Our own voices

Paramedics and trainee paramedics rotate through our Department of Anaesthesia to learn to manage airways safely. A few weeks ago, I had a young man in his mid-thirties, a trainee paramedic with me, learning about airway management. Out of curiosity I asked him, “What is the most annoying part of your job?” He was straight-up, “When people inflict injuries on themselves, I think it’s such a waste of time. It takes away from others with real problems, who really need our attention.” I just smiled. I wasn’t surprised. I know full well that paramedics do a great job of looking after all kinds of people in all kinds of trouble. But attitudes can only be changed through education.

A professor of Psychiatry tweeted today “Twice in the last week I’ve been told of cruel comments by health staff to people who had self-harmed. I really believe this is unusual now but it shows there is something deep-rooted that we have to eradicate.” A classic example of ignorance within medicine of attitudes within medicine.

No training of first responders is complete till someone with lived experience of a mental illness has spoken with them, be it a police academy, social workers, fire fighters, nursing or medical students or ambulance crew. Lived experience includes suicide attempt survivors, others who have experienced a suicidal crisis and those who have lost a loved one to suicide. Sharing by these individuals can be a powerful agent for challenging prejudice and generating hope for people at risk. It enriches the participant’s understanding of how people with these serious disorders cope with their symptoms, recover and lead productive lives with hope, meaning and dignity. The program also empowers those who are faced with mental illness and provides living proof that recovery is an ongoing reality. Presenters gain confidence and self-esteem while serving as role models for the community.

Disproportionate focus on research and clinical expertise too frequently fails to see the person at the centre of a crisis as well as their loved ones who ride the wave of terror of suicidal behaviour. This needs to change and with urgency.

Lived Experience is an underutilised and underappreciated resource in the UK.

Roses in the ocean, a charity in Australia is an excellent example of harnessing this invaluable resource and making a huge difference.

Day 384

Do ‘normal’ people not have conversations in their heads?

I definitely do. And I know for sure that I am not the only one as often I see people talking to themselves while walking around town. Are they responding to voices that only they can hear or are they all just barking mad?

“This is a really dumb thing to do.”
“She is not listening to me.”
“We should do it this way rather than that.”

“When Eleanor Longden began hearing things, she soon found herself drugged, sectioned and labelled schizophrenic. Then a psychiatrist taught her how to talk back.”

By Kate Hilpern, Published: The Independent, 06 March 2007

Eleanor Longden, 25, started hearing voices when she was a teenager. They weren’t destructive: “It was rather mundane, simply giving me a narration of some of the day-to-day things I was doing. In many ways, the voice was companionate because it was reminding me that I was carrying on with my responsibilities despite feeling so sad inside. There was something constructive about it.”

A group of psychiatrists and psychologists believe it’s time we reconsidered labels such as schizophrenia. They believe we should get people to listen to, and actually engage with the voices inside their heads.

Longden believes her biggest mistake was in telling a friend she was at university with about her experiences. The friend was horrified and insisted she see a psychiatrist, who ignored her unhappiness and homed in on the voices, assuming it meant she had no sense of normality.

Longden was sectioned and hospitalised. The drugs she was coerced into taking did little except cause weight gain, and the terrifying label of schizophrenia she was given was, she believes, directly responsible for the arrival of 12 very hostile inner voices.

“Voices themselves are not a problem; it’s people’s relationship with them that’s important. So, rather than voices being something that we should avoid at all costs – the traditional psychiatric view – we should be trying to get people to face them, understand them and work with them.” Says Dr Rufus May, a psychologist.

Once Eleanor learnt to work with the voices she made peace with them. Her TED talk is an inspiring and informative one, reiterating the fact that dispensing pills in not always the correct solution.