Two books (Jul/Aug 09)

Friday, 01 April 2011 18:04

I have been reading Jean Davison's The Dark Threads (Accent Press) about the time she spent as a patient at High Royds Psychiatric Hospital in Yorkshire when she was just eighteen. Jean waited forty years to complete writing this book, which was very wise because she was able to give an account of her experiences that showed a wealth of understanding rarely found in memoirs written when emotion is still very much alive. I found it a painful book to read, because I was a psychologist then at Whiteley Woods Clinic and Middlewood Psychiatric Hospital in Sheffield. I witnessed the kind of scenes in which Jean was a participant, and so her book took me back to those times when I saw the cruelties that passed themselves off as psychiatric care. I tried to deal with the awful helplessness of witnessing cruelty and being unable to prevent it by spending time talking with the patients. In so doing, I came to see the gap between the way psychiatrists and nurses thought and worked and the reality of the patients' lives. In recounting her interactions with the people who were supposed to be looking after her, Jean shows just how great this gap was.

She also shows that these men and women were not monsters determined to do evil. They all meant well. Her consultant,  Sugden, was just like the consultants I worked with. These men were practising the psychiatry they had been taught ten or more years before. It did not occur to them to question what they were doing because that was how the system worked, and they benefited from the system.  Prior,  Sugden's junior doctor, did no other than elaborate Jean's diagnosis by  Sugden. He dared not query the diagnosis because his future career depended on  Sugden's good will. Sister Oldroyd was a martinet. She terrified the patients, but was herself frightened of  Sugden. However, in one encounter, through the fog of drugs that filled her head, Jean could see that she was a tired woman 'bending under the burden of a difficult, depressing job'.

What Jean could not report but I can was what these people said privately to one another about the patients. They all saw the patients as inferior beings whom they tried never to encounter outside the hospital. The consultants patronised the nurses to their faces, but amongst themselves they agreed that the nurses were not intelligent or educated enough to understand what the practice of psychiatry was. The nurses knew what the consultants thought, but got their revenge. If they could make their consultant dependent on them, they did, and they had no difficulty in manipulating the junior doctors' weaknesses.

Much in the current psychiatric system maintains this pattern of relationships, but, so I do not fall into despair, I remember that there are now consultant psychiatrists like Sami Timimi. His latest book Straight-Talking Introduction to Children's Mental Health Problems is amongst of the first of a series of pocket-sized books from PCCS Books, called Straight-Talking Introductions to Mental Health. Sami has never had any difficulty in writing in ordinary language free of the jargon so beloved of psychiatrists and psychologists who want people to think that they have special knowledge that no one else possesses. He treats adults and children as fellow human beings, and never feels the need to patronise them. In his book, he aims to make sense of childhood distress without having to resort to psychiatric diagnoses. Indeed, he wrote, 'There are currently no childhood psychiatric diagnoses whose existence in the objective physical world (beyond the subjective imagination of the diagnosing doctor) is not disputed. The classification system we use for categorising childhood psychiatric disorders did not develop as a result of new discoveries, but as a result of a change in the way we think about and categorise children's emotions and behaviour.'

Not all of Sami's colleagues will be pleased with him giving their game away like this. They will be even less pleased that his book includes step-by-step instructions about how to wean a child off Ritalin. Research by Mind has shown that many doctors do not agree to help when patients say that they want to come off their psychiatric drugs. Perhaps these doctors genuinely believe that their patient needs to keep taking the drug for years to come, but a sceptical person might wonder whether a doctor might want their patient to remain dependent on him. Does he prefer, as Jean's psychiatrists preferred, to believe in lifetime mental illnesses rather than look at what actually happens in life?

Everyone concerned with children should read Sami's book. If only, forty years ago, Jean could have read a little book like Sami's about being a teenager in a troubled family!