model we have consistently worked on, with little substantial success, for all concerned.
While I am also looking into the methods and approaches I have proposed a greater emphasis on, though, it is not ideal for a lay person to try this alone – it being always beneficial, instead, to have professional, experienced and informed support to assist you in your development. It should be a simple matter of choice, though I acknowledge there are complications that need working on which are as much to do with me as services. So, despite agreeing with you that psychotherapy, for example, should wait until after I have recovered from medication withdrawal (fingers crossed), that should not necessarily mean there is no counselling or similar support available at all as I go through that process, to help with it. That could be with you, though my reservation with that is, again, that this is not your speciality and you may have some sort of funnel approach, seeing all options as inevitably necessitating medication in the long-run and working towards that conclusion, which would be unnecessarily detrimental to the alternative I hope for. Ideally, as I tend to benefit from considering different people’s informed opinions on important matters, it may be wise to consult my G.P. and someone who specialises in socially-based therapies, as, especially with the latter, their perspectives may differ to yours in relation to a specific non-medicinal path. Although this conflicts with some of your advice, it does not conflict with your ultimate goal of securing my health, so I hope it is an option you are not too uncomfortable with. Moreover, talking therapies, at least, are supposed to be more readily available to patients, these days, and are also offered to those both taking medication and with diagnoses like that with which I am diagnosed.
The advice I have come across on withdrawal makes clear that withdrawal from medication can all be quite a rocky road and there are times when it looks like symptoms are re-emerging, while this can be more a symptom of adapting to chemical changes within the body which tend to decrease in time, if the process is properly managed. Even though I acknowledge that both can also be the case simultaneously, I am hopeful that you will be able to distinguish this and act accordingly, should such issues arise. You did mention that it can take months for deterioration after medication withdrawal, but this was a very important piece of information both for a medical as well as a social-based perspective and it was something I will have to keep paramount in my mind in the coming months, at least. However, I have to repeat that I would be even more hopeful of all this if you were more receptive to these social approaches to mental health within psychiatry than you appear to be, as that could be an option to build productively on your flexibility, and does not necessarily remove the option of the medical approach once and for all, but does not instinctively rule that out, either.
You were very personable, as usual, which is always nice to experience, but you also seemed uncomfortable about what I am doing in terms of going against much of your advice (even though you are allowing me the opportunity to try a different approach). Your seeming discomfort is entirely rational, but as I think you already knew we would reach this stage – I hope you do not take offense about the withdrawal, as you seemed to know that was going to happen far sooner than I did – and that the disagreement is of concern to us both, I would have been more satisfied had the appointment progressed further so we could have discussed matters and options more. In other words, you did seem a bit eager to cut the appointment off short, where further discussion may have led to observations, options and strategic points which may have been of benefit in the long-run, not least in alerting me to potential physical reactions, behaviours and thought patterns I may need to be mindful of. Furthermore, despite disagreeing, we seemed to be getting along well, which also bodes well, whether things go well or take a turn for the worse.
As I tried to clarify, I am receptive to what you have to say – I may disagree with you about some things, which can understandably affect your professional pride and I apologise if that is the case. I do listen carefully to you than I think you realise, always taking away with me what often prove to be valuable points to consider and reflect upon. That is a common way I approach problem-solving (when not in a crisis) – not making rash decisions on the spur of the moment, but taking time to think things through when that is appropriate, aiming for the best solution in the circumstances – so I hope you consider this in future and realise that, although I may say things that sometimes sound dismissive, disrespectful or uncooperative, it might help to know that with me such things are not always as they may initially seem. Again, I think that I just find the psychiatric consultation process to sometimes be insufficient for my needs, though that is not an issue specific to you.
I understand that all of the above may still be unduly dismissed and I think I can see it from your point of view. Though I doubt you will do this, it is as easy to caricature someone with such ideas as it is to caricature psychiatrists and psychiatric patients, something which in the cold light of day is best avoided. However, with ideas like biological determinism and reductionism, insight, psychosis, relapse and so on, it is always going to be difficult to de-escalate concerns and simplify the rationale for a different approach, with services more inclined to default to a set standard, regardless of its ultimate appropriateness for me. I hope we take into account the butterfly effect, try to work in the interests of my well-being with an open mind and, regardless of whether or not I get it right this time, acknowledge that we will have a plan in place that should go some way to addressing potential concerns now and in the future, while also giving another approach a good chance of success. Apologies for writing such a long letter. It would be silly to try to cover everything I could, but I thought it only fair to give you a sufficient account of my thinking for you to be able work with.
Today, I have an appointment with Dr K, who I will give a copy of this letter to in case you wish to confer (which I would personally welcome), and I will request that he writes to you about the weight and heart issues around Olanzapine, along with the status of my physical health after my latest blood test.
Again, thank you for your flexibility, I hope you accept my feedback in the way it is intended while I am also open to discussing it with you if you wish to do that, and I look forward to my next appointment with you, but I hope that is without what turned out to be the unnecessary apprehension I felt yesterday.
There once was a priest of a large congregation you’d been led to believed in, but you went away after learning there was more to life. You thought a bit, learned some more, and came back, seeing him, his congregation and his gospel in an entirely different light. The priest had a background no-one could really question, but which you weren’t entirely comfortable with. At one time, he’d developed his faith with the Nazis and, though he swore that this had nothing to do with his political outlook, activity or what he preached now – admonishing you for even bringing it up to make you look bad for mentioning it and him look good despite doing it (raising the question of whether this was the greatest confidence trickster of all time) – you retained your doubts, querying if this could be more significant than the priest wanted you to think in light of seeing how he related to people, how the congregation worked interpersonally, how the gospel and its ways were spread and who were the main beneficiaries of it all. However, you had to tread carefully: the priest had a bizarre attraction to personal power, even at the expense of his congregation, to the point that they were dependent on his every word, while outsiders had merely to submit to them with the excessive respect and abandonment naturally deserving of someone of such high prestige as the priest.
You’d also discovered a worrying attachment the priest had to worldly goods, with him doing many things to bring in the bucks. He sold Coca-Cola laced with toxins as medicine to people who wanted to believe so much that they’d often sit around singing it was ‘The Real Thing’, thinking the tonic had cured them and they’d rejoice, telling others about this magical concoction and their new found freedom from anything other than The Real Thing. Then, when the funds from them wasn’t enough, he’d start selling it to more people, convincing them that they needed it, too. And didn’t they come in numbers, having got word of the wonders of this priest, who would advise them on how, when and why to drink Coke. And they believed, partly because they saw what happened to those who didn’t drink it. And it made sense and they believed. And when they didn’t believe, the toxins the Coke was laced with would space them out so much that they’d then either believed the priest when he said anything, not least that it was working, or they had to put up with having it forced down their necks, because they were too far gone, there was no-one to stop it and no way to get out of the congregation. If they couldn’t be restored by the wonders of laced Coke, then it was best to just give it them, keep them out of view (they weren’t good for sales) and hope for the best.
But, although there was no-one to really query the ways of the priest, there were Others. Others who called the congregation nasty names and made them feel bad and mad. Ignorant fucking bastards – no education or class, the dirty fucking scum – MOM, DAD, LOVE, HATE – why are they so nasty, Dad? The priest was in a bit of a fix, here, as his own work had led to this as his entire gospel was built on ideas of bad, mad and everyone else. But he managed to convince the believers that the Others didn’t know what they were on about. There was nothing wrong in drinking toxically-laced Coke. It was all good. He hatched a plan to get the congregation to set up communities to spread the gospel that all bad names were bad (unless they were the priest’s bad names – the Church has its needs, after all). No-one really thought to wonder exactly why the names were bad in the first place, but they believed, and so went about doing whatever they could to tell even more people that they needed to be nice, learn happy, nice names and believe, because bad names are bad, we must all believe and we must like the congregation, because their future depends on it, without even realising that, like that Coke, they were the same old names merely dressed up in the priest’s gowns, and the fact that they’d still make the congregation look the same as the old bad names would just feed through to the Others, anyway. The priest clearly had to do something, so he just got more and more people drinking Coke and saying the same things again and again, but making it that they wouldn’t think about anything they were really saying – they’d just be spaced out on the Coke and the gospel, capable of only listening to his words and his words alone, whoever said them. And it worked. Well, for the believers, because they were believers. So, they came to believe that if everyone was nice and if they supped their Coke, the world would be a nice place for believers to live in – The Real Thing – because everyone else, including the Others, would believe, too, whether or not they all drank the Coke, which they probably would in the end anyway. Let’s face it, if it ever came to that, would they have a choice? Well, if the history of the priest’s church is anything to go by, if the world doesn’t want The Real Thing today, you can bet there’s someone, somewhere, working hard to make damn sure it wants it tomorrow.
Having reformed from being a believer to seeing all this in a new light, you realised that there was no such thing as the curative properties of toxically-laced Coca-Cola and that the believers had lost it, not seeing the priest, his names and his Coke for what they really were. But something had happened where it was nearly impossible to save the congregation. The priest had managed to spread his gospel – or, more accurately, have his gospel spread – by newly-appointed priests, along with the congregation, to such an extent and with such a bizarre form of logic running so deep that any contradiction of the gospel brought with it accusations of heresy and the perception of the heretics as possessing the very maladies which afflicted the congregation and even its priest. So, evidence could be neutralised and you were just believing against a better belief, with the deciding factor being who could obtain the most influence and power to persuade the most people. Coke all round! Everyone’s invited! Homogeneity embraced, worldwide…so long as you sing from our hymn sheet. Welcome to Planet Asylum, the studied concentration camp of conservatively-nice, American-Dream-happy homogeneous understanding, aided and abetted by the philosophy and consumption of toxically-laced Coke! No safeguards or escape necessary.
There was little you could do, as too few knew what was going on and fewer were speaking out in a climate where everyone already believed in the gospel and naturally disbelieved the heretics. You watched as even the left-wingers in politics, usually astute in seeing the political dimension of things even depoliticized, developed a blind spot to end all blind spots where the gospel was concerned. To them, also, toxically-laced Coke and the gospel became the way and the light and the truth, while the Others had to be baptised in the new religion or we’d never be saved. The Others – who were only really taking their lead from the priest – had to stop treading on the congregation, according to the left and other believers in the gospel – while failing to recognise that the priest really wanted this pleasure all to himself, something that, once more, would get the Others following suit. But who needs friends when you’re your own best enemy: the congregation, duped as they’d become to chase the rainbow of more bad names and laced Coke, couldn’t even see that it was also doing a good enough job of doing the treading to themselves. Top up, anyone? The left’s instincts against imperialism? Nowhere to be seen, because they’d lost the ability to see it that way, as the priest pushed his gospel around the world to places where the original thinking and (more effective) solutions were overridden, the booty conveniently ending up in the lap of the gods, as the congregation expanded yet further, even ending up in trying to silence political dissidents. Deviants! Heretics! Meanwhile, the seats of learning, with their congregations in place in the universities, would sacrifice everything the PR says they cherish to the feet of the priest, but making sure to take backhanders for spreading the gospel, making it more likely that those outside, who would usually say something based on the evidence available, were not only clueless but less likely to even discover they were clueless in the first place, the morass of bad learning had become so deep.
In the face of all this, you could additionally see how the Coke often made people ill in ways they frequently couldn’t see, dragging everyone down as the ever-increasing moves to sell Coke could drive nearly everyone nuts with increasingly more people losing the ability and the sense to resolve what had previously been even minor issues. You witnessed the priest’s ways in all fields of life extending yet further, like it does across the globe, only more inwards, too, creating the need for ever more Coke and working against anything that would get in the way of people supping it or the way of life that sustained its perceived value. In the end, then, you just thought ‘fuck this, I wanna get off.’ So you did. You, at least, knew, and so you let the congregation be on their way, clutching The Real Thing as close to their hearts as they could, with you glad that you’d been there, mainly because it meant that you never wanted to go there again. What about the priest? Despite everything, it could just be down to a matter of time before he’s got the whole world in his hands.
I’m gradually leaving the Church of the Poisoned Minds: the philosophy, chemicals and other systems of medicalized psychiatry. I was on two meds and now I’m on just one, having successfully withdrawn from the more difficult one to come off. It was a very tough withdrawal, even though it was spaced out over a year and done very gradually. But the psychological and physical trials are now over and I’m stable again, gradually building on that stability in many ways, not least being able to pause for thought and have a consistent personality. I’m still suffering sleep loss, but that looks like a side-effect of the increased relative strength of the other med, which also brings feelings of nausea with it. I’m relieved, though, that I’m now able to get a few power naps throughout the day to supplement the few hours I get at night, but a reduction in the other medication should start helping with that.
I have a meeting with my psychiatrist this coming week, where I’ll lay out my plans for the months ahead, which includes withdrawal from this other drug. I don’t expect enthusiasm and yet the research is that, for the diagnosis he gave me, people who come off meds are vastly better off than those who stay on them in the long-term. Not only that, but in the short-term, the chances of relapse through an increase in dopamine receptors, in the absence of chemicals which block such receptors, should be non-existent, now, as I’ve surpassed that danger with the one medication designed around that idea (the need of which, like most things about meds, is without solid foundation) and regained stability – the danger really lies in if there’s any complications with withdrawing from the other.
Moreover, planning, for a time, to add another therapy to the mix should address any remaining residue and build on the work I’ve already done myself in those areas. Again, though, despite this approach being backed up by research, it might not get the reception it could with my psychiatrist if it conflicts with his beliefs. And his beliefs are backed by power, so ultimately it’s his call, regardless of what science states. However, I’m optimistic that he’ll offer support, though that support will probably come with negative expectations, based on the poor analysis of false records (WTF! Sounds bizarre, I know, but get me to a judge and I’ll prove it!). That lessens the chances of success but I don’t think by enough to affect the outcome, as my environment at home is the best it’s been for a very long time.
The only involvement I’m looking for from my psychiatrist is to help with the doses in withdrawing and I’m partly having to do this for political reasons, rather than medical ones, which isn’t the way it should be. And yet, my psychiatrist will cling on to a number of baseless concerns framed by false beliefs brought about by a poor approach to assessment I can only offer to put right, subject to whether he chooses to believe me. It may not be worth my time, even though that approach maintains a lot of power over my life. I could turn to another organisation and therapist for the withdrawal, which would deal with the problems of the dominant psychiatric approach my psychiatrist is part of, but I can manage my approach to these, even though it would be better if I didn’t have to. It’s a bullshit situation by anyone’s standards, but medicalized psychiatry is a severely broken and discredited system, enough informed people – even many at the top of psychiatry – have known this for a long time, but little is being done about it because so many side issues are involved that really shouldn’t enter into it. But that’s the situation as it is and that has to be dealt with, however surreal it is.
What can happen when you withdraw from psychiatric meds and even psychiatry itself (if I do do that) is that a number of issues and factors start cropping up that you have to both identify and deal with. It isn’t just a case of adapting to the withdrawal of chemicals from your system – that can be the minor part, but you do have to manage the thoughts which re-emerge when you come off meds, which you probably went on to avoid confronting or to dismiss completely and yet still had swimmingly around – unresolved – in the recesses of your mind, almost certainly causing unforeseen complications, which are potentially compounding. However, it helps to confront and make sense of them, because these thoughts and the circumstances that contributed to them can show you why you originally became distressed and lead to problem-solving strategies, also building on your experience, while preparing you for if they return. Here, knowledge really can be power, and empowerment is usually no bad thing.
Many factors can lead someone to experiencing a level of mental distress that many consider requires psychiatric care. There’s a very good chance that a complex social environment of early neglect or abuse was a factor and that the underlying fissures have never been addressed. This can lead to a situation where breaking from psychiatric ideas challenges the power dynamics which moulded around you, promoting your disempowerment while a patient – not only are mental health patients stigmatized (as they always will be in the medical model), but people become comfortable with the power around adopting some sort of dominant carer/advisory role as it validates to them their approach to life. Challenge these and you can promote bizarre behaviour in people who find it difficult to adapt to this loss of power and position – becoming equal to a mental health patient who fed your guru status isn’t always palatable to many people – and try instead, sometimes unconsciously, to reinforce the old dynamics. This process can go to some extreme lengths. Indeed, it can be so problematic and intractable that you are faced with little alternative but to break off contact from some people completely. Another of the factors hindering this approach is that it can necessitate an explanation of the original social problems and that can also lead to a very hostile response if taken the wrong way by people who’ve never understood the situation in such terms before explained by someone of such a relative lack of social status as a patient. But another important point in using this approach is to also see other people’s behaviour in contextual terms – that there’s reasons they might not get it and that that’s not entirely their fault. That way, you don’t make their mistake of carrying baggage you don’t understand away from the encounter.
Another problem you have to face is a philosophical one. The shift from a medical perspective to, say, a psychosocial one isn’t by any means easy, either. This also shouldn’t be the case, as the science and informed opinion is that the medical model is comprehensively an unscientific failure, often doing more harm than good, and where it does seem to do good, it’s often because of unreliable definitions of success backed up with shady evidence that’s not fully understood, including when the model works merely because the patient believes it will (a common factor), while rarely understanding the potential implications of its treatments. But the medical perspective is partly so persuasive because it’s so widely held and now embedded throughout our culture and in our everyday thinking. Here, prior research can help in giving you confidence that the ideas which may confuse, lead to doubt and get you unnecessarily running to the medicine cabinet if the going gets tough, are largely based on prestige and belief, not reliable science.
There’s also the shift in support that you can experience. You can’t expect the bulk of the psychiatric community to be supportive in you withdrawing from meds because it’s not really an option they frequently consider. To them, as with mainstream psychiatrists, you may have an ‘illness’ which they need to put right with ‘medicine’. That there’s no grounds in realism for such a belief in psychiatric matters doesn’t wash. That’s what they’ve been led to think, so that’s the way it is. As with the above factor, there’s a lot of belief involved, here designed around maintaining your self-perception as a patient, with those limited, disputed and misguided definitions of success based on false interpretations frequently thrown into the mix. You can also invite hostility if you’re vocal about what you’re doing and why, partly because it challenges and even threatens ideas, ways of life and even institutions, along with a world view which, although false, a lot of people have come to rely on and deeply believe in in ways similar to how religious faith works. Although many people who work in mental health are great on a personal level (if tending to be a bit on the conservatively-limited side), in this light, is it really help at all? All told, this shift in support can be a release because a better understanding of the system, yourself and the world, along with the experience you’ve gained, your successful withdrawal from medication and other forms of misguided support can lead to you experiencing increased independence, confidence and empowerment.
In the midst of all this, you also have to try to apply what you’ve learned (if you have) from your experiences via intuition, thought, reflection, interaction and research. I’ve possibly gone over-the-top in my approach to getting to this stage, gradually, over time, assessing pretty much everything I could from any angle I know, but it seems to have reaped quite good rewards in the longer-term, even though I’m more than open to an experienced and effective therapist going over things at some stage. That said, the more I look into this stuff, the more I realise that I’ve been quite astute in my approach, discovering much of it being supported by informed opinion and research. Your experiences and adaptation to a life off meds does affect your personality, but at least you’re working on the basis of your personality and an approach to it that’s up to you. Many people experience this change in personality unpredictably imposed on them by a system that obscures this process, with some devastating consequences for too many people, especially over the long-term. It really boils down to being able to make informed judgements about your life, including your environment, developing strategies according to this, so that you have a healthier relationship between the two. In other words, don’t adapt to your environment because your environment might be wrong; don’t impose your maladaptations on an environment, because it won’t accept that anyway; and, don’t try to impose your new way of life on your world, because the rejection from a world – however misguided much of it currently is – might knock you back. Instead, understand yourself and the world around you enough so that your life’s a successful negotiation but where your mental state isn’t vulnerable to damaging distress and potentially worse ‘solutions’. So, sure, all that does change you, but, based on an effective approach to the trials of life, it’s a more rounded and thus better you and so, arguably, a better life – not for everyone, perhaps. Maybe not even for most, as the philosophy of medical psychiatry runs so deep and distorts so much, but that’s partly the point.
I wasn’t fully ready to leave the Church of the Poisoned Minds the last time I tried, but neither was my environment. Now I feel a lot more ready and parts of my social environment are transformed from the toxic atmosphere that was dominant even a couple of years ago. That my medical team clings on to the ideas born of that atmosphere is something I’ll have to deal with or leave as an unresolvable issue with services, but not with me. If this ultimately fails, and I’m dragged back in by psychiatric services – which, now I’ve been in the system for so long, will probably remain a lifelong hazard – I’ll at least try to make it that I’m not put on anything other than tranquilizers, much as I dislike even those. But rather that, than potentially damaging ‘cures’ for ‘illnesses’ that don’t even exist. But you try telling someone that whose whole career has been spent in the belief of that approach. That said, I seriously doubt that I’ll be returning to a ward any time soon, though, because of the absence of the toxicity I experienced for years, while I lurched from crisis to crisis, in a probable – though moderate – brain-damaging fog of psychiatric medication (is there even such a thing as ‘moderate brain damage’?).
Although there’s more to contend with in coming off medication than the simple act alone, once you’ve got there, then what? Well, then the temptation to ‘spread the gospel’ and enlighten everyone can be immense and also frustrating, but, from one angle, this is to make a similar mistake to that of the Church itself. Medical psychiatry’s a belief system, from top-to-bottom – from the creation of diagnoses to the perception of the results of pill popping. There are psychiatrists who are trying desperately to enact reform, but there’s not much hope for them, the beliefs and what keeps them in place are so strong. Debate is skewed, so that the burden of proof is always with the people who are on the side of science against those who claim to be, coming, as they do, with some of the most bizarre arguments you’ll ever find in any sphere, once you know what they’re really saying in context. And, as you’d expect from such a belief system, proof is never enough, anyway, not least because it’s a system backed up by almost unparallelled power, influence and often desperate adherence. Back in 2007/8, I made the argument that the situation with the dominant strain of psychiatry is a civil rights issue and a huge one at that. Nothing’s happened since to change my mind. If anything, with more experience and research, that belief’s now stronger than it was. When even the people medicalized psychiatry limits and damages are often more than willing to collude – granted, unwittingly – in their own maltreatment, and there’s little hope of them, the majority of the politicians supposedly representing them, or even the bulk of the media that’s supposed to inform them, seeing this, debating it or being able to do much about it, and you can see that’s a serious impediment to reform or even the very conditions to see the urgent need for it. One of the great tragedies I’ve often seen is when someone in the system tries to come off meds they somehow know are wrong in a way they can’t begin to understand, gets no support but is usually faced instead with a wall of power and influence that has nothing to do with health, apart from its hindrance. It’s the closest many of them ever get to regaining some of what they’ve lost but it’s soon lost as the system is usually quick to swoop in, lock down and dope up.
There’s disincentives to saying anything that conflicts with the ideas of mainstream psychiatry, especially if you’ve been through the system as a patient, as I have. You’re an easy target from the off. Not only that, but you’re rarely believed, even by people who’ve seen the abuses of the system first-hand, and yet been unable to really understand them or have the resolve to see through such an understanding. I have friends in the system I can talk to about this stuff, who listen but sadly can’t really hear, then go on to appointments with the psychiatrists they see as parental figures – or some other nonsense idea about their relationship – while the psychiatrists, as many carers tend to do, lap up the power the whole scenario gives them, ignorant of why and how to adequately resolve it, while often waxing lyrical about empowerment in a system that damagingly offers anything but. I can’t, because I don’t have the prestige my friends regard as paramount because that’s what they’ve come to value in a system that encourages deference towards that stance in many, many ways. Elsewhere I recall interactions on forums that get nowhere near breaking through, people are so wedded to ideas that simply don’t add up, concentrating primarily on debates within the framework of psychiatric diagnostics, too often failing to see there’s clear alternatives. I even recall commenting on a TED Talk that was about the perceived need to introduce psychiatry to India, which was breathtaking in its ignorance and omissions, while the audience – typical of such talks – lapped it up. Essentially, my argument, which most people reading this probably won’t get, partly because good knowledge isn’t as prominent as it should be, was that India achieved its independence a long time ago and it would be grossly wrong to impose on them such a bogus colonial system, though in a different form, again. The scale of the blinkered nature, not least the depoliticization, of this debate is such that I was even quizzed about whether I was a Scientologist, a common belief of the believers towards the disbelieving. There’s no space for reason in such a repressive church. But, whenever you discuss anything like this, you get used to the fact that, with the vast majority of people, all it takes a simple mistake or a piece of misinformation from a believer to get everyone running, once again, to the altar of the Church of the Poisoned Minds.
You’re not only faced with marginalisation and the ‘Crucible thinking’ of mainstream psychiatry which consumes the vast majority of its advocates, but the imposition of that thinking in political and medical institutions (including the NHS, where resources are being squandered on a massive scale in their misapplication), the legal framework, the bulk of the media and the web, charities, support groups, individuals, and so on. Almost wherever you go, you’ll face it sooner or later, because it’s become how we tend to think as a society, while we also tend to believe we live in an age of science. And when you do face it with someone who’s taken their ‘body of Christ’ – people who stand to benefit hugely from the abandonment of mainstream psychiatry, if only they could somehow wake up – you also have to contend with all that along with the additional complications of facing someone who’s personality is probably different to what it’d otherwise be in ways they often can’t fully see, with thinking influenced chemically and psychologically by the system and, the chances are, a further set of unresolved social issues dating way back, that locks them in and you well and truly out. Is it really worth anyone’s while trying to reach these people in those circumstances? Ultimately, yes, especially from the perspective of it being a civil rights issue, but that it isn’t and is unlikely to be seen as such in the near future, it’s probably best for those in the know to hold their tongues, concentrate on their approach, and remain on the margins, leaving everyone else to dance in the moonlight, until the meds run out.
So, although it looks like I’m well on my way to leaving the Church of the Poisoned Minds, and there are some positive signs for reform even in psychiatry (though predictably marginalised), the disappointment has to be that the almost limitless potential for the wider society of a cultural shift to a psychosocial approach based on science, rather than belief, almost certainly won’t be taking place any time soon. It’s also clear to me that we need far more awareness of ourselves, our environment, their relationship and our adaptive strategies in ways that address pre-existing problems along with those we might face but, again, is anything like this really on the horizon? I doubt it. It all needs a cultural shift that’s currently too distant a vision for too many people. This coming week, I’d just better make sure I don’t mention most of this to my psychiatrist or I face being bundled on some ward somewhere for quite some time, while my feet, however right they may be, won’t even touch the sides of the walls.