Issue 9: May 2015 - Young Friends General Meeting

Jonathan Gadsby

22nd July 2015 at 10:15 pm

Dear Friends,
Thank you for your article reporting on your experiences at the Woodbrooke weekend on mental health. I would like to respond by reaffirming your realisation: you are not alone.
I am a mental health nurse, and I have worked in all kinds of places – from acute psychiatric wards and locked ‘forensic’ units to all kinds of community mental health teams. Some of the time I have had a role specifically working with 18 – 25 year olds.
The role of mental health nurse has never been uncontroversial, and some of you may know that the validity of viewing distress as a medical illness has been questioned from many angles. The rise of mental health problems across the globe, but especially in Western countries, has reached such proportions that many people feel that medical psychiatry is failing us. It has never been so contested as now, and there are many changes afoot. For some, there is a turn away from biomedical understandings towards thinking about distress as being something that is linked not so much to the body as to trauma, to inequality, to prejudices and oppression. In other words, away from medical perspectives towards psychological and social explanations. Many people also want to reclaim spiritual ideas as highly significant. The ball is up in the air. We move from one fad (CBT for example) to the next (Mindfulness, for example).
It is a confusing time. Some people feel that the enemy is ‘stigma’ and the key to helping distressed people is by spreading the message that mental health problems are ‘an illness like any other’. Reading your report I felt that this is a way of thinking that you are attracted to. Other people say that such an argument hides the fact that, actually, a lot of mental health problems are not out of the blue, but most frequently happen to people with a history of very difficult experiences to overcome, or else that it hides the fact that for many people life is full of the pressure of expectations which are impossible to meet, or else very difficult social situations, or all three. People with this point of view say that the ‘illness like any other’ story lets abusers and an unequal society off the hook.
You probably know that Quaker William Tuke was famous over 200 years ago for creating an asylum called ‘The Retreat’. You may not know that he and others from that time have been hugely criticised (by Michel Foucault, for example) for making mental health problems seem like moral failings, a question of bad behaviour and poor character and blame (actually, there is reason to think that Tuke was a little kinder than some of his similarly minded contemporaries). The illness story seems to avoid this blame and personal responsibility, but it also makes us seem like our emotions do not have reasons. When we don’t have reasons, or if our reasons are found by others to be of less importance than our ‘biochemistry’ we often end up feeling invalidated and confused, and even if at first it feels like a welcome relief to have a diagnosis (‘finally I know it isn’t all my fault’) later on it can lead to a feeling of being frustratingly stuck, and needing others (doctors, for example) to make things better (and they often seem to be just as stuck).
Why am I writing all this? Because I want to encourage you ask two questions when thinking about mental health. They are two questions which are very dear to many Quakers in one form or another, and I want to let you know that they are as relevant in the world of mental health as anywhere else, be it Trident, the environment, elections and much more. The questions are: ‘What does this story do?’ and, ‘whom does it suit?’
I also want to assure you that the story ‘chemical imbalance’ has no factual basis, and I say this as someone who has a masters in the philosophy of science. Even the American Psychiatric Association recently had to admit it was ‘only ever a metaphor’.
If anyone is interested in doing some more reading, I suggest two texts which at least enter this minefield with plain English:
http://www.bps.org.uk/system/files/Public%20files/rep03_understanding_psychosis.pdf which is a recent publication by the British Psychological Society (and free to view). It is not perfect (no one is) but it is very helpful.
and
Johnstone, L., 2014. A Straight Talking Introduction to Psychiatric Diagnosis. PCCS Books, Manchester.

I wish you the very best on your journey – a journey that many that have travelled before you, and many are travelling with you – trying to understand our emotions and distress, where they come from, how to help, where to look for solutions.

Jonathan Gadsby (Hartshill Meeting)

One Reply to “Issue 9: May 2015”

Jonathan Gadsby
22nd July 2015 at 10:15 pm

Dear Friends,
Thank you for your article reporting on your experiences at the Woodbrooke weekend on mental health. I would like to respond by reaffirming your realisation: you are not alone.
I am a mental health nurse, and I have worked in all kinds of places – from acute psychiatric wards and locked ‘forensic’ units to all kinds of community mental health teams. Some of the time I have had a role specifically working with 18 – 25 year olds.
The role of mental health nurse has never been uncontroversial, and some of you may know that the validity of viewing distress as a medical illness has been questioned from many angles. The rise of mental health problems across the globe, but especially in Western countries, has reached such proportions that many people feel that medical psychiatry is failing us. It has never been so contested as now, and there are many changes afoot. For some, there is a turn away from biomedical understandings towards thinking about distress as being something that is linked not so much to the body as to trauma, to inequality, to prejudices and oppression. In other words, away from medical perspectives towards psychological and social explanations. Many people also want to reclaim spiritual ideas as highly significant. The ball is up in the air. We move from one fad (CBT for example) to the next (Mindfulness, for example).
It is a confusing time. Some people feel that the enemy is ‘stigma’ and the key to helping distressed people is by spreading the message that mental health problems are ‘an illness like any other’. Reading your report I felt that this is a way of thinking that you are attracted to. Other people say that such an argument hides the fact that, actually, a lot of mental health problems are not out of the blue, but most frequently happen to people with a history of very difficult experiences to overcome, or else that it hides the fact that for many people life is full of the pressure of expectations which are impossible to meet, or else very difficult social situations, or all three. People with this point of view say that the ‘illness like any other’ story lets abusers and an unequal society off the hook.
You probably know that Quaker William Tuke was famous over 200 years ago for creating an asylum called ‘The Retreat’. You may not know that he and others from that time have been hugely criticised (by Michel Foucault, for example) for making mental health problems seem like moral failings, a question of bad behaviour and poor character and blame (actually, there is reason to think that Tuke was a little kinder than some of his similarly minded contemporaries). The illness story seems to avoid this blame and personal responsibility, but it also makes us seem like our emotions do not have reasons. When we don’t have reasons, or if our reasons are found by others to be of less importance than our ‘biochemistry’ we often end up feeling invalidated and confused, and even if at first it feels like a welcome relief to have a diagnosis (‘finally I know it isn’t all my fault’) later on it can lead to a feeling of being frustratingly stuck, and needing others (doctors, for example) to make things better (and they often seem to be just as stuck).
Why am I writing all this? Because I want to encourage you ask two questions when thinking about mental health. They are two questions which are very dear to many Quakers in one form or another, and I want to let you know that they are as relevant in the world of mental health as anywhere else, be it Trident, the environment, elections and much more. The questions are: ‘What does this story do?’ and, ‘whom does it suit?’
I also want to assure you that the story ‘chemical imbalance’ has no factual basis, and I say this as someone who has a masters in the philosophy of science. Even the American Psychiatric Association recently had to admit it was ‘only ever a metaphor’.
If anyone is interested in doing some more reading, I suggest two texts which at least enter this minefield with plain English:
http://www.bps.org.uk/system/files/Public%20files/rep03_understanding_psychosis.pdf which is a recent publication by the British Psychological Society (and free to view). It is not perfect (no one is) but it is very helpful.
and
Johnstone, L., 2014. A Straight Talking Introduction to Psychiatric Diagnosis. PCCS Books, Manchester.

I wish you the very best on your journey – a journey that many that have travelled before you, and many are travelling with you – trying to understand our emotions and distress, where they come from, how to help, where to look for solutions.

Jonathan Gadsby (Hartshill Meeting)

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