Do Diagnoses Injure People?

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Yes, a psychiatric diagnosis can be a dangerous thing to have. But, these days, so is having any medical diagnosis. The names and words of the diagnoses themselves are not so much to blame for the harm. Rather, the harm comes through the ways the diagnoses are created and how they are used.

The dangers of medical diagnoses:

Hypercholesterolemia:  An overweight but otherwise healthy woman nearly dies from “treatment” with cholesterol lowering drugs (rhabdomyolisis, grand mal seizures, renal failure).

Sleep apnea:  A thin healthy young man is given a diagnosis of sleep apnea. He can no longer access health care. This “pre-existing condition” makes him ineligible for health insurance coverage unless he can find employment with a company that offers group coverage.

Hypertension:  An 89 year old man falls and hits his head on the curb because his blood pressure has been lowered to the newest standards.

A.D.H.D: A girl is not allowed to attend public school unless her mother  gives her pills that make her obese.

Schizophrenia: A woman’s “non-compliance” with prescribed antipsychotics could mean loss of  income, loss of housing and loss of her child into state foster care.

Why diagnose at all?

The process of categorization and naming of medical disorders has historically been used so that doctors could communicate with one another in a kind of verbal shorthand. Making a diagnosis was also done so that specific treatments could be targeted for specific illnesses. If you have a cough, for example, the treatment varies depending on the cause of your cough. If your cough is from a cold, the treatment is very different than if your cough is from lung cancer. Medical diagnosis has also been used to predict possible outcomes. The expected outcome from a cold is different than from lung cancer.

Lawyers and sailors, chefs and software engineers each have their own specialized vocabularies so they don’t have to continually explain everything in minute detail. Tort limits and  starboard, roux and router all impart specialized meanings to those working in their respective fields.

The DSM

When the DSM III was being ushered into existence, I was in training. I questioned what it was good for. We already had the ICD-9 medical billing codes used by the insurance industry and Kraepelin’s diagnostic categories. This seemed enough for me.

When I asked my faculty supervisor about the utility of the DSM III, he explained that it was  a tool designed to be used by researchers. He told me the field of psychiatry was in its infancy with regard to the larger practice of medicine. We had few ideas as to the causes of the extreme states we were seeing. And there was no consistency in diagnosis. One psychiatrist’s diagnosis of schizophrenia was another’s diagnosis of mania.

He told me that we needed a book like the DSM III so that researchers could all be more clear that they were studying the same things. The use of these standard diagnostic formulas, he said, would move psychiatry along in a more scientific manner toward the mainstream of modern medicine.

Making a diagnosis

I was taught that medical diagnosis, including psychiatric diagnosis, is based upon lists of both signs (things the doctor observes and measures) and symptoms (subjective experiences the patient tells the doctor about).

Congestive heart failure, malignant melanoma stage four and  rheumatoid arthritis are all defined by lists of signs and symptoms. The criteria defining each medical diagnosis is generally consistent but can evolve over time as medical information and beliefs change.

The DSM III looked a lot like standard medical diagnostic categories. It contained lists of criteria one could choose among to make each psychiatric diagnosis.

The (essential) history and physical

In medicine, it’s good to know whether the cough you treat is from a cold or lung cancer. The doctor must go beyond the presenting  symptom or complaint (“Doc, I have a cough.”) by way of collecting information through a history and physical. Doctors used to have time to collect enough information to have an idea of the cause (the diagnosis) of the presenting symptom before she would offer treatment.

This process of asking and examining is the same in behavioral, mental and emotional complaints. The person’s complaint (“Doc, I can’t sleep.”) was once clarified by collecting information through the history and physical. Sleep problems can be caused by many things.  They each require different treatments.  A person’s mood complaint (“Doc, I feel depressed.”)  was once thoroughly evaluated in the same way. A feeling described as depression can be caused by many different things.

A subjective symptom is not a diagnosis

Schedules are dictated by the medical services corporation a doctor works for. There’s no time to ask or look or listen. The thorough  history taking and physical examination has been left behind. This is true throughout medicine. These days it’s common for people with sleep complaints to be given sleeping pills, those with coughs to be given cough syrup, people with pain to be given pain relievers and those that report depression to be given antidepressants.

Without a diagnosis, the medical services company that employs the doctor often will not be paid by the insurance company.  If you see a doctor, a diagnosis will be made.

In medical care today, the patient’s spoken complaint (the subjective report of a symptom) is quickly translated into a “diagnosis”. This usually triggers the firing of at least one prescription. Many doctors have been reduced to quick-trigger cowboys, shooting both diagnoses and pills from the hip all day.

Do diagnoses injure people?

A diagnosis is no longer a professional judgment based on collected signs and symptoms used to direct medical advice and care. Without the underlying information and thought necessary to formulate a true diagnosis, it becomes a misleading label without clear meaning or medical utility. Rather than being part of a specialized language to aid in communication, diagnoses have devolved into words used to market pharmaceutical products and segregate health care.

People are being injured by a health care system that segregates access between those that have jobs and those that don’t, those that have a “pre-existing condition” and those that don’t, those that swallow the pills (compliant) and those that do not swallow the pills (non-compliant).

People are injured when diagnostic labels are used to direct prescribing of prescription drugs.

People are injured when diagnostic labels are used to deny basic human rights.

 

Thanks for reading, thinking and writing.

Alice

 

 

 

 

 

 

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59 COMMENTS

  1. “Do Diagnoses Injure People?”

    Yes. They do.

    According to “science” and “psychiatry”, I am a delusional, retarded, borderline, narcissistic, multiple-personality schizophrenic, with post traumatic stress disorder, permanent psychosis and bi-polar / depression, who also happens to be both homicidal and suicidal.

    Have you helped or hurt me?

    Report comment

        • Insanity is a sexual disease.

          Consistent sexual obsession
          Intrusive, distracting sexual thoughts and feelings
          Hyper-arousal
          Inappropriate sexualizing of people and non-sexual things
          Sexual abuse
          Inappropriate partners
          Profanity
          Perversion
          Lack of Hygiene

          I’m sure the list of aspects is much longer than what I can produce.

          There is a certain knowingness – If I tried to tell myself that I was not insane, I know I would be lying. I am not a sexually healthy person. I am very sick. I know this for a fact.

          It is not my WILL to be insane. It is the consequential result of sexual abuse.

          Report comment

    • MJK,

      Thanks for reading my post and writing back. I appreciate your willingness to share so openly here.

      Wow. What a collection. How is it possible that these are all accurate medical diagnoses based on careful examinations?

      I’m sorry you’ve been hurt by this pack of words. To throw this many labels at a single individual demonstrates my point. The words that are being tossed around by psychiatry today as if they are medical diagnoses are not useful for communicating an individual’s situation or useful in planning a course of action. They are being used in other ways.

      For me, psychiatric dianosis has gotten in the way of my work with people. It was something I worked around and tolerated and kept to a minimum. In order that a person can access their insurance benefits, a diagnosis is required. In my private practice, I worked together with individuals to determine what we both thought would be an accurate (by the official lists) and the least damaging label to use to bill insurance. There were times that these discussions lead people to skip the diagnosis and skip the insurance payments.

      The way these words are used hurts people. I think we agree here.

      I suppose your final question is meant to be rhetorical and aimed from you to the “you” of the larger psychiatric community you’ve had contact with. I won’t address it personally.

      All the best.
      Alice

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      • I have a friend who has had nine diagnosis. He used psychiatric services for seven years with no improvement. Now he is doing quite well, but not due the psychiatry.

        All those DSM diagnosis and five types of drugs (major tranquilliser minor tranquilliser, anti-depressant, mood-stabiliser).

        Psychiatry – my diagnosis – Pants, possibly, Big Pants.

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        • John,

          I’m glad to hear your friend is doing well. Nine diagnoses and five drugs for seven years with no improvement. That’s an indictment of the treatment he recieved.

          Sorry. I don’t follow that last line.

          “Psychiatry – my diagnosis – Pants, possibly, Big Pants.”

          Perhaps a British turn of phrase or I’m completely out of the reality loop (possible).

          All the best.

          Alice

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          • Pants – a word that has become popular in the last decade or so in the UK. It means something like – Rubbish – but also contains the idea of the ridiculous or the ridiculously stupid and perhaps gobsmackingly unbelievable that anyone should take this idea seriously.

            My friend is fairly typical of many day centre users I know, they cycle from barely coping to having a crisis, which is when there medication regime is upped and perhaps they go into hospital. Now he has a bicycle mending business, is studying for an open university degree and works an afternoon a week as a peer supporter. I like to think that is largely due to the time I put in offering understanding and support for about nine months (about 2 – 16 hours a week, which is a lot, but I’m glad I did it. Now I hardly see him and he continues to grow and thrive).

            I like your analysis in this series of articles. I’m looking forward to reading more.

            Report comment

          • John,

            “Pants”. I like it. “gobsmackingly unbelievable that anyone should take this idea seriously” What a way with words you have. I may have to steal this phrase with regard to having a diagnosis if your grief runs beyond two weeks.

            The human relationship is the most powerful healing tool I know. I’d like to think it was the time you put in with him as well. It supports my belief.

            Thanks for your support of my writing here. I enjoy your commentary and your point of view from the other side of the big pond.

            The discussion helps keep the ideas percolating

            Alice

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      • ” To throw this many labels at a single individual demonstrates my point.”

        Exactly.

        I call it “the evolution of a diagnosis”.

        My first diagnosis came at about 14 years old. “Depression”, it was.

        By 16 years old, after two hospitalizations, I had acquired “Post Traumatic Stress Disorder” and “Borderline Personality Disorder”.

        By 32 years old, and 7 hospitalizations, I had acquired “paranoid”, “psychotic”, “psychosis”, “Bi-Polar”, “Cluster B Personality Disorders” and two evaluations for homicidal feelings.

        That is where I drew the line and said ENOUGH and NO MORE, with psychiatry. Took almost 20 years to realize, without a doubt, that I was actually NOT being “helped”, at all. Psychiatric pills were a certain toxicity, in my experience of them, and so I was finally, fully defeated.

        Multiple-personality and schizophrenia are not “legally” or “officially” diagnosed, that I am aware of. However, there are too many features of both of these conditions that I actually do qualify for – such as hearing thoughts that are not mine, psychic visions and “spiritual manifestations” (the physical presence of non-human beings). I could go on at great length but won’t.

        Spiritually speaking, I question and debate if I am a “medium” who “channels” the spirits (minds) of other people. It is possible that I have the gift of mimicry and that it isn’t a disease or disorder. I often speak in voices that are not mine, and they confuse me.

        There is no doubt that I am a mental, emotional, spiritual / psychological “mess”. I often consider myself to be a “walking, talking train wreck”.

        Psychiatric diagnoses are highly questionable when using Knowledge Base from a SPIRITUAL perspective. It is possible that my shift to “spiritual” in the past 4 or 5 years has actually caused more complexity. In that case, I do not doubt that I might qualify for even MORE “diagnosis”.

        You are correct – my use of the word “you” is meant for the “world-at-large”. It makes me glad that you knew that.

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          • “shift to a spiritual perspective”

            gno·sis
            n.
            Intuitive apprehension of spiritual truths, an esoteric form of knowledge sought by the Gnostics.

            gnosis
            n pl -ses
            (Christianity / Ecclesiastical Terms) supposedly revealed knowledge of various spiritual truths, esp that said to have been possessed by ancient Gnostics

            gnosis
            a superior form of wisdom, as that of the Gnostics, supposed to have been acquired mystically. See also mysticism.
            See also: Wisdom

            http://www.thefreedictionary.com/diagnosis

            Psyche by definition means Spirit.

            Science and Government are married as intimate lovers. There will be no divorce.

            I am quite fond of PARA-PSYCHOLOGY, since it seems to be the only thing in the world right now that makes an attempt to know the Spiritual, “scientifically”.

            par·a·psy·chol·o·gy
            n.
            The study of the evidence for psychological phenomena, such as telepathy, clairvoyance, and psychokinesis, that are inexplicable by science.

            As someone who is a Living Witness to satan in it’s physical form – satan being “the god of insanity” (sexual immorality) and “the god of this world” – psychiatry, psychology and government each and all have absolutely NOTHING to say to me. Or about me. They do not have the ability (which strips them of any perceived “right”) to judge me.

            Satan is NOT a fabrication, hallucination or creation of HUMAN BEINGS. It is a genuine entity that does exist. Because I am a Living Witness, what does that say or mean then, about ME, and “who I really am”?

            I have my very own garden story (and a lot of other stories, too). Who knows, I might be Eve in the flesh.

            WHO am I, “really”?

            We’ve gotta SAVE SOME SOULS, man.

            Psychiatry can’t do that. It DOESN’T do that. It does the opposite; it condemns souls.

            Psychology / psychiatry use a different language, different words, for SPIRIT and for SOUL.

            When we use certain, specific words – the MIND shifts and so do the vision and the view. The “perspective”.

            It sure is a war – for minds, for souls. Information war. Psych war. Mind war. Spiritual war.

            I come from Everett, which is a small city that borderlines Boston. EVE-rett is where satan physically presented itself to me. I was kinder-GARDEN age.

            Eve in the Garden …
            Eve in the Garden …
            Eve in the Garden …

            And my grandparents are Mary and Joseph.

            LOL

            Hilarious.

            And here I sit, in “Bethel” – which is a BIBLICAL name, not scientific or psychological. It means “the house of god” and “the house where god lives”.

            LMAO

            I have NO IDEA who the Hell I am. Nobody does, because whatever they think or believe is not correct and not true.

            I DO know that I’m not nearly as “stupid” (mental assault) or “crazy” (mental attack) or “retarded” (mental abuse) as all the Hellions would like for me to believe about myself.

            My life has been Hell on Earth. I’m looking for that “EDEN” and I’ve figured out exactly what “eden” IS.

            I figure out all sorts of things, with my hour-glass FIGURE and my twisted-tick-talking biological CLOCK.

            Do dia-gnosis injure people?

            Does GNOSIS injure people?

            Some things, we do not know we do not want to know.

            Some things, we are better off blissfully ignorant.

            How did Missy feel, when satan sat there and THEIR EYES MET?

            NOBODY WANTS TO KNOW.

            I once read, “a child becomes the first thing it sees”. OH, jesus “fkn” christ. Just added an extra Hell-dimension to my mind, no-thank-you very much. I DON’T want to “see” myself as that THING.!

            Here’s another feature of INSANITY:

            I have an apple in the refrigerator. Due to societal and cultural abuse, I am going to “see” that apple as a child or a vagina, and have a sexual experience while eating a simple “god-damned” piece of “fcking” fruit.

            Don’t even get me started about COOKIES.

            In addition to all my other CRIPPLING “diagnosis”, I might also have a severe EATING DISORDER.

            One of MANY reasons why I suffered REAL starvation was because of how defiled food is, and I didn’t want to eat metaphors. Mark tried to feed me ONIONS, many times, and I don’t know what METAPHOR he was trying to FEED ME.

            If I’m “crazy” at all, I’m crazy for everything the world has put into my head and having a gigantic big mouth, by which to TELL THE TRUTH.

            I’m not so “open” because I “want” to be. I am stripped of my everything and I am pried into, pried wide open.

            I “make a “federal case” out of everything” and my “mental case” is NEVER CLOSED.

            Do you swear (yes)
            To tell the truth (sure)
            The whole truth (absolutely)
            And nothing but the truth (uh-huh)

            Such a good, obedient, compliant little girl (it’s a sexual thing).

            I “scream”, endlessly. There is no comforting and no consoling me. There is no “helping”, “recovering” or “fixing” me.

            There is no “diagnosing” of me. NOBODY HAS THAT ABILITY.

            You know Claudia, in that movie Interview With a Vampire? She CAN’T GROW. She is an “eternal child”.

            THAT is how I see myself.

            Now let’s ignore all pain and bad memory, all trouble and all problem …

            Split me open, let’s sing and dance. Let’s rip my heart out, and eat it.

            http://youtu.be/iRYDUFuKzgs

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  2. mkj,

    The labels are harmful, no two ways about it. But psychiatry no longer has the power to define you, right? You are a mother, a poet, an activist, and a friend.

    We know better now than to accept those labels as anything more than a subjective snapshot. We’ve lived to tell the tale!

    Emily

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    • Thank you for your positivity, Emily. Positivity is an energy and perspective that I seem to completely lack.

      I used to be a mother. I’m not anymore.

      In order to “rescue” and “free” my soul from psychiatry, it cost me my kids (which I knew would be the case).

      Court order: follow doctor recommendations to take psyche drugs and be hospitalized long-term, or my rights would be terminated and I would never see my kids again.

      I said goodbye to my kids.

      My parental rights were terminated. I have not seen my two daughters for over three years.

      My motherhood has been a brutality that NO human being would ever envy.

      OH WELL.

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      • Ahh, my friend mjk, you are right. I do not envy your current situation of losing your daughters. It is a terrible, terrible thing. I’m very sorry. But I do admire you. You are smart and kind and my world is a better place with you in it. I regret my time in psychiatry, but one of the good things about it is that it brought me to MIA. From the sorrows and tribulations of our lives, promising and hopeful events do arise. I have confidence that you will find your faith again, in your own time.

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  3. Yes to all the above, but the names of the diagnoses themselves are problematic as well. “Post traumatic stress disorder”. “Attention Hyperactive Deficit Disorder. Clearly, these labels are more about psychiatrists than about the people they diagnose. How much does a field that gives people such labels to describe their conditions with actually care about the people they think should carry these labels and identify with them?

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    • WW,
      Thanks for reading and posting here. You’re right. The names of the diagnoses are problmatic as well.

      Changing the names to new names doesn’t always help a great deal either. Thirty-five years ago there was a push to change the diagnosis from Schizophrenia to Bipolar disorder for many patients. The more common diagnosis was schizophrenia. Bipolar disorder was fairly uncommon then. I was told that bipolar disorder was a “more hopeful” diagnosis and we should always start with this one, rather than say “Schizophrenia” when a person first presented.

      Over the years the “popularity” (if I may use this word) of the bipolar diagnosis has skyrocketed with each new drug approved for its treament. This is a case of the diagnosis being sold to sell a drug.

      I have even heard of people being given a psychiatric diagnosis because they took a drug and felt better while taking it. For example: You are have trouble sleeping. You are given a drug that has been marketed for bipolar disorder. While on the drug you sleep better. This means you have bipoar disorder. This is very bad reasoning. One can’t reason backwards from what a drug is marketed for to make a diagnosis. If the drug was originally sold for siezures (drugs marketed for bipolar disorder frequently are), does this mean you have a siezure disorder?

      Psychiatry (and all of medicine) is plagued with this kind of bad reasoning. If an antidepressant makes you feel good, you have depression. If an antianxiety drug makes you feel good, then you have an anxiety disorder. If amphetamines make you feels more focused, then you have A.D.D. Come on. Most anyone feels more focused on a stimulant.

      In my private office, I knew that saying “adjustment disorder with depressed mood” had fewer negative effects to a person’s insurance status. This implies you’re adjusting to a stress that could cause depressive symptoms in anyone. Once you say “Major depression, single episode” you’re on the lookout for recurrance and chronicity. You have a permanent risk mark on you from an insurance perspective.

      There are clinics that cannot get paid for treating anyone with a “lesser” diagnosis. You have to have one of the big Axis I diagnoses for the govermental agency to approve payment. How do you think this effects the diagnosis made at the time of evaluation and intake?

      Thanks for reading and writing.

      All the best.

      Alice

      Report comment

      • Hi from Canada.

        Obviously we have a different ‘funding’ model, but we face common problems.

        I have been assigned many labels and only learned of them through access to information requests. None were ever discussed with me.

        I had 4 appointments with 4 different psychiatrists in less than one year. They all had access to the previous notes and all had different diagnosis. Some very mild, some plain scary – so scary I consulted a private counsellor to find out what it all meant.

        I can, after a long wait, get free access to mental health care, but it is rushed, impersonal, and with no continuity of care. I also cannot shake my record. Every provider (mental health or physical health) gets to have access to these notes. I have no control. I cannot remove the scary diagnosis and am carrying it around like a stain.

        It may interest you to know that even with publicly funded care and meds that our psychiatrists are just as prescription happy as yours 🙂

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  4. I knew that the DSM-5 is off the deep end when they will give you a diagnostic label if you grieve more than two weeks over a major loss in your life. This was the final straw for me because I’m a retired hospital (both psychiatric and medical) and nursing home chaplain. I know about grief, not only because of the people I worked with over the years but from my own personl loss of my mother and sister. My mother took 17 months to die and my sister was murdered in New York City. I know about grief. And what I know is this: no two people deal with grief in the same way or in the same amount of time. We are unique individuals and we deal with grief in our own unique ways. I will not allow any group of smug, self-satisfied, powered and privileged, upper class, white men to dictate what grief is. I will not allow them to pathologize this very personal and unique experience. There is absolutely nothing scientific about the labels in the DSM-5; they were concoted by these delusional men as they washed their hands in the mens’ room. The DSM-5 and all of its diagnostic labels is the highest example of how psychiatry and Big Pharma have gotten into bed with one another. Pseudoscience to the max. Just as grief is unique and individual, so is schizophrenia. There is not one experience of schizophrenia, there are many schizophrenias. Lumping everything together into one pile is not helpful.

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    • Stephen,

      I’m sorry for your losses. I have known people who grieved their whole life from losses as deep as yours. How is this psychopathology? You’re right. Grief is a highly personal process. The DSM 5 allows two weeks for grief? The idea that grief is mandated a problem to be medicated after two weeks is beyond insanity.

      Keep us up on the DSM 5.

      Alice

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  5. Hi Alice, thank you for this wonderful and insightful article. I agree that thoughtless and poorly administered diagnoses are very harmful and dangerous. In general, I gravitate toward the energy and vibration model of health and well being, which basically puts forth that all illness is the result of chronic resistance. What we aim to heal, therefore, is the energy of resistance.

    In resistance, we believe stories outside of our own nature, and we do not believe in our innate power to self-heal. In this model, it is very easy and common to go through illnesses without even being aware of them
they manifest and heal simply by our process. When we are tired, we rest. When we are in pain, we soothe. How we interpret anything that we might call ‘symptoms’ is key to what happens next in the healing process.

    I went from clinical intern (MFT) to mental health system client to spiritual counselor and energy healer. What kept me feeling ill and disabled was first, a diagnosis of chronic illness (proved to be false), and then all of the negative associations made with this. At one point, it caused me to try to take my own life, as I felt I was doomed, from what all the messages coming at me implied or even stated directly. Up to this point, I had tried *everything* imaginable in the field, that I knew of. I was surrounded by mental health people, given that I had just been to graduate school.

    To make a very long story short—learning about energy and spirit, etc., my diagnoses of bipolar and panic disorders became a more accurate and workable ‘diagnoses’ of 1) being ungrounded, 2) adrenal exhaustion and 3) festering heart wounds. Needless to say, all of this did cause my brain a lot of stress and created some temporary distortions in my reality, but that all subsided completely and the amazing information from this period integrated when I learned to ground, which is a matter of practice and having a sense of our connection to earth energy. Among other things, I sought herbs from a qualified herbalist to calm my adrenal glands, and this practically re-built my nervous system, no more fight or flight anything, ever. I can even dance on bridges now, over the highway, whereas before,for years, I couldn’t tolerate going over a bridge in an automobile.

    My heart wounds I healed in many ways, mostly by addressing where they originated and a lot of forgiveness, letting go, etc. Taking responsibility for what it all meant to me and my life. That’s it. After 30 years, all of this is behind me. And that’s specifically because of how I was taught how to re-defined the diagnoses from medical model to energy and vibration. Worked like a miracle.

    Bipolar and panic attacks went away when I called them something else that made sense to me, because it was precise, logical, and there were remedies. From what I understand, these other DSM diagnoses have no remedies. That doesn’t seem natural to me, and therefore, I would deem it harmful—in fact, I go so far as to call it toxic–to push against nature this way. Somehow, it seems betraying to our souls.

    Thank you again. Writing this in response to your article actually gave me a bit more clarity about it all!
    Alex.

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    • Alex,
      Thanks for reading here and taking the time to respond. It means a lot to me to know that people are reading and thinking about what I write. Thank you for this gift.

      I can tell a lot of thoughtful consideration has gone into your remarks. I appreciate the time you took to review your life experiences and get clearer about what worked for you and what didn’t. I’m glad you’ve been able to find your way beyond fear and despair by using your “energy and vibration theory of health and well-being”.

      Thanks for telling about your experiences in the mental health systems. These make a strong contrast with how you transformed your life by looking at your experiences in very different ways and trying new approaches.

      I like “miracle” stories. The world can always use more hope.

      If the ways you’re looking at things and doing things isn’t working for you, try different ways.

      Thanks for reading, thinking and writing.
      All the best.
      Alice

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  6. Random thoughts.

    1. “Disorder” promotes the belief that something is wrong with a person’s brain, when psychiatry has yet to find a persuasive pathophysiology or physical diagnostic test for any mental/emotional/behavioral problem. “Disorder” drives us into the arms of those who argue, without proof, that our problems come from “broken brains.”

    Psychiatry’s rush to “diagnose” and extinguish “symptoms” is like someone who pulls the wires on a smoke detector because it’s interfering with their sleep. Psychiatry doesn’t consider that the detector is functioning just fine, and the “symptom” is not part of a malfunction, but a properly working signal that a serious problem in the environment or in the person’s social history needs addressing.

    Another physical analogy: do we think a ship’s bilge pump kicking on is a “malfunction” or “disorder”? It is working fine and serving an important function. How many “symptoms” and”disorders” are natural human responses to human problems that, if allowed to proceed in the presence of confident caring people, could help to resolve the problem.

    2. “Diagnosis” imposes an illusory certainty on something about which we have almost no clue. We have 100 billion neurons with thousands of potential connections between them; according to a Nobel laureate in medicine, there are more possible different connections between these neurons in our prefrontal cortex alone than there are atoms in the known universe. Our brains have 100 billion glial cells, about which very little is known; we have well over 100 neurotransmitters, and only about six are being researched. And that’s just within one person – when each amazingly complex individual interacts with families, groups, communities, cultures and countries, it is unimaginably complex.

    The certainty of a “diagnosis” is silly in the face of our complexity and what we don;t know. But it isn’t funny when diagnoses are used as the basis of actions that determine life choices of vulnerable people. Check out Paris Williams’ new book, Rethinking Madness – Towards a Paradigm Shift in Our Understanding and Treatment of Psychosis – he argues that “psychosis” is what our minds do to reorganize our psyches to correct desperate problems caused by very bad experiences. He doesn’t nail everything down, but then psychiatry nails very little down, and most of the world listens to psychiatry.

    3) We assume that we must “diagnose” before we can do anything about someone’s mental/emotional/behavioral problem. Open Dialogue, the world’s most successful approach to first episode “psychosis,” doesn’t rely on “diagnosis”. In Open Dialogue, professionals to meet almost daily for the first few weeks, and regularly thereafter, with the “patient” and anyone who is significant in his/her life – they could be family, friends, neighbors, teachers, employers, colleagues, clergy. Everyone, including the “psychotic” patient, is listened to with respect and without interruption or correction. The group is non-hierarchical; professionals do not offer diagnose, but take part as equal listeners and speakers, with the goal of promoting a safe atmosphere where all are taken seriously. Over time, new meanings are developed between the “patient” and his/her social network.

    Sounds totally unscientific, except a 5 year follow up showed about 83% of “patients” without psychotic symptoms, living in the community and working (or actively seeking work) or in school. Only a small percentage ever took neuroleptics , and most of them only short-term.

    So here is a system whose main means of acting doesn’t even require a diagnosis – and it works better than any other. Now add the World Health Organization’s three longitudinal studies over 25 years that found consistently better “schizophrenia” outcomes in “developing” countries. The studies’ final conclusion was that these outcomes were due to complex cultural factors (not diagnosis and treatment by professionals). In fact, the WHO studies may well stand for the idea that the further “patients” were kept from the modern medical model, the better they got.

    4) Until proven otherwise, my money is on this paradigm: our mental problems come from being overwhelmed by negative interactions with other humans, or other kinds of trauma. Generally, we would recover from these (mostly childhood) experiences if we were consistently in the presence of loving, calm and strong people who paid warm attention to us, were not put off by how we look when we are hurting, and could provide sensible structure to keep us and others safe.

    If that is so, the first, most important step for those concerned about someone in emotional pain is not to “diagnose” them, but to be the kind of person they should have been exposed to all along. The psychiatrist/therapist/counselor/social worker/friend/family member needs to be the one who starts that ball rolling and helps others to be there for the “patient” too. The attention, the support and the faith in the suffering person IS the “treatment”.

    The argument that we need “diagnosis” so professionals can communicate with each other, or so they can get paid by insurance companies, is lame. I was a social worker, supervisor and director in a treatment foster care program for 15 years (don’t get me started on the abuse of “medications” to keep those kids quiet). I know it is perfectly possible to describe someone’s problem in common sense terms: “he hears voices that say frightening things to him,” he is desperately sad about the loss of his brother and his inability to see his biological parents,” “he touches people inappropriately, most likely because of sexual mistreatment he received in the past.” And regarding insurance, if there must be a manual, just call it an insurance reimbursement manual; the better route would be just to reform the insurance industry – but we would generally rather mistreat “mental patients” than insist that for-profit industries behave in a rational manner. I am sorry to say that, at the present time, the “mental health system” is also a “for profit industry.”

    People get really hammered and put in untenable binds when they are treated like objects. “Diagnosing” “mental illnesses” is unlike other medical diagnoses in that it is global – it labels the person, not just their pancreas or their ankle. That is like putting the whole person in a petri dish, “observing” them, and then saying what is “wrong” with them. It just adds insult to injury – taking people whose pain comes from having been treated like objects, and “helping” them by treating them like objects again.

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    • Peter, so many truths in your post, as I see them.

      And because of what you say in the last couple of paragraphs, I feel compelled to share that the last clincian I saw in the system did trigger this feeling over and over again for me that I was being ‘observed’ and categorized. I would share with him that I was feeling this, and of course, this was turned into my issue, exclusively (this is how you felt with your family!).

      When I would indicate how his words or delivery made me feel this way–as well as blatantly mythologized and stigmatized, not at all seen as a human spirit, but as a category of disenfranchised–he would argue defensively. I would call him on that, too, that this was not only a complete lack of empathy, but also that there was nothing helpful about it, and in fact, fueled my anger and frustration even further. True, I got that from my family, but my family aren’t trained psychotherapists. I expected better, here.

      I wanted support in my transition, and being on disability, this was what I naively believed was my best option, although it proved to be not only futile, but damaging. Like so many others, I’ve had to heal from post traumatic stress from chronic demeaning responses in a private psychoatherpeutic setting while in a very vulnerable state of mind.

      Finally, I gave up and said to hell with the system, I can do this on my own. But first, I requested my notes from him. Lo and behold, all these trivial details of my private thoughts were written down glaringly to tell the story of some mal-adjusted hot head. Whereas in reality, during my period of disability, I trained as healer, created a healing business, made a film, and have started doing self-healing workshops. My last gig was with Humboldt Co. Dept of Health and Human Services. I tried in San Francisco, but they would not even entertain the notion of someone like me having a say in healing around here. It’s a terribly shut down system. None of my focus, determination and courage were anywhere to be found in my file. Mostly what is implied is that I was ‘hanging on to anger and unable to work because of this.’ I’m not alientated from my community at all, I’m an actor and involved in all sorts of things. Been married 27 years, and my relationship with family is totally fine, no issues at all going on there any longer. But from the looks of my file, you’d think I was some kind of self-imposed outcast and angry rebel. Pure fiction, and incredibly disrespectful to the truth I was speaking in his office. (I’ve learned, don’t cast your pearls before swine).

      I’m deliberating how to best utilize my file as a tool for reform. Not sure yet, but I’m consulting with a few people here about this. Anyway, thanks for sharing these thoughts. I think they’re right on and would like to see us move foward from these harmful and dehumanizing practices. It would be interesting if all clients requested their files and checked out what is being written (and discussed) about them. Now there’s a revolution for ya! Best, Alex.

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      • Alex,
        Yes. If more people requested their own files (It is your right to have them.), folks would be more cautious of the things they said in them and how they said them. These files are passed between providers whenever you sign a “release of information”. They are accessed by any third party payor for care. If you don’t sign a release, they won’t pay.

        All the best.

        Alice

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        • I found it to be necessary to my mental health because I trying to get feedback in person only resulted in hearing how it’s all from my projection, when in reality, my suspicions were confirmed unequivocally. That feels kind of sinister to me. I felt gas-lighted here.

          Plus, it can undermine one’s legal rights. The reason I started the practice of requesting my notes is because several years ago, I filed a grievance of discrimination against the Dept of Rehabilitation with the CA Office of Civil Rights. It was well-founded and quite clear. When they finally responded 6 months later, I got a written response, turning away my grievance because “according to your file…” and the investigator proceeded to list all the reasons why I am not credible, based on what had been notated in my file. They never interviewed me, nor responded to me so that I could not only refute the distortions in my file, but to protest because my grievance was never responded to per se, as the main thing highlighted in the response was the fact that I had these ‘issues with authority’ which made me lack credibility with my grievance. When I turned to advocacy, they claimed that they did not know how to help me with this. This is when I woke up to the extent of this closed system. It is a cartel. Talk about crazy-making and maddening. I think ‘doing more harm than good’ would be an understatement, here. There is a tremendous amount of responsibility how a client is written about–including how they are diagnosed, of course–that others might gain access to. I do not feel it is being met well, and causing mental health issues as well as social problems. I feel it should be common practice for the client to approve of what is written about them, on a regular basis. That way, client and clinician can be on the same page. That would be healing in so many ways.

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          • Alex,
            To have the patient and doctor work together to populate the information of the file is a great idea. Once upon a time, when I had a private practice and still had my own little boat to steer, I did this.

            The first time I came in contact with the medical profession and medical records was when I was in college and accessing the “free” medical-student-run clnic as a poor patient. An unlabeled student doc I’d never met and didn’t expect clumped in, plunked down and, without so much as a howdy or introduction, began grilling me on intensely personal aspects of my life. I was not happy or pleasant with the young woman. The supervising doctor (himself a trainee) came in and caught me reading what the other young ass had written about me in my own record. None of it was pretty. This supervisor snatched my medical record out of my hand and verbally chastised me for reading it and for treating the medical student in a less than polite manner. I lectured him on polite behaviors to supervise his trainee in.

            I can see how easy one may get the medical record reputation of having authority conflicts.

            All the best.

            Alice

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          • Reading your post reminded me of something this is in my file that I actually know about.

            When I was in the state hospital the procedure is that they have to check every half hour during the night and log what the patient is doing, how they’re sleeping, whether they’re awake, etc. Now, if you look like you’re asleep they come into your room and shine a flashlight near you to make sure you’re sleeping. Well, I have trouble sleeping around other people and when I would just get to sleep this one nurse would come in and shine the light in my face! With that kind of treatment you never get any sleep. One night I told her that if she shined her light in my face or the face of my roommate again I was going to get up and moon her. She ran down to the nurses’ station and wrote in my chart that I threatened to beat the s..t out of her. The charge nurse came to ask me why I was threatening her staff. When I asked what she was talking about she stated what the nurse had written in my chart. My roommate, who was awake at the time and heard exactly what I’d told the nurse originally about mooning her spoke up in my defense and quoted me exactly. The charge nurse told him to stay out of it because it was none of his affair. Of course, psych patients can’t be trusted because we always lie you know. I demanded for three days that her comment be removed because it was a blatant lie. They refused. I said that I wanted what I’d actually said entered into the file below her comment. They refused. So, in my record it stands that I threatened a staff person! You can’t win with these people. Now that I work at that same hospital I’m thinking about trying to have my chart opened up again concerning this and see what happens. They will squeal like pigs.

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          • Stephen,

            Back to my premise that professionals should all be very thoughtful, careful and considerate of the records they make. Medical records, psychiatric records, credit records, work performance reviews, police records, school records all (especially in the electronic age) can follow us.

            I wonder if it would be possible to go back and have the record ammended now? I’ve amended charts for people in publicly-funded mental health clinics. For medical-legal reasons, even I (as the doctor) can’t erase or cross out anything I’ve written so as to make it illegible. I was told that files can’t be altered because there is a concern that if the records go to a court of law, it will look like an intentional alteration of the record to cover something up. But it’s possible to enter additional information and corrections as an addendum, even in electronic medical records. The old record stays legibel with a line through and the time and date the change was made is next to it.

            It is also possible that your records have been destroyed already, depending on how long ago it was. Medical records don’t have to kept forever. Depending on the state and the year, there is a finite numer of years after a patient is last seen that records have to be maintained.

            In my private office, I aged out and destroyed medical records in line with the state laws of Oregon at the time. I have had individuals look me up to find out if their old records were discoverable years after the fact. Nope. Without a record I can only reply that I have no record of you.

            You could always check with the medical records department and find out their policies and procedures. Medical records staff are generally helpful.

            ALl the best.

            Alice

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    • Peter,
      Thanks for taking the time to read and especially the time to write here.

      My “random thought” from reading yours:

      The entire medical system is a for-profit “industry”. I cringe when I hear the word “industry” these days. “Prison industry” comes to mind at once to me. Then I have to think about the millions of prisoners we keep locked up as part of a for-profit “industry”.

      Once upon a time, “industry” mean you produced or manufactured a product. What is the “product” in the “insurance industry”, the “health care industry”, the “military-industrial complex”, the “defense industry” and the “prison industry”?

      More to think about.

      Alice

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      • I think the concept of “industrial complex” implies a system where different parts play product, costumer, seller, payor, payee, subject, object, instigator, victim, etc., depending on their relations to the other parts. Part of the literal “complex” is that it is difficult to discern a meta-motive or benefactor, because the pieces function together in a way where there is not a lot of choice to participate in the system or not, and that the pieces only exist as parts of the system and cannot imagine themselves ineligibly in a different context/relation. This is complicated by the resiliency of industrial complexes, as they respond to challenges and challenge by trying to maintain itself, often seamlessly reconfiguring and disciplining the components of the system to stay functioning. There is not all that much agency for individuals or individual parts, because the parts of the system become themselves only as part of the system.

        So your more direct question, “what is the ‘product’ in the…[mental] health care industry,” I think is difficult to answer as such, as there are all sorts of products in transaction as part of the systemic aparatus. I might propose a different question, who/what tends to materially benefit least from the system. While not a great question, I think it does help keep in mind that while all players in the system have limited agency in their participation, some are more exploited and duped for the benefit of others (who rely on that exploitation to stay in business). I think in the mental health industry, patients tend to most meaningfully fit the bill here.

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        • Nathan,
          Thanks for hanging in with our discussion in the comment section.

          I found this part of your comment particularly well stated and in line with my experience as a physician in relationship with the “insurance industry” and “health care industry” over the past twenty-five years.

          “This is complicated by the resiliency of industrial complexes, as they respond to challenges and challenge by trying to maintain itself, often seamlessly reconfiguring and disciplining the components of the system to stay functioning. There is not all that much agency for individuals or individual parts, because the parts of the system become themselves only as part of the system.”

          It has been my experience that, as an indiviual physician, I have been relegated to the position of being an interchangeable cog in a larger machine. There is one role, writing prescriptions, allowed me. The mass of the industry is such that, even when experiencing and expressing concerns about real dangers, I could have no impact on the larger system. No one, including the top managers, CEOs and governemnt funding gatekeepers could shift things either. When I did get someone to talk to me, the answer was “It can’t be changed”.

          Yes. The bottom of the “dupe” pyramid is the patient. But duping travels pretty high in the pyramid and doesn’t seem to thin out until close to the top of the upper management levels. Even those that invest their retirement stocks in nice medical investements are duped. But earnings on your investment makes it easier to turn a blind eye.

          Prisoners are the stock in trade of the prison industrial complex. Those bad people half a planet away and our young soldiers are the “cannon fodder” for the military-industrial complex.

          All the best.

          Alice

          My choices were always only two: play along quietly or go away and be replaced by the newest cog. Guess which ultimately happened?

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  7. Thank you for your article, Alice. Your patients and ex-patients are very lucky people.

    Sometimes when I think back over my experiences (I wrote a book called ‘Surviving Schizophrenia: A Memoir’ which sums them up) I used to wish I’d had more trust in mental health professionals. I think maybe I wouldn’t have had such a bad time in hospital if I’d trusted more (eg. willingly swallowed the pills instead of having to be forcibly medicated).

    Now, however, I see that I am lucky not to have trusted psychiatry, and to have found a way through my problems without it.

    I have found a safe and nurturing environment with my husband and children, and for the last twelves years I have not taken medication and don’t have any symptoms of mental ill health. A psychiatrist recently confirmed though, that in his view I still have ‘schizophrenia’. I don’t see how that can be right in the circumstances…

    But at least my children have not been taken away from me (and won’t be – they are very well looked after and growing into wonderful people). That must be truly awful, and I do sympathise with the lady who commented above. I think things are slightly different in England, certainly the health care system is more equitable. If I was offered a choice between losing my kids and taking pills though, I would take the pills every time (I am not saying this to criticize, although I know it must sound like that – it’s just the only choice I could make. I admire the lady for being strong enough to stand by her principles and I recognise that I am really lucky never to have been put in the position of having to choose).

    Anyway, I have gone off at a tangent. What I originally wanted to say is that I wish all psychiatrists thought the same way as you about diagnosis – and that there was much less reliance on medication, especially long-term use of it.

    Let’s keep on working with ‘Mad in America’ everybody, to change the way the world thinks!

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    • Louise,
      Thanks for your support. “Ex-patients” would be all there is for me right now. I and the American “prescription-pad style” practice of medicine have parted ways for now.

      I, also, would have a hard time making a diagnosis of schizophrenia in the absense of symtoms for 12 years. This is rather like the habit of continuing to say a person is diabetic when they’v lost weight, changed their lifestyle and have normal blood sugars with no medical intervention. But this is done. Or continuing to be labeled as hypertensive with normal blood pressure off medicines. Once you get a diagnosis, it’s yours forever.

      There are no “cures” in Amreican medicine. Everything in maintenance and requires pills.

      Sigh.

      Thanks for reading and writing. Encourage others to do so as well.

      Alice

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  8. And – ‘mjk’ – you still are a mother. One day, when they are old enough, your kids will come back to you of their own accord. Write down what you have written here somewhere safe and permanent, so they can read it and understand why you did what you did. I believe that in time they will be glad that you preserved yourself as a person for their sakes.

    And also – you write well. I would suggest that you try to write down more about what has happened in your life, and what it all means to you. It will help, and you will continue to get stronger. I’m sure of it! (But do try and get some support while you are writing, in case it becomes traumatic to remember and record it at times)

    Sorry for the unsolicited advice!

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    • Sorry appreciated but not necessary – I understand your intent.

      I have “hypergraphia”. My hands are often covered in ink, as if it were blood and I’ve been in a war.

      Beneath my arm, as I’m typing, right now, is a notebook.

      I am fully expressed, emptied out. I am HOLLOW.

      How does psychiatry diagnose a hollow person? They probably don’t.

      What on Earth am I going to do with the mountain of writing that I’ve produced? 5 full boxes now, full of scream-style writing. It is yet ANOTHER problem.

      Now that you know, which of course – you probably didn’t – writing is a serious problems for me.

      “Hypergraphia”. Even writing is a “psychological disorder”.

      I CAN’T win! LOL.

      And my writing is a “spiritual” thing, where I am NOT always the author of what my physical hand writes.

      Consider Neale Donald Walsh, the author of “Conversations with God”.

      My hand wrote this, but I’m not the author:

      Something fake is real
      Something real is fake
      Can you fake the real
      Can you feel the rake?

      When my hand wrote it, I began to feel burning sensations all over my body – but burning sensations is a “sign” or symptom of a “Vitamin B” deficiency. You’ve GOT to be kidding me.

      I write to the point of physical PAIN. My fingers, wrists, arm and shoulder. I rush out to the store, just as they’re about to close, to buy more paper and ink.

      Why am I COMMUNICATING to “the world”?

      WHY.

      Absolutely NOBODY knows the answer. They don’t know why I’m communicating, and they don’t know why I communicate the way I do.

      Nobody asks.

      I’m only one of over 7 billion on this planet. In a word, I am WORTHLESS.

      They don’t even know WHAT I’m communicating, let alone “why”.

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      • I often read your posts while sitting in my office, waiting to be allowed something worthwhile to do. Often, a line of yours stays with me and I take it home and mull it over, gnaw on it, process it; until it pushes me to sit down and write something of my own. But my writing experience is not as painful as yours. Your writing reminds me ot the writing of T.S. Eliot. The Wasteland. He talks about the “mud people” and the dessicated, cracked earth that growns and cries out for water but there is no water to be had. I think he even wrote something about Hollow Man. I selfishly want to tell you to keep writing because some of your images give me pleasure or insight and I value that. Does it bring you any happiness at all, your writing?

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        • Oh Stephen. Thank you for asking after my happiness. Every day I am surprised by the ability to touch one another using words alone. Words are powerful, aren’t they?

          I take great personal joy in my writing. This is the thing (beyond caring for my family) that gives me pleasure and personal meaning. I get up before dawn while it’s quiet every day and write. This process clarifies my thoughts and directs growth and change in my life. I have done this for many years.

          Having gained a small readership here gives me joy as well. I love that people read what I write and then write back to me about it. I can imagine few greater pleasures.

          I’m sorry if so many things I write here are so sad and desolate. I am, by nature, a hopeful, energetic and happy person. I shall attempt at some point to write about the immeasurable joy of life on this planet.

          Thanks so much.
          Alice

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        • Stephen, thank you for your willingness to acknowledge and share with me.

          If there is any worth and value in Me and anything I do, it is vital for me to be aware of it. Otherwise, I remain trapped in extreme negativity.

          For years, I have struggled with hostility and resentment for what I feel is something that has been “put upon me” – and that is the “prescribed belief” that I am to be “in service to Humanity”. It causes me to feel *enslaved*.

          Each day, I wake up with resources that must be spent and managed:

          Consciousness
          Awareness
          Energy
          Time

          Communication seems to be my inclination and primary function.

          I debate the concept of “choice” – “it’s all choice” and everything in my life is a result of “choices” I have made. I have never agreed with that and insist that in many things, I actually do not always have “choice”. I begin to feel like a “thing”, a robot, and “like a puppet” – much too easy to manipulate and control. I’ve learned that Muslims believe women are “toys”, which is exactly how I feel I have been treated (mistreated, abused).

          With more than half of my “life” in “psychiatry” and “the system”, this is what I have to “work with” and all of the “issues” that drove me onto that “path” (the “psycho-path”).

          I have exited “the system” – the cost, enormous – yet with only about 4 years out, I am still having to process the 20 years of my spent life. My daughters being in foster homes means, to me, that *i* am still in foster homes. There is not much “choice”.

          In most ways, no – writing is no pleasure or joy. But per your request, I will share a piece of writing. It is a “letter” I wrote to “psychiatry” in Winter 2007 – homeless, in my van, in a parking lot.

          Little miss tag along, one of many stories.
          Million faces to show them how I felt,
          always out of place.

          I was the one
          the target
          So easy to abuse
          There was no guidance
          no protection
          nobody ever asked what was wrong.

          Then the family changed.
          And again, and again, and again and again
          until finally I could no longer keep it in.

          The secrets began to creep
          through the surface where they had always lived
          And the shit hit the fan.

          My life was delivered to me
          one fateful night
          unable to protect myself
          not because I didn’t know how
          but because I was never allowed.

          Spiral down, down, down…
          CRASH. BREAK. All those years of pain
          rained a flood in a moment.
          And I had to face it all
          all over again

          Pin it all on me, shape me, mold me
          into someone small like you
          Because you’re afraid to go where I go
          And your solution was to drug me up
          Drug me, Drag me
          finally, no longer kicking and screaming.

          Quiet it, the alarm
          because we don’t know what to do
          ignore it, it will go away
          tomorrow’s another day
          Distract, forget
          Distract, forget
          moving on

          but the wounds don’t heal that way
          and time will never be a cure
          Never again will I step through
          your door
          of deceitful “HELP”
          because I’ve learned all too well…

          you’re terrified of the living hell
          that swells
          it’s crowning, about to be born
          there is no abort
          there is no drug to kill any part of it

          you were part of it’s creation
          all those years you lied it away
          tried to hide it away
          all the while it grew
          with your fertilizers of denial
          and chemical remedies

          Are you ready?

          I wrote constantly while in my van. I did extensive, intense “work”. I got to a point, in writing, in processing – that pushed me far over the edge.

          “now I live in car with kitty” was the last line I wrote, before crashing my van and setting myself and all of my writing on fire.

          When I was a young child, I was playing on a pay phone. A man approached me. “Do you want to see my kittens? They’re in my car. Do you want to see them?” YEAH! I went over to the car and looked, but there weren’t any kittens. “They’re at my house, do you want to see my kittens?” YEAH! I got into the car.

          I was 31 years old when I found myself alone, in a brand new state, homeless. My kids had been taken from me. I placed my cat in a “foster home” but later went and picked her up, rationalizing that if I could be homeless and living in my van, so could she. She was my only source of love and comfort. She kept me warm at night, laid out across my belly, where we slept together in the backseat of my van.

          In my processing and writing, I realized that my childhood trauma of “getting into a car with kittens” had RE-MANIFESTED itself into another reality, where I was then living in a vehicle with a cat.

          Sophie did not survive the fire. She was trapped in the van and she died. I went to a psyche hospital for a month.

          The crash and burn happened on my daughter’s 11th birthday.

          I finally realized that *I* was the kitten in the man’s car that day. A “sex kitten”.

          Despite having talked about it, it was NEVER acknowledged by ANY “professional” – not foster parent or therapist or social worker or doctor.

          I had to do all “work”, for myself and by myself.

          Today, I know I am insane. The extent of the consequence of not only multiple traumas but absolute IGNORANCE of my needs has created a MONSTROSITY inside of me.

          Fury is a level of Hell that I know too well.

          I am the one who burns.

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          • Thank you for gifting me with a piece of your powerful writing. I’ve saved it onto my computer.

            I don’t know what to say. I’ve sat for a while now, staring at the monitor and trying to put something into words. It will not be adequate but I will try. I don’t feel that you are insane. Your experience parallels very closely what my roommate also experienced growing up. He too was molested and when he tried to get help no one would listen to him. He is filled with a rage that almost goes beyond understanding. We met as patients on the same unit in the hospital and have known one another for almost four years now. Watching him struggle with everything is heart wrenching in every way, and all I can do is be here as “witness” and to listen when he chooses to share something about his life. I am privileged to be his “witness” and the “Keeper of the Door” and I see, little by little, some growth towards wholeness and well being. It’s a constant battle but he’s starting to win. So, in some small way, I know a little about your pain and some of your almost overwhelming struggles. And I believe that you also will win the healing and well being that you so just deserve. I just wish that finding it could be easier for you and my roommate.

            I also understand how overwhelming the loss of Sophie is for you. I had a female Siamese who shared all 20 years of her life with me. Mai Ling gifted me with her constant love, total acceptance, and her sense of humor. She never once gave a flip about how weird I was or how dorky and she didn’t care about labels. I didn’t “own” her and she wasn’t a pet; she was a life companion and a little person in a fur coat. I will always love and remember Mai Ling. I sense that Sophie was this for you.

            I suspect that your writing, as painful as it is, has value that goes farther than you see. It’s not only a testimonial to your endurance and strength; it is something that speaks to others and which teaches in so many ways. Perhaps you’re driven to write, not only for yourself, but for all the rest of us who need something to latch onto during the times and experiences that strive to overwhelm us. We all come here to MIA to sit at the feet of one another to learn valuable lessons.

            So, once again I thank you deeply for the gift of your writing. I am going to share it with my roommate. And I mourn your loss of Sophie.

            Stephen

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          • “choice”.

            I don’t have “choice”. I don’t have RIGHTS.

            This damned psychiatric BRAINWASH is still dominating and controlling my life – and I DON’T have “choice” about it.

            People *believe* in this so-called “mental illness” so strongly that it seems absolutely impossible to ever undo the damage.

            I have yet another situation that I have NO CHOICE and NO control over. It is another situation where I would need “help” – support and assistance – to DO something, and get something done.

            I suppose I’ll forever have no control over my own life. No control and no choices. NO right, to my own life.

            I call that CONDEMNED.

            Do diagnosis injure people?

            They DESTROY people.

            They CONDEMN.

            Hopeless.

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  9. Alice, your post is moving and informative as always. I totally agree with the parallels between the psych world and regular doctors – all have moved away from history and causation into a focus on immediate symptom reduction through prescriptions, and it serves us poorly. It was noted in the JAMA in the last several years that receiving medical care was the third leading cause of death in the USA, mostly from prescription side effects.

    But I do think there is something more heinous about psychiatric diagnosis. Because of its subjectivity, there’s no way to dispute someone’s “professional opinion” by seeing the x-ray or test results. Additionally, the “treatment” is in most cases the very opposite of what might actually be helpful. I am actually less concerned about the drug effects (which are VERY concerning!) than I am about the message that people get when we dispense the label.

    First, it tells them that their emotional response to the world is WRONG. They SHOULD apparently be feeling happy and contented with things as they are, even if they’re in foster care or in a domestic abuse relationship or have recently lost their mom or can’t make enough money to pay the bills. (But don’t get TOO happy – then you’re MANIC!)

    The second message is that YOU CAN’T DO ANYTHING ABOUT IT. If you know you are feeling depressed because your relationship with your husband is destructive, that gives you options. But if you’re depressed because your brain is broken, you are powerless. In my experience, depression is often a result of a loss of a sense of agency or control over life’s experiences – feeling trapped or hopelessly committed to a destructive course of action. Telling a person they have no power to change their emotional state by changing their views or their relationships or their world in some way reinforces the depressing thoughts they already have.

    Finally, the medical model holds out hope that their magical pills will make everything all better. As all of us know, this is at best misleading and can be deadly in the long run, or sometimes even the short run. People will wait months and years for their doctor to come up with the right combination of drugs to make everything OK, and meanwhile, their lives pass them by and they feel more and more hopeless about their existence.

    Healing (in my experience) has generally come from three things: VALIDATION of the depressing/confusing/scary/infuriating contditons; EMPOWERMENT of the suffering person to do something about it; and SUPPORT for creative approaches that the person decides to try, whether those are physiological (improved sleep, exercise, thyroid treatment, energy medicine), psychological (therapy, self-help, support groups, role-playing, etc.), social (new activities, friendships, ending destructive relationships, renewing past successful endeavors), or spiritual (meditation, religious practices, exploration of the meaning of “hallucinations,” protest movements, writing, art, and many more).

    All of these things help the person feel more in control of their lives. Psychiatry as generally practiced helps people feel less in control. It also denies the social realities that cause emotional distress, including poverty, racisim, sexism, warfare, global corporate domination, and the general commercial stupidity of our current way of living. The labels place all the cause of distress on the person’s malfunctioning brain. It’s not just destructive – it is absolutely the WORST thing you could do to a person who is suffering mental or emotional distress!

    But I guess it makes money for people, so we should just be OK with it. I’m getting depressed and angry just writing this…

    Thanks again, Alice – you’re awesome!

    —- Steve

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    • Steve,

      Thanks for reading and writing. Every time I log on to MIA and look through the comments, I am amazed all over again at the depth of wisdom I read.

      I smiled a lot when I read this. You sound so much like the inside of my own head and how I think about things that I feel like I know you from somewhere. I can only say that I wish I’d written what you just wrote here. You spell things out so clearly and concisely. Very nice.

      Your experiences with what healing takes is exactly what mine were during the ancient days of yore when I still was allowed to practice psychotherapy as part of my professional work. Even before I knew of the serious medical side effects of psychiatric drugs, I was still reluctant to hand them out. Once I gave a person that first prescription, they stopped working for change and growth. They went into “waiting for the meds to kick in” mode. If they felt better on drugs, then there’s no need to grow or change. Then when “the meds pooped out” we’d have to “try” other drugs.

      There is something very dis-empowering about handing over the locus of control for your happiness to a bottle of pills. If not this one, then perhaps the next, or the next, or the next.

      Thanks for checking in with us.

      All the best.

      Alice

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