Can Its New Board President Turn NAMI Around?

Jack Carney, DSW
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“The word is out!” That was Dr. Keris Myrick’s reaction when she was elected earlier this month as the new president of NAMI’s Board of Directors (personal communication). “Wow!” The reaction of many of us when we heard the news. For those of us who know Dr. Myrick, it seemed an inspired choice. For those of us that have known NAMI for many years, some of us since its founding in 1979, we wondered whether the selection of a peer/survivor as its Board president signaled a sea-change for the organization or whether it was a political move designed to restore some of its lost credibility. Perhaps, of course, it’s both.

I met Dr. Myrick little more than a year ago when she sent me an e-mail requesting information about a training program I had developed. She was particularly interested in one of the training modules, “How To Communicate with Your M.D.” So I sent her a Powerpoint copy, which she put to immediate use, travelling up and down California and presenting at various conferences. I was impressed with her commitment to the task and her sense of mission. She’s one of the few people I know who immediately understood the importance of utilizing the Metabolic Syndrome Monitoring Protocol as a first step in addressing the adverse effects of neuroleptic medications, which is the prime message of the module.
We communicated back and forth via e-mail and occasional ‘phone calls; actually, we’ve never met face-to-face, although we’ve promised one another to do so.

I learned Dr. Myrick’s backstory when Ben Carey’s article about her appeared in The New York Times in October, 2011. Two months later, after I found out she was the 1st V.P. on NAMI’s Board, I asked her if she would be willing to ask the Board to endorse the petition then circulating to have the American Psychiatric Association delay publication of the DSM5. We both knew it was a longshot — NAMI had a long-term connection to the APA, was still wedded to the biomedical model and had only begun to address its financial entanglements with Big Pharma. Indicative of the leadership I’m confident she’ll bring to NAMI, Dr. Myrick pressed on and raised an issue that had to have challenged the culture of NAMI’s Board, indeed of the entire organization. And while the Board did not sign the American Psychological Association’s petition, it did bolster its original statement re the DSM by including language acknowledging the metabolic risk presented by psychoactive medications. In sum, it seems Dr. Myrick was able to bring to the table issues that the Board rarely discussed; and she also managed to wangle an invitation for Bob Whitaker to speak at NAMI’s next annual convention.

This is the way I imagine change will come to NAMI – slow, steady and hard to achieve.
I began my own involvement with NAMI in the mid-1980’s with our local Brooklyn chapter, A.P.R.I.L. – the Association of Persons for Rehabilitation & Independent Living. (For those of you who might not know, NAMI, in addition to its national office in Washington, D.C., has chapters in every state and over 1100 local affiliates.) This was at the time I was compiling psychoeducational family therapy data for my doctoral dissertation and investigating local family support groups for the families we were working with. I attended APRIL’s monthly meetings, did some presentations re psychoeducation and got to know the group’s leadership and its members. Its president was Sunny Brodsky, a lovely caring woman who, similarly to her members, was an elderly person with an aging child long ago diagnosed with a serious mental illness. I was struck by APRIL’s members’ determination to help their marginalized children and the burden they had been made to bear by a public mental health system that denied them and their children the resources they needed and by mental health professionals who maligned and blamed them. These were folks desperate for validation, for help, for answers. Not surprisingly, they looked to individuals who seemed to offer solutions, first and foremost, E. Fuller Torrey, a psychiatrist , whose Surviving Schizophrenia: A Manual for Families, Consumers and Providers, provided a blueprint for treatment and advocacy for NAMI and its members that was followed for years. He posited – and NAMI members latched onto – the notions that mental illnesses are neurobiological in origin; anti-psychotic medications are the treatment of choice; and treatment must be compulsory for mentally ill persons since they can be dangerous without it. Fuller Torrey did provide answers, but he earned for NAMI the enmity of peer/survivors and their advocates which has lasted into the present.

In the ensuing years, I had several other opportunities to collaborate with NAMI on the state and local levels and with individual members. The first was occasioned when New York State instituted its Intensive Case Management Program in 1988. This was shortly before the first atypical neuroleptics were introduced and just as the State began a decade-long expansion of community-based services. It was also twenty years before the extent of NAMI’s involvement with Big Pharma was brought to light by the advocates and journalists who pay attention to these matters. I happened to be Director of Training for the downstate half of the ICM program, and I promptly enlisted several members of NAMI’s State Board to lead the training module we had included to address the issue of family involvement in case management, a role they fulfilled for the nearly ten years I was connected to the training program.

The second occurred when I left as full-time training director in 1993 to assume responsibility for developing an ICM program for individuals that were encountering great difficulty accessing treatment services in New York City , principally so-called “forensic “clients, or those persons released from State correctional facilities with serious mental illness diagnoses. The concern for forensic clients soon spread city-wide with the initiation in 1999 of the infamous “Brad H.” lawsuit by the Urban Justice Center on behalf of presumably mentally ill inmates released from Rikers Island jail in the middle of the night with two subway tokens and no treatment referrals. NAMI members, particularly those affiliated with the NYC Metro chapter in Manhattan, the largest NAMI chapter in the State, were very much involved in this struggle, knowing their children were always at risk for arrest and mistreatment by the NYPD. These were, after all, the Giuliani years. Many chapter leaders were regular participants in the monthly training and information workshops I conducted over a three-year long period to address the concerns and apprehensions of treating professionals. They were among the last of NAMI New York’s founders and , I assume, among the last not yet touched by the corruption slowly enveloping the organization on the State and national levels.

My most recent opportunity came in Spring, 2009, after the client and case manager participants and I had completed the demonstration phase of the training program I referenced at the outset of this article, the Integrated Collaborative Care Management Program. A summary of the demo’s outcomes had been published on-line in Fall, 2008, generating some interest. I received a tentative invitation from the Director of NAMI’s NYC Metro chapter asking me to present an overview of the program, which sought to promote primary health care self-advocacy on the part of our case management clients. I never received a follow-up call confirming a date for the presentation, so I assumed that my Introduction, which contained summaries of the CATIE (2005) and the NASMHPD (2006) studies outlining the potentially devastating effects of the atypical neuroleptics on those prescribed them, had been deemed too threatening for NYC Metro’s members. I didn’t know that at that very moment Senator Chuck Grassley was lambasting NAMI as a “front” for Big Pharma in Congressional hearings he was holding in Washington. As proof, he produced NAMI financial reports indicating that, since its founding, NAMI had received, on average, 50% of its annual budget from pharmaceutical companies; further, that the figure had risen to 75% in the three years preceding his hearings, i.e., from 2006-8.

An old UCLA classmate of mine, Mickey Weinberg, recently reminded me that MindFreedom International, the Oregon-based advocacy organization, has been keeping tabs on NAMI since 2003, when he as lead organizer and David Oaks, MFI’s executive director , led a group of activists on a 21-day long hunger strike to underscore their demand that the U.S. Surgeon General, the American Psychiatric Association and NAMI provide “valid scientific evidence…” of the biological origins of serious mental illnesses. When the strike, formally called the “Fast for Freedom in Mental Health”, concluded in September of that year, meetings were held between the strikers and representatives of NAMI and the APA which proved mutually unsatisfactory – the proof demanded wasn’t provided and the strikers’ “opponents” (Mickey’s term) maintained their public stances if not their equanimity. As Mickey concluded, “… We’re still waiting … The challenge will not go away …” (personal communication). In the interim, MFI has tracked the number of times the term “biologically-based” appeared in pronouncements on NAMI’s website as a readout of its continued commitment to the biological model. As per MFI’s chart, “biologically-based” made 195 appearances in 2009, the year of the Grassley hearings, and dropped to 136 the year after. The wait continues.

In my estimation, this is the key challenge Dr. Myrick will be facing … to move NAMI off the biological dime and get her Board, the general membership as well as the organization’s staff to consider environmental stressors – trauma, racism, poverty – as the source of most folks’ emotional distress. My own experience working with families and NAMI members is that they reflexively fear being blamed for their children’s presumed illnesses, and reliance on environmental explanations, particularly as regards trauma, might re-open a conversation that I’m sure most hope is over. Hence the attraction of the biomedical model. All the loose ends seem to have been connected – the existence of mental illness, its cause and essential treatment and the shibboleths of wellness, rehabilitation and recovery. To challenge the biomedical model is to begin to untie those knots, to raise members’ anxiety and to invite resistance that can be expected to be fierce. I will not presume here to suggest to Dr. Myrick how she should begin to question ideas which currently comprise NAMI’s fundamental belief system. I believe that Dr. Myrick has no illusions about the difficulties she will be obliged to confront; I also believe that she knows, as I wrote above, that change will come slowly, will require a steady hand and will be hard to achieve. As she wrote in a recent personal communication, she will require support and luck. Keris, you have mine and, I’m sure, that of your fellow bloggers and our readers. As for luck, Branch Rickey, the old Brooklyn Dodger G.M., once described it as the residue of design; by which he meant you make your own. Or, as my old friend, Joe Hill, would remind you, “Don’t mourn, organize!

References:
Carey, B., “A High-Profile Executive Job as Defense Against Mental Ills,” The New York Times, October 22, 2011
Carney, J.A., “Access to Care: Training Consumers & Case Managers,” www.miwatch.com, Fall, 2008
, “Ask Questions … Get Answers: The Integrated Collaborative Care Management Protocol & Training Program — Final Outcomes,” powerpoint presentation, September, 2010
National Institute of Mental Health, University of North Carolina, “The CATIE Studies: Clinical Antipsychotic Trials of Intervention Effectiveness, Phase I,” www.nimh.nih.org, www.catie.unc.edu, 2005
Fuller Torrey, E., Surviving Schizophrenia: A Manual for Families, Consumers & Providers, 4th ed., Harper Collins, New York, 2001 (1st ed., 1983)
Gaouette, N., “Grassley Probes Financing of Advocay Group for Mental Health,” Bloomberg News, www.bloomberg.com, April 5, 2009
Harris, G., “Drug Makers Are Advocacy Group’s Biggest Donors,” The New York Times, October 21, 2009
,“NAMI Board Member Resigns in Protest Over Drug Money,” The New York Times, December 8, 2009
MindFreedom International, “The Many Faces of Big Pharma’s Disease Mongering,” www.mindfreedom.org, 2009
National Association of State Mental Health Program Directors, “Morbidity & Mortality in People with Serious Mental Illness,” http://www.nasmhpd.org, 2006
Parish, J.J., “N.Y. City’s Brad H. Settlement, www.miwatch.org, April 30, 2007
YouTube, “Big Pharma Front Groups, NAMI?”, www.youtube.com, May 18, 2009

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20 COMMENTS

  1. You got that right.

    “To challenge the biomedical model is to begin to untie those knots, to raise members’ anxiety and to invite resistance that can be expected to be fierce.”

    I can think of lots of mommy bloggers who have hitched their wagons to NAMI because they are terrified of even considering that the family environment may not be perfect.

    • What family’s life ever is perfect? Only Beaver Cleaver’s. People make mistakes, even when it comes to reaising children, the most difficult job in the world. The issues leading to what the system calls mental illness are extremely complex with no one particular cause. I suspect that the causes are a mixture of nature and nurture all rolled up into a messy bag. MAMI’s unwillingness to look at some of these things mirrors the way our society doesn’t want to deal with the fact that it’s sick. They need to buck up, get some backbone, accept the fact that life is a messy business and that they’ve probably had a hand to play in what happened to their children, not the only hand but at least one hand, and move on to work for better lives for everyone. Sometimes you have to quit thinking about your own welfare and work for the betterment of the entire group. Maybe Dr. Myrick can help them to move in this direction.

  2. ” My own experience working with families and NAMI members is that they reflexively fear being blamed for their children’s presumed illnesses, and reliance on environmental explanations, particularly as regards trauma, might re-open a conversation that I’m sure most hope is over. ”

    They wouldn’t have that reflex or feel that way if they didn’t have a guilty conscience from knowing that such abuses did in fact occur in the first place. It’s like that old saying, “If you didn’t do anything wrong then you’ve got nothing to worry about.” or “Where there’s smoke, there’s usually fire.”

  3. Lots of good historical information in your blog. Thanks!

    There is an interesting ambiguity in your introduction about describing Keris Myrick as a peer/survivor. Survivor is often a short-hand for “psychiatric survivor” (i.e. recovering in spite of psychiatric intervention), whereas she describes her relationship with her psychiatrist as one significant component of her recovery. I was wondering if the ambiguity is from her own message, or in how others perceive her.

    One thing I particularly like about Keris Myrick talking about her story is that she clearly put forward and foremost the fundamental goal of well-being and recovery and life fulfillment. Explanations of mental illness, diagnosis issues, management and treatment issues are subordinated to that goal, those aspects don’t matter by themselves.

  4. Fantastic essay Jack,

    I fully agree with “My own experience working with families and NAMI members is that they reflexively fear being blamed for their children’s presumed illnesses, and reliance on environmental explanations, particularly as regards trauma, might re-open a conversation that I’m sure most hope is over.”

    Yet as the late and truly great Harry Chapin would say “all my life’s a circle,” and what goes around, comes around, again and again, till we learn to do it right?

    I really appreciate all the historical background to an issue that appears at first sight to be an American problem?

    Yet the core of the problem seems to be our common preference for constructing a consensus normality, using that great tool of the civilizing process, “denial.”

    How does any parent address an unconscious urge to keep their child “infantile,” in that great “don’t grow up and leave me,” desire for the close proximity of support and protection?

    I’m reminded of a close friend in Australia, a high functioning individual who regularly completes his daughter’s homework assignments. “I’m just helping her out, being a good parent,” he protests when I point out his “unconscious” desire, that his little girl never grows up & leaves him?

    Where I now live, in South East Asia, there is far less of an issue with mental health problems, not because emotional distress remains “un-diagnosed,” but because there is a timeless trade off to the fundamental human need of support & protection through the felt reality of close proximity.

    The extended family support network is alive and well here in Thailand, where foreign teachers bemoan a lack of critical thinking, once a student leaves the education system and goes back into the age old ways of group and family oriented survival.

    To an educated Westerner the reverence to ones elder’s and a tradition of subservience can be incredibly frustrating, to our ethos of individualism. Yet when I and others like me seek to examine the emotional rather than the “objective,” truths of a different societal system, reality stares us in the face.

    This societal system does “togetherness,” better than we do? In my own education, I can’t help but be reminded of all that fearless thinking of the 1950’s, when the crucible of madness was challenged directly, as we sought to understand our own reality, as it’s actually constructed from within?

    Murray Bowen’s seminal ideas about the family spring to mind, and his notion of two opposing forces of human development, “togetherness & separateness,” and how we each manage our differentiation of a self, within these largely unconscious and very powerful, opposing forces?

    “Or, as my old friend, Joe Hill, would remind you, “Don’t mourn, organize!”

    Will we ever really organize, until we honor the reality of the human condition within and stop pretending that life is all about “them & out there.” Will we ever really organize until we face the reality of our denial about an internally constructed “consensus reality.”

    Are we in love with OBJECTS and “objectivity” because it helps us to avoid and remain in denial about our own internal reality?

    “Consensus reality is an approach to answering the philosophical question “What is real?” It gives a practical answer: reality is either what exists, or what we can agree seems to exist.
    The process has been (perhaps loosely and a bit imprecisely) characterised as “when enough people think something is true, it… takes on a life of its own”. The term is usually used disparagingly as by implication it may mean little more than “what a group or culture chooses to believe”, and may bear little or no relationship to any “true reality”, and, indeed, challenges the notion of “true reality”.

    The difficulty with the question stems from the concern that human beings do not in fact fully understand or agree upon the nature of knowledge or knowing, and therefore (it is often argued) it is not possible to be certain beyond doubt what is real. Accordingly, this line of logic concludes, we cannot in fact be sure beyond doubt about the nature of reality. We can, however, seek to obtain some form of consensus, with others, of what is real.

    We can use this consensus as a pragmatic guide, either on the assumption that it seems to approximate some kind of valid reality, or simply because it is more “practical” than perceived alternatives. Consensus reality therefore refers to the agreed-upon concepts of reality which people in the world, or a culture or group, believe are real (or treat as real), usually based upon their common experiences as they believe them to be; anyone who does not agree with these is sometimes stated to be “in effect… living in a different world.”

    Throughout history this has also raised a social question: “What shall we make of those who do not agree with consensus realities of others, or of the society they live in?”

    Children have sometimes been described or viewed as “inexperienced with consensus reality,” although with the expectation that they will come into line with it as they mature. However, the answer is more diverse as regards such people as have been characterised as eccentrics, mentally ill, enlightened or divinely inspired, or evil or demonic in nature. Alternatively, differing viewpoints may simply be put to some kind of “objective” (though the nature of “objectivity” goes to the heart of the relevant questions) test.

    Hmm! (though the nature of “objectivity” goes to the heart of the relevant questions)

    Food for thought, perhaps?

    Or continued denial?

  5. Thank you for a thoughtful post. Like Rossa I can attest that there are mommy bloggers which are clinging with ferocity to the false notion that family dynamics do not play a role in causing or exacerbating their children’s distress, emotional difficulties. Ironically, they also seems devoted to the notion that as parents, they always act in their child’s best interests, regardless of how their children are impacted by their actions. While a parent’s intent may in fact be to act in an adult or a minor child’s best interest, it is not the parent’s intent that leaves the biggest impact; it is the effect their actions have that is experienced by their child.

    There is not a day that goes by that I have not remembered that my intent have my children taken care of when I was unable to do so led to them experiencing things which gravely harmed them. As children and as adults, my children know that their feelings about these events are honored and respected by me. It is a lesson in humility to own my mistakes. It is my willingness to do everything in my power to help them to overcome the harm they’ve experienced that has earned me my both of sons’ respect. There is no way I could have possibly done so without honoring what they themselves said hurts them; especially when it is something I have done or said—it is impossible to act on another person’s behalf without listening to what they say, and honoring it for the truth that it is.

    • And this is the very thing that NAMI, biopsychiatry, and many parents do not do. They absolutely refuse to accept that “it’s impossible to act on another person’s behalf without listening to what they say, and honoring it for the truth that it is.” For these groups there is no truth in anything that we as survivors have to say. After all, they know what’s best for us. How dare we to not let them have their way with us, since it’s all in our best interestsk?

  6. Thank you, Jack, for your insightful blog that highlights some of the challenges and opportunities that lay ahead for Keris Myrick and NAMI National.

    I would just like to point out the obvious that there are also many mommy (and daddy) bloggers like Rossa Forbes who are courageously and willingly venturing into a relational field to explore emotional distress, suffering, and dysfunction as a shared experience.

    Every day we speak to family members who genuinely want to support their family members, to be a real source of hope and encouragement, and to learn how to empower their families members in their recovery and transformative processes.

    There is a great deal of compassion that can be found when we acknowledge we come by our fears and our dysfunctional coping mechanisms naturally. They span generations. We don’t need biology or pathology to wriggle free from the crushing weight of guilt, we can choose compassion, insight, forgiveness and understanding. We can invite our loved ones to tell us what they need, and we can learn to listen and create safe environments where their needs can be given authentic voice.

    As we have begun developing our Mother Bear Community Action Network, we have been touched to see the warm welcome we have received from many “NAMI mommies.” They are beginning to fill our Family Dens. We are glad to offer a safe place to explore new ways of thinking about mental health and family recovery.

    We wish Keris the very best in her new leadership position and hope that our organizations can grow together to discover a much richer, broader and more empowering way to promote healing and wellness for the whole family and our communities.

      • I’m sorry for this comment, Jennifer Maurer. A comment of this nature surely detracts from my character and mine alone. I believe that you are a person of good will and deserve more respect than this. I think I can do better. I’m sorry!

    • Hi Jennifer,

      “We don’t need biology or pathology to wriggle free from the crushing weight of guilt, we can choose compassion, insight, forgiveness and understanding. We can invite our loved ones to tell us what they need, and we can learn to listen and create safe environments where their needs can be given authentic voice.”

      I think there is an understandable assumption in your statement of good intentions that we actually have real insight and people actually know what they really need? An understandable assumption that we are consciously aware of our motivations, and how we really function?

      Yet is that the case, do we posses realistic insights into ourselves?

      Here is an example of the unconscious reflective fear that Jack alludes to in his essay. The realities of family life which we all prefer to deny, in our usual fearful reactions about blame, shame and guilt?

      “The Family Projection Process:

      The family projection process describes the primary way parents transmit their emotional problems to a child. The projection process can impair the functioning of one or more children and increase their vulnerability to clinical symptoms. Children inherit many types of problems (as well as strengths) through the relationships with their parents, but the problems they inherit that most affect their lives are relationship sensitivities such as heightened needs for attention and approval, difficulty dealing with expectations, the tendency to blame oneself or others, feeling responsible for the happiness of others or that others are responsible for one’s own happiness, and acting impulsively to relieve the anxiety of the moment rather than tolerating anxiety and acting thoughtfully.

      If the projection process is fairly intense, the child develops stronger relationship sensitivities than his parents. The sensitivities increase a person’s vulnerability to symptoms by fostering behaviors that escalate chronic anxiety in a relationship system.

      The projection process follows three steps:

      (1) the parent focuses on a child out of fear that something is wrong with the child;
      (2) the parent interprets the child’s behavior as confirming the fear; and
      (3) the parent treats the child as if something is really wrong with the child.

      These steps of scanning, diagnosing, and treating begin early in the child’s life and continue. The parents’ fears and perceptions so shape the child’s development and behavior that he grows to embody their fears and perceptions. One reason the projection process is a self-fulfilling prophecy is that parents try to “fix” the problem they have diagnosed in the child; for example, parents perceive their child to have low self-esteem, they repeatedly try to affirm the child, and the child’s self-esteem grows dependent on their affirmation.

      Parents often feel they have not given enough love, attention, or support to a child manifesting problems, but they have invested more time, energy, and worry in this child than in his siblings. The siblings less involved in the family projection process have a more mature and reality-based relationship with their parents that fosters the siblings developing into less needy, less reactive, and more goal-directed people.

      Both parents participate equally in the family projection process, but in different ways. The mother is usually the primary caretaker and more prone than the father to excessive emotional involvement with one or more of the children. The father typically occupies the outside position in the parental triangle, except during periods of heightened tension in the mother-child relationship. Both parents are unsure of themselves in relationship to the child, but commonly one parent acts sure of himself or herself and the other parent goes along. The intensity of the projection process is unrelated to the amount of time parents spend with a child.”

      http://www.thebowencenter.org/pages/conceptfpp.html

      “These steps of scanning, diagnosing, and treating begin early in the child’s life and continue.”

      People may recall my earlier comments about how we scan for emotional resources to enhance our sense of self, and how we adopt a mind-reading diagnosis of each other, in our lop-sided “I think therefore I am,” culture?

      Murray Bowen’s seminal ideas on how society functions like an extended family, are as valid today as they were in the 1950’s. People confuse subjective and emotionally charged perceptions with real-life facts, we think and react to relieve emotional anxiety, more than we perceive and critique the reality before our eyes?

      • David, you make many important points. Thank you.

        Thank you for sharing the Family Projection Process. I am not familiar with Bowen’s work, but have been studying and working with Attachment Theory and this sounds like familiar ground. I have found this approach to be very helpful for understanding my own generational patterns, my parenting style, and areas for healing. Mindfulness practice is also very helpful for realizing how much humans live in an act out of projection.

        For the reasons you point out, I think it takes a great deal of courage to consider the possibility that suffering can be created and maintained in relationships.

        As for the invitation to insight, you are correct that this may be a long time in coming. That seems to be our life’s work as humans.

        In the midst of a family crisis, if the family is involved, perhaps it would be more helpful for a family member to ask is “what would help you feel safer right now?” or “Is there someone or some place that would feel more supportive right now?”

        I’d love to hear your thoughts on this. We are currently exploring ways to help families respond more wisely to emotional crises that promote healing, autonomy and empowerment and reduce the risk of harm.

        With gratitude for your perspective…

  7. Hi Jennifer,

    Attachment certainly is the prime mover in family affairs, and indeed in human motivation, and I think we could quiet reasonably sum up emotional-mental anguish as a profound disruption of our unique dependence on attachment?

    Over the past five years of closely monitoring my triggers into Bipolar type 1 mania, loss of attachment is the No1 trigger into a soaring state which seeks to address my existential reality? A reality which had become conditioned through birth trauma, to a primary expectation of negative state. Mania seeks to redress this primary and deeply unconscious expectation, in my embodied, implicit sense of my life.

    In the West, we have gotten lost in the secondary processes of the mind’s “subjective” state, confusing its idealization of life, with the real thing? The body and primary process communication are the very core of our attachment needs and our living experience. Feeling SAFE, is the vital need which “opens” us up to embracing life, beyond the hard-wired, wary defense, which is our first reaction to life and anything new?

    In the TV program “minds on the edge” there is a segment when a role play of a typical emotional crisis, is enacted and Pete Earley and Avel Gordly play the role of parents to a daughter in emotional crisis.

    Pete’s reaction when rushing to help, is to bombard his daughter with questions, a typical male, goal oriented and “secondary process” approach? While instinctively Avel’s reaction as a mother is to hug her daughter and transmit the crucial primary process need, of secure attachment?

    They are both asked about what to do, in this challenging situation and unfortunately, with good intentions, hospital and medical treatment is the seemingly obvious choice? Yet is it a choice made by a secondary process awareness, which has become “disembodied” in our crazy making, “I think therefore I am,” cultural zeitgeist?

    What would I have done as the father of a daughter suffering an existential crisis of “can I cope.” Can I cope? Is the fundamental life question for all of us, and as Peter Levine points out, it is the pivotal challenge underpinning our vast variety of subjective explanations for the anxiety of the lived moment? It is not unreasonable to suggest that this is the classic historical trigger to early adulthood, onset of primary emotional disorders like schizophrenia and bipolar disorder?

    The very challenge facing the role play parents in “Minds on the Edge’s,” “What’s happening with Olivia?” A family nightmare begins when parents find out that their daughter Olivia, who has been a successful college student, has developed mental illness. (Or is having an existential crisis about her ability to cope?)

    I would have approached my daughter quietly and with an open emphatic acceptance of her distress, taken her in my arms and gently rocked her, in a soothing of her heightened existential fear. I would have taken her home to familiar surroundings, where peace, quiet and appropriate proximity would be the prime concern. I would hope to enable an embodiment of my own high functional sense of “I can cope?”

    “The parents’ fears and perceptions so shape the child’s development and behavior that he grows to *embody* their fears and perceptions.”

    Existential fear triggers a desire for “escape,” and we escape into the secondary process of subjective state, in an unconscious reaction which seeks to avoid pain in the body. Understanding this critical point about “escaping” into a disembodied state of mind, is vital in accepting that primary processes of unconscious communication, must come first in these situations of emotional crisis.

    Until we accept that the body comes first and not the mind, we will continue to exacerbate the problems of emotional-mental distress, in our “mind oriented” Western cultures. What saddens me deeply about the mainstream debate on mental health, is the continuing focus on shallow “secondary process,” headline news?

    Beyond the mainstream headlines, there is a wealth of solid science and therapeutic knowledge, which never makes the drama fueled and predominately negative view of emotional-mental distress. An example, is Allan N Schore’s contribution at brilliant programs like Yellow Brick?

    “PARADIGM SHIFT: SECONDARY PROCESS COGNITION TO PRIMARY PROCESS COMMUNICATION.

    In 1994 I suggested that nonverbal communication in both early development and the therapeutic alliance is the output of the right brain primary process communication system. Like myself, Panksepp (2008) refers to right brain primary process systems and the affective states they engender. Other neuroscientists contend, “The right hemisphere operates in a more free-associative, primary process manner, typically observed in states such as dreaming or reverie” (Grabner et al., 2007).

    The relational trend in the field shifts primary process from intrapsychic cognition to intersubjective communication. In an important article on “primary process communication” Dorpat (2001) argues, “The primary and secondary process may be conceptualized as two parallel and relatively independent systems for the reception, analysis, processing, storing, and communication of information.” He asserts that affective and objectrelational information are transmitted predominantly by primary process communication, and that secondary process communication has a highly complex and powerful logical syntax but lacks adequate semantics in the field of relationships. Echoing a description of right brain attachment communications, he concludes such nonverbal communication contains “both body movements (kinesics), posture, gesture, facial expression, voice inflection, and the sequence, rhythm, and pitch of the spoken words.” Integrating this and other research and clinical studies I have argued that therapy is not the “talking” but the “communicating cure” (Schore, 2005).”

    http://www.yellowbrickprogram.com/Papers_By_Yellowbrick/Paradigm_Shift_p3.html#Explicit

    Looking to the left side of the homepage here on MadinAmerica.com, there is an endless stream of research papers which beneath the secondary processes of “interesting,” subjective mind states, are actually about the livelihood of the researchers, and not any deep desire to uncover new empirical information about the human condition?

    Yet in our so-called 1st World countries, we have built a consensus reality based on this secondary process need, and we all agree to look at these research publications with a sense of “something’s happening,” when in reality there is nothing new under the sun? We have reached that point in human civilization when we really need to re-address the basics of life? Hence we are now flocking to ancient wisdom’s, like meditative mindfulness?

    The double bind in “mindfulness” though, for those with trauma experience, is the possible maintenance of the unconscious need to “escape” in the hyper-vigilance of emotional distress.

    In my own daily practice of releasing my habitual, trauma fueled “muscular bracing,” I seek a mind-less letting go of inner tensions, which stimulate this secondary process, we call, the mind?

    Our projected ideals are often wonderful, yet they are fantasies which will not be made real, until we let go this lop-sided, consensus reality of “I think therefore I am.” The way forward, is back into the primary process reality of the body? Once such a felt/thought awareness breaks through the common denial of mind based awareness, we see ourselves in the other, and feel the common reality of one species, loosing our unconscious, fearful projections about “them,” & otherness?

    I hope we can continue a shift towards answering the very valid question of “what is madness,” in forums like this one. Hopefully coming to understand that our continued focus on “them,” is simply an “acting out,” of unconsciously projected needs, rather than any fundamental critique of reality?

  8. David, thank you so much. I couldn’t agree more on a philosophical and a lived experience level. Perhaps one day we will all embrace, “I am (in pure essence) and, by the way, I also happen to think.”

    As a fellow mindfulness practitioner, I wanted to acknowledge and thank you for pointing out how challenging it can be to “sit” with emotional pain, particularly anxiety, fear, existential free fall and other states that trigger fight or flight, deeply embedded physiological experiences. In my experience, the only way out of the pain is through it, much like childbirth, and the emotional, spiritual and/or literal midwives can make all the difference for getting to the other side.

    I love your hypothetical response. If I were your daughter, I think I would appreciate that grounded, embodied, loving and patient presence. It reminds me of Emotional CPR as well.

    Do you have a link to that TV program you mentioned?

    With gratitude, Jen

    • Hi Jen,

      The program is called “Minds on the Edge: Facing Mental Illness” and is a perfect illustration of our “I think therefore I am.” cultural zeitgeist. http://mindsontheedge.org/watch/fullprogram/

      In watching the show, are we watching people with a deep self-awareness, or a sense of self based on all we are taught, with its subsequent assumptions about the true nature of reality?

      Are we in fact, watching reasoned reactions here, in the actual anxiety of the lived moment? Is it in fact, a common denial that WE ALL do this, which keeps us stuck in a, not so mindful, “acting out?”

      Your childbirth analogy is a perfect metaphor, for where we now stand, in our journey towards a mature self-awareness?

      In line with Eckhart Tolle’s “A NEW EARTH,” and Arthur Young’s “The Reflexive Universe,” we are perhaps approaching the moment of our truly conscious birth?

      Beyond the in-sanity of headline focused attention, much is actually happening in the background, as mass-consciousness begins to stir towards a moment of being Buddha. (awake now?) Are these times our birth pangs of realization? Not a doomsday revelation, after-all?

      What gets lost in fearful judgment about psychosis, is the flip-side of the curse, in its heightened sensory awareness, for a uniquely sensitive human-animal?

      Soon we will see that so-called history, in the desert tribes articulation of our existential journey, is in fact, true prophecy?

      The power of psychosis, and its harvesting of blue sky, existential meaning? Watch the movie Avatar again & see the mythology of an ever present NOW, and the true depth of understanding in that eternal metaphor, of Blue?

      Sorry I can’t help the innate philosophical, in the physiological nature, of my being:))