Meaning not drowning according to Barker

Mental Health Nursing,  Jul 2004  

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'We are all in recovery and struggling I with things that haunt us and limit our capacity to be fully human'.

Professor Phil Barker giving the Mental Health Nursing lecture suggested that the complexity of early relationships provided much for us to recover from. he invited delegates to reflect on recovery as a process of reclamation - the recovery of land previously submerged by water and the experience of those reclaiming their lives from the waters of madness. he invited them to find meaning in drowning.

'From something thought to be meaningless and worthless they are reclaiming something that is priceless.1

Everyone was on the road to Recovery and in dreams and nightmares everyone experienced psychosis. But 'madness' threatened because it was alien, an Other' experience, beyond the pale. And most mental health services would fall foul of the Trades Descriptions Act he asserted. Focus on becoming mentally 'healthy' was far from the agenda. Fire fighters, for instance, fought fires but they also had a prevention role.

The single most important factor, whether they are in-patients on close obs or clients visited by an assertive outreach team - most people spend most of their lives living alone with their demons. If you had a faulty plug, you wouldn't put it on observation, you would examine the interior.1

Professor Barker emphasised issues of wholeness and I completeness, drawing on an individual's experience and the meanings attributed to this. he urged delegates to 'forget nonsense about psychological education' and recognise that a person (affected by mental illness) was already finding a way of dealing with the distress.

'How may I help nurture what they have already learned? Where has nurture gone?1 he challenged. he also feared for the concept of 'recovery' in case it was adopted and translated 'by someone from the Department of Health into procedural mumbo-iumbo'.

I fear the appointment of a "recovery tsar" and attempts to prescribe programmes that will drown the recovery infant before its birth.1

As an example of recovery without heavily formalised intervention, Professor Barker related the development of Alcoholics Anonymous.

'AA is the most outstanding achievement in twentieth century psychiatry. Nothing has worked more effectively. There is no profit, nothing to patent, procedures are human, not technical, outcomes are human not categorical.

'People who believe themselves to be alcoholic attain abstinence. The alcoholic recognises that this crucial point can never be erased but that (the circumstances) associated with it should never be revisited.'

he pictured individuals establishing an 'islet' of sanity with nurses helping them to stay on dry land and evade the attractions of returning to the deep - whether the water round the island, madness or the bottle in the case of alcoholics.

Rounding on the 'altar of the medication cabinet' he said psychiatric treatment was a suffocating process like a plaster cast's inability to promote physical fitness and suggested that instead of evidencebased practice, professionals might look for practice-based evidence.

Copyright Community Psychiatric Nurses Association Jul 2004
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