Without boring the hell out of you with a whole bunch of social dynamics theory, humans naturally form groups, or tribes. We gravitate to other people who are similar to ourselves, where we feel we belong, and create our own little worlds, our own idea of what ‘normal’ is. From inside our groups, we look out at everyone else in our culture, and our group is ‘us’ and they are all ‘them’. We might get along just fine with some different groups, but most of us have our ‘other’, a cultural group we do not like, understand, or find anything admirable about. And often we feel totally justified in dehumanising, alienating, and shaming those others, who we consider to be beneath us. The enlightened educated who wouldn’t make jokes about gay people, or derogatory comments about Asians consider that Northern Suburbs ‘white trash’ girls who go shopping in their ugg boots and have lower back tattoos are fair game.
In blue collar circles it’s the ‘paper pushers’ and academics. In wealthy areas it’s the poor, the ‘drop-outs’ and ‘dole bludgers’. For many of the middle class it’s addicts. We’ve all got them. We all seem to need to find a reason that we are not like all those other pathetic, unhappy people, why our lives will be okay, our marriages will last, our dreams come true. We build theories that comfort us, often at the expense of our ‘other’, the people we allow ourselves the luxury of talking about with contempt.
I’m not talking about ideological differences, I have huge problems with neo-nazis and gangs because I loathe their values and behaviour. This is cultural, and not much more sophisticated than laughing at the next village because they put mud in their hair and think it looks good, while we all know that wearing blue anklets is the essence of beauty. We deride our ‘other’ and really struggle to see that under the different cultural norms, dress, and values, they are all just humans like us, and many have good values and are decent people. In a similar way, we also often struggle to see the flaws and nastiness within our own group. We tend to be permissive and accommodating, and defend our own from any perceived attack.
For many parts of society, people with mental illnesses are a convenient out group, who can be demonised, humiliated, and treated with contempt. It is becoming less socially acceptable to do this in some circles, which is a step towards reducing stigma and prejudice. But unfortunately for those of us with mental illnesses, we are in constant contact with one of our greatest ‘other’, the staff in the mental health system. Cramped into constant interaction, these two cultures are often at war, and as a peer worker, I’m painfully aware of how little each group understands or respects the other.
I’ve sat in pubs and felt the disgust as a loud conversation at the table over turns to how those crazy people should all be jailed for everyone’s safety. But the level of contempt and loathing within the mental health system has been just as high, if differently expressed. The language changes as the culture evolves, but the contempt remains the same. I hear things like “consumers just want everything handed to them on a platter, they don’t want to have to work for anything”, “they don’t take any responsibility for their own lives”, “refuse to commit to the program”, “clearly don’t want to get better”, “enjoy the attention”, “faking it”, “pathetic”, “just bringing everyone down with them”, “if they were really serious, they’d have killed themselves”, “a drain on the system”, “they think their story is more important than anyone else’s”. In some cases the hostility is more subtle, in others more overt. It’s not everyone in the system of course! But in my experience, there’s a lot of it. Most of these people are not awful people, they are deeply frustrated, they have been told they are responsible for making mentally ill people ‘better’, and they have been trained and now work in a structure that has a powerful them-and-us dynamic going on, where we the educated are here to fix those the sick. I hate everything about this. It utterly repulses me and I find it everywhere. People with mental illnesses themselves, once in staff positions, seem just as likely to pass these kinds of judgements on the ‘borderlines’, complex cases, addicts and traumatised, just as likely to react to the cultural conflict by taking more and more control away from those they are supposed to be helping, while talking about empowerment and having a voice.
People with mental illnesses cast into the consumer role in this relationship can be equally as hostile and divisive. I’ve sat in conversations where people talk about how “doctors just want to keep us sick so they get more money off us”, how staff are “evil”, “twisted”, “parasites”, “control freaks”, “nazis”, “who want us to suffer”.
While I’m drawing a parallel between these similar, dehumanising behaviours, I’m not putting them on the same level. Why? Because the staff group has most of the power, control, and voice in this relationship. If this is a war, they have the biggest sticks. When you have a disagreement with your doctor, your doctor’s opinion is the one that carries weight, in a letter for housing support, for child custody arrangements, for welfare. If you think your doctor is a bigot, and he thinks you’re a drain on the system, your opinion carries no weight in his world. His opinion could see you thrown out of hospital and cut off from services despite being in crisis. And this happens.
So, what’s my point? My point is that we have a massive culture clash that is hurting people. A forced relationship that lacks equality, reciprocity, humility, mutuality. Dehumanising each other is not helping. When you have two groups who dislike each other, one of the most powerful ways to reduce mutual contempt is to create what is called a ‘superordinate group’. This is a larger identity that unites both groups, usually with a common goal where they work together, humanise and develop respect for one another, and overcome the original conflict. I would dearly love to see this in mental health. To have this idea of genuine partnerships between staff and consumers, a superordinate group of people who are passionate about mental health and who work together to create it. For this to happen, respect and equality need to replace control and contempt.
When I tell people I work in mental health, the reaction is often respect for my courage at working with those ‘crazy people’. I tell them, I am those people. I’m ‘crazy’. When I sit among service users and hear their disgust and ridicule of staff who try and fail so dismally at times to create useful services, I tell them I am those people too. I know how incredibly difficult it is to get it right, to create flexible structures that can adapt and respond to the vastly different needs of different people, the challenge to engage and support the most wounded and disillusioned, to cope with the hostility of service users who don’t just get frustrated when you get it wrong but also believe you deliberately got it wrong.
As a peer worker, I am almost always the ‘them’, part of the other, a diplomat on foreign soil trying to translate and inspire and encourage without being seen as a spy in enemy territory. I don’t see my dual citizenship as a challenge, I see it as a necessity, part of my identity as belonging to this whole community of people who are passionate about life, and peace, and easing loneliness, pain, grief, suffering. I’m not just a service user or a service provider, I’m someone who is passionate about mental health.
This is Vincent. He’s going to live in my office at Aceda, ready to give big cuddles to me, clients, other staff, or anyone who wanders in looking like they need it. He’s very big and slightly soft, slightly scratchy, with ears you can rub and a long pointy nose that gives him a bit of an anxious expression. He loves cuddles and needs at least one a day. 
Sarah K Reece 