The Elephant in the Room

“So you’re indifferent to the patients?”
“I’m emotionally indifferent it’s true, but that doesn’t mean I don’t think about the situation. I probably think about it too much. I think the whole damn place is a sham and a con, and it’s actually doing harm to the very people you’re defending. They need self-respect, not spoon-feeding like babies…….”
“But there are compelling reasons why they behave the way they do. Some of them come from abusing families, poor backgrounds, traumatic circumstances…..”
“Yes… yes….you sound like a full-on advert for the therapy industry Kate. But for every person who blames their disordered life on past circumstances, there are many others who have experienced the same sorts of problems and lived without disorder. These things aren’t really ‘causes’ at all, they’re more like negative influences in a person’s life which can be either overcome, or accepted, depending on the person’s character. That’s the critical variable.
“So, people choose to be mentally disordered?”
“Well, people don’t wake up one morning and make a single life-changing decision to be mentally ill – of course not. What I’m saying is that some people end up in care because they drift through a lifetime of expedient decisions. They evade immediate social responsibilities so often that they finish up either unnecessarily over-dependent, or dangerously anti-social. In their cases, the whole process is driven by personality disorder, not mental illness – just look through a few histories and see what I mean…..”
“Oh, that’s rubbish, Steve. They do need therapy. Medication, support, care…….”
“There isn’t any medication for the absence of willpower or conscience, Kate. That’s why the existing drugs rarely ‘cure’ mental health problems where personality disorder is an underlying feature. And that’s exactly why psychiatric settings have to give direction and motivation.”
“These people need compassion, Steve….”
“No!” I shouted “that’s just where you’re wrong. They need more structure around them, a positive working environment, and less time to fixate on their own problems. They need to be part of a constructive community, not an open-ended institutional charity which effectively encourages people to be self-obsessed and asocial. Some people need to be parachuted into Africa or Syria to see what a big problem actually looks like…….”


3 Responses to “The Elephant in the Room”

  1. I enjoyed this poem it actually looks at the societaly views of people with psychiatric issues from two extremes. The question is are these people actually sick or choosing or to opt out of dealing life decisions. I dont think it is for anyone to decide. I say if someone wants help in starting their life over so be it. And if I can help them in any way I wil.

  2. Anonymous Says:

    what a load of crap – I lived in a very poor war torn country for a year volunteering and doing my best to help, using both my will power and conscience. Whilst the experience made me care much less for any kind of consumerist distraction in the UK, it did nothing to cure my severe depression and only relieved it whilst I was there. It is not a choice. I didn’t decide to be depressive it’s not a case of thinking your way out of it and being rational and comparing yourself to the plight of others. Its a case of having a horrible agonising feeling inside of me which causes lapses in my motivation and that is the most difficult part about it.

  3. leovineknight Says:

    Hi Kate,
    Thanks very much for your comment. I believe that psychological and social factors can play a significant part in the development and treatment of depression (e.g. via cognitive therapy). At the same time, I respect your right to disagree with this view, if you so choose.
    Best wishes,

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