I have decided to share this because I suspect such experiences are far from rare. We probably don’t talk about these things enough.
I was an in-patient in your adolescent unit in the early 1980s. I have been thinking quite a lot recently about my stay in the Cassel, and about my adolescence generally.
I don’t know how many adolescents are at the Cassel now at any one time, how long they tend to stay, etc. Do they still have a meeting every Tuesday evening which parents are expected to attend? In my day, there was such a meeting: the adolescents themselves, the parents, and the two mental health nurses who specialized in adolescent mental health. The stated aim of these meetings was for adolescents and parents to raise any difficulties that had been encountered at the weekends (when we had to go home) and to discuss such difficulties within the group. In actuality, this meeting was really an opportunity for parents, many of whom were demonstrably disturbed themselves, to let rip about their children and to “play the victim.” My parents always came, driving all the way from Stevenage.
My father was the world’s best at putting on an act (in this case “Concerned Father”), and my mother was (and still is) extremely passive, would never challenge him even when he was lying outright about what went on at home. She’d look sheepish, that’s about it. What was going on at home (and what had been going on at home for quite some years) was that Dad was a shouter, verbally and emotionally abusing his wife and his three children (I have 2 brothers.) He was very manipulative, very infantile, a chaotic person, a “mummy’s boy” who had never cut the apron strings. This was a great source of conflict in my parents’ marriage from the off; my mother even then was confiding in me about this and looking to me for support. My father had been exempted from National Service on psychiatric grounds (but was always vague about the details); he had later had what appeared to be several “nervous breakdowns” prior to meeting my mother. On several occasions he had turned down treatment, and he and my mother never sought any professional help about their problems as a couple. My father clearly had great issues with women, and his hostility towards me increased exponentially when I hit puberty; I remember him sneering at me for having my period, he hated any mention of sex or reproductive biology, and was extraordinarily prudish. My brothers and I certainly did not have an environment in which we could ask questions or receive any reassurance about sex and sexuality! My dad was also very contemptuous of the fact I wore glasses, and would sneer in my face about this. (My mother just let it drop in the few days before his death that he considered people who wore glasses to be “defective.”) My mother saw and heard most of this behaviour on a frequent basis but did not intervene. If I mentioned any of it at the Cassel meetings, she would shift uncomfortably in her chair but would say nothing; I can’t remember her once challenging my dad’s hostility or his neurotic attitudes. (Perhaps she shared them?)
I broke down when I was 15. Is it surprising? I had been getting more and more depressed for some time, demoralized, cried a lot. (Years later, I found out that an educational psychologist suggested to Mum when I was 13 that I was severely depressed and offered to make a referral for help; this offer was turned down, I wasn’t even asked.) I was in an adolescent unit in Exeter for a short while about a year before I came to the Cassel. I don’t know the whole story but I do remember the consultant psychiatrist saying to my parents, in front of me, “I’m not really interested in depression. I’m much more interested in juvenile delinquency.” The day I was discharged from that place, one of the staff announced to the whole group of teenagers that I was going to be discharged (this hadn’t even been mentioned to me). I know that the Cassel prides itself (and did then too, in my time) as taking on people whose problems have “exhausted” other avenues. It wasn’t that my problems exhausted anybody; I had not been given proper help. The provision at Exe Vale was shabby. A month after I had been discharged my parents and younger brother and I had an appointment there. . .and the consultant seemed genuinely surprised that I was no longer an in-patient. .. how could that happen, I wonder, when he was meant to be the one in charge? It was arranged for me to see one of the registrars on an out-patient basis. This woman’s oft-repeated phrase to me was, “I don’t know why you’re so angry.” Once she asked me (in a corridor) “Were you ever a Daddy’s girl?” and when I said “No,” she simply said “I don’t believe you.” I was on several occasions asked “Do you consider yourself to be an honest person?”
Yes, I came to the Cassel very angry. Who wouldn’t be angry? My big question to you is, if you had been living as a teenager with one parent who was constantly abusing you verbally and emotionally, eroding any sense of confidence you might have had, sneering at your gender while the other parent looked on, making excuses and actually expecting you to be “forgiving”, how would you have reacted? I got depressed and I got angry, perfectly predictable responses to the situation that I was in. I felt there was nowhere to go; I was sure that any approach to a teacher, say, or to our GP would have gone straight back to my parents. I find it very disturbing that you are still labelling this kind of situation with your patients as “Personality Disorder.” I broke down in circumstances that were intolerable (much as did the shell-shocked soldiers for whom the Cassel was originally set up, I may add): were they “personality-disordered” as well? This term, by the way, was never used to my face but it is in my medical records. (The fact that I was on the receiving end of abuse is not in my medical records. There is virtually no sense of context in those records at all, and there are a lot of presumptions.) And I note that the adolescent unit at the Cassel today is actually called “The Emerging Personality Disorders Clinic.” What hope does that offer to those patients? You might as well say “You are untreatable”. .. but there you are, trying to treat them. I don’t understand this. Do you recognize that they are, in many cases if not all, people who have been abused? That is a heavy legacy to carry, and someone with that legacy needs help to carry it, but to be handed a label like “Personality Disorder” is to be given a further burden. My father was really rather pleased, I suspect, that I’d been pathologised; it enabled him to carry on believing that there was nothing wrong with his own behaviour.
I’ve read quite a lot about personality disorders. I am not of the opinion that there is no such thing. There certainly are clusters of behaviours that could fall under various headings. I’ve come to understand that my father was very likely a Narcissist; the behaviour of other narcissists which I have read about tally almost uncannily with the behaviours that he showed throughout my childhood, adolescence and beyond. When all of his children were grown up and damaged, he finally sought out a psychotherapist. .. who was the very same person who had supported me for 18 months after I left the Cassel! He somehow prevailed upon this therapist to take him on; I was abroad working at the time and not in a good position to challenge this. She shouldn’t have taken him on, end of, but he was infinitely charming and manipulative. I suspect she had no real idea of the extent of his problems; he would have done a PR job on her of course, and there was no-one present to provide another narrative. So yes, personality disorder exists. He convinced so many people that he was Concerned Father, Good Neighbour, Supportive Colleague, but these were all masks to be shuffled and worn as and when it suited. The people at his funeral who spoke of him as having been a supportive colleague had never heard what he said about them to us behind their backs! Snide, unkind, condemning things, especially if they were female and/or more intelligent than he was. I’m afraid that such a person would have no problem at all in convincing some psychiatrists and psychotherapists that his daughter was unhinged, dishonest, etc. .. and I strongly suspect that’s exactly what he did. He managed to perpetuate more abuse, with the unintended co-operation of mental health professionals. With my mother’s compliance, of course; I don’t let her off the hook. My relationship with her has been difficult throughout my adult life for precisely this reason; nowadays, I have minimal contact with her because I have chosen to have minimal contact, for my own wellbeing.
Maybe my experiences are not “typical” of teenagers who come to the Cassel. I don’t know how “typical” they were back then. But I do think we still live in a society where children and young people are not being sufficiently listened to. If their narrative deviates significantly from that of their parents or older relations, too many doctors/social workers, etc. seem to prefer the narrative of the parents. This, too, is an abuse. Just as the many victims of Jimmy Saville, Cyril Smith, etc. have been finding out, lots of people want to turn a blind eye, or to trivialize what happened, or to say that reports of abuse are malicious, etc. But if professionals involved in mental health seem uncertain of where they stand over such matters, it’s hardly surprising that lay-people don’t know either.
I wish the Cassel well. It provides an environment which can benefit some troubled people. But I feel it could do so much better, just as mental health services in general and society in general could do so much better. We have a long way to go.
(Ms) Sheila Hamilton
Sheila’s letter has been sent to the Cassel’s ‘Emerging Personality Disorders Clinic.’ She is awaiting a response. If there is a response I will publish it here.
Sheila’s poetry collection Corridors of Babel is published by Poetry Salzburg. She has also written two pamphlet collections, one by Flarestack entitled The Monster in The Rose Garden and one by Original Plus entitled One Match.