Ian Yates

I helped to facilitate the This is Madness group whilst training to be a clinical psychologist. Guy was doing some teaching on my course at the time and a lot of what he talked about chimed with my own ideas - so I approached him to ask if I could be supervised by him and take part in one of his groups. I have written a short account of my experience of the group for a South Staffordshire & Shropshire Trust magazine and what was the ‘shropsych’ website (which is no longer available). However you can read the article here.
At the time when I started working with Guy I was becoming very frustrated with the mental health service and the world of psychology. I probably still am. Having grown up in Merseyside I spent a lot of time on housing estates where working class people had been hit by the harsh realities of Thatcher’s post-industrial Britain. The pride of the shipbuilding industry had been replaced by high unemployment and poverty. For many areas violence, hopelessness, misogyny and pervasive reliance on drugs to get by were features of many people’s everyday reality. I have always found it hard to reconcile the idea that ‘mental health problems’ are due to bio-chemical changes or patterns of thinking with my common sense understanding of the world - that difficult life experiences are frequently distressing and overwhelming. As a psychologist it felt that, whilst the help we offer might be valuable and appreciated, what many people need is a change in the material conditions of their lives or the social structures that deny them the things they need.
I often feel that the mental health system is founded on a set of narrow, politically dubious ideas - ideas that we must first indoctrinate people in and that can fly in the face of our own common sense understandings. When we feel awful we direct our gaze increasingly inwards; we may take drugs to make us feel better. Meanwhile, who is tackling the harsh realities of life - the things that we intuitively know are damaging us and our relationships? I have never been comfortable with the notion that as a therapist I have some special power to ‘treat’ others. The idea that one person has the power, expertise or skills to show another person the correct way to deal with distress has never fit very well with me. This doesn’t mean I don’t feel able to help people - I frequently do - but this often appears to occur despite the unhelpful systems and dynamics I find myself in. ‘Professionals’ feel under tremendous pressure to help people yet are often powerless to change the aspects of people’s lives that cause distress. I sometimes wonder if this dynamic encourages ‘patients’ to take a passive role in their lives - patiently awaiting the benefits of the ‘treatment’ to kick in, only to find later that ‘professionals’ are getting frustrated that they aren’t ‘taking responsibility’ for their lives.
In the
This is Madness group I was able to talk to people outside of this dynamic which was a relief and a challenge. A relief in that I felt able to honest and excuse myself of the responsibility of doing the impossible. I felt I didn’t have to say things I didn’t believe in. I could talk about the things I felt passionate about. It was also a challenge - like any human being I enjoy the status that my role provides me with. Status and power structure group discussions and it can feel overwhelming in their absence. As a professional we often find ourselves in a position of ‘leading’ a group - sharing our ideas with ‘the others’. Whilst this can be frightening, we enjoy the power this gives us. It also creates a sense of order to things - even if this may in some ways be oppressive to others. With this taken away I felt liberated but at times lost - struggling to find a voice in a room with some forceful characters. Some members of the group said that in the past they had struggled to be heard – I wondered if that might be a factor in them speaking louder than others. Others were still struggling to be heard. After the group many of us worked together to write about our experiences of the group and reflect on the way power operated.
Although I took part in the group whilst training as a psychologist and working in mental health services this work differed in some fundamental ways from my usual ‘clinical practice’. The model for most mental health work is to encourage a person to understand their problems in a certain way. As I said above, the explanations we offer are often limited and focus on changing brain chemistry, thoughts and behaviours. As professionals we hold and disseminate the knowledge - and if we do it well enough then people will get better. This is Madness seemed to have more of a feel of an educational course. People could critically examine different explanations about human suffering. Importantly, a much wider range of explanations were explored than are usually discussed in mental health services. For example, I (and others in the group) were interested in research about the relationship between mental health and power and inequality - these things are seldom discussed in clinical practice. Clinical psychologists often feel severely restricted in what they can say to people. Within a treatment model it can often feel inappropriate to talk about problems located in the world, such as income inequality. Our job is to help people look inwards. Yet, in doing this, I often feel like I am misleading people and more importantly not treating them as a responsible adults capable of making up their own mind. And sometimes it just feels ridiculous.
At the time of working with Guy and Phil I was also undertaking research into the things that help recovery from severe mental health problems. As will be apparent, I was interested less in what went on in people’s heads and more interested in what was happening in the everyday reality of the person’s life. I wrote a couple of articles based on my research which are listed below. Some very simple things became apparent to me whilst doing this research. Firstly, it became obvious to me just how hard it is for many people to meet people and form supportive relationships. This I knew from my own life - moving around from place to place and job to job, you are always in a position of needing to get to know people, and it isn’t easy. For people recovering from really distressing situations, these challenges can be are even tougher. What I found really interesting was that the ‘psychology in the real world groups’ had fostered networks of interesting people - networks of people interested in the fascinating complexities of life. People were able to speak to each other outside of unhelpful mental health settings that have so much stigma attached to them and outside of unhelpful mental health dynamics that confuse everybody’s sense of personal responsibility. People have described the mental health system to me as a club you gain membership to. It gives you benefits but can confine you to a social world in which it becomes hard to talk to people in the world outside. By aiming services only at people who have such membership we are reinforcing social divisions and making it harder for people from different spheres of life to come into contact with each other. Guy is one of only a small number of people I’ve ever met who tackles this problem head on. By opening groups up to everyone he creates places for people to meet and have interesting discussions. I have fond memories of many people who attended the group - interesting people the likes of whom it is not easy to meet.
Wouldn’t all our lives be better if it was simply easier to meet people in this way?