Apparently, I’m in the best shape I’ve been in during all my involvement with psychiatric services. This stint in hospital lasted five and a half weeks. It could have been two. My decline was rapid, but so was the turnaround and, because problematic ways of thinking and behaving didn’t have a chance to bed in, normality’s returned and the work needed to get there was minimal. As a consequence, too (thinking long-term), I’m starting to pick up the pieces from a better position and that bodes well for the times ahead.
But this goes against the trends. By now, I should be a cabbage and it’s strange to think of how mad I’ve been in the past. Re-entry to normality’s not been an easy ride, but then the way psychiatric services blasted away my mind for over a decade was hardly a walk in the park. Now, though, I should in theory be able to come off meds completely, but it looks like I’m physically dependent on at least a small dose of them, which is a problem – you’re never told the full story about side-effects and most people who should know haven’t a clue – but one I think I’m prepared to live with. All-in-all, I think I’m philosophically and psychologically where I would have been had I never entered the psychiatric system at all. At last, I’m grounded in a reality that’s both comprehensive and coherent. My world and my place in it make sense, so I can take things from there and actually get more enjoyment from life.
This time it’d been two years since I’d been hospitalised, a time during which I increasingly focused on ideas I’d had before psychiatry had ‘persuaded’ me against them – most notably, the importance of context in our lives. Psychiatry, as I’ve written before, makes a good show of considering context, but it can’t help betraying its true philosophy in singling out the individual for ‘treatment’. There is no such thing as society, sort of thing, as even the left ultimately champions decontextualisation when talking about ‘mental health’ with just about every bogus and ill-informed stunt in the book.
I’d spent a long time thinking about my experiences in the system and now and again views buried in the back of my mind would emerge and chime with the sociological approach I’d once had. But it was a gradual process of picking apart my life from a number of angles – sociological, psychological, economic, historical, cultural, etc. – and informing this further with research which grounded me in a better sense of the world as it is, my place in it, and how to manage the relationship between the two – not how psychiatry had led me to believe in how things were and should be.
Psychiatry stigmatises while persuading its advocates that the public at large are the great stigmatisers. According to psychiatry, the ‘mentally ill’ are chemically or genetically deficient – a set of theories with no scientific basis whatsoever, which are put forward and adopted as fact throughout the system for all sorts of bizarre reasons. Tragically misguided campaigns formed on their basis spring up all over the place with campaigners failing to grasp why their attempts are doomed to failure (during this last spell in hospital I even had to politely tell a psychiatric nurse this as he reeled off a list of theories about ‘chemical imbalances’ while I told him that there was nothing whatsoever in the field of science to substantiate his beliefs. He wouldn’t have believed me). Indeed, so wedded are campaigners to the false assumptions of psychiatry that the wider public are done a great disservice in being singled out for doing essentially what the campaigners are doing themselves and often to themselves. You can’t win. But then, no-one can, faced with the hook and crook power grab psychiatry’s historically pulled off that blinkers so many people to the true state of affairs.
I know all this sounds as if I’m bitterly anti-psychiatry and ranting about a system out of mere dissatisfaction but a bitter-sweet moment came when I realised that, although all my thinking wasn’t original and I wasn’t some sort of pioneer – there’s plenty of people who’ve reached similar conclusions about the ‘system’ – at least I wasn’t alone.
Moreover, I’m not anti-psychiatry at all. As I see it there are three schools of thought in this area: anti-psychiatry, critical-psychiatry and pro-psychiatry. I fall into the middle category, seeing psychiatry as needing urgent and thorough reform, if not a complete overhaul, but still seeing it as an important option in assisting people at the extremes of thought and behaviour who wish or need it, so long as that’s accompanied by an understanding of what people’s full options are, aside from how we’ve been culturally conditioned to think.
The pity is that the three schools of thought don’t seem to interact and learn from one another. Learning of them and their approaches has opened up options to me that I hadn’t been made aware of by a system supposedly acting in my best interests. Psychiatry’s a powerful system and it seems highly unwilling to risk relinquishing its power – personal attacks on critics are only the tip of the iceberg of how badly it reacts to its philosophy being questioned, something that should ring alarm bells for even it’s most blinkered advocates.
It doesn’t and yet psychiatry’s a very broken system. Again, I’m not alone in observing this, but what came as a surprise to me during this spell in hospital was that many of the people working in that very system also see a need for thorough reform. In researching the subject, I’d come across evidence that there are many senior psychiatrists who are calling for change, but I still saw things stereotypically in an ‘us versus them’ scenario. So I was taken aback by how passionate many people working in the system were in their calls for change.
Does the wider public or those ignorant enough to unwittingly campaign for more stigma believing they’re challenging it have any awareness of all this? It seems not, as I was once one of those people and even wrote a dissertation partly dealing with challenging stigma, without once questioning the basic assumptions of psychiatry or that my approach would encourage stigmatising processes as much as anything else. Just as it’s frustrating to now watch most campaigners unwittingly chase their own tail, it’s also a great tragedy that there are people throughout services working so hard and to such a high standard in the face of a deeply damaged system with little realistic hope for the kind of substantial and effective reform in the near future that would see their efforts as rewarded as they deserve them to be.
For me, personally, these ideas and my experiences of the fallibility of the system, along with alternative approaches, have ultimately proven more productive than passively accepting the singular approach of one failing discipline. We live in a context that influences us, where we need to reform ourselves but also the world around us, while adapting to things as they are. Not only are there people who believe that I’m in better shape than I have been during my time in psychiatric services, but I feel better than I have during all that time, also, however difficult it was to emerge from the mire. It’s difficult to put myself in the mindset I experienced for so long, I went in so deep and at times didn’t look like coming out. But I did and it’s given me the conviction that the same can be achieved for anyone.
As for services themselves, even within the pro-psychiatry model, they’ve declined shockingly even during my 15 year time with it. Nursing staff consumed with paperwork didn’t train to be clerical workers, but that’s what most have become, with implications for those in their charge. The stigmatising social effects of diagnoses remain, but without the knowledge that they’re only theoretical and highly disputed. Social services on offer have diminished so people have even fewer places to go for therapy or even to just spend time interacting with others. Therapies that can help aren’t widely on offer while other potentially successful approaches aren’t usually considered at all. Spaces even on confined wards have become fewer, squeezing people at different levels together – with the inevitable personality clashes – as they’re ‘needed’ for yet more office space, as decreed by (as far as I can tell) centralised senior managers who understand little about the needs of people in the system.
I hear calls for improvements in ‘mental health’ care from all sorts of quarters, but they’re usually misguided and betray a shocking level of ignorance when you consider the positions many of these people hold in society. Yes, services need to be improved, but in the right way, not just more of the same because the same doesn’t work – currently, psychiatry is flawed from top to bottom, its assumptions are wrong and its practises are ineffective. Moreover, the ideas needed are relevant for everyone, not just those who enter psychiatric services, with the promise of improvements on a societal level on offer, if people would just look.
That the upper echelons of psychiatry are unlikely to risk their unjust power being challenged by calls for thorough reform doesn’t bode well, but my approach is working while theirs didn’t, never really has and never really will. That there are people with a good understanding of the issues is helpful, but that they’re still being sidelined isn’t. It’s time the bulk of campaigners did their homework, but maybe part of the problem is that, if they were going to, they would have done so by now. That said, I remain optimistic, but only in the longer-term.