Medication does not make you any safer. Just because you are so knocked out that you literally dont have the energy to do anything, doesnt mean you FEEL safe. Isnt that the most important thing…to support people to make them feel safe. You might be less likely to kill yourself because of the medication you have been given but you are still petrified inside. Thats not a cure…thats torture!

Sarah…yes he is suggesting that someone with ”catatonic schizophrenia” should try his methods. There is a reason why someone suffering such distress is ”catatonic’. Its appalling that one might suggest that Rufus’ methods wouldnt work for someone who is ”too far gone”. How would you have felt if you had been denied the opportunity to talk about your experiences? Im guessing you would still be depressed.

The truth is that individuals who have come into contact with the methods of the Hearing Voices Network are being treated like human beings. They do recover…there are many voice hearers who have an active role in the community. You wouldnt even know they hear voices. In contrast, so many voice hearers have been on medication for years and are not happy with their quality of life. They may not have killed themselves or anyone else but that is more likely to be because they are so sedated by the fucking medication! Trust me, if they were going to kill someone or themselves, tranquilizers are unlikely to stand in their way.

Im glad that the venlafaxine is working for you…one thing though…good luck coming off that. Then tell me that medication is the answer…

I can’t see, why on earth the fact that Rufus May is a psychologist would be a basis to dismiss his views. Does it make someone less qualified to help people in existential crisis, that they have a somewhat more humanistic than medical background, and that their human qualities outweigh by far the good any possible medical qualifications could do for these people? I don’t think so. Soteria employed students without any psychiatric knowledge at all. The recovery rate was 85 per cent. But that’s the problem, isn’t it? The moment we acknowledge, that what people in existential crisis need the most isn’t medical but humane help, psychiatry loses it’s raison d’être.

Oh and, it’s almost five years since my crisis. I’m not back to where I was before. I moved far beyond that, and am still moving. “Transformation” and “balance” sound a lot more attractive to me than “stability”. And, as far as I know, “Ruth” is doing just fine, too.

I think that the point here is to think about prevention, and stopping people getting to the point where they need to be detained or need inpatient hospital care. It would actually save the NHS a lot of money too, but nobody seems to like the idea.

Also it’s Ruth that’s convinced that she would lose her job, and we’re convinced of it by the narrator, but whether or not it’s actually true remains to be seen. However I do sympathise with the need to hide previous psychiatric conditions, because there simply is so much stigma. I am constantly amazed by how uncomfortable people are when I talk about my experiences and I have learned not to discuss them with people who don’t know me. That’s just how society is. I don’t talk about it. However I do take issue with a lot of the things Rufus says.

Rufus: “You give someone a tablet, it shuts them up. It makes them dumb and stupid. People then have the… have the ignorance to think that medication is making them better. You’re not making them better, you’re making them stupid.”

As somebody who takes 300mg of Venlafaxine a day, I take serious issue with that statement. Is Dr.May suggesting that my medication makes me dumb and stupid? I would argue that it medication has literally given me my life back. I had all the insight in the world into my condition, I knew that I became depressed because I literally pushed myself to the limit, suppressing my emotions all the way, through all sorts of traumatic things, and just eventually had a breakdown. But that knowledge didn’t make it any better. Most of the time I was too depressed to engage in therapy anyway. It’s all very well for somebody like Ruth who is manic, but what about people who are catatonic? Does Dr.May suggest that those people should also stop taking their medication and try his methods?

I would also like to say that my family has been a victim of untreated Bipolar Disorder. My grandfather suffered from Bipolar I and when he was manic he became psychotic and delusional. He too refused to take his medication, like Dr.May thinks is a good idea. He subsequently murdered my grandmother and was arrested and put in a secure hospital. Eventually he killed himself. If anything could have prevented the death of my innocent grandmother, whom I would have loved to meet, I wish it had been done. Even if that meant him being detained. “To the medical authorities, Ruth not taking her medication represents a risk to herself and the public” Well, indeed. One could say that Rufus was purely lucky that she did not end up hurting herself or others. The problem is how do you distinguish between who is a risk to themselves or others and who isn’t?

I think a sort of middle ground would be best here. I know from experience, having been on both Quetiapine and Aripiprazol, that psychiatric medications can have horrible side-effects. Aripiprazol made me so tired I could barely stand, yet when I lay down, my whole body trembled and twitched and my mind was acutely alert and my pulse raced. I could get no rest and that was all I wanted. That plus cookies. LOTS of cookies. I have every sympathy for anyone who does not want to take anti-psychotics. They can be hell. But these side-effects can be managed, so that they are tolerable. It takes a long time to get the specific medication and dosage right for an individual.

But the whole psychology vs. psychiatry thing has got to end, what’s the point slagging each other off? Psychologists need to accept that although the science is admittedly patchy, medication can and does help a huge number of people. And Psychiatrists need to accept that medication is not a cure-all, but a stabilising substance. There needs to be hope for people who hear voices, yes, but it’s also important to be realistic. The fact is that statistically the likelihood of somebody like Ruth experiencing a relapse is high.

And the fact is that I may have to take antidepressants for the rest of my life. I hope not. I hope one day I can come off them, and stop needing therapy, but you never know. And you know what, as long as I don’t have to experience the deepest, darkest depths of depression ever again I’m happy to do so.

I see psychiatry and all areas of mental health as the most individual illness anyone can have. There are no exact right or wrong’s – the medical, social and holistic model all have their benefits and negative’s. We can’t even claim to know how each person will react to any of these models and while many do well with each or combined intervention, there are just as many who remain chronically unwell for the rest of their lives despite everything that has been tried.

Rufus May reminded me of the work of Ron Coleman, Marius Romme, Sandra Escher etc who look at voice hearing and other psychotic phenomena in a different way from the medical model.

I don’t particularly engage with any as having an advantage over the other. I personally have used everything out there, including medication to help myself. ALL have played a part, but I would never try to influence somebody else specifically with those methods that have helped me. The brain is far too complex for that.

Re: employment – with discrimination legislation you cannot be prevented from working. I have now been in employment as a mental health support worker for around 4 years now and have not hidden the fact that I have had mental health issues. My declaration always states “I have suffered from……. but this in no way impairs my ability to do this job effectively”

I disagree with the comment about bipolar and schizophrenia being chronic, remitting etc. There are a minority who are so badly affected that they never live independently, but the majority go on to either recover, or manage their illness very well, working, hobbies etc and have a good quality of life.

Lastly, as far as psych hospitals go, they are always last to have money ploughed into them, under-staffed, full of temporary posts whereby there is no consistency of care and insanely boring and dilapidated. I visit my local one as a worker (visiting clients) and it sends shivers down my spine and is disheartening when so many have to access advocates to address errors, incompetences and lack of care.

Mrs Chris Loizou (Administrator)
MedNet
Tavistock Centre
120 Belsize Lane
London NW3 5BA
Tel : 020 8938 2411
Fax: 020 7447 3745

And what if they didn’t kill themselves, but decided they could identify the aliens for all to see by carrying a knife, because aliens bleed green not red.
So immediate risks to self and others have to be considered – though, Ruth did seem to have command hallucinations saying destructive things about herself and Rufus, which DOES equate to risk.
In Schizophrenia (I’m not saying that’s what Ruth had – only a clinician meeting her could properly formulate her distress.) there is some evidence shows voices reduce risk of suicide, and that affective (mood) symptoms are the single biggest risk factor, however with homicide, command hallucinations are a different kettle of fish – risky.

Then there’s the second point – very briefly glossed over in one of the Trevor Turner moments. What happens long term?
The advocates of the recovery model like Rufus often make an excellent point about seeing relapses as a moment of adversity in a persons life from which a recovery can be made.
I understand and sympathise with this strategy, to reduce stigma and empower patients. However I do think it’s quite dishonest i that it misses completely the nature of the condition, focussing only on the th here and now of the experience.
Schizophrenia – for one example (whilst I realise the term itself sparks a debate about categorical diagnosis – which clearly has limitations) may relapse and remit, but untreated (by psychotropic medication) does lead to a cognitive deficit, and profound negative symptoms. You only have to read about schizophrenia patients prior to 1953 (invention of Chlorpromazine.) to see what is meant.

So to use a contentious medical model analogy – you can live with diabetes and not take your insulin. You’ll get ill from time to time, go to hospital and get your infections and ketoacidosis managed, but eventually you’ll go blind.
The thing is diabetes doesn’t change your capacity for decision making – you could chose not to medicate, but what if you didn’t believe you had diabetes and would go blind?
What if you don’t believe in mental illness?

Now I’m not saying Ruth should have been detained under the Mental Health Act and forcibley treated (as I’ve mentioned it would take a clinician who met with her to properly formulate her problems and risk.)
By Rufus’ intervention the NHS may have gained an excellent clinician – I really hope he’s right. Maybe Ruth will recover, and never relapse, but maybe things aren’t as simple as the snapshot of her life the film portrayed, and maybe there won’t be a happy ending.

Once Ruth had worked through her pain she was ready to go back to work much fitter and stronger than before when she was getting bog-standard psychiatric treatment. I believe psychiatric intervention for Ruth’s voice hearing (and other distressing exsperience) would indirectly have deprived society of an excellent clinician.