Friday 9 October 2009


The political parties have had their get togethers and rattled sabres muchly. They've talked of "vision" and "character" and "challenge" with little detail of content. Except the Conservatives, to their enormous credit, who've shared specific policy details. Having endured Thatcher's Britain I'd never have imagined I'd see anything the Conservatives did as laudable; plus ca change.

I still think that the likes of the UK Libertarian Party have the right notion.

Government govern through making laws. We have lots of laws. About time someone, instead of just generating loads of edicts, starting doing away with 'em and pulling back to what's necessary.

In this notion of laws, and the desire to be explicit about laws (rather than just posture and waffle) and to have the minimum amount of law that's necessary, how does that translate to mental health? Well, I'm glad you asked. In 1978 we gratefully received the work of Shem, The House of God, a book dressed with humour as a vehicle for the grim themes explored, which sadly resonates with an awful lot of truth in it. The tale is of a keen junior doctor, who's first year as a doctor is damaging to both him and his colleagues and his patients. Having finished medical school and entered hospital practice, his up beat mentor schools his to survive in the really real world through breaking rules and instead using his own rules.

The House of God gave us 13 laws.

In his sequel, Shem offers us insight into progress as a trainee in psychiatry. With the book come new laws. The 13 laws of psychiatry in Mount Misery are as follows :
I. There are no laws in psychiatry.
II. Psychiatrists specialise in their own defects.
III. At a psychiatric emergency, the first procedure is to check your own mental status.
IV. The patient is not the only one with the disease, or without it.
V. In psychiatry, first comes treatment, then comes diagnosis.
VI. The worst psychiatrists charge the most, and world experts are the worst.
VII. Medical school is a liability in becoming a psycho therapist.
VIII. Your colleagues will hurt you more than your patients.
IX. You can learn everything about a person by the way he or she plays a sport.
X. Medical patients don't take their medication fifty percent of the time, and psychiatric patients don't take their medication much at all.
XI. Therapy is part of life, and vice versa.
XII. Healing in psychotherapy has nothing to do with psychology; connection, not self, heals.
XIII. The delivery of psychiatric care is to know as little as possible, and to understand as much as possible, about living through sorrows with others.

What do you think of these laws? Better than HMG suggest, worse than the opposition are proposing, relevant to mental health work? Discuss.

1 comment:

The Girl said...

Every time I hear something from a political party these days I think of George Orwell's 1984 or Animal Farm. They use words in ways that have very little to do with their actual meanings.

I read Mount Misery recently. As sad and caricature-laden as I found the book, I think it is probably more accurate than anything that comes out of the mouth of somebody who is making public policy.