“In our culture voices represent something that is to be feared. For ordinary people the experience has become inextricably bound up with unpredictability, being out of control and general issue of danger” (Voices of Reason, Voices of Insanity – Phil Thomas and Ivan Leudar)
Ruth hears voices. She is suicidal and depressed. She’s a junior doctor. She knows full well about stigma and mental distress. Instead of seeking psychiatric intervention she turns to former psychiatric user and”maverick” psychologist Rufus May (based in Bradford), who has a very distinct and unorthodox way of treating voice hearers.
Last night Channel 4 showed the drama/documentary, The Doctor Who Hears Voices, Rufus May played himself while an actress played Ruth. They were doggedly followed around by the director, Leo Regan, who continually questioned May’s methods.
Rufus was open and honest about his time within the psychiatric system, and like countless people, got the label, the depot injections and his experiences medicalised. He was a former user at the Hackney Hospital (My own experience of that place was a psychiatrist telling me no matter how depressed and suicidal I was this “was not the place you want to be”…..Hackney finally shut its 19th century doors in 1995) He did express his own concerns in the programme about whether his own personal experiences were clouding his professional judgement.
Ruth hears voices that tell her to kill herself and to kill members of her family. When the voices feel threatened by Rufus’s intervention they want to kill him. She is labelled with schizophrenia but knows if she tells her employers about the voices then her job as a doctor will be jeopardised and in all probability got rid of.
Leo Regan visits Dr Trevor Turner, a psychiatrist based at the Homerton, a shrink of the orthodox kind, who believes that the only way to combat psychosis that includes delusions and auditory voices is by medicating them. He explains that this would be “discussed” with the person, and if the voices are threatening then immediate intervention is necessary by sectioning them. It would be “discussed” with the person about medication and if they refuse then they would be restrained and forcibly medicated.
Turner says all of this to the camera in such a business like manner especially talking about forcibly medicating someone, it was so unjust, cruel and dehumanising. Then Rufus, in the following clip, gives the viewer a good understanding of the realities of restraining methods and forced medication.
Turners’ way of treating Ruth would mainly consist of medication on a section. While Rufus takes Ruth out and about, they go for walks, relaxation methods, Rufus debates her voices and encourages her to write a letter to her dead brother. Orthodox psychiatry seeks to suppress the voices while Rufus encourages Ruth to come to terms with hers.
And as he outlines medication quietens people in a negative way and I would also say, dulls the senses. Where users are talked at never to or listened to. He also believes you have to understand the psychosis and sometimes that experience can be liberatory.
The work he does with Ruth has its ups and downs. Sometimes she seems better, the next worse. But that is the nature of mental distress. Her voices seem to revolve around life and death (Ruth is convinced the fish tank on a ward is controlling patients’ heartbeats). The voices also attack the core of her self-esteem (“You are a worthless piece of shit”).
She is sometimes hostile to Rufus, other times paranoid, and other times relaxed. Rufus engages Ruth to unravel the voices, to understand them. In a Langian sense, there’s a method in her madness.
Ruth disappears for a bit and Rufus worries she has committed suicide. She contacts him eventually.
Ruth goes back to work but she is worried that people will find out about the voices (“The power balance has shifted”.
Again, the stigma attached to mental distress was discussed. Turner told users not to disclose their history and Rufus told of not telling anyone about his mental history when he trained as a psychologist.
Turner, rightly, admitted that once someone admits to their history then they will “hauled off to occupational health”. And as a former user myself, I can vouch for that and so can others. The intrusive questions and questionnaires you have to fill out, the hurdles and hoops you go through so you can be accepted and even then it is never a certain.
That you are “fit enough” to work (your opinion doesn’t count…so much for empowerment). Yet there is a hierarchy of “madness” and voices are kinda at the apex along with the stereotype, “mad, bad and dangerous to know” ‘cos all voice hearers are potential killers. Well, according to orthodox psychiatry.
Rufus May at least looks at the underlying reasons for voices rather than to medicate (and there is a real overemphasis on medication and massive profits for the pharmaceutical companies), which treats them and nothing more.
Turner thinks he is “protecting” Ruth when he argues that the best way of treating her voices is to section her, while Rufus May attempts to look for ways to empower Ruth, to take control of the voices as opposed to subjecting her to containment and control by the state.
I am sympathetic with May’s approach. Reductionist psychiatric explanations pathologies and labels people, along with medication as the panacea for all ills. Others in psychiatry have been challenging the orthodoxy like Marius Romme and Phil Thomas, and their work is ground breaking. They have argued that voice hearing is a symptom of life experiences. Life experiences that involve trauma and internalising oppression. These alternatives expose a more creative and imaginative way of dealing with voices. One of the ways is that capitalism makes a profit off the backs of misery through the commodification of drugs. Instead of giving people the time and space we are pressurised and alienated.
The person can come to terms with the voices with support and be able to contextualise them. Others ways of dealing with voices include support groups, coping strategies such as keeping a diary and listening to voices (who do they sound like? when do they appear?). The activist based org. Hearing Voices Network has done so much to challenge the stigma of voice hearing.
As human beings we are complex therefore reducing behaviour to mere biochemistry can not explain our complexity. We need to look beyond biological interpretations. Alternatives that encompass the whole person and their material experiences that may gain us more insight.
If I had to choose between the so-called maverick approach of Rufus May or the orthodox Trevor Turner….
Then Bradford, here I come…..
