This Week in Mentalists (62)

Yes, yes I know, I haven’t got TWIM done until the evening. This is what happens when The Shrink doesn’t shout at me enough. (Where is he, anyway? I know he’s started blogging again. Shrink, get back in our comment threads.)

Anyway, on with This Week in Mentalists.

Marine Snow reflects on psychotherapy.

It could be said that it is only recently that I have begun to understand why I was in therapy, and what it was I was trying to achieve. The mistake I made on starting therapy is that I had a particular goal in mind, the treatment was focused on one particular outcome: ie become less eating disordered. Or at least in my rather shortsighted therapy-virgin state, that was what I had set out to achieve from the process. What this set me up to believe was not really what I gained from it. Therapy skills are life long, and the change is in attitude and outlook, rather than behaviour. The behaviour only begins to change after you have begun to see things a bit differently, or at least until as Tiptoe said recently “you can Fake it till you make it”

Made With Awesome is struggling with CBT.

One thing I did know at that time was that when mental health care professionals tried to talk me out of those negative beliefs about myself, they tried to convince me to replace them with beliefs that were overly positive. I was unsure whether, wrong or not, I wanted to revise those negative beliefs because, even if they were wrong, they did serve a purpose for me. However, I was certain that if I were to trade my negative beliefs for something more positive, that I was absolutely not willing to believe anything more positive than accurate. Even if I had been willing to believe something more positive than accurate, I think it was a little much to expect that I would be able or willing to jump all at once from overly negative beliefs to overly positive beliefs.

Action Replay condemns psychiatric malpractice.

I tell her about the shit I had dished out to me at Big Dublin Hospital, and the shit that various friends around the UK have been given from their mental health services when they sought help. She says, that’s malpractice, that person shouldn’t be working there.

My point is, that doesn’t matter. Because it’s obvious that my experience is not unusual, it is more the norm, and good, well-run mental health services like Edinburgh’s are the exception. It doesn’t matter if something constitutes malpractice if the practitioner in question is allowed to perpetrate it with impunity over and over. Incompetent, wrong-headed or just plain nasty treatment seems to be the NORM in the UK for mental health, and I just get fucking fed up with it being explained away as one crap medic or nurse here or there. There are just too damn many of them.

And it’s because either the rest of medicine doesn’t consider mental health patients to be important enough to deserve competent medics, and dumps the craps doctors in psych as a result, or even that the NHS itself does not consider us mentalists to be people who deserve a proper service, or even, jesus christ, to be treated like human beings who have feelings and might be in distress. How hard is it to explain that one should not shout at, humiliate, refuse to listen to or otherwise intimidate patients? Jesus.

Laurie Penny at the Liberal Conspiracy group blog imagines a world where mental illness is not stigmatised.

Fifty years ago, the idea of having ramps on public transport, in offices and public buildings in order to help the physically disabled participate in normal life would have sounded preposterous and wildly costly – now it is more or less accepted that the physically disabled have just as much drive to work and live as the rest of us, and should be aided in that goal. The same attitude needs to be applied across the board.

It would be a world in which flexible and part-time working is not only available but a respected and well-taken up practice required of all employers, in order to help the mentally disabled, the physically incapacitated and those with caring duties, including parents, to stay in appropriate work. It would be a world in which part-time work is supported by government benefits, allowing the hundreds of thousands of people with mental health difficulties who cannot cope with full-time work to participate more fully in the economic and cultural life of the nation.

It would be a world in which the many laudable grants, higher education places, work schemes and training projects set aside specifically for the physically disabled and other minorities are matched by similar schemes for the mentally and emotionally disadvantaged.

This is about socialism, but it isn’t just about socialism. It’s about creating a world that is fairer and more efficient, carrying every citizen with it. If the government really wants to leave no one behind – if it wants to move more of the mentally ill into rewarding, taxpaying work, rather than simply pare more fat from the already scrawny welfare state – we need to dare to dream of a society in which everyone can participate.

Fighting Monsters reviews an autobiographical account of mental illness.

She rails against the situation that she is forced into as a patient

There was so much you weren’t allowed to do. There was little exercise – we were taken up to the roof for 15 minutes a day – no smoking and a no-touching rule between patients. A necessary rule, in some ways, in a world where people had few boundaries, but to deprive desperate human beings of the healing comfort of a hand on the shoulder or a kindly hug was, at times, just another reason the place made you feel less than human.

Definitely food for thought but everything has a layered value and risk and hospital is and really should be a place for the people who are most acutely unwell that care cannot possibly be provided by any other means.

I am somewhat sympathetic to Vincent’s view and experiences. It is something I think about a lot when determining the need for someone to be detained on a compulsory section in hospital.

Mentally Interesting: The Secret Life of a Manic Depressive reflects on self-harm scars.

That’s the problem with self harm, though. You’re left with the scars. I think that, after a year, they should magically lift from your skin, like some sort of great crotchetted bird, and fly away. Instead the realisation dawns on you that you’re going to get married (or in my case, probably not), write your first book, have a child and die with these scars on your body. They tell the world that something’s wrong with you, that you’re “crazy” (who wants to be friends with the crazy person? Who trusts the crazy person with their children, or their secrets?) and people shrink away. I have seen that flicker of fear, disgust and pity in peoples’ eyes when I’ve raised my hand to my face and my sleeve has slipped down my wrist. It makes me cringe every time, because I’m not crazy. I am genuinely Scarred For Life. And it’s crap. And I did it to myself.

Schizophrenia – A Carer’s Journal receives a phone call from the ward.

Jane tried to phone back a little later when she thought there had been time for things to settle but there was no reply.

Later still she got a call from the ward. Sam had been taken to a quiet room and held gently just so he wouldn’t hurt himself. There was no “pinning down” and injecting as had happened so often on the previous ward. There was no judgementalism over him and what he had done. He is ill and they want to help him. The nurse spoke kindly to Jane recognising that she too would be distressed. They seem to have handled a difficult situation well with some skill.