These are my thoughts from a diary I was writing during my mental distress. The diary extract deals with my experiences of being labelled, and of how psychiatric services, driven by a narrow clinical perspective, sought to label me as a set of symptoms (treatable only through drugs) which were divorced from the social reasons for my mental distress.
Raza Griffiths
2.12pm, 25 April 1997
I am going to have to start getting into the habit of actually finishing each chapter of my diary before going on to a new one, otherwise it will end up a mess. But then again maybe my life is like that. I had my appointment with Dr. O’Brien at 10.30 this morning and coming out of it I was on the verge of tears.
She was wearing her white lab coat as usual. She asked me how I had been, so I told her about my diary. There was a lot in it about homophobia. She wanted me to continue with the medication and asked why I hadn’t attended my last appointment some weeks previously. I didn’t like taking medication because I understood the effect it was having on me, which was to distance myself from the emotional turmoil I was in. But I felt that I couldn’t get better like this because drugs did not destroy those feelings, they just suppressed them. I thought of using the term ‘chemical straightjacket’ but I didn’t want to appear too dogmatic because neither did she. I knew I had probably needed medication during the manic episode, but I didn’t want to keep taking it in the long run. In hospital, the medication had made me feel all the air was being sucked out of my lungs and I had felt I was dying, so I had tried to get my head through the bars over the ward windows to try and breathe some air, but I couldn’t. They had come eventually – it was in the middle of the night - and sedated me, but not before I had bruise marks on my head and temples from hitting my head against the bars.
“We don’t want you to go manic again” she said. But neither did I.
I asked her what kind of words she preferred - nouns, verbs, adjectives or adverbs. I probably asked this because I was meant to be writing my PhD in linguistics at this time, and linguistic ideas kept creeping into my consciousness at the strangest of moments. She said nouns. I had thought she would. Because nouns label things, they make things concrete and rigidly defined - a stone is always a stone, a desk is always unquestionably a desk, just like the label bi-polar manic depressive that she had given me all those weeks ago. But I preferred verbs because verbs are about process, and a particular point in a process can only be seen and understood in the context of what goes before it, and the process is never stationary and thus things can change in the future. A person is not a noun, a person is a process. “We can have this conversation till the cows come home, but you should really take your medication” she replied. I understood at this point how sadly limiting psychiatry makes its practitioners and it upset me that I lived in a world which did not have the compassion to go beyond nouns to verbs and process, a world limited to keeping people functioning in a socially acceptable way while ignoring (or muffling through drugs) the terrible screams that arose from within. I felt deep sadness, because many people, including myself, had suffered and would continue to suffer because they labelled themselves in terms of a noun and could thus make no headway to make themselves better.
“How would you change things?” She asked me, in terms of my belief that I was a process and not a noun, and I replied, rather weakly, that I had meditated this morning and had found that a great help, I had my friend Ann to turn to, and I would be going to meetings of a gay Asian group from which I would hope to gain some new insights and swap shared experiences.
I think she kind of registered what I was saying but she then started referring to my ‘illness’ again, so I knew that I had made no headway whatsoever. “ If I had had my way, you would have been on lithium from the start, and I think you still should be.”
“I’m not going to take lithium”. I said it quietly, but very definitely. It was an unmistakeable “no”. No way.
“I don’t want to get into the position where I have to bully you into taking your medication”. And she smiled as she said this.
I picked her up on her choice of the word ‘bully’. I did not think it was a very good word. I was genuinely shocked because this person, who I had grown to quite like despite our different opinions, was now trying to blackmail me, to use her socially superior position, with all the weight of the law behind it - and that included everything up to and including physical straightjacketing and solitary confinement - to frighten me out of the insights that I had achieved with so much pain, in order to cow me into agreeing with her.
Anyway, Dr. O’Brien thought about what she had said and substituted the word ‘bully’ with another word but by that time the damage had been done. Maybe she thought I was too stupid or insensitive to register the full meaning of ‘bully’. Maybe she did not understand that it upset me. Maybe she did not realise that I was in a nightmarish quagmire of my own helplessness and powerlessness and that I was struggling to get out, albeit unsuccessfully. Maybe she did not realise that by using the word ‘bully’, she was pushing me further in. Maybe she did not realise that what I needed was gentle and persistent, compassionate encouragement rather than threats - I had been bullied at school and always felt the odd person out and I do not recall it ever having done me any good. But these are all just my own thoughts. Maybe what she really wanted was for me to be quiet and open my mouth, so that she could shove the pills down my throat, so as to blank out the thoughts that were so troubling me and causing me to question everything she said. I suppose she was just doing her job.
Have you got an example of social perspectives in practice that you would like to share. It can be as a service user, carer, practitioner, academic or researcher. It can be a small case study, a simple example or longer research - and it can be published anonymously if you prefer.
Email spn@scie.org.uk or call Raza Griffiths or Vicky Nicholls, Joint SPN Network Co-ordinators, at SPN on 0207 089 6864 to discuss.
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