Will Hall, author of The Harm Reduction Guide to Coming Off Psychiatric Medications, has articulated my thoughts on the dangers of the pendulum swinging too far in either direction. We've experienced the one extreme (the biochemical model) of being told that psych meds are the only solution for brain "disease," that medication is normally forever, and that side effects are tolerable and manageable. The growing backlash to that extreme rightfully came about because truthful information was being withheld. But there are now a lot of people working to force the pendulum in the other direction, the one that promotes the idea that medications to treat distress are more dangerous than they are in many cases, that mental illness will go away if people would only get off their meds. A lot of the recovery movements complaints are with how psychiatry has abandoned the nurture of the psyche, therefore perhaps we over-vilify the meds -- the most obvious thing psychiatry does do these days. (It's an easy target.)
I agree with Will, that we are in danger of creating a backlash if we don't take a more balanced approach. (Remember, we want the pendulum to swing disproportionately on our side for as long as possible.) One way to avoid the backlash is to be careful not to replicate the mistake of withholding or denying information that doesn't fit our sometimes simplistic view of getting on or off the drugs.
In the comments section to his post, Will writes:
I think, in our efforts to alert the world about the dangers of psych drugs, we sometimes overstate the case. Psychiatry has erred for so long in favor of meds, we shouldn’t make the opposite mistake by exaggerating the dangers of drugs.That is not to deny that people are killed and seriously damaged by medications, but if we express only these accounts we are distorting a complicated picture.
What I am seeing these days is people and families who read Bob’s work and think that getting off meds is the solution. Often it is, like a magic bullet in reverse. Sometimes it’s not. I fear if we promote coming off meds, we are setting ourselves up for a backlash just like is happening now to those who promoted taking meds. Maybe a smaller backlash, and maybe the overarching message is better, but I’d rather be honest at the outset.
Will Hall is always worth reading. He knows his stuff and he's willing to admit what he doesn't know, and that people and situations are complex. Here's the link to his post at the Mad in America site.
Sunday, November 11, 2012
Thursday, November 8, 2012
Ubuntu
Op-Ed
Lost and Found in Santa Barbara
by Suzanne Beachy
November 7, 2012
A few springs ago, I flew out to Santa Barbara from Columbus, Ohio for what would have been my son Jake’s 29th birthday. I needed to see for myself where he had lived and died as a homeless person the year before. Even now as I write those words, I am flooded by sorrow and shame. How could this have happened? How could my beautiful, sensitive, generous, funny, brilliantly creative son’s life have ended this way? It was unthinkable.
So many unanswered questions. This doesn’t happen to good parents, does it? Just lousy parents, right? Or was this horror Jake’s fault? Had he been just plain stubborn? Maybe the grip of substance abuse and escapism was too strong to resist? Had he suffered from a mental illness? Was he just plain bugged? Shouldn’t I have been able to save this precious person from a spiral of self-destruction? I had tried so many ways but nothing had helped – not the counselors or the psychologist, or the recovery programs, or medication. Years of frustration finally caused my kindness, patience, and understanding to give way to desperation, panic, and ultimatums.
Read more of Suzanne's moving story here
Lost and Found in Santa Barbara
by Suzanne Beachy
November 7, 2012
A few springs ago, I flew out to Santa Barbara from Columbus, Ohio for what would have been my son Jake’s 29th birthday. I needed to see for myself where he had lived and died as a homeless person the year before. Even now as I write those words, I am flooded by sorrow and shame. How could this have happened? How could my beautiful, sensitive, generous, funny, brilliantly creative son’s life have ended this way? It was unthinkable.
So many unanswered questions. This doesn’t happen to good parents, does it? Just lousy parents, right? Or was this horror Jake’s fault? Had he been just plain stubborn? Maybe the grip of substance abuse and escapism was too strong to resist? Had he suffered from a mental illness? Was he just plain bugged? Shouldn’t I have been able to save this precious person from a spiral of self-destruction? I had tried so many ways but nothing had helped – not the counselors or the psychologist, or the recovery programs, or medication. Years of frustration finally caused my kindness, patience, and understanding to give way to desperation, panic, and ultimatums.
Read more of Suzanne's moving story here
Wednesday, November 7, 2012
The new aging
Another birthday milestone was celebrated this past week-end. Mine. Looking over the past eleven months in terms of numerology, I was in a personal year 2, which means I began a new nine tragetory of change in 2011. A personal year 2 is a wait and see time, of small contributions rather than large ones, of delays, detours and stoppages. It does seem that 2012 has been stoppages and delays, since I have virtually stopped working on my eponymous memoir. I just can't muster up the enthusiasm.
Chris is in a personal year 4 of hard work, transitioning this coming January to a personal year 5, a year of major change, freedom, new friends and social activities. The good news is that I, too, will be transitioning to a more action packed year in 2013, and, according to the above link, "a good time to expand personal creative talents, particularly those related to the arts and verbal skills. Recognition in this regard is likely this year." Maybe I'll finally finish the memoir!
These predictions may sound as vague and open-ended as a daily horoscope, but I have come to rely a lot of numerology, almost as nature's way of telling me to take a longer term view, to be thoughtful and patient. Change takes time. Change is continous. With mental health labels, we often let time be our enemy. Most of us don't think in decades, we think in deadlines. If I'm not married by the time I'm 30, if I don't have a career or even a job or degree by the time I'm such and such an age, etc.
Paying attention to numerology is also a needed dose of optimism that change will happen. I've been a hovering parent for the past ten years and I don't want this role much longer. Chris is coming along nicely. He's loving his musical theater work and has found a good group of diverse individuals who share a common passion for music and the stage. He has picked up a girlfriend (a chorus girl!) who shares these interests. It took him eight years to open up enough to seek out the companionship of others.
Change needs to happen for us both. I'll be retiring at the end of 2013 and would like to see Chris by then having a toehold on a future path so that I can be free to enjoy wherever mine will take me. Chris has plenty of volunteer work to his credit. He needs to start building credentials either through vocational training and/or further schooling . Will he be able to make the transition? Does he have the commitment to set a goal and carry out the hard work involved in getting there. This is a question mark. He's still too concerned about MY welfare. How do you explain to someone to forget about me, be selfish for you? I've tried making that point many, many times since Chris was a child, and from what I can tell, it's part of the territory of SZ to be so totally self-less. (In her memoir, author Elyn Saks writes that she once told a therapist that she no longer wanted to see her (Karen) because her parents were upset that the therapist hadn't figured this out and come up with a plan, and that it cost them too much money to continue to see her. "It never occurred to me back then (and if it occurred to Karen, she didn't say so) that I was taking better care of my parents than I was of myself.") Amen, Elyn.
I've told Chris in as many ways I can make the point, that his father and I aren't feeble, we aren't looking for his support, nor do we want it. Our job is to help him become independent, which is largely about his putting himself first, for once. He can also be of much greater service to others, I continue to point out, if he has some credentials behind him that can orchestrate bigger, more permanent changes in people's lives than helping little old ladies across the street or a picking up litter on a daily basis.
Chris is in a personal year 4 of hard work, transitioning this coming January to a personal year 5, a year of major change, freedom, new friends and social activities. The good news is that I, too, will be transitioning to a more action packed year in 2013, and, according to the above link, "a good time to expand personal creative talents, particularly those related to the arts and verbal skills. Recognition in this regard is likely this year." Maybe I'll finally finish the memoir!
These predictions may sound as vague and open-ended as a daily horoscope, but I have come to rely a lot of numerology, almost as nature's way of telling me to take a longer term view, to be thoughtful and patient. Change takes time. Change is continous. With mental health labels, we often let time be our enemy. Most of us don't think in decades, we think in deadlines. If I'm not married by the time I'm 30, if I don't have a career or even a job or degree by the time I'm such and such an age, etc.
Paying attention to numerology is also a needed dose of optimism that change will happen. I've been a hovering parent for the past ten years and I don't want this role much longer. Chris is coming along nicely. He's loving his musical theater work and has found a good group of diverse individuals who share a common passion for music and the stage. He has picked up a girlfriend (a chorus girl!) who shares these interests. It took him eight years to open up enough to seek out the companionship of others.
Change needs to happen for us both. I'll be retiring at the end of 2013 and would like to see Chris by then having a toehold on a future path so that I can be free to enjoy wherever mine will take me. Chris has plenty of volunteer work to his credit. He needs to start building credentials either through vocational training and/or further schooling . Will he be able to make the transition? Does he have the commitment to set a goal and carry out the hard work involved in getting there. This is a question mark. He's still too concerned about MY welfare. How do you explain to someone to forget about me, be selfish for you? I've tried making that point many, many times since Chris was a child, and from what I can tell, it's part of the territory of SZ to be so totally self-less. (In her memoir, author Elyn Saks writes that she once told a therapist that she no longer wanted to see her (Karen) because her parents were upset that the therapist hadn't figured this out and come up with a plan, and that it cost them too much money to continue to see her. "It never occurred to me back then (and if it occurred to Karen, she didn't say so) that I was taking better care of my parents than I was of myself.") Amen, Elyn.
I've told Chris in as many ways I can make the point, that his father and I aren't feeble, we aren't looking for his support, nor do we want it. Our job is to help him become independent, which is largely about his putting himself first, for once. He can also be of much greater service to others, I continue to point out, if he has some credentials behind him that can orchestrate bigger, more permanent changes in people's lives than helping little old ladies across the street or a picking up litter on a daily basis.
 |
| 105 today! The men all died off years ago. |
Monday, October 29, 2012
Wednesday, October 24, 2012
Afghanistan shrine treats mental illness
At Afghan shrine, ancient treatment for mental illness
By Kevin Sieff, Wednesday, October 24, 3:00 AMThe Washington Post JALALABAD, Afghanistan
— No one here knows the man whose left leg is shackled to the wall of cell No. 5. Last week, he finished tearing his mattress to shreds and then moved onto his clothes, ripping his shirt and pants off before falling asleep naked.
“He’s insane,” say the villagers who have come to gawk at him. “He doesn’t know whether he’s in this world or another.”
“He’s getting better!” said Mia Shafiq, the man responsible for his recovery and the one who shackled him to the wall of a shrine in this eastern Afghan city.
The man’s brothers drove him here from southern Kandahar province two weeks ago, drawn by the same belief that has attracted families from across Afghanistan for more than two centuries. Legend has it that those with mental disorders will be healed after spending 40 days in one of the shrine’s 16 tiny concrete cells. They live on a subsistence diet of bread, water and black pepper near the grave of a famous pir, or spiritual leader, named Mia Ali Sahib.
Every year, hundreds of Afghans bring mentally ill relatives here rather than to hospitals, rejecting a clinical approach to what many here see as a spiritual deficiency. The treatment meted out at the shrine and a handful of others like it nationwide might be archaic, but the symptoms are often a response to 21st-century warfare: 11 years of nighttime raids, assassinations and suicide bombings.
For over a decade, Western donors have helped train Afghan psychiatrists, who diagnose many of their patients as having an ailment with a distinctly modern acronym: PTSD, or post-traumatic stress disorder. Mental health departments in Afghanistan are plastered with posters detailing the disorder’s symptoms. Pharmacies are stocked with antipsychotic drugs.
But many of those suffering from the disorder never see doctors or pharmacists. Instead, they are taken on the long, unmarked dirt road, through a village of mud huts, that leads to an L-shaped agglomeration of cells.
Read the rest here
By Kevin Sieff, Wednesday, October 24, 3:00 AMThe Washington Post JALALABAD, Afghanistan
— No one here knows the man whose left leg is shackled to the wall of cell No. 5. Last week, he finished tearing his mattress to shreds and then moved onto his clothes, ripping his shirt and pants off before falling asleep naked.
“He’s insane,” say the villagers who have come to gawk at him. “He doesn’t know whether he’s in this world or another.”
“He’s getting better!” said Mia Shafiq, the man responsible for his recovery and the one who shackled him to the wall of a shrine in this eastern Afghan city.
The man’s brothers drove him here from southern Kandahar province two weeks ago, drawn by the same belief that has attracted families from across Afghanistan for more than two centuries. Legend has it that those with mental disorders will be healed after spending 40 days in one of the shrine’s 16 tiny concrete cells. They live on a subsistence diet of bread, water and black pepper near the grave of a famous pir, or spiritual leader, named Mia Ali Sahib.
Every year, hundreds of Afghans bring mentally ill relatives here rather than to hospitals, rejecting a clinical approach to what many here see as a spiritual deficiency. The treatment meted out at the shrine and a handful of others like it nationwide might be archaic, but the symptoms are often a response to 21st-century warfare: 11 years of nighttime raids, assassinations and suicide bombings.
For over a decade, Western donors have helped train Afghan psychiatrists, who diagnose many of their patients as having an ailment with a distinctly modern acronym: PTSD, or post-traumatic stress disorder. Mental health departments in Afghanistan are plastered with posters detailing the disorder’s symptoms. Pharmacies are stocked with antipsychotic drugs.
But many of those suffering from the disorder never see doctors or pharmacists. Instead, they are taken on the long, unmarked dirt road, through a village of mud huts, that leads to an L-shaped agglomeration of cells.
Read the rest here
Bob Chiarelli speaks for the first time about his son's schizophrenia
Bob Chiarelli is an Ottawa and provincial politician who is contemplating a bid for the Ontario Liberal leadership. This story appeared today in the Ottawa Citizen.
It's frustrating for me that no comments on this article are allowed, and I assume it is a way of protecting the man and the position from some of the more outrageous things that the public likes to say in comment boxes. If comments were allowed, I would respectfully take issue with the dismal depiction of schizophrenia as a life long brain disorder and chemical imbalance, and with the notion expressed in the article that "medications are so much better" these days - an opinion that is compromised by the mounting evidence about the ineffectiveness of the drugs and the side effects. I was astonished to read that Chiarelli's son Christopher was on 100 pills a day when he was first hospitalized. 100 pills a day? Did I read that right?
My sympathy is very much with Mr. Chiarelli and his family in their bereavement. My issue is with the continued spreading of pessismism, by the media and through the media, about "schizophrenia." How can one recover or help others to recover when the condition is draped in black cloth? So called "mental" illness is considered after all, mental, and therefore IS particularly amenable to a positive thinking approach.
Casual readers of the Citizen story will come away with the same dismal view of schizophrenia that has the effect of preventing the public at large from learning that, properly understood and handled, "schizophrenia" is not a life-time sentence. (Talk about stigma!) When I read articles like this, I ask myself, what if members of my extended family read this? Would they assume my son will eventually work full time, get married and lead an otherwise productive life, OR, would they, like the general public absorb the pessimistic message? My guess is the latter. Unlike me, my family hasn't needed to be up to speed on the latest research and controversies about the label, so they may rely on articles like these to tell them what's what.
I hope that Mr. Chiarelli will continue to work for mental health organizations, and will keep an open mind about the good news coming out of today's recovery movement.
It's frustrating for me that no comments on this article are allowed, and I assume it is a way of protecting the man and the position from some of the more outrageous things that the public likes to say in comment boxes. If comments were allowed, I would respectfully take issue with the dismal depiction of schizophrenia as a life long brain disorder and chemical imbalance, and with the notion expressed in the article that "medications are so much better" these days - an opinion that is compromised by the mounting evidence about the ineffectiveness of the drugs and the side effects. I was astonished to read that Chiarelli's son Christopher was on 100 pills a day when he was first hospitalized. 100 pills a day? Did I read that right?
My sympathy is very much with Mr. Chiarelli and his family in their bereavement. My issue is with the continued spreading of pessismism, by the media and through the media, about "schizophrenia." How can one recover or help others to recover when the condition is draped in black cloth? So called "mental" illness is considered after all, mental, and therefore IS particularly amenable to a positive thinking approach.
Casual readers of the Citizen story will come away with the same dismal view of schizophrenia that has the effect of preventing the public at large from learning that, properly understood and handled, "schizophrenia" is not a life-time sentence. (Talk about stigma!) When I read articles like this, I ask myself, what if members of my extended family read this? Would they assume my son will eventually work full time, get married and lead an otherwise productive life, OR, would they, like the general public absorb the pessimistic message? My guess is the latter. Unlike me, my family hasn't needed to be up to speed on the latest research and controversies about the label, so they may rely on articles like these to tell them what's what.
I hope that Mr. Chiarelli will continue to work for mental health organizations, and will keep an open mind about the good news coming out of today's recovery movement.
Tuesday, October 23, 2012
National Public Radio on the changing face of psychiatry
Dr. Steve Balt, psychiatrist and editor-in-chief, The Carlat Psychiatry Report, and Dr. Richard Friedman, director, Psychopharmacology Clinic, Weill Cornell Medical College
Copyright © 2012 National Public Radio. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required.
NEAL CONAN, HOST:
This is TALK OF THE NATION. I'm Neal Conan in Washington. Just about everyone's image of a psychiatrist's office includes a long couch, dim lights and a doctor with a notepad asking: And how did that make you feel? A stereotype, of course, and way out of date at that. Over the past 20 years, few professions have seen more change than psychiatry.
Weekly, 45-minute appointments are largely a thing of the past. Many psychiatrists see patients for 15 minutes, one after another. Instead of listening, they ask a series of questions, write out prescriptions, and refer their patients to a psychologist or to a social worker for therapy.
While some in mental health circles feel these changes are necessary, others worry they hurt both patients and doctors. We want to hear from psychiatrists in our audience today. How has your practice changed? Give us a call, 800-989-8255. Email us, talk@npr.org. You can also join the conversation by going on our website. That's at npr.org. Click on TALK OF THE NATION.
Read the rest of the transcript and listen to the audio link.
Copyright © 2012 National Public Radio. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required.
NEAL CONAN, HOST:
This is TALK OF THE NATION. I'm Neal Conan in Washington. Just about everyone's image of a psychiatrist's office includes a long couch, dim lights and a doctor with a notepad asking: And how did that make you feel? A stereotype, of course, and way out of date at that. Over the past 20 years, few professions have seen more change than psychiatry.
Weekly, 45-minute appointments are largely a thing of the past. Many psychiatrists see patients for 15 minutes, one after another. Instead of listening, they ask a series of questions, write out prescriptions, and refer their patients to a psychologist or to a social worker for therapy.
While some in mental health circles feel these changes are necessary, others worry they hurt both patients and doctors. We want to hear from psychiatrists in our audience today. How has your practice changed? Give us a call, 800-989-8255. Email us, talk@npr.org. You can also join the conversation by going on our website. That's at npr.org. Click on TALK OF THE NATION.
Read the rest of the transcript and listen to the audio link.
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