Prof. Jim Lucey, Medical Director at St. Patrick’s Mental Health Services and Clinical Professor of Psychiatry at Trinity College Dublin, has more than twenty five years’ experience in his field of specialisation.
Lucey has used this experience to pen a thoughtful and compassionate look at the varied experience of some of the patients he has encountered. Coalescing around the themes of experience, worth, freedom, memory, truth, balance, hope and possibilities, he explores individual stories, and pieces together complex narratives with a view to understanding and facilitating recovery.
At the outset, Prof. Lucey sets out the conceptual framework around which he practices medicine. He writes: ‘psychological medicine has no role in directing anyone along any specific philosophical route or towards any specific response to the personal challenge of existence’. Whilst I very much agree that it is never the place of the physician to dispense spiritual advice, it has to be acknowledged that each form of psychological intervention, from CBT to logotherapy, and from psychoanalytic psychotherapy to individual psychology, is underpinned by a specific psychological worldview. Consider Viktor Frankl’s logotherapy where the ‘will to meaning’ is at the fore; contrast this with Freud’s psychoanalysis where the ‘will to pleasure’ underpins the therapeutic theory.
Notwithstanding minor differences in semantics, Prof. Lucey understands exactly what it means to be a patient. He very perceptively writes: ‘to be a patient describes an experience that deserves respect. We will all be patients at some stage and this is part of what it is to be alive’.
Depression, anxiety, self-harm, OCD, suicide and other issues are explored through the lens of his patients. The pain is obvious in each individual, but crucially so too is the will to wellness and the capacity to recover. And if you’re not sure about some of the medical terms, the author has included an excellent jargon-free summary in the notes section at the end of the book.
Prof. Lucey does a superb job of dispelling the myths that all-too-frequently surround mental illness. Shockingly, Lucey writes this of his own institution’s findings:
‘In 2013 St. Patrick’s Mental Health Services published some disturbing findings from its own nationwide survey of attitudes to mental health disorder in Ireland. Over one-fifth of people surveyed believed that those suffering from mental health problems are below average intelligence and 31 per cent of respondents revealed that they would not accept someone with a mental health disorder as a close friend. It was discovered that 62 per cent would discriminate against hiring someone with a history of mental illness on the grounds that they would be unreliable, and 42 per cent believed that undergoing treatment for a mental health disorder is a sign of personal failure’.
That this degree of ignorance and prejudice still exists in a modern society is deeply worrying. And that is why Prof. Lucey’s book makes such a valuable contribution; it is very well written and one senses that author’s deep concern and sensitivity for those in his care. In describing ‘ordinary’ people dealing with mental ill health, Prof. Lucey does an enormous amount to normalise our perception of mental illness and to see his patients just as they are – just like any other person, but with the added burden of living with a complicated condition.
Recovery is very much possible, as attested to by Prof. Lucey’s clinical experience. With the right blend of medication, therapy and psycho-social intervention, recovery is achievable, although it does of course look different for each patient. Lucey demonstrates that Psychiatry is very much an art as well as a science and understanding individuals, their circumstances, drivers and aspirations are as important as prescribing medication.
And before I forget, there is another aspect of the book that I really like – Prof. Lucey uses poetry at the end of the chapter. By referring to Emily Dickinson, Robert Herrick, Philip Larkin, Seamus Heaney and other such literary luminaries, Lucey adds to the poignancy of his case studies and encourages reflection. It really does round off the book beautifully.
I thoroughly recommend this book to anyone who lives with mental illness, those who treat them and to the wider population looking to understand a phenomenon that is still shrouded in too much mystery, misunderstanding and prejudice.