Perpetuating unkindness

We are very grateful to Dr Alec Grant, who has contributed the following post. Alec is Reader in Narrative Mental Health in the School of Health Sciences, University of Brighton. He originally trained as a mental health nurse in the 1970s, then as a cognitive behavioural psychotherapist. After teaching and writing in these areas for many years, his academic work is now informed by his narrative research. We find his view that “…institutional psychiatric treatment spaces create possibilities for already damaged bodies to perpetuate unkindness on other bodies” to be one of the most simply provocative statements we have yet published.

Alec made contact with us through this website, and we very much hope that readers will continue to do so. The website is now being viewed by hundreds of separate individuals every week, mostly in the UK, Ireland, the USA, and Australia – and 32 other countries! We feel that this website is beginning to do precisely what we hoped it would do – bring together people who identify as critical thinkers about mental health nursing and start to describe the shape of our interests and concerns. This is making its way into the planning we are doing for our next event, which will be on the 9th of September in Birmingham, UK. Tickets and further details will soon be available on this website, so, if you have not already, please click ‘follow’ to make sure you find out about it in good time.

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As a scholar engaged in narrative inquiry in mental health, I place emotionality,  relationship and embodiment centre stage in my research, writing and teaching. I do so from a broadly feminist concern about the need for all people involved in state mental health systems to be increasingly kinder to each other. My standpoint position is informed by my ‘hybrid’, mental health academic/professional-survivor of the institutional psychiatric system, identity and lived experience.

The work of myself and my co-writers/researchers is often complex theoretically, so this blog post strips it down to what I think is its central message (I’ve included a few selected references at the end for those of you who may be interested in reading our work in greater depth, and following up citations in it).

It seems to me that institutional psychiatric treatment spaces create possibilities for already damaged bodies to perpetuate unkindness on other bodies. Mental health nurses and other state psychiatric workers are systematically stripped of their capacities to be kind through, among other things, being neoliberalised, classed, gendered, Psydisciplined, and socialised to institutional psychiatric custom and practice. On this basis, many then proceed to pass on extra helpings of human misery to many mental health service users, already burdened with large dollops of this.

This is done through a process of simultaneous environmental and narrative colonisation of users. Institutional psychiatric stories, and corresponding activity, are carried out in the name of psychiatric ‘business as usual’. These stories often ghettoise, medicalise, stigmatise, dignity-strip, humiliate, degrade, de-humanise, discriminate against, trivialise, silence, abuse, ridicule, biographically assault and insult, ignore, de-privatise, life-decontextualise, institutionally racialise and sexualise the lives of users in a process which I have described as narrative entrapment. Many service users, sometimes re-defining themselves as survivors, then attempt to re-story themselves in ways totally independent, and often rejecting, of the psychiatrised stories that were once told about them. This is true for myself and the people I write with.

All of this is, of course, often denied by liberal-humanist writers and practitioners, who blame the problems I describe above on the ‘few bad apples’ in an otherwise healthy tree. This signifies for me the ways in which mental health humanists violate in a different kind of way. They sentimentalise and romanticise the service user in a manner that both denies the exercise of power and constantly celebrates some imagined triumph of personal agency over structure. In the language of humanism, mental health organisations are simply regarded as benign bricks and mortar structures; a kind of neutral environmental backdrop for the practice of ‘caring’ or Tidal modelling.

In my view, this is exactly why mental health nurses and other workers in this field need critical social science to help them re-imagine their professional identities and moral purpose.

Further reading:

Grant A. 2014. Troubling ‘lived experience’: A poststructural critique of mental health nursing qualitative research assumptions. Journal of Psychiatric and Mental Health Nursing. 21 544-549. 

Grant A, In press. Demedicalizing misery: Welcoming the human paradigm in mental health nurse education. Nurse Education Today.

Grant A., Biley F., Walker H. (eds).  2011. Our Encounters with Madness. Ross-on-Wye: PCCS Books.

Short N, Grant A, Clarke L. 2007. Living in the Borderlands; writing in the margins: an autoethnographic tale. Journal of Psychiatric and Mental Health Nursing. 14: 771-782.

Grant A, Leigh-Phippard H, Short N. 2015. Re-storying narrative identity: a dialogical study of mental health recovery and survival. Journal of Psychiatric and Mental Health Nursing. 22: 278-286.