Women and mental health services(91 Posts)
Been thinking about a lot of things recently. Hope I can put this coherently...
Basically I'm concerned about the effect of mental health services on women, regarding therapeutic approaches and general approaches of professionals, including misogyny and attitudes to abuse and expected gender roles. (Am in the UK so specifically thinking about NHS services).
For example, everything seems very focussed on positive thinking, thinking about what you can change in your life rather than what you can't. This is I suspect very influenced by severe funding shortages meaning a service that tries to get people vaguely functioning in their expected roles ASAP rather than bringing about lasting insight or change. But sometimes, people need to get angry. On a personal note, despite feeling terrified and helpless at some of my life experiences, simply understanding the context is a help.
I suppose I sort of feel that services gaslight women. (Potentially men too, but I think there's particular issues for women.) A service that aims to get a woman out the door as soon as possible isn't going to be very good at spotting the signs of abuse, for example - or at least, of realising abuse is happening rather than the woman just being mentally ill. And in fact services try to push as much care as possible onto family/friends of the unwell person, so a woman could be doubly trapped.
Also men working within mental health services can come with shedloads of misogynistic attitutes (as can women actually). I won't repeat some of the advice I've been given here but it's hair raising.
Plus the whole idea of trauma as a mental illness, naming the problem as being within the person rather than the experiences they've suffered. Are women viewed as unstable because on average we kind of are, as so many have been traumatised (by men) over the years?
I don't know... I mean, psychiatry is set up to preserve the status quo, I guess. So it shouldn't come as a surprise... (And saying something like "psychiatry is set up to preserve the status quo" sounds like tinfoil hat territory... amazing how th system does that to you )
I suppose I'm still reeling at the shock of a system one expects to be there to help, not being. In fact potentially being harmful. And a sort of realisiation I'm not that crazy, but the world sure is <admires tinfoil hat in one-way mirror>
I hope this post makes some kind of sense... er...
Oh my gosh you put all that so well. Could not agree more. Also so little long term therapy available, they want to shove cbt down everyone's throat when the patient may have been through years of abuse and just really needs to talk. I was in a psych unit once having group therapy, and the nurse was focussing on what you can do etc to help yourself, but my gently talking to another patient she finally blurted out to me that her husband had justvbeat the hell out of her. The nurse looked shocked and a bit annoyed with me. The staff had all had this idea that her dh was a lovely bloke and she had a perfect life, but that's how I used to act too so I saw through it.
I agree OP too.
I don't know much about mental health I must admit but I've listened and read about a lot of women's experiences with PND (for example). PND has traditionally been touted as 'hormonal' whereas if you listen to women's experiences it appears far more situational. Lack of sleep. Lack of support. Massive upheaval of lifestyle. Pain/illness. A human being totally dependent on you.
It is completely gaslighting.
Scallops - that's so true. When I had a newborn, I wanted a t-shirt which said "This is not PND. This is a rational reaction to intolerable circumstances."
I don't think it's tinfoil hat territory, OP. I've seen it over and over again. Particularly women being given anti-depressants to effectively zombify them when they should be being helped out of a situation (e.g. my sister in an abusive marriage - which the local GP knew about, because it was a small rural place and everyone knew everyone's business).
And it's not just mental health services, it's health services generally - check out the current thread about the contraceptive implant. Women suffering profound depression, total loss of libido, heavy and unpredictable bleeding - and HCPs are refusing to take the damn thing out, resulting in women either doing it themselves (how desperate do you have to be to take a scalpel to your own arm?) or lying about wanting to try for another child, or putting up with months more misery.
I'd love to find other women who have somehow survived the system. Some kind of positive stories or inspiration or just solidarity. I'm trying not to make this too personal, but what do you do if you are kind of overwhelmed and traumatised by it all and you cannot actually turn anywhere for support, because the world is in denial? I stress I am not actively suicidal right now but it certainly crosses my mind.
Agree, very much agree.
Also poverty - you can't go to the doctors and complain you are so broke or in debt that life doesn't feel worth living, you go, get your meds, and carry on with your terrible job or caring responsibilities.
Good female friendships have helped me, and finding outlets to express how I feel. But I do take my meds as well. I also had therapy for two years. Right now I'm exploring my feminism on here and learning as much as I can about it all, I see it as a process of my own self development. But I'm far from being fine.
Oh and I'm furious, I'm angry about a lot. It also seems that only men are even allowed to be angry, angry young men and all that.But women have so much more cause to be fuming. I need to channel my fury into some activism I think. Or helping out a charity or something.
Titania Do you know what happened next with the patient? Did they urge her to "repair the relationship" or anything? Ugh, and the nurse looking annoyed at you...
No DC myself, but I can totally see what you mean about PND.
Sorry if my replies are weird, a screw in loose in my tinfoil hat tonight.
I'm not entirely sure, they took her aside after the group and she spoke to her primary nurse about it all. I think by the time I left the hospital she was still planning to work things out with her husband though. Her choice of course, and it wasn't a place you can stay in long term (the ward) but I do wonder if she is still with him.
She kept blaming herself for his violence and talking about the lovely holiday home they have.
May I ask how you found a helpful therapist, Titania? Is it possible to find a feminist/antipsychiatry one?!
Oh and meds... not on any psych ones but they offer them (not therapy) yet when I needed pain relief for endometriosis it was really hard to get hold of any. It's interesting how the "all in the mind" type view provokes a response of "medicate to shut them up" rather than "provide indepth therapy"... (although of course some people find meds helpful, this has been my experience of their attitude... offered antipsychotics and told it was for the sedative effect.)
It also seems that only men are even allowed to be angry
... with anger in women (in a psychiatric context) deemed "irrational" and a step on the road to getting a diagnosis of
hysteria borderline personality disorder.
I have a friend currently in a crappy abusive relationship, and as soon as I talk any sense into her, everyone else just undoes it. Life sometimes feels like watching a slow motion car crash constantly.
Meant to add, mental health services seem so relevant because that's where women who have been seriously hurt end up. It seems horrific that the cause of their pain is then ignored.
Oh again I agree.
Basically for years and years I kept asking my psych team and various doctors to refer me for long term therapy. Because I have psychosis they kept telling me it wasn't possible or available for me and kept offering me CBT or short group based CBT for a limited number of sessions. I went to a hand full of the one to one CBT sessions but I knew it wasn't for me so stopped going so I was told I had made my choice and to get on with it. Various care co ordinates later, all of whom I asked for psychotherapy, just told me I was on the waiting list. In the mean time I phoned up charities only to be told that my problems were to complex so they could not help me. I found a private psychotherapist and went to the first session and was willing to pay though realistically I could not afford to and she knew that, she again told me to go back to the NHS my problems were too complex.
So one day I had a psychiatrist appointment and got a locum which I wasn't happy about, and I moaned and complained and gave him the whole sorry tale, anyway within two weeks I had my first appointment with a senior psychologist, I liked her, she felt she could work with me and happy days it was from then on for the next two years. And I'm pretty sure she was a feminist. She worked with me using a flexible approach, patient led, which suited me much better than lits of fucking CBT homework because I actually got to talk.
Even after that care coordinates would say oh why don't you try some of the techniques you learned with Sarah, until finally I lost it and said well actually she didn't teach me any techniques, I found my own way through most if the psychosis and have my own ways of dealing with it which she let me get on with it. What she did do was listen! That shut them up
CBT can be very useful, but if you have years of trauma its only ever going to have a sticking plaster effect. I knew that. But because of my diagnosis, they assumed that's what I needed. They always try to say you are not just your diagnosis but are usually the worst ones for making you feel like that. I wanted to be treated as a whole person, and part of that is a lot of terrible past experiences that needed addressing.
My grandmother underwent Electric Shock Therapy (the term therapy used very loosely there!) in the 50s/60s for depression.
Her problem: an abusive husband who offered her zero support; being made to give up a job she loved because she got married; three children that her husband didn't want and blamed her for conceiving. He was a real piece of work. But he was an excellent grandfather apparently. So all is forgiven .
All this was, of course, ignored.
She survived and was wonderful. She had a completely different life once her husband died. She outlived him by 30 years and until the last few years, made the most of it.
And strangely enough didn't need ADs/therapy or anything else.
CBT therapist has twice written to tell the GP my problems are too long-standing/complex for her to be able to help
GPs seem irritated that I won't just take a prescription for anti-somethings and leave their office within a 10 minute window.
Now being passed to a psychologist.
Anger/rage is a big part of it, it just pops up out of nowhere and is terrifyingly strong
CBT is popular because it's the only talking therapy that has been proved to be effective. Other forms, psycho analysis, for example, wouldn't get a licence if they were medication. Unfortunately CBT is not suitable for complex problems. However it's cheap and it helps most people.
I've had two courses of CBT. The first was ok, not dreadful, but at the end she said "I shouldn't say this but if I had your life I'd be depressed". This was when one of my DS had been seriously ill for years, in and out of hospital. The second was so poor I abandoned it after the second session.
I keep meaning to look up the qualifications required to be an NHS CBT therapist. From my experience I'd guess it is a short course. Both my CBT therapists were not terribly bright, tbh.
That's why I loved my psychologist, she is a very smart woman. I love being around brainy educated women so we had a good transference.
Yes it's very frustrating when the therapist doesn't seem to understand because they see everything in a very simplistic way. Worse when they're men and you get a loads of mansplainy shit on top of it.
On another thread today I see someone has been given antidepressants due to being in a relationship with an utter bellend . I wish the NHS would stop colluding with abusers.
[God I'd love to meet some intelligent, empathetic women. My life has been dominated by idiot men and their handmaidens. I'm not very educated though and unemployed through ill health so I don't seem to fit in anywhere. Any ideas..?]
I went private in the end, to deal with the trauma from male violence. Originally I was given anti depressants and offered cbt. All my nice enough male drs, but with no real understanding that I wasn't mentally unwell, I was and am injured.
I "have PTSD". I reject this entirely. Not because I don't display the symptoms, but because I don't have a disorder, I am not ill.
I am working with a wonderful male therapist who has allowed me to tell him everything that happened to me, rage, be upset, her, feel shame etc etc. And he is working with me now to integrate the "PTSD symptoms" into my life. That might sound odd, and I don't want to explain it, cos I'd be here all week, but he recognises, validates, realises the severe impact of male violence, he doesn't tell me I'm ill or disordered.
Anyway, my point is, I agree with you entirely. Previously to my current therapist, I'd had a push from every direction, to accept that I had a problem and it was my fault. I needed treatment for my problem apparently.
I didn't need treatment, I needed support to work through hideous abuse. I needed allowances, love and care. Not pills and labels and a stigma.
I'm thinking if finding myself a feminist group to join. My fb friend goes to one in brixton which isn't too far from me. I need to find myself a group of like minded women.
I had a little look around here but they've all been taken over by trans ideology...
Maybe we should set up our own somehow.
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