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Further Writing by Swan Morrison

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?’


‘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?’


‘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?’


‘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?’