The voices in my head: Eleanor Longden’s ‘psychic civil war’…

This blog has featured a lot of discussions about mental health. This is because I have served my time as one of societies psychiatric policeman- an Approved Social Worker in England, and a Mental Health Officer in Scotland.

I started out 25 years ago with a clear idea about mental illness- people who were ill did not always realise that they needed help. It was my job to try to make sure they got help. I had all sorts of different ideas about what this help should look like, and lots of frustrations with the psychiatric machine that I had to deal with, but fundamentally, the idea of mental illness itself was a stable reality within what I did.

Sure, we challenged the medical model (Illness-diagnosis-treatment (maintenance)) as this failed to take into account the social context in which some ones illness develops, but the dominant paradigm that affected work with people with ‘severe and enduring’ mental illness remained firmly medicalised. It was the only way to make sense of the psychic chaos we were faced with – hospitalise, medicate and sanitise it out of our immediate circle.

Increasingly I became a skeptic- not just of the machine, but the actual underlying concepts of ‘mental illness’.

It started many years ago when faced with young men and women who, once diagnosed with schizophrenia, were condemned to half-life at best. The medication we gave them to control their symptoms (particularly the ‘voices’) often did not work, and had such destructive side effects that everything would slowly slide downwards into a kind of suppressed humanity. Is this really the best that we could do?

Alongside this other movements were emerging. They were dangerous and threatening. One of these grew up in and around Manchester, where I was working, and was called ‘The Hearing Voices Network‘. It dared to suggest that hearing voices was a NORMAL human experience- not a symptom of ‘illness’. Rather it was a way of coping with trauma for the most part.

Rather than pushing the voices away, suppressing and chemicalising them, the HVN suggested we needed to embrace them, engage with them, understand them- even the destructive aggressive ones.

More recently we have has another movement- around the idea of ‘recovery’- living fully in the presence (or absence) of the ‘symptoms’ of mental illness.

None of these are easy concepts- they are really stories of life long journeys for people experiencing one of those ‘psychic civil wars’ that all of us go through to some extent.

What convinces me most about these revolutionary ideas in relation to mental health issues is the HOPE that they bring. The best that psychiatry can offer to many is ‘maintenance’. All the so called break-through s of the pharmacological machine that spend millions convincing doctors to use their new wonder drug have done little to change this. Suddenly however, people are saying clearly- The treatment you are offering me is NOT WORKING. I want something better for my life. 

That is not to say that there are not people in the system who see it this way too. I heard this wonderful TED talk the other day. It is saturated with hope, and the raw joy of life…


A little self-review of the downshifting process…

As I climbed a ladder to paint a patch of re-rendered pebble dash on the outside of our old house, my thoughts were strangely on my former employment- all those years of social work. It has been just about two months since I took redundancy from my post as Mental Health Area Manager- which is something of a surprise- where did all the time go?

Time is a precious commodity- this is the longest period of my adult life without some kind of paid employment- even as a student I was so skint that I always had to find some work in between terms. I am acutely conscious of not wanting to squander these weeks of rest and recovery before the next chapter of my life can begin.

My hope was that the redundancy payment will give me some time to do the following;

  • Recover from what has been an exhausting, stressful and even damaging job.
  • Go on holiday somewhere.
  • Transform two large en suite rooms in our house to offer bed and breakfast accommodation.
  • Plan retreats, activity/craft breaks at the house, using our B and B as well as a holiday cottage.
  • WRITE.
  • Hope that the recharging of the batteries might result in me finding some part time work within the social work field that will allow me to continue to do the above things but have enough money to live.

How has it gone then?

Well, it took quite a few weeks (with hindsight) to ‘stop’ after all the madness preceding. I found myself, weeks after I left work, driving back towards Dunoon thinking about all the stuff I had yet to sort out in work. There came a point however, about four weeks after I left when I realised I no longer felt ill. I should add that I had not previously realised that I did feel ill. It was as if some pressure had been released out of my system and everything was working a little better. Long term exposure to high levels of stress is a terrible thing.

We managed a few days away, down in Northumberland- a place we had not been to before. I have also played a lot of cricket for both Innellan and Greenock clubs, and the chance to run around a field for a while playing a game I love has been like a holiday too.

The work on the house is now well under way as can be seen above. The biggest single task has been to fit an en suite shower room, and it is now finished;


My perfectionist friends will point out the rather irregular tiling in places but nothing in this old house is straight, so perfect finishes are simply not an option. I think it looks great though and is very usable.

The planning of retreats- well we are not there yet, but Michaela and Pauline’s craft workshop business is going great guns and already people are asking about the possibility of staying over in the B and B, which is just what we were hoping for.

Finally- writing.

If I were to pick one thing that I wanted to find time to spend doing, it is this. However, as yet, it has not happened really. I think this is partly about discipline, making a slot each day- but this kind of way of being creative has never really worked for me. Inspiration may be 70% perspiration but it still requires the nurturing of an idea. I have a project in fragments at the moment, waiting for the glue that brings them together.

Better boil up some horses hooves…

Square world…

I went for a meeting today in a posh new hospital. Everything squeaked as if in disapproval of my polluting presence.

I was there to chair a meeting about one of the patients, who had been transferred there recently to receive more specialist care. She had previously spent most of the last 40 years of her life as a resident of the local psychiatric hospital. Things went wrong after the death of her husband, and she somehow lost herself in the grief of it all. The whole range of psychiatric science was rolled out for her benefit – drugs that greyed her vision, Electric Shock Therapy that blew holes in her memory then finally psycho surgery in an attempt to cut grief out of her brain with a scalpel.

And here she remains – toothless, but given to scratching. Occasionally abusive but still with sense of humour intact.

She used to be a worker, a wife, a mother. She used to go on picnics and loved to dance. She enjoyed holidays and gossiped with her friends about the comings and goings of the village.

But that was 40 years ago.

Today we met to discuss her future care – a likely move to a specialist nursing home, and the legal issues around that given her lack of capacity to understand or to give consent.

But in the middle of this, she looked at the ceiling and said;

I hate those squares. Everything is square in here. Put me outside next to the beech hedge. Just put me outside.

And I looked out at the brown beech hedge, with dry leaves still rattling on the close cropped branches.

Through the square window.

And I wanted to wheel her out there, and sit her under the winter sky, wind waving her long grey hair in a curve of protest against all those bloody awful squares.

The church and social economy…

community 1

As part of my job, I am currently leading one of the groups responsible for planning a redesign of mental health services. I am enjoying it so far- I like the creative process of developing new things.

The remit of my group is to look at how we develop mental health services in primary care and also to think about how services might help to prevent mental health problems- and contribute to the mental wellbeing of our society.

It is a huge subject, that requires connections across many parts of society- statutory services, housing providers, voluntary bodies, social networks etc etc. It does not take long to realised that mental wellbeing and mental health are very different issues. It is possible to have a severe mental illness, and yet still have good mental wellbeing, but poor mental wellbeing can easily lead to mental ill health. In fact, good health of any sort is simply not possible without goon mental wellbeing.

It is a subject close to my heart, as it resonates deeply with my faith.

I believe that the followers of Jesus are to be a source of blessing for our communities. Too often, we get into pointless condemnation or narrow defensiveness- the foolish idea that we need to ‘defend the faith’ against rising secularism and Godless sinfulness. But the call of Jesus is to show a better way- a way of love and service that transforms lives and communities, and wherever we see the flowering of these good things in society, then we are to savour them with salt, and illuminate them with light.

Because the alternative is grim.

Here is a quote from one of the documents that I have been re-reading for my group-

Across Scotland, the UK and European Union, stress, anxiety, depression,hopelessness, isolation, fear, insecurity and distrust are increasing. We witness daily the effect of this on the lives of individuals, families and whole communities.

Many people in Scotland find themselves isolated and vulnerable due to their mental health status, poverty, class, ethnicity, age, disability, gender, sexuality, homelessness and many other forms of exclusion. The resulting lowself esteem and feelings of being undervalued have serious effects for them
as individuals, for their families, their colleagues, the wider community andScotland.

The consequences of cycles of social exclusion for how people think and feel are complex:

Some people faced with chronic stress and disadvantage may retreat and stop participating. Their social networks reduce, their vulnerability increases, their incomes and security reduce and many spiral into cycles of anxiety, depression and other more severe mental health problems. This not only impacts on them as individuals but can damage relationships between family members, partners, parents,
children and siblings with a chain of negative results-

  • changes in life situations – having babies, getting old, losing a job, becoming disabled, getting ill or family separation – can result in people becoming isolated, vulnerable and excluded
  • others may get resentful and angry and act on these feelings in their personal and community relationships, through aggressive behaviour, violence, abuse, theft or vandalism
  • hopelessness and low expectations may mean some people do things which might be considered to be ‘risky’

Taken together, such experiences are damaging to wellbeing. People, families, groups and communities of interest do not feel involved, connected,safe, secure, caring, creative or active. These types of experiences also affect how communities function: communities can come to feel more and more
vulnerable and close ranks, displaying exclusive attitudes and behaviour; or become divided and disarmed by fear of ‘the other’; or find it hard to believe that it is possible to break the cycle and create a different future.

From the ‘Small change, big impact’ conference report, 2006.

It is possible to get all doom and gloomy when looking at this picture. The question is what can we do about this? How can we break the negative cycles that are at work on individuals and groups? How do we break down isolation and low confidence and self esteem? How do we do this in a way that supports, encourages and empowers, rather than just further labels people as responsible for their own failures?

The report digs into some community projects that have begun to do this, and identified some of the characteristics that appeared significant-

Even though the projects developed independently they articulated a shared sense of purpose: to bring about connectedness

  • With self – A sense of self and worth internally for the individual,
  • With others – A sense of belonging and worth in relation to family, communities of interest and the community
  • With the bigger picture – Creative engagement between individuals,the family, diverse communities of interest and the community that opens doors for a caring and creative society to flourish
  • Between communities of interest and individuals,
  • Spatially – Knowing it is ‘my place, I belong here’ so that people feel safe, involved and want to invest
  • Institutionally – We delivery agents participate too, it effects us also.

It is OUR agenda, our community, our Scotland. We are community too. We are participants with a specific role to facilitate processes that encourage and enhance social development across services to make it easier to respond effectively and holistically to a community as it develops and grows.

The report goes on to speak of the importance of the arts in this process too…

Does this sound familiar? That list of characteristics of groups that build communality, health and satisfaction- does it not sound like what CHURCH is supposed to be? Is it not possible that this is the role that church USED to fill within society?

No longer however. Perhaps we squandered the opportunity, or perhaps the world left us behind. But the challenge to us all- perhaps particularly those of us in church, is how we might again be a blessing to our communities- not so that they might fill our pews again (at least not as an end in itself,) but rather so that we might be change-agents of the Kingdom of God.

This perhaps requires a different set of skills traditionally valued by church- networking, hospitality, reconciliation, listening, neighbourlyness- providing opportunities for real, deep connections between people.

Perhaps it also demands of us that we become JOINERS with others, rather than just INVITERS to our own safe places.