My theme, that psychiatry threw the baby out with the bath water when it stopped implicating parents in their children's mental health issues, continues.
From a Child & Adolescent Bipolar Foundation blog.
In 1977, a Northern California mother named Eve decided she’d had enough. Eve had raised a child diagnosed schizophrenic and had endured the prevailing thinking by the medical community and society at-large at the time; that her son’s condition was her fault. That something in how she raised him caused his psychotic break with reality during his teens. Trying to get appointments with the local mental health facility administrators was frustrating, and the results of meetings she could get just made her angry. So on October 22nd, Eve and another couple, Tony and Fran, met with seven other concerned families of mentally ill children and formed the California Association of Families of the Mentally Disabled (CAFMD). But, they were just parents. What could nine sets of parents really do?
She explained why she took this dramatic step to the World Congress on Psychiatry that same year. Eve said, “We failed to understand why parents of a child with Leukemia were treated with sympathy and understanding, while parents of a child with schizophrenia were treated with scorn and condemnation.”
I'm old enough to remember the bad old days of parent blaming, which I mainly get a whiff of through the comments of people my own age whose siblings had a diagnosed mental illness (usually schizophrenia.) They tell me that how badly hurt their parents were by the attitude of the psychiatrists that they were at fault. I have no doubts that this is true and awful to experience. Psychiatry could have done a better job of it though, by skillfully and diplomatically promoting family based therapies.
Instead, at the behest of parent organizations like the one started by Eve that eventually became NAMI, psychiatry became pharmaceuticalized. By not taking a stronger stance, based on educating parents about what makes families tick, psychiatry deprived parents of meaningful ways of helping their children. The point of organizations like NAMI, as demonstrated by this quote, was to force psychiatry to retract its thinking that the family environment was largely responsible for major mental health issues. It was a tragedy in the making, because can we really say that there is less mental illness now than there was then, and that more people are leading productive lives? Robert Whitaker's book, Anatomy of an Epidemic, says "no."
What seemed like a justifiable course of action that the CABF article above relates (stop making parents feel bad about their child's mental illness), warped into what we have today, where psychiatrists routinely tell people that they have a brain disease, not a malfunctioning environment. Most psychiatrists will no longer even tolerate a parent pleading with them to help them in some other way beyond the drugs. If you don't already believe this, please read the latest Daniel Carlat interview here. NAMI and CABF have received the bulk of their funding from pharma. The belief that it is just plain wrong to link family trauma to mental health outcomes is seen in the number of people who accept that they have a brain disease. This belief is expressed by the CABF blogger who clearly wants parents to continue to fight the good fight.
I pulled a couple of comments in response to the CABF blog post which illustrates how far the pendulum has swung the other way. The first comment makes me laugh, because, thanks in large part to CABF, pharma and psychiatry's efforts, she wonders if her kid's problem is a circuit burn-out issue (almost like the kid needs to go back to the repair shop.) Poster number 2, if I read this correctly, is taking two drugs and has a nine year old DS (diagnosed son?), who is on a cocktail of drugs.
Comment 1
My seventeen year old son is diagnosed with bi polar disorder. He can be very energetic and try exsessively hard to be "good". on the other hand he can become very irritable, unmotivated and bullyish. Between the cycle of mania and depression he appears to "crash" he behaves as one that has been on heavy drugs and is experiencing withdrawl symptoms. He acts very sedated and calm. Is there something that is taking place in his brain that is similiar to a ciruit burn out that explains this behavior ?
Comment 2
Thank you for that blog- It gave me goosebumps. What an inspiration!
Heather (40) Cymbalta; Seroquel XR
DS (9) BP, ADD, IED (TBD?) 1800 mg Trileptal; 10 mg Abilify; therapeutic level of Keppra; Clonidine for sleep, trying Home School in the fall; DH (39); DD (7); DS (3); Dog
CABF and NAMI are professional organizations that lobby for the brain disease model of mental illness because they won't accept the blindingly obvious, that parents do play a role in their children's mental health problems. Organizations like these have made getting good help for my son more difficult than it need be, because psychiatrists block their ears and will not listen to you if you aren't talking drugs and diseased brains with them. They have been bullied into this position by lobby groups.
Posts
"Psychiatry could have done a better job of it though, by skillfully and diplomatically promoting family based therapies."
ReplyDeleteYes, exactly. Like they try to do it in Western Lapland with some more success than the "blaming" had, back in the old days. A "blaming" that surely often took the shape of open, hostile accusations, which isn't very productive, if what you want is acceptance and, hopefully, change.
The problem, I think, is that human beings, mh professionals included, have this unconscious need to scapegoat (=project their own shadow, to use a Jungian term, into others) that expresses itself today in about the same way as it did during the era of eugenics, defining people whose behavior doesn't fit the norm as genetically defective, while it during the 1960ies and 70ies, at least in part, found its expression in a wide-spread oversimplification of, among others', Laing's observations and theories that then seemingly justified the pointing fingers at "bad parents", or "the schizophrenogenic mother", demonizing them as being plain evil, while all they were (and are), most of them, is unconscious, and thus no more evil than the professionals who pointed fingers at them. Just as those who today are defined as being genetically defective are no more genetically defective than those who define them.
Professionals acted out their unconscious trauma demonizing, scapegoating parents, which couldn't do anything but make parents feel not - empowering, and ultimately liberating - responsibility but guilt, and consequently a strong urge to defend themselves and pass the buck to those who are at the bottom of the pecking order without any chance to defend themselves: the identified "mentally ill" family member.
Psychiatrists are the victims of NAMI-parents, yes, but they're also perpetrators themselves in as far as they're unconscious of their own "issues" - and most of them are, and, IMO, indeed chose their profession just because it offers an unequalled opportunity to, unrestrained, act out trauma without having to face legal consequences (they even get paid for it). If they weren't that unconscious of their own "issues" or trauma, they wouldn't let themselves be this easily, even happily, manipulated by NAMI-parents and the pharmaceutical industry, and they wouldn't have fallen into the trap of scapegoating parents, in the past. Consciousness, self-awareness, has no need to scapegoat.
Psychiatry, IMO, is institutionalized scapegoating, or bullying, demonizing, as it turns into an evil, an illness, what could be seen as a gift: "In reality, our greatest blessings come to us by way of madness, which indeed is a divine gift." -Plato, Phaedrus. You don't need to go to med school to be able to figure the blessing in the madness. But you need to go to med school to be able to turn the blessing into a curse, a plague: "mental illness".
So, psychiatry could have done a better job, like they do it in Western Lapland, sure. But I think, in order to really put an end to the scapegoating it needs something else than skillfulness and diplomacy. It needs a degree of consciousness and self-awareness that would make the scapegoating - and psychiatry with it - unnecessary.
BTW: I wonder about the dog in comment #2. I'd expect the dog of such label-loving people to have, at least, one label too. Maybe these people haven't heard of "ADHDD" yet? :D
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ReplyDeleteThe dog had me wondering, too.
ReplyDelete