Dave's Progress. Chapter 72: A Dangerous Profession?

After, only a couple of chapters ago, writing about the seemingly "insane" practice of diagnosing and medicating children with psychiatric disorders, I have found myself again pondering the apparent dangers which I think are inherent in psychiatric practice. In that post I pointed to Thomas Szasz's belief that in the wrong hands, psychiatry could become a means of social control and indeed, with diagnoses such as "oppositional defiance disorder" and the ongoing need to "pathologise" what would be seen by many as perhaps difficult, but nonetheless "normal" behaviour, it seemed that Szasz's beliefs were turning in to hardened fact.
I was reminded, also, of the experiment undertaken by psychologist David Rosenhan in 1973 which resulted in the paper, "On being sane in insane places", which exposed the unreliability of psychiatric diagnoses in the US. The experiment involved admitting a number of "sane" patients on to a psychiatric ward who at first complained, falsely, of hearing certain auditory hallucinations. They were all taken in to hospital where, once there, were told to behave "normally" and say that they no longer were hearing anything. Despite this, and the fact that they were indeed sane, many found themselves detained at the hospital, having to admit, before their release, that they did indeed have a mental disorder and would continue to take anti-psychotic medication. Conversely, in another branch of the experiment, hospital staff were asked to identify non-existent fake patients and they all identified people who were genuinely ill.
Indeed, I can begin to relate some of these apparent failures and dangers of psychiatry to my own experience.
When I first came to be sectioned in 2004 (that is, legally detained in hospital), a number of incidents went on preceding my admission. My psychiatrist and I, it seemed, had come to some sort of impasse in my treatment, him saying that he had run out of ideas as to how to cope with me. At the meeting in which he said this, he also explained that I seemed "not to respect people" and that my drinking habits had become a concern. In other words I had become a "difficult patient" and he suggested, then, that I see a different doctor. Later that day, I received a 'phone call from one of his staff saying that I was being offered either a place on the acute ward at the local psychiatric hospital, or an assessment from another doctor. Not wanting to go in to hospital, I took the assessment from another doctor. Later that evening, I was visited by a social worker and my GP and they asked me how I was. I said that generally I was doing fine, but by this time of day, I was under the influence of alcohol, and said, somewhat flippantly, that I had had some suicidal thoughts. This was enough to get me sectioned. I really was no danger to others or to myself, despite my remarks, and I think any doctor with any nous would have seen through my admission as the maudlin effects of alcohol. But, I was sectioned anyway and in the morning, when I awoke in hospital sober, I could not help feeling that I had been "tricked" in to hospital.
Indeed, later I was put under a de facto detention (something I wrote about in a previous blog) and was told, when I asked my psychiatrist why I had been sectioned as I did not feel I was a danger either to myself or others, that I was a danger to myself "because I drank". Now, in this country, one can not be sectioned for substance abuse alone and with this information and some legal advice I pursued, and eventually took, my own discharge. At this, my psychiatrist erupted with anger, disowned me as his patient and left me without any medication.
As I look back on these events, then , one does begin to wonder if I was sectioned not only because of my drinking, but because I was "difficult" to treat. At that time I think I was, indeed, a difficult person and even the more wayward in-patients on the ward fell in to the habit of calling me by the nickname, "trouble". But, even though I was genuinely unwell, one now asks the question- was it just certain aspects of my personality that ended up getting me sectioned? And, if my drinking was a concern, that's all it should have been, as, purely on libertarian grounds, it is something which remains an adult's choice. No matter how much we may want to intervene, it is ultimately up to the person in question to give up or cut down and as Anthony Burgess wrote, in "A Clockwork Orange", "take away a man's choice, and he ceases to be a man."
Around eight months later, by which time, in the absence of medication, I had indeed fallen in to a delusional, hallucinatory insanity, I came to be under the care of a new psychiatrist and it seemed, exactly the reverse of the above situation ensued. Now trying to get in to hospital because I was genuinely unwell and somewhat desperate, I was told that I could not be assessed or admitted while under the influence of alcohol, something which had not prevented me from being sectioned before. Indeed, I came to be seen as a drunk, and despite my history of psychosis, my increasingly bizarre behaviour was just seen as a result of drinking and as "part of my personality". I was told, on numerous occasions, that there was "nothing wrong" with me. This time, when I expressed my genuinely suicidal ideation, my new psychiatrist told me that if I took such drastic action, it would be entirely my choice. No sign of a section in sight! Eventually my parents had me taken in to private care. I was detoxed, diagnosed and medicated within two weeks and since then have only got better.
It would seem, then, that my own experience would prove the findings of both elements of the Rosenhan experiment, at one point having my personality mistaken for some form of pathology, at another having my illness mistaken for aspects of personality.
One wonders, then, if psychiatrists are aware of the enormity of the power they yield, their ability to either help or condemn to suffering. Both the philosopher Michele Foucault and Szasz himself warned of the dangers of the power inherent in the psychiatrist's position, and it would appear, if my experience is anything to go by, that they were right. Who else in society has the ability to take away some one's liberty purely, it seems, on a hunch or by, in my case, what seems to have been a misdirected and unprofessional over-concern and lack of objectivity? Moreover, a psychiatrist also has the power to set free those who may not yet be ready to go back in to society. Hence the huge public and media concern, misrepresentative though it is, about the danger of some patients. What is worrying, as well, is the seeming lack of any accountability for the decisions a psychiatrist makes. All I was offered, after my ordeal in "treatment", was a cursory apology, spoken and not even written. Mind you, should we really hump all of the blame for this on to psychiatry alone, given that it is extremely difficult to make such judgements and that the profession itself is not an "exact science"? Or is it that this is a convenient excuse for a dangerous profession, open to and ridden with abuse, which rarely acknowledges its own accountability for the decisions it makes?
That's all for now from your normal, average, delusional and paranoid man.


bazza said…
A fascinating and scarey tale David. In a way it encapsulates the whole history and standing of mental health issues:
-Who is being protected when someone is sectioned?
-Who decides when a person needs to be sectioned?
-Whats rights do any of us have against this action happening to ourselves?
I suppose you might have said. "I'd rather have a bottle in front of me, than a frontal lobotomy"!
David said…
Dear bazza,
This is indeed a worrying and yes, scary tale. One does begin to wonder about the reliability of such decisions and the possible abuses which such power brings with it. Particularly in the case of minority groups, one wonders, for example, about how women have been treated both now and in the past by such authorities. Why, also, is it still the case statistically that black people are twice as likeky to be diagnosed with schizophrenia than white people? Could it be the case that there are still some hierarchical power structures at work here?
In my own case, I was told by one solicitor that what happened to me bordered on an abuse of my human rights, but such opininons never, in the eventuality, seemed to reach the light of day, despite my protestations. But, how to convince people you have a point, when you are regarded as "insane"? It seems that no one will listen to you when presenting clear signs of mental distress.
As for accountability, the psychiatrist who disowned me as a patient, left me without medication and therefore subjected me to perhaps eighteen months of harrowing illness was never, as far as I know, reprimanded for his actions and he continues to work in the same capacity at the same hospital. OK, so I was not "compliant" to his treatment, but I don't think that should then mean being wholesalely rejected. Indeed, I read of one patient in the "Observer" newspaper who had killed themselves after a long time away from mental health services. Their response was that she had not been treated because she was not "compliant" and had been, like me I suppose, a "difficult" patient. The thing is, how can you expect someone whose behaviour may be affected by their illness to be "compliant" to anything. When your oen reason seems to have disappeared, how can you be expected to be "sane" and reasonable. Such things simply do not make any sense.
Anyway, bazza, I have gone on enough, but as you can see, many issues arise out of this. I thank you for your commnet, though, you seem always to be the first these days, so thank you so much for your support.
Yours with All the Best,
klahanie said…
Dear David,
I had a good read of this posting. I echo the thoughts of bazza and your follow-up reply.
David, I can relate to much of what you alluded to in your posting. I have had similar situations occur.
It is a very worrying situation when the authorities can make such judgement calls. I have been sectioned under the mental health act. I had entered hospital under the premise that I was in for a detox. I then discovered that I was under constant watch and was not allowed to leave my room or go outside for a week. I was scared. I went in for a detox and the attitude of the staff was shocking.
They talked to me like I was a 'bad little boy'.
It is not, without any doubt, an 'exact science'. In fact, after my treatment at the hospital, it took me ages to recover from a most disturbing ordeal.
Take very good care, David.
Kind wishes, Gary.
David said…
Dear Gary,
Thanks for your comment and concern. Sorry to hear that you have had bad experiences of the system yourself. Indeed, I can't think of anyone who has "liked" going in to a psychiatric hospital, and people at my "Pathways" group often complain about the Harplands in particular. More enlightened attitudes and new ways of providing treatment seem, then, to be sorely needed.
Yours with All the Best,
dcrelief said…
Hi David,
One of your best articles, I think. Then again, I'm not the person who would stand willingly in any psychiatrist' corner! So it's so easy to agree with you.

I feel I've shared a great deal of my life with you, over the last couple of years. In the world of mental health issues, I was a 'failed experiment'. (big smile)

I think your post is 'spot on'. Follow the money to the new medical toys the psychiatrists can own. Or follow the power journals they publish to compete in destroying people.

One trivia fact for you and then I'll close. The day after September 11, 2001 when the World Trade Center Towers were knocked down... 20 million people (in the USA) were placed on an antidepressant for anxiety. No other treatment or program was recommended.
Thank you David.
Super kindness,
David said…
Dear Dixie,
It seems that many of us who have been invloved with psychiatrists share a somewhat jaded view of their profession.
Thanks for your continued interest and am glad that you are no longer seen as merely a "failed experiment".
Very interseting stat too, dc. How unlike psychiatrists just to throw pills at people, as if this is the answer to everything!
Yours with All The Very Best,

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