‘Don’t Try to Fix Me’: Why Relationships in Mental Health Care Matter
This event was held at the University of Sheffield in September 2018. Many thanks to Sam Nash for writing the piece here.
‘Don’t Try to Fix Me’: Why Relationships in Mental Health Care Matter was an insightful, moving and constructive chaired conversation between Kim Gosling, a community psychiatric nurse, and Chrissy Bonham, a freelance facilitator and researcher working in mental health, and also one of Kim’s patients. The event also featured a talk on relationships and mental health by Dr Helen Crimlisk, Deputy Medical Director for SHSC, a Consultant Psychiatrist, and Director of Undergraduate Psychiatry at the University of Sheffield. The conversation was chaired by Professor Brendan Stone, and explored the importance of long-term, compassionate relationships between mental health workers and their patients at a time when mounting pressures on health services are resulting in an increasingly clinical and impersonal approach to care. The somewhat unconventional format of the event showcased the value of such relationships perfectly. Unlike the traditional lecture panel format, at no point did the talk feel stilted, rehearsed or polemic; rather it gently undulated with an infectious warmth and humour that nestled in the mind, provoking reflection long after the event had finished. The compassionate and profoundly human nature of the relationship between Chrissy and Kim very much took centre stage.
“I used to love Stevie Nicks, but I’ve gone off her a bit lately. I prefer Peter Gabriel now,” announced Chrissy by way of introduction, largely skipping over details of her work as a researcher and facilitator. Kim grinned knowingly, as if this recent shift in musical loyalties was part of a conversation with which she was already well acquainted. Clearly for Chrissy, at this stage in the conversation it was important that her sense of humour and musical interests be privileged over details regarding her professional life. This little detail generously offered the audience an insight into who she was as a person, rather than as a professional. This attention and care for the very human details that form our identities in the face of the broader contexts amongst which they often lose their definition was typical of the way in which the event continued to unfold. It illustrated that by allowing the personal details and qualities unique to the patient to become central to the patient-carer relationship, it becomes possible to gain insights that reach beyond a given set of empirical data and one-size-fits-all narratives which cast the patient as a “broken” person in need of “fixing”. As Chrissy explained, instead of attempting to fix her, Kim helped her to “build a life in which [she] could be ill” and that be okay. It became evident through listening to Chrissy’s stories that any attempt to force her to conform to a normative concept of wellness as defined through a set of empirical charts and guidelines would have been deeply damaging. It seemed that the value of Kim’s care stemmed in a large part from a willingness to understand Chrissy’s personal sense of wellness and normality, and then work according to that.
Whilst throughout the conversation Chrissy and Kim clearly retained control of their individual voices and stories, bravely offering up illuminating details, at times the level of personal detail and distress became appropriately unsettling. There was a profound and valuable unease about hearing such stories within the pristine, minimalism of a modern lecture theatre, where earlier in the year I had sat and calmly taken notes on Robinson Crusoe. As Judith Herman explains in Trauma and Recovery, discussions of mental health and trauma have the effect of reminding us all of our own human capacity to both suffer and perpetuate suffering. It is therefore often taboo to speak openly about such things. Prevalent discourses that equate wellness to productivity in both the media and medical institutions serve to sanitize and contain much of what is genuinely unsettling about mental distress. Consequently, stories like Chrissy and Kim’s are seriously underrepresented. It is perhaps this that made the conversation so brave, so generous, and so important. It was one-step towards, as Chrissy put it, “Recovering the humanity in mental health relationships”.
Following the event, I reflected on my own experience as someone who has used various mental health services on and off for around 10 years. I realised that I had absolutely no idea where any of the practitioners I had seen stood on Stevie Nicks. Not wishing to deviate from my role as someone to be fixed I had consistently resorted to the kind of narratives and phrases a patient is supposed to present. Mass produced stories about difficult childhoods and feeling a bit low, told with a neatness and a lack of personal detail so pronounced that they now seem to me to boarder on the uncanny. Seeing that I was playing my part, the practitioner would reciprocate, and every couple of weeks when I was asked to fill out a self-assessment form I would gradually shift my answers to questions like “How often have you been bothered by feeling down, depressed or hopeless?” away from “Nearly every day” and towards “Not at all”, regardless of how I actually felt.
When I sat down with my counsellor this week, I asked her how she feels about Stevie Nicks. It turns out she isn’t a fan; she is more interested in folk music. It felt good to know where she stood on that issue. I told her about when I was 8 years old and I wanted to be James Brown.