The Impossible Psychologist by Rebecca Lawrence review – doctor turned patient
This daring memoir of a psychiatrist with severe mental illness shows how the lost and confused mind and its patients have changed. Future readers will be amazed, we must hope, at how poorly we understood and how ineffectively we treated a troubled mind.
Rebecca Lawrence has had frequent and terrifying bouts of depression throughout her life, interspersed with periods of emotional highs. Despite many challenges and hospitalizations, her determination and perseverance, along with the support of her wonderful husband, Richard, enable her to survive and thrive, becoming a psychiatrist and mother of three children.
However Lawrence’s vivid descriptions of his hospital stay, his electroconvulsive therapy and the effects of various medications indict the type of treatment he endures and administers.
As he conducts his final psychiatric evaluation, Lawrence listens to revision tapes that contain “a lot of information about psychiatric diagnosis from my ICD-10 (International Definition of Diseases) … It was incredibly refreshing and surreal,” he writes. It is not surprising. The ICD, like the infamous Diagnostic and Statistical Manual of Mental Disorders used by US psychiatrists, groups many symptoms under diagnosis and recommends medications to treat them.
It is possible and common to take home a psychiatrist’s salary by comparing patients to broad groups and trying different pills on them. No need to think. There is no need to try anything difficult, new or progressive. No need to read the latest research. Many people who contact me seeking advice on mental health report this psychological experience, which I experienced again during a breakdown five years ago. When Lawrence joined the Royal College of Psychiatrists he says: “I never had to write any more exams.”
Lawrence’s strength and Richard’s support continue to prove, especially since his psychiatrists are confused. Prof Lawrie replaces Professor Blackwood, whom he has seen for decades: “‘I think your diagnosis is stress, mental stress. Prof Blackwood thought he had a psychosis but I’m not sure … ‘ I wasn’t sure what to say. ‘Oh. OKAY. But don’t think I have a personality problem. That’s what you thought before. That’s what you think.’ ‘This is not what I think…’
after the news release
Here is the system in brief: jokes, the results for patients were not such a disaster. No one in this story differentiates between the symptoms of stress – which drugs, at best, suppress – and the causes, which drugs cannot solve.
Lawrence’s psychiatrists are so wedded to group therapy that they miss what seems obvious to the reader: he’s nearly dying from depression therapy. Richard and his friends see and say that his “strict and disciplined” upbringing, by parents who seemed to find his problems embarrassing, contributed to his problems.
He has non-invasive cognitive behavioral therapy (CBT), a standard approach to the NHS, which is cheap and easy to administer. But as one of my fellow patients said to me, ‘I don’t need plans for tomorrow, I need help with what my father did when I was a child.’ In fact, Lawrence makes a strong, unintended argument for the widespread transfer of over-the-counter medication and CBT to trauma therapy. But there is no mention of proven treatments like eye twitching and reshaping (I’m a fan because it changed my life), of Open Dialogue – which would hold the entire Lawrence network, including his family – or psilocybin and ketamine.
You can only despair of the system that Lawrence survives. A cruel psychiatrist who suppresses the symptoms he describes is incredibly ignorant and weak. Many, less powerful and less privileged than Lawrence, have died because of it. Fortunately, this is not the whole story. I hope Lawrence looks at adversity and recovery; with the honesty and courage he displays here, he could write a compelling book about it.
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