NAMI 2011 Convention

Blockbuster Line Up Of Convention Symposia

NAMI is pleased to announce an exciting line up of symposia for our 2011 Convention.

Health Care Reform.

Part I will offer a Washington,D.C., focus on how the health care reform bill is likely to be handled by the new Congress.

Part II will offer "take aways," or what to do with this information when you return home.

Veterans. How NAMI is working to help veterans, the National Guard and reservists in need of mental health and readjustment services post-deployment.

Employment. Why, after all the work to develop supported employment, are 80 percent of adults living with mental illness unemployed? What can local NAMI State Organizations and Affiliates do?

Disciplinary Confinement. Isolation and confinement exacerbate psychiatric symptoms. Efforts underway to respond--including legislation, litigation and voluntary initiatives--will be examined.

Disparities and Cultural Competence. These issues will be addressed in the context of health care reform, supports and treatment availability and strategies for input and action.

Faith, Spirituality and Mental Illness. Dr. Nancy Kehoe returns to further explore the impact of religious and spiritual beliefs on recovery.

Emerging Creativity in Diagnosis and Treatment. Cutting-edge ideas to push the boundaries of our understanding of mental illness and further the effectiveness of diagnosis and treatment.

Federal Special Education Laws. Understanding IDEA, knowing your child's rights and getting effective services.

Change of environment needed

In the car on the week-end, listening to the same radio show. This time the interview was with a management somebody, who was making the same point as the sports psychologist. He said that people are sent on management courses all the time, yet they usually come back to the same dysfunctional office environment that they left. Very quickly they slide back into the same way of thinking and acting.

Here we go again. The same is true with mental health. The patient is released from the hospital (not necessarily improved, just patched over, I may point out) back into the same environment. It could be the family, it could be social housing, it could be living alone. Often, the person regresses because the environment has not changed. It needs to in order to begin or sustain recovery.

I have yet to have a psychiatrist tell me this simple truth or suggest books to me that would help me see how this works because it goes against the disease model of mental illness. Honesty is needed here, even if it means suggesting things people have trouble accepting.

Athletes and mental health sufferers unite!

I was listening in the car this morning to a radio interview with a sports psychologist. He was discussing the case of an internationally competitive skier who had suffered extensive head trauma. The psychologist mentioned that after major accidents like these there is often Post Traumatic Stress Disorder (PTSD) as well as the actual physical trauma.

The sports psychologist treats his athletes using visualizations and other psychological techniques. It occurred to me while he was talking that with professional athletes, the focus is always on getting them back to their former level of fitness and ability to compete. It seems to be universally expected. Athletes are considered society's "winners." All kinds of "right thinking" behavior is credited to them, from being exceptionally focused and mature, to being "intrinsically better" than the next guy, who is roundly criticized for quitting athletics early despite obvious talent.

You probably can tell that I have limited tolerance for putting jocks on Mount Olympus. What irks me is that positive expectations are lavished on jocks and the same cannot be said for those suffering from mental illness. Where are the sports psychologists for our relatives? Our relatives, too, have to get back in the game.

The radio interview discussed the long term prognosis for returning to the sport for the worst kinds of injuries, and the psychologist said that it can be done. He made it sound like it wasn't even such a big deal. In several cases he cited, athletes even managed to surpass their previous records. The psychologist mentioned that PTSD and subsequent recovery can be delayed by people around the athlete, who, in their worried state, actually make the athlete doubt his ability to get back in the game. (That would be the high expressed emotion that I have referred to elsewhere on this blog.)

The sports psychologist discussed the importance of allowing time to heal, and not rushing back too soon because, thinking you are well before you actually are is not a good strategy. I have heard that, too, from psychiatrists, but the difference is that they were coming from a place of pessimism, not positivism. They believe schizophrenia is chronic and, of course, the medications treat everybody as if they were chronic.

So, the psychiatric patient is not getting the kind of treatment that star athletes get. The typical psychiatric patient gets lowered expectations, no hope of full recovery and ability to surpass the previous self. Nobody clues in the family that being worried hinders the individual's recovery.

What's so special about athletes that we can't apply the same treatment to those suffering from mental health problems?

NAMI loves consumers

A festive newsletter from NAMI, exhorting the consumer mentality. You don't even have to get dressed up and go out.

This year, as you recover from your "turkey hangover," start your holiday shopping from the comfort of your own computer by shopping at Amazon.com.

The best part? By shopping Amazon.com NAMI will receive a portion of the proceeds generated by the sale.

Those dollars will go directly to improving the lives of individuals and families affected by mental illness.

Time to practice what I preach

The teenage son of a colleague of mine has just been committed to a psychiatric hospital. He's fourteen years old. He's been receiving psychiatric help for years, but the situation was taking a new turn and becoming dangerous. His father feels all the psychiatry his son has had to date hasn't prevented what is happening now.

Here's an excellent opportunity for me to rush in and give my friend the benefit of all my experience, and yet, I don't. At least, I don't very much.

My advice wouldn't be understood because it's too soon for most people in crisis mode to absorb its simple and, at the same time, complicated message. Mental illness is so personal that it seems that nobody else can possibly have the answers for your own relative. And, of course that's true to some extent. It seems all of us are fated to learn about how to get over mental illness the hard way.

It shouldn't have to be this hard, but it is, because, unfortunately, most psychiatrists aren't willing to embrace alternatives. Right now my friend's son is in isolation, so early empathetic intervention à la Soteria or Open Dialogue isn't being considered. Even if it's not Soteria, doctors should get in there early and tell the parents it's their job to be non-judgmental, low expressed emotion and unafraid. They should but they don't. As long as the parents are scared stiff and worried, doctors can count on being in control.

In our own case, Chris's psychiatrists have, at various times, rejected vitamins, second opinions, sound therapy, and ideas coming from us. Had Chris's psychiatrist known about the Assemblage Point shift, well, I never even proposed it because I knew it would be rejected.  Most psychiatrists, even the ones I think have been helpful for Chris, don't appreciate hearing about add-on therapies. I can understand that to a point. But it often looks more like they want to control the entire process, even if it means that recovery will never happen or be delayed.

So, what did I say to my colleague? Not much, but I tried to interject optimism and a positive attitude about his son's future. I suggested that psychiatrists don't have most of the answers and a healthy amount of skepticism is needed. I mentioned that the Internet is full of different views about mental health. It's far too early to confide in him that one of the best therapies for Chris was for his parents to decide to change the family dynamics by changing ourselves, rather than our thinking that Chris was the problem in need of changing.

It's too bad that psychiatry doesn't share these insights with the family. If it did, recovery would be quicker than it actually is.

The Chandra Levy verdict

I am probably stretching it, but here goes.

You may ask what's the recent verdict in the Chandra Levy case got to do with a diagnosis of schizophrenia?

Chandra Levy was an intern in Washington, D.C. who went out for a run one day in 2001 and never returned. Her body was discovered about a year later in a forested area off a jogging path.

On Monday Ingmar Guandique was convicted of her murder. Astonishingly, he was convicted despite the fact that there was no forensic evidence linking him to the crime, no murder weapon, no knowledge of what actually killed Chandra, no witnesses, and no confession on his part. Other lawyers declined the case because they felt it would be impossible to convict.
There was, however, testimony from a cell mate who claimed that Guandique "confessed" to the crime and from two female joggers who were molested by Guandique around the time that Chandra went missing.

It is astonishing that a conviction could be obtained based on lack of evidence and speculation. It looks like the jury based its verdict on what they would like to believe about the accused, and in doing so blithely overturned centuries of the common law principle of reasonable doubt. Other prosecution lawyers declined the case because they felt it was unwinnable.
A diagnosis of schizophrenia or other mental illness  is arrived at through similar leaps of faith. There is no scientific evidence that schizophrenia is a pathological disease, many people will not confess to being "sick," and yet they will be "convicted" anyway, based on their appearance and of acting outside of social norms.

Is it so astonishing that the Chandra Levy verdict is being heavily criticized for its lack of scientific evidence when those of us in the trenches see lack of scientific evidence guiding most of the legal and policy decisions governing mental health treatment?

What's it like for other people?

It is well-known that no two people labelled "schizophrenic" are alike. One of the hardest things for me at the beginning of this crisis was comparing how Chris was stacking up against "the competition." The competition were the people who were doing better than Chris at the moment or the people who were much older and fully recovered. I was frightened that Chris would be part of the group that wouldn't make it.

Well, I shouldn't have been so worried (and neither should you be about your own relative) because Chris is making it and far surpassing the expectations of the psychiatrists who labelled him in the first place. Even though Chris is not like your son or daughter in the way the crisis unfolded in him it doesn't mean that the remedies are different.  

The point I'm trying to make is that when I report progress with Chris, it may not at all ressemble anything that you are experiencing. When I write that I am pleased that Chris seems utterly bored these days, it may bear absolutely no relation to what's happening with your relative. Yet, I wonder if boredom (or some other under-exercised emotion) is a significant sign of progress that can be applied to anybody in this situation, especially if your relative is the type who never expressed much discontent one way or the other. To be discontented means that something will eventually change. A light may go on. The trick here for me is not to leap in with all kinds of ideas to alleviate boredom. He needs to take sustained action himself.

Let him be bored.