“Rigidly evidence-based psychiatric/psychological mental help or liberation”?
May 28, 2015: Edited
As I see it, psychiatric knowledge is based on a belief system, and I cannot accept it as “reality” or “truth” or “science”. And if people are comfortable with a psychdiagnosis, I respect that and have no need to try to change their minds. Neither do I reject the use of drugs. In “Models of drug action“, Joanna Moncrieff makes sense:
The drug-centred model focuses our attention on the impact that drugs have on the body and the brain, and on all the possible consequences that drug-induced alterations can have on how people think, feel and behave. It is a necessary starting point for the sensible, cautious and safe use of drugs in mental health services.
“If we ever want to be seen as truly equal with other branches of medicine, we should start valuing and empowering the choices of our patients as highly as they do.”
“We don’t know what, but bad things happened to Granny when she was young, and she shut them away because they were too scary to deal with alone, and there was no one to look at them with her.
«Because of these shut-off memories, she can’t remember what it is like to be a child, which makes her act weirdly around children.
«And the hidden memories build up a lot of pressure, and sometimes the lid bursts open and so much gunk comes exploding out at once that she gets lost in a frightening nightmare world.”
Dr C insisted that I had not been sexually used as a child, I needed to accept the “reality” that I had has a sexual relationship.
When I asked how an incest victim could have a sexual relationship, he said that words were my strongest muscle, so I had to set them aside in order to be helped by him.
And he gave me a choice: “Realize that I am right, or complain and be told that I’m right.”
When I left, he wrote: “Her verbality often served to obscure problems, and she fully demonstrated omnipotent control, where she tries to control the therapist and use that as a defense against looking more closely at her own problems.”
And he began to teach the GP how to defend himself against my omnipotent control and obscuring verbality. There is a marked change in my medical files after this: Much of what I said is misunderstood or distorted.
I should of course have left in my first meeting with Dr C, when he began to insist that his story of my life was reality. I didn’t. In two more meetings I tried to answer an unanswerable question: “What do you want me to do for you?”
Before the third meeting, I brought with me a written answer in order to avoid Parallel Monologues:
I have to separate “What do you want me to do for you?” into three questions before I can answer:
What do I want to do for me? I want to give me who I am.
What do I want you to do for me?
- Show me that I can trust you.
- Listen creatively, maybe show me new doors that I can open in the direction I am going.
- Help me win over my fear of violations by expecting respect and giving respect.
- Never tell me that I am going in the wrong direction; I need you to trust that my direction is right for me.
- Give me lots of room to grow and let me build on a base of my own strength.
- Never try to force or manipulate me into anything.
- Do not violate my right, when I need it, to be miserable with dignity, to be helpless and pathetic with dignity.
But I cannot program you into giving me what I need. Neither can you. You are not a flawless healer robot, you are a human being who works as a therapist. Therefore the third part of the question is yours:
What CAN you give me? That part is yours, and only yours.
I took this along to my second meeting with Dr C:
I am living in Chaos right now. I have anxiety, headaches, insomnia; loose bits of my life whirl threateningly around me. I want to hide in the old defenses: Sort, understand, pull myself together, lose myself in work, put a thick layer of calories over what I do not want to think about.
I know that this will pass. Chaos is now a familiar landscape, and I am not afraid of dying in here, as I used to be. I know that the best thing to do, is to accept it.
Do we all have chaos in us?
Is it natural to fear chaos in others if we are scared of our own inner chaos?
I started life as a parenting object of my mother and father … who had their own stuff to deal with.
Then I became a sex object of a Catholic priest, who also had stuff to deal with. And I dreamed of growing up so that I could protect my “no”.
As an adult I became a “borderliner” in the health services without knowing it. And lost the right to say “no” again. I was an object of well-meaning, correct and legal psychiatry, an omnipotently controlling, projecting, delusional and chaotic … balrog?
I asked a psychologist for help to unravel the mess I was in, and after a year of therapy I was suicidal, hallucinating, hearing voices and very, very confused.
And I planned to kill myself. Every day. In secret. Hiding how I felt had been a survival strategy in my childhood, and that helped me now.
But certain criteria had to be met:
- It had to look like an accident. I wanted to liberate my family and friends from me, not burden them with guilt.
- And I had to make sure that I died immediately. I couldn’t risk surviving with permanent injuries that would burden others.
- And it shouldn’t hurt. Not much. And I did not smile at this thought.
I don’t remember much from this time, only that the parts of me that wanted to live became more and more concerned when I drove on the steep, winding roads where I live. And, one evening when I was alone, I got in touch with the part of me that wanted me dead. And I let her communicate. And promised not to stop her, not to sensor, just let her say all she had to say.
She began to write. Grunge. Detailed, poisonous grunge about me, about how evil, useless and stupid I was. Ugly, power-mad, fat, wrong, illogical, manipulating, wrong, wrong, stupid, wrong, too dumb to realize that I had no social skills and should not be allowed to interact with people, I should never have been born, I was an affront to all right-thinking people in the world … and as I wrote, my writing became larger, sharper, and the pencil stabbed the paper like a knife in flesh.
And I began to recognize voices. Moods. Shades of people, some of the words. Critic wrote corroding concentrates of feedback others had given me. About me being wrong. And if I could just stop being wrong, everything would be OK, but as I couldn’t, the world should not be burdened with me.
She had communicated and strengthened signals from my surroundings, so that I could try to avoid doing what people I needed did not like. And I explained that her help had been crucial then, but my life was different now. I was not helpless, not in the way I had been then.
And Critic heaved an enormous sigh of relief and took a vacation.
In my next meeting with the psychologist, I was able to be in the situation for the first time in months, and after a while I asked: “Are you trying to manipulate me into realizing that I’m paranoid?”
And I insisted on a straight answer. And got “yes”. And a copy of the letter that GP had sent to him … warning him about my delusions and all my other wrongnesses.
My first reaction to this letter was relief: “I’m not being paranoid, they really do think I’m crazy!”
When I finally stopped trying to clear up misunderstandings in the health services and sent a complaint to the oversight board, the board did not reply to a person, but to a delusional, controlling and chaotic borderliner: my complaint was “meaningless” because psychotherapy is clearly voluntary, and I had transference reactions, so I did not have opinions. A scanned version of the Norwegian document is here:
A lawyer said that I had one option left: I could find a psychiatrist with more authority who was willing to contradict Dr C in court. I only wanted to disagree, I had been rejecting polarization for years, so this was not an option. And because I work freelance and didn’t need sick leave, it was possible to avoid the health services and concentrate on liberating myself from psychiatric harm.
One important element in this process has been to look for and take responsibility for mistakes I made before and after being borderlined. I have collected my experiences in Communication 101.
And there were three things that caused problems that I would do again:
- Trust that my direction was right for me.
- Evaluate authority
- Treat mental helpers as my equals, instead of looking up at them.
My road has been longer and thornier and much more tangled than it would have been if my choice – to give me who I am – had been seen by the health services as an autonomous, reasonable decision.
In 1988 I wanted “to give me who I am”. It has been a long journey in the direction I chose, millimeter by millimeter. Often uncomfortable and painful, but it belongs to me.