Sunday, December 30, 2012

I Was Adam Lanza - from The Daily Beast


I Was Adam Lanza 

from part I of III


Recently, the Huffington Post published an article titled "I am Adam Lanza's mother" by a woman named Liza Long. The article presents a picture of a 13-year-old boy who threatened his mother, sometimes going so far as to pull a knife on her, scream obscenities at her, and leap out of cars as they're driving down the highway.
The rest of the world has reacted to the idea of such a child with horror and incomprehension. I sympathize with the horror. I can only wish that I shared the incomprehension. I understand, intimately, how Liza Long’s son feels. I was like him.

Like the author of that piece, Liza Long, my mother had no idea what to do about my sudden transformation (in my case, around 16) into a borderline homicidal maniac. Like her son, I used knives to try and make my threats of violence seem more real. Like her son, I would leap out of our car in the middle of the road just to get away from my mother, over the most trivial of offenses. Like her son, I screamed obscenities at my mother shortly after moments of relative peace. And worse than this poor woman's son, whose mindset toward his peers we can only guess, I will admit that I fantasized multiple times about taking ordnance to my classmates.

By the logic which leads Liza Long to say, "I am Adam Lanza's mother,” I have to say: “I was Adam Lanza.”
.............
from part II of III
When your brain works more efficiently than everyone else's, that means it performs most mental tasks more efficiently than other people, including go crazy. Worse, because a smart person's brain is so good at running through hypotheses and rejecting them, it tends to come up with insanity that's more resistant to basic therapy, because the rationalizations are built to withstand the assault of a genius level intellect. When people say genius and insanity are close cousins, this is what they're talking about.

And when you're isolated from other people, your own mind - and its crazy ideas - becomes the only company you have.

...........
Moreover, this kind of solitary confinement inside your won head breeds paranoia and lack of empathy, even where none existed before, because when you only live inside your own head, after a while, you fail to notice that anyone else is really human. They become means to an end, an end like getting media attention for your suffering by shooting them.
Can the tendency by society to isolate and shun people like me until they go mad be countered? I don't know, but I hope that by putting its existence to print, someone might take a step to mitigate it. Sappy as it sounds, the day I stopped being dangerous was the day I learned what it was to really have friends, and by extension, to care about others, even if only (so far) a limited number of others. Society doesn't create these disorders, but it can amplify them, and by extension, it can diminish them.
I don't think you can avoid this copy cat effect entirely, but someone needs to call out the hypocrisy of a media that performs public autopsies on shooters' psyches for the sake of hand wringing, and yet still covers these kinds of people like they're dangerous animals instead of deeply damaged human beings. Everyone always wonders what the shooters were thinking before they pulled the trigger. I humbly submit that if those kids sent an essay on their feelings to any media outlet before they pulled the trigger, that outlet would refuse to print them for fear of accidentally frightening their readers.
If this series has conveyed anything, I hope it's that there is an Option C, for troubled young people, for the parents who love them, and for the society that otherwise thinks about the odd and the unlikeable only when it gathers to grieve for the damage they have done. I did my first part by fighting the devils in my own head. I would think that fight was even more worthwhile if I could now find a way to communicate to others how to win victories of their own.

Friday, December 21, 2012

Tomorrow shall be my dancing day

The year is fast drawing to a close, and before I leave for the holidays I want to express how grateful I am for how well my oldest son is doing. For how well each of us in our household is doing. We are still on the journey, but Chris is now spending more time steering the boat and Ian and I are quite content after all these years to be merely the passengers.

What's different about this year than last? One big observation that I have  is that Chris is losing the "flat affect." When he began singing in public in earnest a couple of years ago, he had a beautiful voice, but his facial expressions and physical mannerisms were stiff. Not so much now. A friend from church who observed Chris while he underwent the Tomatis Therapy, told me she noticed when he sings in the church choir that he is developing the body/mind connection. This was borne out when I saw Chris perform in the Christmas pantomime. He was much more expressive on stage than he was in last year's pantomime.

Chris has a girlfriend! She shares his love of musical theater. Hurrah! She also has a car to take him to rehearsals and back. Hurrah! Chris does not yet have a driver's license. Perhaps a goal for the New Year?

He has friends! They are all around my age or older (horrors), but they share his passion for music and throw some great parties. Chris has spent many lonely evenings after he was first hospitalized almost nine years ago.

While Chris still has further capacity to grow and learn, recovery is to be expected for each of us if we have the patience, wisdom and fortitude to stay the course.

I wish you all the best of the holiday season.

Tomorrow shall be my dancing day   An old English carol     Turn up the volume



Wednesday, December 19, 2012

Who is on the child's side?

A Reflection on Mothers, Children, and Mental Illness


By Faith Rhyn

Excerpt:

Parents will do anything to try to help. They will miss work, they will fill out forms. They will take out loans and they will even, if asked to, hold their own child down, believing that it is what must be done to help.

I don’t think parents realize the exchange they are making when they buy into ideas and treatment that, over time, have the potential to erode some very basic relational/trust bonds between child and caregiver. When I was in the midst of recognizing what had gone wrong in my story, I angrily told my mother, “You believed the professionals over me! You even trusted the professionals over yourself…and they didn’t even know what they were talking about!”

When the professionals teach mothers to see their children as ill, both mother and child are harmed in that they lose something essential to the parent-child relationship, which is the ability to see their children clearly, with compassion, love and a commitment to their brightest possible futures.

Read more of Faith Rhyn's post here


The downside of the family-organized mental illness advocacy movement

The following article is from Pat Risser's archived website  www.patrisser.com  June, 1998 also printed in Psychiatric Services. (Thanks to Maxine for sharing it at the ISEPP discussion group)

THE DOWNSIDE OF THE FAMILY-ORGANIZED MENTAL ILLNESS ADVOCACY MOVEMENT

by Sylvia Caras

Ms Caras, a disability rights advocate, is coordinator of electronic mailing lists for The Madness Group, an Internet service for users or former users of mental health services. This article was from a column printed in "Psychiatric Services", June, 1998


Groomed, mature, confident, the family advocate articulated from the podium -- carefully, with strength: "The horror of mental illness ..."

"horror"

I felt as if a laser were searing me, shattering my sense of myself as a member of a caring family.

"horror"

I heard "the horror of your illness," "horror ... you,"

"horror," "horror," "horror"

The speaker was telling me what parents felt,

"horror," "horror,"

what my children wouldn't tell me,

"horror," "horror,"

what my sister feared.

I felt an intruder. Afraid to speak, I tried to make myself outside as small as I felt inside -- shamed, vulnerable, unwanted.

I imagined shaking hands with her, that family advocate. I imagined her wanting to wipe off the touch of my horror on her skirt.

We were at the plenary assembly of a federally sponsored annual meeting reporting the results of innovative community mental health programs.

I sat with 250 invited guests at the Holiday Inn and listened as, again from the podium, another mother brandished the "tragedy of mental illness." At the word "tragedy," many in the audience sighed together in shared grief. Even though my own family was not like this, I conjectured visiting my parents, reaching out for an embrace, and watching their hopelessness as they greeted their tragedy. I felt so dishonored.

That was in the fall of 1993. Until that time, I had been facilitating a local mood and melancholy support group. I had attended local mental health system improvement meetings and even a few national conferences. I had met friends and families who were caring and supportive. But I was new to national advocacy and that was my introduction to the powerful, well-funded mental illness lobby of families whose mission is to make the family issues central, to reveal the family pain, to spare the family image. Later I learned how in 1979 families had organized to protect themselves from blame, how they had put forward a biological model of disease, and how they were now lobbying, with the pharmaceutical and medical industries, for research dollars to support the biohealth approach to managing behavior.

Now, in 1997, I've served on boards and led groups and gone to conferences. Now, I have seen the families' relief at finding exoneration become an ambition to medicate social disarray. I've felt their shunning since I started publicly to reformulate what I thought about my own 1987 experiences with the mental health system.

The family advocacy I watch seems to focus on the family's misery, the family's despair, the family's efforts and frustrations, the family's engrossment with itself. Despite a convincing collection of serious diagnoses, hospitalizations, and treatments, we who get on with our lives and offer ourselves as examples of recovery are dismissed as not really ill, exceptions, misdiagnosed. Our experience is not valued.

Instead, the idea of the loved one that is held on to is of one terribly, terribly sick -- without hope. To me, this is an example of self-absorbed collateral family members intent on stilling the patient's voice: the primary voice. By suppressing this voice with, if needed, handcuffs, restraints, sedation, seclusion, family advocacy has a chilling effect on the civil rights of individual loved ones. These violent interventions make me wonder what this loved voice might reveal if it were allowed to speak?

But the voice is co-opted by family advocates who don't consider the impact of their patronage on the loved ones, discounting the loved ones as unaware of what they, these loved ones, themselves need. Who is well served by this reproduction of stigmatizing, patronizing sympathy, these repeated images of disturbance? I know I am wounded by the advocates' language.

What I want from those who love me is not sympathy. I want my family members to welcome me, as me, just for being me. And I want to hear the language of respect.

Words express and interpret; words include and exclude; words matter. Verbal categories mold thinking; verbal categories can contribute to integration or to discrimination. Family advocates shape and use words and ideas in ways that seem to me to change the meanings so much that for the sake of clarity, different words should be used.

Family advocates regularly breach privacy by telling their children's stories. These stories are not family property. They belong to the primary patient, not to the family. But family advocates tell of their loved one's labels and behaviors.

So urgent are the wishes of active family advocates for personal relief that they use their children's voices, disallow independence, and sensationalize their children's anti-social activities. I have never heard family advocates assert that they have informed consent to tell these stories. I have rarely seen parents beside their own child, testifying together in advocacy for the same goals.

Not all families are so authoritarian. But authoritarian families curtail growth with coercive interventions and a flourishing fundamentalism, using fear and polarities, displaying no tolerance for ambiguity, no flexibility, accentuating the unnegotiable authority of the medical and psychiatric professions. In any social setting, rules must be learned; then rules must be tested and questioned and retested to be sure they are still applicable; that is the way of maturing. Some families understand the many parts and obligations of parenting. Some family members seem to be grieving for who they remember their loved ones were at some earlier time, while objecting to who those loved ones actually are now. Perhaps the hardest, arguably the most important part of parenting, is to trust the child enough to let go. Even children with disabilities deserve the chance to be let go.

Moving counter to social trends of diversity, globalization and openness, the family advocacy movement fragments, segregates, isolates, imposes secrecy, shames. I believe today's mental health approaches will be remembered along with the Salem witchcraft trials as a dishonorable scapegoating of transformative experiences.

As a person with a disability, what I want is acceptance. When you speak of my life as a tragedy, you are robbing me of my dignity. I want you to see my potential, and to stop sensationalizing the family despair. I don't want to uplift you with my pain. If you can't love me as me, or accept me, or respect me, at least create a life for yourself separate from me. Today's family organized advocacy stigmatizes your loved one, me, you, all of us.

Instead of seeing disease, listen.

Instead of discussing medication and non-compliance as an inability to understand one's condition, listen to your loved one's objections.

Instead of thinking how you gain, think of what, with medication, your loved one loses.

Instead of forcing your loved one into unwanted treatment, attend to what is wrong with services, attend to why services are refused; listen to the experiences.

Put the well-being of your loved ones above your wish to fence them off.

Truly listen, for just a moment.

Find the worth -- the flair, the ingenuity, the ability.

See that worth, not disease.

Hear hope, not horror.

Listen.




Reprinted by permission of the author.

__._,_.___

Monday, December 17, 2012

Can antistigma campaigns be improved?

Can Antistigma Campaigns Be Improved? A Test of the Impact of Biogenetic Vs Psychosocial Causal Explanations on Implicit and Explicit Attitudes to Schizophrenia


Tania M. Lincoln1,2, Elisabeth Arens2, Cornelia Berger2 and Winfried Rief2

from The Schizophrenia Bulletin

In the hope to reduce stigma, campaigns have been emphasizing biogenetic (BG) explanations of schizophrenia and have been promoting the concept of “schizophrenia is an illness like others.”1517 For example, the “changing minds” program by the Royal College of Psychiatrists18 lists “changes in the structure of their brains,” “infections before they were born,” “disorder appears to run in families,” and “chemical messengers in the brain … are not working correctly” before mentioning any psychosocial (PS) cause. The National Alliance on Mental Illness19 lists no explicit PS causes of schizophrenia but states that “the brains of people with schizophrenia are different from the brains of people without the illness,” “schizophrenia seems to be caused by a combination of problems including genetic vulnerability and environmental factors that occur during a person's development,” and recent research has “identified certain genes that appear to increase risk for schizophrenia.” Similarly, the World Psychiatric Association antistigma initiative “Open the Doors”20 states that “a predisposition is inherited” but that an “environmental trigger,” such as “complications during the mother's pregnancy or labor,” “prenatal exposure to virus,” or “complications during pregnancy and delivery,” must also be present to bring on the “disease.”

There is reason to assume that antistigma programs might be improved by promoting a diathesis-stress model of schizophrenia.21,22 The diathesis-stress model, which is widely accepted in the scientific field, acknowledges genetic and early biologic developmental risks along with environmental stressors, such as life events, daily stressors, family communication, and trauma as relevant risk factors.2329 Its potential usefulness as a means of reducing stigma seems to be supported not only by the theoretical reflections about the possible effects that varying information is going to have on illness attributions and stigma but also by an array of empirical findings. On the one hand, it seems reasonable to assume that if the causes of mental health problems are attributed to factors outside the control of individuals (eg, biological factors), people's reactions will be less negative and patients and families will experience less blame.3032 So far, however, this assumption has only been supported in one experimental study carried out with male students by Mehta and Farina,33 who found a disease view to be associated with less blame. On the other hand, it has been argued that BG explanations might cause the disorder to be viewed as more fundamental and immutable,33,34 exacerbate the “stickiness” of the mental illness label, and strengthen links to other undesirable characteristics.31 In support of this, a large number of studies have found biological explanations to be associated with higher levels of stigma and social distance, while this has not been shown for PS explanations.7,15,35,36 For example, in representative population surveys carried out in Germany, Russia, and Mongolia, it was found that the more respondents endorsed a brain disease as a cause, the more dangerous they believed a person with schizophrenia to be and the more desire they showed for social distance.7,37 The analysis of data from 601 adult respondents to a US telephone survey revealed genetic attributions to be associated with decreased optimism that a mental health professional could help with the problem.38,39 In their experiment, Mehta and Farina33 found that students who were provided with a disease view were prepared to apply more electric shocks toward fellow students whom they believed to have a history of mental disorder than students provided with a PS view.33 Finally, in a trend analysis of data from 2498 participants in Germany, Angermeyer and Matschinger40 found that as biological causes are being more widely acknowledged by the public, the desire for social distance toward people with schizophrenia has increased.

Read more of this study here.

Friday, December 14, 2012

Brain scans, plant power, and the immune system

Those of you who follow my blog will know that I often italicize the word "schizophrenia" because I find it a catch-all term used by the medical profession for a condition they know little about. Many people attribute their schizophrenia to early childhood trauma, others claim that their schizophrenia cleared up after an undetected medical condition was discovered and treated, and some claim that the medication they were on triggered psychosis. I have a foot in all camps for a very simple reason. If the medical profession doesn't know what causes schizophrenia in individuals, then, in order to help my son, I should try to find a likely explanation for what caused his condition, and then learn how to heal it. In practical terms, this means that Chris and I try many kinds of healing modalities. These methods aren't offered by your general practitioner or psychiatrist.

Chris and I have been on two recent adventures that I haven't written much about. The first adventure began last June when Chris and I underwent scalar energy work. You can read about our experiences here, so I won't go into the details now of what the therapy involved. The shaman, or "scalar energy guy," as I like to call him, was puzzled by the results of the work he did on Chris. He felt he had cleared Chris of all his early traumas, but a blockage continued to show up when Chris performed the color exercise. So, he took a new photoimaging of Chris's brain. What he found were two dark masses. The first covering the entire pre-frontal cortex and the second in the temporal lobe area behind his ear. I then wrote to the hospital that did Chris's original MRI when he was first hospitalized almost nine years ago. The MRI had revealed nothing abnormal. I then sent the original MRI with the superimposed photoimaging of Chris's brain to the neurologist husband of a friend of mine. The neurologist found nothing abnormal about the areas the scalar energy guy was concerned about. While the neurologist's findings were a huge relief to me at least, the scalar energy guy feels that there is something going on that remains undetected. "Welcome to schizophrenia!" is all I can say. Short of drilling into Chris's brain, the mystery remains for now.

Today Chris came along with me for his first visit with the "plant power guy," who has been treating me for several months with energy captured from plants, not plant extracts. There's a difference. It's power, not actual plant extracts like you would find in homeopathy. Apart from that, I can't explain what this guy does, and one reason is that the two-way conversation is in French. I'm just not that good in French to probe into this latest subject. The scalar energy guy knows the plant power guy, and was curious to find out what he would see in Chris.

Keep in mind that the plant power guy, who is actually trained as a medical doctor, does not want to know the patient's medical complaint or past diagnoses. All he wants to see is a recent blood test, and all he wants to know is if the patient has ever had an operation or suffered a broken bone. So, knowing nothing about Chris's schizophrenia diagnosis, he would not be able to leap to conclusions based on the diagnosis.

The plant power guy, after running his tests, told Chris that he has an almost non-existent immune system. That's pretty dramatic, I'd say. It's weird, too, because if that were the case, I would have thought that Chris would have a history of colds and various other immune-related illnesses, which he doesn't.

Unless, of course, schizophrenia, Chris's particular "illness," is a manifestation of a disorder of the immune system.

I  pulled an abstract (1999) from off the Net, which, as usual, makes me wonder if the authors were funded by pharma. I've underlined the juicy bits below. The authors claim that antipyschotic medication activates the specific immune system and increases antibody production. This may very well be true, except that Chris is on an antipsychotic and yet his immune system continues to set off alarm bells. My conclusion is that whatever the antipsychotic may be doing for Chris, it isn't working on his immune system, and I certainly don't want him on higher doses of an antipsychotic to bring his immune system up to par. What remains to be see is what plant power will do for Chris over the course of the next year.

1. Eur Arch Psychiatry Clin Neurosci. 1999;249 Suppl 4:62-8.

The role of immune function in schizophrenia: an overview.

Müller N, Riedel M, Ackenheil M, Schwarz MJ.
Psychiatrische Klinik, Ludwig-Maximilians-Universität, München.
nmueller@psy.med.uni-muenchen.de

Immune alterations in schizophrenia have been described for decades. However, modern immunological methods and new insights into the highly developed and functionally differentiated immune system allows an integrative view of both, the older and also recent findings of immunological abnormalities in schizophrenia. Both, the unspecific and the specific arm of the immune system seem to be involved in the dysfunction of the immune system in schizophrenia. The unspecific "innate" immune system shows signs of an overactivation in unmedicated schizophrenic patients, as increased monocytes and gamma delta-cells point to.

Increased levels of Interleukin-6 (IL-6) and the activation of the IL-6 system in schizophrenia might also be the result of the activation of monocytes/macrophages. On the contrary, several parameters of the specific cellular immune system are blunted, e.g. the decreased T-helper-1 (TH-1) related
immune parameters in schizophrenic patients both, in vitro and in vivo. It seems that a TH-1-TH-2 imbalance with a shift to the TH-2 system is associated with schizophrenia. During antipsychotic therapy with neuroleptics, the specific TH-1 related immune answer becomes activated, but also the B-cell system and the antibody production increases.

PMID: 10654111 [PubMed - indexed for MEDLINE]

Monday, December 10, 2012

Making the most of the journey

Matt Samet writes in The Other Side at the Mad in America site, about benzo withdrawal and the spiritual lessons he learned. Many aspects of his journey are also applicable to recovery from schizophrenia - to take the longer term view, and learn to make the most of the downtime. I'll expand on his point below to include parents and family members. As a parent, I wanted Chris to be fully recovered as quickly as possible, and there were long periods then and there still are, when focusing on short, medium, or long term goals, is very discouraging and self-defeating.

How did you do it — how did you get better? (And I am better, almost completely so!) And of course, “Will I get better too?”

The easiest answer and the first one I turn to is also the simplest: time. I did my research, realized it would likely take months and years — not weeks — for my brain and nervous system to normalize to something resembling a baseline state, and I made my peace as best I could with a time span then ultimately unknowable, even as I craved nothing more than its end. Even as I prayed for a fast-forward button on my very life so that I might wake up some magical, sun-soaked morning no longer paralyzed by a swarm of profound and horrific symptoms.

But time is only half the equation, because the true crux is what you do with that time. There is no fast-forward button on life, and I don’t believe there should be. Why treat your stint on Earth, even the darkest hours, like slogging through an eight-hour shift at some crappy, low-paying job?

Read more here

Friday, December 7, 2012

Two ways of looking at it

From today's New York Times

His physical injuries healed, but his mental illness persists. More than anything, Mr. Salomon does not want to be sick, so much so that he does his best to ignore the voices he says he still hears, denying them to most people who ask. He feels comfortable talking about his illness in group therapy, but does not like discussing it elsewhere. “I don’t know how to explain it to anyone,” he said.

It scares him that he will have to take medication for the rest of his life, both for schizophrenia and for diabetes. He also has a learning disability, which prevented him from advancing in school past the sixth grade. He excels at math, he says, but has trouble with reading and writing.

It is discouraging that Mr.Salomon tries to ignore his voices - I wonder if he or those around him are aware of the Hearing Voices Network and its way helping people to appreciate voices as messengers of themselves. It bothers me that the the reporter unquestioningly writes that he will have to take medication for the rest of his life. It bothers me that the story does not enlighten readers by connecting the outcome of diabetes to the medication. I wish that these stories weren't so focused on the supposed sadness of "schizophrenia" and instead conveyed a more positive message.

Entre Il et Ailes

Last Sunday during lunch, I found myself having a lively discussion with two transgendered individuals (male to female). The lunch followed a screening of a documentary film entitled Entre Il et Ailes (crudely translated: Between He and Wings.) Christa, seated opposite me, and I are at best casual acquaintances. Chloe came along as a guest of another member. Christa and I are both members of a group that meets quarterly to discuss the many aspects of consciousness, so we have occasionally crossed paths. While munching our vegetarian fare, Chloe, Christa and I, shared observations on the tediousness of applying daily make-up. "I thought it would be fun," said Chloe, while Christa nodded in agreement, "but after six months went by, it was a chore." I hear you, Chloe.

Entre Il et Ailes is the story of Christa's sex change operation and her journey before and after.

The film is delightful, not at all sad, and actually very funny. This was a deliberate choice by director, Laurence Périgaud, who was on-hand at the screening. Périgaud said that all the films she had seen on transgendered individuals took on a sad air and that's not the tone she wanted to convey. Incidentally, that's exactly the intention with my schizophrenia blog - to show the upside, the hopeful side, the funny side, and always the human side of what others stereotype as "way beyond the norm."

I am not in Kansas anymore ( and neither are you!), to paraphrase Dorothy in The Wizard of Oz. If you are a parent of someone with a schizophrenia or related diagnosis, our perspective of "normal" took a huge hit when our relative veered from the norm. Oz is a most interesting world.

Entre Il et Ailes
Devenir femme à 60 ans
un film de Laurence Pérgaud
English subtitles












Wednesday, December 5, 2012

Accepting and indulging differences

"It was time to do some work of our own. If Tyler felt alienated and alone, it was because we had failed to acknowledge—and accept—his difference. I was so focused on the conceit that my son would be like Kevin Costner’s character in Field of Dreams that I failed to see the son I was lucky enough to have. It was time to get to know Tyler."

This story* from the National Journal reminds me in a different way of Rupert Isaacson's journey with his autistic son, which he recounted in the memoir The Horse Boy. Isaacson tells an unusual story of riding horses in Mongolia and visiting Siberian shamans in a search of healing. He had early on noticed that his son had an affinity with horses and shamans so decided to immerse himself in what his son was interested in to see if this had a curative effect. Isaacson makes the point that if your son or daughter is interested only in trains and numbers, then indulge their love for trains and numbers by joining them in their pursuits.  Further reading: interesting interview with Isaacson

*PERSONAL ESSAY


How Two Presidents Helped Me Deal With Love, Guilt, and Fatherhood
Guidance from Bill Clinton and George W. Bush taught the author how to accept and understand his son’s Asperger’s syndrome.

By Ron Fournier

Updated: December 4, 2012
10:35 a.m.

November 29, 2012
9:00 p.m.

Tuesday, December 4, 2012

A well aimed letter to the editor

I tried to ask permission of blogger extraordinaire ALT_mentalities to reprint her letter on my site, but for some reason it seems I can no longer comment on her site unless I join Wordpress. I am having the same problem with other Wordpress blogs. So, figuring it's easier to ask ALT's forgiveness than to seek her permission as the saying goes, I have swiped her broadside and pasted it into my post. 

FROM: ALT


TO: Cristina Traina and Laurie Zoloth

CC: Editors, Northwestern Daily and Huffington Post College

SUBJECT: Response to your article: “Culture stigmatizing mental illness must change”

Dear Professors,

In your recent Huffington Post article (Culture stigmatizing mental illness must change), you wrote that “depression is really a chemical imbalance in the brain.” I understand this was not an academic publication – but could you provide a citation to back this up?

Try.

You’ll find it impossible to do so; because this mantra, this advertising slogan is about as scientific as the statement that “the best part of waking up is Folgers in your cup!” The best? Really?

Meanwhile, let me provide with you with a few citations of my own:

[Antidepressant] advertising campaigns have revolved around the claim that SSRIs correct a chemical imbalance caused by a lack of serotonin… Contemporary neuroscience research has failed to confirm any serotonergic lesion in any mental disorder, and has in fact provided significant counterevidence to the explanation of a simple neurotransmitter deficiency… In fact, there is no scientifically established ideal “chemical balance” of serotonin, let alone an identifiable pathological imbalance.
 from Lacasse, J.R. & J. Leo (2005) Serotonin and Depression: A disconnect between the Advertisements and the Scientific Literature.

A serotonin deficiency for depression has not been found.
- Psychiatrist Joseph Glenmullen, clinical instructor of psychiatry at Harvard Medical School, in Prozac Backlash (2000)

Although it is often stated with great confidence that depressed people have a serotonin or norepinephrine deficiency, the evidence actually contradicts these claims.
- Professor Emeritus of Neuroscience Elliot Valenstein, in Blaming the Brain (1998), which reviews the evidence for the serotonin hypothesis.

But I am not writing merely to correct a factual error in your post – there’s more.

Read more.
Depression is really a chemical imbalance of the brain” – just one more branch on the eugenics tree 12/03/2012




Wednesday, November 28, 2012

Psychotherapy is so old-school

excerpts from a hilarious, thought-provoking article in The New York Times Magazine.
By LORI GOTTLIEB

Published: November 23, 2012 493 Comments


“Nobody wants to buy therapy anymore,” Truffo told me. “They want to buy a solution to a problem.”

----

One day right before Christmas, I got a call from a man in his early 30s about coming in for therapy. He explained that he wanted to figure out whether to marry his girlfriend, and he hoped we could “resolve this” quickly because Valentine’s Day was coming up and he knew he either had to produce a ring or she’d bail. I explained that I could help him with clarity but couldn’t guarantee his timeline. The day before our appointment, he called again and told me he found a relationship coach to help sort things out. She gave him a four-session-package guarantee.


---
I remembered something that Casey Truffo told me. A few years ago, she was at a business-networking event and wrote “psychotherapist” on her name tag; nobody wanted to talk to her. At the next event, she wrote the words “happiness locator” and got several referrals. In the past, going to a life coach might have seemed tantamount to a snake-oil cure, but now psychotherapists were branding themselves to play down what they do and what credentials they hold. I added up the money spent on grad school, the years it would take to pay off the loans, the time spent on training, the commitment to helping people that brings most of us into the field in the first place, and I knew I wasn’t willing to leave. My only choice now was how far I would go in order to stay.




Tuesday, November 27, 2012

Undue faith in evidence based treatment may lead to commitment orders

In a recent edition of  Huffpo, Marvin Ross takes on the recovery movement, in his blog post entitled For Some with Mental Illness, There is No Recovery.

Mental health advocate Lembi Buchanan of Victoria, B.C. released a new report called Emergence of the Recovery Movement: Are medications taking a back seat to recovery? She points out that the popular recovery model threatens to take centre stage at the expense of the urgent needs of the people diagnosed with severe and persistent mental illnesses such as schizophrenia and bipolar disorder. What sounds like a logical approach to the treatment of mental illness, recovery, is actually regressive because it does not focus on the evidence-based neuroscience of these brain disorders.

Read more here

Mr. Ross's complaint about the recovery movement, is that "They reject the emphasis of the biomedical model of mental illness. Instead, they believe the patient is the expert on treatment rather than the doctor and that there is no need for clinical evaluation or evidence-based treatment. This model does not accommodate the needs of individuals with severe mental illness (3 per cent of the population) who may lack insight into their illness and are unable to make appropriate treatment choices."

Dr. Mark Ragins, Medical Director, MHALA Village, stepped up to the plate with a detailed critique of Marvin Ross's post.
Your argument is irrational: Because some people don't recover, the recovery movement should be stopped.

No approach to anything requires a 100% success to be implemented. At best pills help about 70-80% of the time and we don't urge stopping them because some people don't respond to them. Not everyone learns in school, some people can't read and some people can't see or hear TV. That doesn't mean schools, books, and TV shouldn't be widespread.

There are some people for whom the recovery model seems a bad idea - people who are repetitively seriously dangerous, predatory people, people with severe brain damage or mental incapacity, and people incapable of any human relationships. This is a very different group and a much smaller group than the group this article discusses - people who don't believe they have a biochemical illness, "lacking insight," and people who won't do what other people want them to do, "noncompliant". Those two sets of people are failures of our existing medical system, not the recovery model. I spend my life focusing on working with precisely those people (low insight and compliance) in a recovery program and we have very high success rates including reductions of over 70% in homelessness, jailings, and hospitalizations, increases in independent hosing, family reunification, and working along with very low dropout rates. Those people (low insight and compliance) are the main group of people who will benefit from more recovery based programs, not a reason not to use recovery.

Misleading assertion 1: The recovery movement neglects people with severe mental illnesses. The core focus of the recovery movement is people with severe mental illnesses. It is people who have suffered the most loss and suffering in their lives who most need a person centered approach instead of an illness centered approach. For them mental illness is not just a medical condition needing medical care, it is a profoundly destructive experience needing recovery. Recovery is for people who don't respond to just treatment alone, not for people who respond very well to treatment first. The vast majority of the recovery based strategies are specifically directed towards people with severe mental illnesses including - outreach and engagement, trauma sensitive inpatient treatment, housing first, harm reduction, motivational interviewing, integrated substance abuse treatment, supported housing, employment, and education, skills training and psychosocial rehabilitation, clubhouses, self help and consumer staff, building protective factors and resiliency, and strengthening families.

Misleading assertion 3: Recovery is anti-medication. Many people use medications as part of their recoveries, but they have a choice just like people with physical illnesses. If you have high blood pressure you may want to use pills, at least for awhile, and/or you may want to exercise or diet, or you may want to live with your condition and its risk of stroke and heart attacks because of side effects, or even just because you don't like doctors. In contrast, anyone who doesn’t agree to take psychiatric meds "they "need for the rest of their lives" is labeled as "noncompliant" and shunned in our current system. Recovery favors a collaborative, goal driven, client driven approach to "using" medications, instead of a professionally driven, compliance based, symptom reduction based approach to "taking" medications. Many people who don't agree they have a mental illness and don't like following orders, can find their way to using medications to improve their lives if they have a psychiatrist willing to collaborate with them. In many cases it is the system that needs to be committed to helping the person more than the person needs to be committed to working with the system. Recovery is an improvement in accessibility and customer service. Dropouts go way down.

Misleading assertion 4: Recovery eliminates involuntary treatment. Most people in the recovery movement believe that involuntary treatment is occasionally absolutely necessary. However, most people presently treated involuntarily today, could and should be more humanely and effectively treated in voluntary, trauma informed, welcoming, accepting crisis programs that include consumer staff. It only looks like we have too few involuntary treatment resources because we have almost no recovery based voluntary treatment resources. None of the horror stories of desperate people being turned away by hospitals included those people being offered anything else as a meaningful alternative. Involuntary treatment, even when it is effective and necessary, is a violation of human rights, usually highly traumatizing, and destructive of relationships with the mental health system overall. So we shouldn't use it for social disruption, poverty and homelessness, avoiding responsibility, or frustration by staff and family that someone is not doing what they're told to do. There should be highly restrictive usage. Also having coercive power over someone else is corrupting and damaging to the staff, family, and society that uses it. Locked hospitals have a way of becoming dehumanized, burned out, hopeless places for everyone involved. Recovery programs have higher staff morale and hopefulness.

Irrational conclusion: Because we can find a heartwarming story of someone's recovery that included involuntary treatment and medications, the present system is working and should be defended against the threat of the recovery movement.

Our present system is not "all bad" nor are the people working in it evil and unhelpful. Sometimes recovery does result from our current efforts. Everything we're doing doesn't need to be changed. (Sometimes recovery results from placebo too.) That doesn't mean we should stop trying to improve things. We all deserve a better approach and system to work with. The recovery movement has developed better approaches and continues to learn and implement new strategies.

The recovery movement is actively fighting for positive reforms. Please join us.

Mark Ragins, MD
Medical Director, MHALA Village
www.mhavillage.org

novabird Lover of Life, Radical Centrist comments:  My daughter literally lost everything as untreated schizophrenia ravaged her mind over a period of years. She ended up sleeping on the streets because she was in psychosis and all of the women's shelters kicked her out because her behavior was so out of control. She was in full blown psychosis for many months, a fact that was well known to the police department as she kept breaking the law. The police took her to the emergency room many times and the hospital repeatedly refused to admit her or treat her due to the fact that she has extreme lack of insight.

I went to a judge and got a court order and she finally got admitted and put on the anti-psychotic drugs she so very desperately needed. And she has continued to stabilize since that time.

You say that involuntary treatment is a "violation of human rights, usually highly traumatizing, and destructive of relationships with the mental health system overall". And yet evidence based science tells us that the earlier the person can be treated with anti-psychotics, the better their chances for recovery.

Are you OK with the massive and permanent losses my daughter suffered due to the fact that she has extreme lack of insight and the local hospital saw fit to not provide the involuntary medical treatment she so very desperately needed? That is not a rhetorical question by the way. I would sincerely like an answer.

MarkRagins replies: 1) Was your daughter offered any meaningful assistance in the community that accepted her as she was, psychotic, and tried to form a relationship with her and help her with her goals, even if they were irrational - for example, housing first, voluntary crisis housing, peer outreach and support, quality of life community policing, drop-in-serivces, charity, benifits assistance? If not, I'm not "OK" with that.

2) After all of that and more is tried and failed and if there is acute danger (and I assume there was since the judge granted your order), I'm "OK" with involuntary treatment even with it's massive downsides, if it's trauma sensitive and used to engage in voluntary recovery-based services before discharge,

3) What family services and supports were you offered to you?

BTW It's hard to distinguish between correlation and cause in early intervention studies. Many people who take a long time to engage in treatment have significant risk factors that impact their outcomes in additon to not taking meds. Many places are now using intensive psychosoical interventions with first break psychosis instead of jumping straight to meds to build relationships and coping skills and avoid antagonizing people. Also it's unclear whether meds themselves may have long term negative effects.

I hope, in addition to stabilizing, your daughter is now recovering.

Mark Ragins






Thursday, November 22, 2012

The evolving nature of the recovery/liberation movement

Seth Farber has written a brilliant Op-Ed post today at the Mad in America site. Szasz and Beyond: The spiritual promise of the Mad Pride Movement 

It's a very long read, but well-worth the time for anyone interested in the history and theories of madness and its movements, and the great names  i.e. Thomas Szasz, R.D. Laing who have contributed, often by the force of their own personalities, to shaping our beliefs about sanity . According to Farber, we are in the second phase of the movement, the phase where the movement no longer cares to strive towards socially sanctioned "normal."

The Politics of Experience was in effect the first Mad Pride manifesto of the 20th century. But it was 35 years ahead of its time. There was no mad pride movement then that invited Laing to become the theoretician of a mad revolution. The mental patients liberation movement that emerged in the 1970s was focused on gaining equal rights and on ending coercive treatment. Laing did not take much interest in this. What was the point of integrating schizophrenics into an insane and self-destructive society? As Laing became a new age speaker, pioneer of innovative therapy and advocate of the individual mad person, Szasz accepted graciously the role of the theoretician of mental patients’ liberation, a movement that demanded equal rights for the psychiatrically labeled—and reform of the mental health system– but did not seek to otherwise change society. Szasz’s libertarian capitalism was tolerated grudgingly by patients’ who tended to be left-wing and who often remained, at least temporarily, dependent on the government’s financial help of which Szasz disapproved. Although many patients had been influenced by Laing, his ideas were not incorporated into the movement. Why? In this initial phase of the movement the emphasis was on the similarity between so-called schizophrenics and normal people. Laing’s emphasis on their distinctive albeit admirable traits was only an obstacle to the movement. Former patients wanted to demonstrate that they were as rational as “normal” people. (This was similar to the black and gay movements for equal rights which in their initial phases tried to be as conventional as possible.) One of the former leaders of the patients’ liberation movement whose story was recounted in my first book became enraged with me when I told him I was writing a book about Mad pride. “If you call us mad they will view us as irrational” he protested. But by then the younger generation was ready for mad pride, and tired of trying to seem normal.




Wednesday, November 21, 2012

The social consequences of "insight" and rumination

I've made lots of mistakes along the way with Chris, and one of them, in the early stages, at least, of his "officially diagnosed illness," was getting caught up in negative thinking patterns. I attribute this to the dismal diagnosis, being counseled by mainstream to see the "illness" in medical terms, and interaction with dismal doctors. All of these factors influenced me to dwell negatively on Chris's future. The purely medicalized view of this "illness" has huge impact on the patient and how s/he is treated by family members.  If I was influenced to adopt negative thought patterns, consider what happened to Chris. People do much better where families behave as if they are not particularly concerned/worried about them. It's a skill one can learn. Also, think about the message given out by families who are convinced that their relative lacks "insight" into his own condition. "If only they were as worried as I am, they would know they are mentally ill."  This is called "insight" from the point of view of the relative. The relative assumes that, armed with this "insight," the patient will learn to take better care of himself, to avoid future relapse.

This research article suggests that "insight" (believing you are mentally ill) and rumination is associated with depression and negative self-appraisal in people with chronic schizophrenia.

Abstract
Rumination, Depression, and Awareness of Illness in Schizophrenia
Neil Thomasa1 c1, Darryl Ribauxa2 and Lisa J. Phillipsa2
a1 Monash Alfred Psychiatry Research Centre and Swinburne University, Melbourne, Australia
a2 University of Melbourne, Australia

Background: Depressive symptoms are common in schizophrenia. Previous studies have observed that depressive symptoms are associated with both insight and negative appraisals of illness, suggesting that the way in which the person thinks about their illness may influence the occurrence of depressive responses. In affective disorders, one of the most well-established cognitive processes associated with depressive symptoms is rumination, a pattern of perseverative, self-focused negative thinking. Aims: This study examined whether rumination focused on mental illness was predictive of depressive symptoms during the subacute phase of schizophrenia. Method: Forty participants with a diagnosis of schizophrenia and in a stable phase of illness completed measures of rumination, depressive symptoms, awareness of illness, and positive and negative symptoms. Results: Depressive symptoms were correlated with rumination, including when controlling for positive and negative symptoms. The content of rumination frequently focused on mental illness and its causes and consequences, in particular social disability and disadvantage. Depressive symptoms were predicted by awareness of the social consequences of mental illness, an effect that was mediated by rumination. Conclusions: Results suggest that a process of perseveratively dwelling upon mental illness and its social consequences may be a factor contributing to depressive symptoms in people with chronic schizophrenia.

Keywords:

schizophrenia; psychosis; rumination; post-psychotic depression; insight

Monday, November 19, 2012

Dear Abby's advice to "Hearing Voices in Illinois"

DESPITE TWO SUICIDE ATTEMPTS, FAMILY INSISTS WOMAN IS 'FINE'
11/19/2012
DEAR ABBY: I'm a 40-year-old woman, diagnosed with schizoaffective disorder after two suicide attempts. I have tried to get my parents and siblings to attend a session with me so they would understand my diagnosis, but all I hear is, "You don't need all those drugs. You're fine -- just a little different than the rest of us," and, "You have always been 'odd' and we like you that way."
I have given up trying to get their support, but my gifted 14-year-old nephew has been asking questions about my diagnosis. I'm not sure how much to tell him, especially about the suicide attempts, one of which landed me in the hospital.
Any advice about what I should tell him and how to get family support? -- HEARING VOICES IN ILLINOIS

DEAR HEARING VOICES: Tell your nephew the truth. If he is as intellectually gifted as you say, he will go online and start researching. Explain that your condition can be overwhelming at times, which caused you at one point to try to harm yourself, but that it is kept in check with medication.
Your relatives may be reluctant to admit that there is a mental illness in the family, which is why they refuse to allow your psychiatrist to confirm it. However, you may be able to find support from NAMI, the National Alliance on Mental Illness. With 1,200 affiliates, NAMI provides grassroots, self-help groups for people with mental illness and family members who are affected by it.

The website is www.nami.org and I hope you will check it out. The organization was established in 1979, and it may be able to help you get through to your family that your problems are not imaginary.

Here's what SRK at Refusing Psychiatry without Pissing Off the Neighbours has to say about Dear Abby's advice.

Trashing Dear Abby (again)

Jeanne Phillips, 70-year-old daughter of the original Abigail Van Buren, Pauline Phillips, has always told almost everyone who writes to her to see a psychiatrist as the "common-sense" solution to whatever problem they are having.

Today, her omnipresent Dear Abby column inadvertently reveals the obnoxious agenda of all psychiatric shills, particularly so-called "family support" groups like NAMI.

Abby sagely suggests to a writer she calls "Hearing Voices in Illinois" that the only reason her family might think she doesn't need psych drugs is that they're "reluctant to admit" what Hearing's psych would confirm -- that in fact, there is a mental illness in the family.

In other words, if the family weren't so irrationally prejudiced against people with diseases of the brain as opposed to the heart, kidney or stomach, then they'd surely see the obvious logic of taking drugs which reduce your life expectancy by twenty-five years and do virtually nothing to help you.

Abby speculates that Hearing's nephew could go online to research mental illness since he is gifted. She presumes that this gifted nephew will clearly see the truth -- that the orthodox, hyper-medicalized view of all human problems absolutely must rule.

Families are only to be respected when they tell people to take psych drugs. If they tell people not to get "treatment" then they're wrong, and they deserve no respect. That's the way NAMI has always operated. Today's Dear Abby just takes the implication to a more obvious, blatant and pedestrian level.

Read the rest of the SRKs post here.

Should relatives buy into the diagnosis, as Hearing Voices in Illinois wants them to do? Would this help or hinder the relative to get better (getting better is not something that "Hearing Voices" seems to set as a personal goal).



Friday, November 16, 2012

Chicago doctor accused of taking kickbacks to prescribe clozapine

In 2007 he prescribed various medications to 4,141 Medicaid patients, including more prescriptions for clozapine than were written by all the doctors in Texas put together, Medicaid records show. Records also showed he was getting government reimbursement for seeing an improbably large number of patients.






A federal lawsuit accuses a Chicago psychiatrist of getting illegal kickbacks from pharmaceutical companies and submitting at least 140,000 false claims to Medicare and Medicaid for anti-psychotic medications he prescribed for thousands of mentally ill patients in nursing homes.

Dr. Michael J. Reinstein also submitted at least 50,000 claims to Medicare and Medicaid falsely claiming he had provided “pharmacologic management” for his patients at more than 30 area nursing homes and long-term care facilities, according to the health care fraud lawsuit filed by the U.S. attorney's office.

“This is the largest civil case alleging prescription medication fraud against an individual ever brought in Chicago,” said Acting U.S. Attorney Gary S. Shapiro.

Reinstein was the subject of an investigation by ProPublica and the Chicago Tribune in 2009 that found Reinstein, 69, had compiled a worrisome record of providing assembly-line care with a highly risky drug.

Searching publicly available documents, reporters discovered that Reinstein had been accused of .........................

read the rest here

After reading this article, I have several questions not specifically connected with this particular case: Why are mentally ill people in nursing homes in the first place? Warehoused by their families? Disabled by years of drug use? A special arrangement with Medicare/Medicaid? Are old people considered mentally ill by definition? Is dementia considered a mental illness? And, I can't believe that clozapine, as stated in the article, is taken by 4% of patients. I bet the figure is much higher. Clozapine has been widely touted, since the time of the  CATIE study, at least, as the greatest thing since sliced bread. There are many shameful aspects to this newspaper report. 

Opening this week-end in a theater near you

Silver Linings Playbook

Sunday, November 11, 2012

Schizophrenia Commission not re-thinking schizophernia label

Louise Gillett writes about Rethink Mental Illness Members' Day and other matters in her most recent post. Status and the status quo, continue to be alive and well in England, like they are in so many other countries where official "commissions" are established to preserve the status quo. Shame, shame!

Here's an excerpt from Louise's blog, Schizophrenia at the Schoolgate:

I suffered a major disappointment yesterday - I learned that the Schizophrenia Commission have not recommended that the label be abolished or changed as I had hoped.  (The report is not due to be published until next week but I feel no sense of loyalty that would prevent me from publishing this 'spoiler'). 

I was not actually surprised to find out that the label has not been changed - I suspected as much by the fact that after asking me to write a case study (of my own case) I was asked if I would mind if it was 'tweaked' to reflect the fact that some members of the Commission do not agree with my view of the damage done by the diagnosis of schizophrenia.  After some thought I rejected my instinct towards compliance and wrote back to say that if they did use my case study I would prefer the wording left intact.  They agreed to use the case study as I wrote it, and apparently it has been included in the report (although I think anonymously.  I am not sure, I have not seen it, but one of the other Trustees who I spoke to yesterday dropped a big hint to this effect).  Although of course, it might be removed after I have published this blog post!

So I had an inkling of what the outcome of this report would be - and it was confirmed as soon as I saw the title of Robin Murray's*  talk at the meeting yesterday - 'What next for the Schizophrenia Commission?'

So the Schizophrenia Commission will continue - having already let down the people they are supposed to be helping.

I am staggered that they haven't effected the change.  Robin Murray was questioned on the subject by a member of the audience and he couldn't produce a coherent reply - he stuttered and stumbled over the issue, saying there were differing views, even claiming that, 'The Schizophrenia Commission doesn't have the power to say one way or another' (really, Sir Robin?).  Eventually he told us that although the diagnosis had been changed in some countries it wasn't going to happen here at the moment, but that maybe in a few years time, things would be different.

_________________________
Rossa's comment: Do we think this guy's going to change the system?

Robin Murray

From Wikipedia, the free encyclopedia

Sir Robin MacGregor Murray (born 1944) is professor of Psychiatric Research at the Institute of Psychiatry (Kings College, London, United Kingdom).[1] He also sees patients with schizophrenia and bipolar illness at the South London and Maudsley NHS Trust. He is originally from Glasgow. Murray is part of The Psychosis Research Group, one of the largest outside the United States. It uses a range of methods to improve understanding and treatment of psychotic illnesses, particularly schizophrenia. For the decade from 1997 to 2007, Murray was ranked as the 8th most influential researcher in psychiatry by Thomson Reuters' Science Watch[2] and 3rd in schizophrenia research.[3] In 1994 he was the president of the European Association of Psychiatrists; now the European Psychiatric Association. He is a Fellow of the Royal Society (elected 2010) and also a Fellow of the Royal College of Psychiatrists.[1] Murray is co-editor-in-chief of Psychological Medicine.[4] In 2009 Murray had a public disagreement with David Nutt in the pages of The Guardian about the dangers of cannabis in triggering psychosis.[5] Murray previously wrote that while the risk increase is "about five-fold [...] for the heaviest users", the issue has become political football.[3] Murray has commented repeatedly on these issues in BBC articles and programmes,[6][7][8] including in a Panorama documentary on BBC One.[9][10] He has also been critical of the proposed use of cannabis for its anti-depressive effects as a "very big leap of faith" based solely on preclinical data.[11] Murray was knighted in the 2011 New Year Honours for his services to medicine.[12]

The scientifically demonstrated effects of qi on the human body



Here's a YouTube clip showing demonstrable, measurable evidence of the effects of qi  on the human body. Austin Goh teaches human energy healing and is a master of Wing Chun kung fu.
Pier Rubesa is an independent researcher looking into the practical uses of sound waves in living systems as the basis for diagnostic schemes therapeutic systems and their interaction (bioharmonic research).

Chris and I were clients of Pier's. You can see the room where, over the course of a year, Chris was treated by Pier using the same technology. The difference is that in this video, human touch, not sound waves, is the medium being manipulated to bring about changes in the body. If you look closer at the video you will see speakers situated at various points in the room. In a sound therapy session, Pier introduces pure sounds that vibrate to the individual colors of the chakras. The machine picks up the body's reactions to the sound or the touch through sensors that are placed under the mattress.

Here's a link to some of the posts where I discussed the sound therapy. (Note: Chris was quicker than most to achieve an out-of-body experience.) If you wish to read more, just put "sound therapy" in the search bar.
http://holisticschizophrenia.blogspot.ch/2009/11/holistic-explanation-of-out-of-body.html
http://holisticschizophrenia.blogspot.ch/2009/12/desert-matrix.html
http://holisticschizophrenia.blogspot.ch/2009/11/myths-are-public-dreams-dreams-are.html

Will Hall on extremism

Will Hall, author of The Harm Reduction Guide to Coming Off Psychiatric Medications, has articulated my thoughts on the dangers of the pendulum swinging too far in either direction. We've experienced the one extreme (the biochemical model) of being told that psych meds are the only solution for brain "disease," that medication is normally forever, and that side effects are tolerable and manageable. The growing backlash to that extreme rightfully came about because truthful information was being withheld. But there are now a lot of people working to force the pendulum in the other direction, the one that promotes the idea that medications to treat distress are more dangerous than they are in many cases, that mental illness will go away if people would only get off their meds. A lot of the recovery movements complaints are with how psychiatry has abandoned the nurture of the psyche, therefore perhaps we over-vilify the meds -- the most obvious thing psychiatry does do these days. (It's an easy target.)

I agree with Will, that we are in danger of creating a backlash if we don't take a more balanced approach. (Remember, we want the pendulum to swing disproportionately on our side for as long as possible.) One way to avoid the backlash is to be careful not to replicate the mistake of withholding or denying information that doesn't fit our sometimes simplistic view of getting on or off the drugs.

In the comments section to his post, Will writes:

I think, in our efforts to alert the world about the dangers of psych drugs, we sometimes overstate the case. Psychiatry has erred for so long in favor of meds, we shouldn’t make the opposite mistake by exaggerating the dangers of drugs.That is not to deny that people are killed and seriously damaged by medications, but if we express only these accounts we are distorting a complicated picture.

What I am seeing these days is people and families who read Bob’s work and think that getting off meds is the solution. Often it is, like a magic bullet in reverse. Sometimes it’s not. I fear if we promote coming off meds, we are setting ourselves up for a backlash just like is happening now to those who promoted taking meds. Maybe a smaller backlash, and maybe the overarching message is better, but I’d rather be honest at the outset.
Will Hall is always worth reading. He knows his stuff and he's willing to admit what he doesn't know, and that people and situations are complex. Here's the link to his post at the Mad in America site. 

Thursday, November 8, 2012

Ubuntu

Op-Ed


Lost and Found in Santa Barbara

by Suzanne Beachy

November 7, 2012


                   


          A few springs ago, I flew out to Santa Barbara from Columbus, Ohio for what would have been my son Jake’s 29th birthday. I needed to see for myself where he had lived and died as a homeless person the year before. Even now as I write those words, I am flooded by sorrow and shame. How could this have happened? How could my beautiful, sensitive, generous, funny, brilliantly creative son’s life have ended this way? It was unthinkable.

          So many unanswered questions. This doesn’t happen to good parents, does it? Just lousy parents, right? Or was this horror Jake’s fault? Had he been just plain stubborn? Maybe the grip of substance abuse and escapism was too strong to resist? Had he suffered from a mental illness? Was he just plain bugged? Shouldn’t I have been able to save this precious person from a spiral of self-destruction? I had tried so many ways but nothing had helped – not the counselors or the psychologist, or the recovery programs, or medication. Years of frustration finally caused my kindness, patience, and understanding to give way to desperation, panic, and ultimatums.

        Read more of Suzanne's moving story here


Wednesday, November 7, 2012

The new aging

Another birthday milestone was celebrated this past week-end. Mine. Looking over the past eleven months in terms of numerology, I was in a personal year 2, which means I began a new nine tragetory of change in 2011. A personal year 2 is a wait and see time, of small contributions rather than large ones, of delays, detours and stoppages. It does seem that 2012 has been stoppages and delays, since I have virtually stopped working on my eponymous memoir.  I just can't muster up the enthusiasm.

Chris is in a personal year 4 of hard work, transitioning this coming January to a personal year 5, a year of major change, freedom, new friends and social activities. The good news is that I, too, will be transitioning to a more action packed year in 2013, and, according to the above link, "a good time to expand personal creative talents, particularly those related to the arts and verbal skills. Recognition in this regard is likely this year." Maybe I'll finally finish the memoir!

These predictions may sound as vague and open-ended as a daily horoscope, but I have come to rely a lot of numerology, almost as nature's way of telling me to take a longer term view, to be thoughtful and patient. Change takes time. Change is continous. With mental health labels, we often let time be our enemy. Most of us don't think in decades, we think in deadlines. If I'm not married by the time I'm 30, if I don't have a career or even a job or degree by the time I'm such and such an age, etc.

Paying attention to numerology is also a needed dose of optimism that change will happen. I've been a hovering parent for the past ten years and I don't want this role much longer. Chris is coming along nicely. He's loving his musical theater work and has found a good group of diverse individuals who share a common passion for music and the stage. He has picked up a girlfriend (a chorus girl!) who shares these interests. It took him eight years to open up enough to seek out the companionship of others.

Change needs to happen for us both. I'll be retiring at the end of 2013 and would like to see Chris by then having a toehold on a future path so that I can be free to enjoy wherever mine will take me.  Chris has plenty of volunteer work to his credit. He needs to start building credentials either through vocational training and/or further schooling . Will he be able to make the transition? Does he have the commitment to set a goal and carry out the hard work involved in getting there. This is a question mark. He's still too concerned about MY welfare. How do you explain to someone to forget about me, be selfish for you? I've tried making that point many, many times since Chris was a child, and from what I can tell, it's part of the territory of SZ to be so totally self-less. (In her memoir, author Elyn Saks writes that  she once told a therapist that she no longer wanted to see her (Karen) because her parents were upset that the therapist hadn't figured this out and come up with a plan, and that it cost them too much money to continue to see her. "It never occurred to me back then (and if it occurred to Karen, she didn't say so) that I was taking better care of my parents than I was of myself.") Amen, Elyn.

I've told Chris in as many ways I can make the point, that his father and I aren't feeble, we aren't looking for his support, nor do we want it. Our job is to help him become independent, which is largely about his putting himself first, for once. He can also be of much greater service to others, I continue to point out, if he has some credentials behind him that can orchestrate bigger, more permanent changes in people's lives than helping little old ladies across the street or a picking up litter on a daily basis.  

105 today! The men all died off years ago.