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What Happened To Sad

January 21, 2016

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

  1. “Poised where the falling angel meets the rising ape”. Pinpoint accuracy, Mr. Neary.

  2. Pauline Thomas permalink

    Mark you have hit the nail on the head. I agree with everything you have written. When will doctors stop throwing SSRI’s at people with LD and start to understand why they are angry in the first place. For someone without speech or have difficulty in being understood anger and violence is the only way of letting people know that they ill, unhappy or just bored. Boredom is soul destroying, especially if you not in control of your every day life and do not have the power to change what is happening to you.

    Like you so rightfully say anger and sadness are emotions that all human beings experience. Unfortunately people with LD are not considered quite human, so any emotion they have has to be analysed and acted upon. Usually turning them into obedient zombies.

  3. Spot on, but then they can use any tripe they want, as they have made sure, we are at their mercy,

    The autistic are easy fodder, to increase the mental health industry.

    Support now consists of mainly assessments.

    Every move the autistic, or, indeed, parent make, is construed in favour of a mental disorder, or inappropriate behaviour, or at very least parental incapacity.

    They are not ‘sad’ at such a predicament, but, clinically depressed, a danger to their children, and need to be Prozaced.

    Prozac/ antidepressants, change our personality and turn us into robots, incapable of real emotions including empathy and rage
    Normal reactions/ behaviour by disorder diagnosis is used to control.

    We now have health and social care trusts, and community medicine.

    Compliant, appropriate social behaviour is enforced by medication, and pharma boosts our economy as third largest industry despite being based on no evidence other than their PR.

    And, there are now 375 mental disorders to choose from thanks to the USA.

    At 6, my diagnosed autistic daughter, was described, as moving ‘inappropriately’ across the class room.

    If she returned from crowded shops with carers, it was a major issue, if she had pulled some ones shoulder bag strap.

    This all, despite huge sums of money justified on campaigns like,’ autism awareness’. ‘Tolerate difference not indifference’. When it was the experts etc, where not.

    Behavioural charts, psychiatrists feeding the autistic into the mental health industry, diagnosing them with mental disorders – anxiety, ADD to justify more assessments, more pharma, and more containment.

    We live in a world, where we must be robot, happy clappy, prescribed conversations and reactions, otherwise medicated.

    It is ‘us and them’, and we are used to feed into for unnecessary scrutiny, every move, word ,behaviour made to fit the box, they want to tick.

    The only policy for the autistic. to ‘lock them up and shut them’, and charge the government the maximum, and, it appears, we can do nothing about it.

  4. Sally permalink

    Mark! Mark!
    January the 23 British Medical Journal ” Letter of the week”
    A call for a Roual Collegd of learning disabilities . Pinpoints the appalling service given to the LD, Good ideas to address this .
    Connor Sparrowhawk’s photo is included

  5. James permalink

    Dear Mr Neary,

    The suggestion for a Royal College of Learning Disability is in the latest issue of the BMJ (letters section) and is “letter of the week”.

    If you have an email address I can send it to you. I cannot figure out how to send it to this comments box as I am not sufficiently computer literate.


  6. Sally permalink

    Not very computer literate, hang on..

  7. Sally permalink

    So I have the BMJ article in front of me and have the article on the computer as an email too..any use?
    Page 352 author: Diane Willis school of nursing midwifery and social care
    Edinburgh Napier university EH114BN.

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