This post is, in part, a response to an excellent article in Asylum magazine in which Akiko Hart expresses some concerns about the nature of the discourse in “mental health”, and makes a call for less concern with being right and more concern for offering vulnerable people who struggle more choice.
You can read Akiko Hart’s article here:
I’m with you Akiko.
The way out of this mess is not going to be more of the same: fighting about who’s right and who’s wrong. All that does is dig a deeper hole.
It might just be that we can find a way out by offering options and choice – real choice – and then letting people exercise their right to choose whatever works for them.
Simply replacing one single story – “that your struggle is caused by a chemical imbalance and that needs to be fixed with drugs” – with another: ” Trauma, innit?” is not much help – and is for some itself traumatising and disempowering.
Especially when the currently held notion of trauma is limited to a narrow single story orthodoxy that was generated to satisfy the needs of a triumvirate of powerful institutions namely, the US Military, the US Veterans’ Association and the American Psychiatric Association especially it’s DSM-III task force headed by Elliot Spitzer that designed and bestowed upon us the new diagnostic disorder.
That single story – that orthodoxy – is harmful too.
Trauma is not a list of horrible, bad things that happened to us – it is the pain we live with now. Trauma does not mean “bad things done to me by evil people”. “Trauma” means “wound”.
It is also entirely possible that we could look at the DSM as chock full with descriptions – about three hundred-or-so ways that trauma or as I nind more useful: “woundedness” can be observed to manifest in humans. I don’t see why we need that many, but there you go.
A diagnosis is a [partial] story too
A “diagnosis” is also a story -usually a pretty thin story and, for sure, incomplete.
The first part of a diagnosis is some description of some observable pattern of noticeable “symptoms”. At least since DSM III, this has been designed to obviate need for clinical judgement so be observable by pretty much anyone in a couple of minutes, meaning they are necessarily superficial. They are also for the most part, basically made up on the back of a golf scorecard and then voted for round a table: that is often the “evidence” they’re based in so they don’t really amount to anything much that has any solid claim to be scientific if that’s important to you.
What it’s worth is what it means to you
A diagnosis is supposed to be useful. The test is whether a diagnosis [or more] means something to you, as a description, a partial story [if you like] of what you experience, and if that helps you find your way to live your life then t can be useful. And only you get to decide if it is useful to you.
And it is possible to find common ground here.
This pattern of struggle can be read as manifestation of a person living with pain and struggle struggle.
What of those who believe in a lie ?
It woudln’t be the first time politicians large corporations- institutions of state including “independently regulated institutions have lied to us, or have have colluded to lie to us- it kinda is what they kinda do.
The “lie” part – not so secretly embedded within most psychiatric diagnoses – is with regard to the why- why you struggle – that “single story” referred to by Akiko in her article – because there’s something wrong with YOU.
Typically that’s embellished with a tale that you have a chemical imbalance and therefore you need chemicals- drugs – to fix what’s wrong with you and you need take them for the rest of your life.
That is some pretty big-time telling of big porkies.
And that’s why you’ll find hardly any doc saying it in a way they believe it but instead say it something like my doc did “they say…”
It’s one of those things where no one takes responsibility for saying it but is happy to report how “they” say it…
Part of why they do this is that for many years they’ve been at serious risk of being sued for malpractice if they don’t.
On the other hand, another is that it takes longer to give a fuller explanation that empowers people to make their choices- but not that much longer.
Its not about drugs
Like anything else a psychiatric drug will “work” somewhat some of the time for some people.
Not there a “work” is whatever effect you happen to be looking for. Whether or not you find a particular drug helpful to you is down to you to decide- because only you know what its like living in your body, inside your life.
We’ve made it all about drugs.
We need to make it about people.
Lies, lies, lies
As for what it means for an individual person that they believed an elaborately constructed lie, seriously where have you been?
We live in an age of high on its own mendacity, in which pulling-the-wool over people’s eyes is celebrated and rewarded almost as much as the ability to strike a ball. We’re at the point where politicians no longer even pretend that they’re not lying, and instead constantly push boundaries of what is the biggest lie they can tell today.
If you have never believed a lie then you are alone.
Human history is a story: of people telling and believing-in lies.
It’s hardly a new thing.
And if you have ever believed in a lie then you are not alone.
I doubt though if there is a person alive who does not believe now in some story they intuit or well know to be untrue.
What any of us believe is always our personal choice – and no one else has any right to tell us they know better about what we do with our own body.
Each of us has that right to choose. And if we want to retain our own right we honor the right of others to make their choice too.
Shot by both sides…
I really don’t know who or what is served by the locked-in-false-certitude nature of the discourse with each side seeking to dominate, have its single story be yhe one accepted as ”The Truth”, The One Truth, and the only truth.
If we strip away whatever content there is in each side’s argument and focus on the dynamic of how the arguments are made, then they look and sound much the same. There is a horrible, moralising, holier-than-thou ugliness to it all.
It is tiring being yelled at by both sides. It is tiresome that there is more yelling than listening.
And it is suffocating us all by sucking the air from the room.
And whom it ill-serves the most are those who are already hurting and those diagnosed, de-humanized and discarded by our society and left to deal with their pain alone.
Stuck in suckingness
For me it is this very attitude that underlies the stuck-in-suckingness that we’re in and have been in now for decades – and it is the exact same attitude displayed on both sides of the divide.
“I’m right you’re wrong and you have no right to speak.”
I would -only half-jokingly – like to propose that the two sides got suited up in giant Sumo-wrester suits and bounced each other right off the mat so we can get on with co-creating a better world together without them.
I’m right there alongside Akiko Hart, I want people to be offered choice: more choice and real choice- and that necessarily includes real information that allows and enables them to make their choices.
Part of providing real information includes making personal choice to not repeat lies- and that means for every person who works in MH and social services. What is sad is that it is too often too rare.
I know it’s possible because I’ve seen I’ve it and seen its effect – I was offered just this when I needed it most.
Your opposable brain…
We humans are blessed with having opposable thumbs so we can hold a coffee cup but also other less advisable activities like texting while driving.
We are also blessed with opposable brains – it is entirely possible for us at one and the same both time challenge and hold to account those powerful institutions and individuals members of those institutions for using their power to lie to us and cover up lies made to vulnerable people – and also at the same time – allow individuals to believe whatever they choose with regards what works for them and do what they choose with their bodies and their lives.
That is their right – and it happens to be the same right that you enjoy too.
It is entirely possible that we can do both,
and it is entirely necessary that we do do both.
Go on, you can do it, give it a try. Today
Your opposable brain is waiting for you to let go of needing to be right and the different future that can emerge if you do is waiting for you too.
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