The mental health professional and the patient (wrapped into one).

This is a reposted piece I wrote in June of this year (2010)

Originally it was entitled The mental health professional and the patient (wrapped into one).

For the purposes of this tab it’s been renamed.

In certain respects this particular piece about the mental health system of which I’ve been on “both sides of the couch” so to speak, underscores the entire problem with the mental health system.

Patients, consumers, the mentally ill, the crazy, the insane, survivors, clients…whatever the heck you want to call people who have been psychiatrically labeled are considered OTHER. They are not considered credible or equal to their “care providers” in pretty much any regard even by the *most* enlightened/alternative practitioners.

It is a rare individual who provides services to those with psychiatric labels who does not also imagine some sort of superiority over them. The system encourages this. The best of us fall prey to it. I know this intimately in a way many don’t only because I’ve been on both sides of the divide.

When I first published this I actually got a lot of mail from people like me. Those with psychiatric labels who are still working in the system. It’s hard for a lot of people and most such people still in the system don’t reveal their histories to their coworkers.

The original article:

This piece explores my experience of having been both patient/ex-user of psychiatric services vs. a professional in online circles. I find that I am treated radically differently depending on which of my experiences I speak from when talking to other professionals online.

Lately the arena in which I’ve thought about this has been twitter. I’ve been spending some time on twitter since I’ve been unable to negotiate more extensive correspondence. I discontinued commenting on this blog almost a year ago now because the sheer volume of correspondence I was involved in at that point was completely overwhelming. I also made it much more difficult for anyone to find my email address and this blog, in the right hand column states that I am not available for correspondence. Once the commenting and emails flows slowed down, I actually slowed down even further in personal correspondence finding it difficult to correspond with even friends and family. I’ve been really sick.

At the time I was checking out in this way I signed up with twitter. I found that with twitter that allows for “micro-blogging” of spurts that contain no more than 140 characters I could amazingly enough, stay in contact with the broader world in a low-impact way that still offered a stunning amount of intimacy and information and real sense of connection.

I also really enjoyed the fact that your twitter world can reflect a much greater segment of the population at large than a blog generally attracts. I have all sorts of people I follow on twitter as well as those who follow me being from a large range of interests. Perhaps this was always true of my readers, but those who actually communicate with me on Beyond Meds are much more clearly identified with the specific issues of this blog.

On twitter I have a significant percentage of folks who follow me and engage with me as well who clearly have not thought about the issues I present on the blog much at all if ever. It’s a nice way to introduce new ideas and I don’t have to be in an exclusively mental health scene either which frankly I was getting tired of. I now follow artists, Buddhists, philosophers, political news junkies, environmentalists, foodies, academics of all stripes, therapists and of course there is a fair number of people who are particularly interested in my work and personal lives may indeed have some parallels.

Anyway, a rather long preamble for what I want to get to. A lot of therapists follow me. I also follow quite a few of them. Prior to my current twitter account** in which I am now identified as the author/editor of Beyond Meds, I had one in which I used my real name and did not “own” this blog. I decided to present as the “social worker” I used to be rather than “the psychiatric survivor” this blog more strongly identifies with. So in my first incarnation on twitter I was a professional and I spoke from that place. I was still a strong advocate for all the things I share in this blog but I was never explicit about having been subjected to the great harm that psych drugs and psychiatry can visit upon so many. I was a critic, but I did not ever say I was a victim.

I got tired of that. I had a very interesting group of people I talked to but I found it exhausting to be the professional and kind of sickening too. Therapists and other mental health providers just can’t seem to help themselves from saying really offensive things about clients. They don’t realize it either even if they are called on it. It’s the biggest reason I do not identify in general as a professional anymore. Not primarily anyway. Because I find I can reach and help those of us who have been labeled so much more effectively as a peer. Certainly it’s helpful to bring up my professional experience when I talk about what I’ve learned in my lifetime, but now I have to do it in the context of one who has learned so much more as a user and then victim of the mental health system. My intimate knowledge of the professionals who fill the ranks of the mental health system only strengthens my arguments against it and so it would be stupid to pretend I do not have that experience.

In any case,  what I want to talk about is my online experience of identifying as patient (I never use that word. Not sure what I should call myself, but I do know that is how I’m identified by professionals out there. The mental patient. Yup. We’re still stigmatized and in my experience we are stigmatized MORE IN MENTAL HEALTH CIRCLES THAT INCLUDE PROFESSIONALS THAN ANYWHERE) vs. the clinician and social worker. When I identify as clinician and social worker but not as ex-user of the system, lo and behold, there is a hugely different reception of me and my ideas. It’s horrifying. I’m instantly taken more seriously when I wear the hat of professional.

I’ve seen this on twitter and before that in email groups. The most disturbing place that this has happened is among professional groups in which I’ve revealed my ex-patient status. Even in professional groups who at least in theory profess and share my interest in radically changing the system and using alternatives to psychiatry is this bigotry present. Not by all the professionals of course but depending on the group whether it be alternative or mainstream mental health professionals anywhere from 50% to 80% I’d say are dismissive of me when I identify primarily as lets say, the author of this blog. This in spite of the fact I will include my professional history as well. It’s clear what people remember though is that I was a user of psychiatry. A mentally ill person, I guess. (I don’t consider myself such but that doesn’t seem to matter even among those professionals who profess to not believe in mental illness!!)

When I am not the author of this blog and only identify as clinician and/or social worker I am received with a respect I do not receive as author of this blog. I am also engaged more deeply and with more interest.

This is by no means true of all professionals as indeed I have had many wonderful therapists contribute pieces on this blog. I have good friends who are part of the mental health professions too. Always there are those who get what I’m doing and treat me with equal respect and regard they would anyone else, but in general they are in a minority in all mental health professional groups. PERIOD. It gives me great pause and is sometimes rather heartbreaking.

Think of those who are still subject to the care of mental health professionals. They are by definition subject to care, if my experience is to be taken seriously, and I for one do take it seriously, that considers them inherently less than equal. I remember when I was a clinician too. Some of these people who are prejudiced are well-meaning. But well-meaning and acting without prejudice are unfortunately not mutually exclusive. I don’t know how one extracts this insidious form of prejudice. They don’t see it in themselves…how do we help them see?

**that twitter account is no longer. It got too large of a following and I couldn’t keep up with the amount of communication coming my way. Alas, I still need to rest and get well. (update 5/2012 — there is a twitter account once again, but it is only a feed with no social dimension)

**there is now a page with a collection of posts on: About having been both a mental health professional and a psych patient