Why I Prefer to Manage my Mental Health without Medical Professionals

Recently, I had a big, unruly struggle with my mental health problems. The struggle was immense and acutely visible to people close to me. It was suggested, albeit very gently, whether I might benefit from re-entering the world of doctors: GP appointments, 'monitoring', medication, possibly contact with community mental teams or referrals to psychiatry...that sort of thing. You'll know it all too well if you've been through stuff similar to me.

My response was clear. I didn't want to go back into that all-too-familiar world. A world of being a patient. Waiting room gloom, being told 'I'll just put you on hold', tick box questionnaires that decimate all emotional nuance, pharmacy queues, dealing with 'side effects', 'tapering', not being listened to fully and other forms of frustration. A world in which I had to code switch to be taken seriously. I now name my feeling of being a patient as voicelessness and powerlessness.

Now I know there are other ways to think about myself. Different ways to think about the unusually high amplitude of my emotions, the responsiveness of my moods to the texture of my relationships and my fierce appetite for a life that feels deeply and authentically meaningful to me. Generative ways, to conceive of my emotions, moods, relationships and needs. In oth

er words, I no longer need to see myself as broken, messed up, disordered or a problem to be erased.

The more I distance myself from the medical system, the easier it is for me to leave this view of myself behind.

When I'm in the medical system, each interactions tends to be rushed and, increasingly, mediated by a screen. The framework through which my experiences are being understood is most likely going to be the DSM. Every intimate shred I share may be shrunk into a tick box so my story is now told wrongly.

How can I answer an intimate question like 'what's making you feel this way?' in two minutes to a stranger I've never met before and may never meet again. What if opening up creates a deluge they can't safely contain, and I don't know how to make it stop? What if I tell my story and it's disbelieved?

Many medical professionals have not had high-quality, nuanced training on the BPD diagnosis and its emotional and sociological textures, including how people with lived experience of the label are harmed by the people who are supposed to help.

With or without such training, a practitioner needs to be a highly-empathetic effective listener in order to take what I call a cognitive leap of imagination and believe me when I reply honestly to their well-meaning question 'what is making you feel this distress?'.

Because numerous medical professionals wouldn't and haven't, and don't, and can't, or don't want to believe me when I answer their question.

And not being listened to and believed is one of the main reasons why I try to avoid having to trust medical professionals with the deepest, darkest, rawest, most vulnerable and most human parts of me. If someone asks a question but they don't want to respect the answer, then I'd rather not be asked at all.

Don't open the box if you don't want to accept what's inside.

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I will never not remember a particular instance of being in a medical setting, feeling very distressed, and answering the question about 'why' I was there.

The staff couldn't believe my story and that my 'reason' was the 'reason' why I was there.

They couldn't, or didn't want to, take a cognitive leap of imagination to understand that the 'reason' had a resonance far deeper and far wider than they were failing to see.

Someone— anyone!—skilled in cognitive leaps of imagination would have looked beyond the present moment, would have taken the time to understand, and, crucially, would have reached out to me as a human being in need of comfort and support.

Not treated me like a silly little girl and pushed me out into the dark night alone.

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I can't remember who said this in a mental health context, but when all you have is a hammer everything looks like a nail. And make of that what you will when doctors have lots of medications and very limited capacity to offer relationally-based treatments and supports like psychotherapy, peer support workers and so on.

This is not to suggest that medication isn't helpful, or even life-saving, for some people in some situations. Of course it is, and I'm glad we have it. Medication isn't the right thing for me though, as is the case for many people diagnosed with BPD.

I'm not anti-doctor or even anti-psychiatry. I've had some empathetic, warm and supportive interactions, but these were sadly the exception within medical contexts rather than the rule. What I am against are personal failures in empathy from professionals in the face of distress.

I've suffered iatrogenic trauma from individuals within systems that was supposed to help because of personal failures to prioritise empathy.

In the same breath, I acknowledge that there are times when I have got what I needed from the medical system. It was a GP who referred me to a specialist mental health team who assessed me and gave me Dialectical Behaviour Therapy. This therapy, as I've written about extensively on this blog and in my books, utterly transformed my life for the better.

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Whilst DBT taught me ways to regulate my emotions, the people I've met, conversed with and got to know in the last decade taught me new ways of thinking about myself. I've come to realise that people with this diagnosis have expansive emotions and huge capacities for love, care, awe and creativity.

It's my privilege to know others who have been in similar situations to me and have felt similarly. I've gained a sense of much-needed community and mutual emotionality after many years of feeling alone. I've also had the luxury of a great education and enough time to read widely and think deeply— to think beyond the narratives I've been told directly and indirectly, and to think around their limitations.

I'm buoyed by social and relational structures that support me and keep me able to move forwards. I have people who hold onto complexity and ambiguity, who meet me where I'm at in any given moment. I have people who challenge me with their honesty and fresh ideas, but gently enough for me to not break. I have people who respect nuance and suspend judgement for long enough to take cognitive leaps of imagination. My husband, my friends, my family, my readers, as well as the thinkers and writers I engage with whose work empowers me to think differently.

Whilst I am privileged with these social and relational structures that propel me forwards, I also acknowledge that I have worked towards building these too. I try to put as much into others as I can.

I love deeply and try to make gratitude something I do. I might not always get all of my relationships right all of the time, but I'm here trying. Why? Because this world can be hard one to live in, especially if you have a big, open, unfiltered heart.

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My intention was that this post would be a restrained explanation of why I tend to avoid talking with medical professionals about mental health. Instead, it turned into an unruly and emotional piece of writing, and you know what, I'm going to leave it as it is. It feels honest and real like this.

I'm holding onto hope for social and relational structures within medical spaces that nurture people for who they are.

-Rosie x