‘Taking medication involves the risk of accepting something that is less than your full potential’: judgments therapists and mental health activists often express

Father  Stalin
Liberty – Who needs it? 
I strongly distrust  paternalism of any kind and wherever it may come from – be it  biomedical psychiatrists, psychosocial therapists or mental health activists.  Members of all three groups very often behave as if they know best when it comes to ‘the right’ way of dealing with mental distress. Biomedical psychiatrists swear by psychiatric drugs and somatic treatments (including ECT), whereas psychosocial therapists and mental health activists  categorically talk about the need to pursue ‘alternatives’ to medication. In addition, therapists and mental health activists often express judgments along the lines of  ‘Taking medication involves the risk of accepting something that is less than your full potential…’ I mostly consider such judgments rather unhelpful -especially when they are made as blanket statements that seem to ignore the complexity of individuals’ circumstances- and they make me feel blamed…
I am an individual who is taking psychiatric medication (with a view to reduce it and come off it when I can)...but I have also pursued ‘the alternatives’…I have been in therapy for 20 years (11 years in Lacanian  psychoanalysis) and that has really saved my life… and I am also involved in mental health activism through being in the editorial group of Asylum, the magazine for democratic psychiatry… and finally, I am a social scientist doing research in women’s mental health…so, I have tried ‘the alternatives’ and I have worked really hard on  realising my full potential…but I take medication too as it seems to be helping me…
I do not consider myself as “accepting something that is less than my full potential‘ through taking psychiatric  medication  but I feel very ambivalent towards medication as well given my full awareness of  the often very serious and damaging side effects of such medication. I have written about my profound ambivalence towards psychiatric drugs in an article that  I co-authored with another mental health service user and which has been published on the Ragged University website  http://www.ragged-online.com/2013/03/a-journey-light-psychiatric-drug-promotion-marketing-madness-dina-poursanidou-lou-rawcliffe/.
 I strongly distrust  paternalism of any kind and wherever it may come from…
  • reply an.plumb ,

    hi dina

    I think it is important for mental health activists to respect individuals’ use of medication while at the same time challenging psychiatry and trying to pursue alternatives (especially at time of major crisis). Joanna Moncrieff, for example, distinquishes a drugs-based model from a disease base – where the psychoactive aspects of an intervention maybe helpful, if understood in these terms,(although, of course, for many people,a medical explanation is seen as meaningful).
    Unfortunately, however careful we may try to be, in strongly advocating the need for alternative support and exposing aspects of psychiatry and the pharmaceutical industry we are seen as being simply ‘anti-medication’. (We can also find ourselves just as easily dismissed!). But we need the debate.

    The demand for alternatives, like user-led crisis support, has been around for over forty years and has been consistently ignored by the establishment – there are maybe three such crisis serives in England today? It challenging for a mental health activist to get the balance right. A frequent response from the authorities is that people find psychiatric interventions useful and that we are the one’s who lack insight in our ‘illness’. And if we persist may find treatment is given without our consent.

    As with your blog we need to talk amongst ourselves as to how to promote innovation (alternatives) without denying that psychoactive interventions have their place for many people. My own hope is that if our mental health issues were approached differently fewer people would opt for powerful psychiatric drugs (most drugs , psychiatric or otherwise, being toxic to some degree)!

    It was not so different in the 1970s when disabled people were objecting to be forced into residential institutions. This was seen as threatening for people who had come to rely on such support. And while, notably Ken Davis and Maggie Hynes of the Union of the Physically Impaired Against Segregation arranged to move into their own home, few then followed their example. Yet, residential ‘care’ is not assumed today to be THE option for young disabled people (although young disabled people are finding themselves in nursing homes with maainly elderly people when discharged from hospital because there is no suitable housing).

    x anne

    • reply WiseMonkey ,

      Totally agree. I also tend to resist any one-sided perspective on many issues, especially those as huge as mental health. I am not taking psych meds and am against medicalizing every human problem, which seems to be one of the current tendencies in the mental health system. On the other hand, I would never say that no one has to take meds or to get a psychiatric diagnosis. Who am I to invalidate anyone’s experience and who am I to say that I know everything there is to know about mental health or mental illness? At this point of our development, when virtually there is no scientifically valid information available, how can anyone say that they know exactly how things work in our brain (and not only brain) and what works for people and what doesn’t? Since we know so little, there seems to be the whole big variety of human experiences with psych drugs ( or any drugs for that matter). Some people say they helped them greatly, even saved their lives. Others say they almost killed them. There are also those who say that they acknowledge the harmful side effects but still choose to continue to take the drugs because they feel that their overall benefits overweigh the downsides. Some can also be ambivalent about taking them, like the author of this article, and constantly weigh pros and cons while taking them. Everyone’s experience is valid and should be taken into account if we want to understand the big picture. And no one’s experience, in and of itself, represents the whole “truth”. The truth can be discovered slowly and gradually if we humbly accept that this issue is too big and our individual knowledge of it is very limited. Therefore, we can share it with each other as pieces of information that help us to construct the big puzzle together as opposed to fighting each other with the attitude “my knowledge superceeds yours”. When we believe we are the only ones who know how things “should” work, we don’t allow ourselves to study the subject and, therefore, miss a lot of important information. Rigid beliefs don’t give a room for a scientific research. Unfortunately, all the groups who discuss this subject on social media seem to be too rigid in their views to have any mindful and constructive discussion with them. I don’t see the point of continuously asserting and re-asserting one’s beliefs to someone who holds a different view. When people do that, this is a debate, not a discussion, and debates don’t make sense to me, as they don’t change anything. The only way for a discussion to be constructive, in my humbe opinion, is for everyone to approach it with the desire to understand the other party’s perspective, not with the desire to fight it and assert your own. It’s fine to believe whatever we want to belive, but if we are not willing to be receptive to new information that may challenge our beliefs, this attitude will stall our development.

      • reply Dina ,

        Hi, Wise Monkey
        many thanks for your thoughts on my blog post. ‘ You are saying ‘The only way for a discussion to be constructive, in my humble opinion, is for everyone to approach it with the desire to understand the other party’s perspective, not with the desire to fight it and assert your own’. I cannot agree more and i hope to see more of this attitude growing…
        thanks again
        Dina

      • reply Helen Spandler ,

        Enjoying your Blog Dina! You raise some really important issues. I recently came across the work of Will Hall in the States – he takes a very sensible and pragmatic approach to psychiatric medication. He was diagnosed with ‘schizophrenia’ himself and succesfully came off psychiatric drugs but he doesn’t moralise about this. I’d recommend his stuff . See for example:

        http://beyondmeds.com/2013/05/27/will-hall-at-ohsu-psychiatry/

        • reply Dina ,

          Hi, Helen
          thanks for your thoughts.
          Yes, I know Will Hall’s work. I listen to Mad Radio (he is the host) and i have read his/Icarus Project’s Guide to coming off medication. I sent it to Robin too. I have also seen a very recent documentary/film that Daniel Mackler made based on a workshop around coming off medication. Will Hall is a facilitator of the workshop and I really like the fact that he does not moralise about medication – for example, he is encouraging people not to beat themselves up if they do not manage to come off medication completely the first time the try.
          I can lend you the DVD, it is really good.

          talk soon
          thanks again
          Dina

        • reply WiseMonkey ,

          I was going to comment again because last time I did it didn’t come through. Now I see that it’s posted. Nice. The only thing I want to add to my previous comment is to thank you Dina for your article. I have already posted it everywhere I could on the social media but I am going to do it again because I think the point that you make here is very important for many people to “get”, especially in this day and age when mental health is such a “hot topic”.

          • reply Dina ,

            Hi, Wise Monkey
            thanks for your comments and encouraging words.
            regards
            Dina

          • reply Emily Tingley ,

            I agree with you. Medications are becoming a first response to mental illness. It’s sad the system is being overcome by psychiatric medications and treatments through the use of medications. When working in a community mental health agency it is common today that there is more time spent on ensuring that the client is being seen and treated (medically) for their mental illness. Not only that it has become practice to use short-term Therapeutic interventions—-like I said Short Term—when does a person have the time to actually process all that they need to in order to overcome and move forward. Short term coping skills are being taught. Either way—the system is skewed, but the process still works…there has to be room for long-term therapeutic treatments based on the clients wants and needs.

            • reply Dina ,

              Hi, Emily
              thank you for your thoughts
              I could not agree more with you about the need for long-term therapeutic interventions, eg long term psychological therapies.
              regards
              Dina

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