Docile Mental Health Patients
We can agree that all mental health consumers are at different places along the road to wellness. Let us also agree that medical science has, in the past, required a high degree of faith in its practitioners (doctors and therapists) which is becoming somewhat outmoded as consumers rely on themselves for wellness. It follows that consumers will be at different places in their beliefs in the effectiveness of the medical establishment.
Many consumers were raised in an era during which “the doctor is always right”. Others are only at the beginning of their recovery process, and need faith in their healers in order to progress. Many are, from personal history, fearful of those in authority. Whatever the cause, numerous patients continue to be docile and to conform to whatever the medical practitioner requires—however strange or unreasonable it may seem to others. I can’t speak from authority, but from observation, many professionals appear to prefer these patients in their practices.
Other consumers are farther along the road of trusting themselves for answers. These patients will openly disagree with their doctors or will grumble among their family about the mental health system, but generally will comply with medical or therapeutic requests. These consumers are also seen by professionals as being easy to work with, though with a mind of their own. Most consumers probably fall here, on a scale from the “most docile” to the “most independent”.
At the maximum independence from Western medical science are those consumers who consider themselves to be totally free of the system. It doesn’t matter how or why they arrived at the end of their involvement with professionals: disillusionment; disappointment; a greatly improved self-esteem; or alternatives to relying on traditional providers for support, may all be causes for autonomy. In whatever way these consumers have achieved their independence, they are unmistakably assertive. It takes a lot of strength to maintain your own integrity in the face of a general tendency in society to be approved for cooperation.
These consumers seem to appear to professionals as impossible, judging from the imagery used to describe them. “Argumentative”, “uncooperative”, and “angry” are words that all consumers will recognize as having been used against a patient with whom the practitioner is uncomfortable. These categorizations have the effect of keeping not merely the independent consumer in line, but also work to great effect on any consumer who, for personal reasons, feels uncomfortable with conflict, especially with authority figures.
It is unfortunate that there is a cost every consumer has to pay who has a mental illness, no matter in which way they choose to interact with the mental health system. Passivity (docility) costs the consumer the ability to find out that he or she is capable of much more than the providers will admit. Compliance while protesting maintains the overriding control of those who, in the last analysis, don’t know you as well as you know yourself. And those who are assertive pay a huge price, as they will until the majority of consumers become self-sufficient.
There is a payoff for all these positions, as well. Those who are submissive to authorities don’t need to stick their necks out, or take responsibility when things go wrong. Those who are more independent find that they have established a misleading self-concept of independence, while surrendering in all important areas of self-government. And those who have achieved independence have found that it takes a lot of strength to be free, but the payoff is knowing that they can survive almost anything.
I hardly need to say that all consumers, no matter where they fall on the scale of relationship to providers, need to have patience with those who are in a different place.
Finally, we need to look at the payoff for professionals to keep patients docile. First, there is a boost to their egos: they see themselves as having special knowledge which no other “laymen” can share. Next, there is the relative ease of completing their work without any interruptions. Have you heard the joke, “I’d get a lot done around here if it weren’t for these darned customers”? Every time a consumer challenges a professional, it makes it harder for that unfortunate provider to do his or her job. And, last, like any well-run restaurant, the faster the runover, the more money you make. Docile consumers make it easier for the “experts” to see more clients.
Doctors and therapists must work to keep consumers docile. They discourage patients from seeing their healthy side. They discourage independence. They frown at questions. And, they ridicule attempts by the client to make his or her own decision.
Mary Ellen Copeland, who developed the WRAP plan, said that when she first told her psychiatrist that she was going to teach a workshop, he said, “You can’t do that.” Later, when she told him that she was going to publish a book, he said again, “You can’t do that.” She now says that she maintains her mental health without meds or doctors, by practicing WRAP.
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