Understanding Mental illness

The reflection process came a little while into my time as a practitioner but it did have in common with some earlier ideas about mental illness, the possibility of bringing client’s behaviour into a newly intelligible form. Earlier encounters of this kind had been with the work of Ronnie Laing and Thomas Szaz. It may seem that I am turning aside from discussing the concept of personal boundaries, but as a student, first meetings with mental illness were a powerful experience of new forms of individuality. At first sight, it all seemed completely incomprehensible, as though there were no connection between the form of humanity evident in the closed wards of a mental hospital and the individuals one had met in ‘real life’.

I came to think differently about the incomprehensible nature of mental illness, and psychotic illness in particular, at a later stage, but for now as a student, Laing and Szaz offered something hopeful amidst the bewildering wreckage of humanity that faced me on the wards of the hospital. They both illustrate a principle of which I am fond – in that it is better to be helpful than right. Of course this is an oversimplification, but worth putting in front of those bright intellectual staff who are mystified by the fact that the world does not work according to reason.

For me therefore, before he became increasingly divorced from reality, Laing opened up the possibility of listening differently and of discerning a different kind of meaning in what people said or how they behaved. Instead of always thinking rationally, in well ordered verbal categories, why not think in images and symbols? Why not consider behaviour as a language? What if emotions were too abstract for a person to articulate, and could only be expressed as stories or as if the feelings were beings? To designate such people as sick seemed to the enthusiastic and ‘green’ young student mind, to be an excellent way to avoid listening to the meaning of what patients sought to express. It appeared to adopt the rigidity and closed quality of the very illnesses that we were trying to address; the fixed and impermeable boundaries.

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