The Death of a Great Little MagazineSaturday, 14 August 2010 16:38
If there is a special place in heaven for magazines that encouraged freedom of speech Openmind is on its way there. The next issue of Openmind will be its last. It will be replaced in May 2010 by, according to the Chief Executive of MIND, Paul Farmer, by a ‘lively, engaging and thought-provoking magazine that will work alongside an interactive members’ area of our website.’ This will provide ‘the dialogue between service users, professionals and providers so valued in the current publication.’ Thus the one beacon of light in the murky world of the lies and misinformation in the psychiatric system will disappear. However, when historians come to research how thinking about severe mental distress has changed over the twentieth and early twenty-first century, the archives of Openmind will be a vital resource.
When terrible disasters befall us we often find it difficult to summon up the courage needed to behave in the ways that our society expects us to behave. The people around us might comfort and support us, but often they do not, perhaps because they are too wrapped up in themselves to care about us, or perhaps they know that they are implicated in the cause of our distress but wish to deny this. For instance, it is only quite recently that psychiatrists have had to accept the research that shows that a significant number of the men and women who become deeply depressed or psychotic were sexually assaulted when they were children by the very people they should have been able to trust. When we become severely mentally distressed, some of us try to deal with our distress by withdrawing into ourselves to such a degree that we lose contact with the reality we share with others; some of us try to run away from our distress and become extraordinarily active; some become highly obsessional and compulsive; some retire to a place such as their home where they feel safe and refuse to venture out; while some blame themselves for the disaster and become depressed. Instead of seeing that such behaviours are the extremes of what we can choose to do when we become very anxious, psychiatrists have given each of these a label that they call a diagnosis. These psychiatrists believe that the label tells them all they need to know about the people they regard as being mad.
Different societies at different times have created different kinds of mythical causes for these states of severe mental distress. The medieval Church claimed that severely mentally distressed people were possessed by demons. By the nineteenth century many doctors in Europe saw that they could make money by opening asylums for mad people. They justified this by claiming that mad people were suffering from mental illnesses. Psychiatrists invented causes for these mental illnesses, and told, and in some cases continue to tell, their patients that their illness is caused by a gene or by a biochemical change in the patient’s brain. No physical cause has ever been found for any mental illness. Physical causes of mental illnesses are myths. A myth is a fantasy, and a fantasy presented as a truth is a lie.
People are so frightened of madness that the words we use in connection with madness become frightening in themselves. New terms have to be created. Thus ‘asylum’ became ‘psychiatric hospital’, while ‘mental illness’ became ‘mental disorder’, and then ‘mental health’, as in, ‘He’s got a mental health problem.’
Whatever the name, life for the people locked up in these asylums was far from pleasant. On the rare occasions when a psychiatrist talked to a patient, all he wanted to establish were the symptoms the patient experienced. He was not interested in the patient as a person. When I was working at St Johns Psychiatric Hospital in Lincoln, I met people who had been there for fifteen or even twenty-five years, yet in all that time no psychiatrist had asked them to tell their life story in the way they wanted to tell it. Yet, when they told their story to me, I did not need a biochemical change or a gene to explain why they had been severely mentally distressed. The reasons were there in the person’s story; clearly visible to anyone who had a reasonable knowledge of the way we live our lives, and who wanted to understand.
The psychiatric patients I met in the 1970s the patients were what psychiatric patients had always been – obedient, grateful and uncomplaining. They knew what the punishments were if they were not – being labelled ‘troublemaker’, moved to an even worse ward, silenced by an injection of a major tranquiliser. The physical conditions of these hospitals had somewhat improved since the nineteenth century, but the ethos had not. According to the psychiatrists, a mental illness was lifelong and incurable. When they did speak to patients, they patronised them and often lied to them. When they spoke about them to their colleagues they often used the vilest terms. One consultant I worked with referred to long-stay patients as ‘the dregs’, thus ignoring the fact that the drugs that the psychiatrists had prescribed for these patents destroyed the tissue of their cortex and caused the illness tardive dyskinesia. The management-speak used in mental health settings nowadays conforms to what is considered to be politically correct, but it can be used in ways that are as destructively patronising and insincere as the language used by the psychiatrists of past years.
The great glory of MIND is that it did not become a worthy, self-regarding charity where superior people showed concern for people who were incapable of looking after themselves. When I first encountered MIND in the form of Dr Falla, the superintendent of St Johns Hospital, I found that this was how he interpreted the role of MIND, as did many like him. However, by the end of the 70s a group of the most extraordinary and supremely brave people emerged from the psychiatric hospitals. They called themselves Survivors of the Psychiatric System, and they demanded equal representation in MIND. They were tired of being patronised and silenced. They wanted change. Not everyone in MIND was in favour of this, but there were sufficient people of good sense and good heart who knew that this was the way MIND had to go.
Many of these Survivors were well educated. They subsequently wrote books that took these issues to a much wider audience. They encouraged others Survivors to write about their experiences, especially when in 1981 Anny Brackx founded Openmind. She remained either its editor or latterly publisher more or less throughout its life. Sara Dunn took over editing it in 1997, and Kathryn Perry came on board in 2002.
Openmind was sold on subscription and was not widely known. I recommended it to all the clinical psychology and social work students I met so that they could discover what actually went on within the psychiatric system. The magazine carried information about any changes in the regulations affecting the psychiatric system, and short news stories to do with mental health. Even more important were the reports from the local mental health associations that were part of MIND, the critical studies of some aspect of the psychiatric system often written by someone who knew the system from the inside, and, most important, first person accounts of severe mental distress and of the treatment the person received. Just as no one can know what war is actually like without reading the accounts written by soldiers in the front line, so no one can know what happens to us when we lose our grip on our life without reading the accounts by people in their solitary struggle to hold themselves and their life together.
I know nothing of how the team managing MIND come to their decisions, but two decisions made recently have left me wondering whether MIND might be in danger of losing its way. The first is the decision to close Openmind without having ready in its place a website that continued Openmind’s outstanding work. The second is the decision to include Alastair Campbell in the list of candidates for the 2009 Champion of the Year.
This award celebrates ‘the work of people who have made an outstanding contribution to increasing understanding of mental health.’ Candidates are nominated by local association of MIND and the Mind staff, and the short list published on the MIND website so the public can vote for the person they feel should be the Champion. Perhaps the MIND website should spell out more fully what is meant by ‘an outstanding contribution’. Mental illness used to be unmentionable in public but now many celebrities claim to be depressed or have a ‘drug problem’ in the hope that the ensuing publicity would revive a flagging career. Indeed, Alastair Campbell did not mention his breakdown publically until he lost political power along with Tony Blair. Such celebrities are very different people from the Survivors who began the revolution and those who followed them.
The Survivors did not get together to plan the revolution until after each of them had carried out the private revolution of changing themselves. The treatment patients received in psychiatric hospitals was so destructive of self-confidence that most came to believe that they deserved nothing better than what they got. What was so extraordinary about the Survivors was that they had managed to cling on to a vestige of their belief that they deserved something much better than what they got. They asked themselves, ‘How did I end up in this horrible situation?’ They allowed themselves to question what the psychiatrists had told them. Then each of them set out on a journey of discovery into their past. I have never forgotten Brian Davey telling me how he had questioned his mother about what was happening in the family during his early childhood, and she, brave woman, told him. Many parents of the severely mentally distressed refuse to do this, and get very angry when their adult child’s questions imply that they were not perfect parents.
What the Survivors were doing was what we all need to do, to examine our childhood with an adult eye. It takes courage to confront our demons from the past and see them for what they are. We all have such demons because childhood is never the perfect happiness that many people like to pretend theirs was. Many people refuse to recognise their demons’ existence, preferring to pretend that they have nothing inside them that cause unnameable fears and conflicts.
Some demons, once confronted, fade away, but some stay within us forever. However, a person can devise tactics for keeping demons in order so that they never run amok again. Thus a person learns how to manage his life, and, in the course of this, gains much wisdom about living. Such people demonstrate their wisdom in the way they live. For instance, Clare Allan writes most perceptive articles for Guardian Society. Stephen Fry became notorious for abandoning his role in a West End play and running away to France. However, he returned, confronted his demons, and since then he not only produced such magnificent work but he has become a National Treasure.
Alastair Campbell will never become a National Treasure. He had his breakdown true, but he gained no wisdom from it. If he had, he would not have so ferociously supported Tony Blair in following George Bush into the Iraq War.
The achievements of the Survivors and those that followed need to be celebrated. For instance, the Hearing Voices Network has effected that greatest beneficial change in the care of severely mentally distressed people since the Quaker William Tuke built the The Retreat in York in 1792. Champion of the Year has also celebrated those people who, not having experienced severe mental distress, chose to learn about it from the inside. In deciding to have a story line of a much-loved character developing dementia, all the people involved in the making of the radio serial The Archers had to learn not just the process of developing dementia but the mental distress that the process causes not just the person experiencing it but the mental distress each member of his family suffers.
We hear a great deal about the stigma of mental illness, often from people who have not considered its origins. People are stigmatised when they are looked down upon by people who regard themselves as their superiors. Stigma cannot be eradicated while there are people who regard themselves as being superior because of their wealth, class, nationality, race, religion, or their supposed mental health. Such people forget that human beings differ very little in terms of genetics or in terms of our basic needs and desire. We might be very intelligent in understanding things and the world around us, but in understanding ourselves most of us are very stupid. Openmind set itself the task of educating us about ourselves. We cannot afford to lose such a great little magazine.
Mind replaced Openmind with a pamphlet called Connections.