Beyond Fear
Dorothy Rowe shows us how to have the courage to acknowledge and face our fears – only through courage can we find a sustaining happiness.‘Beyond Fear’, first published in 1987, has changed the lives of thousands of people. In this edition, the renowned psychologist Dorothy Rowe examines the changes in the psychiatric system since 1987 in the context of showing how most of our suffering comes from our greatest fear, that of being annihilated as a person, when we shall disappear like a puff of smoke in the wind, never to have existed.We feel this fear whenever others humiliate or belittle us, or whenever we discover a serious discrepancy between what we thought our life was and what it actually is. The greater our fear, the more desperate our defence against it, the most desperate of defences being what psychiatrists call mental disorders. Yet, by knowing ourselves we can go beyond our fear and face life with courage.
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DOROTHY ROWE
Beyond Fear
20th Anniversary Edition
To my dear friendsHelen, Galen, Marc and Naomi
Contents
• Fear of Not Being Good Enough
2 Understanding the Nature of Fear
5 How Society Responds to Mental Distress
• What Has Changed, and for the Better?
• Popular but Confusing Diagnoses
• Choosing a Desperate Defence
• Punishing the Body to Ease the Mind
8 Turning Fear into Depression
• Public Discourse - Muddle and Confusion
9 Turning Fear into Anxiety, Panic and Phobias
• Relinquishing Panic, Phobias and Fear
11 Turning Fear into Obsessions and Compulsions
• Doubt, Hate and the Denial of Feeling
12 Turning Fear into Schizophrenia
Ideas about mental health and mental illness have changed over the last twenty years. Some old ideas like ‘chemical imbalance’ and ‘a gene for this and a gene for that’ linger on despite the fact that research has shown that these ideas are not hypotheses but myths. There is now a general acceptance of the idea that mental distress can be relieved by talking to a listener who has no vested interest in the situation which gave rise to the distress. The media take this idea for granted, but many members of the media fail to grasp what the talking therapies are, and speak of counselling as being a kind of unguent which is poured over some unfortunate person, as in ‘the victims were counselled’. No one would willingly talk to the media about being psychotic because the media, and many members of the public, still regard anyone diagnosed as schizophrenic as being a potential axe murderer. Yet prominent figures now speak openly of their depression, and pop stars seem to regard as obligatory a drug habit followed by a period in a fashionable psychiatric clinic. Politicians speak most sympathetically about the necessity for good mental health care, though the money for such a service rarely follows through. But, in all, when it comes to mental illness, everyone’s heart is in the right place.
Or is it? Despite all the changes for the better, the notion that madness is some strange thing that can fall upon an unwitting individual at any time is as strongly held as ever. The language in which we talk about madness might have changed, but the belief in that strange, wilful, sinister, mysterious force is still in the minds of most people, including the minds of those who ought to know better. To be seen to be mad is still regarded as being alien, no longer a full member of the human race. The Royal College of Psychiatrists and MIND, the National Association for Mental Health, have run a campaign aimed at removing the stigma of madness, or, in current terminology, ‘having a mental health problem’, while some sections of the media have a stylebook setting out what language may or may not be used (the Guardian stylebook bans ‘offensive and unacceptable terms such as “loony, nutter, psycho and schizo”’). However, little seems to have changed in private attitudes. Despite the courageous work by members of the user/survivor movement, the term ‘mental health problem’ is taking on all the negative connotations of ‘mentally ill’. Writing about the report issued by the National Institute for Clinical Excellence (NICE) following their study ‘Mental Health and the National Press’,>1 the journalist Lynne Eaton summed up NICE’s results with, ‘Some of the reports about people suffering mental illness, particularly news stories, contain a level of discrimination that would be deemed unacceptable for most other social groups (except, perhaps, Gypsies and asylum seekers).’>2
In their report, NICE recommended that mental health professionals be prepared to inform the press about mental health issues. However, the language used by the majority of mental health professionals is itself suspect. In 1987, when the first edition of Beyond Fear was published, psychiatrists spoke of mental illness. In the intervening years the word ‘illness’ has disappeared from the diagnoses used by psychiatrists, though not from their general discourse, to be replaced by the word ‘disorder’. When I first came to England in 1968 and worked in psychiatric hospitals there were only five basic mental illnesses, namely, schizophrenia, manic-depression, anxiety and phobias, obsessions and compulsions, and depression. The behaviours associated with these diagnoses are very distinctive and found in all societies and throughout recorded history. Many of the psychiatrists I worked with had their own idiosyncratic diagnoses for people who could not be fitted into any of these categories. At Middlewood Hospital (a Sheffield psychiatric hospital now mercifully closed) a favourite diagnosis was ‘Irish’. Over the years the idiosyncratic diagnoses of American psychiatrists were pooled and the more popular ones were presented in what is now a vast tome, the
