Five Nights in Finland

Duane-
I would add that there is another group of people who we do not here from as much here and those are the ones who have had periods of extreme distress, were treated within the current system and had good outcomes. I know that from my daily experiences. It is one of the things I struggle with since I do not know why it is OK to dismiss their experiences.

Sandra,

Re: Good experiences from the current system

Where are they?
They’re not on this site, and they seem pretty hard to find – anywhere.

Oh, sure.
They’re are a few out there who will speak highly of having been locked up and forced to take drugs – but not many.

And when it comes to outpatient psychiatry – even the 15-minute med checks (not by force), there don’t seem to be a lot of people who are pleased with the results.

Consider the fact that 1 in 5 adults in this country are on some form of psychotropic – this means tens of millions.

With those numbers, you would think that at least a million or so would be stepping up to the plate – to let the world know about how much they were helped.

But there doesn’t seem to be a million (which would be a very small percentage).

Could it be that the “treatment” causes more harm than good (at least for the vast majority)?

That’s where I’ve got my money.
IMO, that’s where the smart money is!

Duane

I answer this with some hesitation because I think whatever I say will be discounted or attributed to the power differential I have with my patients. I also can not find the initial thread from which this arose so perhaps I am loosing the train of thought.
All I can tell you is that I have been actively engaging people in conversations about the medications for a long time and more intensively in the past year. Many people I talk to are satisfied with their treatment and do not want to stop taking the medications. Most of them have no interest in websites or blogging. Maybe they are wrong or misguided or they have been mislead into overvaluing the role of medication. But I think that to discount their reality would be another trauma and not dissimilar to discounting the realities of people who report they have recovered without medications (which is what has happened to some people).

Ok, it is annoying when we run out of “reply” buttons in the middle of a thread, but here goes.

Sandy,

In regards to the people who wants to stay on the medications because they feel or believe that it is helping them, I hear you.

However, lets not forget that we know for certain that the medications cause a whole lot of side effects – obesity, diabetes, shrinking brain matter, high blood pressure etc. etc. It is an impressive list of side effects – so even if someone feels that the medications helps them emotionally there is reason to be really cautious with those medications.

Now, that said, I agree with you. If someone feels that the medications really help them, and they prefer this option to other options, then at this time I do not think we should push our agenda on them. While we might not want to “push” our agenda of getting off medications on others, we should however make certain that they are given other options, that they are on the smallest dosage possible, and that the option to taper off the medications are always available to them.

I would much rather that we spend our resources on how to go forward, and the system needs a major overhaul. I wonder how many fewer people would be put on those medications if we had a humanistic system to respond to people in crisis. And, if we offered actual kind and caring help to get their feet under themselves, I wonder if people would be on smaller dosages and stay on the medications for shorter times than what we currently see. I think it is a failure of gigantic proportions of our mental health system that so many people are on those medications – a failure that the leaders of our system must own.

I will also say this to you again, you should be very careful of your own cognitive dissonance. You have a vested interest in believing in the system you represent. If you started to really check in to how many people experienced being harmed by what you represent then I suspect you would have to go through a very dark night of the soul.

Malene

We agree on all points.

Cledwyn & Malene,

I maintain my skepticism about *anyone* being helped by psychiatry via 24 years of having actual proof of good outcomes ONLY for the small minority who escaped or were rescued from psychiatry. On inpatient-locked units, I have witnessed what Dr. Pat Bracken shared in his lecture currently up on this site; that there is no particular therapy/treatment that has proven to be beneficial; the one element that creates a good outcome is the *relationship* between the mental health professional and the patient. Quite honestly, there are precious few beneficial relationships between patients and psychiatrists there! Outpatient psychiatry is predominantly medication check in interviews- 15 minutes or less! Something other than *psychiatry* ALWAYS accounts for good outcomes in my 24 years of clinical experience!

Pat Brackens lecture is about Psychiatry’s CRISIS of LEGITIMACY. Watching this video is an hour well spent. Every facet of the *fraud* perpetrated by this so-called medical speciality is revealed with alacrity, and solid historical social/political relevance.

A lay person can easily point out the fundamental flaw in psychiatry as a medical specialty and booming business. The flaw is in the premise, the medicalization of human mental/emotional/spiritual suffering. The error in the premise appears in ALL the conclusions— from the DSM to the PDR! Only those who are seeking an authority figure to diagnose them with something similar to diabetes or epilepsy; something that is physiological and beyond their control, are *helped* by psychiatry’s fraudulent paradigm of *care*. Dr. Bracken makes this point as he attempts to explain WHY this paradigm has persisted these past 50 years, when there is so much compelling evidence that it is harmful and potentially fatal.

Working very recently with a 40 year old withdrawing from Heroin- on a locked unit because he was status post OD as a suicide attempt, I can tell you there was a big difference between what he believed and wanted and what would be considered *helpful* even by purely medical standards. For the most part, he got what he wanted. His psychiatrist ordered Ativan IM quite liberally along with Clonidine, so he could sleep off the worst of his withdrawal symptoms. Additionally he received the diagnosis Bipolar disorder and the assurance that he was *self medicating* his bipolar symptoms with Heroin! His shrink was more than happy to prescribe drugs that *treat* his bipolar symptoms when Heroin is not avaailable! IF you pause to consider what *psychiatry* had done and was doing for him, it would be hard to conclude he was being helped by psychiatry. BUT, if you asked him. Well, he had more issues with nurses who would not give him Clonidine when his pulse rate was below 50, than he had complaints about his psychiatrist! He was clear about how his Bipolar was the REAL problem! Go figure!

Maybe you will think this an extreme example, but it is fresh in my mind and heartbreaking in terms of all of the purely human stuff that this guy really needed.

I contend that psychiatry id dehumanizing by virtue of its lacking in realizing the human experience as a purely unique and maybe even sacred experience. Psychiatry is dehumanizing in its posture of authority that negates the experience, wishes and basic human needs of a person that they have the legal right to call their *patient*. Psychiatry is dehumanizing in its overzealous assumption of a role in separating people from a *society* that desperately wanted protection from *crazy people*. Psychiatry has built its fortress and its wealth on countless dehumanizing actions, AND by consensus IT formulated a Bible of pathology for every sort of human suffering IT encountered.

I wholeheartedly agree with Dr. Pat Bracken. Psychiatry is facing a LEGITIMACY crisis. In an ideal society, one whose governing and regulating agencies were established for the sole purpose of protecting and caring for us all, Psychiatrists would be facing criminal charges.

I am prepared to enter the witness protection program at a moments notice. 🙂

Re: “toxic” attitudes

Breggin calls psychiatry “toxic” –

http://www.toxicpsychiatry.com/

Warning: He is not concerned about *political correctness* when it comes to the *rat poison* psychiatry calls *medication*.

IMO, we are in the spot we’re in because too many people are not willing to stand up and speak out.

Not because of *black and white thinking* or *political incorrectness*.

1 in 5 adults in this country are taking some form of psychotropic drug (rat poison), and their own doctors have no idea that the drugs are no better than placebo, cause grave harm and according to Marcia Angell, M.D. are are “worse than worthless”…

Do the math.

Duane

P.S.: Is Breggin too “radical” for the politically-correct dialogue? Because, before Robert Whitaker, there was Breggin.

Sinead,

There is not doubt in my mind whatsoever that in a Just society every single psychiatrist who has “treated” my son would be facing criminal charges. Every single one lied to me—Mental health so called professionals wonder why I can’t be more ‘respectful’ i.e. just accept what we do don’t question OUR Authority; The current “provider” is either just plain stupid or IDK what. She has ‘no idea’ why I would possibly have any “anger and trust issues” or why my son is absolutely TERRIFIED of going to any kind of medical clinic or hospital. Knowing the absolute power and control they have is THE ONLY reason I do not tell her or the punk psycho pharmacologists at the clinic what the heck I think of them and their lack of respect for my son. I too can be locked up and drugged into a state of disability—

They are not.

I was not rejoicing about anything. I was sharing a conundrum and an observation. I do not know if the belief that the drugs are effective are a result taking the drugs. If this is so, why are there people who take them who do not want to continue. Why would one type of attitude be caused by the drug and another attitude reflect the “true” underlying belief. If so, how do we know which attitude is the “true” one?

I am in the Cincinnati airport, soon to board to come back from NARPA. I spent two of my three and a half days there there bedridden with the flu, and got little MIA work of any kind done. Just mentioning this because i probably would have responded to this already. Perhaps unadvisedly, I will post whatever I have written when the airplane boards. If I offend, I’ll blame it on traces of the flu.

Funny that you mention Descarte’s folly at the end; it’s what was drifting through my mind while reading the post. Having observed some Open Dialogue sessions up close last week, and done some training in it previously, what comes to mind is that Open Dialogue is about resolutely negating dualism in all its forms. Though it’s nominally about dialogue, its form is really all about creating a field of awareness in which connections form at a very experiential level, and the dialogue arises therefore on a solid (and perhaps improved-upon) ground.

It’s often noted that people leading Open Dialogue sessions “use” a lot of humor. It was my observation that the sessions began with a notable shift into a shared physical/experiential space. This came from the intentionally “open” sense of time; there was simply no hurry to say anything or reach any conclusions. It seemed to me that mutual awareness increased, and that humor percolated up out of that connection. Since the sessions were in Finnish it’s hard for me to know the actual content or how on-task the conversation was, but I was told that the meetings had been very productive.

One of the OD therapists was very proud of having been trained in Sensorimotor Psychotherapy, a modality I favor because of its very careful attention to both somatic and “conscious” experience.

It occurs to me that one of the reasons OD always has two facilitators present is for reasons similar to those you mention, but with a different philosophy underpinning it. With three people, there can be no dualism (so long as there is no “in-group” formation, as you note.) This requires, though, a tremendous tolerance for uncertainty and ambiguity; which is another of OD’s strong foundational principles.

This goes beyond tolerance, etc., and it goes beyond the reflexive understanding of relationship or family therapy. It goes, I think, to being open, on an ongoing basis, to reviewing our understanding how we “know” what we think we know. Does it arise from our somatic/perceptual experience, or vice-versa? Or does it arise in the space between ourselves or others, as some have theorized/philosophized. “Mind” or “consciousness” or “knowing” is always and only something of which there is a shared component; to experience any of them is to imply the actual or potential shared experienced of another. (See Daniel Dennett, or Durkheim).

I think that Open Dialogue is built on such thinking. But when coming at it from a conventional perspective, it just looks like family therapy or the like, and is immediately suspect in the way that such work has come to be held, acculturated as we have become against anything that seems to imply that our families (or other environmental factors) may have had as much a role in our dysfunctions as our reverence for “family values” implicitly suggests they may have in our function.

No one of these ways of seeing the totality of our experience is sufficient. Our bodies and minds are inextricable from each other. Pills DO affect us; the question is how, and what it means, and what they truly suggests they may or may not do for us in our search for a more fulfilled time on earth.

My observation is that a tolerance for ambiguity and uncertainty is the most important thing in all that we discuss here. This is why the “I may disagree with what you say, but will defend to the death your right to say it” principle is so important here. I’m glad you express all that you do.

The airplane is boarding. I look forward to discovering whom I have disgruntled.

Dr. Keys has been enjoying the summer and changes that have come with leaving her practice of psychiatry. She looks forward to writing more, last we spoke.

Ok, then, Sandy it is.
I should give fair warning, I am no less opinionated when using first names. We can blame it on my grandmother – among the first few women in her country to ever demand equality. She was a significant role model in my life.

I think there is a huge difference between talking to a trusted friend about someone,and what happens in “clinical meetings”.

For instance, my best friend works with autistic children. She often talks to me about feeling heart broken when a teenager struggles to communicate. In this situation we are talking about her heart break – about how she is impacted. We are not talking about what is wrong with the teenager she is trying to help, rather about how she handles her own sadness at seeing suffering.

I wish that is what would be going on during various staff meetings etc. But truth is, it isn’t. Diagnosis are discussed, what is wrong with a person, and most importantly, what the clinical setting can do to control this person – now that is all discussed. When a staff member refers to something wrong with the person in distress the staff member is not ever encouraged to look at their own emotions – the person in distress has a diagnosis and what is wrong with that person is fair game to discuss.

None of this is the least bit helpful. None of it fosters a therapeutic environment. It doesn’t foster caring, concern, humanity or dignity.

Besides, how can a person in distress ever truly get better if they are not 100% involved in the process?
Malene

Here is what I see as a “tip-off”: “In one hospitalization, I knew that I only really needed at that very moment to be held. Not a hug – I needed to be held.” (is that what a straight jacket is for?)

How awkward and … “pathetic”? Had I embarrassed somebody and revealed the “stunted growth” of Americans, where “strangers” are so icky? EWW, I’m not touching YOU.

That was in 2007 – I was 31 years old. My “no PC” (physical contact) training began in my first hospitalization in 1991 when I was only 15 years old. Things have not changed.

When I think of this – “What seems clear is that this is fundamentally a humane approach to talking to people in distress. What was wonderful about this meeting is that these individuals seem to practice their ideas in the way they live. They are humane in their interactions with one another.”, I have to really wonder if I had expressed my need to be held (comforted and consoled) with those people, would it have been granted and given without the other person feeling ALIEN about it?

Not that I should have to explain to justify why needing to being held was so NORMAL but wait a minute, DO I actually have to explain it? In fact, I do think so.

I put a belligerent, drunk homeless woman to sleep when “staff” (volunteer) could not handle the situation. I got down on my knees beside her, I touched her. I spoke to her. She told me “I love you, I love you” and she went to sleep. She woke up a short while later and I immediately ran to her side, again, and put her right back to sleep.

I have the love of a woman that 99% of people would laugh at, devalue, mock or even ridicule. But every time I think of her, I’m pained and joyed. She’s on my heart and in my mind for all of ever. No professional that I know of could have cared for her and handled the situation as effectively as I did.

I CARED about her.

I bring it up because it is crucial when the very essence of ‘being’ goes beyond language and talking. Sometimes, we have that need to hear the right words. Sometimes, the *inner* world is literally falling apart and no word is able to do what contact CAN.

I’ll give another brief example: I was struck and bed ridden with an intense vision. I cried out for it to stop. A man knew enough to tend to me by placing his fingers on my temples. It gave me relief. You see, in that instance – to have spoken to me would have agitated me, especially if someone decided to say “call an ambulance” or deemed it some “psychotic episode”. The man did the exact right thing.

And in case anybody’s wondering what the vision was – it was the Earth caving in with bubbles rising up from very, very deep. I’ve since learned those are called “sink holes”.

And thank you Malene and Sandy, for your acknowledgments.

Malene-
I ran out of reply buttons above. I think I understand what you are saying about the distinction between personal conversations and clinical meetings and I expect no lightening up on your critical thinking (in the sense of incisive) when you comment here.
I do want to think more about this for personal reasons. I had the sense that the Finns have this sense of respect on many settings. It seems to be a case where culture influences practice whihc influences culture. Maybe I need to apply this outside of work.

Hi Malene, I really think these comments expressed by you and particularly mjk’s clear articulation of deeper needs and the emotional projection process which denies them, are crucial to our self-understanding and what we need to see about the Pride/Shame foundations of society, which prevents progress in mental health care.

I hope & pray that any so-called professional reading this thread, is able to let go their habitual intellectual posture & *feel* the primary process reality of human need, in this wonderful articulation of the power of *touch*

I share a similar timeline with mjk, regards 2007, which was my 1st & only sectioning, when an “as if” intellectual posture of “I know & you don’t,” triggered a reaction in young psychiatrist who ran out of ideas, when I challenged his presumption of a disease process in my experience of what is labeled bipolar type 1 disorder.

This clear statement by mjk is very powerful & people to pause % feel their resistance to it, through a consensus norm of “I think therefore I’m so identified with my thoughts that can’t feel my own body, its sensations of primary process need, & and the reality of *presence*

IMO Even the cognitively articulate on our side of the us vs them fence, do not want to acknowledge a primary process reality which makes a mockery of the minds sense of superiority? Descartes error has caused a fundamental mind-body split in Western societies, that founded on a Caucasian NEED to feel superior, IMO.

I resonate completely with mjk’s statement & give an example of it from my own experience;

“Sometimes, the *inner* world is literally falling apart and no word is able to do what contact CAN.” From my own experience;

““All behavior is communication,” springs to mind now as I walk towards the city center and the old “That Dam” stupa. Old and crumbling, I gaze on the conical structure and try to sense its deeper symbolic meaning, its unspoken voice as an expression of metaphor and the projection of unseen processes.
Behavior built this monument, yet something deeper and unseen informed its shape. Like the behaviors of psychosis and the unseen, hidden thermo-dynamic processes that drive the motor movement patterns of behavior.

A scene from 2007 springs to mind as I muse before the wisdom of this ancient monument, a hospital room and a beautiful young woman. She was on the bed as I entered the room, legs drawn up tight, her arms warped around her knees, rocking backwards and forwards, and quietly sobbing.

Alone, frightened and abandoned, her face was a mask of tragic loss and the deep sorrow of a harsh biting reality, “what love, what empathy, what understanding?” It was a gut wrenching scene to behold because she could have so easily been my lost daughter, perfect age. I sat beside her, putting my arm around her shoulder enjoining the movement, an unconscious prompting about need?

She turned towards me burying her face in my shoulder and allowed me to embrace her and power the rocking motion. It was probably about fifteen minutes before I’d felt the solid heaviness of her secure slumber and lowered both our bodies down onto the mattress. I remember thinking that if nurse Ratchet had re-entered the room right then there would be a fearful misperception, in that loss of sensitive awareness which tends to fuel the denial of our mechanical, “stand apart” cognition. As it was, I quietly left the room thinking about the generational transmission of emotional affects, my Grandmother, my Mother, my lost Daughter and Monica McGoldrick’s profound statement, “loss is the pivotal human experience.” A daughter may have helped to heal a generational wound which powers the emotional cut-off reactions within my family tree. “The ghost in our emotional systems machine?” Strangely there is always a song with poignant lyrics which come to mind at moments like these. Do you get that unconscious, and implicit inner self, messing with your mind too?”

http://www.born2psychosis.blogspot.com/p/chp-4.html

Professionals, please note that I did not say a single word to this girl, I did not ask any questions, I simply allowed my body & the power of presence to inform my movements?

Warm regards,

David Bates.

“4) Scientific evidence supports: A) the brain responds to dopamine blocking drugs by making more dopamine receptors. B) When the dopamine blocker is suddenly removed, there will be a sudden increase in dopamine C) Insomnia is a sure bet…. D) Consistent with *patient* reports: “Haven’t slept in … several days!””

Not sleeping, is not the reason stated for committing somebody. There has to be someone who doesn’t like the content of the person’s thoughts.

Nobody can prove any “dopamine flooding” is the cause of the prohibited thoughts.

I see how you view your job, you’re better than most, but the way I play it, is I boycott earning any money from people’s detention, don’t set foot in an evil place, and I’m happy that way.

Hey Anonymous,

Well, I was asking for help at that moment. I shouldn’t have been committed, and if the person I had spoken to had any kind of ethics, I wouldn’t have been. So right there, if the person in front of me had been “real”, things would have worked out better.

That doesn’t change the fact that I did ask for help. Instead of help I got dehumanization, degradation and a ridiculous and irresponsible amount of medications. I will never forgive the corrupt hospital system for kicking me while I was down. But I did want a kind and understanding person to listen to me. That would have been “help”.

Malene

Why do you even accept the very notion of being imprisoned “for your own good”?

?? What NOTION?? It’s the LAW!

ACCEPTING *that* is crucial !

Maybe there is some measure of personal pride in defying an unjust LAW. But defying it is a personal choice to risk the consequences… no matter the specific law, no matter the innocence of the one negatively impacted by it. In the case of involuntary commitment statutes, there is a very real possibility that the dire consequences will far exceed the personal benefit of pointing out the injustice of the law !

I want to change this reality, not become another failure statistic. There are countless minds that must be changed, IF this law is to be justly abolished. I can’t help worrying that when you instigate out right rebellion at the point of confrontation with this law as a *detainee*, you are actually fueling the mindset that defends this law!

Sinead,

I am really enjoying this exchange and I am very glad when I can have a welcoming conversation on this site. Thank you for your courtesy.

I have not read Anatomy because it it not in my local library system yet. I’m on a low budget and don’t spend a lot of money on books.

I have seen Robert Whitaker lecture in the past and have watched all of his lectures that are available online.

I think his C-Span discussion on Anatomy of an Epidemic is excellent.

If you have not seen this presentation, it is a bit long but well worth watching.

http://www.c-spanvideo.org/program/293935-1

Mr. Whitaker provides a concise outline of the research used in his book regarding the treatment of psychosis and shares the conclusions he has come to along his “intellectual path” of discovery.

Ironically, the conclusions he has come to regarding the treatment of psychosis along his “intellectual path”, relate closely to those I have formed from my not-so intellectual, sometimes psychotic, very grateful for restored sanity path.

My desire to help others and become an advocate did lead me to coursework that I thought would be helpful including, sociology, public justice, medical ethics, abnormal psychology, Constitutional law and some training in complimentary therapies.

Mr. Whitaker makes his C-Span concluding statements very clear.

My interpretation (summarized) of his his beliefs regarding the treatment of psychosis are:

– the research supports short term efficacy of antipsychotics and long-term chronicity

– the comparison research from 1945-55 involved treating psychotic episodes with hospitalizations that lasted between 12 months and five years.

– his book is not a medical advice book and does not encourage patients to go off of medications (although some psychiatric patients have gone off medications after reading Anatomy)

– he believes psychiatric medications have a place in mental health care

– Anatomy of an Epidemic does not take an anti-medication position and is in fact a “pro-med”, best use practice

– when considering psychotic patients, some will do better off meds, while others do better on meds

– he believes the psychophramacology paradigm is a failed revolution

– psychotic episodes have flu-like characteristics of coming and going on their own, treatment with medication is the best approach to quickly stabilize

– his appeal is to create a national discussion that incorporates the long-term data

Earlier this year, Jason Russell, the creator of “Kony 2012” suffered from “reactive psychosis” resulting in a bizarre incident in San Diego that ended with police transporting him to a mental-health facility.

TMZ posted the video and described him as “not your average crazy person”. This video demonstrates an important aspect of psychosis, that it can come on quickly and change how others perceive you permanently.

If this is what having a bout of the flu was like, I would sure want a flu shot.

http://www.youtube.com/watch?v=yGiR2TmeNYc

If I has the opportunity to ask Robert Whitaker two questions in an interview it would be:

If you experienced a first time psychotic episode, what treatment, if any, would you choose? and why?

What do you think of the BMJ’s guidelines for Best Practice Assessment of Psychosis?

I would love to know his answers.

Sandy,

I’ve been mulling over this statement in your comment/response to Maria:

” As you know if you read what I write, I continue to prescribe these drugs but I try to be very cautious and I try to be as open as I can with my patients about what I know and – as importantly – what I do not know.”

I see this as an example of your employing *theories* as a basis for your interventions. ??

Earlier you commented:

” Psychiatrists are not the only ones who can use their theories in a way that is hurtful.”

Regarding your own writing here, I feel an urgency to point out that you seem to be discounting two important factual points:

1) Psychiatrists are the ONLY ones in the mental health field who CAN cause true, physiological/emotional/spiritual harm with the actions they CAN take on their *theories*. Psychiatrists wield the prescribing pen; the commitment to involuntary *mistreatment* and forced drugging pen. There is a big difference between “hurting someone’s feelings” and “destroying someone’s life”.

2) You have consistently cited Anatomy of an Epidemic as a “neither a pro or anti medication” book, while failing to comment on the this book being the first strongly referenced, clear exposure of the “lie(s) behind the biomedical model of psychiatry” . So while you are quick to point out that an investigative journalist is NOT assuming the role of the MD, you avoid commenting on being one of the MDs who has and “still does” prescribe drugs for *non-existent* bio-chemical disorders of the brain.

Yes, you do have your theories. And surely many of us do as well, but your unique position of power to cause harm via the authority by which you CAN act on your theories, places you in a very separate, unique category.

Open dialogue takes place on a level “playing field”, so to speak. The very real and present barrier for psychiatrists to utilize this very human form of understanding seeking exchange, IMO, is their inability to see themselves as *non experts* with no *special powers of authority*. And this extends to the confrontation with who they are in the scenario that has produced very formidable psychiatric survivor/ service user groups. IF psychiatrists want to engage in open dialogue HERE,I believe it is imperative for them to demonstrate the most basic of human traits: acknowledgement of error, remorse and dedication to repairing the damage caused to millions of people, a growing number of whom are children.

Sandy, you and other psychiatrists who present yourselves here, have inspired the following analogy :

I see: MIA blogging psychiatrists are like beach balls thrown into a pool, where psychiatric- survivor/reform groups are like heavy objets that have migrated down to the bottom of the pool, forming a new floor/foundation. Many attempts are made to push the beach balls down to the new floor, foundation. Some of the” balls” claim they want to be part of that newly forming floor/foundation– but something about their basic nature, causes them to pop up to the surface, again and again! I assume that the beach balls float because they are full of air; that so long as the air (could be hot?) remains inside the balls, they will keep popping up to the surface!

Holding on to false beliefs regarding their participation in widespread deceit (based on theories upon which they have reached consensus)(despite lack of scientific evidence) and perpetuation of their expert,- take- the -lead- on the surface of the pool- status; many psychiatrists cannot fully engage in open dialogue. And they won’t be able to do this, I maintain, until they release all of the” hot air ” that keeps them at a great distance from those who will succeed in alleviating the suffering caused by psychiatry and establishing something like a new world order of basic humanism where open dialogue is just “what WE DO”!

In my 24 years of associating with psychiatrists, I know only one who has said: “I made a terrible mistake.” or “This *medication* is harming my patient”. This one psychiatrist was in agony over these realizations. I hardly wanted to bash him for his errors. And he is my actual proof that beach balls can make their way to the bottom of the pool and become part of the movement for change!

Here at the bottom, we like to keep it real 🙂

Thanks,
Sinead

Maria-
I also want to add that your summary of Anatomy (in one of these comments) is incredibly articulate and clear in my opinion. Perhaps we can get Bob to provide an answer to your questions.

David,

Jason Russell’s wife said a contributing factor to the brief reactive psychosis was dehydration. Dehydration can cause psychosis.

This “as if” assumption in comparing psychosis to a viral infection came from Robert Whitaker, not me.

Does anyone know if Robert Whitaker has ever taken a course in Abnormal Psychology?

Or what degrees he holds? and from where?

David,

In your opinion, what can society do to prevent tragedies like that of Chevonne Thomas?

Police found the body of 2-year-old Zahree Thomas after his mother, Chevonne, placed a rambling, sometimes incoherent call to 911. Thomas openly admitted to the dispatchers that she had stabbed her son and in a gruesome discovery the toddler’s head was found in the freezer.

She admitted to the 911 operator that she was on Prozac before killing herself.

http://isepp.wordpress.com/2012/08/24/cases-of-filicide-do-911-operators-easily-recognize-medication-induced-psychosis/

Thank you, David, MY FLOWER !!

Is what I think best captures what I experienced when reading your response above…

WORDS— and beyond !!!

In any case, I hardly go into the trenches alone… anymore

*:-)
Sinead

Dear Anonymous,

Your thinking about “human rights,” looks spot on, at first sight. There is a lot about life which “should be” right. Yet does this rational reasoning serve an inner purpose which is not easy to see?

We all tend to think in idealized terms about how life should be, and hopefully will be in the future, yet how do we in so-called 1st world societies explain higher recovery rates in countries which have less “human rights?”

Our mechanically minded cause & effect logic, usually assumes its because of “lack” of access to medications? Yet these countries where recovery rates are higher also lack a welfare system of state support, which allows individuals & families to avoid “responsibility,” for their survival?

I know you don’t like me mentioning Murray Bowen, yet please consider this explanation about how society “functions”;

“After the mid 1960’s there was more evidence of an even lower level of societal functioning. There was more feeling-oriented action and less long-term principle planning, more “rights” thinking than “responsibility” thinking. The overall pattern was closer to that of a family with a problem child, giving into emotional demands, hoping the problem would go away.” _Murray Bowen.

Murray Bowen’s seminal ideas, inform much of the ground for the systemic approach which Sandra is reporting on here, and which Robert likes to quote in a meta-analysis, cause & effect approach, to analyzing mental health. A cause & effect approach which works fine if we’re analyzing a machine, yet gets nowhere near understanding the systemic interactions of our body/brain, or the systemic emotional interactions of group dynamics.

IMO What we all avoid in our “intellectual” rationalizations, is the reality of how we actually function, with far more unconscious reaction stimulating our so-called reasoning, than we care to admit?

Your “should be” idealizations are great, and I agree completely with your sentiments, yet suggest that what these idealized fantasies are largely self-stimulated to avoid, is the reality within, as we project an emotional need onto the world out there?

Perhaps you might care to read this comment & tell me what you think?

“What I’m saying, is about our common tendency to look at the world, and think that we really do perceive what is going on out there, and why society functions the way it does?

Yet consider the role of *unconscious* motivations, and ask yourself if perhaps there is a system within, which creates the so-called *system* we observe, without sensing how each of us functions, on an unconscious level? Consider;

“The subconscious, the other 90% of the mind, is responsible for a variety of functions, such as the physiology of the autonomic nervous system, our dynamism or energy, and our *habitual patterns*.

I think these unconscious habitual patterns create the system, we call society, and we are all far less self-aware than we admit to? Keeping a focus on *them* serves the useful purpose of avoiding our own internal motivation?

Its the *realization* of our common humanity, in the way we all function, that I think is required to change *the system.*”

http://www.madinamerica.com/2012/08/rxisk-stories-azathioprine-withdrawal/#comment-15371

Best wishes,

David.

Stephen,

Please forgive me for possibly getting you into more hot water,,, BUT, you are expressing realizations that gave me goose bumps for the second time today as I revisit our *open dialogue* here. The first goose bump reaction did happen to occur when I was reading David’s response to me above–.

Yeah— this stuff is more visceral than cerebral and FEAR itself is the strongest catalyst for so much sub and/or unconscious impulses to affect expression and action. sometime I think that the more we focus on just overcoming the fears we can name, the more we will become aware of those that plague us anonymously. (no reference to our dear friend here, intended).

I was working night shift with two MHC’s a few years back. All three of us women, but the MHCs were both young enough to be my daughters. One particular (15 y.o.) patient was evoking fear responses from one of these young women while evoking a steady flow maternal nurturing responses in me. My plan to set a tone for day shift where this young man would greet the day in a place of warmth, acceptance and care involved my waking him fully after vital signs assessments to offer him a tui na back massage — which he often requested to help him fall asleep, but also provided a sense of grounding and safety for him as well. One of the young women began to interject what she interpreted as “the treatment team’s” strict guidelines for minimizing “rewards” for this kid due to his episodes of acting out– property, not people destruction, but none the less scary because he was 6″1″. (same height as my own adult son) I am, according to my son “5 foot nothing – just shy of 100lbs)— the least intimidating presence with absolutely no skill or desire to develop skills in limit setting… etc. You get the picture. My *staff* obviously was more focused on my physical appearance than spiritual strength?—- even knowing I had a solid track record for kids NOT needing restraint of any kind when I was in charge. So, here I was assuming T., the young MHC would just TRUST me and I was becoming irritable with her challenging my plan to create a safe unit for day shift. MY plan was to create a safe feeling for the most *disruptive* (in THEIR eyes) patient. Perfect sense. Nope! T. continued to challenge until she began to slip in little threats, like,

“I will need to inform the team leader and nurse manager if you don’t follow the *treatment* plan”.

I pondered the whole situation and said to her: “I am going to carry out what I believe will be the best intervention for our patient. His safety and feeling of being cared for is my focus, but I know it will benefit ALL— so here it is :first, the patient, then the unit, followed by the staff… etc” My priorities– logic, reasoning all spelled out in WORDS with the goal of easing the edge off of this MHCs attitude of challenging me as the charge nurse. She said :

“Yep, you are in charge all right. It’s YOUR license. So, go ahead and do whatever you want.”

That was not the response I was going for. I am always uncomfortable with lack of unity amongst front line staff. but, the more WORDS I used, the more entrenched she became, and I realize I was just going to be following HER directive, that is :go ahead and do whatever I wanted”

Intervention/ back massage TLC etc, worked like a charm. Everyone seemed happy on day shift as well, but T. had placed a complaint call about me to the “brass”— and let me know on her way off the unit at the end of our shift.

The “brass” is currently a colleague and back then my strongest supporter/advocate in the nursing scheme of things. He urged me to talk it out with T. and invite him in of that didn’t work.

So–I had an opportunity a few nights later. Me and T. on a quiet night. I started the discussion with wanting to understand what exactly about my intervention plan was causing her so much anxiety.We went back and forth with superficial stuff and political roles on the unit and suddenly she just said :
“That kid scares the hell out of me. I did not want him awake when just the three of us women were here. ”

Mind you we were not without immediate back up… can;’t provided details or I will give too much info about ‘where this took place” BUT , still I started to notice T.’s affect… more than I thought about the WORDS she used.

She was scared, no doubt. So , then I asked if she had cause to feel that I was jeopardizing her safety; that I was not confident in my own practice and relationship with this kid. Ego stuff, Right? but my ego touched off this— the crux of the matter:

T. said: “The way you show caring for some of these really rough kids makes me feel bad–(inadequate). I guess I really do’t’ feel “unsafe” when you are in charge, but you do have a way of making me feel terrible about myself… even for being afraid- even when there is good reason because a kid has acted out violently— you still make me feel bad for having the fear in the first place .”

I felt terrible. I could sense her suffering and see it all over her face. I don’t really SEE myself as some special entity as far as kids go, BUT I do sometimes get irked when I demonstrate confidence that is REAL and get reactions that make it seem that something is WRONG with me, or that I don;t GET IT. I will always— continue when I KNOW that my plan is best for the *patient*… and ALWAYS have and will say:”I am taking FULL responsibility”

I told T. that we could learn from this— I wanted to show attentiveness to her “feelings”– and wanted her to feel comfortable saying “I am scared of this kid”. That matters to m,. and it isn’t up to me to talk her out of it… but realize that the goal is for her to overcome the fear. Genuinely. THEN, regarding the way my caring about a kid she felt negative towards, I shared an experience from my early days as an ICU nurse when I failed to live up to my own standards of compassion, and became physically sick at the sight of a patient’s head injury. IShe was very supportive around this being a universal reaction- potential— even nurses have their *weakness*.. BUT,” NO !”… I replied this is about how I FELT about ME… I could not accept my response… and went on to say that this episode had happened when I was about her age; that I have seen the story change in my mind over time to being a learning experience of my own humanity… humility..
“I know how it feels, T.”, I said, ” to realize you aren’t as good as you believe you are or should be. It’s OK. ”

Since then, I have placed more emphasis on the affect my co-workers are showing—-attuning to it… feeling it myself. I am less critical and judgmental about staff as individuals and more aware of my influence over creating an environment where they—-where WE all can be steadily growing and improving.

THIS story could have been a very descriptive narrative about the challenge of working with “untrained people” who cause trouble for anyone who actually DOES care about the patients. Maybe it would have led to my UNJUSTLY being disciplined for being a “good nurse”— or how “bad kids” just wreck a unit and threaten the safety of staff— because STAFF won’t own their own FEAR and work to overcome IT, instead of the easier route of “Blaming the patient” for scaring the crap out of them.” You see what i mean…?

IF we can sustain engagement with each other—- we WILL find the place of increasing our understanding of each other and ourselves— WORDS are our tools, but affect awareness and recognition and all the sub/unconscious underpinnings are the horizon… our “collective” evolutionary challenge?

Welcome aboard!

xo,
Sinead

Sandy,

What a team we would make… whatever our roles and wherever the setting!!!

Thanks for this deeply meaningful compliment

*;-)
Sinead

“I think that some people here believe that working on the locked units is a walk in the park and that we go home in the evenings counting all of the big bucks we’ve made that day and feeling very proud of ourselves. ”

I never said this with relation to “peers” who do this.

There are psychiatric nurses etc who are very proud of themselves. Whether they find it a walk in the park, I could not care less.

The folding of psychiatric survivors into paid employees in mental hospitals is a co opting coup for psychiatry.

There are all sorts of rationalizations.

We are going to have to agree to disagree.

And, Stephen… we can’t continue to do this work ALONE, isolated and struggling to heal from what is now being called, “vicarious trauma”… but really is another chapter David Bates has been kind enough to write for us…HERE!

And rather than going down with the ship.. how ’bout we build some kind of flyin’ contraption??

xo,
Sinead

Stephen,

I found a YouTube link to this documentary created in MA. and used extensively in restraint reduction/elimination training . I have witnessed some transformations in staff who were strong proponents of the therapeutic value of “force” and threat of force. The ultimate teacher, the equalizer… when all else fails, such are the rationalizations of those who have become completely disconnected to the deeper awareness we have of what it feels like to be violated. Perhaps, it is a shield, used to prevent the conscious memory of that feeling, or the fear of having it. The task at hand is not easy. It is difficult to know what sort of stimuli will penetrate the walls built up by suppressing this fear. As a teacher, I try to come up with as many different venues , as I can to share a message that is difficult for most of my audience to hear. This documentary,like any on this subject, carries the warning of being very disturbing. Guess what? THAT is precisely what drew the audience I most wanted to reach into the conference room for the showing of this video/documentary/training film. They were lured in by the disclaimer! Not so tough after watching the film.

I think you are amazingly courageous to challenge yourself to work on a unit where you have experienced so much humiliation and degradation. Perhaps because you showed up with the capabilities you obviously have, this reinforced to your ‘enemy’ that they are justified –“Look!, Stephen is cured- and WE helped!” Of course if you had sunk deeper into despair, these same people would no doubt absolve themselves of responsibility and pat each other on the back for trying so hard….”poor, Stephen…”

There are peer specialists in the video who speak very candidly about their experiences being restrained. Maybe your co-workers will hear something that leads them down a different path on a journey of understanding .

I really admire how you are walking into the lions den. Though you may not be aware day to day of the growth you are achieving, I bet you will see the cumulative effect of conquering your own fear in order to help your comrades still in captivity. You could just let it be known that your appearance on this unit it not about wanting to connect with and thank people who treated you with disrespect and degradation, BUT to be the light and warmth you were seeking when locked up with them.

Wait a minute! IF your presence is a beacon for another *patient*, then there is something profoundly valuable about your initial experience being locked in with bullies. And if even a horrible experience like that can become the catalyst for all of the good you are doing…., then ,in effect, we all could say thank you to whatever the adversity that caused us to awaken to our own humanity. That’s an enlightened view of things… and NOT a suggestion that you party/celebrate with this group until they have completed sensitivity training. 🙂

http://youtu.be/Z0iqYGE01-Q

Here is the link to the sensitivity training I had in mind when I started this response to your comment…

May the Force be with you!! or at least, not AGAINST you!

xo.
Sinead

I understand you are from Denmark?
It makes no difference.
“Constitutional” rights are universal.

Natural law is not complicated.

Human beings have inherent rights.
Including the right to life, liberty and property.

These rights cannot be taken away, without “due process” of law.

Forced psychiatric treatment that ignores this Natural Law is destructive to the spirit and inhumane.

Duane

Oops,

My apolgies, you said you are ‘English’.

Duane

Hey Duane,

I remember a woman a few years back who spent a lot of time talking with her voices. She lived on the street and her whole existence was preoccupied with the voices. She often was unable to find food for herself, and by the time she was put on a 72 hour hold followed by a 2 week hold her clothes had rotted off her body so that her privates were showing. Never mind the indecency – it was cold out. Something she seemed to not even really notice.

There were resources available in the community for homeless people that would give her access to food, shelter and clothing, but she was too far gone to take advantage of those resources.

Now, I hear you – force is wrong. Even worse, what we had to offer this woman after using force sucked fish.

The woman in question clearly met a legal definition of “severe mental illness”, in that this definition specifically stipulates a person who is unable to provide food, clothing or shelter for themselves.

The reason that I can accept the use of force in such an extreme example is because I think it is just as wrong to ignore this level of suffering. I am the type of person that if I see a wounded animal on the side of the street i stop. Even if I just see a lost dog I stop. I cant live with myself if I ignore it. If I come across someone on a highway that has a flat tire I stop my car and ask if I can help. I can’t turn away from a woman who stands around talking to the voices, with her privates showing, and unable to realize how hungry she is because of how loudly the voices are screaming. I am sorry, I cant ignore the suffering.

Now, I think we need plenty of non-coercive options. I think the options we currently have are horrific. I think our current systems should be trashed so we can start over. If we do it right, then maybe we wouldn’t have to use coercion in above mentioned example. If we do it right maybe she would have never gotten so far out to start with.

But, in examples that are this extreme I will rather show my caring and do something – even if initially that something is not what the person claims they want, than I will ignore someone who so clearly needs help.

So, you are right, we have rights. Coercion is wrong. I agree. But, I think there are extreme examples of human beings who so clearly needs help, even if initially they are unable to accept the help. I am not prepared to ignore their need either.

As for above mentioned woman, she was on a 2 week hold in a hospital and was force medicated. Then she came to the half way house I worked for an additional 2 weeks. During the two weeks in our house she did not express not wanting the medications. After that I don’t know what happened to her. When she left our house she was still officially homeless although we had hooked her up with some community resources. When she left she seemed able to feed herself, realize if she was hungry and perform daily actions related to hygiene. She was also able to hold a conversation that included thinking about the future and taking care of herself. I think a lot more should have been done for her – in fact, I think we should have had the mandate and resources to make certain we got her permanent shelter as well as someone to make certain she continued to make certain she could feed herself.

Again, i dont like our current options in this situation. I dont like the medications. I hate the hospitals. The half way house were I worked was only marginally better. I will even say that the people who decided to hold the woman in question might have been more upset about the indecency and nudity than motivated by a sincere wish to help her. It was a conservative community, those old church bitties got an eyeful.

Still, could there be a place were we can meet? I will rather use some force than I will ignore the suffering of above mentioned individual – is that a point of view you can relate to or respect? Or, do you think I should be willing to just turn a blind eye and drive on?

Malene

Malene-
In an ideal world, what would you have wanted to do for this woman?

Malene,

Each one of these cases needs to be heard in court, because they are each unique. (with a lawyer, representing the person).

Before anyone is put in a “hospital” for their “own good,” the facts of the case need to be sorted through, and the best interest of the person whose freedom hangs in the balance need to be considered.

If these basic freedoms do not apply to the most vulnerable, then they apply to none of us.

Anyone is a do-gooder away from being forced to undergo brutality, in the guise of “wanting to help.”

If a person cannot take care of themselves, a judge/jury might consider a non-profit – three hots and a cot, until someone could be seen bt a doctor, arrangements made for long-term place to live – least restrictive, most therapeutic environment – not an expensive, dangerous psychiatric ward!

Duane

Well – like it or not coercion is a fact of life. We meet it both in psychiatry and in a thousand other situations in life having nothing whatever to do with psychiatry. So NEVER is a very unrealistically categorical stance to take if left unqualified.

I’m not quite sure what you mean by “due process” but something along the lines of the protocols required to be adhered to by a police officer making an arrest is my guess.

Life and liberty I go along with as inherent human rights but property? That’s a weird assertion I’ve never read in any book on philosophy, and sounds especially weird in the world’s most supreme capitalist state where the doctrine that rights to property are not inherent but have to be earned is almost religion.

Anyhow whatever the case what has it to do with psychiatry? Are psychiatrists now beginning to take people’s property as well as their lives and liberty over there?

Hey Sandy

You asked: “in an ideal world what would I have liked to do for the woman talking to her voices”.

In an ideal world, I do not think her situation would have ever gotten so far out. In an ideal world there would have been people involved in her life, whom she trusted, that could have prevented this ever coming to that point.

I think it was a lack of people whom she trusted that made her completely withdraw. In an ideal world she would have been offered qualified help by kind and respectful helpers well before it came to the point it did.

If she refused the help then I could imagine one or two people getting assigned to go by her daily hang out spots on an every day basis making sure she had food and clothing. Making sure to take her to shelter again and again until it sunk in to her clouded self that there were options she could rely on. Then I think she would have started to take advantage of those options on an ongoing basis and help could then become many faceted. No force would be needed then. She wasn’t self destructive just lost in a world of voices.

So far I have never met a human being who didnt want or long for kindness and caring when things are difficult. If they are shown that kindness, caring, non-judgmentalism and respect then I would hazard the opinion that 99.9999% of people will want to take advantage of assistance. The problem is that
the system is inherently judgmental and disrespectful.

I have a question for you too Sandy. Let’s say that by some miracle we managed to completely reform the system. In the new system there were probably not nearly the need for psychiatrists with an MD because lets just say that 1/100 the amount of medications would be prescribed. Which means only 1 in 100 psychiatrists remained. Would you be willing to take a drastic pay cut to remain working in the industry but not as an MD? or would you leave the industry and use your MD in a different capacity?If you would not be willing to take a drastic pay cut, can you see how that sets you up to maintain status quo?

When I refer to a drastic paycut then I can tell you that in this area people working in the mental health field without an MD typically makes from $12-$30 an hour.
Malene

Once again, we are in agreement. We have a new program now – staffed with peers and professionals – that goes out to where people are to try and engage and thereby avoid the kind of situation you have described. I am not sure there is a need for psychiatry. I undoubtedly will never convince you that I have little stake in maintaining the status quo but I understand your point.

Hey Duane,

I think we essentially agree. It should be exceedingly difficult to rob someone of their freedom based on “mental illness”. Judges should be involved, I can easily agree with that. I think there are situations when decisions have to be made quickly and we might not be able to get someone to a judge instantly, but in principle I completely agree with you. I also agree that we should have good options available when we decide to force someone into treatment. Options that are not currently available. Our current hospitals are not valid options.

Malene

Hey, Batsey!

You provocative dog, you! Just so you know, I am a “credentialed intellectual” (Masters in Education, BA in Chemistry, history as a counselor/therapist, MH professional, including 9 horrible months doing evaluations for “involuntary detention”), and love the ‘real’ conversations. But I do agree, there are actually a lot more professionals out there who are sympathetic to these ideas but are afraid to speak up for fear of being attacked. I was never one, but I have been attacked or ostracized or simply marginalized for my views. The oppression does not only exist for the recipients of “mental health treatment.” There is plenty of oppression for any provider who strays from the prescribed path!

— Steve

It IS a compliment David. More often than not when you offer your thoughts, ideas, insights, feelings, the responses are numerous. Some agree, some disagree but I think it helps the discussion. I’m afraid of being exposed for my lack of self-awareness all the time, especially with women. Let’s say you’re chatting up a nice young lady and at some point in the conversation (at least my conversations) she says, “You don’t know how you’re coming off do you?” To which I say, “No, no I don’t. Please, enlighten, hold on, let me order another round.” It’s a typical Friday night for me Batsey, so I’m not afraid to admit it.

Sinead – I hold no assumptions about you just as I hold none about anyone else I don’t know personally, except for the one assumption I did mention in my last post. Perhaps I ought to revise that one however.

Once again I do appreciate your thoughts even if they can seem a little abstruse for me, and rather seem to – in a slightly arrogant holier than thou attitude – only draw esoteric circles around the concrete issues I’ve been bringing up instead of addressing them head on.

People on this site on the other hand are certainly not withholden when it comes to flaunting their prejudices about me; for one who has only just recently discovered the site and been commenting – I think in a decent, sober and respectful way – just a short while, I have to admit I find the vitriol pretty overwhelming and distasteful already, although of course I can only blame myself. I knew full well what I was letting myself in for when I stuck my head into the lion’s den. I’m chastized for abusing my patients, although none her really know anything about that, and the abuse I’ve already received here certainly isn’t going to convince me that the ideas being promoted by the site are worth considering in any depth. So perhaps it is already time for me to be on my way.

That’s a great pity really because even though I don’t and will never buy the lock stock and barrell hopelessly unnuanced “Psychiatry is all wrong – dismantle it now” slogan, I am dissatisfied with psychiatry as it is and am on the lookout for credible ideas for reform and alternatives. But I don’t think any longer I’m going to find any here, though actually the reason this blog did interest me (we’ve strayed far from the subject – a bit disrespecfully of the author perhaps?) – was that it was about Open Dialogue, which seems to me to be one of the most promising projects launched in the last quarter century. I have for many years now had a fruitful working co-operation with the Fountain House movement which pre-dates Open Dialogue by more than half a century, and like Open Dialogue has stood the test of time and achieved impressive results. It is not however and never could be a replacement for mainstream psychiatry, nor has it ever promoted itself as such.

If psychiatry is going to change then people like you and I have to meet somewhere neutral where we can exchange ideas in a slander free zone, and accept that we won’t always agree on everything. You have criticized but not slandered me and I appreciate that. I am pragmatic and doubt if I ever will be absolutist like you, but I imagine we can agree that reducing coercion in psychiatry to the absolute minimum must be a goal we should wholeheartedly commit ourselves to. (which I am already)

Best wishes Colin

Colin-
Thank you for reading my blog. I understand what you are saying. I wanted you to know that there were quite a few people at the conference from Denmark. Perhaps you can connect with them. The meeting is scheduled to be held there in 2014.

Malene,

I believe that your clearly articulated explanation for the behaviors that characterize a locked psychiatric unit bring us back to one fundamental issue or question:

What is *mental illness*?

So long as there are psychiatrists and psychiatric nurses who view *mental illness* as the malady that incapacitates to the extreme opposite end of the spectrum of human traits, it won’t matter how clearly these “professionals'” transgressions are cited, “they” will defend their degradation of the *mentally ill* as the “dirty work” that someone has to do to spare normal people the burden of dealing with them. “They” will insist they are heroes and superior in many ways to those of us who feel compassion and try to empathize from our own humanity.

Unless nurses like Colin change their view of what *mental illness* is, and seriously scrutinize their own aversion to the *mentally ill*, they will not be phased in the least by the harsh admonishments that Colin had already blown off as being “demonized”, which he blows off as an “occupational hazard”.

Colin does not question the propaganda psychiatry has masterfully infused into Western culture and he has not found cause to ponder the implications of his failure to do so. Laziness, apathy, or cowardice– any or all of these accounts for merely accepting the teachings of psychiatry. But only if one can become blind and deaf to the pain and the needs of the “patients’ themselves, is it possible for a nurse or a doctor to continue on rationalizing their inhumane posturing against the human rights of the *mentally ill*. This is a deadly combination– blind allegiance to unproven doctrines and lack of empathy for those entrusted to your care.

I have not responded to criticize your beautifully written admonishment of mercy. I am sharing what I am reminded of whenever I unlock the doors of any one of the three units I now work on; it is this:

There is a fine line separating the mental incapacitation of the patients and the staff. If not for the power wielded by the staff , both groups would find common ground and infinitely expand each other’s humanity. The power is based on an evil, erroneous doctrine. When that has been exposed and then disposed of, we can get about the task of becoming fully human. And, the term *mentally ill* will fall out of our consciousness. Without the evil doctrine, it, the term *mentally ill* has NO power, and no meaning.

Malene – I liked you when I read your previous post but that was one of the most violent and hateful things anyone has ever said to me. Shame on you.

Colin,

I simply reflected the violence you described right back at you. You didnt like the mirror I held up?

There are a lot of people on this site who have been the victims of abuse at hospital locked wards, and we generally have very little respect for those who wants to perpetuate the violence.

Now, I get it. You have no comprehension that what you represent is wrong. You are arrogantly certain of yourself that you are doing nothing wrong. You have never stopped to truly, genuinely consider how many people find their personhood, their sense of self destroyed on your locked ward.

Your lack of awareness does not excuse the daily engagement in violence that you so easily describe. Your description of a “non-dramatic” altercation where someone is forced to acquiesce based on a superior show of force made me nauseated in it’s inherent violence. You described it as non-dramatic. I saw deep violence – the kind of violence that destroys a persons sense of self. I was further horrified by the fact that you didnt even consider the harm such a use of force would cause.

So, no, I feel no shame for holding up the mirror for you. The aggression that is cruel and unusual is the one you have described engaging in. The fact that you have gotten to the place where you take it for granted is horrifying.

I love the Danish common sense, but i am also aware that DK have a few stains on their conscience. The ease with which they discriminate against foreigners is one such stain. Clearly, the way locked psychiatric units functions is another.

I doubt you will find anyone here sympathetic to your point of view though. If you want people clapping their cute little hands at your ability to handle all these terrible patients you might want to reconsider if this is the place for you.

Malene

Sinead,

I love your writing and your insight. You have so much more patience than I do. You also have an ability to simultaneously express your disgust with violence in psychiatry without letting your anger in the way. I admire that.

Malene

Malene – it’s a distorted mirror you hold up. I neither like nor am proud of having to use restraint, and usually feel that I’m lacking something when my communication skills fail to resolve a situation in a more professionally satisfactory way. But coercion is there on a daily basis in lieu of the fact that the door is nearly always locked, and sometimes it’s locked because a judge has ordered it to be locked, so it’s not as if I have any influence whatever over the situation. The only thing I can do is quit the job, (which I’m not going to do) but if I and all my colleagues did that, where would the patients be then? Are you and all your likeminded ready and willing with your alternative to take over and assume responsibility? I seriously doubt you have anything near the competence needed.

I can reassure you that had you been in DK when you were in distress, and admitted to my department it would have been on a voluntary basis only, if indeed you had been admitted at all. At most you would have been offered (not forced to take) an Oxapax (benzo) and 100 – 200 mg Seroquel, daily within the first 72 hours. Unless your condition deteriorated you would almost certainly have been quickly discharged, perhaps even the next day. Grade 3 close observation probably would not have been instigated at all and grade 2 would most likely have been concluded within the first four hours. We would have taken contact to and consulted your relatives only to the extent you yourself gave consent. Only in the event that you attacked a member of staff or another patient, started vandalizing the surroundings, set fire to something, abused the telephone to ring false alarms or terrorize persons known or otherwise, repeatedly ignored the smoking restrictions, or seriously threatened to harm yourself would you have been subject to any restraint, and the restraint employed would be considered and measured to meet just the need and avoid excess. (It would by no means automatically involve harnesses and syringes, but but even minor restrictions would give you the right to consult a patient counsellor and lodge an appeal to the patient complaints body.) The door to the outside world would be opened to you as soon as we could ascertain the risk of doing so was defendably low. At any time we would attempt to meet your needs for contact and communication, although we might discourage long drawn out nocturnal discussions which could mean you were deprived of sleep, which we regard as an important healing factor.

That’s how the Danish common sense would have reacted to a case like yours; like you I’m a subscriber and find it hard to see how it could be much more reasonable. You might find this hard to believe but sometimes we have to use coercion to get people out of the place, who no longer really need us, but would prefer to stay longer.

Colin,

You claim that you have been unfairly judged, although the only thing you have been judged based on is what you have told us yourself. The violence you have described engaging in at a Danish locked unit is horrifying to many of us. A number of us here have walked away from locked wards feeling deeply scarred from the experience. In my case – I have described it as being “kicked while I was down”.

I will never, ever forgive them as they stood in a circle, giving me an ultimatum that terrified, humiliated, and dehumanized me out of my mind. It is 6 years ago, and I can still start to shake in terror when I remember that moment. it took a few years to move out of the thinking that i deserved the cruelty perpetrated by “psychiatric nurses”, now, I am just angry. You don’t like the anger? It is an anger that was started by nurses who felt justified in using non-dramatic coercion.

The anger you hear from me is the anger of someone whose sense of self was hurt doing exactly the type of “non-dramatic” coercion you referred to. Now, I tell you point blank i was damaged in that interaction. You can choose to invalidate that story, I am sure you have a vested interest in not hearing about the damage. But let me be clear, I am sure that by far most of the people you have used “non-dramatic” coercion with feel deeply violated, just as I did. This is not to mention the violation of those you have to physically subdue – I am sure their experience of violation is comparable to rape.

Now, I would like you to consider for just 2 minutes the pain of each of those people. Pain that you took part in perpetrating.

You come in to this site defending “treatments” that do more harm than good. Then you claim that no one else can do it as well as what you do. And then you get surprised when someone gets pissed at hearing the arrogance.

If you truly want to learn something better then I suggest you work hard to learn non-violent ways to interact with your patients, instead of defending the violence. There are quite a few options on the market today that does not propose to work through violence.

As far as the treatment protocol that you outlined for me, I highly doubt I would have been hospitalized in DK. If I had been, there would have been no financial reward in trying to keep me, and I would have been released fairly soon, as you mentioned. I believe that prescribing seroquel to me was then and remains now deeply irresponsible. I have several very high risk factors for diabetes already. Seroquel for any amount of time would almost guarantee that I got diabetes. That is irresponsible to prescribe based on a one time emotional breakdown – even if that break down is extreme. Have an emotional break down – go to the hospital and add diabetes to the mix – not right. Now, the doctors failed to inform me of the risk of diabetes as they prescribed several medications that would easily cause it. They prescribed the medications knowing of the risk factors I had for diabetes.

I could maybe imagine a benzo and an ssri, given that I have zero history of substance dependency.

Ultimately, I needed a bit of kindness and some understanding that I had just experienced something I was not equipped to handle. Nothing more and nothing less. I didn’t need the dehumanization. I didnt need the coercion. I didnt need the fear tactics. I didnt need the medications. I needed one human being to sit down next to me and express kindness. Not one single person in the 72 hours I was there had the inclination to offer that kindness. They had time for coercion. They had time to force horrific amounts of medications down my throat, they did not have even 30 minutes for kindness.

So, really Colin, consider the violation of your “non-dramatic coercion”. Consider how many people still start to tear up 5 or 10 years after you have used it and forgotten all about it – because for you, hey, its just in a days work. For the people you did it too, it is a horrific violation of personhood.

Malene

“Not one single person in the 72 hours I was there had the inclination to offer that kindness. They had time for coercion. They had time to force horrific amounts of medications down my throat, they did not have even 30 minutes for kindness. ”

Sheesh! OK Malene that makes me angry too. I’m stumped. Don’t know what to say other than that I don’t believe it would have happened to you in DK. If it did I’d have been there protesting with you. I apologize on behalf of my profession.

I think the risk of diabetes with taking 4 -500 mg Seroquel over three days is effectively zero, but in any case as I say, no-one here would have forced you to take it anyway.

“If you truly want to learn something better then I suggest you work hard to learn non-violent ways to interact with your patients, instead of defending the violence. ”

I couldn’t agree more and of course I already have worked hard at learning non confrontational conflict management. 99 times out of a hundred I succeed too, there’s just the odd occasion when no-one seems to have the skill to solve a problem without the use of force. When I mention that coercion is a daily affair on my department I don’t mean that there are violent episodes every day, where we force medicin down people’s throats and strap them to beds. I just mean that the door is locked for a proportion of the patients who have been sectioned under psykiatriloven and this is something we always have to keep in mind even though everything is peaceful on the department. Sometimes six months goes by without a single case of belt restraint, and the average number of days in total annually, adding together all days for all patients using this form of restraint is about 25. Every kind of coercion used is registered and submitted to a national board for review and statistical analysis. This year for some reason has been a bit of a freak year where the number of belt days already is up over 80. But our ambition is always to reduce this number.

Stephen,

Although my ‘people’ (the nurses) were the ones who rained on your parade, I relate so strongly to the spiritual experience you were part of and, as a matter of fact, some of “my people” rained on a few of my parades as well. So, here we are “us v them” representatives, but clearly on the same side of what is humanistic and the same team regarding what is therapeutic!

I imagine from your perspectives, having experienced coercion and restraint from ‘both sides, now” you would be the perfect witness, embedded reporter, to uncover the effects of creating a *culture* of coercion and force. The *enforcers* seem pretty clueless regarding their role in permeating the environment with vibes that are triggering for most everyone who would be detained in this *culture of coercion and force*.

During some restraint trainings, staff are asked to volunteer to be restrained — to have the experience, and thus develop some sensitivity to the traumatic effects of the restraint. Ideally, ALL staff should have this experience, and especially those who are identified as frequently involved in restraints. I would like to go a step further, in terms of sensitivity training fro staff on locked units ; like to admit all staff TO a locked unit for 72 hours! I suspect there would be a shift in terms of understanding WHO is evoking the fear responses that most often lead to restraint. Perhaps there may even be a serious movement to rid our society of these ‘cages’?

My Buddhist practice, Nichiren buddhism, has been the guiding light for my professional development. I met the woman who introduced me to this practice at the center where I was catapulted into psychiatric nursing. It has often occurred to me, believing in Buddhist doctrines that discount the possibility of random, accidental coincidences, that my bodhisattva practice is being the wacko nurse who maintains hope at the epicenter of human darkness.

Congratulations on your victory. I know only too well how difficult it is to present a convincing ethical argument to management staff & administrators on a locked unit. The problem seems to be one of inability to get the basic “first do no harm” principle and apply it universally ! The ‘us v. them’ mentality, I contend was created by and is perpetuated by psychiatry’s experts. AND, still “they” wonder why anyone would turn on or against them??

If you are in the market for a low key, under the radar spiritual experience, I have a suggestion. I have initiated a “1,000 Crane” project on both the adult and adolescent units where I work. I am providing the origami paper and the direct, demonstration instruction for folding cranes. I ask the participants to put their initials on the underside of one of the wings. After the 1,000 crane is folded ALL participants will get their “wish”… according to my broader definition of this Japanese custom. I make the mobiles and have to hang them inside the nursing station, but they are visible from the unit. Of course, the 1,000 may not be reached before some participants are discharged, BUT I remind them all that WE share equally in the victory that each of us has contributed to.

Folding origami cranes is also my *coping skill*. I will fold them and give them out sitting in the community area of the unit whenever there just seems to be no way to escape the *insanity* of the staff.

Shhh-h-h… when you want to have the most profound effect on those around you…be very, very quiet!!

xo,
:-0

Sinead

Hi David,

Here it is:

“There is no illness to treat. So let’s get that out of the way”

That is the PERFECT thesis statement for the dialogue/debate!!! THANK YOU!

David Bates is looking for the proponents of “mental disease” and their allies to step into the ring, or up to the plate AND tease out the underpinnings for this *theory-belief-model*

Actually this could be an invitation to open dialogue practice for our reporter from the front lines of this model, and/or Colin the psychiatric nurse who ventured in here due to his curiosity about open dialogue!!

Or, it could be that I want to see this happen? want to see the theory of open dialogue come to life!

If wishes were horses….??

Thanks D.R. for the perfect beginning to a thrilling adventure!!

and… Thanks David Bates for indulging me!
xo,
Sinead “Gabor”(?)

Hi David:)) As you say;

“Now how exactly are those people going to truly have a constructive debate here? I’m not saying it’s impossible, but I think it’s far more likely that people become upset and the exchanges aren’t helpful.”

Is there a basic-assumption in this view that the internet platform works with the same proximity of face to face dialogue?

IMO This platform provides a mechanism of distance from the “visceral” impact of face to face confrontation, with “time” and staying in the conversation, providing an opportunity for the kind of “open” dialogue which is very difficult in close proximity, on such highly charged emotional issues.

The difficulty lies in the emotional energy required to keep a conversation going over time, when natural arousal cycles will dilute interest, and the unconscious needs of established homeostatic responses will impose a tried and tested *expectation,* like our assumptions that highly charged emotional issues are best avoided, to maintain a comfortable status-qua.

IMO There is enough experience within the community to tease out the *functional* realities which keep us all stuck in a preference for intellectual posturing and self-preservation needs, as we *project* the system within onto the so-called system, of the world out there.

IMO Its not the world out there which needs re-organizing, like rearranging the deck chairs on the titanic, its a more fundamental reorganizing of the world within, with realization of what we are, not who we are?

In this 21st century A.D. are these old-world dependencies of a projected attachment need, “as if my father is in heaven,” really going to meet the challenge of global warming? Are we or are not part of a global community now?

I don’t expect the conversations to take place anytime soon, as the physiological agenda of self-preservation need, maintains a typical group hierarchy of intellectual assumptions, which are prompted more unconsciously than the majority wish to explore.

In the meantime I’ll keep trying to point out the difference between intellectual assumptions and actual function, as we scan comments looking for emotive resources to fuel our projection needs?

Warm regards,

David.

I wonder, Colin, if you practice any medical or surgical specialties in nursing after graduation? Or did you go straight to psychiatry?

Above you said that you have made no assumptions about me, but yet I detected your view of my posts as “holier than thou and self-righteous’ before you made a passing, casual reference to my tone? I have worked with so may nurses who sought to “train” out of the very aspects of my basic nature and character that have allowed me to connect with ‘patients’ and see them through to recovery ( from the trauma of psychiatric treatment ). At the very least, I remain a pacifist who is routinely under the microscope by fellow nurses, who see me as either a freak or a traitor.) You seem to fit into that group of critics, though you are using the very best internet/on-line form etiquette!

If your interest in open dialogue is as sincere as you have stated, then I welcome you to what IT is. Fully engaging with other human beings is key, and if you are defensive and self absorbed, as would be the case when you are prepared to exit when unpleasant things are said to you or about you, well then, you’ve missed the point. Open dialogue is not a conversation that you entertain based on your personal preferences, but the SPACE between human beings that can be filled with new understandings for all invested in the goal of reaching them. So, it is about transcending the small, ego-bound self, and going through the fire, so to speak to reach a goal that will expand your life. IF you are not able to believe and respect another’s perception— even if the perception is of you, then you will not get the benefit of participating in open dialogue.

I think many psychiatric professionals are viewing “open dialogue” as a new technique they can master and add to their “tool kits”. When engaged with “patients” using their new technique, they will maintain their professional boundaries and sense of themselves as expert authority. This is always a risk— and I think it comes from the adherence to the doctrines that define *mental illness* and view “patients” as a problem to solve using that model. You should read the recovery stories on this site to assist you in the discovery of mental/emotional/spiritual wellness — the possibilities when the biomedical model of psychiatry is obliterated. Pow!! then, WOW!!

I view Buddhism as a philosophy based on teachings that do not stray from natural laws, common sense and everyday experience. Buddhism describes life itself and the living beings who share the experience due to their causal relationships with each other. The difficulty many Westerners have with Buddhist concepts are due mostly to the lacking in a hierarchy or ranking of superior/inferior amongst us, and that living in a web of interconnectedness, we cannot take any action that does not simultaneously effect ourselves. The implications of “self harm” resound in every act of coercion, force, violence and killing, the ultimate grave offense that taints one’s own life throughout future existences. Buddhism holds the highest regard for the dignity and the sanctity of life— the essence we each share. So, those who have many prejudices and “reasons” for actions that violate the dignity or the rights of others , will struggle through many agonizing ordeals in order to free themselves from these delusions. That is to say; Buddhism is not a romanticized world view, it is a practice for purifying and perfecting one’s life. I practice Nichiren Buddhism, based on the Lotus Sutra.
If you are so inclined, you can investigate this practice, which is the means for comprehending difficult to believe and understand doctrines.

I asked about your resume in nursing, because I believe that unless you have had years of experience learning what it means to put your ‘feelings’ and personal comfort aside in order to care for critically, or seriously ill people, you can’t see how ‘by the book’ psychiatric nursing is the antithesis of nursing practice itself. I continue to be shocked by the degree to which psychiatric nurses defer or default to their comfort level and artfully employ “psychobabble” to justify what can only be called, failure to perceive the basic human needs in their patients. Psychiatric nurses are the WORST nurses. They give NURSING a bad name, IMO. Why? Because they are about upholding the *doctrine* at the expense of the patient– and there is no parallel to this mindset in any other specialty of nursing! I still wonder how a nurse can buy into interventions that disconnect them from the feelings thoughts and wishes of their patients. Psychiatric nurses pride themselves on having achieved this disconnect. Psych nurses call it, ” maintaining professional boundaries” and claim it is ‘therapeutic”. Well that is only possible IF they totally tune out the patient’s response!! And they do, right? It is the “behavior” they want to see,; what THEY have decided is BEST for the patient that drives your separating yourself from the hard to miss suffering this disconnect causes your patient! IF the patient complies and behaves as you wish, THEN you may connect— just a little, but never in a personal way!!

I wince when I hear you describe your practice. I feel queasy because it does not resonate with the Florence Nightingale oath or even the code of ethics nurses are bound by (at least in the U.S.) — it does not reflect attention to Maslow’s -BASIC human needs model; IT does not focus on what you give of yourself to patients, but what you take from patients.
Psychiatric nurses give “drugs”; enforce “rules” and enforce consequences, all the while robbing their patient’s of their individuality, their inherent unique dignity. THIS is not what I had in mind when i went into nursing. IT is not what I believe nursing education/training is about— and I make it a point to BE a REAL nurse in every psychiatric setting I walk into!

I have practiced in psychiatric settings for 24 years and medical/surgical adult and pediatric settings for 14 years. I am guessing that I am your senior in terms of years of nursing experience? If not, then,Ii am not admonishing you as a senior nurse, but as a colleague who values the art of nursing practice and “first do no harm” applies to us- RNs in spades!!

Hint: IF you discount the voice of your patient when he/she says you are causing harm, you are not practicing nursing, IMO. Since the doctrines of psychiatry grant you permission to do this; and tell you that the voice of the patient IS the disease… you have become all the more disconnected from your patients, and all the more adept in carrying out interventions that any REAL nurse would question, or like me, out right refuse to carry out!!

I could assemble a team to relieve you and your colleagues of duty in your “hospital” (using the term loosley)– the condition would be that you NOT intervene or interfere when we start doing the *impossible* !!!

Sinead – yes I think you’re right that psychiatric nursing is not “real” nursing á la Florence. It’s more of an art really, and being artful probably isn’t too wild an exaggeration, which isn’t to say it’s about being dishonest. You certainly have to give a lot of yourself IMO to do it well, but in an artful way where humour, compassion and empathy aren’t necessarily worn on the sleeve and trumpeted about, but nevetheless are in place, and allowed to shine through naturally in whatever way the developing relation between nurse and patient allows, to lighten burdens and lend authenticity, without compromising professionalism. As you yourself have discovered connecting with patients is what it’s all about, but if the connection occurs completely on the patient’s terms then you really haven’t done him any good as a rule and may even have done harm.

Maslow and basic needs are all given proper attention in my experience. Perhaps I’m just lucky to be on an excellent department. In DK psychiatric nurses learn to equate the psychodynamics of relations with treatment possibilities, and use the relationship to confer ego support. For me the great attraction and why I love psychiatric nursing is the paradoxes it throws up, and that I have to relearn my psychical juggling skills every day, because there’s always something new. So in that way yes, I do truly get a lot of personal satisfaction out of it, and it’s not as if I “take something” from the patients in doing so. On the contrary I would say it’s greatly to the benefit of my patients that I take something from the relationship too, because that gives authenticity, and offers precisely the opportunity to prepare oneself for the real world of real relations.

I daresay you could relieve me and my colleagues. It wouldn’t be too difficult. The thing is the first day when you unlocked the door you would lose the first six patients and the next six would soon apply for discharge or transfer when they found out they weren’t going to get any medicine. So I guess the remaining four wouldn’t be too much of a handful. I don’t know what you’d do when an alarm sounded for aid on another department, (we don’t have any ‘security’ we manage these things ourselves) but as you say that wouldn’t be for me to interfere with.

Hi Colin, you say its a well reasoned reaction to my comment above, as you type;

“Good ol’ Freud! Haven’t heard from him for a while. Does this have anything to do with The Battle of the Trees?”

Yet you don’t seem to address me at all, as you project this emotional association?

No comment about my introduction to the poem and my thoughts about the parental nature of society, or what I’m trying to suggest with this?

Please tell other readers, what you expected to communicate with this response, other than your internal emotional-intellectual state? As you say;

“I’ve no idea why Bradshaw and Booth might try to synthesize these two things since there’s no obvious connection.”

Perhaps because they didn’t Colin, and your emotive associations and reaction, was simply the need, of an unconscious emotional projection? A need to feel proud of your own functioning?

Hence, no real attempt at perceiving my intentions or initiating a real conversation? Are you sure, you managed to stand back far enough, as you highlighted the emotive associations in your second response here?

In previous threads I’ve pointed out how we *scan,* rather than read and digest, looking for emotional resources to fuel our unconscious projection needs, suggesting this happens unconsciously, at the millisecond speeds of auto nervous system reaction. Perhaps you can give a “well considered reaction nonetheless,” to these thoughts?

Best wishes

David.

Sorry to barge in, but there are no reply buttons for Colin’s last response to me.

Hello again, Colin,

I , too, admire Dr. Freud. I particularly admire hm for coming out of the closet with all of the strange paradoxes he discovered in his own psyche. I trust you have a copy of his “Basic Writings”? The best explanation for your affinity for psychiatry and your love of psychiatric nursing are to be found in this excellent work by Dr, Freud 🙂 Coming out of the closet is a thrilling adventure, IMO. I hope you choose the adventure!

I wonder why you equate connecting with and respecting the individual who has lost all rights to his/her autonomy (my practice) as a non-therapeutic relationship due to its being on “the patient’s own terms”? (your conclusion) These are MY terms, Colin, based on my own standards and values. You see, I could not possibly know if or how I was violating another person’s innate sense of himself if I had no real sense of who he is. It sounds to me as though you operate on many assumptions about a *patient*. Is that based on the presenting symptoms of a specific psychiatric disorder? Or is it simply based on your own beliefs of what would be best for a patient acting in a certain way? I will challenge you a bit on your subtle assertion of authority.

What sort of information do you gather from your professional stance that leads you to believe you are well versed on the best approach with a patient? Do you realize that the degree to which you separate yourself from another human being effects the other’s level of comfort in expressing himself to you? (The greater the distance, the less security, ergo, paucity of content, sorry to say)

Perhaps you have never considered how you might be more of a director than a facilitator of healing? The messages you send out resemble those of an emotionally distant parent. Clearly the rewards for compliance are to be found in your approval, but your approval is ‘professionally derived’ so it does little to support the ego of the person. It does develop the ego identity of a patient, which is more or less the goal of psychiatry. Your professional boundaries make it so! Tell me when you are not helping the person to know there is a difference between “the patient’ and ‘the nurse”?

I can’t help thinking that you need to be in a position of authority and control. You can’t possibly know what my ‘team’ and I would do as the new staff on your unit, because you have no experience with a paradigm that does not focus on differentiating the nurse and patient into separate roles, that are far from equal! YET, there you go telling me what will happen and what I won’t be able to count on for support! I get the sense you did so with alacrity, which is fine, except you really don’t have a clue about the changes in dynamics that would occur when “authority over and control of people” are not the impetus for interactions. If you could realize that you know nothing about my practice, then you would be naturally curious about my approach to relieving you and your staff of duty. No curiosity? More evidence then, of your claiming to know what you cannot possibly know. This is the consistency of your practice, I’m afraid.

Although you did not directly answer my question about having (at least 5 years) experience in medical/surgical nursing, I think I can safely infer that you went straight into psychiatry. Again, I wonder if you can appreciate the significance of what you do not know? The thing is, I am very well versed in the theory and practice of psychiatric nursing, and have heard many of the same reasons for ‘loving it’ that you shared. Obviously this all works well for you. but there is a huge deficit on the patient end of the story. The conclusion matches the error in your premise. I hope you will read a few of the stories on this site that come from the people who are fully functioning and contributing to society BECAUSE they were able to heal from the traumatizing effects of psychiatric treatment!

And, Colin, after you have read at least one of these stories, I challenge you to share from your casebook. I’d like to hear about a full recovery from severe mental illness a la Colin’s artistry as a psychiatric nurse. In the end, results are everything!

Cheers!
Sinead

Colin,

I see you are still holding true to your perception of your disocourse on “our differences” as nurses on locked units?
You did write:
” Sinead – I hold no assumptions about you just as I hold none about anyone else…”

But the I revisit this blog and read you ‘last’ comment:
.
” Classically, Sinead is obviously more comfortable with the maternal, whilst I tend to gravitate towards the paternal.”

Not for the sake of argument, but purely for clarity, I must correct your ‘latest; assumption. My practice is based on 24 years of both education and experience in psychiatric nursing. My conclusions include disbelief in the basis for psychiatric diagnosis, as there is no scientific evidence for it; and opposition to ‘classical’ psychiatric treatment as it is far more harmful than it is ever beneficial. Would you say that my foundation for my practice reflects ‘maternal’ qualities? Are strict, authoritarian control freaks ‘paternal’ by nature? These are the inferences I make from your comment above.

My practice of nursing on locked units is not motivated by a need to nurture and protect people whose freedom has been taken from them. My practice is inspired by the positive outcomes I continually witness, that are the product of connecting with and relating to ‘inmates’ of psychiatry as human beings in distress. Apparently you would view these very people as ‘patients of psychiatry’.

Interesting that you make your claim to understanding Stephen’s preference for a nurse , (Stephen is someone with lived experience on a locked unit); that you analyze and define his choice in such a Patriarchal manner… almost as though you are fully displaying your admiration for Dr. Freud?

Vive le difference!!!