Tuesday, January 5, 2010

It's attitude adjustment time

I recommend the following article Open Dialog — Alternative for Psychosis in Scandinavia and Finland on the bipolarblast website, You can read the article here

To quote the article's author, madnessradio, the open dialogue approach "challenges a key problem with holistic health approaches, which, though they avoid the harm of pharmaceuticals, remain individualistic and tend to ignore social context and immediate relationships as pathways to recovery, remaining in the ’something is wrong with you” framework shared with the disease model."

Madnessradio continues: "In the open dialog session video we watched, I was struck that they chose to show a clinical moment where a change in attitude in a therapist, not the client, was the key to improving the situation. This strikes me as revolutionary in outlook – the problem is in the network of relationships surrounding a person who is “in crisis.”

Well, perhaps easier said than done, as Barack Obama is finding out with the war on terrorism.

Yes, the shared problem, a.k.a. "blame" approach may soon be revolutionary once more, but will need sensitive handling so that parents don't walk. Open Dialog should consider dropping the Marxist references to abusers, a.k.a. the family. Labelling the family as "abusers" will kill any dialog before it opens. How about, instead, using the language of compassion? From what I read in this article, perhaps the needed change in attitude may simply be for the family and the therapist to stop thinking the patient is whacko and instead might actually be making skewed sense. My kind of holistic schizophrenia involves attitude adjustment on the part of the family members and therapists alike. For the past several decades parents have been told that their child has a biochemical imbalance. The so-called biochemical imbalance may be a biological coping mechanism to a perception of the world that is different than the norm. And who of the rest of us is normal?


  1. Rossa, I listen to Andrew and all that he says makes so much sense. I believe he is the normal one and the rest of us have got it all wrong. So how do we go about getting the rest of the world to listen??

  2. I agree that being referred to as abusers probably will put relatives off right from the start. Still, more often than not, people who react in a way that is called "schizophrenic" or "psychotic" have experienced which I don't know what else to call than abuse. Cf. Hammersley and Read who found that about 70% of people labelled "schizophrenic" had experienced physical/sexual abuse during childhood. In addition to the physical/sexual abuse Hammersley and Read limited their metastudy to, there also is emotional, psychological abuse. Double binds, for instance.

    The term abuse unfortunately has an undertone of doing harm intentionally, of consciously choosing to harm someone although a different choice is possible, and even though I do think the person who does the harm knows about the harming nature of her actions, I don't think she has a real choice when her entire being depends on the possibility to use others to satisfy her needs. As it is the case with someone who's completely identified with their ego. They are responsible. And that maybe is a better, and also more empowering, way to put it than to call them abusers.

    But while I think, the people I often refer to as abusers always also are victims themselves (you don't do to others what hasn't been done to you), and thus certainly deserve compassion, I also believe it is at least just as important to recognize and acknowledge the suffering their actions have caused, and to allow for anger and mourning to happen and be openly expressed. Even if that means that the situation can become painful for the family. Nothing is more liberating than the truth. Bateson for instance repots about spontaneous recoveries where family members brought themselves to admit their wrongdoings towards the "mentally ill" person.

    Personally, I've numerous times been in the place of the abuser myself (I regard civilization as thoroughly abusive - towards nature - and I'm a civilized human being, I do drive a car, I do use a computer, I do turn on the heat, the lights, etc.,and, yes, I also do label people every now and then when my hurt ego gets angry enough...), and I find it indeed much more liberating to be aware of that fact, confront it, instead of engaging in all kinds of defence mechanisms in order to suppress the truth.

  3. Liz - Doing what you are doing, respecting your son and not seeing him as "mentally ill" is a great start. More parents should muscle in with this attitude. In the past I am afraid we seemed more willing to go along with the view of mental illness that there was something wrong with the person.

    Marian - Family Constellation Therapy is very good at confronting this kind of pain.

  4. Hi Rossa! Just catching this up on this discussion about Open Dialogue (a year late I'm afraid). I am wondering though, could you explain this to me? Maybe it's just too nuanced or subtle for me but, what do you mean by:

    "Open Dialog should consider dropping the Marxist references to abusers, a.k.a. the family."


  5. Jane - You've caught me out, as I am not a student of Marx. My limited understanding of Marx is that he saw groups (political, religious, governmental) as largely oppressive, especially groups who claim power. They are abusers. I don't think he was particularly interested in the dynamics of the family, but I could be wrong. I think the family qualifies as an abuser of individual rights within the collectivity. However, calling people abusers isn't going to bring them around. The original article that I referred to in this post with a link to bipolarblast, has the word abuse and abuser sprinkled throughout the references to the family members. While I am willing to accept my own resposbility, if I felt that the Open Dialogue group saw me as an abuser (e.g. the enemy), I would be reluctant to trust them. Open Dialogue is Finnish, and we also have to remember that Finland was heavily under the influence of Russia until fairly recently. The program may not even realize the impact of these words are floating around in the air. They are certainly a turn-off for North Americans, maybe not so much for Europeans where Marxist ideas are in greater currency in some countries than in others.


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