Do Diagnoses Injure People?

Alice Keys, MD
59
126

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

 

 

 

 

 

 

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?

  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

    • 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.

  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?

  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.

  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.

  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.

    • 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.

  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!

  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!

    • 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”.

      • 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?

        • 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.

          • 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

          • “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.

  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