Mother and Child (by Paul Klee, 1938)

Mother and Child (by Paul Klee, 1938)
The tension of anxiety, when present in the mothering one, induces anxiety in the infant. (Harry Stack Sullivan)

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Sunday, March 18, 2012

Same wood work, different meaning this time

This post is really not such much about changing my mind on how I felt about something at the time, but seeing the wisdom of doing something meaningful at the right time.

Chris recently started volunteering any spare time he has on the week-ends to help the amateur operatic group he sings with construct sets and props. The idea to volunteer for behind the scenes work was suggested by his occupational therapist. Under guidance from two older men in the group, Chris is swinging a hammer and sawing wood and doing whatever one must do to set the stage for April. He's enjoying himself and he gets to hear all kinds of interesting stories from the men with whom he works.

The kind of work he is doing now is the kind of work that failed miserably —oh so many years ago after he had finished his two year day program. The day program hadn't "fixed" him, and, as kind of a last resort, the psychiatrist at the program arranged for Chris to "apprentice" with a cabinet maker. The apprenticeship or sheltered workshop or whatever it was considered, was covered through our health insurance policy. Chris didn't succeed as an apprentice cabinet maker or sheltered workshop worker, because, well, frankly, he didn't do any work. He didn't do any work not because he wasn't encouraged to, but because he couldn't. According to Chris, he just drank cups of coffee, spoke very little, and watched the cabinet maker hard at work sanding and buffing. Ian and I had to drive Chris to the door of the shop, otherwise he wouldn't go in.

I believe that institutionalizing mental illness through day programs and sheltered workshops hinders recovery because it makes the person feel and act like a patient. The word "disabled" comes to mind.

Perhaps what the doctors in the program should have thought about, but probably didn't, was that parents are still dealing with grief mixed with expectations about their relative. I felt the doctors were trying to turn my academically promising son into a disabled worker. They were lowering his expectations (and mine!) by having him sand wood in a gloomy workshop. Only two years earlier he was at university. Chris's psychiatrist told me point blank that Chris would never again be the promising student that he once was. So, I feel I correctly interpreted what the wood studio meant for Chris's future. Chances are Chris came to the same conclusions as I did.

Today, I can't say I'm thrilled that Chris sees an occupational therapist, because I don't see him as "handicapped" (and this, to me, is what having an occupational therapist implies) but at some point, I just stopped trying to run interference with his recovery and leave it to the wisdom of others. I never thought I had all the answers, but I also don't believe they have all the answers either. I'm very pleased that Chris is happy hacking and sawing away to his heart's content in a woodworking shop. The difference is that this time his being there is a natural outgrowth of his love of the musical theater work that he is doing.

Here's an interesting perspective from Raymond's Room on what's happening vis a vis sheltered workshops in Oregon State.

Friday, March 16, 2012

David Healy in Toronto on promotional tour for new website

Thanks to Chris for spotting this article.

From The Globe and Mail
Drug-risk website aimed at consumers

anne mcilroy Published Wednesday, Mar. 14, 2012 4:05PM EDT

Julie and Peter Wood say they wish they had known more about the stimulant a doctor prescribed for their son to help him concentrate.

John David Wood, a student at the University of Toronto, became addicted to the medication and developed serious mental health problems after he abruptly went off it. He committed suicide in 2008, at the age of 26.

In an effort to help other families learn more about the potential downside of prescription drugs, his parents are working with David Healy, a high-profile critic of the pharmaceutical industry, on a new website – RxISK.org.

They hope the website will make it easy for people to research any drug that is approved for use in Canada or the United States, both brand names and generics. But they also want to build a grassroots database on side effects of these medications. For now, patients can search the new website, at no cost, for information about the adverse impact of drugs collected by the Food and Drug Administration in the U.S. But if all goes according to plan, in a few weeks the new website will ask patients to report side effects and allow them to see whether other people have experienced the same symptoms.

Read the rest here

Thursday, March 15, 2012

International society removes 'schizophrenia' from its title

TUESDAY, 13 MARCH 2012

International society removes 'schizophrenia' from its title

A statement from the ISPS today reveals that the society has voted to remove the word 'schizophrenia' from its title due to the term being deemed 'unscientific andstigmatizing':  
"Members of the International Society for the Psychological Treatments of the Schizophrenias and Other Psychoses (www.isps.org) have just voted, by an overwhelming majority, to change the society’s name to the International Society for Psychological and Social Approaches to Psychosis. The new logo and letterhead are to be adopted by the end of March.  
The change comes at a time when the scientific validity of the term schizophrenia is being hotly debated in the lead up to the publication of the latest edition of the Diagnostic and Statistical Manual (see http://dxrevisionwatch.wordpress.com).  

Read more  http://blog.humangivens.com/2012/03/international-society-removes.html

Wednesday, March 14, 2012

Dr. Drew said it

With a straight face, I may add. He said that before a psychiatric diagnosis is rendered, the doctor will systematically rule out potential biological causes.

What?

Like rule them out as in schizophrenia?

He's got to be joking. Let's see, no doctor ever suggested running some tests on Chris, "just to see if he had any underlying biological problems." The only time Chris ever got blood tests on the doctor's orders was when he was on antipsychotic medication.

The person who suggested that we "run some tests" on Chris was me. He got a brain scan only after I suggested he have one. The doctors didn't just stop at not recommending biological testing. They also balked at sending him for complementary and alternative treatment. 

Running tests to rule out underlying biological problems for cases of mental illness is a myth that goes down well with the public, especially on prime time television. It's like believing that a judge is a neutral party who impartially weighs all the evidence and then delivers a verdict. Hah!

Monday, March 12, 2012

Taken as prescribed, medications kill 100,000 people per year

What use do you make of your physician?” said the king to Molière one day. “We chat together, sire; he gives me his prescriptions; I never follow them, and so I get well.”

The 100,000 per year body count  is for the United States only. Medications, properly prescribed and properly taken, kill twice the number of people per day than car accidents do. The unsettling death statistics from prescribed meds is not something we hear much about. Yet many, if not most of us, simply take the medications we are given and probably take more than we need. It's one thing if a person has a life threatening illness or condition and needs the medication in order to survive. But many people are taking prescription medications that they could shed if they changed their habits and did a bit of research into alternatives.

I got to thinking about this today when I visited a friend of mine in the hospital. She'll be 90 years of age this month. She loves to tell me what her mother told her -- to always buy the best food, because otherwise, instead of paying the grocer, you'll be paying the doctor. She eats butter, not margarine. Up until a few weeks ago, my friend was on no prescription meds. None. She has a heart condition that gave her occasional problems in the past, but she always refused meds for the problem.  Today, the doctor informed her in my presence that she will need to take the meds he had prescribed her the rest of her life. After he left, she complained bitterly to me that she hated being on "these things." I congratulated her for managing to dodge these bullets up until now, that she probably was healthier for having done so, and suggested that taking the meds now for the rest of her life was a small price to pay for avoiding landing back in the hospital. By all indications, she should be able to resume her normal activities within a month. But, she will be hounding her doctor to keep the medications to a minimum, I can guarantee it.

My favorite doctor, the one I prefer to go to avoid health problems in the first place, is Andrew Saul, Ph.D. When people protest that vitamins, not just meds, kill people, thereby implying that vitamins are inherently dangerous, Saul always asks the question, "where are the bodies?" He has done extensive data gathered from 61 U.S. poison control centers, which reported a mere 10 deaths linked to vitamins over the past 25 years.

Saul also recounts that “More than 1.5 million Americans are injured every year by drug errors in hospitals, nursing homes and doctor's offices, a count that doesn't even estimate patients' own medication mix-ups. . . (O)n average, a hospitalized patient is subject to at least one medication error per day.” 

Just as I was about to push the publish button for this post, I was delighted to see that there is a new website about prescription medication side effects that contains a database for logging adverse effects. RxISK.org  The medical and research team behind this venture includes Dr. David Healy and author Robert Whitaker, and many other prominent names in pharmacology and other disciplines.

ALGERNON MONCRIEFF: The doctors found out that Bunbury could not live...so Bunbury died.

LADY BRACKNELL: He seems to have great confidence in the opinion of his physicians. I am glad, however, that he made up his mind at the last to some definite course of action, and acted under proper medical advice. (From Act III of The Importance of Being Earnest by Oscar Wilde)

The humorous quotes on this page were directly cribbed from Andrew Saul's website: www.doctoryourself.com

Sunday, March 11, 2012

There is hope for even chronic cases of "schizophrenia"

Ron Unger is the best blogger I know who can decode schizophrenia to the outside observer and offer  healing words of wisdom. His most recent post is a must read. It's a lengthy look at what Carl Jung believed about schizophrenia. For people who want to know if there is hope for people with " schizophrenia," here's what Jung wrote:

In regard to the latter (i.e., severe cases), Jung stated: “It would be a mistake to suppose that more or less suitable methods of treatment exist. Theoretical assumptions in this respect count for next to nothing. Also, one would do well not to speak of ‘methods’ at all. The thing that really matters is the personal commitment, the serious purpose, the devotion, indeed the self-sacrifice, of those who give the treatment. I have seen results that were truly miraculous, as when sympathetic nurses and laymen were able, by their courage and steady devotion, to re-establish psychic rapport with their patients and so achieve quite astounding cures” (p.265).

Jung then addresses certain countertransference issues:

“But even so one can bring about noticeable improvements in severe schizophrenics, and even cure them, by psychological treatment, provided that one’s own constitution holds out [in my own experience, I have had situations where I continued the long-term psychotherapy of several patients in inpatient state hospital settings, later transferred into my practice, in which I was physically attacked, reported to have sexually molested the patient , etc, to very positive outcomes, e.g., to the point where family thought their family member was originally misdiagnosed as schizophrenic, never having to return to the state hospital after many years of residing there, etc]. This question is very much to the point, because the treatment not only demands uncommon efforts but may also induce psychic infections in a therapist who himself has a rather unstable disposition. I have seen no less than three cases of induced psychoses in treatments of this kind” (pp. 265-266).

Thursday, March 8, 2012

Schizophrenia, conversion disorder, stress and immigration

Year ago, when Taylor, my youngest son, was in third grade, he had a friend "Jeremy" (not his real name). Like us, Jeremy and his family had relocated from North America to Europe that year, where the father was employed in high tech. Jeremy was an only child. His mother told me that when they were in the final stages of moving, Jeremy woke up one day and said he had lost all sight in both his eyes. He was blind for about a week or two. You can imagine how terrifying that was for all concerned.

That's what stress can do to the human mind, or, to turn it around, that's what the powerful mind can do to the human body. When researchers note that there is a higher proportion of "schizophrenics" seen in the Jamaican immigrant population in England, this doesn't surprise me. There are enough Jamaican immigrants to form a ready research pool. Moving continents and cultures is a shock. Schizophrenia is a stress reaction but no stranger than going blind is. You have to see it to believe it.

I came across a similar story to Jeremy's when I was searching for the latest article on the teenage girls in Le Roy, New York who developed bodily tics and twitches. Jeremy had what by all accounts would be  "conversion disorder." It used to be called hysteria.

What did happen to the girls in Le Roy? There is a fascinating article in the New York Times Magazine  by Susan Dominus. Dominus writes that when the environmental explanation for the phenomenon did not hold up, and the diagnosis was the stress-related conversion disorder, here's what happened.

To many parents, the diagnosis was woefully inadequate, even insulting.“It’s a very hard pill for me to swallow — what are we, living in the 1600s?” the guardian of one of the girls said. Besides, kids are always stressed, and some of these kids may have been less stressed than most. On CNN, James DuPont, the father of an afflicted girl, said, “A lot of these kids were just, you know, having a happy, normal life.” Miller told me she did not buy the diagnosis, not one bit. “My daughter hasn’t had any trauma,” she said. “She was just happy, going along. She was as happy as can be.”

Like with schizophrenia, it is hard for many people to equate the really strange behavior with the stressors that many of us take for granted in our own lives.

According to Dominus:

A common thread emerged among the five girls I interviewed extensively: none had stable relationships with their biological fathers. And the father of a sixth girl had seen little of his high-school daughter until his concern about the tics galvanized their relationship. Another student was a foster child who switched foster homes shortly before his tics came on; yet another is in the custody of an older sibling. Another two have spotty contact with their fathers. One young woman I interviewed was close to homeless after she and her mother left her father’s trailer. They’re staying with a friend of a friend while her mother, who was laid off two times in the last year, tries to scrape together first and last month’s rent so they can get a place of their own.

Dominus also reveals that Dr. Rosario Trifiletti, who has diagnosed a mysterious and ill-defined "PANDAS-like illness" was unaware of the trauma in his patient's lives:

When I spoke to him in late February, Trifiletti told me that the girls he was treating were showing dramatic signs of improvement. Katie’s parents said they believed that she was responding well to the antibiotics; Chelsey’s family reported that the drugs are helping her as well. But another patient of Trifiletti’s said she was still fainting.

When the subject of the girls’ personal backgrounds came up — the biopsychosocial factors that might be affecting their health — Trifiletti said he had not had the time to ask them about those kinds of things. The abuse, the troubling family circumstances — much of it came as news to him. “Jeez, I didn’t realize the extent,” Trifiletti said. “These aren’t things people want to talk about. I don’t know, maybe I’m wrong. It’s hard to distinguish between the drug and the placebo effect.”

Schizophrenia is much more common than conversion disorder. Yet, medicine stubbornly resists linking schizophrenia to trauma or stress factors. Medical science favors the biochemical imbalance theory of schizophrenia, almost exclusively. It's quite insulting, really, to those of us who are wanting answers for schizophrenia, and more importantly, more meaningful help, that conversion disorder is taken more seriously than schizophrenia from the psycho/social point of view.

The psychological explanation, of course, hasn't stopped some of the Le Roy parents from putting their teenage girls on drugs. The Dominus article reports that at least one girl is on eleven different medications! One can only presume it is because the parents don't believe that stress alone can produce something so strange.

Well, stress can, and does.

Below are some readers' comments to the Dominus article.

Jill
..Shame on you New York Times for writing such an offensive article. We are not in the dark ages. And to go so far as to blame these girls "instability" on living with single moms is disgusting. These girls don't have conversion disorder. This is just a made up diagnosis for doctors that have egos so big they can't say the words "I don't Know".

And, the following quote from simon Wessely is offensive to every person who has an illness that is not yet understood by science.

"Wessely, the epidemiologist, cited a medical-journal paper whose title had long resonated with him: “If You Have to Prove You Are Ill, You Can’t Get Better.”

Here is another quote from a recent Washington post article on chronic lyme that I think is more fitting for what is going on in Le Roy.

"Just because scientists don’t understand the cause of a disease doesn’t mean that it doesn’t exist."


AS Minnesota
..All of the comments here that suggest that somehow their doctors were being "mean," or were incompetent, or just not empathic enough because they conferred a psychological etiology just seems to further prove the point that for many folks, it IS in their head! Someone who honestly assumes that their doctor is mean for suggesting a psychological contribution has obvious psychological issues. Do you honestly think your doctor is intentionally trying to be mean to you? Why so defensive?? What is so threatening about a psychological diagnosis?? We experience physical symptoms as a result of psychological stress all the time. Nervous about an upcoming performance or a big date (i.e., psychological cause), and so you get an upset stomach (i.e., physical symptom)? Financial stress or work stress (i.e., psychological cause) giving you a splitting headache (i.e., physical symptom)? Honestly, people. Given the complexity of the human brain, it is utterly preposterous that all ailments are due to a physiological cause. Anyone who doctor shops enough will find someone who will eventually render a medical diagnosis (no matter how random or "rare") that suits their PSYCHOLOGICAL need to have a medical explanation rather than a psychological one. Whenever I hear people maligning the "it's all in your head" comment, I think to myself, "where else would it be?? OF COURSE it's all in your head. that's where the most complex organ in your body sits."

Matt Evans New Jersey
..There is a fifth dimension, beyond that which is known to man. It is a dimension as vast as space and as timeless as infinity. It is the middle ground between light and shadow, between science and superstition. - Rod Serling