What Happened To Sad
I don’t very often write about my work. For two reasons. Firstly, no matter how careful I try to be, there is always the risk of breaking someone’s confidentiality. Secondly, I know that some of my views are not very popular in the therapy world. I can get away with it when writing about social care issues. Although I’m in it, I, like all service users and their families, are kept firmly on the outside by all the experts. In the counselling world, I’m speaking from the inside.
This morning, I got involved in a Twitter discussion about the disappearing world of normal emotions. Over the past few years, I hardly ever hear clients reporting feeling “sad”. They will tend to use the word “depressed” rather than “sad”. I often have people turn up requesting “anger management”. It all goes swimmingly until we start addressing that anger is a perfectly normal response to an external stimuli. I often discuss in supervision why people seem quite happy to announce their label – “I’m a bit OCD” but run a mile from experiencing the normal emotions of living.
A few years ago, I had an initial session with a woman in her late 60s. She had been married for 40+ years and repeatedly described her late husband as “my soulmate” or “he meant everything to me”. She told me that as she had been struggling to get over her husband’s death, her GP had diagnosed her with depression and prescribed some Prozac. Everything she said made it sound that she had been widowed for several years but halfway through the session, the penny dropped. “How long since he passed away?” I asked. “Three weeks ago”, she replied. Three weeks. “You’re not depressed. You’re understandably sad”, I said. She couldn’t accept “sad”. She had brought into the idea that she had a condition because she was sad over the loss of her soulmate. It was very cruel.
Not so long ago, a client put me on the spot. He had talked at length about the very destructive relationship with his mother. He said, “I’m sorry Mark. I guess you think I’m too angry”. To which I replied, “Too angry? I’d say you were not angry enough”. It was an honest but not a particularly useful intervention on my part because he couldn’t grasp the idea that anger is a perfectly normal human reaction.
Somewhere along the way, probably influenced by Big Pharma, we forgot that we can feel “sad”. Anger became a word to diagnose a dysfunction of some sort. In the therapist’s bible, the DSM, there are now so many personality disorders, that this industry needs constant feeding. And the only way it can do that is to turn the normal responses to being alive in the world into psychiatric conditions. It’s dangerous, because as we are constantly encouraged to aspire to happiness, we have to learn to supress the polarity. And if we can’t, there will always be a DSM disciple to pathologise us and medicate us. I’m of the school that believes that the inappropriate prescribing of medication actually blocks the normal feelings and creates the imbalance that the medical world are telling us the pills are correcting. Someone who has been repeatedly sexually abused as a child is going to feel angry. They don’t need to be told that their horrendous experience created a chemical imbalance and that only medication can correct that imbalance.
Let’s try and relearn that even if we feel overwhelmed by sadness, it is more useful to our humanity to stay with the emotion and experience it phenomenolgically.
If you’re a client in the social care world with learning disabilities, expressing a normal emotion is especially dangerous. Firstly, for the system to function, that emotion cannot be recognised. I remember Sara Ryan’s blog post from the time Connor was in the ATU. The Unit were very keen on people recognising and recording their emotions. So in Connor’s bedroom, he had a faces chart where he was encouraged to plot his emotion day by day. Sara visited one day and noticed for five days running, Connor had put up a “sad face”. Whilst the arseholes were applauding him for being able to identify and name his feelings, nobody gave a monkeys about the message. This young dude is very sad. Daily. I don’t think it even registered. Far too challenging. Steven had something almost identical in the ATU. He was expressing his distress in a way that was much more acceptable for the managers and therapists and after four weeks, they stopped as they had “achieved a great piece of work”. The distress was never attended to.
The double bind that hits the learning disabled in in patient services is that expressing their emotions is often used as justification to keep them there. This is what the expert witness said in Neary vs Hillingdon 2011: “However, in relation to the counting of incidents in the course of functional analysis, he recognised the risk of circularity, with bad behaviour arising from confinement being used as a reason for continuing the confinement”. It’s interesting that even an expert psychiatrist making a positive statement on Steven’s behalf, had to turn expressions of severe emotional distress into “bad behaviour”. I guess that’s what happens when we cannot acknowledge the most common of human reactions.
Someone during the Twitter conversation said that “it’s like they’re trying to turn us into perfect human beings”. I don’t think it’s about being “perfect”. I think it’s about being compliant. A diagnosis of a personality disorder keeps us in our place and medication shuts us up. Sorted.
I think a perfect human being is one that is happy. And sad. And angry. And all the other “negative” emotions that we are no longer allowed to feel.
From → Social Care