Suffering Insanity by R. D. Hinshelwood

Author:R. D. Hinshelwood
Language: eng
Format: mobi
Tags: Behavioral Sciences
Published: 2011-05-09T21:35:46.496143+00:00

Essay 3

Suffer the mad

Countertransference in the

institutional culture

The lolly scramble was a feature of some days and held both for the amusement of the staff, who often described themselves as

‘going dippy ourselves, stuck on duty here all day’, and for the pleasure of the patients. The nurses, feeling bored because there hadn’t been a recent fight, would fetch a bag of sweets from the tin which was brought every fortnight as part of the Social Security allowance for patients. The paper-lollies would be showered into the middle of the day room and it would be first come first served, with fights developing, people being put in strait-jackets, whistles blowing; and the tension which mounted and reached its peak at intervals both in the patients and in nurses who long ago had had to suppress any desire to ‘nurse’ and were now overworked, degraded, in many cases sadistic, custodians, found its release, for a while.

(Frame 1962, pp. 86–87)

In this essay, I shall build on the description in Essay 1 of the impact of psychosis on carers. I shall argue that the impact on carers affects the way they relate to the work together, and impacts on institutional care itself.

Reality for psychotic patients has lost its meaning. Since the psychiatric institution and its staff and inmates are the reality for a patient in residence, the institution is an entity without meaning for those patients. It is not surprising that the atmosphere on a ward where psychotic people stay for long periods acquires a sense of no purpose, no meaning. Staff become non-entities for those whom they want to help. A bleak ‘belle dame sans merci’ atmosphere affects everyone; by and large those institutions have been closed down for their pains. Populated by shuffling figures in ill-laundered, unfitting garb, bent on spending their days measured in cigarette stubs, the silent televisions high on the walls out of arm’s reach like gargoyles, the ancient, overcrowded and impersonal dormitories, the silence, the worn-out furniture hardly distinguishable from the figures sitting in it, the old mental hospitals testified to the concentrated doses of lack of meaning and loss of identity. Descriptions cannot exaggerate the depressing impact of the atmosphere in such places, nor therefore the halting dedication of those who went on being carers there (Hinshelwood 1979, 2001).

Not much is now written about institutionalisation, nor the deleterious effects of psychiatric organisation on the recipients of our care. Where such questions are considered they tend to be closed off by received knowledge based on power structures, a Goffmanesque or Foucaultian diatribe about the irresponsible power that the caring professions wield. In this essay I want to raise doubts about that closed question. I want to raise the possibility that the crucial problem for psychiatric institutions is the impact of psychosis and the ensuing anxiety that carers have – not the power they have. It is a somewhat unconventional approach, and this account may seem sketchy.

The power of psychosis renders families, friends and loved ones quite ineffective. So, what

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.