And so what I mean how do you make sense of the fact that took long to get a diagnosis I mean you, you said a little bit about one thing that was, could, could you say a bit more about that do you think?

I think it was lack of understanding and I, I still think there’s a major, major lack of understanding in mental health services about what is a mental illness. I think a lot of people will think that you’re being weak. And I’ve, I’ve come across the attitude quite a few psychiatrists who seem to have the impression that I’m malingering somehow or, or dodging work, which isn’t the case. If I really wanted to dodge work I wouldn’t have gone out and got a degree, in fact two degrees I might add, I’ve actually got two degrees, so I wouldn’t have got those qualifications if I’d had any intention of malingering. One doctor in particular didn’t think that I had BPD at all because her, her PhD, and she was resting on the fact that her PhD was in BPD. And she said, ‘You’re not showing any of the traits of it at all. Which in my opinion is, is quite ridiculous in fact, not just strange, because it’s quite obvious that I’m showing the traits of BPD, intense on and off relationships. I haven’t experimented with, with alcohol. I’ve got to admit I have smoked a lot of cannabis in the past. And just, just I am showing traits of BPD probably a bit of narcissistic personality disorder in there and maybe avoidant personality disorder. But I’m showing a lot of disordered traits and that. And the psychiatrist in question seems to think that reading about Gandhi and The Dali Lama would be a panacea for my problems.
I don’t know how she came at that conclusion at all. But I didn’t think I was in any position to question so I didn’t actually go along with what she’d said because I thought it was quite frankly ridiculous. So after that, that was about five years ago, I’ve kind of been bouncing around in the ether between one different psychiatrist and another. And I remember my first point of contact with the psychiatric services, the first question I was asked, ‘Don’t you want financial independence?’ Which doesn’t seem to be a very appropriate question for someone that’s, you know, not really able to think about what time they’re going to get up, let alone financial independence. So I’ve encountered quite a few interesting situations let’s say.
Hmm. So what do you think changed then to, for you to be able to get these diagnoses all of sudden that, that now you agree with?

I think having, I think having a sympathetic psychiatrist helped. And I also think having one, my psychiatrist is from an ethnic minority, and I think that helps quite a lot. Because prior to that I hadn’t actually had a psychiatrist from an ethnic minority and that’s made a big difference, because I think their own personal experiences, they’ll know because they’re of the same kind of age, they’re kind of my coevals as it were. They’ll, they’ll know about the experiences that I would’ve been through. They would’ve had a taste of it themselves. And they’ll know what it really feels like to, to basically have every door slammed in your face.

And I think I read some where about the National Phobic Society. And then, you know, wrote to them and got more information. And I read some of the things in there. And then I sort of knew that I was suffering form some kind of anxiety but I didn’t know what. And I saw just about, I saw, I saw sort of descriptions of how people were saying they were suffering from sort of social phobia but I didn’t know what that meant. So there was other people’s descriptions saying, you know, I’m suffering from this and they needed support or whatever and they were asking for sort of email contact or, you know, writing letters. So it was like a contacts list on their newsletter that I wrote off to somebody this girl in she lived in Rochdale I think at the time and that. And I said, you know, I may be suffering from this , you know, and if you’ve been doing it, and you know, I’d like to know more about it or what help you had. She told me about this group in [nearby city]. I mean I was always reading, you know, reading different things about anxiety and that. And I read the term social phobia but I didn’t, you know, I associated phobia with something like extreme, you know, like the fear of heights or fear of spiders or whatever that you totally have to avoid or. I didn’t see it as being associated with being around people because, you know, how can you be afraid of people? And so she told me about this group which I went to and that’s when I knew in myself that, you know, when I spoke to the group or, you know, that were suffering themselves I told them about myself and what feelings I had and, you know, they agreed that this is, you know, what, what it is. And I sort of, that’s when I self diagnosed myself basically.

Did you try to find out information about the diagnosis that you were given?
Yeah I talked to people whove been my social worker as a child and that and they said personality disorder is given to people who they can’t tick the boxes and put them into a box and that it was a social worker whod known me from a child and he said, ‘You haven’t got personality disorder, they only give you that because they can’t put you into a tick box, under a certain diagnosis so, it’s easier for them to give you a personality disorder.

And how did you feel about’?
Very angry because I was thinking oh I’m glad I’ve got a diagnosis, I know what’s wrong, I didn’t know, understand what it was but I had a diagnosis and then get told it’s only because they can’t find a diagnosis so they’ve put you in a tick box of personality disorder. And now because they’re saying they’re going to stick all people in prison whove got personality disorders before they commit an offence and I’m thinking is that going to happen to me at the end of the day?

Mm, is that a real concern for you?
Yeah.

Right, Well. I mean the Scottish Mental Health Act, which was the one that the government was asked to incorporate into the new Mental Health Act and it refused to do, made it very clear that the same criteria for diagnosis should apply whatever a person’s ethnic group happens to be. But that was refused by the English legislators and I think it’s more or less accepted that mental illnesses present in different ways in different types because they, their presentation at least is socially shaped and that at least in some people’s opinion there are many different kinds of schizophrenia, for example, and that Jewish schizophrenia might be different from Afro-Caribbean schizophrenia and British schizophrenia and therefore the criteria for diagnosis and the method of treatment might be different and that there is therefore a, an unspoken professional folklore, what I call ethnomethodology which, which tells people how to make up your mind about these people. These people and why they’re different and why they special criteria have to be applied to diagnosing them and treating them and assessing them and their risk. And I suppose that’ that as long as we have this very untransparent secretive code that we can, you know, we don’t, we just don’t know what is going on behind the scenes.
And, you know, there are medical anthropologists who try and, and produce value-free judgments about people but I don’t think the work has been done unfortunately to interview lots of people from one ethnic group or another ethnic group and find out how their particular ethnicity shapes their presentation. Actually I suspect that it isn’t down to ethnicity, it’s very, very individual. And that, that everybody has a micro-ethnicity which is unique to them. And the only way you’d find out about this micro-ethnicity is by talking to people and getting accurate information from them and about them but there’s no way that will happen whilst people are so dependent on received opinions about, you know, Jews having sex with their mothers.
Personally I think that, that we would do better going back to first principles, actually, I don’t know if I’ve said that phrase before not in this interview yet and, and, and starting off with a strict medical-legal definition and then as we get to know the person as, as an individual through observation, through acquaintance we add in the, the cultural dimension, that the social model should never be the first thing we lean on. That, that we should explore that and that we, we should I guess one of the purposes of the CPA process, I don’t know if we mentioned that here, is that it should look at the patient’s broad holistic identity which includes, you know, their physical health and it includes, you know, their relationships with the wider community and that includes that, that is their cultural identity partly, and that their religious identity which is part of a, social religious identity, we’re not, I don’t think we’re, we should be interested in their, their relationship with God really. But that’s not something you, you, you look at first of all. It’s very presumptuous of you to do that. If you try and do that you’re sure to jump to the wrong conclusions.