‘I’m not afraid of you: I’m afraid of madness.’ Those were the words used by my abuser to justify his refusal to talk about how he had treated me all my life.
Those were the words that continued to ring in my ears every time a counsellor, psychologist, psychiatrist, therapist, told me that I wasn’t mad. That I was responding with reasonable and understandable distress to a lifetime of mistreatment.
The words that would ring all the louder when I walked out of these sessions, training me to believe I was not mad or dangerous or viewing the world through the distorted lenses of mental illness, onto the locked inpatient psychiatric ward that was my official address for 19 months. Immediately to be questioned about why I was out of my room. Or to be told how many hours it had been decided I could spend off the ward next week, without causing too much destruction. Or to be told to take my three-course meal of daily meds: diazepam to start, a substantial main course of maximum-dose anti-depressant, and a little soupcon of anti-psychotic to round everything off.
I’m not psychotic. That’s one of the few diagnoses they never tried to put on me. But a little of that medication was the only thing they could think of to ease my anxiety. And as I paced up and down the corridor, waiting for someone to tell me if they’d managed to stop the letter that was accidentally sent out to my abuser inviting him to attend my care program assessment meeting; or cried my eyes out after a family member was allowed onto the ward to see me without my knowledge and against my permission; or screamed into a pillow when my benefits application got turned down again; or ran out of a room unable to breathe when I was told I wouldn’t be considered for housing support until I was discharged from the hospital onto the streets – they all looked on, and could not understand why the meds weren’t working.
The therapist that told me to my face that there was nothing wrong with the way I perceived the world, was writing in my notes that I ‘probably’ have a personality disorder. My care coordinator ‘liked’ that diagnosis, he told me, thinking it would make it easier to convince the borough to house me. The nurse that provoked me to call Citizens’ Advice from the ward one afternoon by telling me that they didn’t have a bed for me to sleep in that night, ‘liked’ that diagnosis too. As did the consultant psychiatrist that tried to cover up my complaint to the local MP, when a healthcare assistant lied to the police about a fellow patient, leading to a deeply vulnerable person spending a day in a prison cell. Trauma, it seemed, wasn’t sufficient to explain my responses, because it didn’t make me sound disabled or unreasonable enough.
It was convenient for my abuser to think I was mad. That way, he wasn’t at fault. Then, it seemed it was convenient for social and health care providers to diagnose whatever they wanted – whether because that made it easier to convince the relevant services to help me get my life back on track, or because it was the simplest way to deflect any criticisms that came their way when they failed to provide.
The words with which I started this article were the inspiration for the title behind my one-woman show, NoMad, of which I performed a single showing last month, and hope now to take into full production in the near future. They were said by an insensitive, ignorant and harmful man with very backwards views on mental health. But after everything I went through as a psychiatric inpatient, they may as well have been said to me by any number of the people who were trained and educated in mental health, or social care, who were being paid to support me.
Don’t get me wrong: many of them were also brilliant, and I owe a lot of my current wellbeing to a handful of them. But I left inpatient psychiatric care with even more trauma than that with which I went in, because of the one-size-fits-all, often convict-like treatment that was the culture there.
And if it exists even there, how can we expect the outside world to know how to respond to mental health? If we treat traumatised people like delusional people and delusional people like psychopathic criminals if we abuse the mentally unwell even under the guise of treating them, how are we to defend them from abuse in the world outside?
Many people whose perceptions of themselves are destroyed by ‘convenient’ diagnoses, whether from loved ones or professionals, never recover their own truth and many cannot find ways in which to reclaim it. I am fortunate that my craft as a theatre-maker has given me the resources to do so, and I will use them for all they are worth.
I have received a lot of heartfelt messages from people who have lived experience of homelessness, posttraumatic stress, psychiatric hospitalisation, and a whole host of other mental health-related experiences, who watched the show and said that they felt seen and heard. I have had messages from others saying that it changed the way they see these issues and the people who suffer from them. I felt relief in their words, and want to spread that relief as far as I can.
I hope to bring NoMad to a stage near you soon. Meanwhile, please remember, whether you have experience of mental health struggles, are a care provider, or are simply an interested reader, that people are not diagnoses, and diagnoses are not a short-hand for understanding someone’s state of mind, capability, intelligence or identity. And ‘madness’ is far more often a social state than a human one.
If we listen to people’s needs rather than look for which box has been ticked on their file, we will catch trauma and its causes early, tackle the problems where they really lie and empower people going through hell by validating them when they need it most.
Nell Hardy is an advocate for addressing homelessness, trauma, and the fear of contaminating those we love.