From The Rainbow Machine: Tales from a Neurolinguist’s Journal by Andrew T. Austin.
Imagine being a television set that is always on the wrong channel. Whatever you broadcast, someone reaches for the controls. An objection proves that adjustment is necessary. Agreement proves that the adjustment is working. There is no channel on which your own position is allowed to stand.
The television-set character in The Rainbow Machine is a composite, drawing together autobiographical experiences and observations involving different people. It is a crafted metaphor, not a literal case report of one patient. Its subject is the pressure to become the person other people have decided you should be.
When a diagnosis becomes the whole person
A diagnostic description can help organise treatment and communicate important information. It can also be allowed to expand until every action is interpreted through it. A person who has a diagnosis becomes, in everyday conversation, the diagnosis itself.
My concern is what happens to disagreement in that arrangement. If the person objects to an unkind remark, challenges a decision or asks why an activity is necessary, the objection can be treated as evidence of illness rather than considered on its merits. The professional’s interpretation becomes difficult to question because questioning it is taken to confirm it.
R. D. Laing’s writing influenced my interest in how a person’s experience can be invalidated by the social setting around them. The point does not require denying mental illness. It requires recognising that a person with a mental health condition can still notice an injustice, dislike an activity and make a reasonable complaint.
An assessment of symptoms and an examination of a complaint are different tasks. One should not automatically cancel the other. The content of what somebody says deserves attention even when their manner of saying it is difficult or their account needs clarification.
The balloon-patting group
An experience in a psychiatric rehabilitation day service sharpened this concern for me. The setting was pleasant and the staff were friendly. Older people attended from the community, sometimes to provide respite for carers and sometimes to give structure to their week. My objection concerned some of the activities, not the warmth of the people working there.
I saw a group assembling simple wooden toys and later taking them apart to repeat the activity another time. In another session, roughly fifteen older participants sat in a circle patting balloons towards one another. A few appeared to enjoy it. Many looked uninterested.
In a staff discussion I asked what therapeutic advantage the balloon activity was intended to provide. The answer I recall was that it was on the rota. That explained why it had happened that morning. It did not explain why it belonged on the rota in the first place.
I then asked increasingly pointed questions about the green and yellow balloons and whether a red balloon would have a different therapeutic effect. This was my characteristic way of pressing a question, and it did not make me popular. I recognise that my delivery could obscure the serious issue I was trying to raise.
What would refusal mean?
I asked the staff to consider a hypothetical participant, whom I called John. What would happen if John refused to pat the balloon, stood up and left the group? The response I remember was that staff would check whether he had received his medication that morning.
John was an imagined example within the discussion, not a named patient whose medication I observed being changed. That distinction matters. The story concerns the reasoning expressed in a conversation: refusal was being considered first through the possibility of a clinical problem.
An activity may have a valid purpose that is not obvious to an observer. Gentle movement, coordination, enjoyment or social contact could be relevant aims. The proper question is whether the activity serves an agreed purpose for these people, how that is assessed and what alternative is available when somebody does not want to participate.
Refusal might sometimes accompany a change in health. It might also mean that the person is bored, embarrassed, tired or simply uninterested. A service that calls itself rehabilitative needs room for ordinary preferences. Completing the timetable is not the same as increasing a person’s independence.
Acceptance and the wish for change
Therapy contains a tension. A person may want an aspect of life to change, while also wanting to be accepted as a person. A practitioner can accidentally communicate that the client’s whole way of being is unacceptable and must be replaced with the practitioner’s preferred version.
The statement that everyone already works perfectly does not remove that tension. Nor does an elaborate personal-development promise that somebody can become exceptional. Both can miss the individual who wants help with a specific difficulty without being converted into a new identity.
Consider a person who enjoys parties and recognises that their drinking has become harmful. They may want help to change their alcohol use while preserving friendships, interests and other valued aspects of life. The useful clinical questions concern their pattern of drinking, risks, needs and options. Their entire identity does not have to be reduced to one label.
For some people a recovery identity is helpful and freely chosen. Others use different language. That preference can be explored without denying the seriousness of a problem or pressuring somebody to manage it without appropriate care.
A history that continues into the future
In my twenties I sought help for depression and difficulties with mood. The help I received did not resolve the difficulties as I had hoped. That experience contributed to my later interest in therapeutic approaches and to the questions I asked of them.
I also experienced the continuing consequences of a diagnostic record when dealing with financial and insurance matters later in life. What felt like an attempt to get help during one period became a description that followed me into other contexts. This is my recollection of those encounters, not a rule about present-day eligibility for any particular product.
A medical history can remain relevant without becoming the whole truth about the person now. It is worth distinguishing a past episode, a current condition, an ongoing risk and an identity. These may be related, but they are not interchangeable. Seeking help should not be presented as a mistake; the issue is how information is interpreted and kept responsive to change.
The trainer’s preferred future
During my first NLP practitioner training, I met some assistant trainers in a bar. They belonged to the circle around a prominent trainer. When asked what I did, I said that I was a nurse. One person reacted with ridicule, and the conversation turned towards how much more I could do, including taking NLP trainer training.
I did not have a lengthy argument. I finished my drink and returned to my room. What stayed with me was the implication that an important, ordinary occupation was insufficient and that advancement meant entering their preferred professional identity.
The encounter was not representative of everyone in NLP. It illustrated a pattern I had seen elsewhere: an apparent invitation to develop can carry a judgement that who you currently are is not acceptable. The question is whose values define the improvement and whether the person being advised shares them.
Rights, advocacy and accountable care
Power imbalances in mental health care deserve scrutiny, especially when treatment is compulsory. It would nevertheless be inaccurate to say that a diagnosis removes all legal rights or that detention has no independent review. NHS information on the Mental Health Act explains rights, advocacy and routes to challenge detention, with details depending on the circumstances.
The practical question is whether those protections are understood and usable by the person concerned. Clear explanations, access to an independent advocate, accurate records and opportunities to raise concerns are part of accountable care. Confidentiality should protect a person’s information, not become a reason to ignore their voice.
In everyday therapeutic work, ask what the client wants to change and what they want to retain. Distinguish disagreement from deterioration. Explain the purpose of a task, check whether it helps and offer a meaningful alternative. A person should be able to choose a different channel without every choice being treated as a fault in the set.