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.