As an author and trainer I’ve written enough about mental health to wallpaper a small room. I’ve travelled the length and breadth of the country running courses on personality disorder, and can list the DSM-IV diagnostic criteria while hopping on one leg and loading the dishwasher. I’ve also spent many years working with personality disordered people in secure units, in acute admission wards, in the community. I’ve spent literally hours at a time trying to prevent patients gouging out their eyes, setting fire to themselves or trying to hang themselves with a bath towel, all the while trying to avoid the saliva aimed at my face and blotting out the screaming and shouting with ‘nice thoughts’ about home, family and the post-shift kebab.
So I know a lot about BPD, then? Er, actually no.
Before reading Siân’s posts I assumed, with the eyes of one who has for many years seen BPD from the ‘professional’ side of the ward or treatment room, that BPD rendered a more or less constant diet of chaos, misery, institutionalisation and sometimes death. Through training and writing I try hard to dispel the idea that all individuals with BPD are manipulative, wildly emotional and self-destructive, but if you’re paid to treat or support people with this diagnosis, it’s always seen as bloody hard work and universally unpopular.
I was keen to hear Siân’s account of her encounters with ‘the system’. I’m certainly no apologist for the many, many faults of a mental health structure which has not so much failed over the years but never really got it’s act together in the first place.
As Siân puts it, we have: “A system that insists that mental illness is no longer taboo but hasn’t yet worked out how to deal with it. Whether through ignorance, lack of funding or wilful desire, it just doesn’t take us seriously.”
And it’s just this sort of voice I wanted readers to hear as opposed to some of the increasingly ‘shouty’ anti-psychiatry stuff spouted on just about any online forum having the words ‘mental’ and ‘health’ in the title. I asked Siân for a service user perspective that might inform and stimulate without stereotyping all mental health workers as a battalion of burnt-out, syringe brandishing stormtroopers whipping out section papers at the mere suggestion of deviation from the cultural norm.
To quote Siân again: “The two sides of the equation – let’s call them ‘the professional’ and ‘the patient’ – ought to be travelling in the same direction, should, really, be striving for the same goal but I would suggest that isn’t always the case.”
No it most certainly isn’t, for reasons that are far more widespread and complex than can be tested on the attention span of our readership. But I’d like to think that my guest blogger has eschewed anti-psychiatry polemic for a considered argument as to where at least some of the problems emerge. Siân highlights a rigid mental health care bureaucracy focussed on crisis management and firefighting, often where an inferno might have been averted with the pre-emptive application of a damp tea towel. And please let’s not have any ‘lack of resources’ argument here. Early intervention can save lives AND money.
At the more individual end of the scale, Siân offers us a glimpse of the ‘piss poor professional’. This is a phenomenon I know only too well as being far too common in the caring professions and about which I’ve guest posted in the Not So Big Society blog.
I probably don’t agree wholeheartedly with everything Siân argues. As a self-confessed science nerd I’m actually quite excited by much of the recent research evidence pouring out of the world’s ever growing collection of CAT and MRI scanners. I would argue argue that neither BPD nor any other mental disorder cannot be explained purely by environmental circumstances or social construction. But like Siân I do believe very strongly that ‘patient’ and ‘professional’ should be travelling in the same direction. So how can we do this?
Only by both sides dropping their weapons and beginning to realise that there is nature AND nurture, that there is medication AND talking treatments, that not anyone wearing an NHS badge is the spawn of Satan and that not everyone labelled as BPD is a spitting, screaming attention-seeking nightmare. A little understanding could go a long way on both sides of the void.
I could go on but let’s save that for another time. To paraphrase Star Trek’s Mr Spock, sometimes the needs of the reader outweigh those of the blogger, so let’s just leave it there and say a very big Thank You to Sian Lacey Taylder.
If you missed Part 1 of our BPD trilogy, it’s here, and Part 2 is here.
Siân is author of The Society of Sin, a Victorian Goth-erotic fiction inspired by her Dorset connections, and is currently in the process of publishing her autobiographical novel Death by Eyeliner. You can find out more about her here.