Poem – Understanding the power of professional detachment

In Day One of the Hearing Distressing Voices Workshop training, I had the awful but insightful experience of roll playing a professional mental health worker. It disturbed me deeply but also fascinated me, and I wrote this poem in my lunch break to try and capture as much as the experience as I could, so that I could reflect on it later.

The context of that role play is that the other workshop participants, those service providers and mental health staff who don’t have a personal experience of voice hearing, are trying to do tasks and engage with these pretend services, while wearing ear buds that are pouring ‘voices’ into their ears from an Mp3 player.

Myself and the voice hearers have been asked to pretend to be doctors and treat them as mentally ill patients – to be polite and respectful but filter everything they did through that framework and to maintain professional detachment in our manner. In some tasks we were actually delivering real psychological assessments (to determine their capacity and state of mind) that are used in residential and inpatient services today.

Role playing the doctor
I was nice
I made eye contact, smiled, shook their hand
Used their first name, didn’t touch without permission, didn’t sit behind a desk, didn’t ask questions about sex or trauma

But I also pushed then through,
Subtly dehumanised them
Didn’t give normal feedback signals
Respond to things they said
Treat them as intelligent adults.

And at the end I wanted to cry
I wanted to throw up
I wanted to run around the room and beg everyone for forgiveness and to know that wasn’t me
I wanted to be touched, to be hugged, to hear the voice of my loved ones
I wanted to be made human again.

My voice was screaming “I hate myself”
My hand was ticking violently in front of everyone
I was rocking
Swaying with nausea and exhaustion and intensity

The most terrifying aspect of it
The darkest part
The most triggering thing
Is that it was…

Easy.

So fucking easy to do.
I had a quota to get through
I had to reduce wait times
I had to get people through assessments as quickly as possible
I was totally secure in my knowledge that I was one of the good practitioners
I was one of the nice ones, I smiled and was polite and respectful
I was exasperated by how many of them there were
How unwilling they were to cooperate
How unwell they were
How slow at tasks
Easily confused
Constantly needing me to slow down, repeat myself
Everyone was filtered through a single paradigm –
Did they make my job easier or harder?

They disobeyed even simple instructions
They treated me as the enemy and the bad guy
They allied against me
They were unhelpful in directing their own recovery
Lacking insight
Bewildered
In need of guidance
Nothing like me or the other doctors.

They tested extremely poorly
The ones who tested better were often more aggressive and hostile
Clearly less unwell
Probably too high functioning for the program.

And I was totally outside of the drama
Above it
Detached
They got angry, frustrated, hurt, petty
But I was completely secure
Armoured in professionalism
Nothing they did could actually hurt me
They simply didn’t have that power
They could irritate me or trigger a little warmth
Share a moment of connection if they talked to me with the right mix of respectful gratitude and equality
But they were like children
I saw the whole picture and they knew nothing
Nothing about the service, nothing about themselves, nothing about mental health or treatment
I was the expert and I was here to try to make them do the things I knew would help them get better
They were mostly an impediment to this process
And they couldn’t make me feel anything, anymore than a 3 year old screaming “mummy I hate you!” had the power to devastate
They just couldn’t.

So they were in the muck
In crisis
Hopeless at caring for themselves
Full of needlessly intense feelings
No capacity to see the whole picture
To appreciate my role or how hard I work for them
It was a thankless job
And they were often degrading to me
But fortunately I’m very secure in the knowledge that I’m doing a good thing in the world
I don’t really need their validation
It’s gratifying when it happens but it’s not necessary
And I’m so glad I’m not like them
So glad I can look after myself, shower, dress well, cook, clean, hold down my job, my relationships
I’m very blessed and I know it
There but for the grace of god…
I’m glad that I make a difference in their lives
It’s good to be able to give back to those less fortunate.

*More discussion in the comments

5 thoughts on “Poem – Understanding the power of professional detachment

  1. fascinating the c-inciding ot themes. I went to see the film Hannah Arendt last night in the cinema and the charity organising the show , had a Q and A after. We discussed the ease with which refusal to think leads to abolishment of conscience in decision-making (as Arendt observed in Eichmann!);
    I contributed to the discussion that one sentence of Arendt’s provided a clue how she might have developed her work – namely when she said at the end of her public lecture defending her position “refusal to think,,, leads to inability making conscientious decisions” (or words to that effect – and again, this is only one segment of a very complex systemic issue. But I think Arend was right in not allwoing the demonisation of the unthinking ‘banale’ Eichmann as this – forces/enables everyone to think about their role in the system…
    XX

    Liked by 1 person

    • This isn’t the heart of it, on reflection. It’s so hard to look at! The dark heart of it wasn’t just the conviction of goodness, the total discounting of their perceptions, the way their normal responses to dehumanisation INCREASED my use of it and CONFIRMED my beliefs about them… It was the subtle use of torture. It took very, very little for me to hurt them. I could take tiny pieces of their dignity away without doing anything ‘wrong’, nothing even slightly clearly abusive. So the ones who pushed back against my authority were needled, very slightly. In the actual role play I deliberately and fairly subtly pushed several to the edge of outright rebellion, then stopped. In a real scenario I could have pushed them over if I wanted to and triggered a major episode of violence or emotional breakdown – the cruel system response to such behaviour would be heavy punishment indeed for defying me. I rewarded those I liked, the compliant and grateful ones with tiny bits of treating them as human – and used this to cut them off from their peers. They were ‘not like the other patients’, they were different – ‘real people’, like me. Divided from their peers this way, not only did they have no power base to defy me, they also reinforced my power to their peers. I granted them human status and I had the power to take it away at any time.

      I didn’t think any of this through our plan it or even deliberately choose to do it. I simply occupied the role and informed my behaviour with my personal experiences of otherwise good people dehumanising me in the system.

      Authority. I’ve never experienced how heady it is. I use a word like torture – truth is, that doctor would laugh at you if you used that word to her. I use it because it’s true. It’s generated by sadism and the effect on the victim is helpless pain, but that doctor – me in that role – it was just me having a few tiny little feelings. A little flicker of irritation, a little sense of warmth. Nothing big. My feelings were extremely contained, under no circumstances would I have yelled or lost control. I didn’t need to.

      I’ve been terrified of this stuff for good reason, I think. I need to continue to explore my relationship to power because it’s an essential part of being alive, but I think I was probably right to be afraid. I’ve as much capacity for self delusion and cruelty as the next person – exposed to this too early I could have lost myself.

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