Reviving the Myth of Mental Illness

Steven Morgan
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What do we mean when we say someone has a mental illness? If we are to take the phrase literally, we mean that someone’s mind is ill. But can a mind be ill with disease? To believe so, one must make two serious assumptions: one, that the mind is a tangible object with discrete boundaries, and two, that the health of that object can be measured. Both of these assumptions are wrong. Since nothing called a mind exists that can be looked at under a microscope, the former assumption is wrong. The mind is not an object. It follows that the latter assumption is also wrong because only objects with discrete boundaries can be objectively measured. Thus, it is important to note that mental illness in itself – the idea that a mind is ill, is actually a categorical error, like saying the sky is ill or the color green is healthy. There is no such thing as mental illness except by metaphor.

It may seem like trivial semantics, but the mistake that mental illness is something concrete has led to an epidemic of mythology. Every day, someone is told they have a thing inside them called mental illness that must be contended with long-term in order to achieve health. What follows is people learn to see themselves as having ill experiences and well experiences, unlike the normal population who somehow manage to live without sick feelings and thoughts. This attitude can have devastating effects psychologically, as it assures a person that something is wrong with them at their root – their mind, and that they cannot live confidently in their understanding of the world. Physically this attitude can lead to injury, as it assumes and often persuades anyone diagnosed with major mental illness to take risky medications indefinitely as opposed to selectively, which can lead to long-term addiction and a wide range of disabilities, bodily dysfunctions, and disturbing behavior. And socially this attitude can create alienation, ironically reinforced by the attitudes – “You are chronically mentally ill” – of the very people who are supposed to be helpful.

Of course, many psychiatrists, mental health experts, and pharmaceutical companies do not see it this way. Nor do the National Institute of Mental Health and most of the National Alliance on Mental Illness. They claim that each mental illness correlates to a specific neurological disease. Yet you do not need to read studies or have a medical degree to rest assured that mental illness does not correlate to specific neurological diseases. You need only know that there is not a single reliable test for any of the 297 disorders listed in the current diagnostic manual, and not a single reliable test for any of the disorders being proposed for an expanded manual. Not one.

Biopsychiatric researchers proclaim they will soon be able to find these disorders once more nuanced medical technology develops (“We’re in the middle of a revolution,” said Thomas Insel, head of the National Institute of Mental Health, in 2010. “We have the chance to change the world—not tomorrow, but by staying on course.”), but really, how long have we been hearing this? Here’s a Pulitzer Prize winning article from twenty-five years ago:

…psychiatry today stands on the threshold of becoming an exact science, as precise and quantifiable as molecular genetics. Ahead lies an era of psychic engineering, and the development of specialized drugs and therapies to heal sick minds.

We are still waiting. Besides, several aspects of what we do know now about the brain – that it is complex beyond comprehension, that it is capable of producing the same results through multiple pathways, that it is inextricably connected to and influenced by the body, that it is ever-changing in response to the environment – all suggest that finding a neat and discrete pathology in the brain called schizophrenia is simply never going to happen. Attempts to find even general similarities in brain structure and in genes between people diagnosed with mental illness have produced remarkably unconvincing results. You may not know this, because the media often publishes optimistic headlines like Study Hints of Gene Link to Risk of Schizophrenia (New York Times 2008), but fails to cover an analysis that same year called No Significant Association of 14 Candidate Genes With Schizophrenia in a Large European Ancestry (American Journal of Psychiatry 2008), which was published in the world’s most authoritative psychiatric journal and demonstrated that all of the genes presumed to be associated with schizophrenia thus far are not actually associated with schizophrenia at all.

Or, you may not have had forty-five dollars to purchase a recent review called A systematic review of the effects of antipsychotic drugs on brain volume (Psychological Medicine 2010), which concluded that while “there seems to be enough evidence to suggest that antipsychotic drug treatment may play a role in reducing brain volume and increasing CSF or ventricular spaces…”, “Most studies of drug-naive patients examined here did not report or detect differences in total brain volume, global grey-matter volume or CSF volumes between patients and controls…” There are plenty of studies that show differences between the brains of people diagnosed with serious mental illness and the rest of the population, but almost all of those fail to control for the effects of medication on the brain. When you look at studies of the brains of people diagnosed with serious mental illness who have not taken medication, you find most often that there are no observable differences.

Let us not forget that psychiatry once proclaimed homosexuality a disease. And let us not doubt that if the cultural zeitgeist was still against homosexuality, that biopsychiatry would be hunting for it in the brain and proclaiming it as a legitimate, diagnosable brain disease. What has changed are social values, not scientific evidence.

Even if one day a psychiatrist can show you that a part of your brain is different than everyone else without your particular psychiatric diagnosis, that still does not mean that your brain is diseased. Since the brain is the primary physical house of the mind, it’s likely any conscious experience correlates to it. For instance, the experience of love could hypothetically be correlated to biology in your brain just as much as the experience of hearing voices. But what constitutes disease is culturally-defined, so we don’t isolate love in the brain and diagnose sufferers of love as having Love Disorder. Now, if you’re excessively hyper…

Of course, there is a difference between feeling elevated and thinking the CIA has installed cameras in your mind. The latter can cause much more functional disability within our society. In some contexts, it may be useful to view breakdowns as part of an illness, as long as we recognize that we are talking in metaphor. Some people find great relief in believing they have a brain pathology, and some folks feel invaded and possessed by their experiences to the extent of losing control over their selves. That can certainly feel like a disease taking over. These viewpoints are valid and important if one chooses to make meaning of their experiences in such a way. But let’s not pretend this perspective is empirical – “just like having diabetes” – and therefore applicable to all subjects who have similar experiences. Nor should we ever build far-reaching policies and laws upon such a porous foundation. Let us instead call the brain disease hypothesis what it is: a worldview, a theory with contradicting evidence, and a cultural bias.We can then make room for other perspectives, for one person’s shrunken amygdala is another’s child abuse is another’s combat experience is another’s religious mission is another’s salvation.

What is important is how we build the most connection between people. Talking about experiences in non-clinical, everyday talk provides a bridge between people that is otherwise drowned by psychiatric jargon. I cannot relate to someone who is having a symptom of schizophrenia called paranoia, but I can relate to someone who is really scared. And if I can relate, maybe I can align, be real, and open up with my own learned wisdom instead of parroting prescriptive treatment modalities.

Unfortunately, such alliances are difficult to nurture in a mental health system that assumes clients and staff are fundamentally different. In this system (save progressive organizations and conscientious workers), you’re likely to hear professionals at the water cooler talking about how manipulative those Borderlines are, how John just needs to take his meds, and a range of observations in language usually reserved for machines: “John is decompensating. Amy is below her baseline.” I know: I’ve been at that water cooler. And back in my day, I was the subject of such chatter.

Such chatter is not harmless, as I recently relearned when obtaining my own hospital records. The notes declare me “very paranoid” and make observations that “Steven curls up in a ball and cries uncontrollably whenever anyone enters the room” and “Steven is paranoid that others are watching him,” which is of course true, and may I suggest a valid response to being in a white concrete wall institution where you are the subject of relentless observation despite unfathomable shame? How is this remedied? A shot of Haldol, multiple Ativan, and Symbyax. No more “smiling inappropriately” after that.
Psychiatrists and prescribing doctors wield enormous authority over their patients.

At the very least they should maintain an informed level of skepticism when explaining the nature of behavior to someone who feels out of control. Such caution is an ethical responsibility, but one with rewards, for people in distress will value genuineness more than certainty. Patients should remember that a medical degree does not denote an understanding of consciousness, that people of all stripes have been trying to make sense of the mind forever, and that however unfortunate for industries that stand to make record-breaking profits otherwise, we cannot yet siphon the Great Mystery down into neuronal patterns and genetic variants.

Steven Morgan lives in Vermont, where he is currently Executive Director of a community center for psychiatric survivors called Another Way.  In the Fall he will be Project Developer for Soteria-VT, a residence for folks having a first psychotic break that facilitates recovery by “being with” individuals through their experiences.

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Steven Morgan
Steven Morgan is Operations Manager and a trainer for Intentional Peer Support. Over the past decade, he’s worked various peer support roles in both traditional service agencies and peer-run settings. In Vermont, he was director of a peer-run community center, helped launch a peer-run respite house, and was project developer for Soteria-Vermont. On full moons, he enjoys writing, playing music, woodworking, and taking long long walks.

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38 COMMENTS

  1. Steven,

    Great article!

    Yeah, bio-psychiatry always seems to need more time…
    Just a few more decades…
    And then they’ll finally “prove” their broken brain theories.

    Not only has it been a long, long, long wait.
    But it’s been wasted time.
    And it’s been at a high cost with less than humane “treatments”.

    I say the smart money is on full recovery.
    Without conventional psychiatry’s help (especially their toxic drugs). Call me crazy.

    I noticed from your bio that you’re opening a Soteria House in Vermont. Great news!

    Duane

  2. But since the mind is a product of the brain, “mental illness” also means brain malfunction. It would be hard to argue anybody in the scientific community that the mind does not originate from the brain. This makes the mind a tangible thing, since it is the product of a tangible thing and can be manipulated via that thing.

    • Jeff, your argument breaks down for me in the middle. As the author points out, the word “mind” is a metaphor, like intelligence. It’s not tangible, since metaphor’s can’t be tangible. Although metaphors are perfectly legitimate words and can be used in discussion, we just can’t make the leap that mind = brain. Mind relies on brain, but that’s different than saying it must be tangible since brain is tangible.

      Good article, this seems to me the classical Szaszian position. Szasz has been ignored and marginalized for years but I still think his positions have merit. At its core Szasz didn’t want us to reduce the complexity of human emotions, feelings, behavior to mechanistic and reductionistic concepts. Language does in fact matter. The proliferation of Psychiatry and their plethora of pills for people’s suffering is the outcome Szasz feared.

    • I agree with you, Jeffrey, but in essence, you’ve captured the basic philosophical flaw in these “scientists'” arguments. They are ASSUMING that mind=brain and discount any possibility that the mind is something more. I think there’s plenty of good evidence to suggest that the mind transcends the brain and body altogether, and some to suggest that the brain is simply the “control center” whereby the mind runs the body. But many people who are devoted to “scientism” (as a religion) as opposed to true science (as the pursuit of knowledge, being open to information that may negate your initial assumptions) are unwilling to admit that the mind is much more mysterious a thing than the brain can really explain.

      Of course, even if the brain is all there is, they also are expecting us to subscribe to the idea that any deviation from “normal” is a de facto disease. Let’s take ADHD as a great example. I have no doubt that some kids are genetically programmed to be more active and less tolerant of boredom and repetition than others. (We know for sure that males are genetically more that way than females, based on the prevalence data on ADHD). But why is that a “disorder”? Why can’t it be viewed as simply a normal genetic variation, part of the survival needs of the species? These “ADHD” kids, if they grew up in a tribal society, would be extremely valuable in the aggregate – they tend to be very active, athletic, creative, willing to take risks – they are ideal hunters and would help assure the tribe has food for the winter. Just because we don’t allow them to hunt and expect them to sit for hours in a chair doing boring things, and find they rebel, does not mean there’s something wrong with them. I think it suggests something wrong with our expectations.

      So I think we have to challenge the “scientism” adherents to defend their assumptions and we have to identify them as assumptions. Sure, they won’t like it, but if they are REAL scientists, they’ll be willing to put their theories to the test. Anyone dismissing objections out of hand is not a scientist at all.

      —- Steve

      • You’ve stated it clearly and concisely and I think you hit the nail right on its head. Great writing. You’ve exposed the flaws in the quackery and flim-flammery and you’ve done ti very well. I’m trying to share your article with my director of Clinical Services in the hospital where I work.

    • First, most neuroscientists are de facto neurophilosophers, or neuro-ideologues, justifying the pseudo-medical control of deviancy. They casually interweave ideology and science, making it nigh on impossible to distinguish which is which.

      I wholeheartedly reject the reductionist-materialist view of the concept (whose referent is not a thing, so cannot literally be ill). They stamp their prejudices all over their brain scans, couch their ‘findings’ in impenetrable, polysyllabic terms, and expect us all to prostrate ourselves at their hallowed feet. Not me.

      Mind is nothing but a concept referring to our constantly fluctuating dialectic with our environment, which is not a thing. To say this can be ill is linguistically and ideologically mischievousness. The problem is, inter alia, that throughout history but especially in the twentieth century, so many great thinkers dabbled in the folly of ‘mapping the mind’, and who have programmed our thinking on this matter, so that we believe in the existence of an entity called ‘the mind’, as if it was stored away in some secret passage of the brain.

      Saying an individual’s experiential functioning and engagement with reality is ‘ill’ is just plain insulting, the by-product of egocentrism and ethnocentrism, and embedded in it is the tacit assertion that all these despicable aspects of human nature, such as lying to and conning people for your own ends; such as self-justification for destroying other people’s lives etc., are aspects of normal, healthy experiencing of the world. That is not science, but an ideology of intolerance and arrogance. A person’s brain may be ill, as with some with neurodegenerative disease, and this can lead to experiential symptoms of having that disease, but that doesn’t make our engagement with reality an literally ‘ill’ or ‘diseased’. What intolerable guff.

      Of course, these neuro-ideologues prejudge the brain scans they study, taking it as axiomatic that some modes of functioning and being are healthy and others diseased, which completely prejudices their research. If someone has the putative illness schizophrenia, then anything that is different to the brain of a putative mentally healthy individual is scientific proof that schizophrenia is a brain illness.

      For them, believing is seeing. If you believe ‘schizophrenics’ are diseased (of which I am supposedly one), then you colour it all with your prejudices, interpreting anything inconclusive as evidence that ‘schizophrenics’ don’t have healthy brains (after all they are schizophrenics), whilst deluding themselves that their powers of observation are infallible.

      Of course, their reducing human beings to the mere activity of brains is the result of healthy brain functioning! These people think they are the pre-eminent authorites on human nature; I think they are completely delusional, although of course delusions are not for them intrinsic to the human condition, but something that just literally happens to the them other people.

      They attribute agency to things, not people. If you behave in a way sanctified by culture, this is because of healthy neurological functioning; if you don’t, your brain is ill, which of course undergirds the control of that individual. Yet there is no evidence suggesting that complex, learnt, undesirable behaviours are literally caused by the brain, in the same way for example that we know purposeless, involuntary movements are caused by damage or disease of the so-called brain/mind.

      Free will is the privilege of healthy brains, which are deemed healthy because the behaviours are culturally and socially sanctioned. That’s not science, yet any ideology that is used to support controlling, abusing or exterminating others is vehemently defended in our day and age, just like in Nazi Germany, as scientific, and dissent occasions the reflexive response of derision and fatuous disbelief that someone could dare to question what ‘the science says’ or ‘what a growing body evidence’ has imparted to us, of course without the observer’s prejudiced interpretation, of course.

  3. This is a great piece of writing and perspective, Steven and congratulations on the Vt. Soteria project finding its feet. I know a lot of people are hoping that it will be a model that can be used to establish respite/integrative recovery spaces in other areas.

    So, I read this right after I read Dan Fisher’s landmark article/essay/treatise on human connections and relationships as pathways to healing. It seems I ended up getting a bit, um, broad in my response to your solid deconstruction of “mental illness.” It’s all related, like most things.

    Re:
    “I just don’t think that very many modern science guys are going to read past the first paragraph.”

    It is a problem that modern science guys aren’t going to read the last paragraph, or these next few.

    Why is it that we can handle going from no cars a hundred years ago to a world absolutely choked with cars or that we can unquestioningly write these comments onto little screens invented within the last 30 years, and yet we scoff and sneer about how “naive and unrealistic” some people are to think that the world may need to change significantly…?

    How is it that the (relatively recent in the broad scheme of things) biomedical model is so sanctified in spite of the fact that it clearly has no basis in any reality that is good for humans or the world?

    (I think we could all probably answer that pretty easily.)

    Thank you for articulating this in such a straightforward way. I appreciate your acknowledgment that human experience exists on a multifaceted spectrum, with various strengths and attributes, some of which are, apparently, more valued than others.

    Most everyone can agree that the world is, in fact, “crazy.” (per the language of The Icarus Project) However, the craziness of the world and all its dysfunctions is usually only tangentially identified as being related to “disordered” experiences. Meaning that we seem to be doing well to identify the role of societal stressors and cultural/emotional/physical/etc. trauma as being contributing factors in our difficulty within experience, but I’ve not yet seen a lot of common dialogue that captures the distinct possibility that societal dysfunction may actually be causing experiences that are painful, alienating, and socially traumatic.

    I agree, of course, that the term “mental illness” is, for all practical purposes, utterly useless and, further, is actually harmful. Still, people do have a hard time in this world and those difficulties are expressed in all sorts of ways, depending on a person and their unique human struggle.

    It has been my observation that much of the cultural realities of the “modern world,” as it has arisen on the foundation of terribly(dangerously)flawed ideologies and economies, actually do really hurt people.

    For so many, and increasingly so, there simply is no place to be ourselves and live within (or even develop awareness of) our strengths…because, as ordinary people, our strengths are not valued within exclusionary cultures and economies. For many, when the self is expressed in ways that conflict with normative rigidity of function and expectation the person is actually punished, through bullying, exclusion from the economy, violence and pathology.

    Our access to a dynamic experience of humanity in learning and work and family and community has been severely limited by the structure of our ideas, roles, economies and cultures.

    I suppose that some would say that this is a gratuitous point and a moot one at that because, well, what can ya do?

    As much as I am committed (in my work and in my own life) to nurturing true recovery at the individual+community level, I am really invested in figuring out what will support an empowered macrolevel recovery from the unfortunate events and habits of the 20th century.

    I know that seems lofty, but the alternative is some sort of hopeless complacency and an acceptance of things that really are, in my mind, pretty unacceptable.

    What sort of world is it when people are systemically denied viable opportunities/ideas/language to express their unique experience of self and interest and to be respected and loved simply for who they are? That, to me, is bigger than “mental illness.”

    Can you imagine a world in which people are wrought into narrow modes of existence, function, and meaning…diminished and confused in a tragic state of disconnection from themselves and unable to look one another in the eye for more than a moment or two, slowly destroying themselves with sweet and salty distractions and jokes they know they shouldn’t laugh at?

    “Oh, man, that is so wrong!”

    …and then when our minds/hearts/brains struggle to make sense of why it all seems so tragic and empty and frightening and difficult and pointless to the extent that we get all sorts of turned around and twisted up and stuck…well, somehow it is an “illness” that we have? It is our problem? That is a classic example of shifting blame. That sort of thing is seen at the microlevel in emotionally and psychologically abusive relationships.

    It is so overwhelming to think about, how one deeply erroneous phrase (“mentally ill”) can indicate a problem that is much more far reaching and which, ultimately, affects us all.

    The other night, at a baseball game, I was looking around the crowd and I was wondering what the people might be like if they weren’t 21st century Americans wearing jeans and t-shirts and eating chili fries, watching a field. A lot of people didn’t seem to be having much fun. They were just there. By my estimation, many of them were on psychiatric medication.

    These shifts in language and practice are so important to the world.

    • And if you don’t conform and comply with the rigid norms of acceptable behavior and thought the enforcers take care of you; better kniown as the quzck biopsychiatrists. They’ve teamed up with the legal system to make sure that no one is allowed to point the finger at our terribly injured and pathological society and scream how sick it all is. And of course you have the drug companies that supply the means to tranquilze anyone who dares to yell that the Emperor is naked as a jay bird.

      I’m with you; I’d rather try to find some means to a better end as a society than to do nothing. As my roommate always says, every little bit counts, no matter how small it may seem. Great writing by the way.

    • The level of intelligence and understanding on the part of the people who respond on this sight is overwhelmingly amazing. I’m constantly taking what you all post and sharing it with my supervisor, always giving credit where credit is due. She always wants to know where I find all of this stuff and I’m about ready to turn her on to MIA. I don’t know whether a Director of Clinical Services in a state hospital will be able to deal with it but I’ve been preparing her for rmonths now so we will see what happens.

      Yes, I tend to agree that the people posting have a lot more of interest to share than some of the psychiatrist.

  4. Hi Steve, great essay with fundamental questions about the mind and how this strange subjective state of awareness, is actually created?

    Is our consensus reality, that it is created by the “upstairs” brain completely accurate? Or does the “first born” (touch of biblical metaphor?) brain have far more influence on the creation of these subjective states of awareness, to which we apply the creative self-interpretation, mind?

    “Steven curls up in a ball and cries uncontrollably whenever anyone enters the room” and “Steven is paranoid that others are watching him,”

    If we suspend our subjective state analysis and awful tendency to categorize behavior into parts like metaphors of symptomatic diagnosis. Could we not just see the motor-vation of fear-terror in the body’s real-life communication of what is actually being experienced?

    The most useful phrase I took from my therapist training, was “all behavior is communication?” So when we suspend the “minds” fearful avoidance of the reality before our eyes, do we see the “felt,” yet unconscious experience of the individual.

    An experience which can only be relieved at an “unconscious” level of embodied experience? You curl up in fearful avoidance of a sense of threat, of dread, (unconsciously projected as something out there) while diagnosing others stay within a dissociated mind which fearfully judges an otherness, it does not understand?

    Does not understand because we look with a “what should be expectation,” in interpretation of the actual reality before our eyes? “A socialized norm, of expectation?”

    In the creative use of metaphor, we could perceive those diagnosing others, as acting just like our ancestors 50,000 years ago? Grouped together in support and protection, against a fearful sense of “nature,” out there? Plato’s cave springs to mind here?

    What we don’t perceive in the reality of the lived moment, is our unconscious motor-vation within that personal cave, we call the body? Yet just as Jake Sully reminds us, when he falls through the canopy on a mythical moon named Pandora, “you have to trust your body, it knows what to do?”

    Can we learn to stop seeing in expectation of what we “think” should be the reality before our eyes, and see what actually is, in nature’s artfully constructed “body language?”

    In truth though, we avoid nature’s reality like the plague whenever she demands a stress response, in the real-life reality of the lived moment? We don’t like real-life distress and we recoil from it, in the double-bind trap of nature’s instinct for survival and our socialized denial of our evolved nature.

    Watch the audience recoil reaction here http://www.youtube.com/watch?v=ou2USR1MBrk as the surface image of a stunningly beautiful face is removed to reveal the reality of those evolved 43 muscles, which helped power the metabolic energy needs of our higher cortex evolution?

    I firmly believe that we have reached a point in so-called history, “that ever present moment,” for which we use the metaphor “eternal,” is emerging into a dawning realization, as we begin to look at the reality within, where all perception is actually created? The body/brain as a holistic and creative sense-of-self, or Plato’s cave and our overwhelmingly unconscious, organismic motivations?

    Step back for a moment and look at the big picture, of a Western world now financially and morally bankrupt, and in dire need of a new vision to light the way forward? Just as in the past, it will come from that ancient tribe who are born to psychosis, those sensitive souls Greek mythology called Cassandra? In a dreamlike dramatization of the human condition?

    “Curse the mind that mounts the clouds in search of mythical kings and only mystical things, mystical things cry for the soul that will not face the body as an equal place, and I never learned to touch for real down, down where the iguanas feel” _Dory Previn.

    As the old saying goes, “these are the best of times, the worst of times?” Was it ever thus, and ever will be?

    • Off-topic: Thank you, David Bates, for this quote:

      “Curse the mind that mounts the clouds in search of mythical kings and only mystical things, mystical things cry for the soul that will not face the body as an equal place, and I never learned to touch for real down, down where the iguanas feel” _Dory Previn.

      (…and for also writing long comments.)

  5. Brief note: The world is a vibrant and beautiful place…so long as you don’t think too hard at baseball games. I choose to imagine/know that inside all those tshirts and under all those ballcaps there are – of course – vastly reeling worlds of wonder, story, and heart, the vital human core.

    In spite of the truth of a strange postmodern (and what is truth in postmodernism?)sci-fi/archaic conflict narrative telling tales of a vast multilateral abusive net of social control and exploitation…well, I’d much rather know that even in the most bleak of settings, somewhere someone is dancing and who the heck knows what might happen yet? Thanks for letting me work that out.

    I’m hopeful. I have a lot of confidence in the vital human spirit…of course, its assertion under duress often makes people appear “psychotic”…but that’s another useless word it seems that folks are in the process of deconstructing to null.

    • Perhaps a question of “faith,” Faith?

      That indeed the world is evolving exactly as it already has, if we can trust the creative metaphors, stimulated by this eternal now?

      Personally, I think much creative interpretation of existential meaning, is evolving through the mass-medium of music? Example:

      The Door & Key to Self-Revelation: An Existential Journey? Nature’s unconscious urge, in the creative symbolization of existential meaning?
      http://www.born2psychosis.blogspot.com/p/chp-12.html

      The dream is becoming real, because its an eternal dream, striving to awaken inside us all? The realization of heaven, right in front of our eyes?

      Yet we can’t fully accept the beautiful in nature, while hiding from the brutal? Her deep vibrancy entails the good, the bad, the ugly and the brutal reality of life eats life survival?

      Hence, in our egoistic rivalry we eat each other alive? Emotionally speaking, of coarse? My father’s brutality to own child, was not the rage fueled, clenched fist blows to my five year old head.

      It was was the the utter contempt of his emotion fueled verbal abuse. In the tone of voice and the postural attitude, which so touched upon the primal wound, somehow involved in the birth of the mind?

      Exactly how that awful moment when our mammalian ancestors were being eaten alive, managed to produce the nervous systems ability to induce a state of analgesic shock, who can say? And what part does this evolved nervous system ability, play in the minds dissociated observation of nature?

      Perhaps this is why emotionally stimulated PTSD, is so difficult to resolve?

  6. I so deeply appreciate your comments here. I am curious, this is just a question that occurred to me and may not be appropriate, nonetheless, I’m curious if your understanding of what drove the rage that hurt you helped you to find compassion/forgiveness? There is, of course, no need to answer…but, that is a phenomenon that I’ve witnessed…that understanding brings a bit of resolution, because we can come to see it’s just been such a mess for us all in so many ways that can, if we’re not careful, turn us ugly and cruel. We all have a human responsibility to not let our pain give us any imagined license to hurt other people…but often we don’t even realize when we are hurting. In the case of five-year old head…I’m sorry that it got hurt.

    (Note: Yet the world is a beautiful place.)

    I’ve noted and am consistently impressed with your ability to acknowledge the role of the human nervous system in its participation in our states of experience, without giving a slim ounce of credence to the biomedical model. I do not find mind-only explanations of human distress to be much more helpful than biomedical explanations, as I really do suspect that the human experience is affected by our physiological states in ways that we seem strangely reluctant to acknowledge. The aversion to biomedical explanations has put us in the position of avoiding a pretty big part of it all, which is not medical or ill in the slightest, but is simply the way that humans seem, in my mind, to work.

    (By the way, the vital and the spirit are a part of all this, too, but that’s another long comment on another thread.)

    I usually frame the struggling human experience (and also the non-struggling human experience, any human experience really) as a dance between mind/heart/brain and also the body that carries all of this around.

    Stress is a powerful mechanism in shaping our experience. We probably need new words for stress, since people seem to think that it’s the idea of being late for work or a busy calendar. We’ve little collective awareness of the way that stress affects our experience. Stress hormones are no joke.

    Because I tend to think associatively, I’ve made my own sort of sense out the idea that we feel certain things in response to certain staes/impressions/thoughts, and that certain thoughts/states/impressions arise in response to the way we feel…in cases of complex trauma, it seems that a strong, networked associations of image/sound/feeling/impression can be set in relation to specific stress reactions. Thus, whenever a certain characteristic landscape of stress hormones is activated, those networked associations become our dominant experience – due to the fact that stress strongly cues us to things that present threat (real or “imagined”/associated) the reaction becomes self-perpetuating, driving intense states of experienced disorder and manifesting all sorts of unpleasantness.

    I have found that people are comforted with an understanding of the way that feelings/thoughts/images/sounds/smells/
    states of being
    …all exist in accordance with one another and in can act in a rapid-fire sequence of reactions upon reactions that can, it’s true, become quite a frightening jangle.

    In my experience, emotionally stimulated PTSD seems to be helped by emotional “regulation” skills (not to diminish emotionality, but to learn to navigate it in perspective and safely) + meditation to learn the paths to calm safe spaces and an informal process that I sort of think about as experience mapping…basically sorting out where the bells and whistles and alarms are all caught up together and figuring out what sets off the multiball.

    (Yes, I do use pinball analogies in my work as Peer.)

    Thanks for the exchange and I hope you’ve a wonderful night in the big, bad, brightly, beautiful world out there.

  7. Hi Faith:))

    Its been an amazing journey these past five years, since I first resolved to find a deeper understanding of my classic manic-depressive energy cycles. Five years that has taken me away from the subjective norm, of either objectification or mystification of the human condition. A shift from subjective self-consciousness to a more balanced physiological self-consciousness, which can only be observed, and is lost in any attempt at subjective interpretation.

    Like most people with this burden of highly strung nature, and a seeming inability to self-regulate emotional energy, the “all about the brain,” consensus view had offered no answers or ongoing relief, over a period of twenty seven years. Like most people on this journey I’d tried everything and read most of the subjective observations on the human condition, with Robert Firestone’s “The Fantasy Bond,” and anything written by Murray Bowen up there with the very best, before I stumbled on Allan N Schore’s “Affect Dysregulation & Disorders of the Self.”

    Here was a book that promised to reveal the secrets of emotional regulation beneath experienced and observable behaviors, and bring me real insight into my malfunctioning brain? Yet he kept referring to the autonomic nervous system and feedback signals, implying a whole organism response in energy regulation and our subjective states of mind.

    Over five years I’ve shifted self-awareness from an overwhelmingly psychological sense of “I” to a more deeply rooted physiological sense of “I.” A far more holistic awareness of nervous system orienting responses, like those stress hormones of a chemical reality within? The chemical frizz of my daily “acting out,” of ritual behaviors, including the social graces of meet & greet, with its anxious energy regulation of triangulated psychological (chemical) discharge between any two people? How we talk about anything but, the physical reality of two creatures confronting each other?

    Reading Schore led me to Stephen Porges and his paradigm shifting discovery of a third branch to the autonomic nervous system, regulated by the muscles and nerves of the head and face? This third branch which regulates the heart through its innervation of the the vagus nerve, and is part of the physiological reality within, which stimulates subjective rationalizations about vitality, vibrancy and beauty?

    We all know that being with others in non-threatening mutual support, heals emotional torment, and we all sense there is more going on beneath the surface of our inter-relations than we are consciously aware of. “The Polyvagal Theory,” gives us the “mechanics’ (another object oriented word which bares no actual resemblance to the chemical reality beneath our skin), and yet this is how we talk about ourselves, as if “out there” can give us a useful analogy to the world within?

    Anyway the polyvagal theory gives us a view of the internal reality, in how the unconscious healing power of heartfelt relationship, actually works. Yet our common daily language use, actively blocks our inner awareness with an object-like self-interpretation, which we all take for granted, while denying just how much we shy away from true self-awareness.

    Schore and Porges articulation of “objective” science were manna from heaven intellectually, yet gave no practical advise on how to sense this internal reality, beneath my subjective state of self-awareness, which had been compounded by the dissociation of PTSD? Although such reading did give me a theoretical awareness that dissociation is a fundamental feature of our subjective mind state, on a continuum from so-called normal states of awareness to altered states?

    From the world of academic intellectualism, with its special language of implied rank and status, its branch of knowledge which ordinary mortals shy away from? I found Peter Levine and his unique and unashamed understanding of our nature and its nervous system orienting responses, which dominate our actual behavior in the stress of the lived moment?

    For people with any kind of mental health issue, I urge them to read “In an Unspoken Voice,” at least three times and allow the organic digestion of this man’s wisdom. From Stephen Porges fundamental tenet, that all behavior is dependent on physiological state, including states of mind. Peter Levine articulates a method of “sensate” awareness which allows us to “feel” into our unconscious motivations, as these vital orienting survival responses of the nervous systems?

    Using such insightful awareness, fear and all negative states of internal sensation awareness, can be transformed “psychologically” into the positive needs of survival, in nature’s original intent? Its only the confusion of shying away from our own internal makeup, in our socialized norms of communication, which prevents us from understanding ourselves?

    Understanding this physiological “acting out” of unconscious orienting responses does give me a deeper understanding of my father and my own generational pattern of learned behavior. Forgiveness, I think I’ve had since childhood, with an intuitive sense of the non-conscious motivation in his highly reactive behavior. In an honest and lucid moment during my twenties, he admitted to unconscionable behavior with, “I don’t know why, but it makes me feel better?”

    He was notorious for not giving a dam for other peoples feelings, or what they thought about him, a trait I struggle to divest myself of. As for my hurt head, I think children are notoriously resilient when it comes to most physical harm, yet the emotional dynamics of a despised attachment seem to touch the very core of our common struggle with existential isolation, and the autonomic sense of threat it stimulates.

    It seems to me that Murray Bowen was spot on, when he said we confuse subjective states of awareness as a kind of “as if” objective reality. I’m sure he would approve of all the new research which has given us deeper insights into a layering of brain-body-nervous system function, which he nominated as our need of a differentiation of self? A deeper understanding of how we actually function in the daily dance of our emotive-intellectual, physiological-psychological way of being human.

    As for “long comments?” I urge people to think about accepted norms of behavior, which are more self-soothing than a seeking of perception and understanding. We owe it to ourselves and particularly our children to raise the debate now, and keep talking by using the unique forum of the internet website, to allow all voices to be heard, beyond age old assumptions of our rank & status dependence?

    When we each scan these thread comments, do we dismiss some with good reason, with intelligent response? Or the innate self-regulating reaction, of our unconscious internal guidance system? The autonomic nervous system? A guidance system we can’t think about, only feel the chemical pulse of its survival orienting responses?

    Most will make an automatic assumption about reductionist theory? Yet in the great paradox of life the reverse maybe true, as with patient practice we begin to feel a subtle awareness of a deep reality, which is the Universe within? All that Star Dust & Chemical Elements made manifest as life, inside you?

    “In our terminology, the “Self” of exalted states is that which sees and, knows, while the “I” is the interpretation, that which is seen and known in the physical space-time of the world “out there.” The mutually exclusive relation between the “seer” and the “seen,” or the elusiveness of the “Self” and the “I” may have its physiological basis in the mutual exclusiveness of the ergotropic (sympathetic nervous system) and trophotropic (parasympathetic nervous system)systems.

    Such “I”-“Self” communication is the creative source of art, science, literature, and religion.” _Roland Fischer.
    http://www.born2psychosis.blogspot.com/p/chp-12.html

    Be well.

  8. Thanks to Steven and all the posters for this fascinating, if esoteric, thread. I am greatly encouraged by the fierce intelligence and passion in which the perplexities of self might be constructed outside of neural pathology. I consider myself privileged to be learning from you all now.

    Some questions about your big endeavor: Will the Soteria project in Vermont encourage residents to write out their personal narratives as a way to better understand themselves and their experiences? Will they be given access to good books and alternative thinkers on the possible meanings of madness? Will they be given chores or schedules to order their days and give them a sense of accomplishment? Since this article is an Op-ed, will you consider blogging again?

  9. Steve, I love your writing and look forward to seeing more of it. You might enjoy the work of Candace Pert, who in fact demonstrated in neurobiology that the mind is a different entity than the brain, and exists throughout the body. Her neuroscience research further demonstrated that psychotropic drugs is a very inappropriate approach when people have difficulties with thoughts, emotions, and choices. I disagree with Szasz in that he has an attitude toward people with substantial struggles in this area, that they are malingerers. I do not believe that. My sister was diagnosed as schizophrenic and she was a “psychiatric patient” for many years until she died because of a drug side effect. She was not a malingerer and her difficulties were not due to anything of that nature. She had real struggles, and she worked hard to overcome them the best she could and to contribute to the people around her the best she could.

    I think there are probably some biological correlations with what we are calling “mental illness” because it’s stressful to live in society when you are functioning in a way that people don’t understand, and stress causes biological changes throughout the body. The existence of biological correlations would NOT mean that “mental illness” is biologically caused. Cause and correlation are two different things. And, lots of simple, natural things have huge effects on our biology and neurobiology, so any biological condition that is a perpetuating factor could most likely best be addressed that way. For example, there is lots of research showing exercise to be more effective for improving depression than any antidepressant drug. A rare exception to this is infection. There are infections that have depression or psychosis as symptoms, and in those cases, a drug that kills the infecting organism might be the best treatment. (This is often missed by “mainstream” psychiatrists and “alternative” mental health professionals alike. Infections like hepatitis and GI tract infections can have seemingly “mental” symptoms as their primary symptoms.) Another rare exception is that certain kinds of cancer can have “mental illness” symptoms. This includes breast cancer and brain metastasis of cancer. Physical disease as a potential cause, should always be investigated. In that sense, there is sometimes a biological “cause.” But the ideas of “chemical imbalances” and differences in brain sizes and structures and genetics and all that stuff- that is all based on fake science. There is no real reason to believe any of that stuff, and plenty of reason to understand that simple, natural things like relationships, arts, exercise, contact with nature, emotional expression, etc, resolve the vast majority of these problems. We can look at the benefits of these activities on a neurobiological level and we are sure to find things. Using neurobiology as an excuse to somehow manipulate the “conclusion” that psychiatric drugs are necessary, or even beneficial, is a huge contortion; actually, multiple false contortions of pseudo-logic are necessary to arrive at that idea.

    If science is used with integrity, it establishes similar conclusions to what the people in the anti-biopsychiatry camp have been saying all along. The problem with biopsychiatry is that the science has not been done with integrity; it is fraudulent “science.” Do not be afraid of the real science.

    And we need to recognize that we all have struggles and none or us are inferior or superior to others. We need to accept and try to understand each other. And we need to always see complete full recovery as a possible outcome. It does happen quite often, and more often when people are respected and understood and are not given drugs or stigmatized.

  10. Steven–

    I was so happy to read this. Positive peer perspectives always affirm and strengthen my own experience of myself as a well person, sensitive and spiritually connected, in need of support and connection in a society where that’s just hard to come by. I also dig Szasz.

    I relate to your experience in the mental hospital…being simultaneously watched, and patholgized for feeling watched– drugged up to wipe out so-called inappropriate facial expressions and body movements.

    Today, I am medication free and learning to engage and use these altered states with care and compassion. Lately, they’ve been unbelievably beautiful.

    I live in MA. If you’re looking for peers or volunteers, send me an email. unbeatenpaths@gmail.

    My one objection to the piece lies with this sentence: “We know for sure that males are genetically more that way [ more active and less tolerant of boredom and repetition] than females, based on the prevalence data on ADHD.” I believe women are socialized to be less active or challenging, and more diffident. If biology plays a role in creating this gender behavior disparity, I imagine it’s only part of the equation.

    Looking forward to hearing about Soteria VT’s development. –Vanessa Campbell

    • Just so you know, I’m a different Steve, not the author, but I wrote the quote about males being more genetically prone to “ADHD” symptoms.

      I have no doubt that socialization plays a huge role in how boys and girls act. My point was only to say that just because someone acts differently, even if it is for sure based on genetic propensities, doesn’t mean they are “diseased.” I thought males and “ADHD” was the best example, because we have a huge disparity in behavior that is very likely rooted, at least to some degree, in the 7X higher testosterone levels experienced by males. So assuming that at least a part of the “hyperactivity” of boys is due to being male, how is that a disease? What if males are SUPPOSED to be more active and less tolerant of boredom? And what if a selection of females are also genetically programmed to be that way? So what? Does that make them DISEASED or DISORDERED, just because their behavior (assumed for the sake of argument to be genetically influenced) is inconvenient for teachers?

      An interesting study was done in the 70s that illustrated this point very well. Demographically matched groups of “ADHD” diagnosed kids were put into two separate classrooms, one a standard classroom, and the other an open classroom setting where the kids had control over which station they went to and how long they stayed. They had professionals try to tell which kids had the diagnosis. In the regular classroom, the pros had an easy time picking out the ‘disorderd’ kids, but in the open classroom, they could not distinguish those diagnosed from their ‘normal’ peers.

      You’d think that would have caused a revolution in how we treat “ADHD” kids, but of course, it did not. Few people are even aware of that study, but it really goes to show that a kid’s inherent “negative” propensities can be neutral or beneficial in a different environment. How can “ADHD” be a disease if you only see it in certain environments? Wouldn’t it make more sense to create an environment where those deficits become assets? But that only happens when we stop viewing “difference” as “disorder.”

      Kids are all different. It’s OK for them to be different. It’s our job as adults to work with these differences to bring out kids’ strengths and help them work on areas where they need help. Drugs do none of those things, but they are convenient for those too lazy to want to spend the energy to work out what will actually work for the kids they have to deal with.

      Hope that clarifies things!

      —- Steve

  11. I think that the large increase of kids getting this diagnosis results from lazy parents, lazy teachers, and lazy pyschiatrists. It’s so much easier to make kids into vegetables than it is to actually work with them in all of their moods and variability. I taught high school for fifteen years and know just how trying 15 year old boys can be. Fifteen year old girls can be trying in different ways but that’s part of what being a teenager is all about. What happened to us that we’ve come to the poin tthat we’d rather drug them into being zombies than put up with kids as they attempt to grow into adults?

  12. I lovd this article, and especially the satirical reference to the sky being ill. This is definitely not trivial semantics, because it’s important to be as clear as possible about what we mean when say someone is “mentally ill”. The concept of “Mind” is truly but metaphorical/theoretical/philosophical, as you wisely allude to. Frustratingly it’s hardly a metaphor we can dispense with, just as we hardly can dispense with at least some sort of idea of mental illness. But therefore it’s all the more important to keep the concept bracketted within a placeholder until such time as we can say with reasonable assurance what it actually is.
    I live in a Danish city where the population in the 30’s was between a third and a half of what it is today. At that time (before the advent of psychiatric meds) the city supported an “Asylum for the Insane” which housed up to 2000 inmates, most of them more or less permanently. Around that time the asylum idea gradually became abandoned and the place was transformed to a hospital. By today’s standards of course asylum conditions would be regarded as horrific, but actually the asylum idea was grounded in surprisingly humane ideas and philosophies. You’d only have to compare it with what went before to see that.
    Today only about 220 beds are left and the average admission period is around 3 weeks. There is no doubt that the advent of psychiatric meds was an important factor in making this possible, although of course the asylum idea has to a certain extent been preserved in the post hospitalization social-psychiatric lodging facilities to be found, of which there are possibly 200 permanent places and 7-800 temporary or semi permanent places. So something in psychiatry has changed for the better because now with a population of 2 -3 times that of the thirties, institutional requirement has dropped by at least 50% (80% adjusted for population increase) or if you only think of lifelong institutionalization then it’s well over 90% adjusted for population increase. None of this however necessarily means that the extant concept of mental illness is unassailably correct in its assumptions.
    So from this historical perspective it will be enthralling to see how Vermont manages to get by without a state hospital at all. Even with Denmark’s very good and comprehensive social welfare system, and with all the social-psychiatric centres available it would be hard for me to envisage anything other than complete breakdown in mental health services if the hospital suddenly was not there any longer. Not least because it houses nearly 50 forensic psychiatric patients who, presumably would have to be transferred to ordinary prisons if the hospital was not there. But certainly also because it is there where the clinical expertise is found (could of course be re-allocated) and the facilities for clinical observation exist which enable systematic evaluation of the hundreds of different kinds of psychiatric crises known to psychology and medicine. I mean it’s no use trying to talk someone through a psychotic crisis if the real root of the problem is a slowly developing demential condition brought on by a lack of thiamine, or a rare genetic disorder such as Huntingdons breaking out for the first time. Whatever system is in place has to be able to disclose, diagnose and refer or treat such things, as well as have clear well drilled procedures to cope with the rare occasions where a psychotic or otherwise mentally disturbed person actually becomes dangerous. (These procedures have proved inadequate on at least two occasions in DK this year where one worker was raped and killed and a doctor and two nurses stabbed and severely wounded.)
    This is probably why, however peremptory it may seem to be, we won’t be able to dispense with the concept of mental illness in any near future. A professional system has to be able to respond, communicate, dispense, sort through, evaluate, co-ordinate and act on the basis of commonly understood and accepted categories, in order to discharge its duties in a systematically transparent and effective manner, and be thereby accountable to the public. A system will not be able to marry its resources to the perceived needs if there is not some kind of objective referential framework to define and grade these needs. As a professional myself I would automatically ask, (not unreasonably I think) if I heard that there is no such thing as mental illness, why society then should spend money and resources on either traditional or alternative therapies and treatments for people who are not ill, but have some needs which they alone have the privilege of defining.
    I thought it interesting that you chose to illustrate your point by referring to homosexuality as an example of a condition once described as a psychiatric disorder, now abandoned due to cultural change. The inference obviously being that one day we could come to accept psychosis as a variant of normality, so we no longer would be frightened to have psychotic persons as neighbours or workmates. Hmmm. Have to think carefully about that one. Meanwhile it could be instructive to bear in mind that it is homosexuals themselves who are in the forefront when comes to campaigning for the view that their sexuality is something they are born with and thereby biologically predetermined! It’s not that their brains are diseased or even different in any anatomically detectable way, but some genetic difference apparently causes the brain to function in a different way, at least if the emotional life has anything to do with brain functioning, and it’s difficult to imagine that it doesn’t.

  13. Steven,

    This is a great piece of writing. Well worth reading thoroughly.

    You’ve synthesized poignant and convincing analysis of profound and expansive cultural conceptions – in an impressively succinct way.

    In particular these two excerpts mean a lot to me:

    “It may seem like trivial semantics, but the mistake that mental illness is something concrete has led to an epidemic of mythology. Every day, someone is told they have a thing inside them called mental illness that must be contended with long-term in order to achieve health. What follows is people learn to see themselves as having ill experiences and well experiences, unlike the normal population who somehow manage to live without sick feelings and thoughts. This attitude can have devastating effects psychologically, as it assures a person that something is wrong with them at their root – their mind, and that they cannot live confidently in their understanding of the world. Physically this attitude can lead to injury, as it assumes and often persuades anyone diagnosed with major mental illness to take risky medications indefinitely as opposed to selectively, which can lead to long-term addiction and a wide range of disabilities, bodily dysfunctions, and disturbing behavior.”

    “Of course, there is a difference between feeling elevated and thinking the CIA has installed cameras in your mind. The latter can cause much more functional disability within our society. In some contexts, it may be useful to view breakdowns as part of an illness, as long as we recognize that we are talking in metaphor. Some people find great relief in believing they have a brain pathology, and some folks feel invaded and possessed by their experiences to the extent of losing control over their selves. That can certainly feel like a disease taking over. These viewpoints are valid and important if one chooses to make meaning of their experiences in such a way. But let’s not pretend this perspective is empirical – “just like having diabetes” – and therefore applicable to all subjects who have similar experiences. Nor should we ever build far-reaching policies and laws upon such a porous foundation. Let us instead call the brain disease hypothesis what it is: a worldview, a theory with contradicting evidence, and a cultural bias. We can then make room for other perspectives, for one person’s shrunken amygdala is another’s child abuse is another’s combat experience is another’s religious mission is another’s salvation.”