‘Recovery Narrative’ as a ‘genre’: some uninvited comments

This academic paper (open access) was published two months ago (when I was rather busy being suspended by the GMC/MPTS, for reasons which remain unclear):

Screenshot_2019-05-15 The Recovery Narrative Politics and Possibilities of a Genre

However I did find time to gently ‘troll’ its lead author about her links to the pharmaceutical industry, and my piece published today attempts to say why I think that might be relevant for the ‘Recovery Narrative’ and ‘genre’ paper, and the so-called ‘Medical Humanities’ more widely.

Screenshot_2019-05-15 from NMacFa angela - Twitter Search

Regular readers of my blog will know that in January I suggested a co-author of the ‘Narrative’ paper, Professor Helen Spandler, was running Asylum Magazine as ‘a self-censoring academic front for establishment psychiatry’.

As a psychiatrist long interested in English Literature, who spent much of 2013-17 drafting proposals for a self-funded MD or PhD, I had come across Angela Woods’ work before. She co-edited a 700-page 2016 book on the ‘Critical Medical Humanities’ but, alas, as with so-called ‘Critical Psychiatry’, the claim to be broadly ‘critical’ is questionable.

If one probes for key words on Google Books (and I have also searched the whole text in the British Library), one gets the impression that ‘Western biomedicine’ (for example) is something undesirable ‘practised historically by white males’ etcetera. But the nature of its undesirability, and how it maintains its ‘hegemony’, is circled around rather than stated.

There is no mention of Ivan Illich’s Medical Nemesis, let alone more recent critics such as Marcia Angell, or David Healy. Yes, Nikolas Rose is referenced, but in my view he is more of an observer and chronicler of biomedicine than a critic of its downsides and excesses.

So Pharma-dominated medicine (including Pharma-psychiatry) has little to fear from this kind of academic ‘output’. And that may be partly a consequence of how most ‘Medical Humanities’ in the UK is funded.

Some more fact-checking is required, but most humanities academics I have talked to over the last 6-7 years have believed it to be overwhelmingly backed by the Wellcome Trust, a 26 billion pound charity which mostly invests on the stock market (excluding tobacco, which might put the #Pharma proportion of the portfolio up a bit from the usual 10% or so of the FT 100 benchmark) but also develops its own vaccines and other pharmaceutical products. (Full disclosure: at one point I explored whether funding for my own MD or PhD might be available from the Trust).

Professor Woods appears to be still part of a major Wellcome project and, interestingly, one of her colleagues at Durham University is a Wellcome-funded anthropologist, with an interest in ‘narrative’, who researches ‘health conspiracy theories. These include beliefs about secret agendas behind vaccination programs, the side effects of medical treatments, and cover-ups by the government or pharmaceutical industry.’

On his University page, professor Tehrani simply makes a much vaguer reference to research on ‘conspiracy theories’ (dropping ‘health’), and does not mention his Wellcome funding. However, scrolling down does show his most recent paper was on ‘antivax attitudes’.

Coming back to the paper on ‘Recovery Narrative’ as a ‘genre’ (the first link in this piece), how might Wellcome’s ‘#Pharma-loaded’-ness be relevant?

Well, the role of the pharmaceutical industry, in promoting biomedicine while marginalising psychosocial understandings and interventions, is completely absent.

Take the semi-fictional ‘Ben…a young person struggling with unusual experiences’ in the second paragraph: ‘When he becomes part of a dynamic mental health charity, his world transforms. He grows in confidence and…he becomes an ambassador for a major national anti-stigma campaign…’.

There is no mention of the degree of funding of the charity by Pharma. Some charities disclose the names of companies, but there is no obligation to do so, and I am not aware of any that itemise exact figures. There is also the issue of industry disclosure, by professionals with formal or informal charity roles, being only voluntary (see No. 4 of my ‘manifesto’).

Ben’s ‘narrative’, as told by the two Wellcome-funded professors and their co-author, continues with his audience getting bored with him, and eventually ‘From hospital, where he has been sectioned, he speaks of a painful ebbing away of his sense of self-worth.’

The suggestion, as I read it, is that ‘Ben’ is more a victim of the media’s general tendency to build up ‘fresh faces’ and later knock them down, rather than of Pharma-psychiatry which has a vested interest in mental health services being poorly funded, so that drugs are used rather than more expensive person-delivered support and psychotherapy.

In the 10,000 words of the whole paper the word ‘drug’ does not appear, and even ‘medication’ only does so twice, with the mildest (if any) of ‘critical’ inflection: ‘The Recovery Narrative can…suggest multiple pathways to recovery (including therapy, medication, familial or peer support, religious counselling, and mental health activism)…’.

I suggest a ‘genre’ for this paper, sadly not a new one: ‘Academic Output Disguising Industry Interests’.




About Dr Neil MacFarlane MRCPsych

Independent Psychiatrist providing culturally informed mental health opinion, advice, and a few new facts. Based near London, UK. Main qualifications: BA MBBS MA MRCPsych.

2 responses to “‘Recovery Narrative’ as a ‘genre’: some uninvited comments”

  1. F68.10 says :

    “So Pharma-dominated medicine (including Pharma-psychiatry) has little to fear from this kind of academic ‘output’. And that may be partly a consequence of how most ‘Medical Humanities’ in the UK is funded.”

    I do not know exactly about the UK.

    But given the fact that I do endorse that kind of work, and that I indeed also thought that these kind of “narratives” should be double-checked with serious epistemological rigor, I guess that, reading your post, you are more “antipsychiatry” than me.

    However, I range quite far into the realm of antipsychiatry, given the fact that I’ve been labelled as a scientologist, anti-science, and, explicitly, on my medical records as a “terrorist”, which I’ll never forgive.

    So please do measure how extreme your position should be considered to be according to conventional medical standards, if you believe that the fact that I endorse this paper makes me a pharma shill.

    The reality is that I also know what rationality and science are because I had an upbringing and an education. I also know, having been raised in an extended family of doctors, how the medical power dynamics play and what the various medical ideologies are.

    So, the point is simply about not being naive… There is a knowledge game in place, we do not have any other choice than to play it.

    And the real point is: How do we get tools accepted that will extend the epistemological input that gets incorporated in medical records and medical research?

    Not accepting to “disguise” that kind of work as subservient to “industrial interests” simply means not allowing that such scientific measurement instruments be considered as useful in medicine. And that is what all “service users” and “antipsychiatry survivors” should avoid at all cost, even if they do not understand it. The stakes are too high.

    So please change you stance, keep reading Illich, it’s indeed fun, but start supporting that kind of work. It’s rather vital.

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  1. Asylum Magazine and Pharma-enmeshed Psychiatry | DrNMblog - 19 May, 2019

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