🎧 Listen to Sarah read this installment of Cured above.
How you tell your story matters. Anyone with a psychiatric diagnosis has an illness narrative running in their head.
In books and stories about mental illness, that narrative tends to follow a standard plot line: symptoms, diagnosis, treatment, and acceptance of life with the diagnosis. The diagnosis is a pivotal moment in the rising action: Will it bring relief, a way to finally name and legitimize the protagonist’s pain? Often she rejects the diagnosis—at first—because her medication limits her creativity and/or changes her personality and/or leaves her emotionally numb. Eventually, she embraces her diagnosis and treatment and finds relief and strength (hooray!). Then the book ends, and the protagonist is left to live out her illness narrative in perpetuity.
I followed this narrative for twenty-five years. At first, each of the six diagnoses I received seemed to hold the key to my suffering—yes, I am obsessive and compulsive; yes, I am clinically depressed; yes, I am extremely anxious; yes, I do get manic and then depressed; yes, I am easily distracted or hyperfocused and hyperactive; yes, let’s try that type of therapy, that brand of meditation, that yogic breathing technique, that diet, those herbs, that pill; yes, yes, yes. But no diagnosis or treatment fully explained or relieved my suffering. I went from one waiting room and doctor and therapist and alternative treatment to the next. The point of every treatment—traditional or alternative—was to find relief and strength, not become fully well. My narrative was that I was sick—always.
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To appreciate how we’ve come to believe mental illness is a life sentence, it’s important to understand psychiatry’s history. For the past two hundred years, psychiatric research and treatment haven’t focused on healing. The prevailing notion has been that recovery isn’t possible; the goal has been to find the cause of mental illness, which will someday, they hope, lead to a cure. One cause. One cure. Cure—the noun—a magic bullet, not a process that considers the various factors that cause psychiatric disorders: environment, social support, trauma, physical health, etc.
Psychiatry’s preoccupation with cause and cure has been carried out with the best intentions and has had catastrophic results. It’s meant that patients, particularly those from historically marginalized populations, have been neglected at the expense of research. Nineteenth-century public asylums were overcrowded and inhumane. Patients were neglected or brutalized. “Care” entailed being chained and abused and not given clothing or food. Treatments have focused not on healing but controlling patients. They’ve often been untested, inhumane, violent, even fatal: bloodletting, ice baths, insulin comas, early electroshock therapy, injecting patients with malaria, the surgical removal of body parts, neglect, isolation, restraints, physical abuse, incarceration, psychotropic medications with dangerous side effects. We’ve created a mutually causal situation: The psychiatric condition requires treatment that often exacerbates it.
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