Mental distress from a socialist perspective.
Unike Dr Bruce Scott, I have no medical or psychiatric training, so in some senses I’m poorly prepared to challenge his position. However, I do feel equipped to respond from the perspective of someone who has experienced mental illness, cares for someone with a severe and enduring mental health issue, campaigns against discrimination and stigma and teaches mindfulness meditation for well being.
I’m sufficiently left of centre to appreciate and welcome the socialist standpoint Scott takes. It is refreshing to read a perspective on mental and emotional distress that embraces the social contexts in which distress arises or is so identified. The literature on the prevalence of diagnosed mental ill health in communities experiencing poverty is unequivocal and points clearly to the preconditions that may create mental distress. However, the processes that create understandable reactions to intolerable conditions are less widely recognised. The tendency to respond solely to the individual rather than to their social context is counterproductive and profoundly disrespectful. In particular, the systematic categorisation of people’s experience principally through the Diagnostic and Statistical Manual of Mental Disorders is blinkered and discriminatory. To be diagnosed with schizophrenia is to have only one facet of our being described, and that inadequately. We need to accept, as Scott suggests, that there may be many meanings to our distress, and that to close down our exploration and our challenging of those meaning may also close down routes to our recovery.
However, I take issue with Dr Bruce Scott on a number of points. These are not points of disagreement as much as a polarisation between what I read as a unduly pessimistic view and my own more optimistic perspective:
1. He suggests mental and physical ill health are not comparable, on the grounds that the biological model of mental ill health remains a dubious concept. This seems to ignore the growing realisation that the biological model of physical health is not watertight either and that the mind body connection is much stronger that we once understood.
2. I am uncomfortable with a dialectic that attacks the anti-stigma and anti-discrimination movement for highlighting mental illness as an issue that should receive the same concern, support and funding as physical illness. To raise awareness of mental health is not necessarily to blame the victim, nor to collude with an alienating discourse of mental illness. To refuse to acknowledge the devastating effects that mental illness can have is to deny our human right to support and treatment.
3. I don’t agree with him that his ‘reservations about concept of mental health are routinely overlooked’. This has not been my experience in dealing with health professionals in the case of my own illness, nor in my experience as a carer. The establishment of multidisciplinary community mental health (financial and housing support, work and training support, social services, etc. engaged in tackling many of the societal creators of distress) is a reflection of the wider understanding of mental distress. At primary care level, there is a also a growing recognition that patients who report with experience of mental distress often do so because they are dealing with impossible situations, including bullying work cultures and long term unemployment.
4. Finally, I share with him concerns about the leadership gurus who capitalise on mindfulness meditation, and I am concerned about popular understandings of the practice as a panacea. I am troubled most by its use as a subtle means to induct participants into religious beliefs and practices. However, I think in dismissing it so arbitrarily he has overlooked the many benefits that mindfulness practice brings. The teaching of mindfulness is a skill-based programme that encourages the participant to take back control, so is therefore the antithesis of the 'master-slave dialect'.
Let’s by all means turn our illness into a weapon! The strong recovery movement in Scotland, the campaign to end stigma and discrimination and the increasing focus on the voice of those who experience mental illness are doing just that.
*https://commonspace.scot/articles/1517/dr-bruce-scott-turn-your-illness-into-a-weapon-mental-distress-from-a-socialist-perspective
A Response to Unike Dr Bruce Scott, I have no medical or psychiatric training, so in some senses I’m poorly prepared to challenge his position. However, I do feel equipped to respond from the perspective of someone who has experienced mental illness, cares for someone with a severe and enduring mental health issue, campaigns against discrimination and stigma and teaches mindfulness meditation for well being.
I’m sufficiently left of centre to appreciate and welcome the socialist standpoint Scott takes. It is refreshing to read a perspective on mental and emotional distress that embraces the social contexts in which distress arises or is so identified. The literature on the prevalence of diagnosed mental ill health in communities experiencing poverty is unequivocal and points clearly to the preconditions that may create mental distress. However, the processes that create understandable reactions to intolerable conditions are less widely recognised. The tendency to respond solely to the individual rather than to their social context is counterproductive and profoundly disrespectful. In particular, the systematic categorisation of people’s experience principally through the Diagnostic and Statistical Manual of Mental Disorders is blinkered and discriminatory. To be diagnosed with schizophrenia is to have only one facet of our being described, and that inadequately. We need to accept, as Scott suggests, that there may be many meanings to our distress, and that to close down our exploration and our challenging of those meaning may also close down routes to our recovery.
However, I take issue with Dr Bruce Scott on a number of points. These are not points of disagreement as much as a polarisation between what I read as a unduly pessimistic view and my own more optimistic perspective:
1. He suggests mental and physical ill health are not comparable, on the grounds that the biological model of mental ill health remains a dubious concept. This seems to ignore the growing realisation that the biological model of physical health is not watertight either and that the mind body connection is much stronger that we once understood.
2. I am uncomfortable with a dialectic that attacks the anti-stigma and anti-discrimination movement for highlighting mental illness as an issue that should receive the same concern, support and funding as physical illness. To raise awareness of mental health is not necessarily to blame the victim, nor to collude with an alienating discourse of mental illness. To refuse to acknowledge the devastating effects that mental illness can have is to deny our human right to support and treatment.
3. I don’t agree with him that his ‘reservations about concept of mental health are routinely overlooked’. This has not been my experience in dealing with health professionals in the case of my own illness, nor in my experience as a carer. The establishment of multidisciplinary community mental health (financial and housing support, work and training support, social services, etc. engaged in tackling many of the societal creators of distress) is a reflection of the wider understanding of mental distress. At primary care level, there is a also a growing recognition that patients who report with experience of mental distress often do so because they are dealing with impossible situations, including bullying work cultures and long term unemployment.
4. Finally, I share with him concerns about the leadership gurus who capitalise on mindfulness meditation, and I am concerned about popular understandings of the practice as a panacea. I am troubled most by its use as a subtle means to induct participants into religious beliefs and practices. However, I think in dismissing it so arbitrarily he has overlooked the many benefits that mindfulness practice brings. The teaching of mindfulness is a skill-based programme that encourages the participant to take back control, so is therefore the antithesis of the 'master-slave dialect'.
Let’s by all means turn our illness into a weapon! The strong recovery movement in Scotland, the campaign to end stigma and discrimination and the increasing focus on the voice of those who experience mental illness are doing just that.
*https://commonspace.scot/articles/1517/dr-bruce-scott-turn-your-illness-into-a-weapon-mental-distress-from-a-socialist-perspective