At War With Ourselves

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If we call someone mentally ill, in some ways we may be recognising their predicament as a powerful one, and their need for support.  However, we may also be judging their state of mind as faulty. But what if what seems a faulty mind is much more than that?  What if it is an expression of emotional conflict that needs, not to be cured, but to be understood and reconciled with?
We can go deeper than trying to say what is wrong with someone, how ill they are, or what category they fit into. We can instead ask: How do parts of them feel? What might different parts of them need? And what are the contexts in which these experiences have emerged?
We may also see the social context as an important place in which to create change.  An individual’s difficulties are intertwined with their social network.  Therefore, rather than seek to merely fix the faulty individual, we may want to bring the people around the person together and find new – and more helpful – ways of relating that benefit everybody.
A challenging mood or behaviour can be seen as having its own logic; its own purpose that needs to find new ways to be heard and new ways to express itself. For example, a young person’s refusal to eat may be a way to seek control in a life where the young person has felt they had very little control.  If we can give that person the experience of trusting relationships. Then, gradually, new forms of safety will be experienced and the reliance on controlling food intake will be likely to diminish.  If we merely call this behaviour an eating disorder and attribute it to mental illness we may miss the opportunity to learn from the behaviour about what is lacking, and needed, in the young person’s life.
Calling someone mentally ill may allow us to not think about our role in the development of their distress, and what our role could be in ameliorating it.
I once sat with a young man who had paranoid ideas – and his warring, separated parents – for an hour and a half in my kitchen. By just having a meeting based on dialoguing principles the son’s paranoia lifted significantly.  I am not offering a blame-the-parents model here. We are all connected, and affect each other. We all have different sensitivities. Responsibility is shared. Moving towards understandings of painful events that acknowledge responsibility but also avoid blaming and morally judging each other are important in any peace process.
But if we assign someone the role of being mentally ill, we begin a cold war against their distress. We refuse to listen to possible reasons for their distress in the social contexts around them. Reconciliation will be unlikely to occur.
Personally I prefer the terms ‘confusion’ and ‘distress’ to the term ‘mental illness,’ although ultimately all terms are limiting in their own ways. Many people hold onto the term ‘mental illness’ to signify the extremeness of what they have been through.  So, in offering alternative conceptualisations we need to tread carefully and acknowledge the intensity of people’s experiences. I think if we can broaden the language about our individual sense of disharmony and turbulence we can have greater freedom to understand our complex lives.
We have in the UK a national mental health anti-stigma campaign called Time to Change. They have spent over 25 million pounds on media initiatives aiming to reduce fear and discrimination for people who have been given psychiatric diagnoses.  Time to Change says it’s good to talk about mental illness.  The argument goes; the more we talk about mental illness the more acceptable it will be in society and the less discrimination people will face.
I agree it’s good to talk about a taboo subject but only if that talk – as well as encouraging empathy – uncovers new ways to see problems and find solutions.  I recently challenged Time to Change about how much they use terms like ‘mental illness’ – and diagnoses -because I think, used rigidly, they can add to stigma and misunderstanding.  Even the concept that 1 in 4 people have a mental illness encourages a conceptual division – between those thought to be sane and those thought to be insane – that may make empathy more difficult.
If we replace the illness model with one that sees suffering and confusion on a continuum, then it is easier for us all to relate to each others’ predicaments.  This feels more inclusive, rather than separating off the ‘ill’ from the ‘well’ in an artificial and compartmentalised fashion. A group of us are planning to write to Time to Change about the language they use.  This article is about an alternative way of looking at what gets called mental illness. But first I will share a few reflections on this tension between wanting to embrace this phenomenon many call mental illness and the desire to re-frame it so we can embrace it more wholeheartedly.
My impression is that many people accept the term mental illness and find it useful in their lives. I don’t want to offend them, I don’t want a war of ideas with them where I hope to get them to convert to my way of thinking. I do want to suggest that many people may wish to hold the term mental illness very lightly or not even use it at all. In my eighteen years working as a psychologist I have generally found non-medical terms to be more helpful in trying to help people find more peace and agency in their lives.
However, the term ‘mental illness’ may be helpful to use if you need to access a health service or a state benefit. Some people may like to see themselves as having an illness because it conveys a certain level of suffering, and that it is not something they are choosing but rather something that happens to them. In this way some may find it is quite validating of the level of distress or confusion they at times experience.
In an individualistic society people who fail are often blamed for their failures, to be ill means you can seek some refuge from this blame. On the other hand, the other side to this exemption from blame is that the identity of being ill can lead people to feel helpless in the face of their emotional and social difficulties.
The one thing people are in agreement about is that there is fear and discrimination towards people seen as having mental illness and that this needs to change. Not only is mental illness often seen as dangerous, it is also seen as embarrassing.  It’s embarrassing to talk about our experiences of confusion and distress because we risk being rejected by others.  Also, we are not used to talking about it so we don’t have much of a vocabulary when it comes to talking about troubled minds.
The ‘mentally ill’ person is often represented culturally as a sad pathetic creature or an out-of-control maniac; possessed, we assume, by biological demons.  Stories in the news and in entertainment often feed into the cultural fear of mental illness.  Because madness is frightening and embarrassing we don’t try and understand it in everyday conversation or in schools.  There seem to be two approaches to diminishing this fear of confused minds.
One is to try and get everyone to accept that this thing we call mental illness is nothing to be ashamed of or to be unreasonably afraid of.  The second approach is to say that to reduce the stigma, the fear of mental illness, we need to completely re-conceptualise it.  We need to replace the language of illness with something more inclusive and socially meaningful.  Rather than an individual flaw it’s an understandable reaction to life events. Maybe these two movements of either accepting mental illness or re-conceptualising it are two different ways of trying to get to the same place.
However, when we call an experience mental illness we often then assume the content is meaningless. If on the other hand we see difficulties as meaningful reactions to difficult life events, then we give it a place of learning in our communities, not just something to be sympathised with.
If a word opens a door for us we tend to like it. If, growing up, my mother is from time to time bedridden for weeks – overwhelmed with sadness and unable to communicate with me – it may make sense to me to see her as having a mental illness. It’s a shorthand that lets others know something about the discomfort she is in and how difficult we both find it to deal with. In the absence of a richer vocabulary and a community that responds to this sadness, designating someone as mentally ill gives us a framework through which to see things and a hope of a medical solution.
However, there is a problem with seeing distressed parts of ourselves, or confused behavior, as mental illness in need of a medical cure.  If we see distressed or confused minds as being diseased, like a cancer – to be battled with and got rid of – this takes the inner conflict we are experiencing to a new level of warfare. We are pitching ourselves against ourselves. A more holistic model of illness and healing sees the body’s dis-ease (i.e; lack of ease) as a way to deal with toxins that needs to be worked with, not against.
I am keen to promote alternative ways to view overwhelming mental and emotional experiences that seek to both empathise with the situation, and also understand the deeper possible meanings they point to. Rather than see ourselves as singular individuals with one personality I have found it useful to understand the self as made up of  lots of competing parts that need to be heard and express themselves.  While some of these parts feel in our control others may seem to have a mind of their own and to feel and act in ways we may not be conscious of, or when we are aware we find them challenging. An example is: when we get angry, we may say and do things we normally would refrain from doing.
When someone is distressed or appears confused, rather than seeing this as an affliction that needs to be battled with I find it more helpful to see it as an inner conflict between selves that are in opposition to each other.  The way forward is not for the well-self to defeat the sick-self, which may be what is attempted in a more medical approach to healing. Rather; healing is about a reconciliation between the different energies and personalities that make up the whole of who we are.
When we get mentally overwhelmed it is because parts of us are trying to protect themselves in powerful ways that are confusing to the person or those around them.  For example, in depression parts of us withdraw when they are exhausted. They are perhaps full of fear and don’t want to fail again. The person may also be overwhelmed with feelings of grief, sadness and bitterness to the point of a complete sense of nothingness and pointlessness.
In what gets called obsessive compulsive disorder a child-like part of us may be in control. It knows that – temporarily – it can protect the person from pain by creating an illusion of control in an unsafe and uncertain world. In mania, impulsive energies and child-like parts and power-hungry parts team up and overtake the exhausted responsible adult parts. They are running on suppressed energy, and often it is a powerful cocktail of pent-up frustrations and grief.
When we are seen as delusional, our magical and imaginative children may have taken over our awareness, creating stories that seek to protect us and in some ways symbolise our emotional strife and need for safety. Our heroes and our messiahs are often given a role to protect us  from painful feelings of isolation, vulnerability, and loneliness.
When we hear voices we may be hearing parts of ourselves we have consciously or unconsciously separated from and personified.  Angry voices are often parts of us that have witnessed or been subject to neglect, emotional or physical violation, manipulation and exploitation. They are angry at the person and the world that has let them down.
Somebody who experiences high levels of anxiety may be highly sensitive, and this trait needs to be honoured as an ability to feel energies and emotions strongly.  Anxiety also seems to mount up when we are trying to keep a lid on angry and frightened parts of ourselves.
Suicidal feelings come from parts of ourselves that are overwhelmed with painful feelings. They want a break. They are telling us we need new ways to look after and respond to these painful feelings. When emotional pain feels listened to or is channelled in some way into activity, it calms down markedly.
So, rather than see people who are confused or deeply distressed as just ‘mentally ill,’ we should try to understand the different parts of the person that are trying to protect themselves. Angry voices need listening to, and a safe way to act out their concerns. Manic parts need a chance to express themselves on a regular basis so they wont be over-aroused and cause a mutiny in the future. When I help someone bring parts of themselves to the peace table, I have to confront and make peace with similar energies in myself.  So when we seek help from others to reconcile conflicts we also learn from this about ourselves and we grow in understanding, too.
This is not as easy as it sounds, of course. We have a community of parts that need to be negotiated with. In my experience, for example, renegade parts that have sabotaged the person’s dreams are not easily forgiven and given a new role in the psyche.  Even though the person may logically understand that a part has sought to protect them in the best way it knows, they may still resent the damage they perceive the part has caused. If the person does not want to give space to a part of themselves they are angry with or ashamed of this need to be respected. We need to feel safe and acknowledged before we are willing to make peace with parts of ourselves we may not want to recognise, or still see as our enemy.
I don’t see brains and bodies not being involved in these psychic conflicts.  Genes will no doubt play some role in what selves we develop and will interact with our environment.  Similarly I don’t see drugs and physical approaches like diet, massage and yoga as not being relevant to helping people. A drug may help us get a temporary break from a conflict or lessen our emotional tension but its benefits should not be exaggerated. We can and often use a biological approach to deny and suppress hurting parts of ourselves, and if we sustain this it will likely lead to a back-lash of some kind. Parts that we attempt to block from consciousness may find some way to powerfully rebel and return later; stronger and more virile.  Or if suppression is successful these parts may retreat into apathy and listlessness and this energetically is likely to permeate the person’s life.  Thirdly, the anxiety created by suppressing angry or hurt parts may lead us to endlessly seek solace in addictive behaviours.
As I mentioned earlier, individual distress and confusion occurs in a network of social contexts. We need many ways to intervene in the community that promote dialogues and understanding.  I see what is seen at first as madness as a reasonable response to difficult life circumstances. The peace process required is both within ourselves and within our social contexts.  Our manic or paranoid or depressed parts are all trying to protect us when we are overwhelmed by life events.
If we just see these parts as ‘ill’ we will be unlikely to honour the needs they are telling us about. If we decide distress is a meaningless mental illness we are declaring war on our responses and attempting to force them into exile. They will not thank us for this, a listening approach will reap greater dividends in the longterm.
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Rufus May
Rufus May is a psychologist in Bradford, England. He believes everybody can flourish with the right support network. His work is part of an emancipatory movement that includes the hearing voices movement, community development approaches and other self-help and holistic health movements.

38 COMMENTS

  1. “Some people may like to see themselves as having an illness because it conveys a certain level of suffering, and that it is not something they are choosing but rather something that happens to them. In this way some may find it is quite validating of the level of distress or confusion they at times experience.

    In an individualistic society people who fail are often blamed for their failures, to be ill means you can seek some refuge from this blame. On the other hand, the other side to this exemption from blame is that the identity of being ill can lead people to feel helpless in the face of their emotional and social difficulties.”

    One of the most important questions my therapist asked me was “Do you believe this is something you yourself do, or that it’s just happening to you?” My immediate gut reaction was, it is something I myself do. And so I can choose to stop doing it, and do something else instead. My choice, my responsibility. At that point in time blissfully unaware of modern psychiatry’s groundbreaking research findings, it had never occurred to me that thoughts and emotions could be anything but meaningful and fully understandable responses to life. It made a world of difference.

    Blame, self-blame — Initially, I did blame myself. Or, I was angry with myself. Very angry, and sad. That I had allowed the people in my life to drive me crazy. I had never been the invincible, invulnerable creature I’d imagined myself to be. A, at first, very painful realization. I’d failed. On the other hand, it confirmed that, indeed, I was a human being, I belonged to humanity, there was a place for me in the world. I had been hurt, and I had reacted protecting myself in the best way I could. I had been a pretty strong human being, actually. I hadn’t failed, after all.

    Bio-genetic explanations may seem guilt-reducing, at first sight. But they certainly don’t reduce shame. Time and again, I see people who believe they are “mentally ill” be stuck in a state of being deeply ashamed of, allegedly, being profoundly different from humanity, lesser-than-human, not belonging in this world, a burden, most efficiently prevented from the healing process of grief and forgiveness, eventually arriving at embracing one’s own human nature. And I don’t think, any “anti”-stigma campaign that holds on to the concept of “mental illness” will ever be able to remove the shame that inevitably follows the belief that one’s innermost human nature, one’s self, is a disease.

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  2. I agree with everything you are saying. Having been through a breakdown at the age of 17, heard voices in my head and recovered without any medical intervention, I certainly never considered myself “mentally ill”. I have always had a good insight in what was going on into my inner world. I realised immediately that the voices were just different sides of my “Self” in conflict with each other. Also I came quickly to the conclusion that most of my problems were due to my own attitude and behaviour and that I needed to change. Nevertheless there was also a physical aspect to my breakdown due to sleep deprivation, too much caffeine, anxiety and panic attacks and these were much more difficult to handle.

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  3. People talk about healing and recovery and it makes me really angry. It shows me what they don’t know and don’t understand. It is torturous.

    I actually did heal and recover myself but it was extremely short lived. Something happened and it destroyed my fully recovered self. There is no second recovery.

    Now I have a way of telling it or showing it so that others can understand me.

    The recovery I achieved was in 2008. The “thing” that happened was almost immediately after that recovery, or maybe even simultaneous. Then, in 2009 I moved into an old pink house after two years of homelessness. In 2011 the house I live in was rebuilt. It is an entirely different house now. The pink house DOES NOT EXIST anymore. It is GONE – exactly like “me” – the “me” that I recovered. I am the pink house.

    Can anybody understand that? Or was that too mental?

    I cannot recover was is absolutely GONE to the point of non-existence. I cannot rebuild the pink house. The pink house will never come back and even if somebody could rebuild the pink house – the original is still gone, gone, gone.

    I think psychiatry does not have a diagnostic code for somebody who has been obliterated and annihilated.

    “At War With Ourselves”?

    The MENTAL system (can’t call it health!) IS a war – a war like a holocaust. Mental is a bad, bad word. Mental is an obsession. Mental is a weapon. Mental is a bad, bad word.

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    • If the pink house is entirely gone, annihilated, does not exist anymore, then who is this “I” commenting here?

      That said, to a certain extent I agree with you on “recovery”. In the sense that, indeed, what is gone cannot be recovered. But does it have to? I hear a lot of labeled people wish they could go back to what was and who they were before they encountered their crisis. I for one am grateful that what is gone is gone. Even if I could, I wouldn’t want to go back. After all, what has been was what made crisis a necessity. You have to start from scratch when you can’t recover, that’s true. But there’s just so much to discover, when you can’t recover. Though, I’ve never had a pink house to begin with, so what do I know.

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  4. Thanks Rufus, I think this is the most well written summary of these issues that I have ever encountered! I really appreciate the way you have “tread carefully and acknowledge the intensity of people’s experiences” while also opening up a picture of what’s happening when problems occur to include everything from the social environment to diet.
    You wrote that:
    “In my experience, for example, renegade parts that have sabotaged the person’s dreams are not easily forgiven and given a new role in the psyche. Even though the person may logically understand that a part has sought to protect them in the best way it knows, they may still resent the damage they perceive the part has caused. If the person does not want to give space to a part of themselves they are angry with or ashamed of this need to be respected. We need to feel safe and acknowledged before we are willing to make peace with parts of ourselves we may not want to recognise, or still see as our enemy.”
    This is a tough part. We need to exploring to find ways to create respectful dialogue between parts of a person which have been hurt and the parts which are seen as causing the hurt (which of course have often been themselves hurt in the past, as Eleanor Longden is good at pointing out); we also need to be finding ways to create dialogue between people who have been hurt by the mental health system and the people who work in and support that system. I think many of the same issues come up in both efforts.

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    • “We need to exploring to find ways to create respectful dialogue between parts of a person which have been hurt and the parts which are seen as causing the hurt… ”

      The point I was making is that psychiatry and the mental health system and *people* don’t seem to recognize or be aware of (or have a diagnostic term for) people who are *beyond* being hurt. So far beyond being “hurt” that the CORE personality, the core being – is destroyed. And apparently, there is zero understanding of what that means – let alone what becomes of a person after they’ve been annihilated.

      I think people who deal with torture victims understand. And in my case, psychiatry and the “mental health system” HAVE BEEN an agent of torture (but that isn’t the only part of it – not even close).

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      • This is an internet article with room for comments underneath. So offering empathy and understanding is limited by that.

        However I do have some understanding of your statement, “the CORE personality, the core being – is destroyed.”

        However I find it hard to offer much more than this simple statement via this medium. Face to face I might, but not over the net.

        I also understand your reference to torture victims. I have not been in contact with torture victims or people who work with them on a psychological level, though I know people who offer social support to refugees, some of whom may have been torture victims. I have however known and sometimes supported survivors of child sexual assault and the comparison to survivors of torture is sometimes made, especially when the assaults were extreme and morally confusing such as in ritual abuse survivors have described. In such cases a metaphor of a house that is destroyed and a new house being built that never seems like home and always remains strange is understandable to me.

        However, as I say, this is the internet, and long discursive conversations on how we understand our sense of being in the world is not easy or always fruitful. I certainly seldom expect the mental health services to provide such conversations either. There a few decent units and a few decent staff but they are few and far between.

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        • I read the article but the title, “At War with… ” really stuck in my head (because war is very much part of my reality).

          What really concerns me is that there is never any mention of people like me, people for whom “healing” and “recovery” are NOT an option.

          What are people like me called, officially? What’s the diagnosis? Can psychiatry and the “mental” system EVEN DISCERN when a person is truly destroyed?

          I’m wrecked, ruined and destroyed. Obliterated and annihilated. I’m the living dead. Stick a fork in me, I’m done. I’m gone. Like an empty shell. “The light’s on but nobody’s home” isn’t even something that could be said about me because THERE IS NO LIGHT ANYMORE! The light has been destroyed and it is black now. By the way, that is LITERAL. I used to have inner light. Not anymore. It is black, black darkness now and NO, not in a “dark night of the soul” sort of way.

          So, what’s the term for that? Why does there seem to be no recognition of destruction? Is it because “healing” is hailed up so often? All the world is talking about “healing” and I’m DEAD – wondering when somebody is going to understand that.

          This should clarify it (I hope)

          http://youtu.be/WM8bTdBs-cw

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          • Mjk – I believe I may have a small appreciation of where you’re coming from as a person who currently sees no future for myself albeit for different reasons to you.

            As you can read on this thread I can feel alone in my stance on some things and few people grasp what it and why I’ve reached that position.
            Stephen literally stopped me in my tracks by acknowledging that he did ‘get’ it, and he did so even without knowing much of my experiences which have led me to this point of which I wouldn’t feel able to write about here. He still got something fundamental about me which probably helped me get through that day.

            So what am I trying to say..several things I think. Don’t give up on someone even a complete stranger ‘getting it’ about you, maybe even just a small detail not everything. It comes along when you least expect it and when you’ve given up hope of others grasping it.

            Some of us can feel like we’re in a no-man’s land, because we don’t seem to fit any definition of anything, and to boot can end up feeling alienated.

            Recovery and notions of ‘healing’ mean absolutely nothing to me neither – and you know what? That’s OK because we’re allowed to feel however we feel.

            Sometimes when everything is that black the last thing we want to hear are hopeful words, maybe we need support to help us live (or in a living death) with feeling or being totally annihilated.

            You raise a good point about how recovery models fail to include hopelessness, destruction and suicide, almost as though it was a failure to to grasp recovery. There can be a denial of vulnerability and of enduring difficulties and with judgement of that.

            It’s an indictment of where we are when I listen to a survivor say that at least in 80’s psychiatry anyone viewed as a chronic hopeless case was at least left with some support. It’s hardly a selling point but that person had a point – now contemporary psychiatry (in the UK) means you accept your diagnosis/meds AND you MUST recover in addition. If you don’t, it’s your fault.

            Alternative recovery models outside of psychiatry are in danger of replicating that in reverse – walk away from psych/meds/do some nice alternatives and recover and if you don’t you’re not trying hard enough.

            I’ve commented before that when psychiatry gives up on people as in viewing us as hopeless incurable cases then more typically here you just get dropped like a hot potato. So you could end up in the emergency room every week and slowly die with no support with HP’s saying it’s their expectation and simply observe their notes are in order. This always existed but I do believe it’s more likely to happen now in British psychiatry partly because there’s no room for people who don’t recover. They discharge people with discharge being viewed by service commissioners as recovery when in reality the person is far removed from that. There is virtually no longer term psychological support for people who might be viewed as the psychiatric equivalent of ‘terminal’. There’s no psychiatric palliative care, and I’m unsure whether there’s any alternative palliative support outside of psychiatry for people who feel their state to be without light – but there needs to be.

            In my personal experience of supporting suicidal friends sometimes the best support I’ve been able to offer them is by accepting their position and giving them the space to talk that through. Denial of it can make a person feel worse, at least validation of feelings offers some small comfort at something being understood.

            Acceptance without judgement and with support – psychological palliative care – imagine if we offered that?

            I know an exceptional former psychiatrist who did just that for a woman (as a 2nd opinion} who didn’t want to be re-fed yet again and wanted to go, but at least she had the dignity of support. She fared better than a friend who couldn’t access anything and had to take drastic measures to secure PHYSICAL palliative care simply because it was viewed as “psychiatric” in origin i.e. anorexia.

            I wonder if we offered palliative care how many people would then survive?

            I’m thinking of Dignitas where (I can’t remember actual figures) but a high % of people who consult them and even have their case approved then don’t go ahead with it – I think because they have received proper validation of the depth of their feelings and truly felt like they had ALL choices.

            So I want to say that I SEE your black darkness, and are not demanding you see the light, so maybe we, and others could join us to hold hands in the dark.

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  5. The war is bigger than psychiatry and certainly isn’t the only part of it. I don’t identify as recovered or recovering and never have. I identify as disabled, not as an irresponsible victim with a ‘biochemical imbalance’, and recovery mantra’s have made me feel as lesser-than-human as biological psychiatry did.
    I think anti-stigma campaigns are a complete waste of money and would be used in advocacy and legal representation.

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    • I don’t identify myself as “recovering” either. It implies too many things that I just don’t believe in for myself. If other people want to identify themselves as recovering that’s fine by me and I will support them in this, but it doesn’t fit me at all.

      One of the big problems is that many times it’s the old “one size fits all” business; recovery is defined only one way and everyone is expected to conform to this or else. It’s the way the “system” has always worked. Recovery is another “buzz word” at this point and means recovering in the way that the system approves of and deems fit.

      It’s also another way to separate us from everyone else who hasn’t been in the system or had to deal with it in some capacity. To me it’s like there’s the “normal” boat for everyone who has never been supposedly “ill,” and then there’s the “recovery” boat with all of us in it. In reality, everyone is “recoverying” from something in their lives. Everyone wears an albatross around their necks but most people go around hiding it and pretending that there’s no such thing hanging there. I believe that we’re all in one boat and it’s called the boat of the wounded. The wounded boat carries all of us alike on the sometimes choppy and stormy waters of the ocean of life.

      No matter what the system does it always attempts to set us apart from everyone else. I agree that the money spent on “anti-stigma” campaignes could be better spent in other ways.

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      • Stephen,

        I’m for the term “recovered.”
        As in, that was “then” and this is “now.”

        It seems to me that the past should not restrict anyone from living in the present, especially if the past, however traumatic is processed and accepted for what is is, and where it belongs – in the past.

        I’ve been sober since 1987. I got support from a group for a couple of years, and then went on with my life, without the weekly meetings. I don’t consider myself to be in “recovery.” I just don’t drink. That was the past. This is *today.”

        Duane

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        • And I think the same applies to a “breakdown,” a term I think is much more accepted and understood by our society. Prolonged stress and trauma cause “breakdowns.” These are *events*, not people. And events can be overcome, put in the past.

          I prefer not to discuss my own personal experience in this area, other than to say some of the trauma I overcame as a young man was “unspeakable,” and best left where it belongs – behind me, in the *past*. I *recovered*, and moved on.

          Duane

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  6. The war seems to be between the parts of us that want to heal and the parts that don’t want to, or that don’t believe they can. In fact, I’d call it a pretty fierce tug-of-war. It would seem to be a matter of reconciling this, somehow, and ascending from the conflict, in order to create movement toward healing, integrate all the parts, and eventually feel whole–if that’s what one desires and believes they can accomplish.

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    • It’s amazing to me how many people do not believe that they can get their lives back and move on out of the “system.” I work in a state hospital and am a group leader on one of the units. When people begin talking about how they’ll always be ill for the rest of their lives and that they’ll probably come back to the hospital numerous times I ask them why they feel this way. I challenge them to think about the possibilities of perhaps this being their last admission. It’s saddening to me to watch how surprised and often frightened people become and they refuse to even attempt an answer.

      The reality is that all of the staff emphasize over and over again that they’re supposedly “ill” and this is what they have to look forward to for the rest of their lives and they need to get busy and accept “reality” for what it is. I ask people if this has to be their “reality” or could there actually be some other alternative. Since many of these people have been in the system and in and out of the hospital since they were teenagers they’ve learned the lesson of learned helplessness very well because the system has been an oppressive and tyrannical teacher. Many see themselves only as “mental patients.”

      I go home many afternoons very, very sad.

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      • I agree with much of what you say Stephen, psychiatry makes us scared of ourselves, but we as in survivors/critical thinking allies *can* also collude with this setting us apart through recovery. I’ve felt equally as judged through recovery as I did by psychiatry, this is why I now sit outside all dominant models and it’s a lonely place.

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        • Joanna

          Yes, where you sit is lonely but it’s your place and your space and I believe that’s what counts above all else. It sounds like you’re not willing to bow down, accept,and become compliant with ideas and lables that don’t suit or fit you.

          By choosing your own space where you’re willing to stand and be seen you are an important example for others to do the same. I would even say that you become an inspiration for others and you’ll probably never know about it. But it doesn’t make it any less lonely.

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      • “The reality is that all of the staff emphasize over and over again that they’re supposedly “ill” and this is what they have to look forward to for the rest of their lives”

        You really hit the nail on the head, here, Stephen (as usual!). I had to fight this, myself, when these messages started coming at me, and it was having the effect that you say, here—I was starting to believe that I was ‘permanently damaged and disabled,’ and it devastated me. This was not the vision I had had of myself before turning to the system for support.

        I had already been living with diagnoses and meds for 20 years, with minimal life disruption—I had a career, partner, continued my education, good social life, etc. I had to adjust to thinking of myself ‘chronically ill,’ but it didn’t stop me from having a life.

        Years later, after grad school, when the meds I’d been taking were making me so ill that I knew it was time to come off of them, I *chose* to turn to the system for support, in San Francisco. Was I ever naïve! I had just completed my training and had been interning as MFT, and I withdrew from my training for a time so that I could get myself together after tapering off the meds. Of course, if I knew then what I know now…but, I got myself entrenched, and at this point, I can only say that it was for a bigger purpose.

        I went to a social service partial hospitalization group, and just like you say, these messages started right away. 6 therapists in 9 groups/week. I was there to heal and to get well. Instead, the therapists would make statements, very casually, as if it were fact for everyone in there, like ‘Now that you are disabled’ and she would write on a white board the word ‘dis-abled,’ just like that with the hyphen, so that we could how disconnected were from ‘abled.’ I also remember one therapist who started sentences with ‘Before you got sick and stopped being able to do the things you enjoyed doing…’ She would also make statements dividing people up between those who could ‘function in *normal* society’ vs. those who could not. Seriously.

        I was so raw from the meds detox, I would easily internalize this and fear these ‘truths’ for myself. I began to see myself as marginalized and permanently disabled, even though my actually disability came from the chaos caused by the meds. They thought this fractured person was my spirit and everyday personality, and wouldn’t hear otherwise. My stated intention from the time I signed up for this fiasco was to get back on my feet, not to wither away as they seemed to imply (and sometimes, outright state), was the only prognosis for us ‘mental patients.’

        I dropped from the program after 5 months, despite their attempts to scare me into thinking I could not handle the world (??), so that I’d keep coming back for more of their fun. But I was getting much, much worse there, having learned to feel so utterly terrible about myself.

        Between these group therapists, along with a terribly disturbed psychiatrist I’d been seeing who pretty much also condemned me, and the equally crazy vocational rehab agency which simply repeated these messages as I was trying to transition back into the work force–all occurring as my brain and emotions were at their most tender because of the massive meds tapering–a lot of damage was done to my psyche and self-beliefs that I had to undo myself later, using natural and psychic energy healing methods that work for me. A LOT of forgiving, too, which was hard, but pretty key. I really had to work hard to get this energy out of me, it got really engrained.

        I can still get kind of pissed thinking about it, because some of these people acted like true monsters, and I know they’re still out there, doing this to others. But overall, the charge of the trauma is gone for me. I get the big picture now, and in my work at present, it’s all useful information.

        In the end, I proved them all to be not only completely 100% dead wrong, but also incredibly dishonest and lacking in any kind of integrity and independent thinking themselves, whatsoever.

        So I agree with you completely, Stephen, this is an illusory social hierarchy perpetuated by those that deliver these messages of limitations and needing chronic care, that independence and self-clarity cannot be achieved. This field relies on ‘chronic’ anything. They need people to become addicted, not only to their meds, but to negative self-beliefs. It’s good for business.

        I always admire your clarity, Stephen. The patients in the hospital where you work are so lucky to have you. At least you can hold a space of truth in an otherwise unaware environment. Regardless of how much power we have or don’t have over decisions about others, we can always feel our loving compassion and hope for those who are still feeling their way around in the darkness. There are many forces at work, here, and some of them are actually healing!

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        • That is such a disgusting story! Good for you for resisting their indoctrination into disability. It revolts me that a “professional” would herd a bunch of people together for the purpose of teaching them they can’t do things. What the hell do they think they are accomplishing? Saving you from “disappointment” when you “inevitably fail?” Sounds like projection of their own failure to ever understand how to help another human being.

          Keep telling your story. It’s a much better story than the one they’re selling, and all the more important for actually being the truth!

          — Steve

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          • I believe that what they’re doing is called “job security.” People have nice, big homes, drive nice big SUV’s, and go to the country club for golfing and dinner by making sure that people remain “ill.”

            Call me cynical if you will, but getting the system to change is going to be extremely difficult because changing the system is oging to interrupt the lives of a lot of people who depend on us for “being ill for life.”

            I believe that many psychiatrists know exactly what they’re doing to people when they force the toxic drugs on them, but they make more money prescribing the drugs for four people an hour than they do by working at talk therapy for one patient for one hour. They protect their billfolds and their nice bank accounts.

            And then, we have the business of egos being tied up in psychiatrists being able to see themselves as “real” doctors because they get to write scripts for drugs. They’ve got to keep us “ill for life” and “profoundly and severely schizophrenic” and all the rest of that bologna.

            And it’s not just psychiatrists; it’s nurses, social workers, psychologists, behavioral health workers, peer specialists, people who staff those awful “community mental health clinics,” and just about every other kind of staff that you find in the system. Lots and lots of peoples’ lifestyles depend on us being “ill for life.” Yes, I’m cynical.

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        • Congratulations for discovering the truth and for acting on it. Congratulations for having the gumption to hang in there and find healing and well-being and health even though it was difficult.

          It would be a step in the right direction if people in large numbers would take your example and choose to step out of the “system” and quit believing the outright lies that are told to everyone by the people working in the “system.” What could they do if people stopped believing their lies and quit attending all the things that they get paid for doing? Nothing. And it would be absolutely wonderful. Unfortunately, too many people are too afraid to try it, even though they know deep down that they’re being taken advantage of.

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          • Stephen, I’m cynical, too, when it comes to anything in the mental health arena. I do trust the natural order of change, however, and I also believe that these systems have had their day. How this will occur is anyone’s guess, but I do feel that we’ve all made a big difference here, toward that endeavor.

            Regarding your post about leaving the system (and thank you very much for your kind words), I think fear is the key issue. Learning to trust can be hard in the wake of all this betrayal and deceit. The trick would be to, somehow, get from fear to faith, and that’s really an individual’s soul/emotional journey to take. After that, clarity is much easier to achieve.

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  7. Alex, the word disability means different things to different people, just as survivor, loony, consumer, user, do.
    Physical disability activists in the UK are strong & strident with not an ounce of victimhood about them, disability as a description is not shameful or negative to them.
    Somehow it’s different when it comes to mad people, recovery workers can baulk at the term disability but can sometimes deny vulnerability or the existence of enduring difficulties or that not everyone achieves “full recovery” whatever that is. Sometimes the acceptance and acknowledgement of experiences or ongoing difficulties as resulting in some disability can free a person from trying to be a square peg in a round hole, not an abdication of responsibility or nihilistic pessimism. Disability isn’t always permanent neither, people can be registered blind, which they need the formal recognition of in order to acquire the necessary support and protection they need in order to live more fully. Some conditions can mean regaining sight, at which point the formal registration of a disability is rescinded.
    It’s a bit difficult to fight for the need for all sorts of support without first stating what the difficulties are in some description, and more so when there is longevity – how long does a person have to experience difficulty before it can be described as disability? I know what you mean about psych services, when they use the word they mean lifelong mental patient who’s a good girl/boy and takes their meds and doesn’t expect too much out of life, that’s true, but I’d just like to offer an alternative way of looking at it which isn’t that at all for some people.

    For your interest, the World Network of Users and Survivors of Psychiatry, p12, refers to “persons with psychosocial disabilities”
    http://www.wnusp.net/documents/WNUSP_CRPD_Manual.pdf

    It always amuses me when MH professionals look shocked and horrified on hearing ‘loony’ when for some people it’s a reclaimed term of endearment for themselves and their friends, just as survivor might mean surviving services but not experiences or vice versa or both.
    User is not a term which came from UK psychiatric survivors, but consumer I wouldn’t personally use because that implies choice where there is not.

    For me voice hearer was a break through description because it’s descriptive without giving away any specific theory of understanding it, that’s the beauty of it.
    Language and what it means to us is really interesting, it never ceases to interest me how we define ourselves and how that has evolved.

    Duane, I respect your perspective for you, that fits for you and no one has the right to argue with what works for you, but I can’t go along with your thinking for others that it’s past and present and nothing should restrict because it just isn’t black & white like that, as we know some of our peers were not able to live with their distress at all.I can’t see ‘shoulds’ when it comes to surviving, how we survive, or not. Not everyone can ‘move on’ and I can’t judge others for that and say nothing is insurmountable because if that were the case I wouldn’t be missing several friends.

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    • Thanks for the information, Joanna, I appreciate learning about these different perspectives.

      I agree that disability is not permanent, but these staff people I talk about saw it as such in the case of people who’ve been DSM diagnosed. And to them, it wasn’t just a permanent limitation in social and/or professional functioning. This prognosis came laced with the idea that this would mean chronic pain and unhappiness for the rest of one’s life, always prone to crises, needing ‘overseeing’ like a child, and forget about ever fulfilling your dreams and having any kind of power in the world.

      I don’t care what anyone thinks about me, personally, but when I started to catch on that this is what my ‘support’ projected about my life, future, and well-being, I left and sought support from people who believed and knew that I could heal, and who came from a loving heart space, not a cynical head space. Of course, I never left without leaving my legacy, one way or another. I wasn’t quiet about my opinion, and I rattled a lot of cages, including via legal methods.

      When I was disabled—that is, when my brain was in toxic meds chaos and I could not focus to save my life—I had no problems owning this. I never had shame about it nor did I feel compelled to hide it in any way. I had to navigate it, mostly bureaucratically, which I found to be one of the biggest challenges. It was like having two full time jobs, all the energy one has to pour into navigating disability.

      But the picture of ‘mental disability’ that is drawn by the system and its ‘advocates,’ at least in San Francisco, is really and truly sinister. It’s more than ‘disabled.’ It’s more like…doomed. And perpetually powerless. In other words, “We will ALWAYS be able to overpower you.” That’s why I talk about it the way I do, as devastating.

      Indeed, disability can be a temporary part of our life journey, and an enriching one, no doubt. There’s a lot to learn from this perspective.

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      • And the real pity is that a lot of people can’t move on and get their lives back because of what was done to them by the supposed “treatment” that they had to endure.

        The system has a lot of blood on it’s collective hands and yet it goes on about its business, telling people that they’d better accept the fact that they have no lives.

        “First do no harm” is ignored right and left and lots of innocent people pay the price with their lives and their livelihoods.

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        • Many of the people I work for are so damaged by the drugs that were forced on them that they will have to be taken care of for the rest of their lives.

          My fear is that if and when this system is dismantled and an alternative put in place that these permanently harmed and impaired people will be shoved to the wayside and ignored, both by the system and by the advocates for change. They are difficult to deal with and require lots of attention. They deserve better “treatment” than they originally received and better than they’re likely to get in the future if changes do happen.

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  8. I find this part of Rufus’ post really amazing and helpful:

    “When we get mentally overwhelmed it is because parts of us are trying to protect themselves in powerful ways that are confusing to the person or those around them.  For example, in depression parts of us withdraw when they are exhausted. They are perhaps full of fear and don’t want to fail again. The person may also be overwhelmed with feelings of grief, sadness and bitterness to the point of a complete sense of nothingness and pointlessness.
    In what gets called obsessive compulsive disorder a child-like part of us may be in control. It knows that – temporarily – it can protect the person from pain by creating an illusion of control in an unsafe and uncertain world. In mania, impulsive energies and child-like parts and power-hungry parts team up and overtake the exhausted responsible adult parts. They are running on suppressed energy, and often it is a powerful cocktail of pent-up frustrations and grief.
    When we are seen as delusional, our magical and imaginative children may have taken over our awareness, creating stories that seek to protect us and in some ways symbolize our emotional strife and need for safety. Our heroes and our messiahs are often given a role to protect us  from painful feelings of isolation, vulnerability, and loneliness.
    When we hear voices we may be hearing parts of ourselves we have consciously or unconsciously separated from and personified.  Angry voices are often parts of us that have witnessed or been subject to neglect, emotional or physical violation, manipulation and exploitation. They are angry at the person and the world that has let them down.
    Somebody who experiences high levels of anxiety may be highly sensitive, and this trait needs to be honoured as an ability to feel energies and emotions strongly.  Anxiety also seems to mount up when we are trying to keep a lid on angry and frightened parts of ourselves.
    Suicidal feelings come from parts of ourselves that are overwhelmed with painful feelings. They want a break. They are telling us we need new ways to look after and respond to these painful feelings. When emotional pain feels listened to or is channelled in some way into activity, it calms down markedly.”

    My thoughts:

    If our inner child starts making up stories which seek to protect us and in some ways symbolize our emotional strife and need for safety who is to say that these stories are unrealistic, when they take on an emotional perspective which is connected to the creative energies which steer our destiny and create our lives. The very fact that they stray away from objective substance reliable reality, and the mind does this by itself, shows that they may be tapping into something that’s the source rather than the result. That they are tuning into cause rather than effect, content rather than surface. And often they are being judged because what they express transcends accepted norms, which aren’t objective either, and thus are about challenging people to question their assumptions rather than anything objective at all.

    (Thinking about your thoughts)

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    • Although a nice TV ad campaign saying mental distress, that commonly gets diagnosed as mental illness, is usually caused by: poverty, racism, bullying at work, bereavement, child sexual assault, family violence…..etc etc etc might have made a useful contribution to the national debate

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