the put-down by a professor of psychiatry to my critique of his bio-bio-biopsychosocial model of psychosis: “I must have hit a nerve”

I recently was sent a copy of a BJPsych article, strapline of ‘An integrated biopsychosocial model of childhood maltreatment and psychosis‘ by Victoria Barker , Andrew Gumley , Matthias Schwannauer , Stephen M. Lawrie.  [Link to journal, short abstract as article hidden by paywall]

I knew the 3 male authors personally, 2 professors of clinical psychology and the other a professor of psychiatry, at Scottish universities, having engaged with them at various times over the last few years when trying to get meaningfully involved in Scotland’s mental health matters.  I didn’t know the female author.

The title annoyed me and each page fuelled the fire of my discontent so I put fingers to keyboard and immediately sent off an Email to the professors, on a Sunday morning, shortly after receiving the paper.  I admit to using words like cow dung and eugenics, and could have used even stronger language, such was the passion I felt at the biological psychiatry’s narrow, reductionist focus.

My Email, sent on 1 March 2015 at 11.49, strapline: (bio bio bio) ‘An integrated biopsychosocial model of childhood maltreatment and psychosis’ – not in my family’s experience

Psychosis is normal in my family and we weren’t maltreated as children.  It is psychiatry which has subjected us to abusive treatment.  Plus the article had a flow chart and many technical, biological and scientific terms to back up its premise but I wasn’t convinced of their validity, particularly when it admitted using “rat pups” and animal models in the research.

Then to my surprise (since usually it’s a monologue), 20 minutes later I got a response from the psychiatrist.  Patronising me.  To which I made a swift, reply, appreciating the opportunity for engagement, ignoring the put down.

Here are jpegs of the piece, in 3 parts, followed by the Emails between Prof Lawrie and myself:

Here are biographies of Prof Stephen Lawrie from the SMHRN website and on a presentation slide from an event on psychosis he spoke at in July 2014 which I attended:

 

Here is Prof Lawrie’s Email response to me on 1 March 2015 at 12.08:

And my response to the professor, at 12.58:

Strapline: (bio bio bio) thanks for responding Prof Lawrie – what about resilience? – the damage done by drugs – blog post on being called a “pistol”

“Dear Stephen

Thank you for responding at length.  I think it is the first time of you doing so.  I must have hit a nerve.

“Mentalisation based psychotherapy” – unfortunately, from what I’ve heard, in Cornhill, Aberdeen (a workshop at a nurse research conference last year in Napier Uni), this results in the nurses using military language to describe the supposedly “BPD” patients – tools as “weapons” and suchlike.  I wasn’t impressed.

I would like you to ask yourself, Stephen, what about the children who had difficult childhoods yet developed resilience to cope, to survive and to overcome their difficulties?  That, I maintain, is a much more interesting topic for scientists such as yourself and others, to consider.  Discovering the strengths within human beings that result in them striding forth into the world, brains intact and ready for what life throws at them.  Speak to the survivors.

I can understand that you have personal reasons for concentrating on genes, neurones and the like, due to your many years of investment in this area of science, and because you have links with pharmaceutical companies whose drugs target brains and affect their function.  I can testify to this, having been forced to ingest and swallow neuroleptics which took away my agency and decision-making abilities.  I contend it was the drugs that damaged my brain in the short term and therefore I had to get off them to recover.  My wellness and my optimal brain function.  And so I did.

Others haven’t been so fortunate.  The psychiatric drugs have shortened their lives, caused untold damage to their nervous systems and removed or distanced them from life.  It’s a crime.  There has to be other, far more better ways of working with people in mental and emotional distress that doesn’t mean forcing a biomedical model of mental illness on to a person, and a lifetime of neuroleptic dysfunction.

As for soothing my “ire”, I like to fuel the fire of my discontent with biological psychiatry.  Because it isn’t the whole picture or even a major part of the picture.  In fact it is, and should be, a very small part of the meaning of our existence.  We are far more than brains and chemicals.  You just need to look out of your window, see the beauty of nature, listen to musical creations, view artistic endeavours and read stories, biographies and non-fictional books, to see how very much more there is to life and living.

I recommend looking outside of yourself rather than inside the brains of others.  Consider a shift in your field of study and in your practice.  It’s never too late to have a change of mind/heart.

Change of topic. My blog post for today, still in construction, strapline of “”pistol”: a notably sharp, spirited or energetic person (Merriam Webster); synonyms: dynamo, fireball, live wire”.

Yours sincerely,

Chrys”

I then sent the professor and others my completed Pistol blog post.  There was no further communication ….

 

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5 thoughts on “the put-down by a professor of psychiatry to my critique of his bio-bio-biopsychosocial model of psychosis: “I must have hit a nerve”

  1. As a survivor, I really like that you like to emphasise that we are human beings rather than words in a textbook that slot neatly into our little categories. I’ve commented on your stuff before. I really like reading your constant battle to destigmatise all of this.

    I was an in-patient at Whytemans Brae and Stratheden 15/16 years ago and looking back it was archaic times – I remember applying to read my notes several years later and one of the consultants had labelled me a “strange little boy”. It brings into question the methods and supposed care plan / treatment I was given.

    In relation to your article it was not until several years later that I joined wellbeing services and employment that really likes to focus on your positive abilities, your strengths and humanity. From there I made huge huge strides into recovery and I can confidently say I sit where I have always wanted to be; happily married, child, Manager at work, motivated, intelligent and very happy.

    I fear it is all too common to focus on the illness and what is wrong with people in institutions to really effectively treat people.

    • Raymond thanks for commenting.

      I am looking for a paradigm shift in Fife psychiatric services, Stratheden Hospital in particular, where things have got worse and not better since 15/20 years ago, in my experience (my oldest son was a Lomond Ward inpatient 1995 and it was very problematic back then).

      I think it’s a matter of bringing about cultural change and putting resources in. Some staff need to move on or move out. They shouldn’t be working with human beings. New management is needed, people who are competent and able to implement good practice, not just talk a good game or quote statistics.

      4.4million has been awarded by Scottish Government to build a new IPCU, intensive psychiatric care unit at Stratheden Hospital, but they will need to ensure that staff who use dehumanising practices are not tolerated. Pension them off or sack them.

      • I have been an IPCU inpatient, and was one for around two months. I must admit I did feel very dehumanised – The staff were very cruel there; I understand the need for behavioural modification but it’s used in a very wrong way. If it’s worse now I dread to think what’s happening!

        I was a kind soul, always have been. That’s not to say I am without my faults however I was admitted there wrongly and I had things like dead flies were purposely put in my coffee, rubbish in my food, staff overtly-biased to certain patients, things stolen from me constantly. In my opinion everything was just tackled in the wrong way. Instead of having a secure, empowering and collaborative environment with the proper boundaries and such, we had people constantly fist fighting, overtly aggressive sexual acts, no-one liked one another and there was a constant us and them attitude with staff – as in it always felt like the staff were “the OK ones” when everyone knows no-one is without problems in life. I also hated that some staff rarely smiled.

        I could argue that this was part of my care plan however I run a service at work that combines a lot of people from different backgrounds and varying degrees of problems but with just myself and a few volunteers we are able to create a very positive, empowering and nurturing environment. It’s not hard!!

      • Raymond I am sorry to hear of what you went through in the Stratheden IPCU. February 2012 was our first experience of that unit when my son was transferred from Lomond Ward in only his underpants, bare feet and a broken hand, which I knew nothing of.

        When I said that things were worse I was meaning in Lomond Ward, the open acute psychiatric ward at Stratheden. In 2012 compared to 1995. I have heard stories of the IPCU from 1981 when the locked seclusion room was used punitively on patients, also of sexual grooming taking place. Male nurses to young male patients.

        What annoys me most is the the Mental Welfare Commission for Scotland are meant to visit psychiatric units to be a watchdog. Not much use if they can’t uncover abuse happening to vulnerable mental patients. Useless in my opinion. They had declared the Stratheden IPCU building “unfit for purpose” but they didn’t say anything about the staff being “unfit to practice”. What happens behind closed doors has to be transparent. They should have a method of hearing ALL stories from inpatients. Protecting the whistleblowers.

  2. Yes! Definitely. And wow – that’s as inhumane as you can get! I wish there was a useful way to complain about malpractice in hospitals from patients. Sadly, with the nature of the business I quickly came to realise: “If I’m talking sense in a psychiatric ward as a patient – would anyone *actually* believe me? Or scrub it off as another one of my silly delusions”

    Luckily for me I never bear witness to any sexual grooming taking place, I think luckily malpractice of that sort had been effectively stamped out. However, I did have a lot of family visit me regularly, and had a lot of out-side support. Perhaps it was because of the level of outside care and witnesses I had that deemed me unsuitable for this. Perhaps not. I will never know. I only can judge through my own experiences 🙂

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