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Psychiatry and the Disempowered Writer

By Grégor Samsa


Psychiatric medicine may have helped me to reclaim my reason, but beyond this, it has done very little. My diagnosis of paranoid schizophrenia is one of the most difficult and harrowing metal disorders to cope with. I have come through it, and it would be churlish of me not to acknowledge that a doctor’s expertise was mainly responsible for this.

However, struggling towards mental stability has not been the hardest task: rather it has been the continuing struggle against the imprecision – often to my disadvantage- of clinicians within the mental health system, those who, in their zealousness (or their loyalty to the public good) wish to confer upon themselves the right to believe my self-reports when convenient, and disbelieve them when they are not.

This makes me wonder if psychiatrists work on the assumption that if they repeat an error often enough eventually they will legitimise that error. I’m all for conjecture and healthy debate, but conjecture without supportable proof is valueless.

One should not seek biographical truth and history from a writer’s creative literary fictions; one should seek it from his mouth. To a third-party observer this is such an obvious truth that it still alarms me that mental health professionals do not see this. Instead they plunge headlong into wildly speculative, and inaccurate, psychological profiles of those patients who happened to write. I do not wish to detract from the seriousness of my criminal past, but it seems to me a false move to profile an offender not from his personal beliefs bit from his stories and poems. To say that psychopathology informs my hobby would be to say that had this hobby been something other than writing – rugby for example- then, unlike the motivations of every other wing forward, my rugby playing sprung from all that was dark and dysfunctional. Is this coherent? Is this scientific?

My need to pursue a writing career conflicts with the private interests of the hospital trust that govern my care. This means I cannot write anything without their approval. I don’t know how true this is of other service users but I do know that it feels like a uniquely frustrating and disquieting experience for me.

I fully understand the need to balance free expression with the Trust’s good name, but if every single piece must go through the taste-control and morality-filter of mental health professionals it will achieve nothing but suffocation of the creative impulse that led to it.

A clinician whose search for truth is both objective and earnest has my complete respect. Similarly, a clinician who can freely admit that there are limits to what he/she can author- itatively claim to be truth, also earns my respect. This is how is should be. There is nothing more arrogant, and frightening, than the clinician who believes he/she has all the answers, and that there is nothing he/she cannot pronounce upon.

I have tried to reason with such individuals to no effect. Because, in the end, it is easier for a diagnostician to treat the imaginary worlds of writes as indistinguishable from the mental reality of the patient who writes them. The danger here lies in the fact that to outsiders it seems reasonable that psychiatrists should make these assumptions. If this goes unchallenged, then nothing will put a stop to the persuasive, but false, belief that experts are always experts, or that an authority in one field is master of every other.