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Gareth Edwards – Madness at Work

Gareth Edwards is the founding Director of Positive Thinking, a company that provides knowledge-based solutions for the Mental Health and Addictions sectors. As the name suggests, Positive Thinking focuses on identifying and building on strengths to improve services. Find out more at www.positivethinking.co.nz

His company’s motto is ‘creating clarity from confusion’, and that’s very much the theme of Gareth’s piece here too…

Gareth Edwards – Madness At Work

A Bit about Me

Kia Ora, or as they say round my way, ey up!

I’ve been given this great opportunity to write about madness for the ‘out of their minds’ initiative. I’d like to use this space to talk about how I view my own madness and the role it plays in my life.

But first, the essential stats

  • Name: Gareth Edwards
  • Origin: Manchester, North ofEngland
  • Location: Auckland,New Zealand
  • Favourite Colour: Green
  • Qualifications: BSc Psychology –Sheffield Hallam University,UK (1996) | MSc Applied Artificial Intelligence –University of Aberdeen,UK(1997) | Bipolar Affective Disorder –National Health Service,UK(1999)

Being Mad

How do you describe what it’s like to be mad?

I guess that’s where the complexities really begin, because language, with all its wondrous abilities to articulate and express life’s rich tapestry, fails miserably when it comes to describing madness. We’re limited to weak similes, such as:

“it’s a bit like that feeling you get when you’re really sad or happy or nervy etc, only more so”

and impossible requests on the imagination, like

“imagine that when you listen to the radio you really, really believe it’s talking just to you”

Over the years I’ve tried many times to describe to other people in my life and in my work what it’s like to be mad, in the belief that if I could only make that description compelling enough they too would understand what it’s like to be mad. I can’t remember a single success.

To be able to relate an experience, there needs to be an existing degree of shared understanding – I can describe what it’s like to be a British football fan and you may be able to make connections to that description as aNew Zealandrugby fan. I can’t do the same with madness – depression is not like sadness “only worse”, mania is not like happiness “only better”, and psychosis is difficult to even articulate let alone translate.

But even if a common connection existed, the language at our disposal would fail us. Language is a tool we use to give shape to and convey ideas and for the vast majority of time these ideas are not our own – we carry around the ideas we’ve learnt from others and the ideas we see around us. Sometimes we mix them up in novel ways, and very rarely someone, somewhere will have a genuine ‘new idea’. But for the most part we regurgitate existing ideas through language.

And therein lays the difficulty – if we need language to shape and convey ideas, how do you go about describing an experience when the language you want doesn’t exist! I could very easily set out a potted ‘medical’ description of my mad experiences – the usual depressed, manic and psychotic symptoms you can find everywhere from pamphlets at the doctors to Wikipedia. Google them, select a handful of each and that would probably provide some terms you’d recognise that are one way of describing the ’symptoms’ of ‘bipolar affective disorder’, but that language doesn’t reflect how I view these experiences. The alternative, ‘non-medical’ language is the even more familiar slang – loony, loopy, nuts, crazy etc – and apart from times of being flippant, they don’t really do the job either. What’s more, these terms are really just euphemisms that demonstrate the paucity of adequate language to describe the mad experience. They also hint at something more sinister – wherever there’s euphemism there’s a culture trying to hide the topics it doesn’t like to discuss – just think of all the slang we have for the entirely natural human activities of defecation and coitus.

There’s another aspect to the mad experience that can be just as complex to describe, though potential connections to shared experience are available. The medical language of diagnosis and symptoms provides a framework for describing the mad experience, even if it isn’t a framework I’d choose to use, but it only relates to some aspects of the internal experience – what it’s like to be mad on the inside. There’s also the external experience of madness – what it’s like to be mad in a world that doesn’t tolerate or accommodate madness very well.

There was a period of time in European history (around the Age of Enlightenment in the 18th Century) when mad people were physically and philosophically removed from society – the new world order was to be founded on ‘reason’ (rather than mysticism and superstition) and the ‘unreasonable’ were not seen as in line with this vision. It is here that the foundations of institutionalisation were laid, and also where doctors began applying ‘modern medicine’ techniques with mad people, setting the scene for the emerging profession and paradigm of psychiatry.

It is in the ramifications and ripples of that initial removal from society that we find the language of social exclusion and inclusion, of human rights and discrimination, and it’s a language we share with other people and peoples who have also been pushed out of the so-called ‘mainstream’ of society and been denied the kind of quality of life ‘we all’ believe people should have. It can still be difficult to describe what it’s like to be an outsider because of your experience of madness, but the experience of being an outsider can be more accessible as it’s one many people have – so much so that the sum-total of people who live on the outside of society far outnumbers those who live on the inside!

My own experience of exclusion has been mitigated by mainstream-aligned demographics – I am white, middle-classed, educated, heterosexual and male and so the odds of successful inclusion into society are stacked in my favour. Tweak any one of these criterion and the odds quickly diminish and can become themselves drivers for compounded exclusion.

So I go back to the original question – how do you describe what it’s like to be mad?

My answer is that I don’t. The only way I could describe it is if you’ve experienced it yourself, and then you’d have your own story to tell…

Mad Work

I never really chose to work in the world of madness. Like most people I know who work here, I drifted in, and much against the run of play.

I spent my first 25 years of life committed to anything but a career in this field – my parents work in this sector and our social occasions were flooded with family friends who were social workers, psychiatric nurses, probation officers, counsellors, addiction clinicians and a myriad of other health and social welfare professionals. Listening to their conversations at birthdays and BBQs I knew I never wanted to be in the position they were in – to have genuine compassion for their fellow human beings and to have to work within systems that appeared to subvert and counteract that compassion. In other words, trying to make a difference in a system that was, at best, indifferent about making a difference. What you might call, pushing shit uphill.

So my drift in was, like many other mad people I know, a drift rooted in recovery. I’d come out of my hospital admission demoralised and dejected and, needing to start back on the work path, took a job as a temporary, casual kitchen hand. The kitchen in question happened to be in an alcohol detoxification unit and after a couple of months I started working as a temporary, casual nursing assistant in the unit itself, and so began my occupational rehabilitation and the start of a career in mental health and addictions.

Importantly, the week before I took the kitchen hand job, I’d nearly been successful in securing a job in an inner-city sandwich shop, but had been turned down because I couldn’t butter the bread fast enough on my work-trial day. I like to think that in an alternative universe there is someone just like me with slightly quicker wrist action who spends his work day designing the latest lunch-time nibbles with nothing more complex to consider than 5-grain over wholemeal or whether a taco-based savoury snack can ever truly be conceptualised as a ’sandwich’!

After drifting in, I pretty much continued to drift and in just over 5 years I had just over 10 different jobs. I worked in units, day centres, and hostels in assistant nursing, psycho-education and keyworker roles. Mid-way through this period I started to draw on my academic background, and I worked in hospitals, universities, foundations and government agencies in research, training, promotion and funding roles. In retrospect I can see that those biannual shifts occurred when my own conviction (and possibly arrogance) that I could make things better came up against a system that was more concerned with bed-nights and budgets, publications and presentations, form over function, perception over introspection. At these points it was like I could hear echoes of my childhood perspective on people in this profession, telling me I’d only got half way up the hill and it still all smelt like shit.

After much cajoling I took my first tentative steps towards self-employment and began contracting and consulting, and it is this I continue to do with my company Positive Thinking.

One of the main motivations for working independently was, and is, the greater opportunities for freedom of speech. Like all industries, there are constraints and occupational norms within the world of madness – the professional hierarchies and paradigms that must be adhered to, the ‘party line’ which it is expected you will align your toe to. One of the challenges I think mad people working in this area face, and it’s compounded when your role is within the more traditional organisations, is that much of what we see and encounter in the world of madness requires critiquing, often quite strongly and from divergent perspectives. What’s more, we as mad people have to bring to bear opinions that are informed by professional qualifications and experience and personal experience.

To put it simplistically, we often know something needs to be done better not just because:

  • Our text books and study tells us something needs to be done better or that
  • We can identify the need to do something better from our work experience

But also because we know what it’s like for us and people like us to be experiencing this thing that needs to be done better!

It’s not as black and white as I’ve made out – by using the word ‘better’ I have purposefully set this up to be at least partially based on values. To give a personal example, I am no fan of involuntary seclusion – the practice of confining a mad person in isolation against their will, often used when someone is seen as posing a risk to themselves or others. The literature on seclusion can be read both ways, though contemporary thinking consistently challenges its legitimacy on therapeutic and human rights grounds. People who work in places that use seclusion tell me it is often done out of logistical necessity (low staff numbers and restricted space) rather than any treatment preference. And my own experiences of seclusion back this up – it is degrading and punitive and difficult to link in any tangible way to improved mental health or treatment outcomes.

To articulate and advocate on this kind of multi-faceted perspective is difficult – to do so in an occupational environment enshrined in a protective paradigm is difficult and onerous. For most mad people working in this field though this is the challenge they face – compelled to work with complex perspectives in an often stifling work-place where their critique is often minimised as complaints. With hindsight, it was no accident that none of my 10+ job titles had an explicit ‘consumer’ or ’service user’ label – I think my self-preservation instincts steered me away from having to provide a mad voice as part of a system that doesn’t want to listen.

Stepping outside of that system, working from a place of independence has enabled me to find that voice, to feel comfortable in blending the professional and the personal. I like the concept of the le bricoleur – a person who ‘makes creative and resourceful use of whatever materials are to hand, regardless of their original purpose’. As a bricoleur I am now able to make sense of my mad work, and my life experiences – the study, the madness, the jobs and even the birthdays and BBQs – can be used in the work I do.

I’m still pushing, but it smells sweeter.

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