THE TRUTH ABOUT THE PATIENT/THERAPIST MIND GAME

by Nick Williams, Contributor Waking Times

There is something particularly odious – in my view – about the way in which we in the West approach what (until very recently) used to be called ‘mental illness’. We may use a slightly different terminology now, preferring to talk in terms of ‘conditions’ rather than ‘illness’, but our approach is still the same. There is something very unpleasant – toxic even – in our attitude, and this unpleasantness, I think, stems from our fundamental lack of respect towards the experiences of the people we, as mental health professions, are dealing with.

In a nutshell, we’re arrogant; we’re arrogant because we are so convinced that our ‘neat and tidy’ rational way of looking at the world – which we did not arrive at ourselves but rather passively absorbed from the cultural milieu (in a ‘default’ way that requires no effort on our part) – is the right way that we can’t even come close to empathizing with other, often very different, perceptions of reality. This is precisely where our unconscious arrogance lies therefore – it lies in the fact that we (by some special virtue of our own) know what the right way to view reality is. The great philosophers of the past may not have known what the right way to look at reality is, but somehow we do…

Not everyone is guilty of this unconscious disrespect of course. The point we are making is that the ‘disrespect’ is systematic – it’s built into whole structure of things and so it’s always going to set the tone. It’s always going to be the dominant influence. Disrespect is always systematic where there is an inbuilt ‘power differential’, when one group of people have more power given to them by society than another, and this is exactly the state of affairs in psychiatry, or in the mental health industries in general.

A crude but nevertheless very effective way of determining whether a power differential exists between the professionals whose job it is to work with people suffering from mental health conditions and the people themselves is to ask the question ‘Who is the most successful in society’s terms, a consultant psychiatrist or clinical psychology (for example) or a psychiatric patient? We’re not supposed to ask this question, of course. It is very politically incorrect suggest that patients might be granted lower social status in the basis of the fact that they are patients (i.e. on the basis that they are not, in most cases, highly qualified professionals but are, rather, sufferers of a mental health condition); it is politically incorrect to suggest it but that doesn’t mean that it is true. We all know that it is true…

We don’t want to admit that the actual patients themselves may not have the same social status as the healthcare professionals who are trained to treat them but at the same time we all know very well that this is the case. Society operates purely on the basis of status and prestige, whether we want to admit it or not. Society operates on the basis of the power gradient that exists between those of high status and those of low, and it would be foolish in the extreme to pretend otherwise. Society isn’t a ‘free’ kind of an affair; it’s coercive, in other words. It’s based on following rules….

When you as a patient look across the desk at the mental health professional who is dealing with you it is evidently the case that you are looking at someone who has more power than you; this isn’t just power in terms of how we usually understand ‘social status’, it is power in the sense of ‘Which one of us has the authority to say what the proper way to see the world is?’ Power is a basic part of all human interactions – every time we interact with someone we are involved in a struggle (whether we are conscious of it or not). We are involved in the struggle to see who has the power to define the ‘consensus reality’ that is to be negotiated in the interaction. This contest can be very subtle, or it can be very unsubtle indeed! When we are involved in an argument, for example, then this is an unsubtle example of ‘the struggle to see who can define reality’! Our current way of understanding mental health conditions is a perfect illustration of ‘something that has been defined by the powerful’ – when depression (just to give one example) is defined as ‘a mechanical malfunction of the brain’ then this is ‘disrespect’, this is ‘an abuse of power’….

more…

About the Author
Nick Williams – I work as an occupational therapist in acute psychiatry in the West of Ireland, and have done for the last 25 yrs. Before training to be an occupational therapist I graduated from the University of Kent with a degree in Health Education and Natural Science, and before that I was unemployed in South London for 15 years…
This article (The Truth About the Patient/Therapist Mind Game) was originally published at Negative Therapy and is re-posted here with permission.
https://www.wakingtimes.com/2018/10/02/the-truth-about-the-patient-therapist-mind-game/
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