Here is the chapter from my book where I attempt to show how Family Constellation Therapy worked in the context of our family situation. This chapter was probably the most difficult chapter to write. It has been through many edits because it's important to explain how the therapy works as clearly and succinctly as possible. I've taken a few liberties, not many, with what actually happened, in order to make the chapter flow more smoothly. The names of the characters are fictitious. The entire book, save for the last chapter, is available, for the time being, at the authonomy website.
CHAPTER 26 FAMILY CONSTELLATIONS
Dr. Thomas Szasz writes that there are two kinds of psychiatrists: the institutional ones, who bring the power of the state to bear on the individual through forced medications and coercion, and the contractual ones, who enter into a private, consensual contract with the patient. Ian and I had experienced the power of the institutional psychiatrist at CAMH, Belle-Idée, and the day program. We were eager to find a local, private doctor who would work with Chris in a more consensual arrangement.
It was perhaps a tall order, but I was hoping to find a psychiatrist who was willing to consult with Dr. Erika and who could do a few sessions of Family Constellation work with us. I was convinced Family Constellation Therapy was the missing link I had been seeking. I truly felt that if Chris were going to experience a breakthrough, then this therapy would make it happen. I took Dr. Klinghardt’s observations to heart, that schizophrenia was a manifestation of a magical belief system and had to be approached at the same intuitive level (four).
After pursuing numerous false leads, I learned that the head of the l'Espoir program, Dr. Rx, was the person to speak to who would probably know about Family Constellation Therapy. Dr. Rx? Had Dr. Rx been withholding information about the therapy from us the entire time Chris had been in the day program? What had we been doing for those twenty-two months in his program—paddling around in the shallow end of the pool for young people with psychosis? Or was Family Constellation Therapy, in his view, only reserved for old people with psychosis? The end result of my convoluted journey was humorously ironic. I had no intention of contacting Dr. Rx.
It was our old contact, Dr. Robert, who referred us to Dr. Maria Stern, a tri-lingual psychiatrist and Family Constellation therapist practicing in Geneva. I telephoned Dr. Stern and explained why I thought Family Constellation Therapy might help Chris. Dr. Stern listened very carefully to what I had to say and suggested that we schedule an initial appointment for the end of June.
On the morning of the appointment, Ian, Chris and I drove to Dr. Stern's office, which was located on the first floor of a small residential building near the Hôpital Cantonal de Genève. We circled her street several times before we managed to find a parking spot. We rang her office door bell promptly at 8 a.m. and waited. We rang again. After what seemed like hours, not seconds, Dr. Stern unlocked the door and ushered us in. “Please come and sit down,” she said, steering us towards a loveseat and two chairs grouped around a small glass table in one corner of the room. From my vantage point on the loveseat, I looked out at the rest of the room, which was enormous and devoid of furnishings save for three large Oriental carpets on top of the parquet floor.
While Ian and Dr. Stern talked about where in future to find parking space closer to the office, I sized up Dr. Stern, who I guessed to be in her late forties. Excellent English, slight German accent. She wore no jewelry or make-up and was conservatively dressed in a pearl gray jacket and skirt and light-blue blouse. She seemed like a sincere person. I hoped she would also prove to be a good psychiatrist for Chris.
Dr. Stern wanted to make sure that not just Ian and me, but Chris, too, was willing to participate in the therapy and after more small talk with all of us, she spent several minutes focused on Chris, trying to get him to talk a little about himself. She often had to ask him to repeat what he’d said because he spoke so softly.
When Dr. Stern finished speaking with Chris, I surprised her by handing her a Family Constellation version of our family tree, starting with Chris and his brothers and working back four generations on both sides of the family, up to and including Ian’s and my grandparents. I’d included short descriptions of each ancestor, detailing what appeared to be the central disappointment or tragedy of their lives.
“My clients aren't usually so well-prepared,” she said with a smile, promising to familiarize herself with our family history before our next appointment.
“Normally,” she explained, “I conduct my Family Constellation therapy in French on the weekends with several families at once. The participants act as stand-ins for the ancestors of other families present, and I introduce them to their roles and observe the interactions when they are in their roles. Since French is not your family's first language, I’ll schedule an appointment during the week with just your family. Instead of having each of you play different roles within a family grouping, I'll ask either you or Ian to place paper outlines of shoes on the floor to represent your particular group of ancestors.”
Ian and I stared at her. Shoes?
“Wait here,” said Dr. Stern, getting up and disappearing through a door into her inner office. She soon reappeared with a file folder and held up a piece of A4 paper labeled “CHILD” with the outlines of two tiny shoes that represented a young child.
“I'd best show you what I mean,” she said, walking to the center of the room, whereupon she quickly began placing the file's contents on the floor. “This constellation represents the family of a man I saw last month. The man placed the shoeprints on the floor in the way I am showing you now. He put his father's shoeprints here, and his mother's shoeprints here. His grandmother was very interfering and you can see from her shoeprints that she is blocking the space between her son and his wife.”
Dr. Stern paused. “That's all I'm going to say about this constellation. I think it's enough to show you how we use shoes in this therapy.
“Let's say that Ian chooses to do his side of the family,” she continued. “Ian will place the shoeprints on the floor and resume his seat and then I take over as the actor.” Dr. Stern took a couple of steps backward and stood on the paper representing the grandmother of the man she saw the previous month.
“The actor absorbs and reveals the hidden connections, issues and confusions of the family energy field. Whether I am acting or facilitating, I may sometimes interject to ask questions of myself or the actor about the spatial orientation and distancing of where the shoes are placed; when I am acting, I may simply move my body in a way that shows how I feel impacted by the energy of the other members of the ancestor family. “Eventually, we come to a resolution. I ask the person whose family constellation was acted out to take over from me and position the family members in their rightful places in the constellation. Having placed ourselves in the drama by observing or by acting, we can sense how and where the injustices or exclusions have occurred, and the family member symbolically changes the pattern of the family dynamics by physically moving the shoeprints into a more harmonious grouping. Healing can now happen because the energy of the constellation begins to flow naturally.”
Ian and I looked at each other and nodded. What Dr. Stern explained to us made sense. I pushed up my sleeve to check my watch. Two and a half hours had elapsed and it was time to go. Before we left her office, we booked two appointments for the whole family in the first week of July as Dr. Stern would be leaving for summer vacation almost immediately after.
On the morning of the first appointment, our family gathered in Dr. Stern's therapy room at 8 o'clock. Ian and I deliberately shared only basic information in advance with Alex and Taylor about what the therapy entailed. I had insisted that they read the short descriptions of our family tree that I had given to Dr. Stern. I knew that they were not especially curious about their ancestors and were unhappy about the turmoil our family had gone through over Chris. They attended the appointment under duress.
“I'm quite busy and I don't think I can make it to all the sessions,” Alex announced to Dr. Stern, in a tone of voice that implied, “Don't bother trying to convince me otherwise.” Alex was friendly with Dr. Stern, even though he had already made up his mind that he wasn't planning to stick around for future sessions, but Taylor was aloof and remained so throughout the session. Chris, as usual, was quiet. He spoke only when spoken to.
Chris was more knowledgeable about his ancestors than his brothers were because he had helped me construct our family tree over the course of the previous year. Finding the birth dates and deaths of our ancestors through family records and Internet searches and entering the information into a database gave him and me a new pastime and a chance to talk about what our ancestors’ lives may have been like.
Dr. Stern issued us a short set of instructions. “Decide which set of ancestors you would like the Constellation to be about. If it's the maternal side then Rossa will put the shoes on the floor; if it's the paternal side, then Ian will do it.”
Ian and I had agreed in advance of our meeting that Ian would start with his father's side of the family. Ian's parents went through an acrimonious divorce when Ian was a teenager and he is not close to either parent. He has a tense relationship with both his father and his mother. Ian feels that his father, Bill, has never acknowledged his part in the family breakup and should have apologized to his children for the misery they suffered.
Ian is named after his paternal grandfather. Ian John Forbes left Aberdeen, Scotland at the age of seventeen and arrived in Toronto just before the First World War broke. He joined a local regiment, whereupon he was shipped first to England then to France. His military records indicate that he was in hospital most of the time he was in France, suffering from pyrexia of unknown origin (PUO) or what was commonly called trench fever. A patient usually recovered from trench fever in less than a month, but in rare cases, the continuing after-effects of the fever included fatigue, anxiety, headache, neuralgia and depressed mood.
We knew very little about Ian's grandfather other than that he spent the rest of his life after returning to Toronto as a semi-invalid, and an alcoholic as the years went by. His children were all born several years after the war ended. Ian John's wife, Emma, was an English nurse, so there is a good possibility that she met her husband when he was a patient in her hospital. Bill (full name David William), rarely offers much information about his parents, even when we ask about them. Ian John's children and grandchildren were always under the impression that his health troubles stemmed from being gassed during the war, but his military records revealed no further information.
Dr. Stern told Ian to be spontaneous in placing the shoe outlines on the floor. “The placement should be intuitive, not logical,” she explained. “Don't think about it too much.”
Ian placed six pairs of shoes, for his grandparents, and their four children: Bill, and Bill's twin sister, Bill's older sister, and a firstborn child with the same first and middle name as Bill's. “David William” died of leukemia at the age of three, before the rest of the siblings were born.
After Ian finished laying out the shoes, he sat down beside me on the loveseat. We waited nervously to see what would happen next.
Dr. Stern then began a mesmerizing narrative dance, stepping first into the shoes of Ian’s grandfather. She stood quietly, with her head bowed, her eyes looking down at, but not focused on, her shoes, and her arms hung limply by her side, as if she were a marionette loosely dangling from an invisible string. Her breathing caused her shoulders to rise ever so slightly and her stomach to expand and contract.
“Hmmph,” said Dr. Stern, inhaling a sharp intake of air through her nostrils while still keeping her head bowed. Her marionette shoulders shivered ever so slightly. There was complete silence in the room; all eyes were focused on Dr. Stern. After what seemed an eternity, she shook herself a little and began to speak. “I can see I have three lovely children,” the grandfather continued, but I am not close to them. I have a fine wife, but I can only see part of her from where I am standing. Where is my first born son, David William?” With her feet planted firmly, Dr. Stern rotated her body, her feet not moving, to gaze over her left shoulder.
“Oh, I see; there he is,” spoke the grandfather, in the voice of Dr. Stern. “He died young, didn't he? I thought I had forgotten him. But you didn't, did you, my dear,” he said softly to Emma. “You are standing by him.”
Ian and I had grabbed a couple of tissues from a large dispenser on the glass table and began wiping our eyes. As the drama progressed further, we wept more openly. We were heartbroken about how the grandfather's ill health, death of his first born child, and personal demons had estranged him from Emma, Bill and his two daughters.
Dr. Stern wept, too. There were at least four dry eyes in the room. Taylor and Alex looked bored, occasionally exchanging suppressed smiles.
Every so often, Dr. Stern would glance sideways at Chris, to see how he was following the unfolding drama and to watch his reactions. Chris was too far into his protective shell to cry, but he was riveted by the drama. His eyes never strayed from Dr. Stern. He seemed to understand the dynamics of the constellation, and sense the burden carried by its family members.
Dr. Stern was finally finished with her acting role. “Ian,” she said, “let's trade places. Now it's your turn to stand in the shoes of each family member and to express any emotions or wishes you may have about where you would now like to place the shoes.” When Ian stood in his father's shoes he realized he couldn't see David William, his older brother, from where he was standing. Ian suggested that he should be included in the same line as the other three children. So, Ian moved David William, the almost forgotten child, next to his younger brother and namesake, Bill. Then Ian, standing in his grandfather's shoes, expressed that he would like to feel closer to his wife, so he moved Emma's shoes close to Ian John's.
“How do you feel about the family?” Dr. Stern asked Ian, then each of us in turn.
Ian felt immensely sad, so did I, so did Chris. Taylor and Alex, still resistant to being involved in the therapy, mechanically stated that they felt a bit sad, too. I'm sure that what they said was true; it was hard not be affected by the energy in the room.
After three hours, we were all totally tired and grateful to leave.
“Now, just remember,” said Dr. Stern. “Don't analyze what you have seen and done today and try not to speak to each other or to other people about it. Whatever comes out of these sessions will happen at an emotional level and will take time.”
Two days later we were back in Dr. Stern's office, save for Alex who had suddenly discovered commitments he could not possibly break. All the pleading in the world got us nowhere.
“Alex is tough like that,” I remarked to Dr. Stern.
“Being tough is probably a good way to be,” she replied.
In reviewing the outcomes of the previous session with Dr. Stern, Ian and I agreed that we felt saddened but closer to Ian's family on his father's side. Chris, ever so slightly nodded his head in agreement.
This time, it was my turn. I chose my mother’s side of the family because of the impact that the early death of my grandmother had on my mother. My father lost his father when he was eight, so I could have started with his side of the family, but I knew that losing her mother when she was only four years old had a huge effect on my mother, Lily.
I remember meeting my grandfather, Kurt, on two occasions only—once when I was about three years old, and once when I was a teenager. Lily didn't like Kurt, and so our family rarely saw him. Towards the end of her life, my mother told me that she’d felt her father blamed her for her mother’s death. My grandmother, Anna, died of scarlet fever, which she’d caught from Lily in 1924. While I was growing up what I heard from my mother was not that her father blamed her directly for her mother's death, but that he penalized her by forcing her to quit high school, despite the fact that she was at the top of her class, and refused to buy her new clothes. In her teen years she also had to cope with his third wife, whom he divorced, and his marriage to his fourth wife, who was only slightly older than my mother.
I quickly laid out the shoe patterns for my grandparents, Anna and Kurt, my mother, Lily, and her older brother. I also included in the Constellation grandfather Kurt's first wife, who was his second cousin. She died while still a teenager, leaving him a widower for the first time. Family Constellation therapists would say that her death enabled my grandmother to marry my grandfather, and that's why she should be included in the family grouping.
The pattern was rather conventional ―grandmother and grandfather on the same linear path, shoes facing their children, but not spaced close together, children placed below and parallel to the parents, facing them, and the first wife behind my grandfather but far away.
Dr. Stern took her position as interpreter of personal dramas. She started by stepping into my mother's shoes, and in a plaintive voice asked, “Where is my mother?” As Lily continued to speak, I acknowledged to myself that, as a child, I had never given much thought to the impact my grandmother's death had on four-year-old Lily. To my way of thinking, she died — that was all — and I accepted her early death as just one of those things that so often happened to people of my parents' generation. I knew it was a defining event for my mother, but I didn't dwell on it when I was growing up. Today, in this room, the effect of my grandmother's death would starkly reveal the impact on her immediate family. I sensed I was about to find out some disturbing truth that I had chosen to ignore until now. I felt cold, despite the warm summer air wafting in through the open window.
Next, Dr. Stern took the place of my grandfather. She hung her head and dropped her shoulders in the marionette position, and for a few minutes, she said nothing; then, slowly, horror seemed to pervade her body. She put her hands over her cheeks and shook her head in dismay while rocking slightly back and forth. She said nothing. She didn't need to say anything. Our knowing about the death of his first wife and the death of his second wife who left him with two young children didn't need an explanation.
As I watched Dr. Stern alternate between my grandfather, grandmother and his two wives, I thought despairingly about my mother. My mother was a kind and giving person, but she lived most of her life with three daughters who wouldn't touch her unless they absolutely had to do it. I now began to wonder if there was more to our lack of physical affection than just the societal norms of the era when I was growing up. I remembered how my sisters and I also hated to play with dolls. I thought of an old black and white photograph of my sisters and me on Christmas Day, looking sullen, our faces dark as thunderclouds. My parents had bought us all kinds of dolls as Christmas presents ―Tiny Tears baby dolls and glamorous fashion dolls with frothy tulle skirts. These gifts would have thrilled lots of other girls, but not us. Not one of us at that age wanted to nurture. Of the three sisters, I am the only one of us today who has children. My sisters chose to remain childless.
Dr. Stern paused in her role playing. “I sense a chill in the room. It feels like death.” She pulled her light, cotton cardigan a little closer to her body. I reached for a tissue and wiped my eyes, suddenly recalling that there was another family member who died early, and that was Anna’s mother, Clara. Clara died when Anna was only ten. When I was three years old I almost died from a blood-related disorder. Family Constellation Therapy might say that I was trying to sacrifice myself to fulfill this particular family curse.
Random thoughts popped into my head as I watched the drama unfold.
Perhaps my sisters and I feared getting too close to my mother meant we risked early death, almost as if early death is something we could "catch” from her, and that's why we refused to show her physical affection.
Have I unconsciously withheld affection from Chris because I feared that he would die, too? Did he withhold affection from me because he, too, sensed the contagion of death?
All those sleepless nights after he was born when he cried and cried because I had no breast milk. Chris was literally starving by being denied the most nurturing food of all.
This latest revelation about Chris made me feel sick with remorse.
During this Constellation, the same as in the first one, Dr. Stern again looked at Chris to gauge his reaction. Chris was still keenly following the drama without saying much.
Dr. Stern caught something in Chris’s reaction that she thought was important.
“I think I’ve got it!” she said at the end of the session. She turned to Chris and said, “You should not have to carry this burden any longer.” Without offering any explanation, she announced that the session was over. Each of us was left to find meaning in what we had witnessed, in our own way.
For the second time, we left Dr. Stern’s office, exhausted and deeply aware of the sacrifices that had been made by those who went before us. Again, abiding by Dr. Stern's instructions, we did not discuss what took place in the room.
Chris's illness had already taught me not to take parenting for granted. There are hidden and not so hidden dramas going on in all families despite parents loving their children and trying to do the best for them. Some especially sensitive children may fail to blossom—even though they are loved—if they sense a hidden undercurrent of tension which they will try to correct in their own way. Family Constellation Therapy taught me that to be a parent is to accept one's part in a sacred journey, a journey that began generations before. As parents, we profoundly influence the lives of our children and our children's children, for better and for worse.
By participating in the Family Constellation sessions, I believed that each member of our family, not only Chris, would undergo an energy transference that would positively affect any healing that needed to occur in the present. Healing the present generation would have a positive impact on future generations of our family tree.
In the meantime, we had to wait and let the magic happen.
Monday, February 27, 2012
Sunday, February 26, 2012
Bruce Levine - a better way to see psychosis
Here is an excerpt from Bruce Levine's most recent Mad in America post. This view of psychosis is comforting to me. Psychosis has always struck me as an odd way to rebel because it actually makes people dependent on those they rebel against, and seems to retard their lives. A socially acceptable form of rebellion is to leave home at an early age, tell your parents you are sick of their interference, and get on with your own version of your life, independent of others' financial support or judgements. And yet, we all must rebel in some way if we are to grow. So, if psychosis is rebellion, wish the person Godspeed.
Many people with severe anxiety and/or depression are also anti-authoritarians. Often a major pain of their lives that fuels their anxiety and/or depression is fear that their contempt for illegitimate authorities will cause them to be financially and socially marginalized; but they fear that compliance with such illegitimate authorities will cause them existential death.
I have also spent a great deal of time with people who had at one time in their lives had thoughts and behavior that were so bizarre that they were extremely frightening for their families and even themselves; they were diagnosed with schizophrenia and other psychoses, but have fully recovered and have been, for many years, leading productive lives. Among this population, I have not met one person whom I would not consider a major anti-authoritarian. Once recovered, they have learned to channel their anti-authoritarianism into more constructive political ends, including reforming mental health treatment.
Many anti-authoritarians who earlier in their lives were diagnosed with mental illness tell me that once they were labeled with a psychiatric diagnosis, they got caught in a dilemma. Authoritarians, by definition, demand unquestioning obedience, and so any resistance to their diagnosis and treatment created enormous anxiety for authoritarian mental health professionals; and professionals, feeling out of control, labeled them “noncompliant with treatment,” increased the severity of their diagnosis, and jacked up their medications. This was enraging for these anti-authoritarians, sometimes so much so that they reacted in ways that made them appear even more frightening to their families.
Many people with severe anxiety and/or depression are also anti-authoritarians. Often a major pain of their lives that fuels their anxiety and/or depression is fear that their contempt for illegitimate authorities will cause them to be financially and socially marginalized; but they fear that compliance with such illegitimate authorities will cause them existential death.
I have also spent a great deal of time with people who had at one time in their lives had thoughts and behavior that were so bizarre that they were extremely frightening for their families and even themselves; they were diagnosed with schizophrenia and other psychoses, but have fully recovered and have been, for many years, leading productive lives. Among this population, I have not met one person whom I would not consider a major anti-authoritarian. Once recovered, they have learned to channel their anti-authoritarianism into more constructive political ends, including reforming mental health treatment.
Many anti-authoritarians who earlier in their lives were diagnosed with mental illness tell me that once they were labeled with a psychiatric diagnosis, they got caught in a dilemma. Authoritarians, by definition, demand unquestioning obedience, and so any resistance to their diagnosis and treatment created enormous anxiety for authoritarian mental health professionals; and professionals, feeling out of control, labeled them “noncompliant with treatment,” increased the severity of their diagnosis, and jacked up their medications. This was enraging for these anti-authoritarians, sometimes so much so that they reacted in ways that made them appear even more frightening to their families.
Friday, February 24, 2012
Psychic surgery
I had never heard of psychic surgery until about fourteen years ago when a middle aged man showed up at our newly built apartment building, selling inexpensive paintings from an artists' cooperative. We bought a few paintings from him to cover our bare walls. This man, I'll call him "John" had an incredible story to tell about how his cancer had been cut away from him in the Philippines by a healer using nothing but his bare hands. The healer literally pulled the diseased bits of John's organs out of his body, leaving no scars and only a slight reddening of the skin. John told me he had also seen the healer pluck a man's eyeball out to work on it, then pop it right back into its socket. All of this involved no surgical tools and no anesthetic.
John showed up again at our apartment last night after a hiatus of several years. My walls have all the artwork they need, but it was a chance for John and I to renew our acquaintance, and, instead of buying, I promised to spread the word to anybody I knew who might need a painting. We talked some more about the experiences he had undergone in the Philippines, since he had been back several times since for more treatment. After he left, I got curious and decided to check out this phenomenon on the web. Here's some background information on it and a graphic Youtube presentation featuring Placido Palitayan
Chris Cole has been practicing psychic surgery since the 1970s. "My belief is that I don't heal anybody," says Cole. "All I do is act as a channel for the energy and that energy then helps to initiate the healing response. Your own innate healing wisdom does the healing and all I do is act as a medium for the energy. I believe that universal energy is the God essence and it's a connection with the source of that energy that I'm tapping into."
As with the rest of my holistic journey, I learned to suspend disbelief a long time ago. Psychic surgery seems to be the ultimate energy power of the Holy Spirit chanelled as a physical intervention.
John showed up again at our apartment last night after a hiatus of several years. My walls have all the artwork they need, but it was a chance for John and I to renew our acquaintance, and, instead of buying, I promised to spread the word to anybody I knew who might need a painting. We talked some more about the experiences he had undergone in the Philippines, since he had been back several times since for more treatment. After he left, I got curious and decided to check out this phenomenon on the web. Here's some background information on it and a graphic Youtube presentation featuring Placido Palitayan
Chris Cole has been practicing psychic surgery since the 1970s. "My belief is that I don't heal anybody," says Cole. "All I do is act as a channel for the energy and that energy then helps to initiate the healing response. Your own innate healing wisdom does the healing and all I do is act as a medium for the energy. I believe that universal energy is the God essence and it's a connection with the source of that energy that I'm tapping into."
As with the rest of my holistic journey, I learned to suspend disbelief a long time ago. Psychic surgery seems to be the ultimate energy power of the Holy Spirit chanelled as a physical intervention.
Wednesday, February 22, 2012
Free schizophrenia memoir today on Kindle
Louise Gillett's schizophrenia memoir is available free today on Kindle. It's a great read.
Monday, February 20, 2012
Wellness Wordworks peer support intervention
Wellness Wordworks
Instant Mental Health Peer Support Showing emotional distress as temporary and transformative
“Peer Support is THE most effective mental health intervention”
- National Association of State Mental Health Program Directors, “What Helps, What Hinders,” a report on how effective Peer Support is for Mental Health Recovery
Wellness Wordworks was founded in 2008 by Corinna West. We are building an innovative mental health care model called Instant Peer Support. We are using Google Gigabit technology to provide a 24 hour video call in support line for people to find resources for handling emotional distress. All of our staff will be people who are themselves in recovery for mental health diagnoses. Our video line will be linked with crisis care opportunities and community mentors to bring people into social activities.
This will relieve much of the burden on our over-stressed local mental health centers. We plan for recovery outcomes that are much higher than current mental health delivery models.
Consider joining this great initiative
Instant Mental Health Peer Support Showing emotional distress as temporary and transformative
“Peer Support is THE most effective mental health intervention”
- National Association of State Mental Health Program Directors, “What Helps, What Hinders,” a report on how effective Peer Support is for Mental Health Recovery
Wellness Wordworks was founded in 2008 by Corinna West. We are building an innovative mental health care model called Instant Peer Support. We are using Google Gigabit technology to provide a 24 hour video call in support line for people to find resources for handling emotional distress. All of our staff will be people who are themselves in recovery for mental health diagnoses. Our video line will be linked with crisis care opportunities and community mentors to bring people into social activities.
This will relieve much of the burden on our over-stressed local mental health centers. We plan for recovery outcomes that are much higher than current mental health delivery models.
Consider joining this great initiative
Sunday, February 19, 2012
Peter Breggin on the hazards of psychiatric diagnosis
I've extracted three key points from Dr. Peter Breggin's Huffington Post blog. on the hazards of psychiatric diagnoses. Each one, except for "medication spellbinding" as Breggin terms it, speaks to my own experience. And the reason that medication spellbinding doesn't apply in my son's and my experience is because I sensed that the medication fairy dust fell on the psychiatrists' prescribing the drugs. They attributed all kinds of benefits to things I didn't see at all. Their judgement was impaired, not mine, but that, of course, was a no win point of view for me, because I had already ceded power and authority into the hands of health professionals. On Breggin's third key point below, try as I may to get people to look deep inside their own lives in order to heal their relative, many people just assume that I'm just a mother basher who is determined to push psychiatry back to the bad old days.
Psychiatric diagnoses take power and authority over your life, and the lives of your children, out of your hands. They place that power and authority in the hands of health professionals. Often it takes but a few minutes in an office to transform you or your child from a complex human being into a product on the psychiatric assembly line--and endless assembly line that can lead to a ruinous lifetime.
Perhaps worst of all, these diagnoses almost inevitably lead to the prescription of psychiatric medication to you or your child. Psychiatric drugs are toxins to the brain; they work by disabling the brain. None of them cure biochemical imbalances and all of them, every single one of them, cause severe biochemical imbalances in the brain. The adverse effects of these drugs on the brain and mind are stunning. In my recent scientific books and articles, including Medication Madness, I have demonstrated they cause medication spellbinding. Spellbound by psychoactive drugs we cannot adequately judge the impairments they create in our brain and too often we mistakenly feel "improved" when in fact our feelings have been dulled or artificially jacked up, and our judgment about ourselves and our lives have been impaired.
But something more subtle occurs when we accept a psychiatric diagnosis for ourselves or a loved one. We lose empathy for ourselves and our loved one. Instead of learning about and identifying with the sources of our emotional pain and suffering, and our failures in life, we ignore our real lives and explain ourselves away with the diagnosis. To understand ourselves or anyone else, to help ourselves or anyone else, we must care about the details of the life before us.
Read the rest here
Psychiatric diagnoses take power and authority over your life, and the lives of your children, out of your hands. They place that power and authority in the hands of health professionals. Often it takes but a few minutes in an office to transform you or your child from a complex human being into a product on the psychiatric assembly line--and endless assembly line that can lead to a ruinous lifetime.
Perhaps worst of all, these diagnoses almost inevitably lead to the prescription of psychiatric medication to you or your child. Psychiatric drugs are toxins to the brain; they work by disabling the brain. None of them cure biochemical imbalances and all of them, every single one of them, cause severe biochemical imbalances in the brain. The adverse effects of these drugs on the brain and mind are stunning. In my recent scientific books and articles, including Medication Madness, I have demonstrated they cause medication spellbinding. Spellbound by psychoactive drugs we cannot adequately judge the impairments they create in our brain and too often we mistakenly feel "improved" when in fact our feelings have been dulled or artificially jacked up, and our judgment about ourselves and our lives have been impaired.
But something more subtle occurs when we accept a psychiatric diagnosis for ourselves or a loved one. We lose empathy for ourselves and our loved one. Instead of learning about and identifying with the sources of our emotional pain and suffering, and our failures in life, we ignore our real lives and explain ourselves away with the diagnosis. To understand ourselves or anyone else, to help ourselves or anyone else, we must care about the details of the life before us.
Read the rest here
Friday, February 17, 2012
Neurotic interlude
Yesterday, Chris called me from a pay phone after his appointment with the employment counsellor.
“Great, so how'd it go?” I asked, mentally preparing myself for Chris to divulge some glitch on the road to employment.
“Uh, well, I sort of told her I was thinking about death a lot.”
“DEATH! Why would you tell an employment counselor THAT? She's an employment counselor, not a psychiatrist!”
“Well, anyway, Mom, she called the L'Espoir program (outpatient day program Chris attended) to see if she could get me an appointment right away.”
“THE L'ESPOIR PROGRAM?” I exploded. “Why would you want to involve THE L'ESPOIR PROGRAM? You were perfectly fine this morning, and last night, and as far back as I can remember! ” (By now, I'm heading towards the land of high expressed emotion.)
“Chris, I'm taking the afternoon off. You meet me at home right away!”
Chris and I met up at home. I made him some herbal tea and we talked. There appeared to be nothing wrong with him except that he needs something to fill his days —a job or classes that bring him into contact with people. He has absolutely nobody to talk to during the day and this has been going on far too long. Staying inside the whole day means he can get easily spooked when he goes outside.
“Well, Chris, I guess you've set back the job hunt by several weeks. You obviously really spooked the employment counselor.”
“Yeah, and I haven't told you the whole story. I have an appointment today at 4 p.m. at La Belle et La Bête.” (where Chris has spent a total of six months live-in)
“Okay, Chris, tell me what's troubling you.”
The story emerged, nothing that both of us hadn't already discussed. Chris is 28, at a crossroads.
“Mom, I am suddenly realizing how much time I've lost. I'm panicking. But I've got no plans. I'm an empty vessel. ”
“Right. Chris, this is normal for young men of your age who have gone through what you've gone through. They get to a point of being well when they suddenly wake up to possibilities and they panic. You're perfectly sane, you know.”
Chris brightened. “Am I? Gee, I need to hear that.”
“Well, it's the truth. And the good news is that you are moving another notch up the diagnosis food chain. You started out diagnosed as schizophrenic, the last time you were hospitalized for three months you were favoring bipolar, and now I would say you are simply neurotic. Congratulations!”
“I guess I am kind of neurotic right now.” We both laugh.
“Chris, I know you are not suicidal. You are perfectly welcome to keep your appointment today with the shrink at the residential hospital; I'll drive you there, but let's get our story straight. I'm not leaving you there. When he asks you about the supposed suicide ideation, what are you going to say?”
“Well, I'm spending too much time with old people.”
“That would be your mother and your father, and all the people my age you hang around with in musical theatre. Death is just around the corner for all of us!”
“I don't see anybody during the day my own age. I'm lonely. I also feel I've gone as far as I can go with Dr. Stern. She's quite Freudian, and I think that there is another side to me that is not coming out.”
“You have spent a lot of time with Dr. Stern. Maybe you need a change.”
So, I drove Chris to La Belle et La Bête and left him there and went off to an antiques store.
When I picked him up after his appointment, everything was cool. The psychiatrist, who was not much older than Chris, spent about an hour with him and Chris promised to phone him the next day to let him know how he was. He told Chris he could contact him anytime if he needed to talk further. No drugs, no hospitalization, just empathy.
Crisis averted.
Death: You're an interesting young man. We'll meet again.
Young Boris: Don't bother.
Death: It's no bother.
“Great, so how'd it go?” I asked, mentally preparing myself for Chris to divulge some glitch on the road to employment.
“Uh, well, I sort of told her I was thinking about death a lot.”
“DEATH! Why would you tell an employment counselor THAT? She's an employment counselor, not a psychiatrist!”
“Well, anyway, Mom, she called the L'Espoir program (outpatient day program Chris attended) to see if she could get me an appointment right away.”
“THE L'ESPOIR PROGRAM?” I exploded. “Why would you want to involve THE L'ESPOIR PROGRAM? You were perfectly fine this morning, and last night, and as far back as I can remember! ” (By now, I'm heading towards the land of high expressed emotion.)
“Chris, I'm taking the afternoon off. You meet me at home right away!”
Chris and I met up at home. I made him some herbal tea and we talked. There appeared to be nothing wrong with him except that he needs something to fill his days —a job or classes that bring him into contact with people. He has absolutely nobody to talk to during the day and this has been going on far too long. Staying inside the whole day means he can get easily spooked when he goes outside.
“Well, Chris, I guess you've set back the job hunt by several weeks. You obviously really spooked the employment counselor.”
“Yeah, and I haven't told you the whole story. I have an appointment today at 4 p.m. at La Belle et La Bête.” (where Chris has spent a total of six months live-in)
“Okay, Chris, tell me what's troubling you.”
The story emerged, nothing that both of us hadn't already discussed. Chris is 28, at a crossroads.
“Mom, I am suddenly realizing how much time I've lost. I'm panicking. But I've got no plans. I'm an empty vessel. ”
“Right. Chris, this is normal for young men of your age who have gone through what you've gone through. They get to a point of being well when they suddenly wake up to possibilities and they panic. You're perfectly sane, you know.”
Chris brightened. “Am I? Gee, I need to hear that.”
“Well, it's the truth. And the good news is that you are moving another notch up the diagnosis food chain. You started out diagnosed as schizophrenic, the last time you were hospitalized for three months you were favoring bipolar, and now I would say you are simply neurotic. Congratulations!”
“I guess I am kind of neurotic right now.” We both laugh.
“Chris, I know you are not suicidal. You are perfectly welcome to keep your appointment today with the shrink at the residential hospital; I'll drive you there, but let's get our story straight. I'm not leaving you there. When he asks you about the supposed suicide ideation, what are you going to say?”
“Well, I'm spending too much time with old people.”
“That would be your mother and your father, and all the people my age you hang around with in musical theatre. Death is just around the corner for all of us!”
“I don't see anybody during the day my own age. I'm lonely. I also feel I've gone as far as I can go with Dr. Stern. She's quite Freudian, and I think that there is another side to me that is not coming out.”
“You have spent a lot of time with Dr. Stern. Maybe you need a change.”
So, I drove Chris to La Belle et La Bête and left him there and went off to an antiques store.
When I picked him up after his appointment, everything was cool. The psychiatrist, who was not much older than Chris, spent about an hour with him and Chris promised to phone him the next day to let him know how he was. He told Chris he could contact him anytime if he needed to talk further. No drugs, no hospitalization, just empathy.
Crisis averted.
Young Boris: Don't bother.
Death: It's no bother.
Wednesday, February 15, 2012
We have a duty to protect our children
Becky Murphy is the force behind Involuntary Transformation.
Op-Ed
A MadMother: We Have a Duty To Protect Children
Becky MurphyFebruary 15, 2012
The recent reports by ABC News and the Senate Hearing on December 1, 2011, which was presided over by Senator Tom Carper, are the latest of many investigations and hearings into psychiatric drugs being used on foster children. But the fact is that the indiscriminate use of psychotropic drugs prescribed off-label is widespread, and not limited to children in foster care. Children who live with their parents often have the same safety and protection issues as children in foster care and experience equally harmful effects from the drugs.
When children are harmed instead of helped with psychiatric drugs it is always tragic. When the child lives with his or her parents, the parents can’t understand why the help—the medication—is not helping, but hurting.
My son was diagnosed with temporal lobe epilepsy the month he turned seven years old. It is a neurological condition known to be caused by a brain injury, and can cause the same symptoms as schizophrenia. When he was diagnosed with temporal lobe epilepsy, he also had been getting mental health treatment services for over three years and had a diagnosis of PTSD. He had this diagnosis because he had been the victim of violent assault when he was three years old and in foster care.
My children were in foster care due to my own failure to deal with the effects of my own traumatic childhood. I placed my sons in foster care, when I became unable to care for them. My youngest son was placed in a home that had twelve reports filed with Child Protective Services. After he was victimized, I believe that the State of Washington attempted to cover it up, with little regard for how this would cause my son further harm. I was not informed of the trauma my son had experienced.
Read the rest of this moving testimonial here.
Antipsychotics - a form of birth control
Please read this post from Schizophrena at the Schoolgate. If Louise Gillett suspicions are correct, then chemical castration is one side effect of antipsychotic use that doctors routinely do not disclose to their patients. Yet, science also flirts with the idea that schizophrenia confers an evolutionary advantage for future generations. (See David Horrobin, The Madness of Adam and Eve). If science is correct, then there is an evolutionary DISADVANTAGE for people with a schizophrenia diagnosis not to procreate.
Excerpt from Amazon:
Excerpt from Amazon:
Book Description
This volume presents an argument which aims to fundamentally alter our view of the roots of humanity and answer questions of how a species of clever ape evolved into something different. Schizophrenia is the only illness to be found in equal measure in all racial groups, pointing to the fact that the disease must have been present at the dawn of mankind before the races diversified and spread from Africa throughout Eurasia and Australasia. The book aims to reveal how the genetic legacy of schizophrenia is at the heart of the best and worst of human achievement.
Today's obituary
Dory Previn, Songwriter, Is Dead at 86
By BRUCE WEBER
Published: February 14, 2012
Dory Previn, the lyricist for three Oscar-nominated songs who as a composer and performer mined her difficult childhood, bouts of mental illness and a very public divorce to create a potent and influential personal songbook, died on Tuesday at her home in Southfield, Mass. She was 86.
Read the rest of the article here
By BRUCE WEBER
Published: February 14, 2012
Dory Previn, the lyricist for three Oscar-nominated songs who as a composer and performer mined her difficult childhood, bouts of mental illness and a very public divorce to create a potent and influential personal songbook, died on Tuesday at her home in Southfield, Mass. She was 86.
Read the rest of the article here
Thursday, February 9, 2012
February blah
It's icy cold here. I've stopped bragging that since I'm Canadian, I'm used to this kind of weather. This kind of weather sucks. I no longer have the 40 below wardrobe thanks to the effects of currently living in a more moderate climate. I got rid of the unfashionable Eddie Bauer stuff years ago. Our small apartment is driving me cabin crazy! The only way to make a small apartment bigger is for the people who live there to stay in their rooms or go outside. This works okay for Alex, our middle son. He's got a new job that requires that he arrive at 8 a.m., so he's long gone by the time I get up. He gets home usually around 9 p.m. after socializing with his friends.
This leaves Chris. Ian and I are at work all day, and Chris is alone much of the day, which is not a good thing. Combine that with the wickedly cold weather and self isolation is paranoid-provoking. He sees his psychiatrist, and his occupational therapist, and his voice teacher, but that's kind of "it" in terms of a reason to go out the door during the day. Luckily, he's got a roaring nightlife, for the first time in years, with his various musical commitments. And, a friend of his from first year university (imagine staying in touch with a classmate when you left university after only one year!) has moved here.
Believe me, Chris is mentally stable and I expect him to stay that way. He is a different person in so many ways that the collapsed shell of himself that he was when he had his full blown psychotic episode that landed him in the hospital eight years ago. Would I say he is symptom free? No. The more he stays indoors by himself, the more his mind races. He still has trouble knowing what he's supposed to do in a room. He lingers, he hesitates, he stands in the threshold of a room, undecided about what to do next. Here is a more descriptive example. Ian and I are in the kitchen making dinner and talking about our day. Ian notices that Chris has appeared in the hallway, and is standing facing the kitchen directly, but not saying anything to Ian or me. I've tried to explain to Chris that there is a purpose to being or transitioning through a room. We enter to sit down and read a book, or to shake hands with a guest, or whatever. The point is, Chris, either get into the kitchen and talk (How's your day, is always a good opener), or go off and do something else, but don't just stand there.
The good news is that the occupational therapist, under some pressure from Ian and me, has hooked Chris up with an employment counselor. Chris has filled out a vocational aptitude test for her, called the "Jackson" something or something. Chris pointed out that all these tests seems to have the name "Jackson" associated with them. I immediately thought of Jackson Triggs, but then remembered that Jackson Triggs is a brand name for my beloved red wine. The Jackson test is kind of bizarre. It has multiple questions that, I kid you not, go something like this.
Would you prefer to raise turkeys?
or
Draw a blood sample?
That's all for now. Stay warm.
This leaves Chris. Ian and I are at work all day, and Chris is alone much of the day, which is not a good thing. Combine that with the wickedly cold weather and self isolation is paranoid-provoking. He sees his psychiatrist, and his occupational therapist, and his voice teacher, but that's kind of "it" in terms of a reason to go out the door during the day. Luckily, he's got a roaring nightlife, for the first time in years, with his various musical commitments. And, a friend of his from first year university (imagine staying in touch with a classmate when you left university after only one year!) has moved here.
Believe me, Chris is mentally stable and I expect him to stay that way. He is a different person in so many ways that the collapsed shell of himself that he was when he had his full blown psychotic episode that landed him in the hospital eight years ago. Would I say he is symptom free? No. The more he stays indoors by himself, the more his mind races. He still has trouble knowing what he's supposed to do in a room. He lingers, he hesitates, he stands in the threshold of a room, undecided about what to do next. Here is a more descriptive example. Ian and I are in the kitchen making dinner and talking about our day. Ian notices that Chris has appeared in the hallway, and is standing facing the kitchen directly, but not saying anything to Ian or me. I've tried to explain to Chris that there is a purpose to being or transitioning through a room. We enter to sit down and read a book, or to shake hands with a guest, or whatever. The point is, Chris, either get into the kitchen and talk (How's your day, is always a good opener), or go off and do something else, but don't just stand there.
The good news is that the occupational therapist, under some pressure from Ian and me, has hooked Chris up with an employment counselor. Chris has filled out a vocational aptitude test for her, called the "Jackson" something or something. Chris pointed out that all these tests seems to have the name "Jackson" associated with them. I immediately thought of Jackson Triggs, but then remembered that Jackson Triggs is a brand name for my beloved red wine. The Jackson test is kind of bizarre. It has multiple questions that, I kid you not, go something like this.
Would you prefer to raise turkeys?
or
Draw a blood sample?
That's all for now. Stay warm.
Monday, February 6, 2012
Revisiting "normal"
Gianna Kali at Beyond Meds highlighted in her post today this quote from R.D. Laing.
The condition of alienation, of being asleep, of being unconscious, of being out of one’s mind, is the condition of the normal man. Society highly values its normal man. It educates children to lose themselves and to become absurd, and thus to be normal. Normal men have killed perhaps 100,000,000 of their fellow normal men in the last fifty years.~ R.D. Laing
Which brought to mind the famous Stanford prison experiment
From Wiki
The Stanford prison experiment was a study of the psychological effects of becoming a prisoner or prison guard. The experiment was conducted from August 14–20, 1971 by a team of researchers led by psychology professor Philip Zimbardo at Stanford University.[1] It was funded by a grant from the US Office of Naval Research[2] and was of interest to both the US Navy and Marine Corps in order to determine the causes of conflict between military guards and prisoners.
Zimbardo and his team selected out of 75 respondents, the 24 males whom they deemed to be the most psychologically stable and healthy.
The participants adapted to their roles well beyond what even Zimbardo himself expected, leading the officers to display authoritarian measures and ultimately to subject some of the prisoners to torture. In turn, many of the prisoners developed passive attitudes and accepted physical abuse, and, at the request of the guards, readily inflicted punishment on other prisoners who attempted to stop it.
The condition of alienation, of being asleep, of being unconscious, of being out of one’s mind, is the condition of the normal man. Society highly values its normal man. It educates children to lose themselves and to become absurd, and thus to be normal. Normal men have killed perhaps 100,000,000 of their fellow normal men in the last fifty years.~ R.D. Laing
Which brought to mind the famous Stanford prison experiment
From Wiki
The Stanford prison experiment was a study of the psychological effects of becoming a prisoner or prison guard. The experiment was conducted from August 14–20, 1971 by a team of researchers led by psychology professor Philip Zimbardo at Stanford University.[1] It was funded by a grant from the US Office of Naval Research[2] and was of interest to both the US Navy and Marine Corps in order to determine the causes of conflict between military guards and prisoners.
Zimbardo and his team selected out of 75 respondents, the 24 males whom they deemed to be the most psychologically stable and healthy.
The participants adapted to their roles well beyond what even Zimbardo himself expected, leading the officers to display authoritarian measures and ultimately to subject some of the prisoners to torture. In turn, many of the prisoners developed passive attitudes and accepted physical abuse, and, at the request of the guards, readily inflicted punishment on other prisoners who attempted to stop it.
If conversion disorder makes sense, so does schizophrenia
Bear with me while I try to collect my thoughts on why the opinion of this medical doctor on conversion disorder in a New York State high school should equally apply to the percentage of the population diagnosed with schizophrenia. You can read the full article here.
CNN--Dr. Charles Raison, CNNhealth's mental health expert, is an associate professor of psychiatry at the University of Arizona in Tucson.
Below I have extracted what Dr. Raison says about conversion disorder. Would he, using his own logic*, agree with me that he could be talking about schizophrenia? No, of course he wouldn't agree with me. Schizophrenia is always a special case to a psychiatrist, isn't it?
Dr. Raison
When I teach psychiatry to medical residents, the first thing I tell them is that patients' stories always make sense. No matter how bizarre a person's symptoms might be, our lives follow a human logic, and they follow a medical logic. When a story doesn't make sense, it means you don't know the real story.Medical stories that don't make sense are often big news makers, precisely because they don't make sense. Sometimes, they titillate our hunger for the unexplained. Sometimes, they capture our attention because the medical uncertainty frightens us.
The essence of a conversion disorder is the development of a neurological symptom -- such as the tics seen in the young people of Le Roy -- for which no neural abnormality can be found. Typically, a simple neurological exam will confirm that the symptom doesn't result from any type of brain or nerve damage. And yet patients with conversion disorder have no conscious sense that the symptom is a production of their brains. That is, they are not manufacturing the problem. They are truly afflicted, and it can be horrible.
Only someone who has hypnotized people paralyzed for months and had them hop out of bed and run around the hospital room, or who has conducted "truth serum" interviews of people unable to speak, only to have them erupt into King's English, would believe that such bizarre conditions exist. But having conducted these interventions, and more, I can assure you that people can be completely incapacitated by symptoms with no obvious medical cause.
CNN--Dr. Charles Raison, CNNhealth's mental health expert, is an associate professor of psychiatry at the University of Arizona in Tucson.
Below I have extracted what Dr. Raison says about conversion disorder. Would he, using his own logic*, agree with me that he could be talking about schizophrenia? No, of course he wouldn't agree with me. Schizophrenia is always a special case to a psychiatrist, isn't it?
- strange behavior
- no neural abnormalities
- not manufacturing the problem
- completely incapacitated by symptoms
- makes psychological sense
- age of onset often in teenage years
Dr. Raison
When I teach psychiatry to medical residents, the first thing I tell them is that patients' stories always make sense. No matter how bizarre a person's symptoms might be, our lives follow a human logic, and they follow a medical logic. When a story doesn't make sense, it means you don't know the real story.Medical stories that don't make sense are often big news makers, precisely because they don't make sense. Sometimes, they titillate our hunger for the unexplained. Sometimes, they capture our attention because the medical uncertainty frightens us.
The essence of a conversion disorder is the development of a neurological symptom -- such as the tics seen in the young people of Le Roy -- for which no neural abnormality can be found. Typically, a simple neurological exam will confirm that the symptom doesn't result from any type of brain or nerve damage. And yet patients with conversion disorder have no conscious sense that the symptom is a production of their brains. That is, they are not manufacturing the problem. They are truly afflicted, and it can be horrible.
Only someone who has hypnotized people paralyzed for months and had them hop out of bed and run around the hospital room, or who has conducted "truth serum" interviews of people unable to speak, only to have them erupt into King's English, would believe that such bizarre conditions exist. But having conducted these interventions, and more, I can assure you that people can be completely incapacitated by symptoms with no obvious medical cause.
Read more here.
_____________
* his surname is French for "reason"
Friday, February 3, 2012
OMG - psychiatrist fears losing market share!
I can barely believe what I am reading. Psychiatrist H. Steven Mofic, MD (LOL) is terrified of losing market share. Please click on the link embedded way down in the article (by me!) to see if this particular patient consumer could be recruited for his Occupy Medicine pipedream.
Occupy Medicine: Reclaiming Our Lost Leadership
By H. Steven Moffic, MD | January 10, 2012
Dr Moffic is a Tenured Professor in the departments of psychiatry and behavioral sciences and of family and community medicine at the Medical College of Wisconsin in Milwaukee. He is a regular blogger on www.psychiatrictimes.com. He is an editorial board member of Psychiatric Times.
At last year’s annual American Psychiatric Association (APA) meeting in Hawaii, some prominent psychiatrists wanted to picket the convocation speech of South Africa’s Archbishop Desmond Tutu because of allegations of his possible anti-Semitism. It was a near-protest—but it fizzled out.
Maybe the “Occupy Wall Street” movement suggests a different kind of protest for this year’s meeting. What about “Occupy Medicine” for us psychiatrists? This may sound somewhat ridiculous, given that psychiatrists still make a good living, but we are surely in the 99% of medicine. In fact, we may be in the lower 1% for reimbursement, and high-tech surgeons are in the upper 1%. Managed care companies, Medicaid, and Medicare steeply discount our fees, which are already low. I’m often struck that plumbers make more per hour.
Some may make the counter argument that psychiatrists are increasingly important in the house of medicine. More and more of us have taken on leadership roles in the AMA. Of course, psychiatrists can be criticized for not using our medical training sufficiently in our clinical work. How often we even take vital signs varies quite a bit.
Nevertheless, other medical and mental health professionals have also taken over our business to a great extent. Take primary care physicians, who now prescribe well over half of psychiatric medication prescriptions, despite evidence of limited expertise and success. Primary care physicians don’t even do much minor surgery. Nurse practitioners are hot on the trail of primary care physicians, and in many states and settings, they can prescribe independently (with just with a Master’s education). Psychologists keep trying to join this parade, though so far psychiatrists have risen up in successful protest.
Then there is our other area of major treatment expertise—psychotherapy. Right from the get-go of psychoanalysis—even though Freud was a psychiatrist (and earlier, a neurologist)—other mental health disciplines, even lay people, were allowed and encouraged to become psychoanalysts. Since then, psychoanalytic and newer forms of psychotherapy have been adopted by all disciplines, especially psychology and social work. In some states, unlicensed therapists can freely practice. As managed care has escalated and reduced reimbursement, psychiatrists are doing less and less psychotherapy.
Sure, there are some newer medical psychiatric procedures, like transcranial magnetic stimulation and vagus nerve stimulation, where psychiatrists are dominant. But, for how long and for how many patients?
Where we’ve really given up our product is in diagnosis. Though the APA has put out the official diagnostic manuals in the United States for decades, it opened up its use to any clinician who claimed enough expertise and knowledge. The APA makes a lot of money selling these manuals to other clinicians, who far outnumber psychiatrists, but what does this do to our role and status?
This generosity with DSM authority seems to be a paradox. As we have given away—or had taken away—our leadership roles in many institutions, even medical schools, here we are still in charge. As important as what the diagnostic criteria might be, so is who is qualified to use them. Given that many diagnoses have medical rule outs and considerations, psychiatrists in general should be the most qualified.
Psychiatry is a strange kind of business. We’ve given out our products for free, then watched as other businesses—whether they be other types of clinicians or insurance companies—take over what we do.
Care to try to reclaim more of that 99%? Let us try to reclaim some of our lost leadership. Let us reclaim the upcoming DSM-5 as ours. Let us reclaim the subtle complexity of psychopharmacology and draw the line that other prescribers should have just one strike until we are called in for relief. Let us make clear that combined medication and psychotherapy in one clinician, that is, the psychiatrist, is usually cheaper and more effective for many patients.
However, there is a big obstacle. Psychiatrists, with our Freudian history of being introverted listeners, tend to caring and compassion, but passively. Maybe even at times and places, passive-aggressively. So, we’ve tended to go our own way, adapted to changes in our field, and complained to one another.
Thankfully, the anti-psychiatry movement has died down. In an unexpected way, there’s more of a pro-psychiatry movement becoming embedded in our systems. These are our patient consumers and peer specialists. Could they be recruited as our advance force for Occupy Medicine? Who knows better? Most naturally our patients and their families know what the illnesses have caused them to lose and what they need to recover.
Fittingly, this year’s APA meeting will be in Philadelphia, Pennsylvania, where our country’s Declaration of Independence from Britain was developed and signed. Maybe we psychiatrists should resolve in this New Year to develop a new declaration of our land.
Occupy Medicine: Reclaiming Our Lost Leadership
By H. Steven Moffic, MD | January 10, 2012
Dr Moffic is a Tenured Professor in the departments of psychiatry and behavioral sciences and of family and community medicine at the Medical College of Wisconsin in Milwaukee. He is a regular blogger on www.psychiatrictimes.com. He is an editorial board member of Psychiatric Times.
At last year’s annual American Psychiatric Association (APA) meeting in Hawaii, some prominent psychiatrists wanted to picket the convocation speech of South Africa’s Archbishop Desmond Tutu because of allegations of his possible anti-Semitism. It was a near-protest—but it fizzled out.
Maybe the “Occupy Wall Street” movement suggests a different kind of protest for this year’s meeting. What about “Occupy Medicine” for us psychiatrists? This may sound somewhat ridiculous, given that psychiatrists still make a good living, but we are surely in the 99% of medicine. In fact, we may be in the lower 1% for reimbursement, and high-tech surgeons are in the upper 1%. Managed care companies, Medicaid, and Medicare steeply discount our fees, which are already low. I’m often struck that plumbers make more per hour.
Some may make the counter argument that psychiatrists are increasingly important in the house of medicine. More and more of us have taken on leadership roles in the AMA. Of course, psychiatrists can be criticized for not using our medical training sufficiently in our clinical work. How often we even take vital signs varies quite a bit.
Nevertheless, other medical and mental health professionals have also taken over our business to a great extent. Take primary care physicians, who now prescribe well over half of psychiatric medication prescriptions, despite evidence of limited expertise and success. Primary care physicians don’t even do much minor surgery. Nurse practitioners are hot on the trail of primary care physicians, and in many states and settings, they can prescribe independently (with just with a Master’s education). Psychologists keep trying to join this parade, though so far psychiatrists have risen up in successful protest.
Then there is our other area of major treatment expertise—psychotherapy. Right from the get-go of psychoanalysis—even though Freud was a psychiatrist (and earlier, a neurologist)—other mental health disciplines, even lay people, were allowed and encouraged to become psychoanalysts. Since then, psychoanalytic and newer forms of psychotherapy have been adopted by all disciplines, especially psychology and social work. In some states, unlicensed therapists can freely practice. As managed care has escalated and reduced reimbursement, psychiatrists are doing less and less psychotherapy.
Sure, there are some newer medical psychiatric procedures, like transcranial magnetic stimulation and vagus nerve stimulation, where psychiatrists are dominant. But, for how long and for how many patients?
Where we’ve really given up our product is in diagnosis. Though the APA has put out the official diagnostic manuals in the United States for decades, it opened up its use to any clinician who claimed enough expertise and knowledge. The APA makes a lot of money selling these manuals to other clinicians, who far outnumber psychiatrists, but what does this do to our role and status?
This generosity with DSM authority seems to be a paradox. As we have given away—or had taken away—our leadership roles in many institutions, even medical schools, here we are still in charge. As important as what the diagnostic criteria might be, so is who is qualified to use them. Given that many diagnoses have medical rule outs and considerations, psychiatrists in general should be the most qualified.
Psychiatry is a strange kind of business. We’ve given out our products for free, then watched as other businesses—whether they be other types of clinicians or insurance companies—take over what we do.
Care to try to reclaim more of that 99%? Let us try to reclaim some of our lost leadership. Let us reclaim the upcoming DSM-5 as ours. Let us reclaim the subtle complexity of psychopharmacology and draw the line that other prescribers should have just one strike until we are called in for relief. Let us make clear that combined medication and psychotherapy in one clinician, that is, the psychiatrist, is usually cheaper and more effective for many patients.
However, there is a big obstacle. Psychiatrists, with our Freudian history of being introverted listeners, tend to caring and compassion, but passively. Maybe even at times and places, passive-aggressively. So, we’ve tended to go our own way, adapted to changes in our field, and complained to one another.
Thankfully, the anti-psychiatry movement has died down. In an unexpected way, there’s more of a pro-psychiatry movement becoming embedded in our systems. These are our patient consumers and peer specialists. Could they be recruited as our advance force for Occupy Medicine? Who knows better? Most naturally our patients and their families know what the illnesses have caused them to lose and what they need to recover.
Fittingly, this year’s APA meeting will be in Philadelphia, Pennsylvania, where our country’s Declaration of Independence from Britain was developed and signed. Maybe we psychiatrists should resolve in this New Year to develop a new declaration of our land.
Labyrinth Walking May Calm Stress
Labyrinth Walking May Calm Stress and Promote Tranquility
Labyrinths differ from mazes in that a maze is meant to be a puzzle, posing difficulties in finding the correct path. Labyrinths are simple to follow, the point being that once you enter the path, your attention is meant to stay focused on reaching the center which each person may designate with his or her own value; the end of a journey, the reaching of a goal, satisfaction, balance, tranquility, or God, Himself.
Finger labyrinths were small, desktop sized labyrinths that could be traced with a finger to relax and "balance" oneself. If you would like to try one for yourself, click on the first link provided below to find a pattern to print off for your own use. Notice that the Christian cross is also occupies a dominant area at the bottom center of the pattern. If you are right-handed, try tracing the pattern with your left hand, and vice versa, to increase the challenge, and repeat the pattern several times in a row before stopping.
Read this fascinating article here.
Labyrinths differ from mazes in that a maze is meant to be a puzzle, posing difficulties in finding the correct path. Labyrinths are simple to follow, the point being that once you enter the path, your attention is meant to stay focused on reaching the center which each person may designate with his or her own value; the end of a journey, the reaching of a goal, satisfaction, balance, tranquility, or God, Himself.
Finger labyrinths were small, desktop sized labyrinths that could be traced with a finger to relax and "balance" oneself. If you would like to try one for yourself, click on the first link provided below to find a pattern to print off for your own use. Notice that the Christian cross is also occupies a dominant area at the bottom center of the pattern. If you are right-handed, try tracing the pattern with your left hand, and vice versa, to increase the challenge, and repeat the pattern several times in a row before stopping.
Read this fascinating article here.
Thursday, February 2, 2012
It was much easier being superficial
Sometimes I wish that I could return to the state I was in before Chris and I embarked on the schizophrenic journey, the journey of awakening. I was superficially happy; I didn't want to know about life's darker side. I can't go back to what was, and I also know that my life is much richer now, but still, there is this tinge of wishing that I didn't know so much, perceive so much. If I feel this way, as a mere observer on this journey, imagine what the full experience must be like for Chris and others.
Most writers, poets and artists of all kinds have experienced what happens when everyday reality is stripped away. Aldous Huxley and Percy Bysshe Shelley come to mind:
“The man who comes back through the Door in the Wall will never be quite the same as the man who went out. He will be wiser but less sure, happier but less self-satisfied, humbler in acknowledging his ignorance yet better equipped to understand the relationship of words to things, of systematic reasoning to the unfathomable mystery which it tries, forever vainly, to comprehend”
― Aldous Huxley
Lift not the painted veil which those who live
Call Life: though unreal shapes be pictured there,
And it but mimic all we would believe
With colours idly spread,--behind, lurk Fear
And Hope, twin Destinies; who ever weave
Their shadows, o'er the chasm, sightless and drear.
I knew one who had lifted it--he sought,
For his lost heart was tender, things to love,
But found them not, alas! nor was there aught
The world contains, the which he could approve.
Through the unheeding many he did move,
A splendour among shadows, a bright blot
Upon this gloomy scene, a Spirit that strove
For truth, and like the Preacher found it not.
―Percy Bysshe Shelley
More on Huxley quote in this blog
Most writers, poets and artists of all kinds have experienced what happens when everyday reality is stripped away. Aldous Huxley and Percy Bysshe Shelley come to mind:
“The man who comes back through the Door in the Wall will never be quite the same as the man who went out. He will be wiser but less sure, happier but less self-satisfied, humbler in acknowledging his ignorance yet better equipped to understand the relationship of words to things, of systematic reasoning to the unfathomable mystery which it tries, forever vainly, to comprehend”
― Aldous Huxley
Lift not the painted veil which those who live
Call Life: though unreal shapes be pictured there,
And it but mimic all we would believe
With colours idly spread,--behind, lurk Fear
And Hope, twin Destinies; who ever weave
Their shadows, o'er the chasm, sightless and drear.
I knew one who had lifted it--he sought,
For his lost heart was tender, things to love,
But found them not, alas! nor was there aught
The world contains, the which he could approve.
Through the unheeding many he did move,
A splendour among shadows, a bright blot
Upon this gloomy scene, a Spirit that strove
For truth, and like the Preacher found it not.
―Percy Bysshe Shelley
More on Huxley quote in this blog
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