Archive for May, 2011

Get Out of Gaol Free

May 30, 2011

I do not think that a diagnosis of mental illness that absolves you of all responsibility for your own actions, it does not give you a get out of gaol free card or carte blanche to behave exactly as you wish for the rest of your life.  I have known people who, while they are genuinely mentally ill, consciously use their condition as an excuse for unpleasant, or even violent behaviour.  And their conduct is never questioned.  Not by the nurses who treat them every day, not by the consultant psychiatrist who sees them in ward round, not by the social worker who drops by every once in a while.  They are given tacit permission to act with impunity by people who should know better.  In the long term it does them no favours.  Mad versus bad is a tabloid generated false dichotomy.  They are not mutually exclusive.  It is possible to be both.  The only people  who notice what these individuals are really like are other patients who are abused and intimidated by them and the health care assistants who spend more time watching them than other members of the hospital staff.

The Worst Possible Outcome?

May 29, 2011

So my mother now officially has a schizophrenic daughter.  Some view this diagnosis as a death sentence : ie, your life is a living death until you succumb to your own despair and end it all. I am not that brave and my inner Catholic does not wish to relinquish her immortal soul.  Besides there is no way to commit suicide without causing grievous harm to those around me.  And my inner Catholic claims that I am here for a purpose.  ‘You may feel as though you don’t belong but the fact is that you are here and however you got here you must make the most of it.’. My inner Catholic is a sensible old soul.  She, unlike many nuns, wears the full regalia: habit and veil, her hair is never uncovered in public.  I guess its easy to follow the rules to the letter if you are an imaginary nun existing in someone else’s head and don’t have to bother with practicalities like the weather. Even making a vow of poverty is easy for her because she is imaginary and thus does not need to eat. 

Remember this: The darkest night always surrenders to the Dawn.

Are all mentalists also untermenschen?

Child Abuse is Not Confined to the Untermenschen

May 29, 2011

It is said that child abuse occurs mainly among the lower socioeconomic groups in society. This makes me think of Sue B. a 23 year old university student. She was charismatic and admired by everyone. She sparkled. She was an outstanding conversationalist. I think of her soft pink features and blond hair. She resembled a porcelain doll. We were both on the same ward and we were both bulimic. We bonded over a binge. She confided in one of the groups that she had been sexually abused by her grandfather. She came from a well-to-do family of academics. She had been diagnosed with bipolar affective disorder but, as far as I am aware, her abuse was never addressed.

After six months in hospital I returned home for the rest of the academic year. Sue B. and I exchanged addressed (this was the mid ‘90s when people wrote these paper things called ’letters.’ but we never wrote to one another and I never saw her again. I found out after I had graduated that she had hanged herself in the bathroom of the local psychiatric hospital (my alma mater too) when she was supposed to be on ‘five minute obs’ . So I know that abuse can occur in middle class families. And that when they confide in the authorities they may be the people who are least likely to be believed.

Having said that there are those who cast their net too wide and increase the definition of the word ‘abuse’ to such an extent that it becomes invalid. It is possible to ‘over identify’ abuse. But I shall deal with that on another occasion.

What Are We Supposed to Make of This:

May 8, 2011

An extract from the recently published memoirs of Dr. Anthony Daniels who was, for a couple of decades, a consultant psychiatrist at a large Birmingham hospital, which he claims was located in the midst of a ‘slum’ and catered solely for ‘slum dwellers’. I wonder how many of his colleagues suspected that he was simultaneously waging a long and bloody secret war against his ‘underclass’ patients in a charming little right-of-centre publication called The Spectator under the nom de guerre Theodore Dalrymple (taken from a PG Wodehouse short story). The book is entitled ‘Fool or Physician: the Memoirs of a Skeptical Doctor’. I’ll leave you to make up your own mind about that one.

‘I began to wonder, as I saw a crop of self poisoners every day, whether a hefty fine would not be more appropriate than empathy and false promises of help to come. This was certainly the view of the casualty department staff, who washed out the stomachs of the overdosers not so much for medical reasons, but in the vindictive hope that so unpleasant a procedure would discourage them from repeating their action (it was a vain hope). Once a young girl, well-known to the hospital for her repeated overdoses, swallowed the contents of a bottle of mild analgesic, which she assumed was harmless because it was so widely available without prescription. But she had miscalculated, blood tests showed that she had irreparably damaged her liver. It was not without a certain exultation that she was informed of her unavoidable and imminent death (she was still conscious).’


‘What sweet revenge it was on all the patients who had tormented staff by taking overdoses.’

And then:

‘Patients often held the threat of suicide over us like the sword of Damocles. I was once called to see a girl of twenty who was in psychotherapy with a social worker. The latter was at the end of her tether because the patient, who slashed her wrists regularly, was at the window threatening to jump out unless the social worker devoted even more time to her. I pointed out to the patient that as the window was not very high up she might only break her ankle. (…..). Why not go to a window a couple of storeys higher up? Or better still, find another building to jump off, a small favour to ask.’

Interesting technique. I wonder if he used it on any of his other parasuicidal patients and whether it ever actually worked.

Make of it what you will.

– Posted using BlogPress from my iPad

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