This is one example of the user's view - the most important view when it comes to demystification.
Dave Lowson wrote this for a magazine called Asylum
who published it in 1994. I hope he and they do not mind me publishing
it here, since I got it indirectly and don't know where to contact
them. Dave is a member of Wales Mind Cymru. The article is based
on ideas from Louise R Pembroke or Survivors Speak Out. It is
a neat satirical reflection onto those professionals themselves
of professional ways of seeing and talking about their patients.
In my training as a psychiatrist - and
remember I was especially trying to be human and psychotherapeutic
- I now look back on how I was trained to listen to patients but
only within a framework of scanning what they were saying and
doing for symptoms and signs of psychiatric disorders or psychological
complexes and patterns. In effect, this was not listening but
invalidating. It is no wonder that those who were longterm patients
in a 24 hour a day similar invalidating framework, feel much freer
when they are able to return to more ordinary supportive settings
in the community.
The problem is that psychiatrists do
have to listen within this extra-ordinary professional framework
or they would not be doing their job. They need to keep an eye
open for stories and evidence of disorders like dementia and (debatably,
for sure) for physiologically based serious disorders with mainly
mental presentations. These disorders may need medical investigation
and types of treatment.
In psychotherapy it may indeed be really
helpful to recognise patterns that link with published or individual
experience of similar cases. For example, we now are much more
aware of the way undisclosed sexual abuse can lie behind psychological
and somatic patterns of presentation, so we know how to open our
minds rather than repeat the invalidation again.
In child and adolescent mental health
services, we are facing an unprecedented demand from the public
for us to label and medically treat children for ADHD
etc. Many of my articles (choose from my Home
Page), and forallthat as a whole,
argue in line with Dave Lowson's implied argument in his PTD article.
For my response to a book that tells professionals a related but
also different view of what it is like to be their client (where
special labels and help were wanted by the client), see
Dear Jennie Roberts, a review
of Jennie's book 'Dear Psychiatrist'.
I think it is a really difficult task
to do both kinds of listening at the same time. It's like asking
a surgeon to do the job of cutting human beings up in life and
death situations, and also to remain always aware of the feelings
and pain and life and death human situation around them. But it's
certainly true that professionals are overwhelmingly trained in
the one and not the other important way to listen. So Dave Lowson's
piece is on the mark.
Professional Thought Disorder
By Dave Lowson
PTD is a condition which affects many
professionals but it seems to be particularly prevalent within the mental health field. The major characteristic is an assumption of intellectual or moral correctness
or superiority frequently held in spite of the presence evidence
to the contrary. Signs and symptoms of PTD include:
sufferers often have major difficulties when it comes to dealing
with their own and others' emotions
they have a pathological inability to acknowledge their own
distress and a denial of vulnerability
they have an inability to display empathy with others in distress
they have a compulsion to analyse and compartimentalise the
experiences of others
they show impaired social and interpersonal functioning
communication with others is frequently characterised by an
unusual rigidity. In particular the acknowledgement of the other is frequently missing and often manifests itself in lack of common courtesy
and impaired listening
they have rigidly held beliefs (which they often present as
'facts'). Such beliefs are not affected by empirical evidence from the real world
they ask strange questions which seem to have no relevance to
the context within which they are asked
they tend to see themselves as important, gifted and beneficent.
A particularly frequent delusion is that the sufferer deserves to
be trusted by others prior to exhibiting any behaviour which would make trust appropriate. These delusions are maintained by hostile labelling
of anyone who challenges these self concepts. One consequence of this is
that the worth and abilities of the other are frequently unacknowledged.
the sufferer is unable to distinguish their own wishes and impulses
from those of the people they believe themselves to be helping. This
is assumed to be the reason why they so often 'act out' this confusion by
behaving in ways which provoke anger in other people and then punitively label
this anger as a sign of pathology in that other.
sufferers of PTD do not, or are unable to recognise that they have
much of the sufferer's disturbed behaviour is positively reinforced
by the surroundings they develop for themselves
the main harm caused by PTD is not experienced by the sufferer
but by those they are meant to help. This limits the motivation for change.