Middle Class Blues

It’s the early hours and I’m awake. On a psychiatric ward for about two and a half weeks, I’m suffering from broken sleep and in the ward’s lounge as a new patient is admitted to the unit.

Middle class, she clashes with a system designed around power and prestige applied to an often infantilised working class. The system isn’t ready for people like her – ‘it’s like some sort of fucking school’ – and she isn’t ready for the system. Staff are trying to negotiate their powers into realisation. She’s being assertive. I know how this will play out in the staff’s observation notes the psychiatrist will consult as he decides on medication.

Sectioned (legally detained in hospital for observation and/or treatment), she’s facing a culture shock and isn’t sure she’s going to be able to survive the experience. She has a story while being aware that everyone has, but hers is compelling and it looks at this early stage as if she’ll get off the section. I hope so. She’s edgy but that’s understandable having experienced for the first time the effects of the State’s power to remove your liberty and mind. But she’s nothing more than edgy.

With our traditional focus on key indicators like race and ethnicity, sex and gender, class from a working class perspective, and so on, we sometimes overlook the needs of the middle class in these scenarios, but if we’re going to champion equality in services, it surely makes sense to see and work around our blind spots. The system being largely designed around a rigidly patriarchal hierarchy engineering the conformity of an often infantilised working class, people can be unprepared for the challenges such a structure throws up where everyday behaviour can be pathologised for no adequate reason whatsoever.

Madness, Toothpaste and the Two-Percent Problem

Rough guess: between 2-5% of people writing about madness in the media and online know what they’re talking about.  I don’t include myself in that figure, because I’m still developing my thinking and have quite a bit more to learn about the field, but I’m fast getting there.  The thing is, if it’s only 2%, how come?

What with the fact that psychiatry is heavily about engineering conformity to norms along with what I wrote last time about the copycat element of ‘self-harming’ not to mention the placebo effect involved in anti-depressants’ successes, I can’t help but link in the success of orthodox psychiatry’s powerful position with studies pointing to poorly considered conformity to authority and status.

Indeed, the success of neo-Kraepelin psychiatry’s smoke and mirrors can be equated with the way the toothpaste brands used to sell us their products on TV, with an actor dressed in a lab suit using pseudo-scientific phrases about whiter than white.  What with bio-reductionist psychiatry flying in the face of science, along with the disempowered helplessness of people persuaded by the constructed pathologizing of much ‘normal’ behaviour, not to mention more transgressive thoughts and acts, I have to wonder whether psychiatry’s success in pulling the wool over most people’s eyes is down to little more than disempowerment by misinformation and conformity to what’s seen as a higher order.

It’s easy to stereotype dissenters when you’re living within the confines of traditional psychiatry.  They must be scientologists, they’re in denial, they’re dinosaurs compared with our modernity, and so on.  But, because I’ve been on both sides, now, it should be easier to see the terrain of this debate in better ways.  Going on my own experiences (and having transformed them), then, I’ve often rebelled against the system only to find myself, once medicated, at the disempowering extreme of complete conformity to the norms and values of the system and my locale – both fairly reactionary and conservative – which I’m not ordinarily instep with philosophically.

In your conformity, though, you also face abandoning any argument that risks true analysis and clarity of the true state of affairs by putting such questioning and doubt down to illness in the face of what can be the overwhelming opinion of those around you, especially on mental health wards, not to mention online, in the media and, well, in society in general.  You fail to even begin to realise that there are many ways of perceiving and acting around popular conceptions of causal factors and mental states, pathologized and decontextualised or otherwise.  Sometimes, in desperation and the absence of any understanding of the possibility of better alternatives, you may want to believe in something – anything – and traditional psychiatry increasingly fits the bill, backed by limited perceptions and blatant falsehoods almost everywhere you look.

You maintain what many in the system have long experience of – inadequate reasoning, poor problem-solving skills and other common features of problematic relationships – to reject good arguments and laud the bad, especially when these come in the form of the sales techniques of toothpaste manufacturers.  You sacrifice empowerment over even information by surrendering your mind and senses to the wit of people who don’t tell you the truth about iatrogenic effects, causal factors, how psychiatry really conducts itself across the board from research to treatment, diagnostic irregularities, and so on, but instead give an air of authority and prestige in making many declarations about things of which there’s no certainty on the one hand and make-believe on the other.

This isn’t to say that people who advocate neo-Kraepelin psychiatry are bad people.  I’ve yet to meet anyone in the system who, at some stage, I didn’t think went into the service of people to help them.  But the fact that their work is based on a belief system that flies in the face of reliable science means that what you’ll often find – in the rare moments when there is the chance of effective debate – is the very type of reasoning errors and bogus stunts that can look so reasonable to those who often know little better because of their past exposure to similar ways of arguing: for example, shooting the messenger, giving incomplete evidence, not engaging with arguments when you don’t have the evidence so you don’t have to admit it, ‘Crucible’ logic and the prestige suggestion so heavily involved in also selling toothpaste.

That, by my very rough estimate, merely 2% of people in the media and online actually know what they’re talking about when they discuss madness, could say many things to many people.  To me it isn’t a sign of an open and shut case according to popular opinion (though I could easily become derogatory in arguing that).  Instead, it says that there’s a societal problem around norms, prestige and empowerment (not to mention professional, financial and political interests) which needs an overhaul in radical and creative ways.

Earlier today, I read a tweet by a prominent psychiatrist apparently debunking a theory about madness.  He was wrong in fact and dubious in his casual populism. The temptation was to engage him.  I didn’t bother, partly because of the reasons outlined in this post, but also partly because, despite everything, I didn’t want to just in case I was had, as I also buy toothpaste based on the dubious claims of actors in lab suits.

Thinking the Unthinkable

Last year I was a paranoid schizophrenic.  This year I’m bipolar.  Next year I may be eating cheese on the moon.  However, as is common in traditional, bioreductionist psychiatry, this doesn’t flag up concerns about flawed terminology or diagnostic processes.  Instead it’s seen as a simple shift in diagnosis.

Me and my psychiatric team get along very well.  Unlike many of these therapeutic relationships, it avoids the more creepy elements of a parent-child dynamic that the system can so easily engineer through a combination of dysfunctional former interactions and other disempowering processes.  It wasn’t always this way, but now it’s a healthy, more open one, partly because I’ve worked hard to ensure that’s the case.  That we disagree so fundamentally about just about everything to do with psychiatry is a testimony to what a creative approach to persistence, compromise and workarounds can achieve.

We disagree, but we might as well not, because the results are essentially the same.  I’m on medication for life.  To them it’s because of an underlying disability.  To me, it’s because I was put on medication that I didn’t originally need, but which my brain cannot now manage without, a medication that’s even known to cause significant brain damage.

The origins of this state of affairs, to me, were social and psychological, though they sound biological, too.  Epigenetics essentially worked against me, as did a lack of specific psychological skills in a social environment that was not only made up of intense stress, but also designed to build on it (the ‘tl:dr’, ‘shit happens’ scenario).  Although that sounds like a biopsychosocial model, it’s primarily about nurture, not least the epigenetic part.

Psychiatry’s essentially about conforming to norms, though ironically, with treatment which doesn’t tend to like context, preferring to isolate issues as within the body and mind of the individual.  But what specifically are these issues?  Well, they’re whatever psychiatry says they are, regardless of what the science actually says.  Therefore, if you enter any gathering of people who work in or use mental health services, you’re likely to hear myths spread as if they were part of miraculous religious conversions, like chemical imbalances of the brain, neurological disorders and genetic flaws, even though such beliefs are inaccurate and damaging.

Originally a believer in sociology and the idea of context (sociology and psychiatry don’t get along) this was blasted out of me in my first encounters with the local mental health hospital.  This, along with medication and persuasion centred all the problems I encountered as internal, thus denying context and any chance of real-world solutions based on a full picture.  The results were catastrophic – I conformed to the psychiatric norms and those of my intensely conservative social environment, which led to prolonged and severe mental illness with numerous symptoms, most of which I’d not had before.  As I’ve written elsewhere, I eventually reversed the tide by reintroducing a grounding context and returning more to a coherent, stable character.  But it took a chunk out of my life I could have made better use of.

However, there lies one of the problems.  I conformed to a set of scripts about diagnoses, symptoms, and so on, that you can see repeated by far too many people who don’t question what is going on and why.  We know that the phenomenon of ‘self-harming’ is – and I wish there was a more diplomatic way of putting this – little more than copycat behaviour.  That’s historical fact, so we have a whole load of people conforming to a damaging behaviour because they’ve essentially been told that this is how people at the extremes of the system alleviate internal pain.  We know the positive effects of anti-depressants tend to be down to the placebo effect, so what does that say about our current thinking around, and conformity to, ideas of ‘depression’, not least the more meaty terms from the DSM, psychiatry’s bible, which I’ve read being called ‘The Book of Insults’ and with good reason?

It’s well known in some circles, though not popular knowledge, that psychiatry is not only based on bad science and thinking, but also that society as well as the system is in need of reform.  At the moment, we’ve got a bad system propping up a dysfunctional society.  We need reform, too, in the skills we need to navigate life, but that doesn’t mean we’re somehow inherently flawed and that reform doesn’t matter.  However, most people are sidetracked into arguments, debates and initiatives that maintain the status quo and are, if anything, detrimental to public health, all things considered.  And, when the blurb to initiatives suggests a radical approach, it’s usually a sign to look closer at the wording.

No-one in the system, until very recently – though, funnily enough my relationship with most workers in the system is excellent – ever told me about the importance of key contextual factors – race, class, culture, economics, political influences, etc.  They frequently gave me worldly anecdotal advice on how to live life according to their personal norms but always within the framework of traditional psychiatric thinking, on subjects they were often unqualified to comment on professionally and with a worldview that taught me nothing of how to negotiate a healthy relationship with, and understanding of, my environment.

Since November, I’ve been looking more into mental health.  It’s thrown up some fascinating theoretical standpoints and interesting initiatives – many of which even call into question the functioning of traditional psychiatry – but still nothing that practically goes far enough.  What this research has done, if anything, is highlight that there are very few certainties around the subject of madness, aside from the knowledge that most things are uncertain.  Clinical psychiatry may deal with false certainties because of understandable constraints and limitations, but this shouldn’t be good enough to protect it against the reforms it urgently needs, even while – because of its powerful position in society – it doesn’t need to enact anything.

Meanwhile, most people are left in a form of limbo they have little idea about, living according to a set of narratives that they fail to fully grasp.  Are we really allowing such a flawed system to influence how we think and feel and react so much and with so little supporting evidence?  Seems so.  The good thing for me, at least, is that in having looked at anti, critical and pro-psychiatry material, I’ve reached a point where I’m personally comfortable with the service I receive, I understand my options, and I’m not wrapped up with concerns over stigma, discrimination or ideas about symptoms because I know that to be so concerned about things no-one really knows much about would be foolish and because the service is ultimately based on nothing more than rough and deeply flawed guesswork.

The main frustration, though, comes from knowing there’s other people who could benefit from appreciating such uncertainty, acting accordingly and helping to drive reforms that could comprehensively work, rather than, sadly, being little more than their master’s voice in so very many ways.

The Drugs Don’t Work: Coming Off Psychiatric Meds

It’s been about two years, now, since I was hauled into the top tier of psychiatric ‘care’ in my county after being assaulted at home and my assailant misleading the police about it. On the basis of further misleading comments from my family, I’d eventually be placed on medication I’d said in advance had always done me harm. Over the course of the past year, I’ve been withdrawing from one of those meds, Olanzapine (an ‘anti-psychotic’ and ‘mood stabilizer’), after being told by my GP that the effects of it had led to high cholesterol which put me at risk of a heart attack. In my last meeting with my psychiatrist – someone who I don’t mind, personally, but whose profession I don’t believe in – he stated that my GP has said no such thing, leaving the door open to being forced on the medication again.

Last year, I tried to come off all meds. Not only on psychiatry’s standards was my admission to hospital and the imposition of medication botched, but by any rational standard, the whole situation was dealt with badly and even corruptly, with poor assessment of the evidence and illogical conclusions being made of it. But my mistake last year was in merely acting on the basis of this and not tapping into my long experience of mental health and medication to acknowledge that, once psychiatric medication is in your system, it’s very difficult to come off it. I was rendered incapable that summer, spending much of it deep in psychosis as my body and mind couldn’t adjust to the withdrawal in the time I’d taken to come off the pills.

This time, often working closely with my psychiatrist, I’ve taken a year to come off just the one medication I’ve been on (I’m also on a ‘mood stabilizer’). I’ve had a year of tapering off a chemical that I’m now free of, but even so I’m still enduring an exhausting process with a lack of psychological stability along with the physical punishment of quite severe sleep deprivation as my body gradually adjusts to the new reality and my brain slowly restructures along with my mind. It’s certainly not easy, especially the frequent absence of self-reflection, but it’s something that’s almost impossible to get support in doing (though there are resources online, should you wish to chase them up), not least because we live with a culture which, while having no reliable evidence of the claimed benefits of psychiatric medication beyond limited and disputed definitions of success, asserts almost universally that you should take ‘your’ meds, even seeing the body’s natural adjustment to coming off them as a reason to be on them. It’s just the way we’ve been conditioned to think and that conditioning’s just about everywhere you look.

If I’ve made any mistakes, this time, it’s been in not tapering out the withdrawal long enough, not giving myself time to become stable for a duration before embarking on the next reduction, but even here, there’s not a lot that would have prevented the situation I’m currently in, of being incredibly weak and tired – it’s just part of the process I’ve got to go through and, despite the instability, it’s nothing major and doesn’t fall within the boundaries of ‘mentally ill’. Tired, irritable because of that at times, sure, but psychotic or having extreme moods? No.

What I do know, though, is that if I was on a mental health ward, I could be engineered into mental illness rapidly. That’s happened before in my ‘mad’ career, even when I’ve been functioning well, rested and what you’d call ‘healthy’ (to the uninitiated, these things do happen, and can happen more easily than they’d think). It wouldn’t take much to pull it off now, but what’s in my favour is that I haven’t currently got the social environment to make that likely, though that’s never far from being brought into effect. The last time, those two years ago, was the culmination of my half-family’s behind-closed-doors emotional difficulties and their manipulation of local services and the Police in a process that gradually enclosed me in their abuse of legal and medical powers, without adequate safeguards to get me out of it. Safeguards that should be in place were also abused and, in that environment, there was nothing I could do – no avenue of redress, even – but take ‘my’ meds and agree with the fanciful notions of a psychiatrist who had far more power than cognitive ability or ethical grounding. So, I complied and, in so doing, further empowered my half-family and the bogus structures that had built up around me. It was a blatant abuse of my rights, but one I’ve worked to come to terms with by rationalising around it.  A tough process when your rights have been so badly trampled upon, but I’ve had no choice. There’s nothing I can do about it, anyway.

Like everyone I’ve come across in the mental health system, there’s fault lines in my family life. I’ve distanced myself from my half-family but, psychologically toxic and manipulative as they are, there’s always the danger that they’ll muscle in and I’ll be back on the merry-go-round of mental health again. My half-sister would be classed as quite severely ‘mentally ill’ by psychiatric standards, if psychiatrists went on the evidence of this. Highly manipulative with marked psychological issues, she maintains a control over my mom so that, in any dispute, my mom is likely to lie and sacrifice my rights to the system to protect her self-image. It’s an abusive and highly toxic situation where the family increases the level of abuse whenever it looks like the cat’s going to get out of the bag, and has been very successful in doing so. The problem’s compounded by the fact that local psychiatrists treat their comments as neutral observations, not as the misleading abuse they’re adept at. Indeed, my current psychiatrist, after my last meeting with him, has already claimed that I’m mistakenly ‘blaming my family again’. To him, there are no problems in the family, only with me, highlighting the dangers of poor critical ability in assessing situations (in my experience, common in clinical psychiatry) and making him vulnerable once more to being an extension of the abuse by my family, again in ways that I can do little about. My psychiatrist has claimed that he uses a ‘holistic approach’ but while they give the impression of comprehensive analysis, implying environmental understanding, they still instinctively reduce evidence to the individual’s perceived biological flaws. They really can’t help themselves, it’s so natural to them.

I don’t believe in clinical psychiatry at all. I’ve witnessed too much over the years. The fundamental basis of their medicine is a mess and the worrying thing is that so many people believe in it, without even bothering to adequately check. I’d started out, before being put on a ward, with a sociological approach to mental health. However, after the pills and persuasion that transform your mind, thinking and logic, I came to believe in all the myths and misnomers of the psychiatric profession, even blogging, as many do, about how much better I was with its help, how we needed to overcome stigma and educate the public. Yeah, that cliche. Now, though, I’ve regained my former approach and the proper conclusion: that the real stigma comes from psychiatry’s ideas about the aetiology of mental ‘illness’ and educating the public should mean informing it about facts, not the myths clung on to by the bulk of the mental health community. But that requires the people calling for the public’s education to become aware that they aren’t even remotely educated about mental health themselves, before patronising the public (and themselves) with their missionary zeal on a false journey of deluded hope that’ll only end with the very type of stigma they seek to address.

The situation’s not a good one. Even the left abandons its science and beliefs with the very mention of mental health. They might as well hoist a blue flag and sing ‘There is No Such Thing as Society’ as well as Thatcher ever could when the subject’s raised, they can hardly wait to abandon everything they hold dear in the face of the issue. Like the psychiatrists they take their lead from, they may pay lip-service to nurture and other environmental factors, but break down what they’re really saying and they’re peddling the same old stigmatizing notions of bad biology, without even bothering to independently examine what they’ve come to believe and how much of this approach has been discredited. In the modern world, I’ve got to wonder – outside of religion – if there’s any other set of beliefs so widely held with so little genuine examination and critical ability applied.

While I was spaced out for more than a decade, I did rise to the surface at times and argue such things as I’m arguing here and I also had the sense to pursue some valuable support. What I didn’t know at the time was that this would have a delayed effect, as the pills and ideas of psychiatry had to be gradually overcome. I went to Relate counselling, which meticulously looked at my social context, amongst other things – again, something psychiatry pays lip service to, but when it tries it, always tends to apply the same old framework of decontextualizing the individual to reduce issues to individual biology, to be resolved by other chemicals. Relate, though, almost immediately identified the fault lines in my family life and reintroduced me to thinking that I hadn’t had for a long time, developing some ideas into even more useful approaches. This would be the seed which would eventually give me the impetus to rediscover a sociological approach and reject most of what I’d been conditioned to accept within the psychiatric system.

Even now, though, as evidenced in my last post, it can take me some time to recall the sequence of events regarding, for example, the shifts in my approach and thinking. It wasn’t always that way, but after so long on chemicals, there was always bound to be consequences. I’m lucky, though. Even though I went further into psychosis than anyone I ever met in the system – stupidly, I’m even quite proud of that, but, again, this is not least a consequence of medication (as well as environmental factors that were compounded by the meds) – I haven’t remained on the brink of psychosis, as some people do.

But the experience of having been so far out does give me the authority, at least with myself, to reject the emotional stunts many people who’ve been in the system and live by it try to pull in defending bogus claims about mental health. I’ve been on forums in the past where the stunts are almost without limit in their extremity, but with most things psychological, I can match them point for point and the stunts fall flat. It’s a bit pathetic, like the scene in Jaws where characters compare injuries, but this is what discussions between people who’ve been through the ringer can be like. The pity is that a lot of the people who pull these stunts don’t even realise that their use of these stunts are often a big clue to where many of their problems really emanate from. I’m ultimately quite patient of that sort of thing, because I’ve pretty much been there and can understand why a lot of people cling to a system that can do them so much harm in ways they often can’t see, but that doesn’t mean that I have to agree with them, whatever bogus point they make, emotive or not.

But the body of opinion, however wrong, is, in terms of numbers, against me and other people who’ve discovered themselves the true state of psychiatry and mental health. But this is the way people have to do it. I could, as I’ve tried before, continue sounding off about it all, but it never comes to much. Until people make a concerted effort to challenge what they believe and investigate for themselves, talking about this stuff is like talking in a foreign language. People like me are also easily discredited and ignored. You’ve may have done that already in the paragraphs above, but to cover all the angles that are open to dispute and require significant reframing, it’d take a sizeable volume of writing. For myself to successfully come off meds, I’ve got to often think in creative ways, thinking patterns which are frowned upon in psychiatry, which likes things conservative, and broadly know what I’m doing, too. I don’t know everything and some of my thinking is more extreme than most people who think along the same lines, but at least I know, on the basis of a realistic comparison of approaches that I’m on the right lines.

These days, I can’t watch or hear or read a story on mental health in the media without seeing the cracks. What used to anger me was that most people can’t see them along with my urge for them to be able to. But why? If people don’t want to know and are happy taking their pills in blissful ignorance, while also thinking they’re on the ball as they try to ‘educate’ others into their borrowed ignorance, then they can go for it. That they’re not told of their options and what those options really are in the first place is wrong, but it’s common practice. To me, going to see a psychiatrist is little different to going to see a witch doctor or a clairvoyant. If you don’t believe me, check the science and check it properly.

The approach of clinical psychiatry is common practice that needs a complete rethink: a new approach to language with an entirely different perspective and reforms across the board in how we work as individuals and as a society. I’m lucky in that I had strong ideas about mental health before I entered the system, but the ideas and shifts in thinking required can be so great for many, along with the way psychiatry influences relationships and thinking, that most don’t ever even get close to realising there’s more valid options to what they’ve come to believe. Individuals need to be contextualised and the environment shouldn’t be depoliticized so the highly complex nature of nurture is recognised as crucial to everyone’s psychological well-being and reforms can be thought about accordingly. We need a system which, rather than doping people up to brush things under the carpet, addresses crucial issues in ways that offer long-term solutions, something psychiatry has never been able to honestly, ethically and safely offer.

For me, I’ve got to carry on trying to make sure I’m not put back on pills that could kill me, while taking the strain of the adjustments I’m having to make. All summer, I’ve been all over the place, but this should eventually level out. Then it’s time to think about the other med, then, in the years ahead, a transfer to psychological approaches, then discharge. I don’t tend to bother with debates on this, especially in the UK. The issues of prestige and deference that are such a problem in psychiatry are what beat the heart of Britain, so if I do talk about it, it makes sense for that to be done elsewhere. Even so, it usually doesn’t get very far – psychiatry’s got its feet under the table and it isn’t moving for quite a while. Meanwhile, I’ve got a meeting coming up with my psychiatrist and that’s partly why I’ve written this – writing something about it all is cathartic in a way, but it’s bizarre for me to have to go to a clinical psychiatrist, someone who I have no belief in and know relies on so much discredited science, while lacking the ability to assess real-world situations adequately. But, even though I’m right and there’s ample evidence that I am right, I’m not only in the minority in knowing that but there’s also a legal framework – informed by dodgy science and its own ignorance – that disempowers me and any legitimate argument I may make in the face of a lot of power. There’s nothing I can do about that and that’s why I have to go.

Are we ever going to understand mental health?

I’ve lost count of the articles about the death of Robin Williams that point out that mental illness doesn’t discriminate, while going on to suggest that it does. It doesn’t discriminate, the authors say, because it can touch everyone, rich and poor; famous and unknown – only to go on and write that there are ‘risk factors’, for example, which are more likely among the poorer section of a population. Maybe they understand what they’re saying. Maybe they’ll make their minds up one day. Maybe they’ll just look at the evidence before putting pen to paper, evidence which overwhelmingly points to the fact that mental illness is highly discriminatory and that this, like many misnomers about mental health and the psychiatric system, point to public knowledge and policy that’s in urgent need of some sort of therapy.

Sadly, people seem to lose most, if not all, sense of critical ability when faced with such stories and debates – especially when far too many people get carried away with the death of a prominent figure – and it can be difficult to dispute anything, as such articles are often framed around ideas that dare not be questioned, sometimes in atmospheres which resist deviation, usually to an audience that probably couldn’t accept otherwise, not least in the heat of their moment.

I used to be a bit like that as a patient, comfortable in the nice and cozy system that, little did I know, was doing me more harm than good, totally convinced that I was doing far better than I would without it, fearful of any alternative. Care workers would convince me that they knew me, that I was nice and this and that when ‘compliant’ with treatment, while in reality I was so doped up and useless that I’d be talking like Michael Jackson one minute – head in the clouds, capable of nothing much – then contemptuous of myself for acting thus, not realising that, like with many things, this was a consequence of the treatment I was being subjected to. But, even as I was waking up to the realities of the system and its treatment, research I did in 2011 into social media and mental health would, in the long-run, turn out to be utterly worthless and misguided. Like most people, I’d accepted the dominant views about psychiatry and mental health without question and believed that as long as people with mental health diagnoses could communicate what I thought they needed to with people who needed it, stigma would be addressed and all would be well for mental health, its sufferers and society at large. How wrong could I have been.

I really started to realise how wrong when I came across academic papers – both positive and negative – about the care system itself. The positive papers often didn’t add up but the negative ones tended to fit in with a lot of my experiences as a mental health patient. In the end, I concluded, though not in my final paper, that the best the mental health community, with its current outlook, could hope for would be for individuals to improve the perception of themselves, but themselves alone. There could be no global improvement through improved dialogue for the community via social media or any other media – stigma would remain for the majority, regardless of the efforts made.

But my gradual shift in thinking didn’t end here. I started to read further, beginning with Richard Bentall’s ‘Doctoring the Mind’, an authoritative, convincing and devastating critique of the psychiatric system and how it works on individuals, calling for significant reform. Not only that, though, it also highlighted, through picking apart the misnomers about mental health, how misguided the public debate about it is. It became ever more obvious that the falsehoods which are commonly peddled of faulty genes and chemical imbalances unfairly straightjacket people into a system of thinking that blocks realistic chances of significant improvement by focusing on nature and the individual, dubious conclusions about genetics and brain chemistry, rather than on nurture and the environment, or what we learn and what we’re exposed to. This would lead me further into looking at popular and academic works on toxic relationships, the sociology of mental health, and theories about how our early years are so formative and influential on our later chances of being vulnerable to mental distress.

My experience of the British psychiatric system had begun in 2000. I’d already graduated from university and been on the Internet for quite a few years by then and my approach meant that my views about information and communication – my main interests – were quite well-developed. However, on first being detained on a mental health ward, it immediately felt like going back in time to an approach to human relationships, communication and the handling of information belonging more to feudalism. The patient was the subject, to be questioned and analysed (superficially and often mistakenly). There was a distinct and fixed hierarchy, ultimately based on prestige, with the patient disempowered at the bottom and, at the top, the psychiatrist, perceived by everyone, often including him or herself, to be all-knowing, even about things outside their speciality.

Medical records play a significant role in the psychiatric system and the approach to them can give a fascinating insight into how misguided psychiatry’s approach to relationships, communication and information can be. The patient has to apply – and often pay and always wait – to see them and, if they do, can often be left bewildered at the interpretation of their behaviour, an interpretation which can be bizarre to say the least. Third parties, like family members and other members of the public, can give information to the mental health team that can be detrimental to the patient and can also request that not only is this information withheld from the patient but that they ever even talked to the psychiatric team. The psychiatrist, in turn, can also withhold any information he or she wants to from the patient, if it’s thought the information may be damaging to the patient or if the patient’s knowledge of the information or the source of it may lead the source to be in any danger from the patient – a set of decisions that’s made in no small part on the information that’s already been often unchallengeable by the patient. There are few safeguards in these processes for the patient, aside from having to rely on the psychiatrists skills of verification, something which can’t be guaranteed and which is clearly not good enough when decisions can be made to administer chemicals to the patient which can transform their entire personality and even their environment.

Communication between the patient and the psychiatrist is often limited to effectively running off a checklist of symptoms in order to form a (highly disputable) diagnosis and, if thought necessary, to medicate. Again, this is often within the framework of information which has already been obtained via third-parties in a process with few safeguards for the individual, meaning that it’s often likely that the psychiatrist will merely rubber stamp what information’s already been given to them, regardless of what the patient says. Even if the patient’s to be effective, they’d have to guess who said what and, if the information’s unreliable, convince the psychiatrist of this, which is likely to elicit the diagnosis of paranoia (even if the patient is right, the psychiatrist can judge that the information given was given in the patient’s best interests, so, because the patient questioned that, this can also be diagnosed as paranoia). Understandably, then, whenever the patient’s questioned, most times there’s little opportunity for them to address potentially faulty information, the psychiatrist calls all the shots and the treatment is framed in a way that empowers everyone but the patient, a process which can have the knock-on effect of not only subjecting the patient to dubious treatments, but also to alienation and frustration that may be seen to require further ‘interventions’.

It can easily boil down to a situation where you can have treatment imposed because some Tom, Dick or Harry’s said such and such. A problem with this is that the system tends to assume without question that third-parties are entirely innocent, having no malicious or dubious motives for providing the information they give, something I know first-hand to be false. Believe it or not, there’s more than enough people who’ll willingly use a mental health diagnosis against someone in a dispute, even for quite petty reasons and, when you consider that many people in the system come from families with emotional difficulties where such behaviour could easily be used as a form of subjugation, you have the potential for the system to compound abuse within families and other social groupings.

Alongside all this is a logic that’s often breathtaking to witness in person. Down the years, I’ve come to call it the ‘Crucible logic of psychiatry’, as it echoes the bizarre use of faulty logic, bad evidence and fanciful conclusions in Arthur Miller’s play. For example, if you disagree with the processes or decisions involved in your ‘treatment’, you’re argumentative, lack insight and the whole psychiatric team can turn against you, viewing you as hostile to such an extent that the whole institution reflects this view, characterising it, as psychiatry tends to characterise things, so that it appears intrinsic to the personality of the patient, without context, as if it came from thin air.  If you disagree with or refuse treatment, you’re also not ‘compliant’ and can be forced to ‘accept’ it, after which, the whole psychiatric team can instantly be your best friend, satisfied that you’re now instantly healthier because you’ve accepted the ‘right’ course of action.

The whole framework is loaded to ensure that the psychiatrist’s prestige, logic and system wins the day, regardless of how bizarre, unrealistic and inaccurate it may be. You could even point to a wealth of scientific evidence against a decision or false proposition, but it’d be to no avail. The system’s ultimately about power and prestige, rather than solid science, so the psychiatrist’s decision is final. If the science says an aspect of psychiatry is faulty it’s not, because the psychiatrist says so and that’s that. The usual outcome, often encouraged by care workers, is that patients just take their meds to get the psychiatrists off their back, because there’s really no other option. Psychiatric wards are, sadly, full of excessively deferential people who’ve been made that way by a lifetime of hardships, often not least disempowerment, so the situation doesn’t always reach that stage, but sometimes it does and, although there’s tribunals which are supposed to be a safeguard against the excesses of the system, and though these sometimes work, a determined psychiatrist can deliberately mislead them, with the full collusion of the care team, despite the fact that this is supposed to be illegal – again, something I’ve witnessed first-hand. But who’s going to argue? The patient? The risk you take with such psychiatrists is that you then face a situation where, should the system haul you in again, you could be detained in a worse hospital, with even fewer safeguards. Better to take ‘your’ meds, drop all objections and be on your way, however wrong and detrimental to reform you know this process to be.

From here, then, medication’s usually administered, medication with no track record of substantial long-term success, as it merely dopes people up to suppress them and fails to address the environmental issues and strategies to deal with them that led to the problems in the first place. A realistic approach to all this can lead people to adopting better thinking and coping strategies that are more realistic and stand a better chance of success because you’re dealing with the real world, not the suppression of it which, with meds, always risks being maintained or, at best, submerged for a time. Many people who do figure out that something isn’t quite right with the whole thing come off meds but lack the understanding to address the real issues. It’s not unusual that they’ve become so persuaded deep down by the dominant view of mental health that they can soon find themselves faced with the unresolved issues yet again (which can become ever worse the more the system’s seen as a convenient way by some people to deal with interpersonal issues) and then in the system once more, bottom of the heap, defeated and demoralised.

So, my experience of the system, as I’ve written, began in 2000. Despite having to be released because the original team who came to detain me had made too many ‘mistakes’ and didn’t want this and other more important inconsistencies exposed to a tribunal at the time, I was eventually, and willingly, medicated on the basis of third-party statements I knew to be hogwash, but with a concerted effort to impose them. When I say ‘willingly’, though, it was because I thought that if I took medication, the approach to information and communication would change, but it didn’t. It remained archaic. I was put on quite a high dose of anti-psychotics (Olanzapine, at that time the latest ‘wonder’ treatment), which doped me up, made me obese, depressed and with very bizarre thoughts which, along with the evident pointlessness of the approach to what had gone on plus the fact that I was not in sufficient control of my own thinking, meant that me withdrawing from them was almost inevitable.

In retrospect, had the approach changed and I’d not been given medication, the situation could have been resolved quickly and I’d not have needed the care system again. However, the psychiatrist I assigned to at the time had made up his mind that there was information that I couldn’t have access to because he (mistakenly) thought I couldn’t handle it.  Meds followed. Then my withdrawal gave me more complications than even being on the meds had given. In the years to come, I went so far and so deep at times that it’s a wonder to me even now that I ever pulled out of most of it. The first time was the worst, though. So extreme were the thoughts and ideas I had that the shock of it all took about 7 years for me to even begin to recover from properly. That shock, along with consequentially repeated admissions, treatments and ‘non-compliance’, would send me on a cycle as a decontextualised ‘revolving-door patient’ that pushed me further into the transformation of my personality, mind and environment that the initial shock had brought about.

It was only through properly understanding the context of mental health, my personal history and my environment that I started to regain anything like what I’d lost. It’s only been through realising the faults of psychiatry, those in my environment and my adaptation, plus potential solutions to it all that I’ve regained anything like my former way of thinking, being and relating to the world. It’s entirely at odds with psychiatry’s current approach, but I’m cool with that because, however popular mainstream ideas about psychiatry are, they’re misguided and there’s a bulk of solid evidence to back that up. This way is realistic because it’s based on how things are which has led to an approach of partial acceptance of some things I can’t change, along with strategies to address how other things can and need to be. It never did need medication, it just needed an imaginative and intelligent approach that psychiatry just didn’t do. I knew there was a better, more modern way back in 2000. I do even more so, now.

My situation now is that I have a diagnosis – one of the big ones – that I’m just not buying, not only because I don’t believe in the diagnostic process, but it doesn’t even add up according to psychiatry’s own standards, so mangled has the process been. My psychiatrist once said to me ‘You don’t believe you’ve got a mental illness.’ I kept quiet, but when I was younger I’d have just told him the truth: ‘I don’t believe in mental illness as you see it’. Easy. I’m still on meds, but mood stabilizers, with a view to coming off them eventually, even though it’s tough once those chemicals are in your system and despite the fact that I don’t know how I’m going to get my psychiatrist to buy that one. He’s not a bad fella and I’m trying to work with him on a strategy that should work, even while he abides by one that never has. To be fair, he does let me try to do things my way, but it’s ultimately an empty gesture: he’s insistent that there’s only one way (his) and, even though he never says much of consequence to my face, I’ve become something of an expert in finding out what he thinks from the very third parties he uses to try to find things out about me, the knowledge of which suggests he’s humouring me until it all goes wrong and he can implement his strategy, despite a long record of failure. His biggest problem with me is that his way is based on medical records that are about as accurate as my CV needs to be and, as should be obvious by now, there’s nothing whatsoever I can do about that. He’s locked in with that Crucible logic and he isn’t getting out, not without significant reform. Meanwhile, when I’m not in the middle of another reduction in ‘my’ meds – it’s a drawn out, occasionally bumpy, but often steady ride – life ticks along quite nicely, as it should.

The psychiatric system’s a mess, only some of which I’ve pointed to here. Not all psychiatrists are the same and some are good at what they do, but the system itself is wrong, so even the good ones can’t do much. It’s the same with many of the treatments on offer and the general ideas about mental health, adaptive strategies and the environment. That most of us tolerate this mess is because most of us know little better. Often we’ve been persuaded by the media, with false information and bad thinking, not least of horror stories which seem to have no alternative. But all this isn’t only the media’s fault. Most of us are at it, even most sufferers. The very system of psychiatry, as it tends to work, is a stigmatising system itself, with problematic and detrimental ideas about normality and difference that are rooted deep in our culture, now. The tragedy here, then, is that most people within it are fighting to improve and spread the understanding of ideas that will only ever result in discrimination, but they’ll just keep doing it until they start learning how and why most of them are misguided, while those who do know better – those who are speaking and writing about the realities of all this – need to improve their communication of the shortfalls of and alternatives to our approaches to mental health with the public, the media and policy makers.

What I’ve seen in my years of being a patient and what I’ve learned while a student and beyond is that our ideas towards mental distress, including diagnoses, incarceration and medication are often doing more harm than good. The fact that so many people in the system buy into it and its limited and mistaken definitions of success, to me, points to nothing more than an indictment of how far off the mark public knowledge is about these issues. A problem with that is that many people, especially sufferers, cling onto these ideas, at times vociferously, despite the conflicting evidence that’s out there if only they’d look. A solution for them is to do this: to actively learn more about the context of mental health as it is, to see how the role of the environment and their strategies towards it have affected their lives, and where they really fit in that environment. This is a good, first step to fighting for something better for the individual and the wider society, a part of which is the discrimination that’s all too real in the lives of the majority of mentally distressed people, whether they can see it yet or not.