But you're all right now, aren't you?

This is a response of sorts to a post entitled Slouching Towards Recovery by Philip Dawdy at Furious Seasons, which was also critiqued by Gianna at Bipolar Blast. Read these posts - although I'm going to address some of the issues they raise from the perspective of a 'survivor', as opposed to the 'empowered consumer', there's a hell of a lot of common sense there no matter where you sit on the critical psychiatry spectrum.

But you're all right now, aren't you? This question typically arises on the rare occasions whenever I discuss what I call my psychiatric mythology with anyone, and inspires much eye-rolling on my part (which my interlocutor may well assume is medication-induced). The befuddlement that my disclosure invariably produces is based on a number of factors - I present as neat, highly organised, fairly confident, and above all, competent, both work-wise and when it comes to giving other people advice on how to handle their personal problems, which I manage to give the impression that I do not share. On the other hand, I've still got my quirks, which people who know me well are familiar with, that same familiarity breeding contempt in accordance with the usual exponential formulae. But more about that later.

The biggest thing you've got to do is accept your diagnosis... or you are going to be wrestling with yourself a long time. It's not worth doing. You know damn well that something is up with you, so what do you intend to do about it?

- Philip Dawdy, Slouching Towards Recovery

I was diagnosed with bipolar disorder at 19, a diagnosis I did not then and still do not accept. In fact that was last diagnosis I received, having previously run the gamut of schizophrenia, major depression, dissociative disorder, panic disorder, and schizoid, anti-social, narcissistic and borderline personality disorders in my various sojourns under lock and key. After escaping 'the system' just prior to my twentieth birthday, I spent a year 'in recovery' from psychiatry, a year which more or less amounted to a combination of alcoholism and agoraphobia as I wandered about my rented room trying not to rehash the events that led to my downfall, and occasionally lapsing into what were presumably alcohol-induced waking terrors, when the knife I kept under the pillow in case the crisis team ever visited again was pulled out. I then cleaned myself up by sheer fucking force of of will (which I emphasise not to make a point about what a tough nut I am, but about how involving any so-called 'mental health professionals' in the process was simply not an option) and enrolled at university. Apart from a recent misadventure with Zoloft, I have been medication-free since I was 20, and in full-time employment since I was 21.

So unlike Philip, I don't accept any of my diagnoses, but that doesn't necessarily prevent me from knowing "damn well that something is up" and that something might need to be done about it. It's simply a matter of reframing notions of causality, course and recovery. I've come to believe that while I don't suffer from any of the above-mentioned mental illnesses or disorders, I do suffer from a variety of psychological injuries, many of which are a direct result of the time I spent under psychiatric 'care' and some of which pre-date it, and are in fact part of the reason I became enmeshed in the psychiatric system in the first place - to have these injuries treated, not to be slandered (oops, diagnosed), doped up, locked up, sleep deprived, physically and verbally assaulted, sexually harassed, emotionally manipulated and generally reduced to a ghastly mess of pure, cognitively unmediated impulse and emotion - in other words, madness.

But I digress. For a few years I was 'OK' - functioning well occupationally and academically, but a little less well socially - thanks to my hospitalisations I'd largely missed out on the time of life (the late teens and early university years) when one makes 'friends for life', and the rock-bottom self-esteem that an inappropriate entanglement with one of those so-called 'mental health professionals' had left me with no doubt contributed to my willingness to spend five years in a 'relationship' with a work colleague who would discreetly take me out to dinner and fuck me every now and then, all the while looking over my shoulder for someone older, better paid, better educated and more suitable to be introduced into his inner circle of urban 30-something MBA and PhD-educated friends as his 'girlfriend'.

I finally stopped returning Mr (oops, Dr) Snob's phone calls when I was 27, which removed the focus from my poor judgement when it came to intimate relationships, and redirected it to the work sphere, where the level of responsibility I 'enjoyed' was increasing, but the salary and credit I received for not having the brain the size of an amoeba wasn't. No matter what I accomplished, it seemed like every man and his dog thought they were my boss and I was their personal secretary, and sometimes it seemed like I was spending days on end kneeling in the mud, pooper-scooper in gloved hand. (And then the dog would decide to take a shit too.) I'm sure that when I first brought this unacceptable situation to the attention of my boss, I did so in the nicest possible way - but to no avail, of course, for the Social Darwinist attitudes about the roles of women and of "non-professionals" (more politely known as managers, administrators and support staff) in professional settings are so entrenched that even for him to ask his egomanic underlings to wipe their own arses instead of expecting me to do it for them was a bit like asking them to eat the toilet paper as well. So this was when I began to institute unilateral bans on dealing with particular people and eventually, to start bagging their shit and throwing it right back in their faces, which naturally garnered me a reputation as being "difficult to work with", which I'm told will haunt me down the years.

Even post-promotions and payrises, I still don't know how to deal with snide remarks, subtle put-downs or outright verbal abuse from senior colleagues apart from just throwing it back at them in spades and, more importantly, I still don't know how to put aside the all the fury and frustration at the end of the working day and enjoy what leisure time I have. Where all this comes from, who knows - years of being belittled and treated like an idiot by psychiatrists and their ilk, transference of feelings about abusive parents to all authority figures, my own natural and ample egotism, whatever - the point is, I need to acknowledge that I haven't worked out how to handle it yet. I doubt 'Educating Ruth' will be amenable to a 90-minute adaptation for stage or screen any time soon, with a syllabus that includes learning what kind of people push my buttons, and learning (usually the hard way) to stay away from them, not to try and change them or even to learn how to adapt to them; that there's often no need to obtain mastery over a given interpersonal situation if it can just be avoided. Then there's learning not to learn the hard way, not to piss on the electric fence, and learning everything that I missed out on learning as a result of my incarcerations, and re-learning everything that was un-learned in the onslaught of multiple medications and the clearly communicated expectations of my deterioration, lack of responsibility and even imminent death. And finally, there's learning how to trust, but I have a feeling this will make up most of the Advanced part of the course.

Two basic operating principles: No suicide. No giving up. Once you get those operating principles into your life, it gives you the ability to get down to the most important matter of all, which is environment. You must have as much control of your total human environment as you can possibly manage... Anyone with bipolar disorder, depression, schizophrenia who's had it for more than 15 minutes... knows that there are certain things and situations that don't work out well for them.

- Slouching Towards Recovery

Too fucking right. Privacy. Independence. Doors, without windows, that can preferably be locked from the inside. Avoiding relationships, either personal or professional, that replicate the level of surveillance I was subjected to as a psychiatric patient - people who want to know where I've been, where I'm going, what time I'll be back, who I'll be seeing, how much I'll be drinking. (One of the advantages of my current job is that I don't clock-watch, and no one clock-watches me - but it took much patience and many rabbits pulled out of hats for my boss to learn that the degree of supervision he was accustomed to providing was unnecessary and indeed counterproductive in my case.)

You've got to adopt a no-excuses mindset. That means you've got to stop blaming the illness alone when things get dicey. You've got to dispense with the learned helplessness that the mental health system in this and other countries impose on patients...

My own feeling is that you've got to approach bipolar disorder as a personality disorder - or even as an environmental disorder - as opposed to a strictly biologically based illness. You get to work on all the behavioural problems and cues and triggers then. I know that's a heretical thought, but so be it.

- Slouching Towards Recovery

It wouldn't take a feeling-slightly-defensive psychiatrist to point out that Philip's 'no-excuses' rule applies as much to me as it does to those who accept that they have an illness, given that I nevertheless see myself as suffering 'injuries' that just happen to be largely iatrogenic. Thus, I have to be careful not to blame my time 'beneath the ice' for my every interpersonal misdemeanour or, tempting as it often is, revert to the strategy of the rented room with a bottle of Vat 69 and a knife under my pillow. It can sometimes be hard to remain comfortably 'in the world' as just another flawed but basically functional human being when one is aware of people, places and procedures that may cause one's utter desecration, while enjoying full legal and social sanction.

Philip makes the point that research into people who 'do well' in spite of receiving diagnoses such as bipolar disorder or schizophrenia is sparse. At the risk of overgeneralising from my own case, could it be that many people who 'do well' are doing so as the result of having moved off the psychiatric (and thus the research) radar, having decided that the cure is worse than the disease? I find it rather irritating when the same well-meaning people who say but you're all right now, aren't you? say things like "It's really impressive how you've managed to pull yourself together and put your life back together," or some such shit, because it shows how little they've understood what I've been telling them - sure, I've had to put in some hard yards, but the 'secret of my success' lies mostly in my good fortune to have gotten out of 'the system', off multiple medications and away from doctors who wanted to diagnose me with everything under the sun and tell me I'll be dead by the time I'm 21 if I don't do what I'm told.

I'm 30 now. I might still kill myself yet, but it will be in the back of Dr Kevorkian's van after disease has ravaged my body, and not on the bathroom floor after the mental health system has again ravaged my mind.