Monday, May 28, 2012

His outdoor voice

Outdoor and indoor voice is a phrase I learned from Chris's nursery school teacher many, many moons ago. As I entered the school I witnessed a little tyke running around screaming his cheery morning hello at about a thousand decibels. "That's an outdoor voice, Kyle," said the ever patient Karen. "We use our nice, soft indoor voices when we are inside the school."

Well, I learned this week-end that Chris has an outdoor voice and an indoor voice. His indoor voice around our apartment is sometimes hard to hear, and his indoor persona is kind of glum and rarely smiles. Not so, the outdoor Chris. As an official greeter at church, the outdoor Chris warmly greeted people in a hail and hearty way, smiling broadly while firmly grasping and pumping hands. He was the man.

The indoor Chris, I deduce, is a product of the monotony of living at home with his parents and having no regular social interactions through job or school. Judging from the performance I saw this week-end, this indoor personal will eventually change as Chris's life gathers momentum.

Sunday, May 27, 2012

Ron Unger: on how parents can help

Ron Unger has written an insightful post at the Mad in America site. Please read it in its entirety here. I have extracted what he has to say about how parents can interact with their child to effect a positive outcome.

Mystery and nonlinearity applies to our responsibility for interactions with others as well as interactions with aspects of ourselves. Parents for example should be prepared for unpredictable kinds of interactions. There is this expectation in our culture that if one follows some defined set of instructions, a “good” child should be guaranteed, unless of course the child has a biological illness like ADHD or bipolar! This belief system creates incompetent parents, parents who feel they have to make a choice between believing that they themselves are “bad” as in they failed to follow the linear instructions that every “good” parent should know, or believing that their child is “ill” and that care should be turned over to the psychiatrist for diagnosis and chemical repair.

In contrast, a parent who is aware that his or her child is a mystery, and is a complex and inherently unpredictable non-linear system, will instead approach signs of trouble with curiosity and an open mind. Such a parent will be open to feedback about what works with this particular child, and will always consider the possibility that if the parent and others communicated differently to the child, any problems might be resolved. This does not guarantee a positive outcome, because in non-linear interactions nothing can be guaranteed, but the chances of success are much greater. The child now lives in a world of human beings who respond to him or her in a way that models both self respect and humility, and out of such interactions, the child can learn to also have both self respect and humility, firmness and flexibility, etc. Problems do not entirely disappear, but become manageable.

Competent therapists are able to help people restore this sense of mystery, this willingness to engage. But therapists are often instead like parents who believe there should be some set of defined instructions that should always work, and if the problem doesn’t resolve by using such tactics, then the problem must be a biological illness, and the therapist isn’t responsible at all. Instead, what the person really needs is a medication check.

Thursday, May 24, 2012

As long as it takes and it takes a long time

After a two year psychiatrist interruptis, I have scheduled a family meeting in late June with Dr. Stern, Chris's psychiatrist. I have been blissfully happy during this time NOT retraumatizing myself through regular meetings like we used to have.  I booked this meeting by mistake, actually, thinking that it was Dr. Stern who wanted one, and it turns out I misunderstood something Chris said. Be that as it may, Ian and I will be there, and so will Chris's occupational therapist. And, Chris, of course.

Reality check. Chris has received way more therapy than a lot of people get, and, at age 28, he's still not in a position to live independently. It has only been in the past year that he has developed a proactive interest in vocal performance. Recently he has taken on some occasional part time work helping an entrepreneur with an Internet start-up. He's doing the work from home and he is conscientious about doing a good job.

What does it take to fully reconstruct a personality? A lot of time as I have learned. I don't think everybody needs to see a psychiatrist as much as Chris does, but I'm not against it as long as Chris feels he is getting something out of it. This year, apparently, he feels he is. It has taken many years to get to this point.

Psychiatry should not be the only tool - it should be one of many. I shouldn't have to sneak around behind Dr. Stern's back getting additional help for Chris, and that's what I've had to do on several occasions. Psychiatry should not stand in the way of meditation, yoga, martial arts, hypnosis, sound therapy - or any other practice, discipline or therapy that helps a person to integrate the body with the mind. But, if my experience is typical of the experience of others, we are told that these kinds of activities may "destabilize" the person and this is the reason our requests are denied. This is the psychiatrist insisting on control. In my experience what does destabilize a person is high expressed emotion. "Constructive" criticism coming at the wrong time is still criticism. Conveying a sense of worry about the situation can be interpreted as a lack of hope, etc. There can be many reasons a person relapses, and it takes a while to sort it all out without jumping to the wrong conclusions.

Monday, May 21, 2012

Pass it on

Last week I read a fantastic article on Lisbeth Riis Cooper's blog at the Mad in America site. Her guest post is written by a mother who figured out how to help her son, and she mirrors my own thoughts about how to help an adult child recover.

Four years ago my husband accepted a job managing an American manufacturing facility in Shanghai. For one fun, adventurous year, I lived with my husband. For the past three years, my husband and I have lived separately because our youngest adult child has needed a family touchstone in the States.

I am writing this entry while sitting in my husband’s flat in Shanghai. This is my first vacation away from my son in nearly three years. My husband and I have been able to visit Singapore and the ancient and awe-inspiring temples of Cambodia. I was a little nervous about taking this trip, but all is perfectly calm on the home front.

I feel so blessed to share our family’s healing and recovery. Understand we’re still very much in recovery, but healing is coming as swiftly as the onset of our son’s distress.

The author writes that healing can start happening rapidly once a parent or relative grasps what it takes on their part to help recovery. Read the rest of her post here. Don't miss it. Skyblue, a frequent commenter on my blog, has added some excellent commentary to her post.

Friday, May 18, 2012

How I fixed my drinking problem

It was amazingly simple, a stroke of brilliance, really. No twelve step program needed. I should have known earlier how to do it, since I had used the same technique to magically eradicate Chris's so-called schizophrenia and to lose the "baby fat" that I was still carrying around in my late twenties. I'm sure you've already guessed what I'm about to say. All I did was to stop feeling worried and guilty. Magic. An overnight cure! I wasn't drinking any less, I was merely feeling not at all guilty in fact, I was feeling quite enthusiastic about what I was drinking. Sure, I still over-indulge on occasion, but I am no longer berating myself while pouring red wine into increasingly smaller beakers and trying to pretend that I can stretch one unit of alcohol to last all evening!  Tried that - it was a constant reminder that I thought I had a problem. Luckily I live in a culture that values the grape. School events that I attended on behalf of my children always served beer and wine, although they may have put a stop to that now. Church dinners are always B.Y.O.B. Gas stations often come equipped with bars (I swear I'm not making this up!) There seems to be no cultural guilt trip here about the merits of drinking.

Perhaps I am suffering from agnosognia, the inability to recognize that I've got problems - but hey - so what? I'm enjoying myself these days. I enjoy myself by refusing to read medical news. It's all so contradictory, anyway, and I'm a bit of a hypochondriac. Take coffee for example. My boss gleefully informed me the other day that research now shows that three cups of coffee a day adds to longevity. His coffee addiction (three cups)  is obviously no longer a problem to him. Presto chango.

If the DSM-5 expansion of the criteria for addiction takes hold, there is a simple solution, the same as there is for "schizophrenia." Don't consider your addiction a problem, because you can waste much time and valuable creative resources not really fixing the problem, just making yourself feel the worse for it.

Have a good week-end!

Tuesday, May 15, 2012

You can be correctly diagnosed while being mis-diagnosed

Here are some random thoughts of mine on mis-diagnosis.  I haven't got the time to refine my thinking and tweak this post in time for my self-imposed deadline. I'll look at this tomorrow in the sober light of day and make any needed adjustments.

The APA convention and the Occupy the APA demonstration against the DSM-5 have set many groups like the ISEPP (International Society for Ethical Psychology and Psychiatry) to try to come to grips with what is meant by being diagnosed and by being mis-diagnosed. Most of us are struggling to put into words why we think the initial diagnosis is a sham, and what exactly mis-diagnosis implies.

Here's my take on this. Bear with me. First, let's consult our common understanding on words and their opposites.

management         mismanagement
treat                      mistreat
handle                   mishandle
place                     misplace

We know that the second word in each column is the botching of the first. If you are mistreated, this means you are not well treated, and if something is mismanaged, it is not well managed.

Many English words beginning with "mis" mean that the original root word has been negated, or mishandled, mistaken, misled, etc.

So, what does this mean for diagnosis and mis-diagnosis?

I believe that my son was correctly diagnosed by the DSM as "schizophrenic." I also believe that he was mis-diagnosed. When I say mis-diagnosed, I don't mean that the diagnosis was wrong (he ticked most of the boxes for whatever it is that schizophrenia is supposed to be) - but I believe that the diagnosis was mismanaged, mistreated and mishandled, and I certainly was "misled."

Once you are diagnosed by psychiatry, then this diagnosis should properly managed, treated, and handled if it is a valid diagnosis to begin with. If you are diagnosed with herpes, for example, the patient should expect proper follow-through, meaning proper care, treatment and cure. If you truly had herpes and you were well treated, your symptoms should clear up.

What does my interpretation say about psychiatric diagnosis? If you are correctly diagnosed, and correctly treated by psychiatry, then your symptoms should disappear. But they generally don't, do they, under the care of maintream psychiatry?

Mainstream psychiatry will rarely if not ever, admit to a misdiagnosis, because that would imply that they couldn't manage, treat, or handle, the diagnosis.

Therefore, most of the psychiatrically diagnosed who are still struggling with the label, have been mis-diagnosed,  in the spirit of being mistreated, mishandled, mismanaged, etc.

Sunday, May 13, 2012

Philadelphia riff

"I've got a bus load of schizophrenics that I've driven down from New York to demonstrate against the psychiatrists," the middle aged lady hollered across the room to the owner of the diner. No doubt she was relishing the thought that she lived to tale the tale. Ian and I ignored her while we continued to eat our breakfast of fried eggs and coffee. 

The diner owner chimed in from behind the cash register. "Yeah, do me a favor and get those occupiers outta here. I've had enough of those people, coming down last week ago and disrupting everything. You can take all of those mentally ill people back home with you, the sooner the better!"

"But I was surprised," mused the driver, "how well behaved that bunch were."

Ian and I paid our bill then went next door to the Quaker Meeting House in Philadelphia to wait for the presentations to begin. If I ever had any illusions that Occupying the APA in Philadelphia was going to resonate with the common man, woman, well, obviously there's still lots of work to be done. One of the themes of the MindFreedom campaign in Philadelphia was to point out how destructive labels are to people. We need look no further than the bus driver and the diner guy as ample proof that labeling is alive and well, particularly when it comes to schizophrenia and schizophrenics. The common man thinks Psycho and Norman Bates and wouldn't have it any other way. We all like a good scare. Hollywood needs the occasional schizophrenic to fatten its bottom line,  just like the American Psychiatric Association needs the myth of uncurable schizophrenia to do the same to its.

The only encouraging part of the APA approving the DSM-5 this week was Dr. Allen Frances' call for the fox to stop running the chicken coop - meaning there should be fewer psychiatrists on the DSM revision panel and more "supposedly" (my word, not his) neutral parties like the NIMH and the World Health Organization with a greater say in its revision. Don't expect any changes for now for the schizophrenia label - it's too big a revenue source and a great way to scare patients and relatives into submission to psychiatry. Psychiatry doesn't want to cure schizophrenia, it merely wants an orderly bus.

How Not to Cure Schizophrenia

Parents, if you are searching today for help for your son or daughter, it is worth your while to read what Sky Blue Sight has to say about how to treat the mentally ill. Sky Blue speaks from the experience of someone once labelled "schizophrenic."

Sky Blue Sight
Being Cured in an Uncured World
Reflections on Modern Mental Health by a Successful Survivor

How Not to Cure Schizophrenia
The title of this post applies to most of those mental illnesses that have been classified and labeled as incurable brain diseases by the Pharmaceutical dominated contemporary mental health establishment.

How not to treat the mentally ill? Don't treat them as subhumans or objects. Stop thinking of 'treatment' as 'control'. Don't try to treat only the secondary ('positive') symptoms and ignore the consciousness, the personality structure and emotional functioning of human beings.

How to treat them? First allow them to be ill as much as possible (ie do not stop the human process) while at the same time facilitate them to full emotional functioning and guiding them to well being.

This is the point where the psychiatrist control freaks throw up their hands and say that leaves them with nothing. The truth is there are very few human beings that stay out of contact with reality and the environment forever due to mental illness, if any. Roll your shirt-sleeves up, find those contact points and get to work! You've all got a long way to go, all you in the contemporary mental health system , a lot of knowledge to catch up on, it's time to get started on finding out what you can do by listening to those who are there, and who have been there, instead of laboring on what you think you can't do.

Read the rest of this highly informative article here.

Wednesday, May 2, 2012

Money well spent: consider contributing to That's Crazy


There’s a revolution going on in mental health and it’s being led by "the patients." Thousands of people diagnosed with mental illnesses are rejecting standard concepts of illness, treatment and recovery. THAT’S CRAZY is a documentary feature about Eric and 3 others who are on the front lines of this revolt.

Eric, a genetics major, and his father, a doctor living in Madison, Wisconsin never imagined they would challenge the mental health system. But when Eric, diagnosed as schizophrenic, decided to refuse his medications because they made him feel worse, the county issued a set of court orders that allowed police to pick him up and take him to a local hospital to be force medicated. Eric’s decision to refuse involuntary treatment with the help of his family triggers a series of personal, medical and legal battles that are captured by everybody involved as the events take place in real time. Eric's goal - to try a talking based treatment that has the highest success rate for psychosis in the world. Leading mental health activists and allies such as David Oaks and Robert Whitaker explore the science and the ideas behind the movement that believes people like Eric have a right to a voice and a choice in their treatment. Stylized verite reveals the story - animation by Em Cooper illustrates the inner experience.

PRODUCER/DIRECTOR Lise Zumwalt has produced, written and edited films for NATIONAL GEOGRAPHIC TELEVISION, PBS, WNET, BBC, NBC, THE HISTORY CHANNEL and the DISCOVERY CHANNEL on series including NATURE, NOVA, WIDE ANGLE, WHO CARES ABOUT GIRLS, AMERICAN INVESTIGATIVE REPORTS & LOCKDOWN and has won 14 awards for her work. Highlights include, SEX WORKERS OR VICTIMS, an investigation into the domestic sex trade of teenage girls with reporter Lisa Ling, (Gracie Award for Outstanding Documentary ML), IN-BETWEEN, innovative segments about the economy from mainstreamers like Nouriel Roubini to outsiders like Rev. Billy Thalen and the Emmy-nominated INSIDE THE SECRET SERVICE. THAT’S CRAZY is Lise’s first feature project.

Tuesday, May 1, 2012

Emotional maturity and individuation

Haven't posted much lately; haven't had much to say. So much has already been said by me and others about the experience of psychosis that I wonder if there is any new ground upon which to tread. Which brings me to the front lines: How to deal with the day to day job of recovery.

Chris and I had lunch together today. I have noticed for quite a while now that he is sad and looks traumatized. He rarely smiles. He hesitates a lot, takes him a long time to verbally respond or to physically move. I know this doesn't sound like recovery, but I think there's a logic to what he's going through. "Chris, you're like an open wound these days," said I after we had silently munched our way through our respective salads. "You look traumatized. What's the matter?" After about ten minutes, the story began to trickle out. Not much of a plot, really.

"Everybody else knows what to do, Mom. I haven't a clue."

Putting aside my urge to tell him that nobody really is that confident, I congratulated him on accurately perceiving what it takes other people sometimes a lifetime to figure out -- the more you know, the more you know how much you don't know.

On his bad days, Chris walks and talks as if he is sure of nothing. This is progress. When he first embarked on this spiritual journey, he was a brash knight, full of fantasy, with an assurance that psychiatrists label "grandiosity." This wound has been brought to the surface. This, too, is progress. Chris can articulate. He's in pain, but it's no longer invisible.

He's bored with seeing Dr. Stern. Progress! He says he actually feels more intelligent, and he is aware that his younger self was very confused. Progress! He feels that he is benefiting from transcendental meditation. Hooray!

Numerologically, this is Chris's year of hard work. He has just finished a gruelling week-end of performing in H.M.S. Pinafore. He's been offered a small part time job involving computers.  Fingers crossed!

But where to go from here? How does one get through this present impasse? I found an intriguing story on Gianna Kali's blog, that shows how one woman began her process of individuation. (Clearly, according to Jung, Chris is still too young to individuate. He's going to have to settle for emotional maturity for the time being. That's a new, no doubt traumatizing, experience for him. I mean that without irony.)

In another week or two I began to read Jung again, sifting though his abstruse pronouncements looking for practical advice on what to do next, after one had a heavy-duty confrontation with the collective unconscious. The problem was to assimilate it into one’s daylight consciousness and absorb its life-changing lessons, instead of keeping it walled off where its destructive power could break through again. Jung’s term for this process of assimilation was Individuation. Plainly it was going to be a challenge for somebody like me, because he warned that it was a task for the second half of life, something to be undertaken by stable individuals who had made a place for themselves in the world and achieved the necessary emotional maturity. Nobody under forty, he said, should even consider trying to deal with the collective unconscious. Those too young should be led back to the daylight world via Freud.

. . . I read on, looking for the specific techniques Jung used to help his suitably aged patients deal with the unconscious and its frightening contents. He said he had them express their experience somehow, by painting or drawing or writing or even dancing. When they did this, they would begin to have helpful dreams that gave valuable hints on how they should proceed. And of course, they had Jung himself to interpret their dreams and to give them advice and reassurance.

Our journey continues.