Media’s Failed Approach to Madness, Parts 1 & 2

37
464

“So, how does the media affect our views of mental health?”

When I introduce the elective recovery education course called In The Media, I don’t show any news clips or magazine articles. I don’t pull up any statistics or make any statements. I don’t  offer any definition of stigma.

I just ask that simple question: “How does the media affect our views of mental health?”

Some students speak up immediately, while others settle back in their chairs to think and to listen. Some raise their hands a little, start to speak and then quiet down again.

“It’s like they make it out like your, like you’re…” The young woman studied the ends of her hair as she spoke, dark-lined eyes cast down.

“They make it like you’re crazy!” The older woman beside her exclaimed, her voice emphatic, exasperated, a little angry.

The young woman looked up, looked around at the class, “Yeah!” she said, “they make it look like you’re all crazy! Like you’re just some…I don’t know… crazy person!”

She smiled when she realized that she was in a room full of people who, in their way, understood exactly what she was talking about.

***

The students at the recovery education center where I facilitate classes have typically had less-than-average access to higher education. In general, many of the students at the state-funded center have had extensive trauma in their lives, compounded abuse and injury. It is not uncommon for students to have had dealings with law enforcement and child protection agencies. They have all survived a lot and, in recovery, are eager to explore the shrewd wisdom that is earned through learning how to staying alive and to live well on their own terms. For many, it has been years since they were invited to speak their mind and share their insights, years since anybody listened to them. It is remarkable how wise they are.

***

“The way they talk about it on the news makes you feel like some kind of freak!” The young man who spoke up hadn’t shaved in several days. Under the fluorescent lights he looked tired.

At the hospital, an involuntary commitment that followed an argument with his mother, he’d been put on four different psychiatric medications and was trying to figure out how to establish a self-directed wellness that didn’t require him to be on drugs that caused him to feel tired and slow, to gain weight and to have to contend with erectile dysfunction. He’d been told, on various occasions, that he had bipolar disorder, schizoaffective disorder, and borderline personality disorder, but the primary things that he had decided to work on at the REC were the flashpoint anger that is common in post-trauma disorders and exploring ways to cope with anxiety and low self-worth.

“They treat you like you’re…some kind of…like, psycho or something.”

He fell silent.

***

This past year has been a terrible year for mental health in the news and other media.  The most prevalent and widely publicized messaging has been heartily encouraged by national lobbying groups that “advocate” for expanded treatment of what they have deemed “severe diseases of the brain.” These groups, such as E. Fuller Torrey’s Treatment Advocacy Center, Mental Health America, the National Alliance for the Mentally Ill, and the Balanced Mind Foundation are based on biomedical models and are funded, at least in part, by the pharmaceutical corporations that profit from mental illness.

These groups, along with commentators, public officials and families have been sharply critical of the “mental health system” lately, issuing a sustained outcry for more funding and more treatment availability. The type of treatment that is being suggested is not recovery education or Peer-run respite centers, it is not community support and wellness planning. Psychiatrists and proponents of the medical model are calling for what is basically a soft re-institutionalization of people deemed mentally ill, particularly those with diagnoses erroneously assumed to be unilaterally severe and “treatable, but not curable.”

“More longterm treatment! More access to hospital beds! More outpatient commitment laws! More closely monitored medication!”

This perspective is driven by fear and misinformation, fueled by the belief that struggle in one’s human experience is an illness that has the potential to drive people to commit heinous acts from out of nowhere.

The gains that have been made by anti-stigma campaigns are crumbling as I write this.

Then again, anti-stigma campaigns do not typically support recovery. In fact, anti-stigma messages are often framed in such a way as to communicate, “Hey, you do have a brain disease, and there is nothing you can do but seek treatment, but that’s okay.”

As a person who would be identified by medical model psychiatrists as having a severe and persistent mental illness, I have to say, “No. Actually, that’s not okay.”

On December 25th, an essay written by one Dr. Paul Steinberg, titled Our Failed Approach to Schizophrenia, was published as an Op-Ed in the New York Times. Here is an excerpt:

People with schizophrenia are unaware of how strange their thinking is and do not seek out treatment. At Virginia Tech, where Seung-Hui Cho killed 32 people in a rampage shooting in 2007, professors knew something was terribly wrong, but he was not hospitalized for long enough to get well. The parents and community-college classmates of Jared L. Loughner, who killed 6 people and shot and injured 13 others (including a member of Congress) in 2011, did not know where to turn. We may never know with certainty what demons tormented Adam Lanza, who slaughtered 26 people at an elementary school in Newtown, Conn., on Dec. 14, though his acts strongly suggest undiagnosed schizophrenia.”

The essay written by Dr. Steinberg completely disregards the many viable alternative approaches to healing what is clinically seen as schizophrenia. Instead, he took this approach, which is itself extreme:

“…greater insurance coverage and capacity at private and public hospitals for lengthier care for patients with schizophrenia; intense public education about how to deal with schizophrenia; greater willingness to seek involuntary commitment of those who pose a threat to themselves or others; and greater incentives for psychiatrists (and other mental health professionals) to treat the disorder, rather than less dangerous conditions. Too many people with acute schizophrenia have gone untreated. There have been too many Glocks, too many kids and adults cut down in their prime.

Enough already.”

Well, yes, I would say so.

The perspective presented by Dr. Steinberg is, I believe, dangerous. It supports violence and abuse. It feeds fear and delusion.

It is not helpful.

Why then does the media persist in promoting the medical model of mental illness?

I’ll let you consider that for a moment, and draw your own conclusions.

I’d suspect that it has something to do with:

A) the cultural phenomenon of misinformation

B) pressure from moneyed and influential sources of misinformation

C) a taste for the drama of slow human tragedy

Regardless of how we personally choose to frame our understanding of human distress, it is likely that we can all agree that the media has a responsibility to accurately report all sides of the story and to be conscientious of the language that they use to describe the lives of millions of Americans.

Anyone who visits this site knows that there are alternatives, in both practice and perspective. I’d encourage us all to communicate with media outlets about the importance of offering fair coverage of topics relating to mental health in this country. We can do this through writing letters to editors, blogging, and use of social media.  Below, I’ve copied the letter I wrote to the Op-Ed editor at The New York Times, regarding my concern over the paucity of alternative perspectives.

My hope is that even the smallest voices may help media outlets to realize their responsibility to not deny people perspectives that offer solutions and which support hope and community wellness.

If given access to healing resources, people do heal and it is important that the media acknowledge that fact.

 

That being said:

To Whom it May Concern,

 

I’d like to respond to your 12-25-2012 publication of the Op-Ed titled Our Failed Approach to Schizophrenia, by Paul Steinberg.

I understand that Dr. Steinberg is a psychiatrist and that the training and protocol of his profession support his perspective on schizophrenia and how it may best be intervened upon. However, I think it is well worth noting that there are many other approaches to the human condition that is clinically deemed ‘schizophrenia.’

Dr. Steinberg approaches schizophrenia as a biomedical disease, with distinct pathology and looming prognosis. We know that the condition that is called schizophrenia, and psychosis in general, does involve people’s brains, because our brains are an integral element in our experiencing of life, but people’s minds and hearts play a significant role in how human distress arises. One could say, depending on subjective experience, that the mind and the heart are far more important than the brain in determining what the outcomes and the effects of difficulty in coping may be.

There are good reasons for us to be concerned with the state of mental health in this country and in the world.

Nonetheless, the medical model of mental illness offers little more than a brutally reductionist framing of our humanity, one in which disease severely and persistently supersedes one’s rights and undermines one’s potential.  Perhaps the failure we should be concerned with is the failure of psychiatry itself and the failure of the treatments prescribed.  In the past century, we have seen the rates of “mental illness” skyrocket, doubling and tripling, ever-expanding to now include 1 in 4 adults and increasing numbers of children. [1][2]

This phenomenon is well-documented in Robert Whitaker’s book, Anatomy of An Epidemic, which examines the rise of mental illness in America as a product of the expansion of pharmapsychiatry. According to Whitaker, psychiatry itself may be perpetuating illness in such a way that human distress is exacerbated rather than healed. [3] This is not a radical or anti-psychiatry view, but a well-reasoned alternative explanation for what might be going so terribly wrong that federal and state government agencies are spending millions of dollars to fail, miserably and obviously, in meeting the mental health needs in this country.

I’m sure that a newspaper such as the New York Times is aware of the recovery movement, which supports empowerment, integrated community healing, education and self-determination in structuring one’s own wellness. This is not radical. In fact, in several states, public funds are used to support education centers and non-medical crisis alternatives, such as Peer-run respite houses.  Peers are people with “lived experience” who now work in settings that support individuals in navigating their difficulties and strengths in ways that work for them.[3]

Many of the approaches used in recovery education settings are evidence-based, which means that they have gained the approval of federal agencies as programs and practices that produce measurable rates of self-reported recovery. Common examples of non-medical evidence based practices are Dr. Mary Ellen Copeland’s Wellness Recovery Action Plan and Dr. Marsha Linehan’s Dialectical Behavior Therapy. [4][5] Another promising practice is eCPR, which stands for emotional CPR and is being developed by Dr. Daniel Fisher, who recovered from a diagnosis of schizophrenia and went on to become a psychiatrist who served on President Bush’s New Freedom Commission.[6]  It is worth noting that both Dr. Copeland and Dr. Linehan also have lived experience, as do many other leading professionals in conscientious and ethical mental health.

In addition to state-funded recovery resources, grassroots advocates have organized networks of community support to help people to live full and self-determined lives regardless of their mode of human experience. As a person who carries a diagnosis that identifies me as being on “the psychotic spectrum,” it was transformative and healing to come across the work of MindFreedom International, The Hearing Voices Network, and The Icarus Project, visionary grassroots organizations that seek to redefine what we mean by mental health and to offer people access to resources of support and information.

Why is it that the loudest voice in the room is the voice of biomedical psychiatry?

In many editorials and commentaries, people seem to acknowledge that something doesn’t seem to be working in the “here’s-a-label-and-a-pill” approach, and there is increasing concern over the correlational link between dangerous side-effects of pharmaceuticals (SSRIs, stimulants, and steroids in particular) and societal violence.[7]

I am aware that many statements were released to the press following the Newtown tragedy and I have been saddened to see that the perspectives on mental health highlighted by the media are those which are rooted in disease-model language and practice.  It has been well-established that there are alternative approaches to human distress and that people can, if empowered to do so, recover from even the most damning diagnoses.

Activists and advocates in the consumer/survivor/ex-patient movement, which is largely ignored by the press, are able to speak articulately about the harm that forceful and coercive treatment does. It has been well-established that many of the practices common to psychiatric intervention actually violate human rights as they are outlined in the United Nations’ Convention on the Rights of People with Disabilities. [6]

In spite of viable alternatives, the media would have us to believe that the only response to the mental health crisis in this country is to expand traditional mental health services and enforce further compulsory screening and treatment, regardless of the fact that many biomedical treatments do not support recovery, are costly, and may even be stigmatizing and traumatizing in ways that further human distress. It has been shown that Peer-driven mental health services and recovery education can be more cost-effective and tend to have better outcomes than biomedical interventions.

It is negligent of psychiatry to disregard the role of trauma in people’s experience of distress and while Dr. Steinberg did acknowledge that stress plays a role in the onset of disorder, he failed to indicate what, specifically, the stressors that lead to disordered experiences may be. Trauma, abuse, processing differences, individual personality structures, relational dysfunction…all of these things play a role in our ability to meet the expectations of “normal” coping and compliance placed upon us.

I do not believe that it is a disease if someone fails to have their human needs for affirmation, comfort, acceptance, and understanding met. I do not believe it is a disease if someone is hurt, confused, or angry. I do believe that it is a tragedy that our country’s mental health culture and practice is structured in such a way that these basic human needs are routinely denied in people’s seeking help and that, rather than being helped, people are frequently harmed by the mental health system.

I’d appreciate it if you would consider presenting more alternative perspectives on mental health, as it is important that people know that there are other approaches and, more importantly, that there is hope.

Thank you for your time in considering this perspective. Have a nice day.

Sincerely,

Faith Rhyne, Certified Peer Support Specialist
Asheville, NC

References and Perspective Resources

[1]National Institute of Mental Health http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml

[2] National Institute of Mental Health http://www.nimh.nih.gov/science-news/2009/national-survey-tracks-rates-of-common-mental-disorders-among-american-youth.shtml

[3] The National Association of Peer Specialists http://www.naops.org/

[4] Robert Whitaker, Anatomy of An Epidemic. http://robertwhitaker.org/robertwhitaker.org/Anatomy%20of%20an%20Epidemic.html

[5] Dr. Mary Ellen Copeland, Wellness Recovery Action Plan. www.mentalhealthrecovery.com

[6]Dr. Marsha Linehan, The New York Times, Expert on Mental Illness Reveals Her Own Fight.

[7] The National Empowerment Center, www.power2u.org

[8] Dr. David Healy, Antidepressants and Violence: Problems at the Interface of Medicine and Law. http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0030372

[9]World Network of Users and Survivors of Psychiatry, United Nations Convention for the Rights of Persons with Disabilities. http://www.wnusp.net/UnitedNations_MMtmp03630c55/UnitedNationsConventionfortheRightsofPersonswithDisabilities.htm

Note: All anecdotes have been fictionalized due to sensitivity of confidential information and out of respect for individuals. However, they do reflect actual dialogue and circumstances that are commonly encountered in recovery education settings.

***

Part 2:

To be honest, I wasn’t entirely sure what Part 2 might entail. There are, after all, so many ways that popular media has failed to support an informed and compassionate understanding of madness and humanity.

I figured something would come up in the news and, lo and behold, something did.

Of course, it wasn’t exactly news. It was this:

“…the most seriously mentally ill who are not in treatment and are psychotic, delusional, or hallucinating, or are off treatment that has previously prevented them from being violent, are in fact more prone to violence than others.”

This statement was made by DJ Jaffe in an essay published by the Huffington Post just days after Dr. Paul Steinberg published his perspective on schizophrenia in the New York Times. Jaffe’s essay was, mysteriously, titled Why the Public Doesn’t Trust Mental Health Advocates.

In this recent post, published in the HuffPo Crime section, Jaffe is not saying anything that he hasn’t been saying for years as a lobbyist for expanded commitment laws in New York, California and beyond.

The way Jaffe makes it sound, people with what he terms “severe mental illness” are barely even fully human. In the comments section of his essay, Jaffe is telling people that schizophrenia causes brain loss.

The mind and free will are often seen as core components of our humanity. Concepts such as mental-illness-as-a-brain-disease and anosognosia inherently deny the viability of our minds and free will. Thus, the conclusion is that we can never know what is best for us, because it is assumed that we do not even have the capacity to know what is going on.

I am aware, as a person whose diagnosis and history places me in the worrisome “subgroup” that Jaffe has identified, and as a person who works in an open-access public mental health setting, that some people do have a tremendously difficult time with their experiences.

I also know that we, as human beings, have rights and that we, as human beings, all deserve access to our own full potential. We have the right to not be constrained by limitations in someone else’s understanding of what it means to be us and we have the right to not be harmed as a result of what other people may think about who we are and what we may, or may not be, capable of.

***

Sometimes human beings experience circumstances in which they have the impression that they are being threatened. Sometimes we become confused about what is and is not a danger to us.

Those seen as “severely mentally ill,” and thus commonly seen as dangerous and unpredictable, are routinely threatened with force and restraint, with punishment, and with ostracization.

Most human beings, when threatened, will seek to defend themselves. This is not merely a psychological phenomenon, but an innate feature of our animal mechanisms of survival.

Anybody who has experienced fear, which is anybody, can tell you that fear scrambles our thinking.

“What was that noise?”

“Wait…did you hear something?”

“Oh, my gosh! Something is totally out there!”

This phenomenon is easily observable in children.

Fear feeds the perception of threat and we do, it’s true, live in a very frightening society.

As Pat Deegan articulated in a recent reflection on Nonviolence and Recovery, all humans have the potential to be violent and many humans behave violently at some point in their lives.

We know that violence has never been a good cure for violence.

One day, I’d like to speak with DJ Jaffe, about intervention and education, fear and hope, neuroleptics and brain loss, reactive psychosis and recovery.

I know he’s heard it all before, but I guess he doesn’t trust the advocates, either.

It figures. After all, according to Jaffe, we couldn’t possibly know what we’re talking about.

By the way, I went back to check on Steinberg’s essay about schizophrenia and was pleased to see that several letters in response had been published. All of them, however, were written by psychiatrists.

1] Jaffe, DJ. Why the Public Doesn’t Trust Mental Health Advocates. Pub. 12/27/2012. http://www.huffingtonpost.com/dj-jaffe/why-the-public-wont-liste_b_2360876.html

2] Deegan, Pat. Nonviolence and Recovery. Video. http://www.madinamerica.com/2013/01/pat-deegan-on-recovery-and-nonviolence/. 01/01/2013.

 

 

***

Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

***

Mad in America has made some changes to the commenting process. You no longer need to login or create an account on our site to comment. The only information needed is your name, email and comment text. Comments made with an account prior to this change will remain visible on the site.

37 COMMENTS

  1. Gosh, what an excellent class you teach. I’ve done this exercise with other issues but not mental health. It seems it is well worth doing.

    I also like your letter to the New York Time too. I’ve written to my local paper about the local mental health provider, specifically about how a friend was being treated. Someone I was working with who worked for the provider stopped working with me as she saw my letter attacking her work. It wasn’t. Hey ho. These things happen.

    I guess there is also room for the other side, where your work, and other more social model approaches, are promoted to the press. I certainly do this when I’m working on projects. I think this is a way of addressing the balance too. Though we don’t have the multi-million dollar funding of the drug companies and what I can only describe as their psychiatrist stooges.

    The idea that people get better due to treatment in hospital and are therefore less of a risk, which Dr. Steinberg promotes, is of course rubbish. The opposite might to some degree be true. A hard story to promote to the public or the press as they have been steeped in bio-psychiatry propaganda for so long, but one that is important to try to oppose.

    Report comment

    • “Someone I was working with who worked for the provider stopped working with me as she saw my letter attacking her work. It wasn’t. Hey ho. These things happen.”

      Why is it that when we present other points of view some people take it personally and shift into attack-and-dismiss mode?

      It’s the old offense/defense framework that media and politics have put us in, a stancing that keeps real dialogue and growth from occurring.

      It’d be wonderful if the mental health system in this country were mature enough to appreciate that it may have a thing or two to learn.

      It’s not, after all, about them.

      Report comment

      • Oh, but it is…

        And it’s about the diagnosing professionals, in particular, in my opinion. I have a master’s in counseling, and I was sickened in having to witness the self-assumed power, prescience, and importance incubating in the minds of many of my classmates throughout the course of my graduate education.

        This education taught me to think I know everything, about everyone. Not directly, perhaps, but when all you do is sit around, read, study, and discuss the mental fragility of your companions in humanity, you start to feel less and less as though they’re your true companions, but more as though you’re their shepherd; herding, guiding the bumbling and the incapable so that they may be better able to live their lives by virtue of your presence in their lives, your sentience — struggle as they may.

        You see, well (SIGH)… other people are crazy, not all, but a lot, and even the ones that aren’t clinically crazy certainly don’t have the know-how to live their lives optimally, for Christ’s sake.

        No one understands it but US.

        And even some of us don’t really understand.

        (That girl who sits behind you in cultural competencies, she doesn’t get it. That guy who presented on the sports psychology thing in group counseling, he’s too dumb to get it.)

        And, ahh… how it feels to sit atop Mount Sanity, looking down on everything and everyone. The view is truly to die for: I decide who/what is crazy and who/what is not. I am the fit judge of the human CONDITION, beyond all psychological reproach — all-knowing, all-powerful, and almighty.

        And only I, as well as most of those similarly educated and qualified, can perceive the pernicious, underlying, brain diseases caused by chemical imbalances that chronically afflict so many of those less healthy, less capable than I.

        I am infallible in my diagnostic proficiency. I need not toil in the conducting of any medical tests to see these diseases; perhaps, I have to give out some questionnaires, but that is all. It comes down to MY decision-making. All I really need to do is LOOK, listen, and DECIDE…

        And to question these powers bestowed upon me is BLASPHEMY, for it threatens the delicate balance of things: my self-assumed power, prescience, as well as my immeasurable importance to human society, which is in dire need of myself and those like me to save it! So, away with you! Be gone, heretic!

        This, of course, is hyperbole, but this mindset is out there, to varying degrees — possibly a small part of many diagnosing professionals conscious (yikes!) and/or unconscious mental operations. It’s a scary field to become acquainted with, whether you’re on the couch or not. Of course, it’s much more dangerous to be on the couch. Stay off the couch, people!

        It really is a shame, too, that some ostensibly just aren’t willing to enter a balanced discussion on this topic. I can remember when I started learning there aren’t any chemical imbalances and that the psycho-pharms were, possibly (actually, very likely if not certainly, but shh… don’t tell anyone), making people worse over the long-term. I thought everyone I had gone to grad school with and my co-workers would be fascinated by the prospect of the mental health system perpetuating mental health suffering. Generally, they weren’t.

        This message is so incredibly important, though, because for what seems like every 4 or 5,000 that aren’t willing to listen/consider it, there are those who do (people on both sides of the system) — and perhaps we’re planting seeds that will grow up to be big, healthy plants themselves, in some cases, and that will prove to further the genetic presence of our species, whether we’re there to see it happen or not. And, in my opinion, the more that this message is spread, the better off people considered mentally unhealthy will be.

        Keep up the great work, Faith!

        P.S. I’ve changed my career path.

        Report comment

          • It really is a shame that there was indeed some impetus to what I wrote.

            Talk about egomaniacs! The field attracts and/or creates a lot of them it would seem. I’m sorry you have to deal with them lol — truly.

            Report comment

        • I loved this hyperbolic capture of the prideful “one-who-knows-best” and your keen appreciation of the fact that, in seeking degrees and licensure, many are smugly “earning” the right to impose their minimally informed external views on others.

          Diagnosis becomes a game, “treatment” an experiment.

          The crux of human rights violations in mental health lies in this tendency for the professional to impose his or her own expertise upon people that they do not know, minimally care for, and whose “illness” the professionals benefit from.

          Good luck with the new career path and thanks for sharing your keen and lively language on the subject of self-serving paternalism in professional mental health.

          Report comment

          • Haha I had fun in writing it. And doing so was cathartic, in its own way.

            You hit the nail on the head: “in seeking degrees and licensure, many are smugly “earning” the right to impose their minimally informed external views on others.”

            Smugly. Minimally informed.

            One of the reasons I started searching for more information on all things mental health — which ultimately led me to Robert Whitaker’s books and the MIA website — was because I felt my education was not doing enough to prepare my classmates and I for making such serious decisions upon other people as determining that they have chronic brain diseases simply by talking with them. To think that you can capably do such, given the education I know that many possess who indeed do this very thing is quite arrogant, smug.

            Diagnosis does becomes a game, something only about you, as the diagnosing professional, in far too many cases. One of my former “colleagues” seemed particularly interested in diagnosing his clients with the “sexiest” disorders he could: borderline, schizophrenia, etc. Then, he would often act as if he were some sort of martyr, saying to another colleague once: “Oh, I’d GLADLY trade you my borderline for your bipolar.”

            The key words here: TRADE (vastly disrespectful, as if the people being talked about were playing cards); MY (…in some cases, it really is all about them). Then, there was the whole thing of talking of people as if their whole identity was captured by whatever diagnosis he was thinking of giving them, or gave them.

            One other perk I assume diagnosing people with the sexy disorders did for him was make him look as though he were super-counselor — if he could “fix” them, that is. He was in it for the power; it was all about him. But he actually counseled decently well in-session, amazingly enough. It’s too bad most else of what he did was disgraceful and that the framework from which he was working, itself, was/is rather disgraceful.

            Thank you very much. And, really, do keep up the great work!

            Report comment

    • 😀

      I’ve learned not to write anything to anyone “important” with the hopes of response. I am content to write for the sole purpose of winging some small facet of perspective out into the mix, with the hopes that some aspect of what the words carry may lodge itself some place useful.

      In my mind, non-response is dialogue, too…it says a lot…and I’m taking notes.

      Report comment

  2. Good stuff Faith. We cannot underestimate the influence of media. I’d like to think it works in multiple ways. Meaning, if we have what we would deem “positive, hopeful information” about the mental/emotional distress all people experience that that would get equal coverage. We’re not there though. We can only keep trying.

    Report comment

  3. “We can only keep trying.”

    Yes!

    There is so much that bothers me about the way media frames “mental health” and responses to it.

    I think about what the parent of a young person who is having a hard time might feel after reading a piece like Steingberg’s… that slow cold sinking fear that will stay with them through the day. I think about how much that fear affects people and society.

    Further, I think about what may become of the lives of people who are “treated” by doctors such as Steinberg.

    People deserve accurate information about hope-giving alternatives, which really aren’t so alternative at all…just people being kind, being accepting, giving one another space to safely face the truths and fears in their experience, sharing information and perspective, giving one another a chance.

    That’s not so radical. That’s just human.

    Yes, we must keep trying.

    Report comment

    • “People deserve accurate information about hope-giving alternatives, which really aren’t so alternative at all…just people being kind, being accepting, giving one another space to safely face the truths and fears in their experience, sharing information and perspective, giving one another a chance. ”

      Oo-er, I think you just de-constructed the whole medical approach to mental distress here. I may keep in in my Quotes to be Used file. It makes the whole idea of therapy, peer support, counselling, family therapy, and other competing approaches understandable in what is after all only the experience of trying to reach out to our common humanity.

      Report comment

  4. Thank you, Faith, for taking this one. I find it telling that there was no comment function that accompanied the Steinberg piece. I have been too busy with other projects to write a letter of complaint. My biggest complaint is one you missed. Paul Steinberg took it upon himself to write that Adam Lanza had “schizophrenia,” as if the diagnosis of schizophrenia in Lanza’s case was already well-known. All I am aware of is that Lanza’s brother said he had autism and maybe an anxiety related disorder. So, Steinberg was being highly inflammatory and misleading. The whole point of his piece, to my mind, was to take the heat off the powerful autism community and pin it on the people who are already associated in the public mind with these kinds of tragedies – the vulnerable and not as well funded or organized “schizophrenia” communities. I am angry at the sleight of hand that he demonstrated in his piece, and no access to the reply button to expose what he is trying to do. Yes, he is definitely pushing for institutionalization, but he is doing that by fear mongering, and pointing to “schizophrenia” does this every time.

    Report comment

    • Blimey, that is worrying. Yet another person using the mass shooting to push their unrelated agenda while letting the gun lobby off the hook.

      The almost completely wrong stereotype of the dangerous schizophrenic is common in the UK too. It is a dangerous myth to peddle and adds even more to the problems that mentally distressed people face.

      Report comment

  5. I really think it is important for our movement to be pointing out that virtually all of the recent mass killers have already been on psychiatric drugs, usually SSRI’s and the amphetamines used to “treat” children with “ADHD.”

    Almost all these drugs have black box warnings, required by the FDA, about violent and hostile thoughts and behavior caused by the drugs.

    It is also true that, while there have been a few of such incidents for a long time, a historical analysis has shown that the frequency of such attacks has risen manyfold since the widespread use of psychiatric drugs has begun.

    Why aren’t we saying this?

    Report comment

    • I say this all the time, to friends, to fellow staff, to strangers. The response I get is that the drugs work fine and it’s obvious by what I’m saying that I’m getting “sick” again and probably need to think about going back on my “meds” that I quit taking three years ago! It’s interesting that a lot of these people are on SSRI’s themselves and when I point out the black box warnings they immediately turn off their hearing and start doing something else. They choose not to hear a damned thing that I say.

      The public does not what to hear about this, and I think it’s because so many people are on the SSRI’s and don’t want to admit that the emperor is naked as a jay bird. They don’t want to hear that all of the crap that they been fed and accepted as gospel truth is just a construct made up by the drug companies and biopsychiatry.

      Report comment

      • This refusal to face unpleasant facts is called cognitive dissonance. “Killing”, i.e., discrediting the messenger reduces the pain of cognitive dissonance. Plus the drugs numb the critical faculty of the forebrain.

        This is some great writing and I’m grateful for it.

        Report comment

  6. Excellent article. I enjoyed reading the comments. I find it very interesting comments were not allowed on the article. Why doesn’t the NYT and other media sources allow our voices to be heard. As anyone tried to submit articles and op-eds? Writing to the editor I find releases emotion but gathers dust.
    I really think we need to have the ghost of Saul Alinsky rise up and follow his actvist approach.
    I think pushing for peer mentors on all shifts on psych units would be a good first step. This would allow the conversation to continue without threatening the powers that be.
    Working on the establishment of peer run respite homes would be another effort that would pave the way.
    We need to seek each other out geographically. The online support is good but not enough. The 12 step movements have been doings this in some ways. I think they have just as much emotional issues as psychiatric surviviors.
    Again thank you for the article. It is so frustrating to hear misinformation, to hear of another gun tragedy and pejoritive terms being used. The Bully Project used a documentary and talk backs. Can we get Michael Moore involved with this?

    Report comment

    • Michael Moore has done something concerning this. You can see a portion of it on the right hand side of this site, where the videos, films, and books are listed.

      We all need to point out to everyone we know that we didn’t begin having all of these mass shootings until the advent of the SSRI’s on the scene. Of course, no one will want to listen to you because almost everyone is on the damned SSRI’s and don’t want to admit that they’ve been hoodwinked by Big Pharma and biopsychiatry into taking the damned pills that don’t work any better than placebos!

      Report comment

  7. Faith, thank you for this post and for your letter to the NY Times. You get it exactly right when you state, “the medical model of mental illness offers little more than a brutally reductionist framing of our humanity, one in which disease severely and persistently supersedes one’s rights and undermines one’s potential.” And you write very well too.

    I am a psychoanalyst (http://icpla.edu/contemporary-psychoanalysis) and psychotherapist; I encounter a lot of human suffering in my work. I think a great deal about the themes you lay out.

    You ask, “Why is it that the loudest voice in the room is the voice of biomedical psychiatry?” I think this is because Big Pharma, et al., are extraordinarily skilled at their messaging, invoking cognitive frames that are persuasive, repetitive, and attractive (see George Lakoff’s writing for more on this: http://www.thelittleblueblog.org/framing-basics/).

    Biomedical psychiatry fails to realize that making a diagnosis is a political act—someone in authority declares something about a subordinate person—based on three fallacies.

    First, they assume that empiricism is the only way we can know things about a person, reflecting a bias toward scientism. This excludes learning about people phenomenologically and anecdotally, an equally valid way of knowing things, as you point out.

    Second, biomedical psychiatry is informed by statistics that they assume tell us something useful about what is “normal” and “deviant.” I was both surprised and not to discover that the leading statisticians of the 19th century—those who laid down concepts of “normative data, ” the bell curve, etc.—were eugenicists. (For more on this see L. Davis’ book Enforcing Normalcy, http://www.amazon.com/Enforcing-Normalcy-Disability-Deafness-Body/dp/1859840078.)

    Third, they assume that psychiatric diagnoses are literal things rather than metaphors we use to try to account for human experience as best we can. Diagnostic labels describe behaviors and roughly line up with some experiences people have, but a set of behaviors is not the same thing as an individual’s experience in the world. Sometimes diagnoses are useful starting points. For example, I work a great deal with people with autism and most are relieved to learn that there is a way of describing their experience in the world in a way that makes sense, opening up possibilities and choices. But diagnostic labels are never good endpoints, as that is reductive to the point of absurdity, ignores the contextuality and complexity of an individual’s experience, may lead to harmful over-medication, marginalizes a person politically, and gives the incorrect impression that a person is only and always so labeled.

    Because Big Pharma and biomedical psychiatry are so good at conveying their message most people don’t realize how wrong and dangerous it is.

    Christina Emanuel, MFT, PsyD
    Pasadena, CA

    Report comment

  8. “So, how does the media affect our views of mental health?”

    When I introduce the elective recovery education course called In The Media, I don’t show any news clips or magazine articles. I don’t pull up any statistics or make any statements. I don’t offer any definition of stigma.

    I just ask that simple question: “How does the media affect our views of mental health?”

    Interesting use of the word AFFECT here Faith? I wonder if you used it deliberately? The exact meaning of this word plagues our perception of mental health and what exactly it means to be human? AFFECT lies at the HEART of our REACTIVE nature, rationalized as REASON by the mind, “assumed” to be a product of the brain alone, because further inquiry would undermine the cognitive constructs of our SOCIAL RITUALS of behavioral reactions?

    IMO “Media’s Failed Approach to Madness” is prompted by AVOIDANCE, an urge we all share in the denial of AFFECT and what it really means to the nature of being human? Please consider;

    “The AFFECT of Neuroception, in Mental Illness?

    NEUROCEPTION:
    A Subconscious System for Detecting Threats and Safety.

    So what exactly is, SUBCONSCIOUS perception?
    • Areas in the temporal cortex that are assumed to inhibit fight, flight, or freeze reactions are not activated in people with autism or schizophrenia, who have difficulty with social engagement.

    • Individuals with anxiety disorders and depression have compromised social behavior; difficulties in regulating the heart rate, as reflected in measures of vagal control of the heart; and reduced facial expressiveness.

    • Maltreated and institutionalized children with Reactive Attachment Disorder tend to be either inhibited (emotionally withdrawn and unresponsive) or uninhibited (indiscriminate in their attachment behavior; Zeanah, 2000). Both types of behavior suggest faulty neuroception of the risk in the environment. _Stephen Porges, Ph,D.

    How does SUBCONSCIOUS perception, result in Mental Illness?

    At a glance:
    • Neuroception describes how neural circuits distinguish whether situations or people are safe, dangerous, or life threatening.

    • Neuroception explains why a baby coos at a caregiver but cries at a stranger, or why a toddler enjoys a parent’s embrace but views a hug from a stranger as an assault.

    • The Polyvagal Theory describes three developmental stages of a mammal’s autonomic nervous system: Immobilization, mobilization, and social communication or social engagement.

    • Faulty neuroception might lie at the root of several psychiatric disorders, including autism, schizophrenia, anxiety disorders, depression, and Reactive Attachment Disorder.

    Could most catergories of what we normally see as expressions of a mental illness, be classified under this “umbrella” term, Reactive Attachment Disorder? Is “attachment” a fundamental requirment, in human physiological and psychological health? For example: “Individuals with anxiety disorders and depression have compromised social behavior; difficulties in regulating the heart rate, as reflected in measures of vagal control of the heart; and reduced facial expressiveness.” Certainly, my own, bipolar disorder type 1, has its roots in a “neuroception” of danger and subsequently compromised social behaviors, of which “mania” was at times, a spontaneous attempt to rectify? IMO. “Nothing overrides a sense of fearful aviodance and withrawal from other people and life, quite like an episode of mania,” I said to a psychiatrist recently.

    Has professor Stephen Porges uncovered the hidden biology of Sigmond Freud’s unconscious “Id?” And does “The Polyvagal Theory,” give us a view of the hidden roots of Affective Disorders like Bipolar? Does The Polyvagal Theory & the concept of a “neural,” subconscious perception, professor Porges has called “neuroception,” provide a casual link between mental disorders, many consider the truncated response of a natural, mammalian reaction to a sense of threat? Both external & internal? Is a misunderstood and “intellectually” denied, capacity of the autonomic nervous system, at the core of human disorders from Autism to Schizophrenia, including the many symptoms of PTSD & BPD?…………

    So why did I write AFFECT & not EFFECT in my title?
    Because I used to use a simple cause and effect logic of how things work, when trying to understanding myself, and my bipolar disorder constitution, while now-a-days I sense a subconscious affect within my brain-nervous system motivation? Better understood as motor-vation, when it comes to understanding the subconscious stimulation of muscular tensions, beneath our intelligent rationalizations? Hence my question about Reactive Attachment Disoder, as an umbrella term to encompass a continuum of symptom expressions, for much of what we consensually assume, are separatly definable illnesses? After years of reading people like Stephen Porges, Allan N Schore, Jaak Panksepp and then Peter Levine’s book in 2011, I had a personal epiphany, while remembering a quote I’d read and wrote on this blog dozens of times. (see: bipolar anger) Sensing muscular tensions and nervous sensations within my body, allows an understanding of overlapping symptom expressions in the various mental illnesses, once knowledge of the autonomic nervous system, is taken into account. Strangely, the nervous sytems are rarely mentioned within mainstream reporting on mental health? Please consider a quote from the father of modern neurobiology;

    “The motor act is the cradle of the mind – The capacity to anticipate and predict movement, is the basis of what consciousness is all about” _Sir Charles Sherington.

    Gee, Mom! “The motor act is the cradle of the mind?” Does this mean that much of our thoughts, words and elabaroate language, are really rationalizations of our unconscious physiological motivation? Our unconscious “id,” just as Freud said, once you get past the jokes about your mother and sex, of coarse? A Freudian slip, is when you say one thing, but really mean your mother. A little light relief, in my propensity to be serious, I hope your thinking? My Capricorn thing, perhaps?

    Affect/Effect – A “rational” explanation, of two confusing words?”

    http://www.bipolarbatesy.blogspot.com.au/2012/12/the-affect-of-neuroception-in-mental.html

    Most of our cause & effect explanations for the actual experience of life, are built on the SOCIAL need to avoid the nature of AFFECT and its contagion, hence the deep fear of madness and our rationalized responses to it? Cause & effect thinking, is far to “mechanical” to capture the systemic reality of our AFFECTIVE nature, and it is only our need to regulate our own denied animal nature, which generates the false and all too easy logic of, “mental illness” (cause) results in violence (effect) in our timeless blame (rage) & shame games, which are nothing more than self-empowerment, and not a critique of reality?

    Best wishes,

    David Bates.

    Report comment

  9. God that article’s depressing. Like most of what you read and watch in the print and mass audio-visual media respectively germane to this issue, it is simply designed to mobilize the thought of the psychologically enslaved masses in a direction amenable to the interests of organised psychiatry. Such cynical opportunism.

    He says, “In our concern for the rights of people with mental illness, we have come to neglect the rights of ordinary americans to be safe from the fear of being shot…”. In our furor diagnosticus and furor therapeuticus, we have come to neglect the rights of those labelled mentally ill, this is the real problem. How do we know these people are mentally ill? Because the quack said so, and because, according to conventional wisdom, you’d have to be mentally ill to do what these people did.

    He defines “psychosis” as a loss of touch with reality. Whose reality? The reality of people like him, whose beliefs about human nature and behaviour are little more than an adaptation to a secular world of past superstitions. Hardly surprising that he failed to list ideology as a cause of loss of touch with reality. Reality and psychiatry parted company a long time ago when they could no longer rely on it as an ally.

    “Schizophrenia is a physiological disorder caused by changes in the prefrontal cortex, an area of the brain essential for language, abstract thinking and appropriate social behaviour.”

    By appropriate social behaviour, I assume he means this term to be inclusive of raping people’s biology with pharmacological agents, as well poisoning, mutilating and abusing people, as long as this is consequent to a diagnosis of “mental illness”. This is like reading an article deploring sexual abuse written by Jimmy Savile, or an article about the evils of propaganda written by Joseph Goebbels.

    I like how this complete prat speaks as if he was some sort of neurological savant, a preponderant pretension amongst the particular species of prat we call the institutional psychiatrist. If only he knew that it was the drugs responsible for those changes. Such evidence couldn’t be found in all the autopsy studies done before the advent of neuroleptic medication.

    He tries to intimidate the reader into conforming with his point of view by encasing his gibberish in a veneer of neurological terminology, unintelligible to the lay reader, the tacit assumption seemingly being that the brain, at least not for people like he, isn’t actually a very complex organ at all and he has all its secrets sussed.

    He talks about voices commanding people to jump out of windows (as if he had heard these voices himself). So what? If someone told you to dive into a bath of acid, would you do it? Even if these people can hear voices that aren’t subvocalizations, you don’t have to heed these commands.

    “People with schizophrenia are unaware of how strange their thinking is…”

    Nor do psychiatrists seemingly.

    “Too many people with acute schizophrenia have gone untreated. There have been too many Glocks, too many kids and adults cut down in their prime. Enough already.”

    Too many people afflicted by the miasma of psychiatric ideology have gone untreated. There have been too many poisonous drugs, too many kids and adults cut down at their most vulnerable. Enough already.

    Report comment

  10. Does mainstream media simply present a common understanding of the human condition? Our “I think therefore I am,” cultural zeitgeist?

    Is our cultural zeitgeist based on a deep denial of our instinctual-intelligence? The social need to regulate the raw energies of self-preservation, by “rationalizing” our motivations?

    Please consider;

    “Is a rising awareness of our unique sensitivity to traumatic experience, along with new discoveries from neuroscience research, re-framing trauma, as a root cause of mental illness? Here I have presented Peter Levine’s unique wisdom from his forty years of trauma study and resolution work, I could go on and on, with other supporting information.

    Yet the “paradox” of human experience seems to be the double edged sword of our instinctual-intelligence? We want the easy, fast and instantly digestable answers, to complex questions, too quickly assuming that our reactions to life, are a reasoned response? Like Peter Levine, there are other contributors to a rising new awareness of the human condition, people like Stephen Porges, Allan N Shcore and Jaak Panksepp, to mention a few. People driven by a thirst for empirical evidence, true insights and a deeper understanding, yet sadly we hardly ever hear of them, in our mainstream media? Why is that?

    A Mass Denial of Our True Nature?
    Consider Peter Levine’s sense of our cultural zeitgeist?

    “My approach to healing trauma rests broadly on the premise that people are primarily instinctual in nature – that we are, at our very core, human animals. It is this relationship to our animal nature that both makes us susceptible to trauma and, at the same time, promotes a robust capacity to rebound in the aftermath of threat, safely returning to equilibrium.

    More generally, I believe that to truly understand our body/mind, therapists must first learn about the animal body/mind because of the manner in which our nervous systems have evolved in an ever changing and challenging environment.

    However, there is an almost violent schism lurking in our cultural zeitgeist.
    Lets face it; the fight against evolution by the proponents of “creationism” and “intelligent design” is not really about professed gaps in the fossil records; its about whether or not we are basically animals.

    In fact, the word instinct is rarely found in modern psychological literature.
    Rather it is purged and replaced with terms such as drives, motivations and needs. While instincts are still routinely drawn upon to explain animal behaviors, we have somehow lost sight of how many human behavior patterns (though modifiable) are primal, automatic, universal and predictable.”
    Selected excerpts from “In an Unspoken Voice.”

    Please consider another example of our “I think therefore I am” cultural zeitgeist (spirit of the age?);

    “SEEKING: Systems & Anticipatory States of the Nervous System:

    Self-Stimulation?

    The Seeking System: Like other emotional systems, arousal of the seeking system has a characteristic feeling tone– a psychic energization that is difficult to describe but is akin to that invigorated feeling of anticipation we experience when actively seeking thrills and other rewards. Clearly this type of feeling contributes to many distinct aspects of our active engagement with the world.

    This harmoniously operating neurochemical system drives and energizes many mental complexities that humans experience as persistent feelings of interest, curiosity, sensation seeking, and in the presence of a sufficiently complex cortex, the search for higher meaning. Although this brain state, like all other basic emotional states, is initially without intrinsic cognitive content, it gradually helps cement the perception of causal connections in the world and thereby creates ideas. It appears to translate correlations in environmental events into perceptions of causality, and it may be a major source of “confirmation bias,” the tendency to selectively seek evidence for our hypotheses.

    When this seeking system is manipulated by electrical impulse in other mammals, they will eagerly continue to “Self-Stimulate” for extended periods, until physical exhaustion and collapse set in. There are powerful descending components, probably glutametergic in part, that remain to be functionally characterized, but they may be important for the generation of self-stimulating behaviors. When these descending systems are fully characterized, they may have powerful implications for understanding such psychiatric disorders as schizophrenia.

    1, The underlying circuits are genetically pre-wired and designed to respond unconditionally to stimuli arising from major life-challenging circumstances. 2, The circuits organize behavior by activating or inhibiting motor sub-routines (and concurrent autonomic-hormonal changes) that have proved adaptive in the face of life-challenging circumstances during the evolutionary history of our species. 3, Emotive circuits change the sensitivities of sensory systems relevant for the behavior sequences that have been aroused. 4, Neural activity of emotive systems outlasts the precipitating circumstances. 5, Emotive circuits come under the control of neutral environmental stimuli. 6, Emotional circuits have reciprocal interactions with brain mechanisms that elaborate higher decision-making processes and consciousness.

    It is remarkable how long it has taken psycho-biologists to begin to properly conceptualize the function of the self-stimulation system, in the governance of behavior. The history of this field highlights how an environmental-behavioral bias (world out there), with no conception of internal brain functions, has impeded the development of compelling psycho-behavioral conceptions of self-stimulation. One of the most fascinating phenomena ever discovered, yet still largely ignored by mainstream psychology.

    The prevailing intellectual zeitgeist is not conducive to conceptualizing this process in psychological terms. This would involve discussion of the inner neurodynamic aspects of the “mind” and the nature of intentionality and subjective experience.

    A neurophysiological understanding of such brain systems can explain how we spontaneously generate solutions to environmental challenges. And how this type of spontaneous associative ability characterizes normal human thinking, as well as the delusional excesses of schizophrenic thinking.

    Arousal of the seeking system spontaneously constructs causal “insights” from the perception of correlated events. Some of the relationships may be true, but others are delusional. Indeed, all forms of inductive thought, including that which energizes scientific pursuits, proceed by this type of logically flawed thinking. An intrinsic tendency for “confirmation bias” appears to be a natural function of the human mind.

    The seeking system can promote many distinct motivational behaviors, and the underlying neural system is prepared to jump to the conclusion that related environmental events reflect causal relationships. It is easy to appreciate how this may yield a consensual understanding of the world when the underlying memory reinforcement processes are operating normally ( i.e, yielding a reality that most of the social group accepts). It is also easy to understand how it might yield delusional conclusions about the world. If this self-stimulating system is chronically overactive, it may be less constrained by rational modes of reality testing.

    The fact that the system is especially responsive to stress could explain why paranoid thinking emerges more easily during stressful periods, and why stress may promote schizophrenic thinking patterns. If the normal function of this system is to mobilize the organism for seeking out resources in the world, then we can begin to appreciate how the seeking system might also generate delusional thoughts. Apparently when this emotional system is over-taxed and becomes free-running (self-stimulation), it can generate arbitrary ideas about how world events relate to internal events.

    Is delusional thinking truly related to the unconstrained operation of spontaneously active associative networks of a self-stimulating, seeking system? If so, we may have a great deal more to learn about schizophrenia from a study of the SEEKING circuits that mediate self-stimulating behavior? Through a study of this system, we can also begin to understand the natural eagerness that makes us the emotionally vibrant creatures we are.

    One might also predict that there is an intimate relationship between self-stimulation and dreaming. REM deprivation leads to increased “sensitivity” in the self-stimulation system It is noteworthy that schizophrenics fail to exhibit compensatory elevations of REM sleep following imposed periods of REM deprivation. There appears to be a fundamental relationship between the schizophrenic process and the emotional discharge that occurs during both REM sleep and the seeking system discharge of self-stimulation. These findings suggest that there may yet be considerable substance to psychodynamic theories that relate dreaming mechanisms to symbol-&-reality-creating mechanisms of the brain.”

    Selected excerpts from, “Affective Neuroscience: The Foundations of Human and Animal Emotions.” by Jaak Panksepp.

    Jaak Panksepp suggests that if we can accept this stress sensitized, self-stimulation system as fundamentally a SEEKING system, which requires discharge, new ways of alleviating delusional thinking may be created to provide discharge, while stimulating reality testing, perhaps via computer games for example?

    Personally, I have found deeper self-awareness and self-acceptance, with a new self-educated understanding of my internal make-up, and my evolved animal nature. A sense of “I” and “otherness” which had matured into a commonsense, and taken for granted notion of, “us & them?” Which has dissolved into meaningful acceptance, as I now see myself, in the “other & them?” Is there a huge “elephant in room” of human mental health? One which can be summed up in five simple words?

    I am NOT an ANIMAL?”

    http://www.bipolarbatesy.blogspot.com.au/2012/12/madness-chaotic-energies-of-trauma-trap.html

    Best wishes for to all for 2013.

    David Bates.

    Report comment

  11. But he doesn’t have to be scientifically accurate, he’s the EXPERT! How dare we “sick” people, whom he’s trying to help, make such awful demands of him!

    Yes, it is distressing that the NYT would print trash like this without also publishing other voices with better and more insightful information. Either this shows just how low journalism has fallen or how well the drug companies and biopsychiatry have taken over the arena of discussion, or a combination of both. In any case, we who have been labeled are the ones who will pay the price.

    Report comment

  12. I don’t live in the USA but it might be worth contacting their health editor by e-mail and phone and asking if they would be interested in an article from an alternative point of view? http://www.nytimes.com/content/help/site/editorial/op-ed/op-ed.html

    I got an article in the Guardian Online a couple of years ago. http://www.guardian.co.uk/society/joepublic/2011/jul/25/speak-out-about-psychiatry-treatment

    We will win if we get organised, the drug companies are, they have well funded PR teams. So I’m glad faith replied.

    How about getting in their first next time?

    Or, I could just sit in my bedsit….

    Report comment

  13. …wonderful comments and reflections, questions…if I didn’t have to journey to the next county to get wood pellets for the heat stove I could spend all day conversing on the ins-and-outs of this.

    I’ll be back later…thanks, all, for discussion and for bringing up a few missed points and nuance, e.g. Steinberg’s remote diagnosis of Adam Lanza as having schizophrenia, the fear affect, the role of psychiatric meds in aberrant violence and the violation of human rights and dignity that paternalism in disease model practice entails.

    I was thinking last night about how the likes of Steinberg, Torrey, Jaffe, et al. have made “schizophrenia” a bogey-man of the uncertain and unstable modern age.

    They are, it’s true, fear-mongerers extraordinaire.

    Yes, an organized response to the party-line would be helpful. I’ve considered what the effect may be if “we” (all these activists and advocates and change-makers) flooded national and regional media outlets with productive counter-narrative…raised the voice a little through quiet print.

    Report comment

  14. While I applaud the sentiments about taking action to refute the lies of the typical fear monkers mentioned above, I think that to little energy is devoted to answering Dr Micheal Cornwall’s potent question, “if madness is not what psychiatry says it is, then what is it?”

    Obviously its easier and less risky to take an “objective” view which points to the gross failures of a commercially driven health care system and obvious corruptions, yet until madness is explained with science and the commonsense of lived experience, in a realistic and less threatening way. The scare mongers will find easy ammunition for their personal self-empowerment, in the “us vs them” rank & status game of social politics?

    Its a question I’ve tried to encourage Micheal to submit to a forum debate where we can explore the meaning of the existential metaphors, madness brings up from the depths of that curious space within, some refer to our “soul?”

    The media plays the game of social politics with an objective language ill suited to such an exploration, and as long as we play by the same objective rules, I suspect we always lose? Please consider a different kind of language & meaning;

    “Vertical and Horizontal Chains of Meaning:

    The linguistic chain is split from other chains of life meaning and logic–hormones, genetic codes, solar systems–by the insertion of the subjective “I” where it does not belong. It does not belong in an order whose logic is at right angles to that of the human perspective, as if the codes of living logic, together with the chemical senses, communicate on a horizontal axis, while the human historical viewpoint functions on a vertical one. Without the insertion of the subjective “I” position into the original codes of the flesh, the structure of the linguistic chain is homologous with that of other living chains within. With this insertion, the structures of living meaning are more or less at right angles.

    Life meaning is the result of interweaving–yet diverse–chains, capable of transformation from one order of symbolization to another. Symbolization dependent on understanding the proportionate and rhythmic intersection of numbers of vast and small internally consistent chains that are all communicative and in this respect like languages. If sensory energy is composed of fleshy codes that parallel those of language, this explains why the body seems to do its own thinking, so to speak. (p, 145.)

    It behooves us, as a species, to reconnect conscious language and understanding with the fleshy and environmental codes, from which our consciousness has been split by subjective fantasy and illusion. Those natural codes do their best work in the dark, although bodily physiological and chemical processes do push for admission to consciousness, past the blocks of a self-obsessed linguistic gateway. For us speaking beings, consciousness has been changed into parallel systems of signification; the linguistic, the sensitive, and the affective.

    They belong in a certain natural configuration, and a correct alignment appears necessary for an unimpeded or less impeded flow of nature’s energy. Correct alignment might be described as a symbolic transformation, meaning that the different alphabets of the flesh could be aligned in such a way that life is released from one order into another, yielding more freedom, intelligence, and energy. Symbolization is the means for transformation as the process whereby energy locked up in an alphabet in which it cannot speak (such as traumatic grief) is released back into the flow of life by words, or by the strange chemistry of tears. (p, 149.)

    The notion of aligned codes, like that of the transmission of affect, is at odds with subject/object thought and the “visualization” basic to “objectification.” The gateway between linguistic consciousness and codes of bodily sensation is manned by visual images. Which is to say, to make itself conscious, a bodily process has to be imagined–given an image. Our unconscious ego acts as a visual censor blocking bodily information surfacing to conscious awareness. It is a visual censor because it identifies objects from the standpoint of the subjective “I.” Images are stored from the three dimensional standpoint of a subject arrayed against an object. It is only when we depend on visual perception that we are led astray, into the subjective thought that takes the human standpoint as central. Such thought requires that one stand apart to observe the other and reduce it to predictable motion, the better to study it as an object. It also requires the intention of the body’s life energies, be prevented from fully connecting, in an embodied process. (p, 150.)

    “Hallucinations tend to make the abstract concrete and visa versa. This reflects the ambiguous position of image in Western epistemology, generally. Image has been assigned an inferior function, somewhere between sensation and thinking. On one hand, images are the “dregs of sensation,” carriers of information about sensations, on the way to the summation of sensations into concepts. If, on the other hand, it is realized that sensations cannot account for the formation of concepts, imagery may be granted the function of illustrating autonomous and immaterial concepts in sensuous terms. In ancient times, images were gods or messengers of gods versus sensuous misrepresentations of the unrepresentable.

    The status of image was much higher before we discovered the intellect. The idea of man as slave to his senses was a later transformation of the subjective enslavement to the power of the image. Perhaps this was necessary as a long transitional defense against the image. Distance was gained from the image by seeing it as immediate and concrete. Indeed, it is likely that the very birth of intellect was associated with the cognition of image as image (rather than, say, an idol).”

    Excerpts from “The Transmission of Affect” by Teresa Brennan, PhD.

    And from my own “uneducated” attempts to answer that poignant question, my latest blog post;

    Psychosis!

    A waking Dream or waking Nightmare?

    “The best way to describe having a psychotic episode is like a waking nightmare, where things are crazy, bizarre, frightening, confusing. With schizophrenia, you have delusions and hallucinations and disordered thinking.

    Like, I was on the roof of the Yale Law School, and I was saying, “Someone’s infiltrated our copies of the legal cases. We’ve got to case the joint. I don’t believe in joints, but they do hold your body together” — so, loosely associated words and phrases.

    But, experientially, the — the feeling is utter terror.” _Elyn Saks, author, “The Center Cannot Hold: My Journey Through Madness.” (see: here)

    Is Elyn Saks predominately negative and Western worldview of psychosis an objective fact or a subjective opinion energized by a personal/cultural fear of madness, and a lingering ignorance of the reality of its organic process? Are psychotic episodes the product of a mysterious brain disease, or are they generated by a profound dis-ease, within the body? A profound dis-ease which can stimulate a profound psychic pain subjectively represented within the mind, by nightmarish sensations and images, yet can also stimulate a psychic balm represented by glorious sensations of oneness and images and feelings of love. Is there a positive aspect to psychotic episodes? And why do so many claim its like a waking dream or nightmare?

    Is REM state dreaming a proto-type of waking consciousness?
    Can this, evolutionarily older brain mechanism shed light on the organic nature of psychosis and origin of our minds, subjective experience? Does a personal/cultural fear of the raw power of instincts as the roots of our human emotions and intelligence, promote a socialized denial of our own existential reality? Please consider;

    The Dream? A Container of Existential Reality?

    Why do both the negative and positive experiences of psychosis feel like a waking dream or nightmare? Why is the dreaming state, considered the very crucible of Madness? Consider Jaak Panksepp’s brilliant, “Affective Neuroscience – The Foundations of Human and Animal Emotions,” and a chapter entitled;

    “Sleep, Arousal, and Mythmaking in the Brain:

    Shakespeare proposed one possible function of sleep when he suggested that it “knits up the raveled sleeve of care.” Each day our lives cycle through the master routines of sleeping, dreaming, and waking.
    Although we do not know for sure what the various sleep stages do for us, aside from alleviating tiredness, we do know about the brain mechanisms that generate these states.

    All of the executive structures are quite deep in the brain, some in the lower brain stem. To the best of our knowledge, however, the most influential mechanisms for slow wave sleep (SWS) are higher in the brain than the active waking mechanisms, while the executive mechanisms for REM sleep are the lowest of the three.
    Thus, we are forced to contemplate the strange possibility that the basic dream generators are more ancient in brain evolution that are the generators of our waking consciousness.

    The brain goes through various “state shifts” during both waking and sleep. Surprisingly, it has been more difficult for scientists to agree on the types of discrete states of waking consciousness than on those that occur during sleep. EEG clearly discriminates three global vigilance states of the nervous system–waking, SWS, and dreaming or REM sleep.

    Some people have also thought that dreaming is the crucible of madness. Many have suggested that schizophrenia reflects the release of dreaming processes into the waking state. Schizophrenics do not exhibit any more REM than normal folks, except during the evening before a “schizophrenic break,” when REM is in fact elevated. There seem to be two distinct worlds within our minds, like matter and antimatter, worlds that are often 180 degrees out of phase with each other.

    The electrical activity in the brain stem during dreaming is the mirror image of waking–the ability of certain brain areas to modulate the activity of others during waking changes from excitation to inhibition during REM. In other words, areas of the brain that facilitate behaviors in waking now inhibit those same behaviors. Many believe that if we understand this topsy-turvy reversal of the ruling potentials in the brain, we will better understand the nature of everyday mental realities, as well as the nature of minds that are overcome by madness.

    Perhaps what is now the REM state was the original form of waking consciousness in early brain evolution, when “emotionality” was more important than reason in the competition for resources.”

    Selected excerpts from “Affective Neuroscience – The Foundations of Human and Animal Emotions.”

    * * *

    Certainly in my own experience the dream like state of a euphoric mania, enabled me to overcome a highly defensive muscular posture, and approach others openly instead of in a self-defeating all to wary of threat, attempts at social engagement. Defeated by the unconscious signals to others about my fearful inner state, and kept in this unconscious pattern by signals to my own brain-nervous system, from my habitual muscular bracing. My birth trauma conditioned postural attitude to life?

    The dream state feeling of euphoric mania, acted as a container for an existential reality of innate fear-terror, which threatens to annihilate the conscious mind in any normal waking approach. Any normal conscious awareness which has not been conditioned by experience, to deal with this brutal aspect of our existential reality. In our modern world of assured survival, the ancient rituals of a young man’s right of passage have been been largely forgotten. Yet teaching the young man to face the reality of a life eats life survival, and its real-life possibility of shear terror, were once a vital experience for survival. What ancient trace memories are sometimes contained within our nightly dreams and nightmares?

    http://bipolarbatesy.blogspot.com.au/2012/12/psychosis-waking-dream-nightmare.html

    Best wishes to all for 2013,

    David Bates.

    Report comment

  15. I thought psychiatrists were able to predict dangerousness. It is because of there predictive powers that they are given the legislative powers that they have. Society believes in their predictive powess.

    How is it that the psychiatrists who were treating all of these school shooters were not able to predict what was happening to them?? How could they have diagnosed them wrong?? Most of them were not on antipsychotics, just antidepressents. How could they not have known the person they were treating was psychotic?? I mean they do not require the person they are treating to tell them anything, they can predict these things, well that is what we are told.

    Instead of looking at untreated people, perhaps they should be questioning how the treaters got it so wrong????

    And if I am to take it seriously it also means that EVERY single mass murder in the world that has ever been committed has been done by someone with schizophrenia. It means that ALL criminals are mentally ill and all can be cured or at least controlled by these medications. How is it that people on these medications can do such things, are they not being treated???

    ALL of these perpetrators had theraputic doses of medication’s in their systems. It is not that they were not taking medications prescribed for them. They were taking them exactly as prescribed. ALL had sought and was recieving treatment. For all intents and purposes they were fully complaint and help seeking. Yet they blame them for not seeking and accepting treatment for a non existent brain disease????

    Report comment

  16. David, I appreciate you and Michael’s commitment to trying to answer that question, “If madness is not what psychiatry says it is, what is it?” Thank you for the references and beautiful excerpts, articulations.

    I think the question has been answered, time and time again, in story, song, and poem. It has been answered in essay and theory and it has been answered, even, in research.

    We know that the human experience is the result of subjective interpretation of objective stimuli and that we are, indeed, very sensitive creatures. We know that our minds and bodies are integrally connected and that we are connected to one another. We know, also, that we are touched by the world and what happens in it.

    The meaning we place on our experiences has everything to do with what those experiences may entail.

    It would be interesting to firmly establish the working dynamics between neurology/stimuli/affect and outcome in madness, to pinpoint what the process is, to describe the mechanisms of madness itself.

    It does seem a little close to biopsychiatry. doesn’t it?

    In my thinking, it’s really quite different, because if we were able to establish that this factor (A) and this factor (B) (with x number of factors) tend to create subjective experiences that are self-described as having distinct qualities of madness…

    (…and what might those qualities be, anyway? E. Saks describes those qualities as being nightmarish. What was was nightmarish about it? The disreality? The uncertainty? The content? What was the content? Why was it nightmarish? “Nightmarish” is a reaction to a state, which then constructs that state in reference to the reaction. What is the state that people are reacting to? What drives it and what creates it?)

    Madness is not a human illness, but something much more core, vital even, to our human condition. It is what we make of it that determines what it is in our lives and in the context of the world as we see it. The same could be said for anything.

    I have, in my own experiences, found that the thought that I have a serious brain disease that will doom me to struggle has made many of my experiences fraught with existential frustration and despair, i.e. the fear factor.

    When it occurred to me to think that perhaps I was sensitive, perhaps I was clever, perhaps I felt deeply things that were easily ignored by most people…and that perhaps there was some meaning in it all, some purpose…well, my experience of madness changed entirely.

    While I find conceptual theories of madness to be lovely and interesting, they are – themselves – subjective understandings, externally imposed musings about other people’s experiences.

    Madness is very personal and, particularly, in transformative madness (and most madness has the potential to be transformative), it is crucial that we be empowered to find our own meaning.

    Despite individuation, it seems to me that there are a few known attributes that are common across people’s uncommon madnesses and I think it is important to explore the intersections between madness and a certain autonomy of thought and depth of heart, a knack for holding big ideas in mind, a sensitivity to dissonance, and a history of being deeply hurt by those or that which one trusts.

    In so many ways, madness is a perfectly reasonable response to tragically unreasonable circumstances.

    …but, how do you quantify the qualitative?

    Regardless of subjective phenomenology, I think it’s fair to hypothesize that so-called stress hormones have something to do with the manifestation of madness and, there again, fear is at the core of it.

    The answer to madness that manifests as a response to duress is not to deem the person “mentally ill” and put them on bludgeoning drugs. The answer is to see madness for what it is…a human process.

    This brings us back to the need to somehow persuade more accessible public understanding of what has been well established in the humanistic traditions.

    As for Belinda’s observation that psychiatry has failed in identifying human difficulty that may lead to danger. I think that a lot of people are currently at risk for being wrongly identified as being dangerous and that we ought not encourage psychiatry to try to do a better job at figuring out who is dangerous or not.

    In many cases, psychiatrists seem to not have the slightest idea as to what they are doing and their reasons for treating people as they do is completely misguided in both science and ethics.

    Yes, they assumed the right to impose definition, but they don’t even have the language or perspective needed to even understand what it is that they seek to define and the tools they have to work with are, frankly, quite crude.

    I would not trust a disease-model psychiatrist to tell me what was best for me, or for my child, or for my community…in the vast majority of cases, they simply do not know.

    Report comment

  17. Hi Faith:))

    “Despite individuation, it seems to me that there are a few known attributes that are common across people’s uncommon madnesses and I think it is important to explore the intersections between madness and a certain autonomy of thought and depth of heart, a knack for holding big ideas in mind, a sensitivity to dissonance, and a history of being deeply hurt by those or that which one trusts.

    In so many ways, madness is a perfectly reasonable response to tragically unreasonable circumstances.

    …but, how do you quantify the qualitative?”

    AS Fritz Pearls famously said, “loose your mind and come to your senses?”

    The emphasis in my writing is to point out the folly of our quantifying “left-brained” process which cannot capture the depth of human experience and its Cosmic quality. As Roz Carroll points out the mind tends to cover-up the reality of the body in its attempt at mastery, normally becoming the Emperor with no clothes?

    “Schore proposes that the right-brain correlates with Freud’s “unconscious,’ the right brain is centrally involved in unconscious activities, and just as the left brain communicates to other brains via linguistic behaviors so the right non-verbally communicates its unconscious states to other right brains that are tuned to receive.” _ Roz Carroll.

    “The left-brain style is to verbalize, to fall back on what is already known in order to preserve the sense of self mastery.” _ Roz Carroll.

    “It may be that the “mind-body split,” is in effect a right-left split, with left-brain activation overriding the right-brain assimilation and regulation of sub-cortically generated emotional states.” _ Roz Carroll.

    Stephen Porges new discovery of a third branch to our auto nervous system, which allows the heart to be innervated by the nerves of the head and face, is a paradigm shift in knowledge that exposes the reality of the hearts role in “toning” our thinking and the rich quality of human experience as a Cosmic manifestation of reality?

    Quantifying is based on our instinct for survival and a need to define “objects” in the external environment, yet the internal environment is accessed via sensations and the divining power of the heart?

    What is hard to judge, for each individual, is just how much our cause & effect thinking is driven by our need to belong to the social group and that need is being stimulated by this third branch of the auto nervous system and keeping us focused on the external, social enviroment?

    The paradox, is that “isolation” allows the more ancient stimulation of survival need to access a deeper awareness and the reality of evolution? Hence the notion of our Cosmic nature in through reality of evolution? We tend to think and say, “we are “part” of the Universe, because we fail to “embody” the reality of evolution through our unique sensory nature.

    Reality cannot be quantified, only experienced.

    Changing our “metaphors” of meaning and self-interpretation to embrace all the new knowledge of our chemical make-up will, in time bring a quality to individual experience that will allow us to out-grow our current instinctive-intelligence and stop “acting-out” our nature as animals, and become more fully human.

    IMO Taking a chemical perspective, allows the reality of the Cosmos within, to become acceptable to our, still overwhelmingly “instinctive” mind? Cause & effect logic, is driven more by instinct than a truly insightful intelligence, at this point in our evolving journey to the stars. Hence my statement last June;

    “SCIENCE & SPIRITUALITY
    IN THE 21st CENTURY A.D.

    “Andrew Newberg and his colleagues have, in their seminal book “Why God Won’t Go Away,” brought together a vast amount of research on the brain substrates underlying a variety of different spiritual experiences. The application of this type of brain research to trauma transformation is a rich area of further research and exploration. The autonomic nervous system (ANS) gets its name from being a relatively autonomous branch of the nervous system. Its basic, yet highly integrated function has to do with the regulation of energy states and the maintenance of homeostasis.

    The ANS is composed of two distinctly different branches. (Although the parasympathetic branch is dived into a primitive (nonmyelinated) and an evolutionarily recent (myelinated) branch.)” _Peter Levine, “In an Unspoken Voice.”

    It is this myelinated branch of parasympathetic stimulation of the heart & therefore metabolic rate, ventral vagal complex (VVC), which is metaphorically eluded to in the mythology of the Christian Bible. “The Ark of The Covenant.” Put very simply, it’s the secret of your Smile, and those two hundred muscles of your head & face.

    And of coarse you don’t want to know about this, inside your Cartesian “mind-set” awareness of being, because life truly flows in “unconscious” spontaneous, physiological reactions, like when you feel the pure joy of being alive here in heaven.

    The ascension is not a rising to “above” it’s a Fall, just as its always been, when you seek awareness of the Universe within, & truly feel the presence of this Eternal Now. In Eastern mysticism, such experience is known as a Kundalini awakening, or in the “stillness” of the great Prince, Buddha being?

    Is it time to re-address the tribal metaphors of life’s meaning, to a species understanding? In a Universe of 96% dark matter/energy. Life is “The Resurrection.” That great symbol of sacrifice we see in Christ on the Cross, as all the Light Matter Energy, sacrificed to create your life? How does the Universe become Eternal? By evolving into a form which can act upon itself, YOU & your children’s, children’s children, forever & ever, Amen! Or whatever metaphor of gratitude you use.

    “Rather than describing the autonomic nervous system as a linear ‘arousal’ system focused on the sympathetic nervous system, or a balance system focused on the opposing influences of the sympathetic and parasympathetic pathways, the function of the autonomic nervous system is hierarchically organized. As emphasized above, the hierarchical organization is phylogenetically determined and can be summarized as the following three sequential functional subsystems:

    1. The ventral vagal complex VVC: a mammalian signaling system for motion, emotion, and communication. 2. The sympathetic nervous system SNS: an adaptive mobilization system supporting fight or flight behaviors. 3. The dorsal vagal complex DVC: a vestigial immobilization system. Each of these three neural constructs is linked with a specific response strategy observable in humans.

    Each strategy is manifested via differentiated motor output from the central nervous system to perform specific adaptive functions: to immobilize and conserve metabolic resources DVC, to mobilize in order to obtain metabolic resources SNS, or to signal with minimal energy Expense VVC.” _Stephen Porges, “The Polyvagal Theory.”

    To paraphrase the late & truly great Harry Chapin;
    “Something keeps calling our name.
    Something keeps calling our name.
    Or is it just the rustling of the wind.
    Or is it just that we need our friends.
    Something keeps calling our name, our name.

    Sometimes we don’t talk too much, or touch hardly at all.
    How can we hope to share this life, divided by a subjective wall?
    Is it time to taste the truth and toss it of our tongue?
    You see the world has come a-calling, and it’s bleeding at our door.
    Are we supposed to turn away, or is this what we’re here for?”

    Is it time for realization? 1 Species, 1 World, 1 Universe, 1 Love.

    Is it time to realize, that the Universe is a friendly place & FEAR is only the shadow “within” & not really “out there.” With the realization of a “meant to be” eternal now, can we stop fighting ourselves & get on with building a new Jerusalem, here on Earth’s green & pleasant land?

    Everything we really need is “inside” us, health, wealth & happiness are not “objects,” they are metaphors for the hidden reality of a holistic sense of well being. The very best medicine, is literally contained within our laughter & our heart felt smile.

    Words are only metaphors, metaphors for a hidden reality within?

    Science & Spirituality are converging in this 21st century A.D. Although to an Eternal Now, Time means nothing & everything? Perhaps this is why the existential metaphors always apply to “this” here & now.

    Such is the silly stuff I go through during the height of “psychosis,” my brain dis-ease?

    Be well:))

    David Bates.

    http://bipolarbatesy.blogspot.com.au/2012/06/science-spirituality-psychosis.html

    Will most readers see this comment as nothing more than self-promotion though? And is that intellect or instinct?

    As Jaak Panksepp points out, perhaps its time to rephrase Descarte’s iconic statement for modernity to “I feel therefore I am?”

    Best wishes,

    David Bates.

    Report comment

  18. Society knows how sick and dysfunctional society is. Society likes to hunt out the problem, which is the individual, and have them banished from society (drive the individual into some form of lock-them-up and fix-them treatment, or punish them treatment). Society knows how sick society is. Society is full of loathing, hatred, intolerance, bullying and demons. Society IS sick.

    Report comment

  19. Hey, mjk and David – at some point, I’d really like to talk with y’all about how to possibly explain to the likes of Steinberg, Torrey, Jaffe, etc. that what they call a disease is actually an elegantly complex age old dance between spirit and sense and self/world dynamic.

    Do you think they’ll go for that?

    (ha.)

    🙂

    Much appreciation for you all.

    Report comment

LEAVE A REPLY