Normality
Medicalisation Syndrome
‘Oh, … hello, who
are you? I’m Doctor Smith. I wasn’t
expecting to find anyone here in my consulting
room this early in the morning.’
‘Hello, Doc, my name’s
George. Your receptionist let me in.’
‘Oh well, now you’re
here, you’d better sit down. I’m the
consultant psychiatrist. Tell me how you’re
feeling.’
‘Since you ask, Doc, I’m
feeling a bit down. My old cat died last week. I’d
had her for fifteen years.’
‘I’ll just write
that down: … chronic bereavement reaction.
Do you often feel low?’
‘Sometimes I do; other
times I feel happy.’
‘I see. It sounds like
you might have a bipolar disorder. Have you been
prescribed medication for your mood swings?’
‘I don’t have
mood swings. It’s all just normal.’
‘If you think the way
you feel is normal, why have you come to see a
psychiatrist?’
‘I haven’t. I’m
a plumber. Your receptionist called me to fix the
leak in the radiator pipe over there. I’ve
tightened-up the compression joint on the valve,
so it should be fine now.’
‘So your mental health
issues have never been diagnosed or treated.’
‘I don’t have any
mental health issues.’
‘You’ve just
described to me a bipolar mood disorder
exacerbated by a chronic bereavement reaction. I
really think you should be on anti-depressants
with some additional medication to counter the
side effects.’
‘That’s a load of
bollocks. I feel happy when good things happen,
sad when sad things happen and somewhere in
between the rest of the time. I also get anxious
when something scary is happening. That’s
just the way life is.’
‘Modern psychiatry
takes a much more sophisticated view than that, I’m
afraid. These days we’re constantly
providing new diagnoses for people who didn’t
even realise they were ill. Frankly, I think you
have very little insight into your mental health
problems.’
‘What's that mean?’
‘Well, … it means
you’re arguing with me. I’m
the psychiatrist for God’s sake. If you don’t
agree with what I say then, by definition, you’re
mentally ill and lack insight.’
‘I’ll tell you
some things about myself, Doc: I didn’t do
too well at school. I got into a bit of trouble
with the police in my teens. Then I got onto a
plumbing apprenticeship with old Henry. I loved
old Henry. One day he said to me: “George,”
he said, “you’re a brilliant plumber,”
he said – and do you know what I am today?’
‘What?’
‘I’m a brilliant
plumber. When he said that to me, it gave me
confidence – and it also gave me confidence
that I could be good at other things too. I
reckon I’m now a pretty good husband –
although you’d have to double check with
Marjory on that one. I think I’m an OK dad
too. I believed what old Henry told me, you see,
and that helped me to become the person I am
today. Suppose he’d said that I had Plumbing
Deficit Syndrome or PDS. What do you think would
have happened to me then?’
‘What do you think
would have happened to you?’
‘I’m not sure,
but, as it came from old Henry, I would’ve
believed that too. Being someone who suffered
from PDS would probably have become part of the
way I thought of myself. I certainly wouldn’t
have become a plumber – how could anyone
with chronic PDS ever hope to become a plumber?
Who knows what might have happened then. I might
now be living in a flat on my own; drinking
myself to oblivion; coming to see you for
medication, and ringing the PDS helpline in
between times.’
‘In addition to my
previous diagnoses, I think you might also be on
the autistic spectrum with a condition we call
Asperger’s Syndrome.’
‘What makes you think
that?’
‘No particular reason.
We tend to say it about quite a lot of people
these days. The phrase has even worked its way
into popular parlance – people with not the
faintest clue about psychiatry can often be heard
to comment that someone they have met must have
"Asperger’s". To be super cool
they might even describe that person as “being
on the spectrum”.’
‘You know what I think,
Doc?’
‘What?’
‘I think you probably
suffer from Normality Medicalisation Syndrome or
NMS.’
‘You're very
perceptive, George. I already know about that.
Constantly dwelling on my diagnosis is taking a
real toll on my life, … but how did you
know about the condition?’
‘I didn’t. I just
made it up.’
‘That’s an odd
coincidence. NMS has recently been classified as
a new mental disorder. One of the big
pharmaceutical companies contacted me directly to
market the latest drug they’ve developed to
treat it, Moreprofitrazine.’
‘So, a drug company
convinced you that you had an illness which I
just invented as a joke.’
‘The pharmaceutical
companies have helped to isolate and define any
number of previously unrecognised psychiatric
problems – and have worked hard to market
drugs to treat them.’
‘You’re not
actually taking that Moreprofitrazine stuff are
you?’
‘Quite large does, I’m
afraid. It really worries me.’
‘Have you told anyone
about this?’
‘You’re the first
person I’ve felt I can talk to, George. It’s
not just my NMS that worries me, you see, it’s
all the other mental disorders with two, three or
four letter acronyms which the pharmaceutical
companies have helped me to realise that I
experience.’
‘It all sounds daft to
me.’
‘I’m not the only
one who suffers from these conditions, you know.
Quite a few of my patients do too. Excuse me for
sobbing, but I just want to be normal – like
people in TV adverts.’
‘Frankly Doc, I think
you, and probably some percentage of your
patients, have been misled and are absolutely
normal – even when any of you don't feel
great or people tell any of you that you're
different.’
‘Really? You don’t
know how much it helps to hear a normal person
say that.’
‘Can I give you a bit
of advice?’
‘Please.’
‘Take a rest from
psychiatry and take up plumbing. Anyway, I’ve
got to go – I’m due to fix Mrs Jones'
bathroom tap at nine-thirty.’
‘Before you go, George,
can I ask you one more question?’
‘What’s that, Doc?’
‘Can you recommend a
good plumbing course?’
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