How to avoid a diagnosis
● DON’T be young male and black (or talk about racism), or poor or formally educated.
● DON’T wear baggy clothing to psych appointments
● If you’re asked ‘are you hearing voices’ reply ‘yes yours…’ and never ask, “Did you hear that?”
● DO deny that your mother loved you too much…or potty trained you too hard
● DON’T have/mention any religious or spiritual aspects of your life, or if you have to be religious be as blandly middle of the road CofE as possible and never carry a bible. DON’T share about hearing the voice of your god unless it is a state approved deity. DON’T say to your psychiatrist ‘I don’t need to see you anymore I’ve been exorcised’.
● DON’T stare at your psychiatrist/psychologist, but DO make eye contact
● If you’re innumerate, DO tattoo numbers on your hands from 100 in multiples of 7 in preparation for when asked.
● DO become a good actor
● Women – DON’T wear red or black, always brush your hair, don’t shave your head or have very short hair, wear makeup but not too much, never smeared,
● If you’re male DON’T have a beard and look like Jesus (even if you are Jesus)
● DON’T direct the traffic and do not be tempted to impersonate a Clanger, or any other 1970s children’s television character no matter how farcical your mental health team is
● DON’T burn your house down (this is also quite good general advice)
How to get a different diagnosis
Remember that you are probably going to be stuck with some sort of diagnosis and the one you get is going to depend on what you tell your shrink.
● If you fancy bipolar, DO mention that you have had long periods of feeling low in the past
● If you think they are going to diagnose you as BPD, DO try to get a bipolar one instead.
● Women – DON’T get angry or you will get diagnosed with BPD (remember if you do, real hallucinations are Mon-Friday and pseudo ones are Sat-Sun)
● DON’T have a Scottish or Irish accent or you’ll be an alcoholic
● If you’re told that you’re “too intelligent to have a psychosis”, DO prepare to get a PD diagnosis
Do’s and dont’s of being a psychotic – good psychotic?
● DON’T talk to others about your experiences. This can instantly lead to the kind of insights and solidarity that psychiatry is designed to prevent.
● If you’re black, young and diagnosed psychotic DO try all you can to avoid being detained as your very life may depend on it.
● All physical health problems are of course in your imagination especially if you think they are related to medication, and never say your symptoms might be cancer and if you have cancer expect to need the oncologist to verify in person.
● DON’T have any neurologically based twitching in any part of your body, but especially not your face.
● If asked about side-effects and you can’t pretend you don’t have any, DO say that they are worth it for the benefit of the medication.
● In order to demonstrate insight, DO agree with everything said and DO agree to medication – *small print: failure to respond to meds may result in a PD diagnosis, please see our other leaflet*
● DO mention that you regret taking a lot of acid/hash even if you never have.
● If female, DO pretend you have grown up children, or say you want to get married and have kids when you’ve recovered, but if you have kids under 18, DO hide them.
● DO compliment the nurse giving you the depot injection on how well they did it and see Dolly Sen’s helpful leaflet on how to look after your bum bum for depot: http://disabilityarts.online/leaflet-look-bum-bum-depot/
● If your injection knocks you out for half the day, DO set the alarm clock to wake you back up so you can say goodnight to your family and they believe you’ve been awake
● DON’T ever say you believe in the “New World Order” or “9/11 was an inside job”, or refer to NSA, GCHQ, 1984, government conspiracies, Tony Blair and Theresa May as “shape shifting reptiles” (but make sure you know who the PM is) time travel, multiple dimensions.
● DON’T refer to any hidden vested interests of the government, corporations or the monarchy.
● DON’T talk about those crazy, scary people making decisions in parliament about your life and transmitting via your TV / Radio / Social media so you can’t escape.
● DON’T refer to injustice or be homelessness, especially sleeping in your car.
● If you are homeless, DO gratefully accept meds and counselling and don’t demand a home.
● DON’T insist that “The Tories want me dead!”
● NO ONE IS OUT TO GET YOU OK?
● If you are male DON’T get angry, or talk about leaky tits
● If you smoke DO wear nicotine patches on your arms to appointments and DON’T ever refer to extrapyramidal effects
● DO tell your team that when you get better that you are going to get a job as a gardener or stacking shelves in Poundland, or will become an international recovery speaker.
● DO remember that if you attempt to Dialogue (TM), with the whole of Tesco’s attending your Open Dialogue network meeting, that you must be in the 75% getting back into employment or university (try to be financially supported by family/spouse/partner).
● DON’T ever claim you’re being stalked or harassed even if you are, or refer to shit treatment in the NHS
● DO keep your love of heavy metal music and SF to yourself.
● DO forget Open Dialogue if you are over 25, or have been psychotic before, or if you are unlikely to get a job – you don’t want to ruin their outcomes, do you?
● DO say you love gardening and baking.
● DON’T write on walls or damage the seclusion room
● DON’T ask staff if they are putting stuff in the food or haloperidol in your tea
● DO remember to nod sagely when you hear the CPN refer to how chlorpromazine enabled all the loonies to leave the asylums
● DON’T talk too fast. DON’T talk too slow. Whatever they say, agree. Only talk about how kind/friendly/helpful people are to you. Smile at social cues
● DON’T do too much of anything: talking, shouting, being quiet, sharing an alternative reality, fairies, feeling paranoid or not, etc….If you think the mental health team look evil and demonic, or like Grant Mitchell from Eastenders keep it to yourself
● DON’T own an axe or a drill and whenever there’s a mass homicide ensure you wear a t-shirt saying “it wasn’t me” but remember that homicide and suicide doesn’t cut it with the DWP (unless it’s in their office)
● DON’T ever access crisis services in a police car
● When asked ‘do you have thoughts?’ DON’T reply ‘I’ll think about that’
● DO ake RMNs advice and don’t become friends with other psychotics – they have their own ‘problems’ you know
● DO remember hot drinks, walks, colouring books, ALWAYS avert a crisis
● DO air your views on Stalinist Russian psychiatrists in the history class NOT the mental health act assessment
● DON’T EVER say the genetics clinic is the eugenics clinic (and men don’t refer to iatrogenic erectile dysfunction as chemical castration)
● Occupational Therapy: sleep hygiene – DO always sleep in the bath as directed by your OT
● DO go to bed at the time the OT says
● DON’T go to your CPN appointment naked even if Maddog tells you to.
● DO Remember – voices outside of head = psychosis, voices inside of head = not real voices, don’t state the fact that people of all diagnoses including psychosis hear voices BOTH inside and outside of their heads
● Women – DON’T wear red or black, always brush your hair, don’t shave your head or have very short hair, wear makeup but not too much, never smeared, but if in crisis wear no makeup or you’re faking it (makeup guide to be written next sponsored by the National Clozapine Unit).
● DO ensure when holding a knife to cut a cake to warn others shouting “loony in the community loony in the community!!”
● DON’T ever mention Joanna Moncrieff’s work to your psychiatrist and CBT to your psychologist. If offered Formulation, don’t ask ‘follow-on milk or instant?’.
Managing your mental health team’s mental illness
● DO eliminate sarcasm from your communicative repertoire (we’re going into witness protection after publishing this leaflet)
● If you are from a culture in which difference is less deviant, DO abandon those beliefs because they push MH workers to defend their fixed delusional belief systems by prescribing drug after drug until they feel better.
● If you want Abilify but are not overweight enough, DO wear a fat suit to the next appointment
● DO expect dystonic reactions to be viewed as attention seeking
● DON’T try to explain how you got here or use metaphors to attempt to describe your inner experiences to hospital staff. Remember, if they can understand you’re treatable and better, if they can’t understand you, you’re sick.
● DON’T giggle or laugh unless a professional does first – and then laugh (not too much). Only professionals know what is funny but not smiling is a negative symptom
● DO Let staff know that your stress-vulnerability bucket is filling rapidly
● DON’T tell inpatient staff to ‘calm down’ when you decide not to participate in their medication regime
● DON’T forget your psychiatrist and the nurses are easily frightened by emotions. It’s probably why they are there in the first place.
● DON’T ever warn the staff of an imminent neo-Nazi genocide and do not warn the police of this, you might give them ideas
● DON’T ever suggest that psychiatry is a pawn in someone else’s game. Never suggest that in the future people will think of your views as prophetic.
● DON’T offer to voice dialogue with your CPNs thoughts
● DON’T produce BMJ papers
● Polypharmacy has nothing to do with a parrot
● You are not the Messiah, you are a very naughty boy.
● A big shout out goes for our friends Zito & Marj – CTO’s are such a wonderful initiative, 100% User satisfaction guaranteed. Who said Care in the Community was dead?
● However much you want to prove your recovery your life is not a tampax advert, don’t wear white hotpants and go rollerblading in your psych appointment
● Glossary: CPN = Can’t Print Name
● Anyone with ‘approved’ in their title needs to be approved by us as they are Aspiring Mental Health Patient’s
● Repeat: psychiatry has really moved on since the Rosenhan experiment, with each successive edition of the DSM more reliable than the last.
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