Banned from driving
Transgender people in Russia banned from
driving, says legal amendment
Law change listing medical impediments to driving was signed by prime minister Dmitry Medvedev last year · Shaun Walker in Moscow · The Guardian, Friday 9 January 2015 15.03 GMT Russia’s prime minister Dmitry Medvedev, who signed off on the law amendment late last year. Photograph: Corbis Transgender people have been banned from driving in Russia, according to a new legal amendment published this week. The regulations, which affect people deemed to have “sexual disorders”, also affect fetishists, voyeurs, exhibitionists and transvestites, and were immediately condemned by human rights activists as discriminatory. The amendment to the law listing medical impediments to driving was signed by prime minister Dmitry Medvedev at the end of last year, but only published this week. Russia has some of the worst figures for road accident fatalities in the world, and the new regulations are part of a government programme aimed at reducing the number of people who die on the country’s roads. Currently, official figures say 30,000 people die and 250,000 are injured on the roads every year. The amendments give a long list of physical and mental disabilities which are legal impediments to driving, including conditions such as serious visual impairment or paralysis. But the most controversial section is the list of sexual preferences and conditions given, including paedophilia, sado-masochism and exhibitionism, as well as “fetishism”, which is described as people who gain sexual arousal from inanimate objects. Transsexuals and transvestites are also on the list, which is drawn from the World Health Organisation’s list of “gender identity disorders” and “disorders of sexual preference.” Yelena Masyuk, a member of the Kremlin’s own human rights council, wrote online that the amendment should be scrutinised. “I don’t understand why, for example, fetishists, kleptomaniacs or transsexuals should be banned from driving a car… I think this is a violation of the rights of Russian citizens.” The move was also criticised by international rights activists, who said it could create a climate of fear. “Banning people from driving based on their gender identity or expression is ridiculous and just another example of the Russian regime’s methodical rollback of basic human rights for its citizens,” said Shawn Gaylord of US-based organisation Human Rights First. “Beyond the denial of basic freedoms, this provision may deter transgender people from seeking mental health services for fear of receiving a diagnosis that would strip them of their right to drive.” Russia drew a huge amount of international criticism for a recent law that bans the “propaganda of homosexuality” to minors. It was not immediately clear how the new ban would be enforced, whether there would be medical tests at the time of applying for a driving license, or whether there could be retrospective action taken against people who already drive but fall into the banned categories. |
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Mental Health Institutions
The pain of being an in-patient at a mental health institution haunts these recollections
Susie Orbach
Friday 07 February 2014
One of the first women at The Women's Therapy Centre in Islington in 1976 had been recently discharged from the local mental hospital. She surprised me by saying: "It was ever so lovely. You get your cups of tea, your food and your heat. All in. Nothing to do for anyone else. A good old rest and someone looking after me."
Recently I needed to find a place of safety for a suicidal 30-year-old. Such places are scarce. A house near the Arsenal stadium has such a facility where an individual in extremis may stay and be looked after for a maximum of 72 hours.
Between those two events, the demise of inpatient services and the development of care in the community, occurred. Therapeutic services were always scant. We shouldn't romanticise them and sanctuary was often less benign than the word implies. But as Charcot and later Freud were to demonstrate, madnesses and incomprehensible symptoms could, in principle, be understood, dissolved or endured less troublesomely. During the last century, the talking and listening therapies developed.
What also developed was a wrangle with health services and health insurers who found such services relatively costly in the short term (although no one would argue they are in the long term as they save money in parts of the healthcare budget). Today, as a ghastly compromise, we have a plethora of psychological therapies in the marketplace offering transformations in six sessions and telephone therapy with manuals that don't look so different from the prompts given to salesmen and women. Being listened to and finding a place of safety are not easy and it will be interesting to see if the Coalitions' promise on 21 January – to roll out serious provision for mental health in April – actually reaches the places it needs to go.
The "Death of the Asylum" is detailed in Barbara Taylor's beautiful memoir through her personal experience of breaking down in 1981, ending up in Friern in 1985 and being formally discharged from the psychiatric service in 1992, several years after Friern closed. She tells an engrossing story of her "madness years", of her own analysis and of the demise of the asylum system.
Getting to know oneself is a peculiar business. The individual comes to therapy hoping to discover what's wrong and to excise or change what so hurts and disables them. In the course of a therapy, they discover how very foreign parts of themselves are to their conception of self. It can emerge that attributes they consider strengths turn out to protect them against parts of them which are frightened or appalled by things they consider needy or weak. They may not know the level at which they disdain their own needs. They may not know the conflict between wanting and receiving. They may not know, as Taylor is to find early on in her therapy, that the love and attention she craves from her analyst is not something she knows how to take in.
What she can do and show is how the possibility disturbs her and brings, in turn, the wish to repudiate it or to find it contemptible. It will be years before she can absorb the concern that her analyst, V, shows. It will be years before she can discover the desires behind her apparent wishes. It will be years of being in a place of encountering a nothingness and screeching pain before she is able to show up for herself in a way that can allow her to be on her own team.
The analytic process is paradoxical. It is doing several things at once which can appear contradictory and in some cases iatrogenic. One aspect is to enable the analysand to reflect on her or his experience. By paying attention to the motivations which propel actions, one helps the individual to countenance the feelings from which "doing" may be a flight. Another aspect involves trusting the analyst while simultaneously experiencing that relationship as inherently ambivalent. The therapy relationship is the place of potential hope but it is also drawn as a version of the relationship the analysand experienced with the most important figures in her early life. There is no such thing as a brand new relationship without the history of other significant relationships inscribed within it. What therapy does is to look at those inscriptions, to understand the psychic imprints that shape us. The balancing act of trusting the relationship sufficiently in order to reveal one's insecurities is tricky. Consider how much one wants recognition and acceptance but ends up in the Groucho Marx club full of contempt for those who dare show it.
This dilemma at the heart of treatment – the longing and then tussling with the defences against longing, and the self-hatred this longing can produce as well as the disdain for the other who proffers it – is trying for analyst and analysand. And so it was for Barbara and V. During her analysis, she learns, from the inside of herself, truths to live by which can sound banal. But tasting and knowing them is what makes it possible for her to make a life. Among these important truths is the recognition that familial, parental or lover relationships contain ambivalence. They are never and can never be perfect. Love and intimacy involve inevitable disappointment, getting it wrong, missing what's wanted or being unable to give.
It is hard to write well enough about this book because it is so good. It attempts to achieve many things – personal story, psychoanalytic process, the experience of madness, the feel of being an inpatient in the last days of Friern, the history of the asylum. Taylor does all of these things very well indeed. Her book is a piece of lived history in all senses; she tells us of the outside and the inside – the drama of the red diaper girl, the changing relations between the sexes, the hurts and terrors about being a child chosen to fulfil parental ambition and the struggle to find her way through the madness towards a life both ordinary and extraordinary.
http://www.independent.co.uk/arts-entertainment/books/reviews/the-last-asylum-a-memoir-of-madness-in-our-times-by-barbara-taylor-book-review-9112978.html?origin=internalSearch#
Susie Orbach
Friday 07 February 2014
One of the first women at The Women's Therapy Centre in Islington in 1976 had been recently discharged from the local mental hospital. She surprised me by saying: "It was ever so lovely. You get your cups of tea, your food and your heat. All in. Nothing to do for anyone else. A good old rest and someone looking after me."
Recently I needed to find a place of safety for a suicidal 30-year-old. Such places are scarce. A house near the Arsenal stadium has such a facility where an individual in extremis may stay and be looked after for a maximum of 72 hours.
Between those two events, the demise of inpatient services and the development of care in the community, occurred. Therapeutic services were always scant. We shouldn't romanticise them and sanctuary was often less benign than the word implies. But as Charcot and later Freud were to demonstrate, madnesses and incomprehensible symptoms could, in principle, be understood, dissolved or endured less troublesomely. During the last century, the talking and listening therapies developed.
What also developed was a wrangle with health services and health insurers who found such services relatively costly in the short term (although no one would argue they are in the long term as they save money in parts of the healthcare budget). Today, as a ghastly compromise, we have a plethora of psychological therapies in the marketplace offering transformations in six sessions and telephone therapy with manuals that don't look so different from the prompts given to salesmen and women. Being listened to and finding a place of safety are not easy and it will be interesting to see if the Coalitions' promise on 21 January – to roll out serious provision for mental health in April – actually reaches the places it needs to go.
The "Death of the Asylum" is detailed in Barbara Taylor's beautiful memoir through her personal experience of breaking down in 1981, ending up in Friern in 1985 and being formally discharged from the psychiatric service in 1992, several years after Friern closed. She tells an engrossing story of her "madness years", of her own analysis and of the demise of the asylum system.
Getting to know oneself is a peculiar business. The individual comes to therapy hoping to discover what's wrong and to excise or change what so hurts and disables them. In the course of a therapy, they discover how very foreign parts of themselves are to their conception of self. It can emerge that attributes they consider strengths turn out to protect them against parts of them which are frightened or appalled by things they consider needy or weak. They may not know the level at which they disdain their own needs. They may not know the conflict between wanting and receiving. They may not know, as Taylor is to find early on in her therapy, that the love and attention she craves from her analyst is not something she knows how to take in.
What she can do and show is how the possibility disturbs her and brings, in turn, the wish to repudiate it or to find it contemptible. It will be years before she can absorb the concern that her analyst, V, shows. It will be years before she can discover the desires behind her apparent wishes. It will be years of being in a place of encountering a nothingness and screeching pain before she is able to show up for herself in a way that can allow her to be on her own team.
The analytic process is paradoxical. It is doing several things at once which can appear contradictory and in some cases iatrogenic. One aspect is to enable the analysand to reflect on her or his experience. By paying attention to the motivations which propel actions, one helps the individual to countenance the feelings from which "doing" may be a flight. Another aspect involves trusting the analyst while simultaneously experiencing that relationship as inherently ambivalent. The therapy relationship is the place of potential hope but it is also drawn as a version of the relationship the analysand experienced with the most important figures in her early life. There is no such thing as a brand new relationship without the history of other significant relationships inscribed within it. What therapy does is to look at those inscriptions, to understand the psychic imprints that shape us. The balancing act of trusting the relationship sufficiently in order to reveal one's insecurities is tricky. Consider how much one wants recognition and acceptance but ends up in the Groucho Marx club full of contempt for those who dare show it.
This dilemma at the heart of treatment – the longing and then tussling with the defences against longing, and the self-hatred this longing can produce as well as the disdain for the other who proffers it – is trying for analyst and analysand. And so it was for Barbara and V. During her analysis, she learns, from the inside of herself, truths to live by which can sound banal. But tasting and knowing them is what makes it possible for her to make a life. Among these important truths is the recognition that familial, parental or lover relationships contain ambivalence. They are never and can never be perfect. Love and intimacy involve inevitable disappointment, getting it wrong, missing what's wanted or being unable to give.
It is hard to write well enough about this book because it is so good. It attempts to achieve many things – personal story, psychoanalytic process, the experience of madness, the feel of being an inpatient in the last days of Friern, the history of the asylum. Taylor does all of these things very well indeed. Her book is a piece of lived history in all senses; she tells us of the outside and the inside – the drama of the red diaper girl, the changing relations between the sexes, the hurts and terrors about being a child chosen to fulfil parental ambition and the struggle to find her way through the madness towards a life both ordinary and extraordinary.
http://www.independent.co.uk/arts-entertainment/books/reviews/the-last-asylum-a-memoir-of-madness-in-our-times-by-barbara-taylor-book-review-9112978.html?origin=internalSearch#
Response
Will Self is quite right to stress the importance of groups in supporting those with mental illness and their carers. I speak as a Consultant in the NHS, with 25 years of experience, and also trained in convening groups.
Despite our scientific knowledge of brain structure and functions, when it comes to our mind, it will always have social contexts. We must distinguish between brain function and mind. In psychiatry, we are forced to use labels and compile symptoms into syndromes in order to manage ‘psychiatric conditions’ and illnesses. ‘Prescriptive treatments’ such as medications and CBT are of limited value because they do not address the social context.
The old asylum model intuited this social component, as part of our social evolution and industrial revolution, but since their closure, many with social maladies have found alternative asylums in the form of penal institutions!
The ‘Recovery Model’ in addictions, would not have been effective if it did not draw from group therapy principles. Well-convened groups will by nature introduce an ‘Explorative treatment’ component, with social contexts. This is difficult to define and capture for so called evidence based practices!!
Some ‘Psychiatric maladies’ are of course also biologically based, but our current medical technology and the understanding of the brain function/ dysfunction does not allow us to treat mental illness in a purely organic way. Until (if) such time as we can, I wholly endorse Will Self’s call for greater group support.
Dr N Yoganathan,
Full member, Group Analytic Society, London.
Consultant/tutor in Psychiatry(NHS),
Despite our scientific knowledge of brain structure and functions, when it comes to our mind, it will always have social contexts. We must distinguish between brain function and mind. In psychiatry, we are forced to use labels and compile symptoms into syndromes in order to manage ‘psychiatric conditions’ and illnesses. ‘Prescriptive treatments’ such as medications and CBT are of limited value because they do not address the social context.
The old asylum model intuited this social component, as part of our social evolution and industrial revolution, but since their closure, many with social maladies have found alternative asylums in the form of penal institutions!
The ‘Recovery Model’ in addictions, would not have been effective if it did not draw from group therapy principles. Well-convened groups will by nature introduce an ‘Explorative treatment’ component, with social contexts. This is difficult to define and capture for so called evidence based practices!!
Some ‘Psychiatric maladies’ are of course also biologically based, but our current medical technology and the understanding of the brain function/ dysfunction does not allow us to treat mental illness in a purely organic way. Until (if) such time as we can, I wholly endorse Will Self’s call for greater group support.
Dr N Yoganathan,
Full member, Group Analytic Society, London.
Consultant/tutor in Psychiatry(NHS),
BIG PHARMA?
Is the current epidemic of depression and hyperactivity the result of disease-mongering by the psychiatric profession and big pharma? Does psychiatry have any credibility left at all?
Illustration by John Holcroft
A psychiatrist who once "treated" me used to recite this rueful little mantra: "They say failed doctors become psychiatrists, and that failed psychiatrists specialise in drugs." By drugs this psychiatrist meant drugs of addiction – and his "treatment" of me consisted of prescribing Temgesic, a synthetic opiate, as a substitute for the heroin I was more strongly inclined to take. So, he undertook this role: acting, in effect, as a state-licensed drug dealer; and he also attempted a kind of psychotherapy, talking to me about my problems and engaging with my own restless critique of – among many other things – psychiatry itself. Together we conceived of doing some sort of project on drugs and addiction, and began undertaking research. On one memorable fact-finding trip to Amsterdam, we ended up smoking a great deal of marijuana as well as drinking to excess – I also scored heroin and used it under the very eyes of the medical practitioner who was, at least nominally, "treating" me.
All of this happened more than 20 years ago, and I drag it up here not in order to retrospectively censure the psychiatrist concerned, but rather to present him and his behaviour as a perversely honest version of the role played by his profession. For what, in essence, do psychiatrists specialise in, if not mood-altering drugs? Or, to put it another way, what do psychiatrists have to offer – over and above the other so-called "psy professions" – beyond their capacity to legally administer psychoactive drugs, and in some cases forcibly confine those they deem to be mentally ill?
Psychiatry is undergoing one of its periodic convulsions at the moment – one that coincides with the publication by the American Psychiatric Association of the fifth edition of their hugely influential "Diagnostic and Statistical Manual of Mental Disorders" (DSM–5) – and I think we should all take the opportunity to join in the profession's own collective navel-gazing and existential angst. After all, while the influence of the talking cures is pervasive in our society – running all the way up the scale from anodyne advice dispensed on daytime TV shows, to the wealthy shelling out hundreds of pounds a week to pet their neuroses in the company of highly qualified black dog walkers – psychotherapy and psychoanalysis remain essentially voluntaristic undertakings; only psychiatry deals in mandatory social care and legal sanction. Besides, only psychiatry partakes of the peculiar mystique that attaches to medical care. We may dismiss the opinions of all sorts of counsellors and therapists, secure in the knowledge that their very multifariousness is indicative of their lack of overall traction, but psychiatry, dealing, as it claims, with well-defined maladies – and treating them with drugs and hospitalisation – exerts an enormous pull on our collective self-image. Just what the nature of this pull is, and how it has come to condition our understanding of ourselves and our psychic functioning, is what I wish to unpick.
Full-blown mental illness is an extremely frightening phenomenon to observe – let alone experience. And much of the debate that surrounds the efficacy of contemporary psychiatry is warped by the knowledge – lurking in the wings of our minds – that we wish to have as little as possible to do with it. We may understand rationally that psychosis isn't a contagion, yet still we turn aside from the street soliloquisers and avoid the tormented gazes of those being "cared for in the community". Arguably, the response of those who treated a trip to Bedlam to view the madmen and women as an entertainment had the virtue of at least being a form of contact. At their peak, mental hospitals such as Bedlam (and formerly known as "lunatic asylums") housed over 100,000 inmates, many of whom had been confined for behaviours that today would be regarded as lifestyle choices, such as socialism or sexual promiscuity. The hospitals were also dumping grounds for patients who we now know to have had organic brain diseases. It's sobering for those on the left to realise that the first politician to commit to their abolition was Enoch Powell. By the early 1990s many long-stay inmates had been returned to the outside world, but their lives were for the most part still grossly circumscribed: living in sheltered accommodation and visited by mental health teams, confined not by physical walls but by the chemical straitjackets of neuroleptic drugs.
An engraving of a bedridden patient at the New York City Lunatic Asylum Hospital in the late 1860s. Photograph: Stock Montage/Getty Images
Still, if you wish to visit Bedlam you can do so. The locked mental wards of our hospitals present a terrifying spectacle of seriously disturbed patients shouting, yelping, gurning and shaking – I know, I've seen them. And it's the much-repressed knowledge that this is going on that helps, I would argue, to prevent too much criticism of the psychiatric profession. Just as we are quietly grateful to prison officers for banging up criminals, so too we are grateful for psychiatrists and psychiatric nurses for providing a cordon sanitaire between us and flamboyant insanity. Yet while the regime under which those diagnosed with mental pathologies has changed immensely in the last half-century, the prognosis remains no better. Some say that it is manifestly worse, and that psychiatry itself is to blame. But the truth is that hardly anyone – apart from the professionals, whose livelihoods depend on it – can either be bothered to wade through the reams of scientific papers concerned with the alternative treatment regimens, or understand the different methodologies arrived at to assess competing claims.
Early in Our Necessary Shadow, his lucid, humane and in many ways well-balanced account of the nature and meaning of psychiatry, Tom Burns, professor of social psychiatry at Oxford University, makes a supremely telling remark: "I am convinced psychiatry is a major force for good or I would not have spent my whole adult life in it." This is a form of the logical fallacy post hoc ergo propter hoc ("After this, therefore because of this"), and it seems strange that an academic of such standing should so blithely retail it because, of course, if we reverse the statement it makes just as much sense: "Having spent my whole adult life as a psychiatrist I must maintain the conviction that it is a major force for good." After all, the alternative – for Burns and for thousands of other psychiatrists – is to accept that in fact their working lives have constituted something of a travesty: either locking up or drugging patients whose diseases are defined not by organic dysfunction but by socially unacceptable behaviours. Burns has the honesty and integrity to admit that the major mental pathologies – schizophrenia, bipolar disorder, depression inter alia – cannot be defined in the same way as physical diseases, and he cleaves to the currently fashionable view of psychiatry as seeking to understand mental maladies through the tripartite lens of the social, the psychological and the biological. He also states that he sees the role of psychotherapy as central to the practise of psychiatry – and in this he dissents from the more mainstream "biological" model of treatment that has been in the ascendancy since the 1970s.
But what Burns cannot quite bring himself to do is give up the drugs. In a 333 page book (complete with a glossary, a bibliography and an index), there are just three references to the most commonly prescribed psychiatric drugs: the SSRIs, or selective serotonin reuptake inhibitors (such as Prozac and Seroxat). When he does consider the SSRIs, he notes that they may indeed be overprescribed (as of 2011 46.7m prescriptions had been written in the UK for antidepressants), and in particular that they may be used to "treat" commonplace unhappiness rather than severe depression. What he doesn't venture near are the systematic critiques of antidepressants – and neuropharmacology in general – that have emerged in recent years. The work of Irving Kirsch, whose meta-analysis of SSRI double-blind trials revealed that in clinical terms – for a broad spectrum of depressed patients – SSRIs acted no better than a placebo, is something Burns doesn't want to look at. He also doesn't wish to examine too closely the underlying "chemical imbalance" theory of depression on which the alleged efficacy of the SSRIs is based, presumably because he knows that it's essentially bunk: no fixed correlation has been established, despite intensive study, between levels of serotonin in the brain and depression.
Antidepressant tablets. Photograph: Jonathan Nourok/Getty Images
I've swerved into consideration of antidepressants because I believe the exponential increase in their use is a function of the problem of legitimacy that psychiatry currently faces. Psychiatrists, of course, tell the public that the vast majority of these drugs are prescribed by general practitioners – not by them. But what has made it possible for someone recently bereaved or unemployed to have a prescription written by their doctor to alleviate their "depression", is, I would argue, very much to do with psychiatry's search for new worlds to conquer, an expedition that has been financed at every step by big pharma. Put bluntly: unable to effect anything like a cure in the severe mental pathologies, at an entirely unconscious and weirdly collective level psychiatry turned its attention to less marked psychic distress as a means of continuing to secure what sociologists term "professional closure". After all, if chlorpromazine (commonly known as Largactil) and other neuroleptics don't cure schizophrenia – any more than lithium "cures" bipolar illness – then why exactly do you need a qualified medical doctor to dole them out?
The proliferation of new psycho-pharmacological compounds has advanced in lock-step with the proliferation of new mental illnesses for them to "treat". As Ian Hacking observes in a review of DSM–5 in the current London Review of Books, the first DSM – published in 1952 – and its successor in 1968, were heavily influenced by the psychoanalytic theories then dominating psychiatry in the US. In 1980, with DSM–III there came a step-change. Hacking traces this to the efficacy of lithium in managing mania: "Now there was something that worked … clear behavioural criteria were necessary to identify who would benefit from lithium." James Davies begins his book, Cracked: Why Psychiatry Is Doing More Harm Than Good, with an examination of how these behavioural criteria were arrived at by the compilers of DSM–III and its subsequent incarnations. You may be thinking that all this is so much arcane knowledge – and wondering why we in Britain should be preoccupied by a diagnostic manual published in the US. But in fact the ICD (International Classification of Diseases) used by British doctors is compiled in the same way as the DSM – indeed most NHS psychiatrists favour the latter over the former. In the US it's simple: your insurance won't pay out unless you are diagnosed with a malady detailed in the DSM, but in Britain we have a less tangible – but for all that pervasive – form of socio-medical discrimination: no sick note – and no social benefits – unless what ails you conforms to the paradigms set out in DSM.
The focus of Davies's critique is that the criteria for what constitutes ADHD (attention deficit hyperactivity disorder), or autism, or indeed depression, are not arrived at by any commonly understood scientific procedure, but rather by committee: psychiatrists getting together and pooling their understanding of how patients with these maladies "present" (in the jargon). Under these circumstances it becomes somewhat easier to understand how the tail can begin to wag the dog: rather than arriving at a commonly agreed set of symptoms that constitute a gestalt – and hence a malady – psychiatrists become influenced by what psycho-pharmacological compounds alleviate given symptoms, and so, as it were, "create" diseases to fit the drugs available. This in itself, Davies might argue, explains why there are more and more new "diseases" with each edition of the DSM: it isn't a function of scientific acumen identifying hitherto hidden maladies, but of iatrogenesis: doctor-created disease. So, while it may well be general practitioners who do the doling out, psychiatrists are required to legitimate what they are doing and provide it with the sugar-coating of scientific authenticity. It's a dirty, well-paid and high-status job – but someone has to do it, no?
The vast number of "hyperactive" children in the US prescribed Ritalin is so well attested to that it's become a trope in popular culture – just like the SSRI-munching depressive. But these are our version of low-level "care in the community", the sad are becoming oddly co-morbid (afflicted with the same sorts of diseases) with the mad. Davies treads a familiar path in his critique of the influence of the multinational pharmaceutical companies on the structure and practice of psychiatry. If you aren't familiar with the fact that almost all drug trials are funded by those who stand to profit from their success then … well, you jolly well should be. You should also be familiar with the extent to which university research departments and learned journals are funded by those who stand to profit – literally – from their presumed objectivity. The money generated by the SSRIs in particular is vast, easily enough to warp the dynamics and the ethics of an entire profession, and indeed I would agree with Davies that it has in fact done just this. The sections of his book that deal in particular with the way big pharma has moved into markets outside the English-speaking world and effected a wholesale cultural change in their perception of sadness (rebranding it, if you will, as chemically treatable "depression"), simply in order to flog their dubious little blue pills, make for chilling reading.
Actually, Burns would agree with some of this critique as well; and recall, he's a psychiatrist who fervently believes that his profession has been, and continues to be, a force for good. Davies is a psychologist, and to the outsider the fierceness of his attack might be dismissed as part of a turf war among the psy professions (Irving Kirsch is a clinical psychologist as well). However, I don't think it helps anyone to see the current imbroglio as simply a function of late capitalism in its most aggressive aspect. I'm afraid I have to mouth the old lily-livered liberal shibboleth at this point and observe that, yes, we are all to blame; and our responsibility is just as difficult for us to acknowledge because we are largely unaware of it. We don't consciously collude in the chemical repression of the psychotic (and Davies produces quite convincing statistics to support the view that those with psychosis actually recover better if they aren't medicated at all), any more than we consciously collude in the fiction of depression as a chemical imbalance that can be successfully treated with SSRIs.
Instead, what both clinicians and patients experience is quite the reverse: we feel absolutely bloody miserable, we can't get up in the morning, we are dirty and unkempt, and we go along to our GP and are prescribed an antidepressant, and lo and behold we recover. My GP, who has just retired, and who is a wise and compassionate man who I absolutely trusted, told me that he prescribed SSRIs because they worked, and I believed him. That they worked because of the overpoweringly efficacious curative power we believe doctors and their nostrums to possess rather than because of any real change in our brain chemistry was beside the point for him – and I suspect it's beside the point for the vast majority of patients as well. By the same token, Burns is at pains to stress, contra-DSM, that the great strength and skill of the practising psychiatrist lies in being able to intuit diagnoses by empathising with patients. Diagnosis, for Burns, is an art form – not a science. By his own account I've little doubt that he's a good and effective psychiatrist who can make a real difference to the lives of those plagued by demons that undermine their sense of self. One of my oldest friends is a consultant psychiatrist who I've actually seen practising in just this way, with preternatural flair and compassion.
In both their cases, however, I feel about them rather the way I do about the last archbishop of Canterbury: I consider Rowan Williams to be a wise and spiritual man mostly despite rather than because of his Christianity; and I think many psychiatrists are good healers mostly despite rather than because of the medical ideology of mental illness to which they subscribe.
Interestingly there is one large sector of the "mentally ill" that Burns believes are manifestly unsuitable for treatment – drug addicts and alcoholics. He points to the ineffectiveness of almost all treatment regimens, possibly because the cosmic solecism of treating those addicted to psychoactive drugs with more psychoactive drugs hits home despite his well-padded professional armour. Elsewhere in Our Necessary Shadow he seems to embrace the idea that self-help groups of one kind or another could help to alleviate a great deal of mental illness, and it struck me as strange that he couldn't join the dots: after all, the one treatment that does have long-term efficacy for addictive illness is precisely this one.
Psychiatrists are notoriously unwilling to endorse the 12-step programmes, and argue that statistically the results are not convincing. There may be some truth in this – but there's also the inconvenient fact that there's no place for psychiatrists, or indeed any of the psy professionals, in autonomously organised self-help groups. Burns agrees with Davies that our reliance on psychiatry, and by extension, psycho-pharmacology, may well be related to our increasingly alienated state of mind in mass societies with weakened family ties, and often non-existent community ones. Surely self-help groups can play a large role in facilitating the rebirth of these nurturing and supportive networks? But Burns seems to feel that just as we will always need a professional to come and mend the septic tank, so we will always need a pro to sweep out the Augean psychic stables. I'm not so sure; psychiatry has been bedevilled over the last two centuries by "treatments" and "cures" that have subsequently been revealed to be significantly harmful. From mesmerism, to lobotomy, to electroconvulsive therapy, to Valium and other benzodiazepines – the list of these nostrums is long and ignoble, and I've no doubt that the SSRIs will soon be added to their number.
Sooner or later we will all have to wake up, smell the snake oil, and realise that while medical science may bring incalculable benefit to us, medical pseudo-science remains just as capable of advance. After all, one of the drugs that Irving Kirsch's meta‑analysis of antidepressant trials revealed as being just as efficacious as the SSRIs was … heroin.
- Will Self
- The Guardian, Saturday 3 August 2013
Illustration by John Holcroft
A psychiatrist who once "treated" me used to recite this rueful little mantra: "They say failed doctors become psychiatrists, and that failed psychiatrists specialise in drugs." By drugs this psychiatrist meant drugs of addiction – and his "treatment" of me consisted of prescribing Temgesic, a synthetic opiate, as a substitute for the heroin I was more strongly inclined to take. So, he undertook this role: acting, in effect, as a state-licensed drug dealer; and he also attempted a kind of psychotherapy, talking to me about my problems and engaging with my own restless critique of – among many other things – psychiatry itself. Together we conceived of doing some sort of project on drugs and addiction, and began undertaking research. On one memorable fact-finding trip to Amsterdam, we ended up smoking a great deal of marijuana as well as drinking to excess – I also scored heroin and used it under the very eyes of the medical practitioner who was, at least nominally, "treating" me.
All of this happened more than 20 years ago, and I drag it up here not in order to retrospectively censure the psychiatrist concerned, but rather to present him and his behaviour as a perversely honest version of the role played by his profession. For what, in essence, do psychiatrists specialise in, if not mood-altering drugs? Or, to put it another way, what do psychiatrists have to offer – over and above the other so-called "psy professions" – beyond their capacity to legally administer psychoactive drugs, and in some cases forcibly confine those they deem to be mentally ill?
Psychiatry is undergoing one of its periodic convulsions at the moment – one that coincides with the publication by the American Psychiatric Association of the fifth edition of their hugely influential "Diagnostic and Statistical Manual of Mental Disorders" (DSM–5) – and I think we should all take the opportunity to join in the profession's own collective navel-gazing and existential angst. After all, while the influence of the talking cures is pervasive in our society – running all the way up the scale from anodyne advice dispensed on daytime TV shows, to the wealthy shelling out hundreds of pounds a week to pet their neuroses in the company of highly qualified black dog walkers – psychotherapy and psychoanalysis remain essentially voluntaristic undertakings; only psychiatry deals in mandatory social care and legal sanction. Besides, only psychiatry partakes of the peculiar mystique that attaches to medical care. We may dismiss the opinions of all sorts of counsellors and therapists, secure in the knowledge that their very multifariousness is indicative of their lack of overall traction, but psychiatry, dealing, as it claims, with well-defined maladies – and treating them with drugs and hospitalisation – exerts an enormous pull on our collective self-image. Just what the nature of this pull is, and how it has come to condition our understanding of ourselves and our psychic functioning, is what I wish to unpick.
Full-blown mental illness is an extremely frightening phenomenon to observe – let alone experience. And much of the debate that surrounds the efficacy of contemporary psychiatry is warped by the knowledge – lurking in the wings of our minds – that we wish to have as little as possible to do with it. We may understand rationally that psychosis isn't a contagion, yet still we turn aside from the street soliloquisers and avoid the tormented gazes of those being "cared for in the community". Arguably, the response of those who treated a trip to Bedlam to view the madmen and women as an entertainment had the virtue of at least being a form of contact. At their peak, mental hospitals such as Bedlam (and formerly known as "lunatic asylums") housed over 100,000 inmates, many of whom had been confined for behaviours that today would be regarded as lifestyle choices, such as socialism or sexual promiscuity. The hospitals were also dumping grounds for patients who we now know to have had organic brain diseases. It's sobering for those on the left to realise that the first politician to commit to their abolition was Enoch Powell. By the early 1990s many long-stay inmates had been returned to the outside world, but their lives were for the most part still grossly circumscribed: living in sheltered accommodation and visited by mental health teams, confined not by physical walls but by the chemical straitjackets of neuroleptic drugs.
An engraving of a bedridden patient at the New York City Lunatic Asylum Hospital in the late 1860s. Photograph: Stock Montage/Getty Images
Still, if you wish to visit Bedlam you can do so. The locked mental wards of our hospitals present a terrifying spectacle of seriously disturbed patients shouting, yelping, gurning and shaking – I know, I've seen them. And it's the much-repressed knowledge that this is going on that helps, I would argue, to prevent too much criticism of the psychiatric profession. Just as we are quietly grateful to prison officers for banging up criminals, so too we are grateful for psychiatrists and psychiatric nurses for providing a cordon sanitaire between us and flamboyant insanity. Yet while the regime under which those diagnosed with mental pathologies has changed immensely in the last half-century, the prognosis remains no better. Some say that it is manifestly worse, and that psychiatry itself is to blame. But the truth is that hardly anyone – apart from the professionals, whose livelihoods depend on it – can either be bothered to wade through the reams of scientific papers concerned with the alternative treatment regimens, or understand the different methodologies arrived at to assess competing claims.
Early in Our Necessary Shadow, his lucid, humane and in many ways well-balanced account of the nature and meaning of psychiatry, Tom Burns, professor of social psychiatry at Oxford University, makes a supremely telling remark: "I am convinced psychiatry is a major force for good or I would not have spent my whole adult life in it." This is a form of the logical fallacy post hoc ergo propter hoc ("After this, therefore because of this"), and it seems strange that an academic of such standing should so blithely retail it because, of course, if we reverse the statement it makes just as much sense: "Having spent my whole adult life as a psychiatrist I must maintain the conviction that it is a major force for good." After all, the alternative – for Burns and for thousands of other psychiatrists – is to accept that in fact their working lives have constituted something of a travesty: either locking up or drugging patients whose diseases are defined not by organic dysfunction but by socially unacceptable behaviours. Burns has the honesty and integrity to admit that the major mental pathologies – schizophrenia, bipolar disorder, depression inter alia – cannot be defined in the same way as physical diseases, and he cleaves to the currently fashionable view of psychiatry as seeking to understand mental maladies through the tripartite lens of the social, the psychological and the biological. He also states that he sees the role of psychotherapy as central to the practise of psychiatry – and in this he dissents from the more mainstream "biological" model of treatment that has been in the ascendancy since the 1970s.
But what Burns cannot quite bring himself to do is give up the drugs. In a 333 page book (complete with a glossary, a bibliography and an index), there are just three references to the most commonly prescribed psychiatric drugs: the SSRIs, or selective serotonin reuptake inhibitors (such as Prozac and Seroxat). When he does consider the SSRIs, he notes that they may indeed be overprescribed (as of 2011 46.7m prescriptions had been written in the UK for antidepressants), and in particular that they may be used to "treat" commonplace unhappiness rather than severe depression. What he doesn't venture near are the systematic critiques of antidepressants – and neuropharmacology in general – that have emerged in recent years. The work of Irving Kirsch, whose meta-analysis of SSRI double-blind trials revealed that in clinical terms – for a broad spectrum of depressed patients – SSRIs acted no better than a placebo, is something Burns doesn't want to look at. He also doesn't wish to examine too closely the underlying "chemical imbalance" theory of depression on which the alleged efficacy of the SSRIs is based, presumably because he knows that it's essentially bunk: no fixed correlation has been established, despite intensive study, between levels of serotonin in the brain and depression.
Antidepressant tablets. Photograph: Jonathan Nourok/Getty Images
I've swerved into consideration of antidepressants because I believe the exponential increase in their use is a function of the problem of legitimacy that psychiatry currently faces. Psychiatrists, of course, tell the public that the vast majority of these drugs are prescribed by general practitioners – not by them. But what has made it possible for someone recently bereaved or unemployed to have a prescription written by their doctor to alleviate their "depression", is, I would argue, very much to do with psychiatry's search for new worlds to conquer, an expedition that has been financed at every step by big pharma. Put bluntly: unable to effect anything like a cure in the severe mental pathologies, at an entirely unconscious and weirdly collective level psychiatry turned its attention to less marked psychic distress as a means of continuing to secure what sociologists term "professional closure". After all, if chlorpromazine (commonly known as Largactil) and other neuroleptics don't cure schizophrenia – any more than lithium "cures" bipolar illness – then why exactly do you need a qualified medical doctor to dole them out?
The proliferation of new psycho-pharmacological compounds has advanced in lock-step with the proliferation of new mental illnesses for them to "treat". As Ian Hacking observes in a review of DSM–5 in the current London Review of Books, the first DSM – published in 1952 – and its successor in 1968, were heavily influenced by the psychoanalytic theories then dominating psychiatry in the US. In 1980, with DSM–III there came a step-change. Hacking traces this to the efficacy of lithium in managing mania: "Now there was something that worked … clear behavioural criteria were necessary to identify who would benefit from lithium." James Davies begins his book, Cracked: Why Psychiatry Is Doing More Harm Than Good, with an examination of how these behavioural criteria were arrived at by the compilers of DSM–III and its subsequent incarnations. You may be thinking that all this is so much arcane knowledge – and wondering why we in Britain should be preoccupied by a diagnostic manual published in the US. But in fact the ICD (International Classification of Diseases) used by British doctors is compiled in the same way as the DSM – indeed most NHS psychiatrists favour the latter over the former. In the US it's simple: your insurance won't pay out unless you are diagnosed with a malady detailed in the DSM, but in Britain we have a less tangible – but for all that pervasive – form of socio-medical discrimination: no sick note – and no social benefits – unless what ails you conforms to the paradigms set out in DSM.
The focus of Davies's critique is that the criteria for what constitutes ADHD (attention deficit hyperactivity disorder), or autism, or indeed depression, are not arrived at by any commonly understood scientific procedure, but rather by committee: psychiatrists getting together and pooling their understanding of how patients with these maladies "present" (in the jargon). Under these circumstances it becomes somewhat easier to understand how the tail can begin to wag the dog: rather than arriving at a commonly agreed set of symptoms that constitute a gestalt – and hence a malady – psychiatrists become influenced by what psycho-pharmacological compounds alleviate given symptoms, and so, as it were, "create" diseases to fit the drugs available. This in itself, Davies might argue, explains why there are more and more new "diseases" with each edition of the DSM: it isn't a function of scientific acumen identifying hitherto hidden maladies, but of iatrogenesis: doctor-created disease. So, while it may well be general practitioners who do the doling out, psychiatrists are required to legitimate what they are doing and provide it with the sugar-coating of scientific authenticity. It's a dirty, well-paid and high-status job – but someone has to do it, no?
The vast number of "hyperactive" children in the US prescribed Ritalin is so well attested to that it's become a trope in popular culture – just like the SSRI-munching depressive. But these are our version of low-level "care in the community", the sad are becoming oddly co-morbid (afflicted with the same sorts of diseases) with the mad. Davies treads a familiar path in his critique of the influence of the multinational pharmaceutical companies on the structure and practice of psychiatry. If you aren't familiar with the fact that almost all drug trials are funded by those who stand to profit from their success then … well, you jolly well should be. You should also be familiar with the extent to which university research departments and learned journals are funded by those who stand to profit – literally – from their presumed objectivity. The money generated by the SSRIs in particular is vast, easily enough to warp the dynamics and the ethics of an entire profession, and indeed I would agree with Davies that it has in fact done just this. The sections of his book that deal in particular with the way big pharma has moved into markets outside the English-speaking world and effected a wholesale cultural change in their perception of sadness (rebranding it, if you will, as chemically treatable "depression"), simply in order to flog their dubious little blue pills, make for chilling reading.
Actually, Burns would agree with some of this critique as well; and recall, he's a psychiatrist who fervently believes that his profession has been, and continues to be, a force for good. Davies is a psychologist, and to the outsider the fierceness of his attack might be dismissed as part of a turf war among the psy professions (Irving Kirsch is a clinical psychologist as well). However, I don't think it helps anyone to see the current imbroglio as simply a function of late capitalism in its most aggressive aspect. I'm afraid I have to mouth the old lily-livered liberal shibboleth at this point and observe that, yes, we are all to blame; and our responsibility is just as difficult for us to acknowledge because we are largely unaware of it. We don't consciously collude in the chemical repression of the psychotic (and Davies produces quite convincing statistics to support the view that those with psychosis actually recover better if they aren't medicated at all), any more than we consciously collude in the fiction of depression as a chemical imbalance that can be successfully treated with SSRIs.
Instead, what both clinicians and patients experience is quite the reverse: we feel absolutely bloody miserable, we can't get up in the morning, we are dirty and unkempt, and we go along to our GP and are prescribed an antidepressant, and lo and behold we recover. My GP, who has just retired, and who is a wise and compassionate man who I absolutely trusted, told me that he prescribed SSRIs because they worked, and I believed him. That they worked because of the overpoweringly efficacious curative power we believe doctors and their nostrums to possess rather than because of any real change in our brain chemistry was beside the point for him – and I suspect it's beside the point for the vast majority of patients as well. By the same token, Burns is at pains to stress, contra-DSM, that the great strength and skill of the practising psychiatrist lies in being able to intuit diagnoses by empathising with patients. Diagnosis, for Burns, is an art form – not a science. By his own account I've little doubt that he's a good and effective psychiatrist who can make a real difference to the lives of those plagued by demons that undermine their sense of self. One of my oldest friends is a consultant psychiatrist who I've actually seen practising in just this way, with preternatural flair and compassion.
In both their cases, however, I feel about them rather the way I do about the last archbishop of Canterbury: I consider Rowan Williams to be a wise and spiritual man mostly despite rather than because of his Christianity; and I think many psychiatrists are good healers mostly despite rather than because of the medical ideology of mental illness to which they subscribe.
Interestingly there is one large sector of the "mentally ill" that Burns believes are manifestly unsuitable for treatment – drug addicts and alcoholics. He points to the ineffectiveness of almost all treatment regimens, possibly because the cosmic solecism of treating those addicted to psychoactive drugs with more psychoactive drugs hits home despite his well-padded professional armour. Elsewhere in Our Necessary Shadow he seems to embrace the idea that self-help groups of one kind or another could help to alleviate a great deal of mental illness, and it struck me as strange that he couldn't join the dots: after all, the one treatment that does have long-term efficacy for addictive illness is precisely this one.
Psychiatrists are notoriously unwilling to endorse the 12-step programmes, and argue that statistically the results are not convincing. There may be some truth in this – but there's also the inconvenient fact that there's no place for psychiatrists, or indeed any of the psy professionals, in autonomously organised self-help groups. Burns agrees with Davies that our reliance on psychiatry, and by extension, psycho-pharmacology, may well be related to our increasingly alienated state of mind in mass societies with weakened family ties, and often non-existent community ones. Surely self-help groups can play a large role in facilitating the rebirth of these nurturing and supportive networks? But Burns seems to feel that just as we will always need a professional to come and mend the septic tank, so we will always need a pro to sweep out the Augean psychic stables. I'm not so sure; psychiatry has been bedevilled over the last two centuries by "treatments" and "cures" that have subsequently been revealed to be significantly harmful. From mesmerism, to lobotomy, to electroconvulsive therapy, to Valium and other benzodiazepines – the list of these nostrums is long and ignoble, and I've no doubt that the SSRIs will soon be added to their number.
Sooner or later we will all have to wake up, smell the snake oil, and realise that while medical science may bring incalculable benefit to us, medical pseudo-science remains just as capable of advance. After all, one of the drugs that Irving Kirsch's meta‑analysis of antidepressant trials revealed as being just as efficacious as the SSRIs was … heroin.
08.07.2013
Reply to Kerry Katona article, The Guardian
Your interview with Kerry Katona captures the dilemma we face, as patients and professionals, when dealing with mental illness: should we try to reduce the complex mix of psycho-social factors to a simple definition? On the one hand, the person may take comfort from the label, in this case, ‘bipolar’ – it gives a reassuring sense of identity and acceptance; on the other, the label can become a source of stigma, to be rejected as Kerry appears to want to do. She refuses to comply with conventional chemical treatment, preferring less intrusive therapies, yet paradoxically conforms with the creative/destructive pattern of behaviour implied by her label.
At a time when bad behaviour is a form of fashion statement, she is able to find refuge behind the notion of bipolarity. But is this the correct label? Judging by her words in this interview, Kerry might well tick the boxes for bipolar disorder, but she might equally tick those for personality and addiction problems. The latter remain stigmatised and politically uncomfortable.
As a clinician, I totally support patient choice, and understand the reasons for Kerry’s reluctance to accept medication given her previous experience of side-effects. However, like medications, all talking therapies can have side effects if used inappropriately. One must question the long-term benefits of her boot camp experience and now of ‘life coaches’ unless they are able to help Kerry rediscover her inner self and no longer rely on external sources to boost her self-esteem.
Whether her condition is bipolar or not, Kerry has been medicating herself with illicit substances and destructive relationships, personal and through the media. If her condition is bipolar and even if she finds a suitable prescribed medication without side effects, she will still need to address her emotional past through a form of therapy which will give her long-term stability and peace of mind, at least for the sake of her children. I wish her luck in finding this.
Dr N Yoganathan
Consultant/College Tutor in Psychiatry (NHS)
Full Member Group Analytic Society, London
Your interview with Kerry Katona captures the dilemma we face, as patients and professionals, when dealing with mental illness: should we try to reduce the complex mix of psycho-social factors to a simple definition? On the one hand, the person may take comfort from the label, in this case, ‘bipolar’ – it gives a reassuring sense of identity and acceptance; on the other, the label can become a source of stigma, to be rejected as Kerry appears to want to do. She refuses to comply with conventional chemical treatment, preferring less intrusive therapies, yet paradoxically conforms with the creative/destructive pattern of behaviour implied by her label.
At a time when bad behaviour is a form of fashion statement, she is able to find refuge behind the notion of bipolarity. But is this the correct label? Judging by her words in this interview, Kerry might well tick the boxes for bipolar disorder, but she might equally tick those for personality and addiction problems. The latter remain stigmatised and politically uncomfortable.
As a clinician, I totally support patient choice, and understand the reasons for Kerry’s reluctance to accept medication given her previous experience of side-effects. However, like medications, all talking therapies can have side effects if used inappropriately. One must question the long-term benefits of her boot camp experience and now of ‘life coaches’ unless they are able to help Kerry rediscover her inner self and no longer rely on external sources to boost her self-esteem.
Whether her condition is bipolar or not, Kerry has been medicating herself with illicit substances and destructive relationships, personal and through the media. If her condition is bipolar and even if she finds a suitable prescribed medication without side effects, she will still need to address her emotional past through a form of therapy which will give her long-term stability and peace of mind, at least for the sake of her children. I wish her luck in finding this.
Dr N Yoganathan
Consultant/College Tutor in Psychiatry (NHS)
Full Member Group Analytic Society, London
Plastic surgery, two divorces, drug addiction, the birth of her children, a second bankruptcy: the former Atomic Kitten has lived her adult life on reality TV. But is she a victim of the celebrity machine – or just brilliant at exploiting it?
Decca Aitkenhead The Guardian, Saturday 6 July 2013
Kerry Katona at home in Wigan: 'It’s lovely, but it’s a show house, really, isn’t it?' Photograph: Ben Quinton
The £3m house near Wigan where Kerry Katona currently lives looks as if it has been assembled from the contents of a footballer's wife's yard sale. Clusters of gold lions and porcelain tigers are dotted across marble floors, which sweep past a minstrels' gallery to a large indoor pool area lined with faux Egyptian friezes; there is statement wallpaper here, wood panelling and fake Doric columns there, and a marble dining table large enough to seat 30. But the family of six live chiefly in the kitchen, surrounded by ironing, and last Tuesday – for the second time in five years – Katona was declared bankrupt.
When we meet a month earlier, she keeps up a stream of bubbly chatter for the first hour. Wearing exercise clothes, Katona prepares a salad for lunch while telling me how much she loves vegetable juice, the gym and her new fiance, George Kay, who pads in and out. She shows me pictures of her children on her phone, and photos of herself following a disastrous recent "vampire facelift", which involved injecting her own blood into her face and left her with elephantine swelling for nearly a week. "I was heartbroke!" she laughs. "But my face has been amazing ever since." She laughs a lot – right up to the moment when I ask if her 2008 bankruptcy still affects her, at which point she bursts into tears.
"I'm not in bankruptcy any more, but we're about to go back in it," she says. "It's just a vicious circle and now, because it's going to become public, I can just see what's gonna happen. People are gonna be saying, 'She's fucked up again,' " she sobs bitterly. "But I've not fucked up. I've done everything I can possibly do. But it's almost like it's the norm to do a shitty story on Kerry Katona."
For 14 years, first as a pop singer and then as a reality TV star, Katona has satisfied our appetite for celebrity disgrace, with a turbulent life lived almost entirely through the tabloids. We have seen her in labour on TV, while reading a story about herself, sold to the press by her own mother. We have seen her son born, and her breasts sliced open by cosmetic surgeons; we have seen her in therapy; we have seen her take cocaine. Few reality stars have commodified their privacy so comprehensively: for Katona's family, camera crews are part of the furniture; for her TV audience, her domestic world has come to feel as familiar as their own living rooms.
But it's a paradox of the genre that, no matter how much of their story they reveal, reality stars seldom feel understood, and this latest bankruptcy is yet another chapter that turns out to be more complicated than it looks. If Katona's story reads like a parable about the modern cocktail of damage, vulnerability and a longing to be seen and loved, it also provides proof that celebrity does not guarantee an escape from one's former reality. As Katona reflects wearily, "Sometimes I think I attract drama."
The drama began long before Katona was born. When her mother, Sue, was just 17, her own mother, a prostitute, tried to sell the girl's virginity to six men in a Warrington pub. Admitted to a psychiatric hospital before she'd turned 18, bipolar and alcoholic, Sue was pregnant by 20, and her daughter, Kerry, grew up rattling between relatives' homes and hostels, witnessing her mother repeatedly self-harm and attempt suicide. After seeing her stabbed by a boyfriend, Katona went into care, but the first person to offer her drugs, when she was 14, was her mother, whose chaotic world of addicts and criminals was never far away.
Katona reunited with Atomic Kitten on their recent sell-out tour.
After a brief go at lap dancing and topless modelling, Katona auditioned for a new Liverpool girl band, and at 18 became the star of Atomic Kitten, topping the charts and touring the world, before quitting to marry a member of Westlife, Brian McFadden, in a suitably fairytale OK! wedding. Two daughters, three years and several infidelities later, McFadden left her. She was shattered, and her drink and cocaine use quickly escalated until she checked into the Priory, before returning to Warrington, where she fell back in with her old pre-Kitten crowd. Before long, she was back in rehab; when she came out this time, she fell for her mother's cocaine dealer, Mark Croft. After six weeks, he asked her to marry him.
"I felt such a failure. I felt humiliated cos Brian had just fucked off to Australia with some bird. And then, when Mark proposed, I was like, 'Right, this'll fix the hole.' But I wasn't even attracted to him. I wasn't well in my head, I was on the drugs, Mark was my dealer, and everything just got really out of hand."
The next four years were a dream for tabloid sales, and an unmitigated catastrophe for Katona. Stories of Croft's drug dealing and cheating, the couple's cocaine binges and Katona's ballooning weight deluged the gossip columns, many sold to the press by Croft, his friends and her mother. Katona's endless denials were always insistent but never convincing, and a calamitous 2008 appearance on ITV1's This Morning, with Katona dazed and slurring her words, prompted even her own agent to go public with his fears for her. By now a mother of four, having had a son and daughter with Croft, and unable to pay an £82,000 tax bill, she was declared bankrupt. When somebody planted a secret video camera in her bathroom and sold footage of Katona taking cocaine to a tabloid, her descent from pop princess to national disgrace appeared complete.
But reality television loves nothing more than reinvention, and in January 2010, still hungover from a cocaine binge, Katona enrolled at a fitness boot camp. She came home 14lb lighter, quit drugs, found a new manager, divorced Croft and moved south with her children, providing a new narrative – Kerry's comeback! – for a relaunched career that saw her voted runner-up on Celebrity Big Brother, and put her back on stage this year for a reunion tour with Atomic Kitten, a surprise sellout.
She has been drug-free for more than three years now, and she's still only 32. I wonder if she thinks her childhood hardwired her for a rollercoaster of highs and crises. "Definitely," she nods, and mentions that she has moved house more than 60 times. She is also, like her mother, bipolar, and has always insisted the infamous This Morning interview was due to medication, not drink or drugs. These days she tries to manage the condition through life coaches, and no longer takes medication: "Because I don't want to wake up every day feeling like I've had a stroke."
Playing a celebrity while living as a bankrupt has created its own, at times surreal problems. Katona recently made a TV advert for a payday loan company, which was ruled "irresponsible" by the Advertising Standards Authority, given her financial history. "But that's why I'm doing TV ads for money, so I can put food in the cupboard!" she protests. A greater irony becomes apparent when the full story of her bankruptcy unfolds. "I've already paid more than £430,000 back for an £82,000 tax bill. How am I ever supposed to get out of this?" she sobs, revealing some eye-opening parallels between the practices of payday loan companies and those of the taxman.
As a bankrupt, she has had to agree her expenses with a court-appointed trustee. She moved to Wigan in February because she could no longer afford to rent in the south, and for all its gaudy pretensions, at £3,000 a month the house is cheaper than most five-bedroom family rentals in London. As a location for further instalments of her reality shows, it was ideal, "but to clean these floors takes two days! I'm just a typical mum, I just want a normal-sized house so I can keep it clean and tidy." Her own furniture is in storage, and they have to move again by the autumn, because, "How much is this gonna cost to heat in winter? It's lovely, but it's a show house, really, isn't it?"
The trustee agrees "pocket money" to cover essential expenses. "But only half compared with what you actually need for four kids. I've had to take my kids out of private school. I'm not a materialistic person," she insists, weeping. "I use my 40% discount card from New Look to buy my clothes, the kids' clothes are from fucking George at Asda and Matalan. And people think, 'Oh, she goes on these holidays,' but I don't pay for them. For me to have a holiday with the kids, that's why I have to have a pap picture. I've never paid for plastic surgery – the TV shows and magazines do. My money just goes straight to bills and the kids."
Katona never even paid off her original £82,000 tax debt, despite handing over earnings of £430,000. The court-appointed trustee charges £750 an hour – a startling expense to impose upon a bankrupt, roughly equivalent to a senior barrister's fee – and at the last count almost £400,000 had been swallowed up by the trustee and associated legal and accountancy fees. Meanwhile, still in the 50% tax bracket, Katona was rapidly running up a new bill; but as she wasn't allowed to keep the money she'd earned, she couldn't possibly give half of it to the taxman. The inevitability of a second bankruptcy has been clear to her for more than a year, and the system has made quite sure she could do nothing to prevent it.
Now the legal machinery of insolvency is lumbering into gear once again: her bank accounts are frozen, and any hope of earning her way out of it will depend upon how her industry regards this latest damage to her celebrity stock.
Katona with ex-husband Mark Croft. How did she wind up bankrupt when she was earning millions? By marrying him, she says. Photograph: Rex Features
How did she ever wind up bankrupt in the first place, when she was earning millions? Her answer boils down to four words: by marrying Mark Croft. Everyone warned her against him, but he told her they were all just jealous, and gradually she cut everyone out of her life – for a while even her mother, though they are now close again. "Mark had so much control over me. He'd go, 'Look at the state of you. No one'll love you any more; only I'll love you.' He'd be feeding me drugs, so much so that my nose would bleed. I'd be dirty, I'd be filthy, and then he'd pick me up and put me in the bath. He'd wash me, and I'd think, 'He loves me.' It was out of control."
She knew Croft and his friends were selling stories about her. "But it was easier to go along with it than to walk away. It was just easier. I was on heavy medication for bipolar, I was immensely unstable, I wasn't well. In the end, I just gave up caring." When burglars tied her up at knifepoint in 2007 and forced Croft to lead them to their valuables, did she wonder if he was involved in that, too? "Not at first." Croft has denied he had anything to do with it. But days after the robbery, she says, she found a guide to burgling a house. "And I knew he was in on it. And I was like, I was so distraught from the first marriage, and that kind of brought up all my past for me – my abandonment issues, not feeling self-worth. It was like a vicious circle. It was like, am I, am I, am I that?" and her voice breaks. "Are people that unable to love me?"
Katona kept thinking money would buy Croft's love. She bought him a fleet of luxury cars – more than £1m-worth in one year alone, including Porsches, Ferraris, Aston Martins, Range Rovers, Mercedes, Lamborghinis, BMWs – and slowly he assumed control of her finances, appointing as her accountant an unqualified friend who had previous convictions for dishonesty (he has since been imprisoned for defrauding another client). She says she didn't even know she owed a large tax bill until she began reading about it in the press, but Croft and his friend kept assuring her it was nonsense, right until the day she was declared bankrupt, in her absence, for a debt smaller than the price of just one of Croft's cars.
She still doesn't know how much of her money they got through. She says she begged the trustee to investigate her accountant, but "the trustee just kept saying I had the money hidden under a mattress!" But when I ask if Croft was also responsible for the secret camera in her bathroom, she doesn't hesitate. "Yeah, he was definitely involved in that, without a shadow of a doubt."
The only thing more shocking than the squalor of the marriage was the fact that she allowed the reality cameras to keep rolling. Even if she won the lottery, she says she'd still want her life to be filmed. "It's never, ever, ever been about the money. I just love entertaining, always have." Then, minutes later, she says she has always hated being famous. "I left Atomic Kitten because I hated the fame. My first episode of a breakdown was in the Kittens. I didn't like the fame. I know everyone finds that so hard to believe, but I don't."
Then why keep inviting film crews in? "Well, I like to have a full house. I miss them when they're not here. And I honestly don't think I'd ever have got through it without the cameras, because it was almost like free therapy. I could say what I want – it was like my own psychiatrist, just getting it all off my chest to this camera." Since she was 18, she says, the one constant in her life has been the press. "Or not so much the press, but the public. The one thing I've always had, from being in my late teens, is support from the public. That's always been my, my love. Makes me feel wanted a little bit."
She becomes animated, passionate almost to the point of messianic. "I think people relate to me, and I like to think I'm here for a reason and that is to give people hope in life itself. The one thing I get when I walk down the street without a shadow of a doubt is, 'Kerry, you're such an inspiration. Thank you for being honest, thank you for telling your story, my daughter's been self-harming, my daughter's come off drugs, my husband's been cheating, you know. And we've watched your reality show and we've sat there and cried. Watching your show has given me hope that there is light at the end of the tunnel.' And that makes it worth it for me – do you know what I mean? There's so many people in this industry who, it's all glamour, glitz, high heels: 'Oh, I'm in this showbiz life.' I'm not one of these celebs. Because no one's ever that honest about how shit life can be."
But how honest is she really? She claims that everything we see on the shows is real, but many of the storylines, the holidays and the cosmetic surgery (she has had breast reduction, liposuction, a tummy tuck) are cooked up by producers. Her entire career has been a series of media contrivances: the manufactured girl band, the staged paparazzi shots. Her second autobiography reveals large chunks of the first to have been more or less fiction; in the second, she admits she always knew Croft was a nasty piece of work, and that, despite all the first book's gushing tributes to "my bestest friend", she never really loved or even liked him. But she seems unabashed about the inconsistencies, and admits at one point, "Sometimes I get lost between Kerry at home and Kerry who's in public. Because as soon as I'm in public, I automatically change, and I'm so used to that now that I don't know if I know how to cope without it. Do you know what I mean? It's like Kerry Katona's someone else. There's two completely different people. You know, you've got the Kerry that goes, 'Hiya love! Yer all right?' and I don't really talk like that at all."
One of her former foster parents told Katona recently, "It was always a performance with you. Even if you had a bad day, you never cried as a kid", and I get the impression that she doesn't always know what is real or fake herself. It feels as if she will do literally anything to feel loved, and by my count she has gone through eight management teams in her 14-year career, in what looks like a quest for someone to take care of her. One manager, Max Clifford, gave her away at her last wedding, and even though they have since fallen out, she describes him as a dad. The agents who took her on after she left Croft made the relationship conditional upon divorce and drug tests, and took charge of almost every aspect of her life, to the point where, "It almost felt for me like I went from one controlling relationship straight to another." On her 30th birthday, they threw "the most amazing party for me, and people were there that I didn't even fucking know". She is now back with the manager who created Atomic Kitten: "I look at him almost like a dad."
Katona never knew her biological father, who died a few years ago, and I don't think it's too trite to suggest she has been throwing herself at substitutes all her life. I certainly don't doubt the heartbreak she describes at seeing her own children grow up fatherless, too; McFadden sees his at most three times a year, she says, and Croft hasn't seen his for more than 18 months. "I don't get a penny from the sperm donors," she spits, and makes some fabulously bitchy swipes at McFadden before her publicist reins her in, reminding her that one of his reasons for not paying maintenance (he began paying £500 a month a few months ago) was her habit of bad-mouthing him to the press.
She first met her new fiance, George, when they were teenagers on the Warrington club scene, but lost touch. He became a professional rugby league player, but in 2008 was jailed for six years for blackmail and released only two years ago. Would she say she was a good judge of character when it comes to men?
"Oh yeah," she says at once. "George is amazing. He makes me feel so good about myself: 'Morning beautiful! You're stunning, you're amazing, you're strong, go and exercise', you know," she beams. He's the first man her friends have approved of – "Even my mum says he's the one" – and she tells me several times, with irrepressible pride, that her youngest two call him Dad. "I feel like I've been with George for years. I feel like we're married already." How long have they been together? "Oh, it's only 10 months."
And so the Katona show rattles on, a modern juggernaut that no amount of catastrophe can derail. Whether she is in the driving seat, or being dragged along by an industry skilled at exploiting neediness for public entertainment, is a question I'm not sure even she could answer. Given the life she came from, her self-image as an inspirational survivor makes perfect sense. But stripped of celebrity gloss, all the endless upheavals, the money problems, the merry-go-round of unhappy relationships and the drugs make her current life look not so different from the one she was born into. If fame is another form of addiction for Katona, then as her audience we must come uncomfortably close to the role of enabler: she needs the public to love someone she doesn't even like.
Her ambition now, she says, is to become an actor – "just not to be Kerry Katona for a change". When she marries later this year, she will take George's name to become Mrs Kay. "Because I fucking hate Kerry Katona. I hate that, hate it."
Decca Aitkenhead The Guardian, Saturday 6 July 2013
Kerry Katona at home in Wigan: 'It’s lovely, but it’s a show house, really, isn’t it?' Photograph: Ben Quinton
The £3m house near Wigan where Kerry Katona currently lives looks as if it has been assembled from the contents of a footballer's wife's yard sale. Clusters of gold lions and porcelain tigers are dotted across marble floors, which sweep past a minstrels' gallery to a large indoor pool area lined with faux Egyptian friezes; there is statement wallpaper here, wood panelling and fake Doric columns there, and a marble dining table large enough to seat 30. But the family of six live chiefly in the kitchen, surrounded by ironing, and last Tuesday – for the second time in five years – Katona was declared bankrupt.
When we meet a month earlier, she keeps up a stream of bubbly chatter for the first hour. Wearing exercise clothes, Katona prepares a salad for lunch while telling me how much she loves vegetable juice, the gym and her new fiance, George Kay, who pads in and out. She shows me pictures of her children on her phone, and photos of herself following a disastrous recent "vampire facelift", which involved injecting her own blood into her face and left her with elephantine swelling for nearly a week. "I was heartbroke!" she laughs. "But my face has been amazing ever since." She laughs a lot – right up to the moment when I ask if her 2008 bankruptcy still affects her, at which point she bursts into tears.
"I'm not in bankruptcy any more, but we're about to go back in it," she says. "It's just a vicious circle and now, because it's going to become public, I can just see what's gonna happen. People are gonna be saying, 'She's fucked up again,' " she sobs bitterly. "But I've not fucked up. I've done everything I can possibly do. But it's almost like it's the norm to do a shitty story on Kerry Katona."
For 14 years, first as a pop singer and then as a reality TV star, Katona has satisfied our appetite for celebrity disgrace, with a turbulent life lived almost entirely through the tabloids. We have seen her in labour on TV, while reading a story about herself, sold to the press by her own mother. We have seen her son born, and her breasts sliced open by cosmetic surgeons; we have seen her in therapy; we have seen her take cocaine. Few reality stars have commodified their privacy so comprehensively: for Katona's family, camera crews are part of the furniture; for her TV audience, her domestic world has come to feel as familiar as their own living rooms.
But it's a paradox of the genre that, no matter how much of their story they reveal, reality stars seldom feel understood, and this latest bankruptcy is yet another chapter that turns out to be more complicated than it looks. If Katona's story reads like a parable about the modern cocktail of damage, vulnerability and a longing to be seen and loved, it also provides proof that celebrity does not guarantee an escape from one's former reality. As Katona reflects wearily, "Sometimes I think I attract drama."
The drama began long before Katona was born. When her mother, Sue, was just 17, her own mother, a prostitute, tried to sell the girl's virginity to six men in a Warrington pub. Admitted to a psychiatric hospital before she'd turned 18, bipolar and alcoholic, Sue was pregnant by 20, and her daughter, Kerry, grew up rattling between relatives' homes and hostels, witnessing her mother repeatedly self-harm and attempt suicide. After seeing her stabbed by a boyfriend, Katona went into care, but the first person to offer her drugs, when she was 14, was her mother, whose chaotic world of addicts and criminals was never far away.
Katona reunited with Atomic Kitten on their recent sell-out tour.
After a brief go at lap dancing and topless modelling, Katona auditioned for a new Liverpool girl band, and at 18 became the star of Atomic Kitten, topping the charts and touring the world, before quitting to marry a member of Westlife, Brian McFadden, in a suitably fairytale OK! wedding. Two daughters, three years and several infidelities later, McFadden left her. She was shattered, and her drink and cocaine use quickly escalated until she checked into the Priory, before returning to Warrington, where she fell back in with her old pre-Kitten crowd. Before long, she was back in rehab; when she came out this time, she fell for her mother's cocaine dealer, Mark Croft. After six weeks, he asked her to marry him.
"I felt such a failure. I felt humiliated cos Brian had just fucked off to Australia with some bird. And then, when Mark proposed, I was like, 'Right, this'll fix the hole.' But I wasn't even attracted to him. I wasn't well in my head, I was on the drugs, Mark was my dealer, and everything just got really out of hand."
The next four years were a dream for tabloid sales, and an unmitigated catastrophe for Katona. Stories of Croft's drug dealing and cheating, the couple's cocaine binges and Katona's ballooning weight deluged the gossip columns, many sold to the press by Croft, his friends and her mother. Katona's endless denials were always insistent but never convincing, and a calamitous 2008 appearance on ITV1's This Morning, with Katona dazed and slurring her words, prompted even her own agent to go public with his fears for her. By now a mother of four, having had a son and daughter with Croft, and unable to pay an £82,000 tax bill, she was declared bankrupt. When somebody planted a secret video camera in her bathroom and sold footage of Katona taking cocaine to a tabloid, her descent from pop princess to national disgrace appeared complete.
But reality television loves nothing more than reinvention, and in January 2010, still hungover from a cocaine binge, Katona enrolled at a fitness boot camp. She came home 14lb lighter, quit drugs, found a new manager, divorced Croft and moved south with her children, providing a new narrative – Kerry's comeback! – for a relaunched career that saw her voted runner-up on Celebrity Big Brother, and put her back on stage this year for a reunion tour with Atomic Kitten, a surprise sellout.
She has been drug-free for more than three years now, and she's still only 32. I wonder if she thinks her childhood hardwired her for a rollercoaster of highs and crises. "Definitely," she nods, and mentions that she has moved house more than 60 times. She is also, like her mother, bipolar, and has always insisted the infamous This Morning interview was due to medication, not drink or drugs. These days she tries to manage the condition through life coaches, and no longer takes medication: "Because I don't want to wake up every day feeling like I've had a stroke."
Playing a celebrity while living as a bankrupt has created its own, at times surreal problems. Katona recently made a TV advert for a payday loan company, which was ruled "irresponsible" by the Advertising Standards Authority, given her financial history. "But that's why I'm doing TV ads for money, so I can put food in the cupboard!" she protests. A greater irony becomes apparent when the full story of her bankruptcy unfolds. "I've already paid more than £430,000 back for an £82,000 tax bill. How am I ever supposed to get out of this?" she sobs, revealing some eye-opening parallels between the practices of payday loan companies and those of the taxman.
As a bankrupt, she has had to agree her expenses with a court-appointed trustee. She moved to Wigan in February because she could no longer afford to rent in the south, and for all its gaudy pretensions, at £3,000 a month the house is cheaper than most five-bedroom family rentals in London. As a location for further instalments of her reality shows, it was ideal, "but to clean these floors takes two days! I'm just a typical mum, I just want a normal-sized house so I can keep it clean and tidy." Her own furniture is in storage, and they have to move again by the autumn, because, "How much is this gonna cost to heat in winter? It's lovely, but it's a show house, really, isn't it?"
The trustee agrees "pocket money" to cover essential expenses. "But only half compared with what you actually need for four kids. I've had to take my kids out of private school. I'm not a materialistic person," she insists, weeping. "I use my 40% discount card from New Look to buy my clothes, the kids' clothes are from fucking George at Asda and Matalan. And people think, 'Oh, she goes on these holidays,' but I don't pay for them. For me to have a holiday with the kids, that's why I have to have a pap picture. I've never paid for plastic surgery – the TV shows and magazines do. My money just goes straight to bills and the kids."
Katona never even paid off her original £82,000 tax debt, despite handing over earnings of £430,000. The court-appointed trustee charges £750 an hour – a startling expense to impose upon a bankrupt, roughly equivalent to a senior barrister's fee – and at the last count almost £400,000 had been swallowed up by the trustee and associated legal and accountancy fees. Meanwhile, still in the 50% tax bracket, Katona was rapidly running up a new bill; but as she wasn't allowed to keep the money she'd earned, she couldn't possibly give half of it to the taxman. The inevitability of a second bankruptcy has been clear to her for more than a year, and the system has made quite sure she could do nothing to prevent it.
Now the legal machinery of insolvency is lumbering into gear once again: her bank accounts are frozen, and any hope of earning her way out of it will depend upon how her industry regards this latest damage to her celebrity stock.
Katona with ex-husband Mark Croft. How did she wind up bankrupt when she was earning millions? By marrying him, she says. Photograph: Rex Features
How did she ever wind up bankrupt in the first place, when she was earning millions? Her answer boils down to four words: by marrying Mark Croft. Everyone warned her against him, but he told her they were all just jealous, and gradually she cut everyone out of her life – for a while even her mother, though they are now close again. "Mark had so much control over me. He'd go, 'Look at the state of you. No one'll love you any more; only I'll love you.' He'd be feeding me drugs, so much so that my nose would bleed. I'd be dirty, I'd be filthy, and then he'd pick me up and put me in the bath. He'd wash me, and I'd think, 'He loves me.' It was out of control."
She knew Croft and his friends were selling stories about her. "But it was easier to go along with it than to walk away. It was just easier. I was on heavy medication for bipolar, I was immensely unstable, I wasn't well. In the end, I just gave up caring." When burglars tied her up at knifepoint in 2007 and forced Croft to lead them to their valuables, did she wonder if he was involved in that, too? "Not at first." Croft has denied he had anything to do with it. But days after the robbery, she says, she found a guide to burgling a house. "And I knew he was in on it. And I was like, I was so distraught from the first marriage, and that kind of brought up all my past for me – my abandonment issues, not feeling self-worth. It was like a vicious circle. It was like, am I, am I, am I that?" and her voice breaks. "Are people that unable to love me?"
Katona kept thinking money would buy Croft's love. She bought him a fleet of luxury cars – more than £1m-worth in one year alone, including Porsches, Ferraris, Aston Martins, Range Rovers, Mercedes, Lamborghinis, BMWs – and slowly he assumed control of her finances, appointing as her accountant an unqualified friend who had previous convictions for dishonesty (he has since been imprisoned for defrauding another client). She says she didn't even know she owed a large tax bill until she began reading about it in the press, but Croft and his friend kept assuring her it was nonsense, right until the day she was declared bankrupt, in her absence, for a debt smaller than the price of just one of Croft's cars.
She still doesn't know how much of her money they got through. She says she begged the trustee to investigate her accountant, but "the trustee just kept saying I had the money hidden under a mattress!" But when I ask if Croft was also responsible for the secret camera in her bathroom, she doesn't hesitate. "Yeah, he was definitely involved in that, without a shadow of a doubt."
The only thing more shocking than the squalor of the marriage was the fact that she allowed the reality cameras to keep rolling. Even if she won the lottery, she says she'd still want her life to be filmed. "It's never, ever, ever been about the money. I just love entertaining, always have." Then, minutes later, she says she has always hated being famous. "I left Atomic Kitten because I hated the fame. My first episode of a breakdown was in the Kittens. I didn't like the fame. I know everyone finds that so hard to believe, but I don't."
Then why keep inviting film crews in? "Well, I like to have a full house. I miss them when they're not here. And I honestly don't think I'd ever have got through it without the cameras, because it was almost like free therapy. I could say what I want – it was like my own psychiatrist, just getting it all off my chest to this camera." Since she was 18, she says, the one constant in her life has been the press. "Or not so much the press, but the public. The one thing I've always had, from being in my late teens, is support from the public. That's always been my, my love. Makes me feel wanted a little bit."
She becomes animated, passionate almost to the point of messianic. "I think people relate to me, and I like to think I'm here for a reason and that is to give people hope in life itself. The one thing I get when I walk down the street without a shadow of a doubt is, 'Kerry, you're such an inspiration. Thank you for being honest, thank you for telling your story, my daughter's been self-harming, my daughter's come off drugs, my husband's been cheating, you know. And we've watched your reality show and we've sat there and cried. Watching your show has given me hope that there is light at the end of the tunnel.' And that makes it worth it for me – do you know what I mean? There's so many people in this industry who, it's all glamour, glitz, high heels: 'Oh, I'm in this showbiz life.' I'm not one of these celebs. Because no one's ever that honest about how shit life can be."
But how honest is she really? She claims that everything we see on the shows is real, but many of the storylines, the holidays and the cosmetic surgery (she has had breast reduction, liposuction, a tummy tuck) are cooked up by producers. Her entire career has been a series of media contrivances: the manufactured girl band, the staged paparazzi shots. Her second autobiography reveals large chunks of the first to have been more or less fiction; in the second, she admits she always knew Croft was a nasty piece of work, and that, despite all the first book's gushing tributes to "my bestest friend", she never really loved or even liked him. But she seems unabashed about the inconsistencies, and admits at one point, "Sometimes I get lost between Kerry at home and Kerry who's in public. Because as soon as I'm in public, I automatically change, and I'm so used to that now that I don't know if I know how to cope without it. Do you know what I mean? It's like Kerry Katona's someone else. There's two completely different people. You know, you've got the Kerry that goes, 'Hiya love! Yer all right?' and I don't really talk like that at all."
One of her former foster parents told Katona recently, "It was always a performance with you. Even if you had a bad day, you never cried as a kid", and I get the impression that she doesn't always know what is real or fake herself. It feels as if she will do literally anything to feel loved, and by my count she has gone through eight management teams in her 14-year career, in what looks like a quest for someone to take care of her. One manager, Max Clifford, gave her away at her last wedding, and even though they have since fallen out, she describes him as a dad. The agents who took her on after she left Croft made the relationship conditional upon divorce and drug tests, and took charge of almost every aspect of her life, to the point where, "It almost felt for me like I went from one controlling relationship straight to another." On her 30th birthday, they threw "the most amazing party for me, and people were there that I didn't even fucking know". She is now back with the manager who created Atomic Kitten: "I look at him almost like a dad."
Katona never knew her biological father, who died a few years ago, and I don't think it's too trite to suggest she has been throwing herself at substitutes all her life. I certainly don't doubt the heartbreak she describes at seeing her own children grow up fatherless, too; McFadden sees his at most three times a year, she says, and Croft hasn't seen his for more than 18 months. "I don't get a penny from the sperm donors," she spits, and makes some fabulously bitchy swipes at McFadden before her publicist reins her in, reminding her that one of his reasons for not paying maintenance (he began paying £500 a month a few months ago) was her habit of bad-mouthing him to the press.
She first met her new fiance, George, when they were teenagers on the Warrington club scene, but lost touch. He became a professional rugby league player, but in 2008 was jailed for six years for blackmail and released only two years ago. Would she say she was a good judge of character when it comes to men?
"Oh yeah," she says at once. "George is amazing. He makes me feel so good about myself: 'Morning beautiful! You're stunning, you're amazing, you're strong, go and exercise', you know," she beams. He's the first man her friends have approved of – "Even my mum says he's the one" – and she tells me several times, with irrepressible pride, that her youngest two call him Dad. "I feel like I've been with George for years. I feel like we're married already." How long have they been together? "Oh, it's only 10 months."
And so the Katona show rattles on, a modern juggernaut that no amount of catastrophe can derail. Whether she is in the driving seat, or being dragged along by an industry skilled at exploiting neediness for public entertainment, is a question I'm not sure even she could answer. Given the life she came from, her self-image as an inspirational survivor makes perfect sense. But stripped of celebrity gloss, all the endless upheavals, the money problems, the merry-go-round of unhappy relationships and the drugs make her current life look not so different from the one she was born into. If fame is another form of addiction for Katona, then as her audience we must come uncomfortably close to the role of enabler: she needs the public to love someone she doesn't even like.
Her ambition now, she says, is to become an actor – "just not to be Kerry Katona for a change". When she marries later this year, she will take George's name to become Mrs Kay. "Because I fucking hate Kerry Katona. I hate that, hate it."
Putting labels on people is that it ends up medicalising problems that are not medical in nature.
Dr Sami Timimi, psychiatrist
Dr Sami Timimi, psychiatrist
WHY IS PSYCHIATRY DOING MORE HARM THAN GOOD
The book, Cracked – Why Psychiatry Is Doing More Harm Than Good, by James Davies, published by Icon, is calmly and clearly written in straightforward layman’s English. The author has serious academic qualifications which entitle him to take a view on the subject. He has spoken to a wide selection of experts. And he shows that most of what we believe about modern mental health medicine is wrong. I plan to put a much longer review on my blog, but in the end the book’s the thing. You will gasp with amazement at the sheer nerve of the medical profession, as you turn its pages. Here is what it shows:
There is no objective scientific diagnosis (and so no objective treatment) for almost all so-called mental illnesses.
They are defined every few years by a committee, which once described homosexuality as a sickness (and now doesn’t).
It is currently seriously considering creating an illness called ‘Complicated Grief Disorder’, for those who grieve over a bereavement for more than six months.
There is no scientific proof, repeat, none at all, repeat none whatever, for the idea (still believed by millions) that depression is caused by a chemical imbalance in the brain, though this is the whole basis for most antidepressant prescriptions.
Drug companies control the research into their own products. They fail to publish results that suggest their pills don’t work. They doctor results to make their pills look better than they are.
In most cases, there is no significant difference in effect on depression between antidepressant pills and dummy sugar tablets. But the pills do have potent side effects (often these are most radical when people stop taking them, which is why they should only be given up under medical supervision).
Government regulation of this behaviour is feeble.
Many of the medical experts who recommend these pills, in the media and to other doctors, receive large fees from the drug companies, without disclosing this.
Many medical journals gain substantial income from large orders for reprints, which come from the drug companies. The profits from this industry are colossal.
Doctors who fail to toe the line lose valuable consultancy work, and in one case a leading psychiatrist had the offer of a major professorship withdrawn after he delivered a lecture criticising antidepressants.
Edited from Peter Hitchens : http://www.dailymail.co.uk/debate/article-2323104/PETER-HITCHENS-Wondering-ignored-kidnapper-Ohio-Well-ignoring-MUCH-bigger.html#ixzz2T6An0DQu
There is no objective scientific diagnosis (and so no objective treatment) for almost all so-called mental illnesses.
They are defined every few years by a committee, which once described homosexuality as a sickness (and now doesn’t).
It is currently seriously considering creating an illness called ‘Complicated Grief Disorder’, for those who grieve over a bereavement for more than six months.
There is no scientific proof, repeat, none at all, repeat none whatever, for the idea (still believed by millions) that depression is caused by a chemical imbalance in the brain, though this is the whole basis for most antidepressant prescriptions.
Drug companies control the research into their own products. They fail to publish results that suggest their pills don’t work. They doctor results to make their pills look better than they are.
In most cases, there is no significant difference in effect on depression between antidepressant pills and dummy sugar tablets. But the pills do have potent side effects (often these are most radical when people stop taking them, which is why they should only be given up under medical supervision).
Government regulation of this behaviour is feeble.
Many of the medical experts who recommend these pills, in the media and to other doctors, receive large fees from the drug companies, without disclosing this.
Many medical journals gain substantial income from large orders for reprints, which come from the drug companies. The profits from this industry are colossal.
Doctors who fail to toe the line lose valuable consultancy work, and in one case a leading psychiatrist had the offer of a major professorship withdrawn after he delivered a lecture criticising antidepressants.
Edited from Peter Hitchens : http://www.dailymail.co.uk/debate/article-2323104/PETER-HITCHENS-Wondering-ignored-kidnapper-Ohio-Well-ignoring-MUCH-bigger.html#ixzz2T6An0DQu
Creative T-shirts
Found in a charity shop! INTENATIONAL PHILOSOPHY: GERMANY VS GREECE.
Enlarge this image to follow the evolutionary game between these countries' philosophers and psychiatrists.
Enlarge this image to follow the evolutionary game between these countries' philosophers and psychiatrists.
Creative T-shirts (2)
From north India's Panna Tiger Reserve, this stunning, clever, representation of our endangered species.
The Creative Brain
The Creative Brain, it is a subject that has intrigued me for many years, so I was thrilled to see that the BBC was broadcasting a documentary on the neurological processes entailed when we have those moments of sudden inspiration.
In 2010, as a researcher for SCEPTrE (Surrey Centre for Excellence in Professional Training and Education), I conducted two studies of creativity, first in Creative Arts and then in non-Creative Arts students as part of a Higher Education Academy sponsored project. The aim of my research was twofold:
(1) To identify where in students’ personally determined life-wide curriculum they are able to express and develop their creativity so that they realise their creative potential;
(2) To examine what being professional means to students and how they develop professional attitudes, capabilities and confidence to be a creative professional through their life-wide curriculum.
The research entailed gathering qualitative and quantitative data through questionnaire and interview processes. My first report can be viewed here:
Willis, J. (2010a) Becoming a Creative Professional. Full report available at: http://creativeinterventions.pbworks.com/w/page/27822835/Becoming-a-Creative-Professional
The complete project can be found at:
http://creativeinterventions.pbworks.com/w/page/16609416/FrontPage
Last night’s BBC documentary examined the question of creativity from a more ‘scientific’ perspective, one which both fascinated me and raised anxiety as it proposed the potential for active intervention to make us more creative. The programme can be viewed by following the link below. What do you think?
Horizon
2013-2014 - 2. The Creative Brain: How Insight Works
Documentary - 1h - Broadcast on 14-03-13 at 21:00
It is a feeling we all know - the moment when a light goes on in your head. In a sudden flash of inspiration, a new idea is born. Today, scientists are using some unusual techniques to try to work out how these moments of creativity - whether big, small or life-changing - come about. They have devised a series of puzzles and brainteasers to draw out our creative behaviour, while the very latest neuroimaging technology means researchers can actually peer inside our brains and witness the creative spark as it happens. What they are discovering could have the power to make every one of us more creative
http://www.bbc.co.uk/iplayer/episode/b01rbynt/Horizon_20132014_The_Creative_Brain_How_Insight_Works/
In 2010, as a researcher for SCEPTrE (Surrey Centre for Excellence in Professional Training and Education), I conducted two studies of creativity, first in Creative Arts and then in non-Creative Arts students as part of a Higher Education Academy sponsored project. The aim of my research was twofold:
(1) To identify where in students’ personally determined life-wide curriculum they are able to express and develop their creativity so that they realise their creative potential;
(2) To examine what being professional means to students and how they develop professional attitudes, capabilities and confidence to be a creative professional through their life-wide curriculum.
The research entailed gathering qualitative and quantitative data through questionnaire and interview processes. My first report can be viewed here:
Willis, J. (2010a) Becoming a Creative Professional. Full report available at: http://creativeinterventions.pbworks.com/w/page/27822835/Becoming-a-Creative-Professional
The complete project can be found at:
http://creativeinterventions.pbworks.com/w/page/16609416/FrontPage
Last night’s BBC documentary examined the question of creativity from a more ‘scientific’ perspective, one which both fascinated me and raised anxiety as it proposed the potential for active intervention to make us more creative. The programme can be viewed by following the link below. What do you think?
Horizon
2013-2014 - 2. The Creative Brain: How Insight Works
Documentary - 1h - Broadcast on 14-03-13 at 21:00
It is a feeling we all know - the moment when a light goes on in your head. In a sudden flash of inspiration, a new idea is born. Today, scientists are using some unusual techniques to try to work out how these moments of creativity - whether big, small or life-changing - come about. They have devised a series of puzzles and brainteasers to draw out our creative behaviour, while the very latest neuroimaging technology means researchers can actually peer inside our brains and witness the creative spark as it happens. What they are discovering could have the power to make every one of us more creative
http://www.bbc.co.uk/iplayer/episode/b01rbynt/Horizon_20132014_The_Creative_Brain_How_Insight_Works/
Word Power
Can people with mental health problems take the sting out of stigma by reclaiming pejoratives? By Mark Radcliffe.
There are, apparently, a lot of "nutters" about these days. Only last week, Jeremy Clarkson referred with some admiration to the resident test driver on his Top Gear programme on BBC2 as "going mental - really he's an absolute nutter". And we can be assured that this is a completely different "nutter" to the publicity-seeking stand-up comedian who was so described by the Sun and the News of the World after he tricked his way past royal security at Prince William's birthday party.
The Guardian, Wednesday, July16, 2003
http://www.guardian.co.uk/society/2003/jul/16/mentalhealth.guardiansocietysupplement
REPLY
The Guardian Wednesday July 23 2003
Battle of words
Your article on stigmatising language and mental health (Word power, July 16) was timely: as you observe, the Royal College of Psychiatrists has had only limited success in its campaign to destigmatise mental illness.
Having worked in the field of psychiatry for nearly 20 years, I find it naive to believe that throwing large sums of money at a "problem" will change attitudes that have become part of our culture over hundreds of years. We cannot realistically expect to undo the common pejorative use of terminology: it is an unconscious expression of the anxieties and confusion felt by those in power, an attempt to justify or rationalise certain human behaviours that may have more complex and uncomfortable causes.
For example, it is easier to call Osama bin Laden "psychotic" than to confront the reasons for a sudden increase in recruitment of fanatics.
My approach is to encourage my patients to address aspects of stigma as an essential part of their treatment. I believe that the most difficult stigma to overcome is one's own, and I address this through education and, most importantly, in a group forum. A well-run group will provide a forum in which the pejorative use of language can be demystified, leading to true individual empowerment.
Dr N Yoganathan
Consultant Psychiatrist, New Malden, Surrey.
There are, apparently, a lot of "nutters" about these days. Only last week, Jeremy Clarkson referred with some admiration to the resident test driver on his Top Gear programme on BBC2 as "going mental - really he's an absolute nutter". And we can be assured that this is a completely different "nutter" to the publicity-seeking stand-up comedian who was so described by the Sun and the News of the World after he tricked his way past royal security at Prince William's birthday party.
The Guardian, Wednesday, July16, 2003
http://www.guardian.co.uk/society/2003/jul/16/mentalhealth.guardiansocietysupplement
REPLY
The Guardian Wednesday July 23 2003
Battle of words
Your article on stigmatising language and mental health (Word power, July 16) was timely: as you observe, the Royal College of Psychiatrists has had only limited success in its campaign to destigmatise mental illness.
Having worked in the field of psychiatry for nearly 20 years, I find it naive to believe that throwing large sums of money at a "problem" will change attitudes that have become part of our culture over hundreds of years. We cannot realistically expect to undo the common pejorative use of terminology: it is an unconscious expression of the anxieties and confusion felt by those in power, an attempt to justify or rationalise certain human behaviours that may have more complex and uncomfortable causes.
For example, it is easier to call Osama bin Laden "psychotic" than to confront the reasons for a sudden increase in recruitment of fanatics.
My approach is to encourage my patients to address aspects of stigma as an essential part of their treatment. I believe that the most difficult stigma to overcome is one's own, and I address this through education and, most importantly, in a group forum. A well-run group will provide a forum in which the pejorative use of language can be demystified, leading to true individual empowerment.
Dr N Yoganathan
Consultant Psychiatrist, New Malden, Surrey.
Defining Moment
Clare Allan was an English graduate with dreams and friends until mental illness was diagnosed. She recounts the decade she spent in a system that robbed her of a sense of self
Clare Allan
Guardian Wednesday April 19, 2006
I clearly remember the first time I heard the term "breakdown" applied to me. I was sitting in a room at the Whittington hospital, at the cheaper end of Islington in north London. In my memory, the room is the size of a hall, the doctor sits at one end and I at the other, and we have to shout to make ourselves heard above the A1 traffic, which roars past under the window. "Do you think you might be having a breakdown?" the doctor yells, and I feel myself blush as I struggle to conceal my relief and adopt a more fitting expression.
This was the first time that I'd ever met a psychiatrist. She seemed scarcely human, a mythical being with my destiny in her hands. I remember, too, my surprise, years later, on returning to see her in that same room, a veteran of the system now with 20 admissions under my arm, a section on my records, and a history the length of the bible, if a lot less poetic.
REPLY
Society Guardian
19 April 2006 Defining Moment – Clare Allan
As a practising psychiatrist, may I congratulate Clare Allan on her courageous and cogent account of her experience of mental illness? Many will relate to this.
Her account highlights the dilemma I face in my daily work within the NHS and private sectors: how to balance the psychiatric, scientific, model with a more dialectic, artistic, approach to mental health. Sadly, with increased emphasis on targets and evidence-based practice we are forced into the former, didactic model which inevitably leads to impersonal remedies, with quasi-measurable outputs.
I have found that in addition to prescriptive methods (medication as well as Cognitive Behaviour Therapy etc.) use of an explorative forum creates a medium (matrix) where a holistic approach can be established. I have run groups in the NHS and independent sector, where patients have found a sense of containment, safety and acceptance which is essential for ‘recovery’ (healing).
A breakdown is sometimes essential for a personal breakthrough, because mental illnesses are subjective experiences where the causative factors may be nature, nurture or varying degrees of both, in defiance of the diagnostic labels necessary for scientific research and for planning and costing healthcare provision. I often say to my patients that the diagnostic label is primarily guidance for me to plan their appropriate treatments (e.g. combining medications and psychotherapeutic interventions).
Clare Allan’s dialectic experience brings to mind the words of the eminent ‘anti-psychiatrist’ Thomas Szasz, who observed:
Formerly, when religion was strong and science, weak, men mistook science for medicine; now, when science is strong and religion weak, men mistake medicine for magic. (Szasz T. 1973 The Second Sin)
I hope that Clare Allan’s writing will inspire and encourage many more sufferers of mental illness to find a voice to share their experiences and bring about changes of more humane nature to the provision of psychiatric services in this country. If patients truly are ‘customers’, it is only through their collective voice that health care policy will change.
Dr N Yognathan, Consultant Psychiatrist
Clare Allan
Guardian Wednesday April 19, 2006
I clearly remember the first time I heard the term "breakdown" applied to me. I was sitting in a room at the Whittington hospital, at the cheaper end of Islington in north London. In my memory, the room is the size of a hall, the doctor sits at one end and I at the other, and we have to shout to make ourselves heard above the A1 traffic, which roars past under the window. "Do you think you might be having a breakdown?" the doctor yells, and I feel myself blush as I struggle to conceal my relief and adopt a more fitting expression.
This was the first time that I'd ever met a psychiatrist. She seemed scarcely human, a mythical being with my destiny in her hands. I remember, too, my surprise, years later, on returning to see her in that same room, a veteran of the system now with 20 admissions under my arm, a section on my records, and a history the length of the bible, if a lot less poetic.
REPLY
Society Guardian
19 April 2006 Defining Moment – Clare Allan
As a practising psychiatrist, may I congratulate Clare Allan on her courageous and cogent account of her experience of mental illness? Many will relate to this.
Her account highlights the dilemma I face in my daily work within the NHS and private sectors: how to balance the psychiatric, scientific, model with a more dialectic, artistic, approach to mental health. Sadly, with increased emphasis on targets and evidence-based practice we are forced into the former, didactic model which inevitably leads to impersonal remedies, with quasi-measurable outputs.
I have found that in addition to prescriptive methods (medication as well as Cognitive Behaviour Therapy etc.) use of an explorative forum creates a medium (matrix) where a holistic approach can be established. I have run groups in the NHS and independent sector, where patients have found a sense of containment, safety and acceptance which is essential for ‘recovery’ (healing).
A breakdown is sometimes essential for a personal breakthrough, because mental illnesses are subjective experiences where the causative factors may be nature, nurture or varying degrees of both, in defiance of the diagnostic labels necessary for scientific research and for planning and costing healthcare provision. I often say to my patients that the diagnostic label is primarily guidance for me to plan their appropriate treatments (e.g. combining medications and psychotherapeutic interventions).
Clare Allan’s dialectic experience brings to mind the words of the eminent ‘anti-psychiatrist’ Thomas Szasz, who observed:
Formerly, when religion was strong and science, weak, men mistook science for medicine; now, when science is strong and religion weak, men mistake medicine for magic. (Szasz T. 1973 The Second Sin)
I hope that Clare Allan’s writing will inspire and encourage many more sufferers of mental illness to find a voice to share their experiences and bring about changes of more humane nature to the provision of psychiatric services in this country. If patients truly are ‘customers’, it is only through their collective voice that health care policy will change.
Dr N Yognathan, Consultant Psychiatrist
The asylum experience never leaves you
Though a great deal has changed in psychiatric treatment in the 200 years since the building of the first great Victorian asylums, it is only relatively recently that the most significant shift has happened, moving patients out of those huge institutions and, where possible, supporting them in the community. From 1950 to the mid-1980s, the psychiatric inpatient population in Britain was reduced by 90%.
Leaving aside the question of how successful this change has been, and very real concerns about how spending cuts will affect the quality of community care, the fact that it took place so recently means that many of today's service users were once patients in the asylums. Though services these days strive to be a good deal less authoritarian and a good deal more user-led, the experiences of these patients continue to inform the way they feel about psychiatric treatment in general.
My friend Meg (not her real name) was first admitted to Stanley Royd hospital near Wakefield in 1972, when she was just 17. Stanley Royd, formerly known as the West Riding Pauper Lunatic Asylum, opened in the last years of George III's reign, he of the famous "madness". Construction began in 1816, just six months after the battle of Waterloo, and the first patients were admitted in November 1818.
o Clare Allan The Guardian, 1 September 2010
Leaving aside the question of how successful this change has been, and very real concerns about how spending cuts will affect the quality of community care, the fact that it took place so recently means that many of today's service users were once patients in the asylums. Though services these days strive to be a good deal less authoritarian and a good deal more user-led, the experiences of these patients continue to inform the way they feel about psychiatric treatment in general.
My friend Meg (not her real name) was first admitted to Stanley Royd hospital near Wakefield in 1972, when she was just 17. Stanley Royd, formerly known as the West Riding Pauper Lunatic Asylum, opened in the last years of George III's reign, he of the famous "madness". Construction began in 1816, just six months after the battle of Waterloo, and the first patients were admitted in November 1818.
o Clare Allan The Guardian, 1 September 2010
Sentenced to death?
Sentenced to
death? A talented yet tortured young man killed himself in Strangeways prison's
segregation unit. As a diagnosed schizophrenic, should he have even been there?
Ed Vulliamy investigates
Ed Vulliamy
The Guardian, Wednesday August 2, 2006
In the last letter Jane received from her son, he wrote: "You must understand that one of my beliefs, at a deep level, is that the world is a dangerous and malevolent place - this is common with my illness ... As a result, I do assume that everyone is out to get me, and it does not help when everyone is."
By the time Jane read those words, in early July 2004, her only son, Sean, had died a lonely and comfortless death by his own hand in the segregation unit at Strangeways prison.
REPLY
*** Sean's suicide is sadly inevitable in view of the changes that have taken place in mental health provision in the UK over the last 20 years. While staffing has increased several fold, and we have newer drugs and a plethora of therapies, mental health services are geared towards short, sharp, so-called evidence-based interventions. These are appropriate for minor psychiatric ailments and for perhaps a third of major psychiatric ailments with a good prognosis, but this leaves a significant proportion of people who would otherwise have been cared for in an old asylum now falling to alternative institutions, such as prison.
There has been no statistically significant increase in the percentage of the general population experiencing major psychiatric disorders (psychoses) over the last 20 years. If the prison population has meanwhile increased and there has been a disproportionately high psychiatric morbidity within it, there can be only one conclusion: this is a direct result of the closure of asylums.
If psychiatric services remain geared towards evidence-based practice, sadly, more cases such as that of Sean will have to occur before policymakers recognise the need for changes.
Dr N Yoganathan
Consultant psychiatrist, New Malden
Letters, SocietyGuardian, 119 Farringdon Road, London, EC1R 3ER. Telephone: 020 7239-9943. Fax: 020 7239-9933. Email: [email protected]
SocietyGuardian.co.uk © Guardian News and Media Limited 2007
Ed Vulliamy
The Guardian, Wednesday August 2, 2006
In the last letter Jane received from her son, he wrote: "You must understand that one of my beliefs, at a deep level, is that the world is a dangerous and malevolent place - this is common with my illness ... As a result, I do assume that everyone is out to get me, and it does not help when everyone is."
By the time Jane read those words, in early July 2004, her only son, Sean, had died a lonely and comfortless death by his own hand in the segregation unit at Strangeways prison.
REPLY
*** Sean's suicide is sadly inevitable in view of the changes that have taken place in mental health provision in the UK over the last 20 years. While staffing has increased several fold, and we have newer drugs and a plethora of therapies, mental health services are geared towards short, sharp, so-called evidence-based interventions. These are appropriate for minor psychiatric ailments and for perhaps a third of major psychiatric ailments with a good prognosis, but this leaves a significant proportion of people who would otherwise have been cared for in an old asylum now falling to alternative institutions, such as prison.
There has been no statistically significant increase in the percentage of the general population experiencing major psychiatric disorders (psychoses) over the last 20 years. If the prison population has meanwhile increased and there has been a disproportionately high psychiatric morbidity within it, there can be only one conclusion: this is a direct result of the closure of asylums.
If psychiatric services remain geared towards evidence-based practice, sadly, more cases such as that of Sean will have to occur before policymakers recognise the need for changes.
Dr N Yoganathan
Consultant psychiatrist, New Malden
Letters, SocietyGuardian, 119 Farringdon Road, London, EC1R 3ER. Telephone: 020 7239-9943. Fax: 020 7239-9933. Email: [email protected]
SocietyGuardian.co.uk © Guardian News and Media Limited 2007
Doctor's orders
Liz Miller was a successful surgeon when depression hit. Now the Mind Champion of the Year wants the medical profession to take mental health seriously. By Mary O'HaraArticle history
drlizmiller.co.ukAbout this article
This article appeared in the Guardian on Wednesday June 11 2008 on p1 of the Society news & features section. It was last updated at 10:23 on June 11 2008.
When Liz Miller is told that a blogger recently described her as "a cool chick" and "an inspiration to the public and doctors", it takes some time before she stops laughing and says: "Really? Someone said that?"
drlizmiller.co.ukAbout this article
This article appeared in the Guardian on Wednesday June 11 2008 on p1 of the Society news & features section. It was last updated at 10:23 on June 11 2008.
When Liz Miller is told that a blogger recently described her as "a cool chick" and "an inspiration to the public and doctors", it takes some time before she stops laughing and says: "Really? Someone said that?"
Unthinkable? Rehabilitating RD Laing
He's been unfashionable for decades, but in an era of big-pharma and proliferating diagnoses, is it time to reassess?
guardian.co.uk, Friday 26 August 2011
guardian.co.uk, Friday 26 August 2011
The mental illness industry is medicalising normality
In 2000 the World Health Organisation named depression as the fourth leading contributor to the global burden of disease and predicted that by 2020 it would rise to second place. I suppose WHO didn't mean it to sound like a target to be aimed for, but we seem to be rising to the challenge in any case.
A new survey from the European College of Psychopharmacology, a meta-analysis of a gathered mass of earlier research, reports that a staggering 164.8 million Europeans – 38.2% of the population – suffer from a mental disorder in any year. As well as depression, this includes neural disorders such as dementia and Parkinson's; childhood problems from ADHD to "conduct disorder"; and the leading anxiety disorders – everything from panic attacks to obsessive-compulsive disorder to shyness. Depression and anxiety, they tell us, are disproportionately women's ailments. Men, it seems, become alcoholics (another illness category) rather than depressives, particularly in eastern Europe.
The Guardian, Lisa Appignanesi
A new survey from the European College of Psychopharmacology, a meta-analysis of a gathered mass of earlier research, reports that a staggering 164.8 million Europeans – 38.2% of the population – suffer from a mental disorder in any year. As well as depression, this includes neural disorders such as dementia and Parkinson's; childhood problems from ADHD to "conduct disorder"; and the leading anxiety disorders – everything from panic attacks to obsessive-compulsive disorder to shyness. Depression and anxiety, they tell us, are disproportionately women's ailments. Men, it seems, become alcoholics (another illness category) rather than depressives, particularly in eastern Europe.
The Guardian, Lisa Appignanesi
- Lisa Appignanesi
- guardian.co.uk, Tuesday 6 September
2011
- Article history
I was drugged up to the eyeballs with men who thought they were Jesus
Just after 8am on a spring morning in April, television presenter Gail Porter crouched under a tree on London’s Hampstead Heath and sent a text message to her boyfriend that read: ‘I can’t carry on. I feel suicidal.’
Hours later, the former pin-up girl – whose image was once famously projected on to the side of the House of Commons – was being bundled into the back of a police van and taken to a psychiatric unit where she would be sectioned and forcibly held for nearly a month.
The 40-year-old star’s personal troubles – which have included a battle with the eating disorder anorexia, post-natal depression, being diagnosed bipolar, an acrimonious divorce from her musician husband in 2004 and being left bald by the hair loss condition alopecia – have been well-documented.
http://www.mailonsunday.co.uk/femail/article-2025741/Gail-Porter-sectioned-TV-presenter-gives-haunted-account-3-week-ordeal.html#
Hours later, the former pin-up girl – whose image was once famously projected on to the side of the House of Commons – was being bundled into the back of a police van and taken to a psychiatric unit where she would be sectioned and forcibly held for nearly a month.
The 40-year-old star’s personal troubles – which have included a battle with the eating disorder anorexia, post-natal depression, being diagnosed bipolar, an acrimonious divorce from her musician husband in 2004 and being left bald by the hair loss condition alopecia – have been well-documented.
http://www.mailonsunday.co.uk/femail/article-2025741/Gail-Porter-sectioned-TV-presenter-gives-haunted-account-3-week-ordeal.html#
Shyness in a child and depression after a bereavement
Childhood shyness could be reclassified as a mental disorder under controversial new guidelines, warn experts.
They also fear that depression after bereavement and behaviour now seen as eccentric or unconventional will also become ‘medicalised’.
Internet addiction and gambling might also become forms of illness.
http://www.dailymail.co.uk/news/article-2099078/Shyness-child-depression-bereavement-classed-mental-illness.html 9 February 2012
They also fear that depression after bereavement and behaviour now seen as eccentric or unconventional will also become ‘medicalised’.
Internet addiction and gambling might also become forms of illness.
http://www.dailymail.co.uk/news/article-2099078/Shyness-child-depression-bereavement-classed-mental-illness.html 9 February 2012
British exorcists
The British exorcists: How people are paying thousands of pounds to quack 'healers' because it's more acceptable to be possessed than to have a mental illness
- Hundreds of Asians are operating as healers and removing evil spirits from bodies believed to be possessed, according to BBC Newsnight investigation
- Exorcist in east London said demons can 'deceive doctors' and research found some communities find it more acceptable to be possessed than ill
- Theological ground for belief in evil spirits as Qur'an mentions 'Jinn': http://www.dailymail.co.uk/news/article-2235669/Hundreds-exorcisms-performed-UK-Asian-communities-treat-people-mental-illnesses.html#ixzz2Cm6sDYuE
- Daily Mail Tuesday, Nov 20 2012
What drives a child to drink?
Madeline Hanshaw is standing in her kitchen. The washing is whirling around the machine, there are coffee cups in the sink, and outside kids are playing noisily in the sunshine. It could be an ordinary day: but Hanshaw is wondering how life will ever be ordinary again. "My baby is dead," she says. "That's going to be in my heart every day for the rest of my life."
Hanshaw, 44, is crying now. A week ago, she is saying, she still hoped that Gary – "Gal", she calls him – would pull through. "I believed in the doctors," she says. "I thought they'd find a liver for him somehow. I thought he'd make it."
Gary Reinbach was denied a transplant because, under guidelines drawn up by the Liver Advisory Group, patients who are likely to return to a damaging pattern of alcohol consumption aren't deemed suitable candidates.
So Gal didn't make it: last Sunday, a day after Hanshaw had gone public with her plea to doctors to make a liver available to him, her 22-year-old alcoholic son died at London's University College hospital (UCH). His last hours, she says, were truly terrible. "He didn't want to die. He kept saying that. I really think that if they'd given him a second chance, he'd have changed his ways.
Joanna Moorhead The Guardian, Saturday 25 July 2009
Hanshaw, 44, is crying now. A week ago, she is saying, she still hoped that Gary – "Gal", she calls him – would pull through. "I believed in the doctors," she says. "I thought they'd find a liver for him somehow. I thought he'd make it."
Gary Reinbach was denied a transplant because, under guidelines drawn up by the Liver Advisory Group, patients who are likely to return to a damaging pattern of alcohol consumption aren't deemed suitable candidates.
So Gal didn't make it: last Sunday, a day after Hanshaw had gone public with her plea to doctors to make a liver available to him, her 22-year-old alcoholic son died at London's University College hospital (UCH). His last hours, she says, were truly terrible. "He didn't want to die. He kept saying that. I really think that if they'd given him a second chance, he'd have changed his ways.
Joanna Moorhead The Guardian, Saturday 25 July 2009