As a voice-hearer of 30 years – and 27 years as a user/survivor of psychiatry – I could say, like Stephen Fry did this week, that ‘psychiatry saved me’. But I could also say that it failed me miserably. After five months in a psychiatric unit 27 years ago in Ireland I was very physically debilitated; that was after receiving I don’t know how many bouts of electroconvulsive therapy and drugs like chlorpromazine and haloperidol. The initial phase of my treatment- five months inpatient -was a deathlike experience. I am still harrowed by those ‘treatments’. Yes they stopped the voices and visions – which were a comfortable place to be to me, and a ‘coping mechanism’ as R.D. Laing – the famous Scottish psychiatrist, said, but in which I was sometimes wretched and overall very vulnerable.
The ‘S word’
I don’t like the ‘s-word, as I call it – or ‘schizophrenia’: a phrase which was coined in the early 19th century by Max Bleuler a physician, a term that is sometimes used pejoratively against us and which I find stigmatic to the extent of it physically hurting my head. The fact is that the neoliberal or hyper-capitalistic society we live in puts psychiatric labels & diagnoses – remember that all or most of these terms were recently invented, on the basis of voting, by nine middle-class North American psychiatrists ‘DSM-III’. These so-called diagnoses are not based on any sound science – and place the crude implements that are psychiatric drugs, in an elevated position that have become part of a ‘celebrity’ discourse which presents only one side of the story.
It should be noted that Fry was was speaking as part of his support for a campaign in the UK, run by the Royal College of Psychiatrists. There is no denying the power of the PR machine around psychiatry, which helps it to maintain its powerful status, even when the World Health Organisation and the United Nations human rights office have both called for a radical new approach that means psychiatry isn’t in charge anymore.
I’m not denying psychiatric medication doesn’t help – in my case I needed something, but psychiatric drugs are also severely debilitating and are known to take c. 20 years off our lives. Nobody is advising how to make up for this i.e. that we need vitamin and mineral exercise, healthy eating and decent psychotherapeutic assistance to combat some of the deeply unpleasant side-effects. The Fry article trumpets the wonders of 21st century psychiatry, but presents a one-sided argument and is for want of a better phrase ‘psych-washing’ – or perhaps brain washing. Stephen Fry is a much-loved TV celebrity and writer but one who comes with the privilege of Cambridge University Footlights.
Maybe more psychiatrists are needed but their current approach in seeing all human distress through a biomedical lens does not present a comprehensive view of human health and is often also dangerous and damaging. The fact is, although rates per capita of prescribing populations with psychiatric drugs have shot up exponentially, outcomes have worsened dramatically, especially for those of us from impoverished socioeconomic backgrounds.
Harmful aspects of ‘treatment’
My voices came back within three years of my experience in the psych hospital and I still take one type of neuroleptic ( antipsychotic). I was ten to fifteen years in recovery from my hospitalisation and still have to cope with significant cognitive impairment, short and long term anterograde and retrograde amnesia – I have difficulty forming memories and also remembering past times in my life – dysfunctions of sexuality, heart palpitations etc. Psychiatric drugs are not pleasant. Yes, they may help us to some extent especially in the short term, but they do not come without taking a significant toll on our physical and social health. Why are these points not also being trumpeted by purveyors of the mainstream narrative? Maybe voices like Fry’s help to break down the stigma of seeking help, but on the flip side they are not representative of those of us who struggle to have our voices heard – even within the services we access. More than ever though we do need to hear people’s voices, and not those that are co-opted by services. We need to harness real ‘mad knowledge’ in order to have meaningful and balanced debates about mental health treatment. Despite the rhetoric of ‘social inclusion’ and ‘co-production’, service users/survivors/mad people continue to be viewed as non-credible sources in relation to their own experiences. This is a form of epistemic injustice that renders us powerless within the systems that are meant to support us. Stories and experiences like mine deserve to be heard, taken seriously and acted upon. That’s what psychiatry can do to help ‘save’ people like me.
Owen Ó Tuama is speaking at this year’s Critical Voices Network Ireland conference (taking place Nov 16 and 15) about the importance of listening to and learning from ‘mad knowledge’. Register for online or in person attendance here.