Page 55

Use of a ‘non-illness’ model ‘Loss of control, whether truly lost or merely removed by others, and the attempt to re-establish that control have been central elements in my life since the age of eighteen. My argument is that the psychiatric system, as currently established, does too little to help people retain control of their lives through periods of emotional distress, and does far too much to frustrate their subsequent efforts to regain self-control. To live eighteen years with a diagnosed illness is not incentive for a positive self-image. Illness is a one-way street, especially when the experts toss the concept of cure out of the window and congratulate themselves on candour. The idea of illness, of illness that can never go away, is not a dynamic, liberating force. Illness creates victims. While we harbour thoughts of emotional distress as some kind of deadly plague, it is not unrealistic to expect that many so-called victims will lead limited, powerless and unfulfilling lives.’ Peter Campbell (Campbell, 1996)

Use of an ‘illness’ model ‘It was helpful for me to regard myself as having had an illness. This made me respectful of the need to maintain and titrate medication … the medication has helped me to make more, not less, use of my psychological insight and thus genuinely to gain ground … It has none the less to be said that for this ... to be maintained over years, spiritual, psychosocial and cognitivebehavioural methods were required – otherwise medication dosage would have needed to have been extremely high.’ Dr Peter Chadwick (Chadwick, 1997)

Professionals and other workers should respect and work collaboratively with the service user’s frame of reference – whether he or she sees the experience primarily as a medical, psychological or perhaps even spiritual phenomenon. Often, of course, people are unsure, or even actively searching for a way of understanding and coping with their experiences. These people will find the research described in this report helpful. Arriving at a joint understanding One obvious implication of this report is that services need to offer a broader assessment process, one which enables the professional and the service user together to explore all the different factors that may be playing a role. An important part of this will be for the worker to ask about what the experiences mean to the person and how he or she understands them. It is vital that this process should take into account cultural differences, and should extend beyond those factors usually considered by health services to look at the person’s possible needs in the areas of housing, employment, leisure, finances and friendships. It is only when they have looked at all the possible contributing factors in turn that the client and professional can arrive at the most accurate and helpful understanding of the person’s experiences. What they are likely to identify is some sort of vicious circle that is maintaining the situation in its present state. This emerging understanding will suggest what is most likely to help. For example, the most important thing to do might be to make changes in the person’s environment. If the person is living in a stressful environment, the most important ‘treatment’ might be to help them find somewhere less stressful to live. On

Part 5: Wider implications

53

Understanding Bipolar Disorder  

This report was written by a working party of clinical psychologists who were chosen because of their particular expertise on the subject of...

Understanding Bipolar Disorder  

This report was written by a working party of clinical psychologists who were chosen because of their particular expertise on the subject of...