We Have a Dream:
Getting Engaged to a Doctor

David Healy, MD
60
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Still, you take the medication as prescribed. At first

you imagine your body may adjust or the pills

will come to understand you. It is no use.

From Virginia Chase Sutton: Lithium and the Absence of Desire.

Patient engagement

Patient engagement is one of the mantras of current healthcare improvement efforts. Medical students and junior doctors likely think they are doing it better than their elders ever did. They are after all taught communication skills, where an earlier generation wasn’t. In fact, they are taught that they are being taught communication skills. They are taught how to communicate bad news. They are not taught how to hear awkward or bad news.

The younger generation are almost certainly worse than former generations of doctors at listening for or actually hearing “the treatment you put me on, doctor, has made me worse”.

There are two ways in which doctors have a problem when it comes to adverse events. One is that it is now clear that ever better communications skills, in the sense of friendliness and superficial approachability, will increase the likelihood of trapping patients in a Stockholm syndrome so that they are unable to report adverse events to their doctor.

Doctors, caught in their own Stockholm syndrome, and faced with an industry that is friendlier than and understands them better than ever before, are themselves ever less likely to report adverse events to companies and their unwillingness to report makes it ever harder for them the pick up on hints their patients may offer. There are no training modules within medicine that teach medical students or junior doctors about Stockholm syndrome. There are no courses showing medical students or junior doctors how industry markets to them by encouraging them to stick to the practice of evidence-based medicine.

Against this background, treatment-related adverse events have become the fourth or perhaps the third (depending on the study you go by) or even the leading cause of death if we extrapolate from hospital settings to what might be happening in community settings.

The situation has echoes of the joke about the Black Man thrown out of a Church in the American South in the 1960s. Sitting in the dust he asks God how many hundred years will it take till he and his kin gain entrance. A voice from Heaven says My son, I’ve been trying to get in there for 2000 years.

This is where the rubber hits the road when it comes to engagement. Part of the problem is doctors are inured to the legal, financial and political implications of what they do. We make a virtue of being value neutral when it comes to treating men injured in combat or women with an incomplete abortion. But now when Churches are scared of pharma (see Fn 1), there is a greater need than ever for the kind of moral courage it once took to stand up to governments and treat enemy combatants or to stand up to churches and treat women, we seem to have lost that kind of courage.

Aside from the loss of courage, we miss how political the simple things we do can be and how our position overwhelms basic humanity.

Take Sylvia for instance who has just been put on doxycycline and become suicidal. She has a real dilemma. Let’s say she works in the mental health field. Does she report this problem to her doctor? The first problem is even if she does work in the system, for her like others entering his consulting room, she is rather like a mouse confronting a cat. He may smile and swish his tail, but still…

It’s like a prisoner confronting a warden. Caught in the zeitgeist, warders like junior doctors are no doubt trained in communication skills these days. They may chat about football results but all the power is on one side. If Sylvia goes to her doctor and he enters into her medical notes that she has been suicidal, this might compromise her future employment prospects. If she wants to work with children in the future, her medical records will be scrutinized and if this comes to light her job prospects may be gone – perhaps without her ever knowing why.

If she tries to engage her doctor on the possibility that this is an adverse event, we find out what patient engagement really means. She is the person who has been through the experience. She may be pretty confident in her judgement. The problem came on after she started the drug and cleared once it stopped.

But he has never seen this before – or perhaps seen but never noticed it before, or had it mentioned to him but never registered it before. And he has 12 years of medical training and many more years of practice. He may look at the datasheet on doxycycline, perhaps even check out some internet sources. He will not find anyone saying doxycycline causes suicide – unless he stumbles onto the RxISK site.

This is a moment of great drama. Sylvia will feel every minute of it, but her doctor will likely not be aware of anything. Unless he enters into the medical record, a clear statement that this might be an adverse event, Sylvia is at risk of legal, financial, insurance and other consequences of an entry that designates her as suicidal – i.e. she has a medical condition- rather than as the victim of a treatment related event.

He will be scared to take her side. He may not think he’s scared. This is the lack of fear that walks on by because others have looked at the issue and if drug companies, regulators and other doctors have not found that doxycycline causes suicide who am I to engage with this unclean woman. Unclean –anything as strange as suicidality will make someone as unclean as any Samaritan woman might have once seemed.

What does Sylvia do next?

The first message is this. Any Sylvia or Sylvain bringing an adverse event to their doctor should do so in the form of a RxISK report. You should hand in the RxISK report first before trying to talk about it. If you talk first and your doctor dismisses you, it will then be difficult to bring the RxISK report up.

But presenting an RxISK report and perhaps indicating this has been sent to the regulator – FDA, HealthCanada, MHRA, EMA, TGA, CARM – puts the interaction on an entirely different footing. Your doctor is now faced with the fact that there is a record of a possible adverse event and if he pays no heed to it and things go wrong he is in a less secure position than he would be in if he records that you became suicidal rather than you had an adverse event.

The more standing up for yourself like this feels like violence or disruptive, the more you are getting to grips with the violence that the system is doing to you. The more awkward it feels, the more you are testing whether lip service to patient engagement is just another way to trick patients into doing as they are told – unless of course your doctor proposes engagement.

If he doesn’t propose, how it works out in practice is that smiling sweetly he will double Sylvia’s dose or recommend something else. Smiling equally sweetly, she will say “of course”, will leave and will not take it.

Patient non-compliance is the drapetomania of the 21st century (Fn 2).

We have a Dream that one day people will rise up and live out the true meaning of this creed: “we hold these truths to be self-evident: that all men are created equal”.

Engagement is traditionally the first step to an enduring relationship. Does our relationship with our doctor amount to anything? Is it worth fighting for? If worth fighting for, getting a RxISK report on the record offers a Rosa Parks refusal to give up our seat on the bus moment. Everyone who takes a report to a doctor can help establish whether the affable person they are dealing with is in fact able to engage with them. If a doctor is unwilling to accept a RxISK report and put it on their record, your life may not be safe in their hands.

It would be fatal to overlook the urgency of the moment. RxISK repeatedly gets asked whether we know a doctor who lives in someone’s area who takes treatment induced problems seriously. Getting doctors to accept and complete RxISK reports would help all of us generate a HeatMap showing where the eligible doctors are. If we can seize the moment, the others will die out.

________________________________________________________

Footnotes

  1. I have recently been disinvited from a Catholic Church linked meeting on psychotropic drugs and children apparently for using an analogy between child abuse in the Church and pharmacotherapy abuse in clinical care.
  2. Drapetomania was the DSM (-1) name given to the illness that caused slaves to run away from their masters.

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60 COMMENTS

  1. Stockholm sydrome I think is evident in many places, I have seen female professors, come in with a sexual superiority motif and no class, and make fun of other women, while the males are left in silence, and everyone stares in this creepy way at the professor that must have the class run their way, and everyone leaves thinking the professor is still worth their money, and they start learning how to flash their tits to the class. So I think when we try to finally distinguish people’s thoughts of good, from anglo education, in other words, when we end ethnocentrism, than even dosed, they would have a much harder time, believing a smooth talker. For instance, my boss, is really snivelly and thin, he must be a greedy scrooge at the bank, this theif is young and attractive, think all the harm that must be being done to him. what is the good isn’t suppose to be embodied.

  2. What Dr Healy is saying is that there is a lack of an effective feedback mechanism in modern medicine. He sees RxISK as a possible corrective.

    I have two questions:

    1 A mulitnational corporations main aim is to maximise profits. It would therefore be in the companies interest to ensure negative feedback on products are kept to a minimum. So how much did the drug companies ensure that there is no effective feedback mechanism so that the negative effects of thier products are ignored or downgraded?

    Has Dr Healy already answered this question in his posts? Do I need to go back and read them to answer my question?

    2 What mechanisms could be developed that ensure that the causes of mental distress (those that get diagnosed as mental illness) are fed back to policy makers, service providers and society as a whole?

    Some people think that the function of psychiatry is to obfuscate the reasons for mental distress so that society as a whole and the ruling class in perticular do not have to take responsability for the extreme distress society causes a number of people.

    Richard Bentall has done research where he asked people with diagnosis of schizophrenia about their life experiences and then did some statistical analysis on the results. They showed a high level of psychological trauma in these peoples lives. Truama such as surviving child sexual assault, early loss of a parent, surviing racism, and bullying at school.

    In my conversations with service users I have repeatedly found people talking to me about such trauma, often this has been the first time the person has told anyone. Even if they have discussed this they have not told any service provider, as the service providers mainly give off the message that they are not interested. In one case a service provider was told of the person truamatic past, the service provider said that this was the disease talking. The whole way services are set up tends to militate against people talking about the causes of their distress, or if they do that they are taken seriouly or that it is dealt with in sufficient depth. I see few attempts to collect any data on causes or analyse it or feed it back into serice design or social policy.

    I have come to believe that two core functions of psychiatry are to be the drug delivery mechanism for drug companies and to cover up the real causes of mental distress.

    So what mechanism could a service user use to enable their feedback on whether the service provider was interested in the cuase of thier distress be feedback into the system?

    You may not like this term service user. I’m not sure I do, especially if the argument I have set out, that two core functions of psychiatry are to prescribe drugs for drug companies and to hide the causes of mental distress, is ture. If this is true then service users might be better described as service victims, or to use the slightly unfashionable term, survivors of psychiatry, or more accurately survivors of psychiatric abuse. Though the term survivors of psychiatric abuse raises the question of what proportion are survivors of abuse and how many had a useful and decent service?

    • John, I’m sure trauma plays an important role. So many service users talked to me about trauma, even when we know each other for a couple of minutes. Often they don’t talk about the trauma directly, but most of the time I find it obvious that they haven’t (fully) recovered from the traumatic experience from the past. I never had the impression that this is stuff they just invented because of their “mental illness”.

    • John Hoggett opens his comment by explaining, “What Dr Healy is saying is that there is a lack of an effective feedback mechanism in modern medicine. He sees RxISK as a possible corrective.”

      John,

      You’ve offered a great comment. (To be clear, please know, as I say that, I am reffering to your *entire* comment on June 11, 2013 at 3:05 am, above.)

      This comment of mine focuses on your first sentence only (which, as you can see, I’ve placed in quotes).

      Presuming that’s an accurate summation of Dr. Healy’s blog post, which you’ve offered (admittedly, I have not read his post, and it’s possible I will not do so, because I find his writing to be exceedingly predictable, repetitive and self-promotional), I feel it’s necessary to, once again, point out (for the benefit of any MIA readers who may be unaware), that:

      Dr. Healy’s RxISK is all about pharmaceuticals; it offers no way for anyone to report on the effects of that other perennial favorite, psychiatric ‘medical treatment’ — ECT.

      And, as it happens, he is an avid promoter of electroconvulsive therapy (so-called) — ECT.

      He is notorious for blaming psychopharmaceuticals for all kinds of negative effects whilst claiming that ECT is perfectly safe (or nearly so).

      He refuse to acknowledge that his specialty (ECT) causes virtually any long-term harm, ever.

      Really, I would not trust David Healy to collect feedback, on ECT — as I am aware of how he typically refuses to acknowledge “service users'” complaints about it.

      Why are his views even taken seriously, by anyone who knows this pattern, of his? I honestly don’t know.

      He is so heavily invested in ECT (considering his book, which promotes it as a panacea – and considering he runs an ECT clinic).

      I do *not* trust his collection of data, on pharmaceutical drug effects… for these reasons.

      When assessing the relative legitimacy of “researchers” (such as Healy) who profit from criticizing psychopharmaceuticals, I consider a clear recognition of their activities in all areas of ‘medicine’ to be essential.

      We should not, for a moment, forget that Healy is, first and foremost, passionately, a true-believing shock doctor. To him, ECT is the Way, the Truth and the Light.

      In my humble opinion, RxISK (which only seeks to gather info on psychopharmaceutical effect) is worthless — as there is *way* too much conflict of interest driving its founder (Healy).

      (Really, I can only shake my head, wondering why anyone takes his ‘research’ seriously.)

      To conclude, I emphasize: Though I know you’ve not touched on anything that I’ve just said, that is a truly excellent comment, which you offered; I agree with it entirely.

      Thank you for offering it…

      Respectfully,

      ~Jonah

      • P.S. —

        Also (now considering the full gist of your comment), it is important to remember, that, like most psychiatrists, Healy is, himself, of the belief that so-called “psychotic disorders” absolutely require psychiatric ‘medical treatment’ — meaning, in his view, requiring ECT and/or psychopharmaceuticals, at the very least.

        (Though he critiques Big Pharma and ostensibly aims to expose all ills created by psychopharmaceuticals, no one should be mistakenly led to believe that he broadly condemns psychopharmaceuticals. Surely, he has his own favorite ‘go-to’ drugs.)

        Meanwhile, it is well-known that Healy refuses to acknowledge “consumer” complaints about ECT, typically blaming post-ECT, long-term memory loss and cognitive deficits on psychopharmaceuticals.

        So, he is (wittingly or unwittingly) stripping many of his ECT “consumers” of their ability to clearly recognize their own histories of having been — quite possibly — seriously abused, neglected, etc..

        This is to say (emphatically): ECT is well-known (at least, amongst those who have experienced it) to cause large chunks of ones past to become, quite basically, irretrievable; but, Healy flat-out refuses to acknowledge this.

        And, so, Healy is (at *least* as much as any other psychiatrist – and, probably more than most) supporting precisely that system, which you describe, when you say, “I have come to believe that two core functions of psychiatry are to be the drug delivery mechanism for drug companies and to cover up the real causes of mental distress,” except that his “cover up” is delivered, not only in the form of psych-drugs, but also (very, very much so) in the form of ECT.

        I.e., you have referred (quite rightly, I feel) to the “cover up,” that’s all too real; just, let’s not forget how promotion of ECT is part and parcel of that cover up.

        Respectfully, ~J.

        • Dr Healy is a strong criic of drug companies and their propaganda. He gets a lot of media attention. He strongly challenges the assumptions of the way psychiatric drugs are prescribed, perticularly anti-depressents. My impression is that he uses less drugs than most in his clinic. This in itself is not sufficient to endorse him as a clinicion but does mean that his position is not that of mainstream psychiatry.

          RxISC is not about all of medicine, it is not about surgery or physiotherpy for example. It is about drugs.

          His analysis of drug company practice, those of regulators and other relevent bodies are relevent to anyone who wants to limit the way psychiatric drugs are used. They might also serve as an illustration of how any multi-national could capture regulatory bodies and in other way influence both consumers and government.

          I do not see him as someone with whom I am in total agreement with. I havent read his views on ECT, they never appear on this site. If they are as you say they are I’m glad you and others continue to raise this issue. I have campaigned against ECT myself – I helped a survivor get their story in a national newspaer in the UK.

          However I’m not convince that throwing the baby out with the bath water is the best way to proceede. I can see why others might. The slogan, “No Platform for Fascists,” or, “No platform for Racists,” are quite common these days on left leaning and liberal bodies. So a, “No platform for ECT proponents,” seems a valid position and one well worth debating. However to say that Dr Healy’s position on ECT makes the rest of his work invalid I find *******? (I’m tempted to say stupid, but it’s too blanket a word).

          I’m all for people entering into a debate with the readers of this site and the people running the site on the legitimacy of having Healy on here due to his ECT stance. I’m also all for people finding ways to undermine Healy’s stance on ECT but I also think that will involve more than repeatedly bringing the issue up here. It’s a side debate though and would need to be conducted somewhere else. I quite like strategy discussions, so if you want to do that please invite me along.

          If you think that Dr Healy is too tainted by his promotion of ECT to run RxISC then maybe you could suggest this to the other people involved? To me RxISC seems a valid tool for undermining the power of the drug compaines.

          I am aware of Healy’s promotion of ECT from comments on this site and from other people who talk to me about it. I haven’t seen it in the UK media. His criticism of the Big Pharma does get a lot of UK media coverage.

          I think criticising Healy’s promotion of ECT is fine. But to then criticise his analysis of drug company illigitimate influence needs to be done on the quality of his work not the quality of his writing (though sometimes I would appreciate a little bit more clarity and less opaque metaphours) or his promotion of ECT seems a little ***** (I’m tempted to use the word, silly, but it seems too vaugue).

          To conclude, I don’t see Dr Healy as a core ally in the sturggle for the state to provide proper care for those experienceing mental distress but I do see his work on the dangers of psychiatric drugs, his analysis of the subterfuge of drug comapnies and his analysis of the way the medical system has captitulated to drug company power all useful ways of undermining the power of some of those institutions I oppose.

          If I want a freindly psychiatrist I’d go to the Critical Psychiatry Network. If I want to get information to undermine drug companies and those who promote psychiatric drugs I’d go to Healy amongst others.

          • I can see what you’re saying John, use the work that’s good, and his SSRI work for example is good, I’ll hand it over to anyone thinking about taking them and say read this first.
            I don’t support the use of ECT and holding him to account on that is perfectly legitimate, but I think – I dunno maybe it’s a British thing -some of us will use work which helps our cause even if we cringe at other things a person does. It comes down to this – there are very few professionals we could hold up and say yep this person represents 100% of what I believe in.
            I’ve worked with people where it’s been a 80/20% difference but I’ll grab that 20% common ground if it helps us.

        • Interesting comment on cover-up’s and mechanism’s, Jonah;

          “And, so, Healy is (at *least* as much as any other psychiatrist – and, probably more than most) supporting precisely that system, which you describe, when you say, “I have come to believe that two core functions of psychiatry are to be the drug delivery mechanism for drug companies and to cover up the real causes of mental distress,” except that his “cover up” is delivered, not only in the form of psych-drugs, but also (very, very much so) in the form of ECT.”

          Can you describe the internal mechanisms of your own experience of distress?

          Do we collude with a ubiquitous public cover-up, in our “objective” and rational discussion here?

          Why do we never talk about the fluid emotional reactivity of the lived-moment, preferring to appear, cool, calm and collected? Should we spend more time talking about the sensations of madness, rather than helping the mainstream project its need to treat us like objects, to be pitied?

          Should we be focused on “treatment” or actual experience? How many of us, pause to feel our own mechanism of projected needs, to see others as pitiful?

          Consider some wisdom about a paternalism mechanism in societal function, and why “the more things change, the more they…….”

          “The societal projection process: The family projection process is as vigorous in society as it is in the family. The essential ingredients are anxiety and three people. Two people get together and enhance their functioning at the expense of a third, the “scapegoated” one. Social scientists use the word scapegoat , I prefer the term “projection process,” to indicate a reciprocal process in which the twosome can force the third into submission, or the process is more mutual, or the third can force the other two to treat him as inferior.

          The biggest group of societal scapegoats are the hundreds of thousands of mental patients in institutions. People can be held there against their wishes, or stay voluntarily, or they can force society to keep them there as objects of pity. All society gains something from the benevolent posture to this segment of people. A fair percentage of people are too impaired to ever exist outside the institution where they will remain for life as permanently impaired objects of the projection process.

          The conventional steps in the examination, diagnosis, hospitalization, and treatment of “mental patients” are so fixed as a part of medicine, psychiatry, and all interlocking medical, legal, and social systems that change is difficult. There are other projection processes. Society is creating more ‘patients” of people with dysfunctions whose dysfunctions are a product of the projection process. Alcoholism is a good example. At the very time alcoholism was being understood as the product of family relationships, the concept of ‘alcoholism as a disease” finally came into general acceptance.

          There might be some advantage to treating it as a disease rather than a social offense, but labeling with a diagnosis invokes the ills of the societal projection process, it helps fix the problem in the patient, and it absolves the family and society of their contribution. Other categories of functional dysfunctions are in the process of being called sickness. The total trend is seen as the product of a lower level of self in society. If, and when, society pulls up to a higher level of functioning such issues will be automatically modified to fit the new level of differentation. To debate such a specific issue in society, with the amount of intense emotion in the issue, would result in non-productive polarization and further fixation of current policy and procedures.

          The most vulnerable new groups for objects of the projection process are probably welfare recipients and the poor. These groups fit the best criteria for long term, anxiety relieving projection. They are vulnerable to become the pitiful objects of the benevolent, over sympathetic segment of society that improves its functioning at the expense of the pitiful. Just as the least adequate child in a family can become more impaired when he becomes an object of pity and over sympathetic help from the family, so can the lowest segment of society be chronically impaired by the very attention designed to help. No matter how good the principle behind such programs, it is essentially impossible to implement them without the built-in complications of the projection process.” _Murray Bowen.

          Don’t you just hate it, when health care professionals, treat you with paternalistic condescension?

          Best wishes,

          David.

          • “The most vulnerable new groups for objects of the projection process are probably welfare recipients and the poor”.

            Yes David, it’s shocking what’s happening here, and there are of course psych survivors who are poor/welfare recipients and you know many fear the draconian assessments with the real risk of losing homes/basic income more than being detained in hospital – no kidding.

  3. “So what mechanism could a service user use to enable their feedback on whether the service provider was interested in the cuase of thier distress be feedback into the system?”

    John, you raise the most important point to be addressed by all of us. Maybe we should look at making that happen. Just imagine a few central places online, by post [not everyone has a computer, or the skills to use one] in all countries willing where all service users willing could feed back in their own words what they feel caused [and maintained] their distress.
    If thousands of people feedback it would be an irrefutable massive evidence base.

    • Yes, Joanna, although I also think to do the same thing as Healy is suggesting RxISC could do the data would then need a mechanism for being presented and recorded in service provider notes.

      Then, if the cause of the persons distress is ignored and then things to badly, the service provider would have to justify why they did not deal with the problem. That is what Healy is saying, if you take evidence from a source which he hopes will have some legitimacy to a Dr then they are more likely to take your concerns on board. My assumption is that Dr Healy is using this as a tactic to make the drug companies more responsible for their products and for the medical systems to be more responsive to patients complaints about drugs and also more discerning about drug company products and propaganda.

      So I ask is there a similar tool to put pressure on service providers and policy makers to take acount of what acutally causes mental distress and take less notice of all the guff that comes from DSM etc.

      So it needs more than the collating of information it needs a mechanism to present the information to service providers, commissioners and policy makers. But it also needs to be semething that service users can make use of in an easily accesible way that does not put them under too much pressure.

      • Do you have a mechanism for recording your own cause of distress, John? Or, like me, do run into the limits of language, forgetting the experience of “sensation,” before you ever learned to think? Do you take a learned vocabulary for granted, with its misleading “objective” terminology?

        Do you run into the limits of language, when trying to articulate ideas about madness? Consider;

        “The Limits of Language:

        At present we only have a rudimentary language for connecting sensations, affects, and words, for connecting bodily processes and a conceptual understanding of them. The further development of such language requires an attention to the pathways of sensation in the body. We need to formulate bodily knowledge more accurately and increase the rapidity of human understanding. Extending knowledge in this way is the reverse of gathering it by “objectification,” or studying bodily processes disconnected from living sensory attention. (p, 153.)

        Extending knowledge of sensation, following it further along its pathways, means extending consciousness into the body, infusing it with the conscious understanding from which it has been split, by a subject/object orientation. That split has hardened with the sealing of the heart as an organ of sensory reception and transmission, yet it has also come under examination in all the practices and knowledge’s that, taken together, presage the resurrection of the body.

        Some of these systems of knowledge already nestle in the arms of objective science, especially those focused on the complex systems of both body and brain, while others are found in more ancient, holistic health systems. What these systems of healing have in common with the study of the body and its complexity, is the notion of systems–of language and communication, insofar as a biochemical chain or a DNA sequence can be structured like a language in another medium. (p, 154.)

        The more conscious we become of what we repress in our subject/object orientation (remembering that primary repression is the repression of unprocessed sensory information) or ignore, the less we think in projected and judgmental terms. But such conscious consciousness is only possible when we invent or reinvent the words to say it with. The transliteration into language from the minutia of sensory knowledge and its sifting, may be processes entirely unknown to present day consciousness.

        Extending consciousness sensation, finding the words or images, means grasping the nuances of fleshy grammar and alphabets. It means describing and accounting for sensations, which entails translating them into the everyday currencies of speech and so extending the range of their visualization. What our subject/object ego orientation represses is not available to consciousness. This ego and its repressions, present themselves as disordered flesh, when in fact the ego and its repressions are the cause of such disorder. Disorder is not inherent in the body or the flesh, which loves natural regulation. The body thrives in health when its real needs are respected, as distinct from the ego’s imaginary anxieties. (p, 155.)”

        Excerpts from “The Transmission of Affect” by Teresa Brennan, PhD.

        Can you speak about just how your perception of the world, is created within? Those internal mechanisms, that enable your thinking?

        Best wishes,

        David Bates.

  4. Here’s the most recent comment I’ve seen from David Healy on ECT — on his blog a couple months ago, a guy named Michael asked what did he think of ECT; specifically, could it mess up one’s cognition and memory? Interesting answer … whether it’s the same one he would have given five years ago, I’m not sure. I’d say he’s been known to change, and what use is anyone who never does?

    “Michael – its not my role to tell you or anyone what you should or shouldn’t have. Have never wanted anything banned. The key issue if you and i are working as a team is that we have a full set of information available to us – which we don’t have for any drug and in this sense it is difficult to do pharmacotherapy with informed consent.

    When it comes to ECT there are lots of people who want it and others who would never have it. I would want it available for those who find it helpful and would champion the rights of those who do not want it to avoid having it.

    Regarding what to tell them re memory it would be something like this. When you get to the stage of contemplating ECT you almost certainly have had a bunch of treatments that affect memory. Benzodiazepines have very clear effects on autobiographical memory. Antipsychotics and mood-stabilizers have clear effects on set shifing – being able to remember someone’s phone number.

    ECT also certainly has effects on memory also but its hard to know precisely what. I have had people tell me about their memory problems post-ECT and describe very clearly memory problems of the type antipsychotics cause which they blame on ECT even though they are taking antipsychotics.

    Overall far more memory problems are caused by drugs than ECT and vastly more people are on involuntary drug treatment than involuntary ECT – so if there is an issue to campaign about it should be the drugs.”

    http://davidhealy.org/the-empire-of-humbug-not-so-bad-pharma/#comment-92981

  5. @ Joanna Care and the quick fire response to my comment;

    “The most vulnerable new groups for objects of the projection process are probably welfare recipients and the poor”.

    Yes David, it’s shocking what’s happening here, and there are of course psych survivors who are poor/welfare recipients and you know many fear the draconian assessments with the real risk of losing homes/basic income more than being detained in hospital – no kidding.”

    Notice how you scanned my comment looking for a resource to satisfy an internal need? Can you pause to feel the internal mechanism of your e-motive projections onto the external world?

    As the Buddhist’s say “try to catch the gap between the spark and flame,” and discern within the foundations of an objectively rational facade?

    Do we really understand our hearts and the internal mechanisms of our passionate activism here? Consider;

    “Affects as Passions and Actions:

    The notion that affects are invaders that work against our true nature is expressed in the early modern understanding of “passion” as a pacifying force opposed to action, meaning the activity of the soul. (true-self) Up to and including the seventeenth century, to be the “object” of affects is to be passive in relation to them. Such passive states are contrasted with those in which one is active. Thus, when Spinoza talks of an adequate cause, he means a cause that accounts for actions that take place within us or that follows from our nature. On the other hand, “we are passive when something takes place within us or follows from our nature, of which we are only the partial cause.” Passions may work against actions and actualization.

    Passions and passionate judgments are passive as a result of being “affected by the world around us.” We are not acting to actualize our distinctness, but reacting, and in this sense losing the initiative relative to the things that affect us. Yet it is the peculiar nature of such pacifying affects, that they also “affirm” the ego and individual judgments. The distinctness of our individual judgments depends then on the extent to which we are pacified by various affects, and how far this passification or resistance to it, marks one person as different from another. It also depends on the soul or anima that resists those passions.

    Aquinas tells us, “evil cannot be known simply as evil, for its core is hollow, and can neither be recognized nor defined, save by the surrounding good,” which fits in with Lacan’s psychoanalytic definition of the ego as nothing but “lack.” The notion that pacifying passions work against the soul or form they affect, is also a statement that the essence of the self is something other, something distinct from the affecting passions. “It is this distinctness which comes to be lost.” While passion as passivity and action are retained as key categories, they are recast in a mechanistic worldview which “explains nothing,” Descartes action, rather, is the transfer of motion from oneself to another, and passion is being acted upon.

    With this mechanistic turn, it seems that bodies have a “power to resist change,” as well as the power to impart motion. For Descartes, the soul is not the form that is the body’s affective power, it is the capacity to think. While the soul exists, “it is always thinking,” yet as it thinks it loses more of the physicality it once had. The eighteenth century marks a shift, instead of being reactions to invasions from something external to the self, passions become the very activities of the mind, its own motions.

    The term “feeling” which used to be allied with sensation, has become a victim of our lack of precision in “affective” language. No distinction parallels Aristotle’s between our emotions and sensations. Passions or “affects” now claim to be a class of feeling, rather than something discerned by feeling. They seem to be part of one’s self-contained energetic motivation, and the original understanding of passions or affects as pacifying is lost. (thinking has lost touch with being affected, from both within and without)”

    Excerpts from “The Transmission of Affect” by Teresa Brennan, PhD.

    The Descartian facade of cause and effect logic, with which we try to defend our feelings, is mismatched to the nature our heartfelt needs.

    Not until we are able to discuss the emerging science of the heart, and the nature of affect/emotion, will any real inroads be made into the false assumptions of logic and the scientific method, about the various maladies of the mind, IMO.

    Best wishes,

    David.

    • David wrote, “Can you pause to feel the internal mechanism of your e-motive projections onto the external world?”

      He wasn’t asking me, however my answer is that I barely know what the sentence means.

      If I was to meet David I might struggle to try to understand what he means and give an answer to the questions he is raising. Over the net I probably won’t.

      Usually after a couple of sentences I freeze up, cloud over and skim to the end and then pass onto the next comment.

      Please don’t send me best wishes or any other. I’m an irritable old sod who sometimes finds things on this site to add to my campaigning, though at the moment I’m not doing any so I read it for general interest and contribute, sometimes, for the joy of the argument.

      • however I will say that the comment, “Not until we are able to discuss the emerging science of the heart, and the nature of affect/emotion, will any real inroads be made into the false assumptions of logic and the scientific method, about the various maladies of the mind, IMO.” is in opinion rubbish.

        Mr Bental looked at the proportion of people with diagnosis of schizophrenia who have experienced certain life expereinces (poverty, racism, child sexual assault, family violence) and comapared that to the general population. That is science and logic.

        Mr Whittakers book, Anatomy of an Epidemic is based on science and statistical analysis.

        To understand someone it takes more than that. It takes an imaginative leap and a lot of listening and observiing. That doesn’t have to be described in terms of science. But social sciences has quite a lot to say about the causes of madness

        • Fianlly, if I want a less science based account of madness, or the mind and emotion in general I don’t need to wait for anything, I’d just turn to the literature, poetry, biography, autobiography, opera, plays….blah blah blah blah

          Or go to a few self help groups and listen to a few people

      • Its a perfect response though John.

        “Usually after a couple of sentences I freeze up, cloud over and skim to the end and then pass onto the next comment.”

        As you express the reality of our freeze/flight/fight responses, which lie at the core of so-called mental illness.

        If were to meet face to face, I could demonstrate the nature of the face-heart connection, and just why “the polyvagal perspective” changes everything.

        In the meantime, I guess we’ll carry on with social politics as usual, and protect the facade of our “rational” motivation. Although, as you point out, your behavior does stimulate feelings of joy?

        Perhaps, face to face, my heartfelt smile might affect the same response in you, and I could explain what neuroscience means by “affective states?”

        Like William Styron’s “trance” description of depression;

        “For myself, the pain is closely connected to drowning or suffocation-but even these images are of the mark. The pain persisted during my museum tour and reached a crescendo in the next few hours when, back at the hotel, I feel onto the bed and lay gazing at the ceiling, nearly immobilized and in a trance of supreme discomfort. Rational thought was usually absent from my mind at such times, hence trance.” (Styron, 1990).

        Again, William Styron’s words resonate in identification as he describes his experience of depression, and I’m awed by his ability to paint such poignant pictures of the human condition. Who can forget the amazing scene from the movie, of his book Sophie’s Choice as Meryl Streep is forced to choose between her son and her daughter, as to which one will face the gas chamber outside those gates of hell at Auschwitz concentration camp. How does any woman make such a choice or any Fascist Intellect so loose connection with humanities heart, its soul, and force it upon her? Dissociation, the Devil’s own device perhaps? Or the dark and denied shadow of our instinctive nature, made unnecessarily mysterious by civil societies need of denial, in the long march to a mature civilization?

        Could she ever really say how she felt in that awful moment, could she ever consciously acknowledge the instant of that action and its internal motivation? That awful reality of, “Take my little girl – take my baby – take my little girl.” Perhaps nature has a way of saving us from such awful conscious realization, removes the reality of searing pain by the minds conscious distance from the felt sense. By evolution’s curse and gift, in the impulse of dissociation? The Devils own device, and the reality of our unconscious nature? Is normal conscious awareness founded on a hidden mechanism of dissociation, of denial? We know that the rest of the animal kingdom lives in an instinctual world of pure reflex action, so immersed in the reality of the lived moment, no past or future exists? Its only by a hidden mechanism of dissociation from nature’s ever present NOW, that we posses our special gift of self-consciousness. The gift and curse of the human mind?”

        http://www.born2psychosis.blogspot.com.au/p/chp-11.html

        • David,

          Arguably, that shock therapy is lately growing in popularity, is thanks largely to ripple effects of the now five-year-old book, ‘Shock Therapy: A History of Electroconvulsive Treatment in Mental Illness,’ by Edward Shorter and David Healy.

          In it, the authors mention Styron; but, first, they declare (on page 3), “We will show that the charge of brain damage from ECT is an urban myth” and propose that it was mainly a growing *stigma* associated with ‘shock therapy’ which had, until recently, kept more people from willfully choosing to undergo the procedure.

          The front, inside book jacket flap reads in part, “…for the nearly half of all clinically depressed patients who do not respond to drugs, this book brings much needed hope.”

          I believe they’d like people to believe that nothing but renouncing the stigma associated with ECT stands between a would be ‘miraculous’ recovery of millions, from their so-called “depressive disorders” (if only they’d consent to be shocked).

          To that effect, Healy and Shorter explain:

          “…Patients who themselves were in the depths of depression began to shun ECT. At the age of sixty, novelist William Styron became depressed, for the first time in his life. It was full-fledged melancholic depression, beginning as a kind of hypochondriacal foretaste of what was to come, a premonition in which “nothing felt quite right with my corporeal self.” Then in a Connecticut farmhouse he finally understood Baudelaire’s phrase – “I have felt the wind of the wing of madness.” He became riveted with fear at the sight of a flock of Canada geese above the trees. “I stood stranded there, helpless, shivering, aware for the first time that I had been stricken by . . . a serious illness whose name and actuality I was able finally to acknowledge.” In the depths of illness he became suicidal: “What I had begun to discover is that, mysteriously and in ways that are totally remote from normal experience, the gray drizzle of horror induced by depression takes on the quality of physical pain.” This was true psychotic depression, which responds beautifully to ECT. But did he accept ECT as deliverance from his misery? No. He congratulated himself on avoiding ECT. Once he was hospitalized, the staff thought him a suitable candidate for the procedure. Yet Styron mused: “It is plainly a drastic procedure one would want to avoid.” He had come within a hair’s breadth of destroying himself, yet he shunned the treatment of choice for his depression.” [p. 147]

          They have the nerve to call shock treatment the “treatment of choice” – even and especially for a person whom they describe as very deliberately *choosing* to avoid it. (I find that very ironic.)

          Surely, Styron would not have been one to eloquently write, of the texture of ‘depression’ — had he consented to that so-called “medical” treatment.

          On the contrary, quite possibly, he would have wound up stripped of his ability to believe in himself, as a writer – being at loss to recall large swaths of his past.

          I think that is probably what happened to the great writers, Hemingway and David Foster Wallace, after they were subjected to ECT.

          Everyone knows who Hemingway was; not everyone knows of David Foster Wallace. Here’s the Wikipedia page for him: http://en.wikipedia.org/wiki/David_Foster_Wallace

          And, here’s a *very* insightful review of the Healy/Shorter book: http://www.ect.org/book-review-shock-therapy-by-david-healy-edward-shorter-and-max-fink/

          Respectfully,

          ~Jonah

          • Jonah, tell me if I’m wrong, but I assume that you think my earlier comment to you is irrelevant and off topic?

            I understand your feelings of outrage, at the way DR Healy ‘rationalizes’ his opposition to medications while upholding his professions views on brain pathology.

            I also appreciate your spin on my use of Styron’s ability to paint pictures of the human experience, with his eloquent use a thus far ‘evolved’ language.

            Please consider another’s view of our limited ability to express the reality of our lived experience, with our learned vocabulary;

            “At present we only have a rudimentary language for connecting sensations, affects, and words, for connecting bodily processes and a conceptual understanding of them. The further development of such language requires an attention to the pathways of sensation in the body. We need to formulate bodily knowledge more accurately and increase the rapidity of human understanding. Extending knowledge in this way is the reverse of gathering it by “objectification,” or studying bodily processes disconnected from living sensory attention. (p, 153.)”

            Excerpt from “The Transmission of Affect” by Teresa Brennan, PhD.

            Hence my earlier comment you, “Can you describe the internal mechanisms of your own experience of distress?”

            My effort here on MIA, has been to try and shift the debate away from a focus on treatments, like ECT and medications. Treatment’s which like you, I find abhorrent.

            What I asked you, was a question about internal awareness and your lived experience. Although I do understand your ‘political’ need to stay on message.

            As for appearing to be off-topic with David Healy’s post, my question is about ‘engagement’ with oneself and our rationalized denial of internal motivations. our social phobia towards the reality of our evolved nature. Illustrated so well in Healy’s post.

            “We have a Dream that one day people will rise up and live out the true meaning of this creed: “we hold these truths to be self-evident: that all men are created equal”.

            I suggest the dream is actually mother nature’s dream, for her children, and is within each one of us, where such equality lies.

            But hey, the social politics of “us & them” sure gets the arousal juices flowing, as behavior satisfy’s an internal need. As all good counselors say, “all behavior is communication,” yet we often fail to examine what our behavior is communicating to our own self.

            Respectfully,

            David.

      • John: “He wasn’t asking me, however my answer is that I barely know what the sentence means”.
        Me neither!

        David: “Can you pause to feel the internal mechanism of your e-motive projections onto the external world?”

        Nope don’t need to because it is external fact which can be evidenced.

        • @ Joanna Care

          “Nope don’t need to because it is external fact which can be evidenced.”

          So please tell me Joanna, how external “fact’s” explain what is happening inside your body, and just how this external evidence helps you self-regulate?

          Your earlier “quick-fire” response to my comment, was stimulated by internal “impulse,” yet in the great “rationalization” of life, mentioning such internal motivation is taboo.

          Certainly external events affect reactions within us, but the external view alone, is an incomplete answer to what is actually happening to us, within the reality of the lived moment.

          IMO only expanded internal awareness brings the much needed improvement in self-regulation, which allows us to fully escape the conditioned effects of traumatic experience. Consider;

          “We have also become used to searching for the source of our discomfort outside ourselves. We simply are unfamiliar with experiencing something “as it is,” without the encumbrance of analysis and judgment. As the sensation-thought-emotion complex is uncoupled, experiencing moves forward toward subtler, freer contours of feeling. Eugene Gendlin, the originator of the term “felt sense,” sums this up with, “Nothing that feels bad is ever the last step.”

          This experiential process involves the capacity to hold the emotion in abeyance, without allowing it to execute in its habitual way. This holding back is not an act of suppression but is rather one of forming a bigger container, a larger experiential vessel, to hold and differentiate the sensations and feelings. “Going into” the emotional expression is frequently a way of trying to “release” the tension we are feeling, while avoiding deeper feelings. (p, 323)

          With containment, emotion shifts into a different sensation-based “contour” with softer feelings that morph into deepening, sensate awareness of “OK-ness.” This is the essence of emotional self-regulation, self-acceptance, goodness and change. (p, 324)

          From a functional point of view, bodily/sensate feelings are the compass that we use to navigate through life. They permit us to estimate the value of the things to which we must incorporate or adapt. Our attraction to that which sustains us and our avoidance of that which is harmful, are the essence of the feeling function. All feelings derive from the ancient precursors of approach and avoidance, they are in differing degrees positive or negative.

          Traumatized individuals generally find themselves swinging wildly and unpredictably between being numb and shut down on the one hand and being flooded by emotions, including terror and rage, on the other. These bipolar swings are often erratic and capricious. (p, 246)

          Surly no one would reasonably dispute that we are the product of how our brains and bodies operate. It would be hubris to say that all our subjective experience is precisely explained by the anatomy and physiology of the brain, just as it would be absurd to believe that everything we feel and know is understandable by how the brain functions. (p, 249)

          Our most primitive instincts reside at the root of the limbic system (the emotional brain), in the most ancient, no-frills portion of the brainstem. There a core of barbed neurons meanders along the brain stem. It is this archaic system that serves the functions of maintaining constancy in the internal milieu and modulating states of arousal. The primary requirement for all life is the maintenance of a stable internal environment.

          Whether one is considering a cell, an amoeba, a rock star, a custodian, a king an astronaut
          Or a president, without this dynamic internal stability in the face of an ever changing external environment, we would all perish. It is the brain stem, through a myriad of complex reflexes, that is “control central” responsible for the minutiae of constant adjustments that are required for the basic maintenance of life. This also includes the regulation of our basic states of arousal, wakefulness and activity. And as messy and primitive as the brain stem reticular activating system is, it does its job of preserving life magnificently. (p, 251)

          “Out of the swamp of the reticular system, the cerebral cortex arose, like a sinful orchid, beautiful and guilty.” _ Paul Yakovlev.

          “In the Beginning, before the Word, was Consciousness.
          The primal consciousness in man is pre-mental,
          and has nothing to do with cognition.
          It is the same as in the animals.
          And this pre-mental consciousness remains
          as long as we live the powerful root
          and body of our consciousness.
          The mind is but the last flower, the cul-de-sac.”
          _D. H. Lawrence.”

          Trauma and Spirituality:
          In a lifetime of working with traumatized individuals, I have been struck by the intrinsic and wedded relationship between trauma and spirituality. With clients suffering from a daunting array of crippling symptoms, I have been privileged to witness profound and authentic transformations. Seemingly out of nowhere, unexpected “side effects” appeared as these individuals mastered the monstrous trauma symptoms that had haunted them-emotionally, physically and psychologically. Surprises included ecstatic joy, exquisite clarity, effortless focus and an all-embracing sense of oneness. (p, 347)

          “The life of feeling is that primordial region of the psyche that is most sensitive to the religious encounter. Belief or reason alone does nothing to move the soul; without feeling, religious meaning becomes a vacant intellectual exercise. This is why the most exuberant spiritual moments are emotionally laden.” _Carl Jung.

          At the right time, traumatized individuals are encouraged to and supported to feel and surrender into immobility/NDE states, states of profound surrender, which liberate these primordial archetypal energies, while integrating them into consciousness. In addition to the “awe-full” states of horror and terror appear to be connected to the transformative states such as awe, presence, timelessness and ecstasy. (p, 353)

          Excerpts from “In an Unspoken Voice,” by Peter Levine, PhD.

          Of coarse, in the great “rationalization” of life, we must not mention the reality of our evolved nature?

          Best wishes,

          David.

  6. “So it needs more than the collating of information it needs a mechanism to present the information to service providers, commissioners and policy makers. But it also needs to be semething that service users can make use of in an easily accesible way that does not put them under too much pressure”.

    Agreed John

  7. @ Joanna Care.

    I’m talking about the subconscious aspects of self-regulation (not to be confused with a cognitive sense of self-control) and the emotional dynamics of our lived experience. Perhaps this will help;

    “MODERN REGULATION THEORY

    An explosion of developmental and neurobiological research has added substantially to the theoretical understanding of the 110 years since Freud (1895/ 1966) first published his Project for a Scientific Psychology (Schore, 1997). Having been grounded in drive, ego, object relations, self psychology, and relational psychology through the 1980s, the addition of attachment theory has moved psychodynamic clinicians’ sensibilities into an awareness of real experience and a keen focus on early development as the root of all. Then, beginning in the 1990s, the advances in neuroscience, added to the temperament research, the biological component in our biopsychosocial frame, have provided a remarkable underpinning and expansion of all the pertinent developmental psychoanalytic theoretical concepts that came before. Using this knowledge on a daily basis, finding new understandings in clinical assessments, shaping therapeutic interventions from relevant theory, and providing a unique awareness of the adaptive nonconscious functions of the implicit self are some of the profound results of this theoretical integration.

    The intersubjective process of developing a true self that can enter into meaningful relationships shows us how the internal world is structured on a psychophysiological base, which takes into account the unique genetic endowment of the particular infant in interaction with his or her relational environment. In a recent overview, Glass (2008) concludes, “Recent research in brain imaging, molecular biology, and neurogenetics has shown that psychotherapy changes brain function and structure. Such studies have shown that psychotherapy affects regional cerebral blood flow, neurotransmitter metabolism, gene expression, and persistent modifications in synaptic plasticity” (p. 1589). Tucker (1992) observes, “the baby brain must begin participating effectively in the process of social information transmission that offers entry into the culture” (p. 79). He asserts that social interaction that promotes brain differentiation is the mechanism for teaching “the epigenetic patterns of culture” (p. 122), and that successful social development requires a high degree of skill in negotiating emotional communication, “much of which is nonverbal” (p. 80). Tucker concludes that such emotional information engages “specialized neural networks in humans, within the right hemisphere” (p. 80). This conceptualization clearly suggests an important and unique role for clinical social work in infant mental health and optimal right brain development, particularly for attachment programs aimed at prevention and early intervention.

    In this chapter we equate “unconscious” with “nonconscious”; that is, implicit functions that occur beneath levels of awareness not because they are repressed but because they are too rapid to reach consciousness.”

    Excerpts from “The Science of the Art of Psychotherapy” by Allan N. Schore.

    I assume you don’t mind admitting to possessing, “implicit functions that occur beneath levels of awareness, not because they are repressed but because they are too rapid to reach consciousness.”

    Respectfully,

    David.

    • David,
      Can we all be aware of everything we think and feel all the time and “regulate” it, and why would we want to?
      I get the stuff about connecting bodily sensations, “affects”, emotions, actions.
      I see that those who have been through DBT are trained to “regulate” their emotions to the degree that they police them to an exhausting degree that it’s painful to observe. I feel sad when I see someone terrified of feeling “too much”, or “too little”, and how they express that, and referring to having a “dysregulated day”. Jesus what a terrible way to have to live, in fear of yourself.

      I understand that awareness of ourselves is a reasonable question, and how do we describe our inner landscape. Not easy but on the whole I think survivors do pretty well, there are wonderfully descriptive accounts. I get what you’re saying about intrapersonal communication as opposed to interpersonal, but I don’t accept you deflecting discussion of the social and political by asking us to view that as being purely about an emotive pasting of our inner world onto the material world, that’s getting into intellectual masturbation territory.

      If you want us to look more closely at our inner landscape and awareness [that’s fine in itself] then write a blog on that specifically. The most important relationship we all ever have is with ourselves for sure, and the greatest freedom we can attain is to be ourselves unashamedly.
      When you enmesh that point into questioning why anyone is questioning the social and the political it simply doesn’t work as a discourse and starts to look like group therapy.

      • Joanna,

        I write extensively on the “nature” of psychosis and my experiential journey to understand it. Pointing out how poetic descriptions of emotional/mental distress, tend to be “externally” focused because we have little to no common language to described the internal processes Schore alludes to as to fast to enter consciousness. Examples:

        “I had concluded that I was suffering from a serious depressive illness, and was floundering hopelessly in my efforts to deal with it. Of the many dreadful manifestations of the disease a sense of of self-hatred, a failure of self-esteem, is one of the most universal symptoms. That fall, as the disorder gradually took full possession of my system, I began to conceive that my mind itself was like one of those outmoded small-town telephone exchanges, being gradually inundated by flood-waters: one by one, the normal circuits began to drown, causing some of the instinct and intellect to slowly disconnect.” (Styron, 1990).

        “The importance of language for the formation of one’s self through organizing one’s experience into a coherent core narrative is emphasized, especially as it relates to the micro-sensory experience of the body for which vocabulary is often inadequate. The importance of movement, oscillations, pulsations, and sensations being included in a full experience of a psycho-somatic self is argued. The still open issue of finding adequate cortical representation of the felt sense of these neuroceptive movements is raised.” and, “When I began reading neuroscience, I fell in love with the vocabulary. Words such as neural oscillation, pulsation, or sinusoidal waves, like music, evoked in me a sensory resonance born of a mysteriously intangible recognition. Perplexed, I surmised that this terminology activated contact with a dimension of implicit experience where words bridge the passage of the body through the mind and the mind through the body.” (LaPierre, 2007).

        http://www.born2psychosis.blogspot.com.au/p/chp-8.html

        Madness & The Effects, of its Fear Affect?

        “There is nothing to fear but fear itself” _Franklin Roosevelt.

        A paraphrase of the line “Nothing is terrible except fear itself” by Sir Francis Bacon

        Is fear an Affect! With a contagious Effect?

        Is there an “unconscious,” fear of mad people?
        As if, Madness is Contagious?

        Two simple words, Affect & Effect? What exactly do they mean, and why do they cause so much confusion about the true nature of our mental health?

        Do we now understand the unconscious mechanisms of both fear, as an innate affect and our social need to deny the very existance of innate affects and the primary processes of the body. The body’s evolved nature and the foundational aspects of our self-preservation and therefore our instinctual-intelligence? Consider;

        “The body initiates and the mind follows. Hence “talking cures” that engage the intellect
        or even the emotions, do not reach deep enough.” _Peter Levine, Ph,D.

        It takes a momentary suspension of our normal reasoning, to imagine an unconscious nervous system, mediating much of our everyday social behaviors, as the evolved nervous system we share with all other mammals. As an evolved aid and defense of survival, mammals have an innate ability to feign death as a last ditch, instinct for survival. When there is no possibility of fight or flight, no possible means of escape from immediate and overwhelming threat, mammals escape into a simulated death state. (see: Madness & the Chaotic Energies of The Trauma Trap?)

        http://www.bipolarbatesy.blogspot.com.au/2012/12/madness-effects-of-its-fear-affect.html

        The AFFECT of Neuroception, in Mental Illness?

        NEUROCEPTION:
        A Subconscious System for Detecting Threats and Safety.

        Ideally, a baby’s neuroception of her environment shows her a safe place to explore.

        But even if her perception warns her accurately of danger from a “frightened or frightening” caregiver, the baby can take some defensive measures, even though they are likely to be ineffective and are almost certain to be psychologically costly.

        What happens when neuroception itself is impaired? From a theoretical perspective, faulty neuroception—that is, an inability to detect accurately whether the environment is safe or another person is trustworthy—might lie at the root of several psychiatric disorders: (see: NEUROCEPTION: A Subconscious System for Detecting Threats and Safety)

        So what exactly is, SUBCONSCIOUS perception?
        • Areas in the temporal cortex that are assumed to inhibit fight, flight, or freeze reactions are not activated in people with autism or schizophrenia, who have difficulty with social engagement.

        • Individuals with anxiety disorders and depression have compromised social behavior; difficulties in regulating the heart rate, as reflected in measures of vagal control of the heart; and reduced facial expressiveness.

        • Maltreated and institutionalized children with Reactive Attachment Disorder tend to be either inhibited (emotionally withdrawn and unresponsive) or uninhibited (indiscriminate in their attachment behavior; Zeanah, 2000). Both types of behavior suggest faulty neuroception of the risk in the environment. _Stephen Porges, Ph,D.

        How does SUBCONSCIOUS perception, result in Mental Illness?

        At a glance:
        • Neuroception describes how neural circuits distinguish whether situations or people are safe, dangerous, or life threatening.

        • Neuroception explains why a baby coos at a caregiver but cries at a stranger, or why a toddler enjoys a parent’s embrace but views a hug from a stranger as an assault.

        • The Polyvagal Theory describes three developmental stages of a mammal’s autonomic nervous system: Immobilization, mobilization, and social communication or social engagement.

        • Faulty neuroception might lie at the root of several psychiatric disorders, including autism, schizophrenia, anxiety disorders, depression, and Reactive Attachment Disorder.

        Could most catergories of what we normally see as expressions of a mental illness, be classified under this “umbrella” term, Reactive Attachment Disorder? Is “attachment” a fundamental requirment, in human physiological and psychological health? For example: “Individuals with anxiety disorders and depression have compromised social behavior; difficulties in regulating the heart rate, as reflected in measures of vagal control of the heart; and reduced facial expressiveness.” Certainly, my own, bipolar disorder type 1, has its roots in a “neuroception” of danger and subsequently compromised social behaviors, of which “mania” was at times, a spontaneous attempt to rectify? IMO. “Nothing overrides a sense of fearful aviodance and withrawal from other people and life, quite like an episode of mania,” I said to a psychiatrist recently.

        Has professor Stephen Porges uncovered the hidden biology of Sigmond Freud’s unconscious “Id?” And does “The Polyvagal Theory,” give us a view of the hidden roots of Affective Disorders like Bipolar? Does The Polyvagal Theory & the concept of a “neural,” subconscious perception, professor Porges has called “neuroception,” provide a casual link between mental disorders, many consider the truncated response of a natural, mammalian reaction to a sense of threat? Both external & internal? Is a misunderstood and “intellectually” denied, capacity of the autonomic nervous system, at the core of human disorders from Autism to Schizophrenia, including the many symptoms of PTSD & BPD?

        http://www.bipolarbatesy.blogspot.com.au/2012/12/the-affect-of-neuroception-in-mental.html

        My writing explores the physiological foundation of my experience of psychoses, and the foundation of our “intellectual masterbation” as self-regulation.

        I understand how difficult it is to let go of this “mind-filled” sense of self, we are raised with, in so-called first world countries. It took me two years of living in a different, wiser culture, to even begin to “get-it.”

        Again, I suggest that the vast majority of personal description,, is “externally” focused because, as explained above;

        “Words such as neural oscillation, pulsation, or sinusoidal waves, like music, evoked in me a sensory resonance born of a mysteriously intangible recognition. Perplexed, I surmised that this terminology activated contact with a dimension of implicit experience where words bridge the passage of the body through the mind and the mind through the body.” (LaPierre, 2007).”

        There is no common “awareness” of this “internal” reality. Therefore, we lack both the self-awareness and the language to really address the issue of “what mental illness is” even though we know psychiatry is wrong in its assumptions.

        Respectfully,

        David.

        • David,

          This morning, I left you two comments (posted below).

          One is dated June 13, 2013 at 9:28 am.

          The other is dated June 13, 2013 at 11:14 am.

          In the first one, I began by stating, “I am genuinely pleased with the quality of your participation in this thread of comments,” and I praised you for not, “cutting and pasting *way* to many, long excerpted passages” and, thereby, overdoing it with quotes from your favored authorities.

          IMO, now, in this latest comment of yours, to Joanna Care (on June 13, 2013 at 4:29 pm), you have overdone it, that way.

          What’s bizarre, to me, is how you begin offering those quoted passages. You begin by saying, “I write extensively on the “nature” of psychosis and my experiential journey to understand it…”

          Indeed, you conclude that paragraph by offering the word, “Examples:” (with that colon at the end).

          From there, you launch immediately into offering quoted passages from one of your favored authorities.

          I try to discern what you’re saying, from that point, forward; I try to separate what is a quoted passage from what might possibly be your own writing; and, I can’t do so; IMO, you are not being clear — regarding what is the writing of your favored author/s — and what is your own.

          That happens quite often in your long posts with quoted passages. I find I can’t make heads or tails of what you are posting.

          So, I wind up ignoring your long posts.

          I suspect I’m not the only MIA reader who does so — for this very same reason; your posts can be very hard to follow…

          Respectfully,

          ~Jonah

          • Dear Jonah,

            I understand your critique of my writing and my grammar, yet my main concern here is get the many references I quote up on the site.

            Some people will choose to follow up on these sources in their own research, most, I understand will John’s reaction above.

            “Usually after a couple of sentences I freeze up, cloud over and skim to the end and then pass onto the next comment.”

            As I’ve stated previously, I’m confident that my growing understanding of psychosis, and the knowledge I’ve used to enable this understanding, is on the right track, and as we wind on down the road here, more people will come to see that.

            Sadly, we are all pressed for time, more and more these days, and as I’ve pointed out, we tend to “scan” this written form of communication without “digesting” meaning.

            I’ll respond to your other two comments later today, when I have more time.

            Best wishes,

            David.

  8. “Jonah, tell me if I’m wrong, but I assume that you think my earlier comment to you is irrelevant and off topic?”

    David Bates,

    Let emphasize, first, that: Thus far, I am quite appreciating your participation in this thread of comments, really; though, I don’t necessarily agree with your emphases…

    In particular, I feel, your questions to me suggest that you do not often read my comments, on this website (or, you read them selectively).

    But, I am glad that you’ve interjected your views, very glad — especially, as compared to some times, previously, when I’ve become exasperated with you (you know, I’ve told you, emphatically); at times, I think you’ve gone totally overboard, in your MIA comments, cutting and pasting *way* to many, long excerpted passages from your favorite authorities on ‘mental heath’ (or, perhaps, I should say, more accurately: your favored authorities on psychological and/or bio-psychological issues and/or experts on bio-psycho-social issues, etc.).

    I am genuinely pleased with the quality of your participation in this thread of comments; nonetheless, I disagree with you in ways, and I am fully inclined to concur with the general message, of Joanna Care’s latest comment, to you, above (on June 13, 2013 at 5:35 am).

    She expresses my sentiments exactly, in that comment, of hers (except, I’ll add here, parenthetically, about DBT: my own opinion is, that: If and when DBT — and/or any other form of behavioral therapy — feels useful to a *willing* ‘client,’ then I’ll not be one to judge its relative merits, as a form of help; in fact, I am all for people learning how to better self-regulate their lives, through countless sorts of behavioral trainings; if/when anyone may *seem* to be ‘over-regulating’ himself/herself — whether with with DBT or any other form of training –, that is, most often, only a *temporary* stage, in personal development, I think. It may be a necessary stage — difficult though it may be for outside observers to accept and appreciate).

    You ask me, “Should we be focused on “treatment” or actual experience? How many of us, pause to feel our own mechanism of projected needs, to see others as pitiful?”

    And, you ask me, “Why do we never talk about the fluid emotional reactivity of the lived-moment, preferring to appear, cool, calm and collected?”

    You ask, “Can you describe the internal mechanisms of your own experience of distress?”

    In fact, both Joanna Care and I have been engaging in a rather extended dialogue, of comments, on those very subjects — currently, on another thread.

    Speaking only for myself, here now: I suggest you read my comment (on June 11, 2013 at 11:36 pm): https://www.madinamerica.com/2013/06/a-critical-psychiatry-network-call-to-cancel-charles-nemeroff/#comment-26113

    See, especially, all that I wrote in the second half of that comment, beginning with, “You shared your sense of ‘overwhelm’ and where it comes from. I think I know what you mean…”

    David, quite a number of times, over this past year (in the course of my commenting here, on this MIA website), I have shared my sense of my own inner processes.

    Quite often, I have done so, in my writings (including in blog form).

    Indeed, not to toot my own horn (as I may not be as eloquent as some commenters, here on this site), but because I feel it necessary to defend myself here (in a friendly way), I will say: when it comes to the question of measuring whether politically inclined writers are doing enough to address their own *inner* experiences and motivations, I believe that I’ve presented an unusually *fair* balance of expressions, here and elsewhere, on the Web.

    So…

    Carry on, David — just, please, realize: Here, in this thread, you are speaking to more than one commenter (myself, included) who’s been, in fact, highly inclined, at times, to delve into expressing his/her personal feelings and underlying psychological processes.

    Respectfully,

    ~Jonah

    • P.S — David, (in case I have not yet been *entirely* clear, in responding to your questions), I add these afterthoughts now coming to mind:

      By my having explained (directly above) that, in my written expressions, I’ve been highly inclined to, “delve into expressing [my] personal feelings and underlying psychological processes,” please, understand: Here I am using the word, “feelings,” *not* as substitute for the word, “opinions” — but as a reference to my *internal* emotional experiences.

      That is to say, I am insisting, to you, David, that: I believe I’ve actually done a fair job of *eliminating* — from my own written discourse — this common tendency, of ‘political’ writers (i.e., writers with opinions on social policies), wherein they’ll establish and/or defend positions based on little or no personal insight. They’ll create ‘projections’ that are simply reactive — and never understand or speak of their own, internal processes, which have led them to assume the stances, which they do establish and/or defend.

      In fact, I believe, were we to carefully/methodically study all the comments of all those commenters who’ve been most frequently commenting, on this site, including those with some of the strongest ‘political’ positions and the greatest ability to refer to scientifically established facts, I’m strongly inclined to suspect, that we’d realize: A great many of them (certainly not all, but many) are demonstrating an unusually *high* capacity for becoming *quite* positively introspective.

      (I see this fine introspective quality in the writings of many commenters, here on this site.)

      I think what you don’t like is that some of us take positions, which are not positions which you care to take?

      You can tell me if you feel I’m wrong about that; but, in any event, I assure you: I feel it’s quite alright for you to emphasize your desire to see commenters delving more into their own internal processes. But, there may come a time — in the course of your doing so — when it finally appears that you are simply failing to realize: many of us are doing what you’re calling for us to do; only, *you* are scanning *our* comments (probably unconsciously), finding ways to view us as though we are simply writing from positions of ‘us/them’ reactivity.

      So…

      As for your writing to me, “hey, the social politics of “us & them” sure gets the arousal juices flowing, as behavior satisfy’s an internal need,” I will say: David, I’m sorry if you (or anyone else) cannot understand my ongoing concerns, with respect to David Healy’s qualifications, as researcher of iatrogenic (i.e., medically caused) effects.

      Personally, I think it’s sad that so many people fail to understand this about Healy’s work: He is *typically* blaming ECT effects on psychopharmaceuticals — even as he happens to be an avid promoter/practitioner of ECT; this presents a real conflict of interest, IMO.

      I, personally, believe that, despite his ability to critique Big Pharma, he has *not* demonstrated any ability to critique himself — nor (more importantly) critique the ECT industry.

      All he does is praise ECT. (Yes, I realize that he does not do so, on this website.)

      I well understand that the ECT industry is very small potatoes, as compared to Big Pharma, and most who read MIA are concerned about the effects of ‘meds’ — not ECT.

      However, meanwhile, a great many people (i.e., a great many who are not inclined to carefully study any of these issues) are being persuaded that ECT is safe and effective, by David Healy’s (and, Edward Shorter’s) *terrible* book, on that subject — which was funded by a huge supporter/practitioner of ECT.

      IMO, Healy’s ‘research’ on psychopharmaceutical effects cannot be trusted — because he’s refusing to acknowledge that many long-term effects of ECT are caused by ECT; former ECT “patients” bring them their complaints about ECT, and he’s blaming those effects on psych-drugs.

      Frankly, I don’t know how so many otherwise intelligent people, on this site, can turn a blind eye to this; IMO, they are appeasing at least one terribly *unscientific* process, that’s constantly in play, in the midst of Healy’s research.

      Many people are so upset with Big Pharma and with the psychopharmaceuticals to which they, personally, have been exposed, they don’t really care about the quality of the research that is now being used to hopefully reduce the needless use of such drugs.

      And, by the way, I don’t believe any of those drugs are ever necessary. If people who have been *fully* informed of their possibly (or likely) negative effects choose to take them, fine.

      My main issue is that they should not be forced on anyone.

      And, IMO, there are much better writers than Healy — and far better researchers — to read, on the subject. But, we all have our own, personal favorite writers; and, such is life.

      I won’t always understand why people do what they do.

      Respectfully,

      ~Jonah

  9. Dear Jonah,

    You wrote;

    “You ask, “Can you describe the internal mechanisms of your own experience of distress?”

    In fact, both Joanna Care and I have been engaging in a rather extended dialogue, of comments, on those very subjects — currently, on another thread.

    Speaking only for myself, here now: I suggest you read my comment (on June 11, 2013 at 11:36 pm): https://www.madinamerica.com/2013/06/a-critical-psychiatry-network-call-to-cancel-charles-nemeroff/#comment-26113

    Here is your expression of internal mechanisms of distress;

    “And, by the way, please know: my sense of disappointment, as conveyed to you, in my comment, was enlarged by the stress and sleeplessness of the family health issues I briefly mentioned – and by my laying awake, recalling having been traumatized by medical-coercive psychiatry, decades ago. It came directly from all that; and, this was quite clear to me, as I felt it; but, it didn’t occur to me, to say so, to you.

    Perhaps, I should have said so? But, I had no energy or will to articulate myself, that way — and, instead, expected you to automatically understand that my distress and my feeling unable to get to sleep was a matter of all kinds of issues; so, I apologize if my disappointment was conveyed in a way that seemingly suggested you should feel disappointed in yourself — or suggested that I might view you as the ‘adversary’; and, oh, thanks, too, for being momentarily nerdy. As a kid, I enjoyed the first Star Trek series – but never saw anything of the subsequent ‘generations’ of shows and films. (Though, I appreciate good sci-fi; and, yes, I do get the idea behind the ‘Borg’ characters; the theme is germane to our discussion, you must well realize.)

    Wikipedia explains, “The Borg are a collection of species that have been turned into cybernetic organisms functioning as drones of the Collective, or the hive. A pseudo-race, dwelling in the Star Trek universe, the Borg force other species into their collective and connect them to ‘the hive mind’; the act is called assimilation and entails violence, abductions, and injections of cybernetic implants. The Borg’s ultimate goal is ‘achieving perfection’.”

    You are *not* really a Borg (you only play one at Star Trek conventions). You are against being a Borg, in reality; that is clear from your caring expressions.”

    Please explain to me, just how and where you express an awareness of internal function, in the above?

    Where is the ‘sensate’ awareness which would allow you better self-regulation, to overcome feelings of distress and better release yourself into sleep? Please consider this excerpt from my writing;

    ““In particular, you will begin to notice what various sensations (i.e., tensions, contractions, aches, pains, etc,) tend to emerge in sequences or in groups. For example, you may notice that a “knot” in the belly or tightening of the anus is associated with a suppression or holding of breath.”(Levine, 2010.)

    As I continue to practice what has become so effective in letting go of the surging energies of excitement in mania’s manic mood swings, I’m mortified by how difficult its proving to let go the bipolar opposite of what is beginning to feel like a fall into depression. God knows I‘ve been here before and I‘m getting really scared that I can‘t resist the collapse, scared that I won‘t cope with this first overwhelmingly negative state for five years. So many memories of feeling just like this and helplessly drowning in depression. “How have I become so immersed in this state of fear?” I ask myself. As awareness of tension expands across my whole body, aware too, of “holding myself in,” of shallow breath and the stiff posture of awkwardly positioned limbs. A flashbulb memory of holding myself like this as a child comes to mind, “this is how I got myself to sleep at night.” Fear driven immobilization the experts now call it, or “tonic immobility,” an unconscious response hardwired as a mammalian survival trick, although a paradoxical trap for human beings. “This is what came from a three day birth ordeal, brutal forceps delivery and the immediate isolation of a mechanical crib. This is my default response to life, an existential crisis which has always been the ghost in my internal machine.”

    “Our nervous system assesses threat in two basic ways. First of all, we use our external sense organs to discern and evaluate threat in the external environment. We also asses threat directly from the state of our viscera and our muscles-our internal sense organs. If our muscles are tense, we unconsciously interpret these tensions as foretelling the existence of danger, even when none actually exists.” (Levine, 2010).

    Again I try to bring all awareness into the felt sense of pain, suddenly my eyes open and I become aware of the tension that had been unconsciously held there, along with the corresponding release of pain in my stomach. There is also a frizz of warm sensation in my feet as blood circulation flows more freely there. “A whole brain/body systemic reaction,” I say to myself, suddenly remembering a trick I was taught by an Alexander Technique therapist. I turn over onto my back and focus my eyes on the light switch by the bathroom door, some six yards away. I concentrate on widening my peripheral vision either side of the switch, and hey presto, a spontaneous release of stomach tension. “I think you have an exaggerated startle reflex,” the therapist had told me, explaining that it fitted perfectly with my suspicions about birth trauma. “Its more common than is realized, with people learning to adapt to a rather rigid posture and inhibited responses,” he’d said. “All the world’s a stage,” comes to mind as I turn back onto my stomach and continue to dissolve this physiological state of fear.

    This time when I feel into tension in my stomach I’m equally aware of the tension around my eyes, which now feels like I’m forcing them shut. Holding an awareness of both eye socket and stomach tension, I feel a warm tingling in my feet and fingertips too, as a spontaneous deep breath overcomes me. My nervous system is coming back into balance now, as I de-arouse this unconsciously stimulated, whole body state of fearful rigidity. As I continue to relax into my body and gain a more mind-less state of embodied awareness, I remember how years ago I would have gotten stuck in that pressurized compulsive thinking, maintaining and amplifying this fearful state all the way into that avoidance of life we call depression. Yet just as now happens when I’m too excited and worry about escalating into a manic mood state, I begin to drift back down into my body with a mind-less muscular relaxation. The unconsciously stimulated physical tensions of fear, dissolving, as sleep, per chance to dream, overcomes my “I think therefore I am,” all too self-conscious mind.”

    http://www.bipolarbatesy.blogspot.com.au/2013/01/managing-mental-illness-symptoms-with.html

    As I wrote above, its difficult to let-go this mind-filled sense of self, which we are raised with in so-called 1st world countries. Difficult to grasp the concept of surrender to a mind-less sensate awareness, in the Eastern tradition. Even in the east there is great confusion about the mind and its relationship to the material world and own internal foundations. Its reciprocal connections to the body, particularly the heart. As Schore points out above, we have an “implicit-self” which operates at speeds to fast to enter consciousness.

    Please let me know what you think about this Buddhist perspective, on the minds relationship with itself and the external world;

    ““Presence in Reality

    Presence in reality is not possible if your mind is overwhelmed by thoughts. When the mind is emptied, it is possible to turn your attention spontaneously to reality.

    But what is reality?
    Reality is the environment that surrounds us.

    In fact, for each of us, the environment that surrounds us is our reality.
    This isn’t such a trivial fact, which we unknowingly or unconsciously take for granted .

    Try this little test.
    We are in New York, sitting on the terrace of the Times Square Brewery.
    I ask you, ‘Do you think the Place Pigalle in Paris is real?’
    You probably answer, ‘Yes.’

    But it isn’t.
    If you are in New York, in Times Square, the environment that surrounds you is Times Square in New York, not The Place Pigalle in Paris.
    Therefore “your reality” is Times square New York.
    Paris and The place Pigalle are not the environment that surrounds you. They aren’t your reality.

    They are only in your mind, in your memory, not in your reality.
    Herald Square in New York isn’t real to you either, if your in Times Square.
    Because Herald Square isn’t the environment that surrounds you. Herald square isn’t real to you.

    Do you understand what I’m saying?

    Your reality is the environment that surrounds you, and which you percieve with your senses.
    In other words, your reality is your surrounding, wherever you are.
    Nothing else.

    Paris and the Place Pigalle may be the reality of someone in Paris, but this is not your reality.
    Your reality is only the surrounding environment of wherever you are right now.
    If you behaved as if you where in Paris, you would not be intune with reality.
    You would not be present in your reality.

    There are two worlds:

    1. The world of the mind.
    2. The world of reality.

    The world of reality is real, the world of the mind isn’t real.

    Of the objects which present themselves to our consciuosness, in fact, some belong to the reality that surrounds us , while others belong to our mind – that is, to our memory. (the body/brain and its nervous stimulation).
    We tend to falsly believe that “both” kinds of mental objects are real, yet this is a false assumption based on our past, not the present reality, by which we are surrounded and unknowingly immersed in.
    Only the mental objects which belong to the surrounding environment are real, not those which belong to our memory ( the body/brain nervous energy of the past)

    Your probably thinking that this is a very debatable point?
    Especially, if your still strongly anchored to the world of your mind, here’s proof though.
    A relitive of yours who has died is undoubtedly still present in your memory, yet it is obvious that they are NOT present in the environment which surrounds you, (or even in the environment which doesn’t surround you), which means that they are no longer real.

    The attribution of reality to the mental objects of our mind, is the cause of mental suffering.
    We suffer because of the “fantasies” in our mind.

    “The fantasies of your thought are not real.
    They are generated by your attachment, and therefore by your desire, your hate, your anger, your fear.
    The fantasies of your thought, are generated by yourself” _Buddha.

    We suffer because we mistake the fantasies of our mind for reality.

    It is fundamental, therefore, that we learn to distinguish between reality and the fantasies of our mind.

    A state of “Buddha-ness – truly awake” involves awareness of the distinction between the world of the mind and the world of reality.

    Deprive your fantasies of your approval and they will vanish” _Buddha.

    Most people in the Western world, love the mind and the power of its creations, and rightly so, yet true presence in reality does not negate the power of the mind, it simply offers a way out of suffering.
    Suffering generated by our own mind, due to confusion about the distinct difference between objects of reality and the mental objects of the mind, as NOT real?

    Buddhism has one essential purpose: liberation from suffering.
    All it is saying is, you cannot defeat the fantasies of your mind, by staying within your mind.
    You need to come out of your mind and enter reality.

    This is why “attenuating” thought allows us , quite naturally and without effort – in other words, spontaneously – to implement the second power of Buddha-ness (truly awake): presence in reality.

    In true reality, there is no suffering!

    This is a simple truth, which is difficult for us to accept.
    Again, using an extreme example:
    You have just lost a loved one.
    You think that reality is the cause of your suffering, because in reality the person you have lost is no longer there for you.
    But this is precisely the Buddha’s point?
    In reality that person is no longer there, but that’s ALL.
    In acceptance of true reality, there is no suffering.

    The sun continues to rise, the clouds continue to sail across the sky and the birds continue to sing.
    Your suffering, is only “inside” you.
    Yet you think that reality is the cause of your suffering, and you mistakenly, unknowingly, attribute your suffering to “reality” itself.

    But “suffering” is not an object which can be found anywhere in true reality. Suffering, is a “mental state.”
    In other words, suffering is “inside” your mind, not in reality.
    A famous Zen koan says:

    “Show me the hand which is holding your suffering.”

    You can’t do it, because “mental suffering” belongs to the world of the mind and not the world of reality.

    True presence in reality, is not a question of “intellectual knowledge,” but of “experience.”

    Also please consider this perspective, even though you will no doubt feel that I don’t do this;

    “The versatility of my intellectual interests made me realize that “everyone is right in some way” –it is merely a matter of knowing “how.”

    As for David Healy’s ability to dwell in denial about his true motivations, just as we all do. What is missing from the rational debate on mental health, is the real economy of survival. Self-preservation is need which we don’t acknowledge in the debate. Whether it be self-preservation by way of social benefit payments, insurance reimbursement or private payments, or profits from publishing, the economics of survival is politely ignored.

    It is uncivil, to suggest that health care professionals make their livelihoods of the misery of others. Yet so-called civil society actually functions this way, in one guise or another.

    I will repeat again, my assertion that we are all time pressured these days, and we scan the written format here, unaware of unconscious processes, which predispose us to only taking in, what we already agree with.

    John, described above his natural “freeze” reaction, which has been more clearly defined by Stephen Porges, and why I continue to suggest that the “polyvagal perspective” changes everything.

    I look forward to future exchanges and can only hope that one day those of us with extensive lived experience, will use this format to really tackle the question of “what mental illness is?”

    Regards,

    David.

    • David Bates,

      Thank you for your reply.

      It is meaningful. It raises several good questions. And, I will begin addressing some of them, one at a time, later today.

      Here, now, I will address only this one point:

      You conclude your comment with the following line, “I look forward to future exchanges and can only hope that one day those of us with extensive lived experience, will use this format to really tackle the question of “what mental illness is?””

      David, “mental illness” is an *extremely* vague concept. It covers so much academic territory, it is ultimately meaningless.

      From the context of what you are saying, I believe you would better serve your readers by dropping that term (at least in this instance) and by, perhaps, referring, instead, to “affective psychosis”.

      None of these terms are perfect; all of them have their limitations (including that one). But, I think that is what you are hoping to discuss.

      I will use that term, to address the phenomena which, I believe, you’re aiming to illuminate.

      I will begin doing so later today — and will do so, very deliberately incorporating a bit of what I gather David Healy believes about this. I will do so by briefly quoting him.

      I will make my comments as concise as I possibly can.

      Hence, I will be aiming to set a good example for you — as it has often been the case, with your comments, you’ve presented your positions by incorporating lengthy passages of others’ writings — and in such a way that it may take numerous readings to figure out exactly who is saying what.

      As *all* quotation marks on the page appear exactly the same, and there are quotations within quotations, a reader must very carefully search — almost as though searching for a needle in a haystack — to see where the ‘authoritative’ passages you are inserting begin and end.

      In part, this effect is due to the limitations of the particular WordPress features, which Matt is choosing to offer commenters.

      (My saying so is not a criticism of Matt’s choice. Simply, I believe that, if he wanted to, he could offer commenters buttons for adding a bit of HTML coding, to chunks of text, which would effectively add italics. Probably, too, he could offer us a way to indent passages of text, indicating they are excerpts of others’ writings. I presume he has deliberately aimed to keep the MIA blog comments relatively simple and uniform in appearance… thinking that this will make them more readable.)

      Because I, too, hope to forward a meaningful dialogue (currently, as well as in future exchanges), I ask that you, please, be as concise as possible, in making your points; and, find ways of being very, very clear as to when you are inserting sourced text.

      I will comment further, when I have time to do so, later today…

      Respectfully,

      ~Jonah

      • Thanks for the *paternalistic* advice Jonah:))

        As I described above, we are all time pressed these days, and with the prevailing Mind-Dominated sense of self in our educated cultures, we predisposed to only taking in what already agree with, in these written words. In other words, we instantly relate to the familiar of what we already know.

        You may be aware of the concept that the brain & nervous systems operate below conscious awareness, in a “pattern matching” way. Hence the natural anxiety of the lived moment is better defined as an established *expectation* rather than a clear perception of reality “as it is.” Hence Tolle advises we get in touch with The power of NOW?

        Unfortunately, most spiritual teachers are probably unaware of the latest neuroscience on human development (not to be confused with neuroscience which seeks to define pathology), and therefore what is not made clear in their sage advice, is the “how” of this Power in the NOW.

        What I’m trying to draw attention to, in my seemingly controversial comments, is the understandable lack of self-knowledge (how we function internally) and our limited self-awareness. For example, this natural focus on “external facts” as Joanna puts it, keeps us from becoming more self-aware, and therefore better able to self-regulate.

        The impulse to the social politics of self-empowerment, is a projected NEED of our *internal* dynamics, hence my comment “all behavior is communication.” What we fail to perceive, is just what our behavior is trying to communicate to our own, rather wooden headed mind. IMO we just don’t get ourselves, yet.

        As for the Cartesian circle that some are now defining as “intellectual masterbation,” (always reminds me of my Grandfather’s insistance on calling me MasterBates) I suggest this is because we all lack an *internal* self-awareness in our Mind-Dominated 1st world countries. Consider;

        “The Cartesian circle is a potential mistake in reasoning attributed to René Descartes.
        Descartes argues – for example, in the third of his Meditations on First Philosophy – that whatever one clearly and distinctly perceives is true: “I now seem to be able to lay it down as a general rule that whatever I perceive very clearly and distinctly is true.” (AT VII 35) He goes on in the same Meditation to argue for the existence of a benevolent God, in order to defeat his skeptical argument in the first Meditation from the possibility that God be a deceiver. He then says that without his knowledge of God’s existence, none of his knowledge could be certain. The argument takes this form: 1) Descartes’ proof of the reliability of clear and distinct perceptions takes as a premise God’s existence as a non-deceiver. 2) Descartes’ proofs of God’s existence presuppose the reliability of clear and distinct perceptions.”

        http://en.wikipedia.org/wiki/Cartesian_circle

        We are NOT objects, and we cannot define our own reality with mechanistic “cause and effect” logic.

        We lack an awareness of our own emotional *projections* and the very limited function of rationality, and its denial, of own stimulus from within. Unless we believe the *mind* has an *immaculate conception* and we simply take our thoughts for granted, as just “the way it is.”

        Lacking awareness of the internal creation of our perceptions and our projected needs, we are likely to enter into predictable emotional interactions in a shaming and blaming fashion, in our denied need to displace and deflect away from internal awareness.

        Hence, as Murray Bowen points out, we go around and around the same old Cartesian circle of public debate, in rational denial of our true motivations.

        “The triangling process in a large family will help illustrate the process in society. It may begin with conflict between a parent and child. When another takes sides emotionally, he is potentially triangled. When he talks (to influence others) or he takes action based on feelings, he is actively triangled. Each person who becomes involved can involve others until a fair percentage of the group is actively taking sides. The controversy is defined on “right” and “wrong” issues, and often as victimizer and victim. In societal conflict, those who side with the “victim” are more likely to demonstrate and take activist postures. Those who “feel more responsible” for the total group will side with the parental side. They are more likely to stay silent or take action in letters to the editor, or to actively counteract the activists.

        One interesting group of activists is made up of members of professional and scientific organizations who attempt to use knowledge and social status to further entangle the triangular emotional system. To summarize the process, it begins with emotional tension in a bipolar situation, it spreads by involving emotionally vulnerable others, it is fed by emotional reactiveness and response to denial and accusation and it becomes quiescent when emotional energy is exhausted.

        There are several ways it can be started, intensified, deintensified, or stopped. It can be started by one person who, intentionally or unintentionally, touches an emotional trigger in the second. The triggered person characteristically defends or counterattacks which adds emotional fuel. It can be deintensified or stopped by a calm person who stays in “low key” contact without defending self or counterattacking.

        The words used in triangular emotional exchange, based on rational thinking, are usually not heard by the other except to defend or prepare a rebuttal. The words can be heard only after the emotion is reduced. The triangle emotional system is most intense when anxiety is high. It disappears when the system is calm” _Murray Bowen.

        Hence my opening remark. Thanks for the *paternalistic* advice Jonah:))

        Perhaps its the *paternalistic* nature of the way society actually functions, which is also missing from the debate, along with a missing *internal* awareness?

        Best wishes,

        David.

        • “Thanks for the *paternalistic* advice Jonah:))”

          David Bates,

          As mentioned roughly twenty-four hours ago (on June 14, 2013 at 10:58 am ), I was, yesterday, intending to address some of your earlier questions (from your comment, on June 14, 2013 at 4:12 am) before day’s end.

          I never did so — as you posted another comment to me (directly above, on June 14, 2013 at 4:42 pm). You offered additional philosophical material to ponder — which left me feeling contemplative — and, also, somewhat perplexed, suspecting that maybe you are not yet interested in dialogue, that you are not necessarily ready to receive my answers.

          Instead, I think you are apparently (A) wanting to make further points, to forward your overall thesis — and (B) hoping to emphasize that I have supposedly been ‘paternalistic’ toward you.

          If I’m right about that, I have no problem with it; only, I am confused, wondering: are you or are you not serious when you say that I was “paternalistic” toward you, in my comment? What do you mean by “paternalistic” (what definition of that word best fits your meaning?); and, as you say “Thanks” for that *supposedly* ‘paternalistic’ advice which I gave you, are you feeling genuinely thankful? I honestly don’t know.

          I am confused by the smiley face you offer, at the end.

          Those who offer ‘paternalistic’ expressions are not appreciated on this website — typically.

          So, is your “Thanks” a genuine thanks? Or, is it a sarcastic thanks? That’s all I’m wanting to know, at last.

          Any forthcoming clarifications from you, on this, will be appreciated by me.

          Respectfully,

          ~Jonah

      • Basic html actually is accepted in the comment form. You can bold or italicize chunks of text. The blockquote tag might work too, though I haven’t tested it for users.

        This instruction is written below the comment box and has been for some time. (This is a blockquote)

        I had a plugin that enabled bbcode, which is a little more friendly and familiar to forum users, but it broke something else that I’ve since upgraded. I will go back and see if that works. I don’t want a WYSIWYG editor in the comments for a few reasons, but there’s no reason you can’t use basic html/bbcode formatting to make your comments more readable. Try it!

        • Matt, the blockquote tag is a good idea; I’ll try it, thanks.

          Here’s a bit of advice, for meditators, from Arnold Mindell’s book Working On Yourself Alone (1990):

          We need to add a new dimension to our belief about being human. This new dimension sounds like an ancient one which states: ‘The world is perfect the way it is.’ Even though I do not really feel the world is perfect the way it is I have discovered great enrichment from seemingly adverse events. An important and possibly new dimension in meditation would be to accept and process all events, including anger, jealousy and greed, in order to reveal their life-giving potential. Instead of trying to change our natures to fit our preconceptions of harmony or peace, we could seek to find the purpose behind events. Perhaps they are the seeds of just what we need.

          The author continues,

          My questions are: How can I make use of all my perceptions for my own benefit and for the rest of the world? Who is observing? Who in me wants to get rid of problems?

          [p. 15]

          (Note — I might add these questions: Exactly when is a ‘problem’ no longer a problem? Does the ‘problematic’ situation need to be essentially resolved, in order to say, “There is no problem here anymore”? What about a seemingly ‘problematic’ situation that I fully commit myself to addressing, in a way that feels entirely creative? Is it, perhaps, at that point, of committing myself to addressing it, a problem for others — and not a problem for me? Or, is it still a problem for everyone, including me, as long as it persists?)

  10. Test

    I had a plugin that enabled bbcode, which is a little more friendly and familiar to forum users, but it broke something else that I’ve since upgraded. I will go back and see if that works. I don’t want a WYSIWYG editor in the comments for a few reasons, but there’s no reason you can’t use basic html/bbcode formatting to make your comments more readable. Try it!,

  11. Dear Jonah,

    No I wasn’t being sarcastic in a demeaning way, I was trying to tease out the nature of our common paternal projections, as I’ve alluded to here: https://www.madinamerica.com/2013/06/leading-experts-to-speak-at-vatican-about-the-controversy-of-children-and-psychotropics/#comment-26213

    Last year, when I first began commenting on MIA, during an active psychosis, which according to the medical model, should have made me totally incoherent, I asked you whether you were describing my reality, in your assumptions about me, or if you were ‘projecting’ your own reality, subconsciously?

    When you write: (you know, I’ve told you, emphatically); at times, I think you’ve gone totally overboard, in your MIA comments, cutting and pasting *way* to many, long excerpted passages from your favorite authorities on ‘mental heath’ (or, perhaps, I should say, more accurately: your favored authorities on psychological and/or bio-psychological issues and/or experts on bio-psycho-social issues, etc.)

    Are you projecting your own sense of ‘authorities’ onto my reality, assuming we think about others in exactly the same way?

    I stopped deferring to authorities a long time ago, no longer feeling that need of childlike reverence for a ‘subconsciously’ perceived ‘parental figure.’ I don’t see a world of I & other, I see a world of ‘we.’ Hence when I quote people, I do so with a sense of gratitude for their contribution in our common struggle towards improved self-differentiation.

    Personally, I’m not so fixated on the literal meaning of words and the quality of grammar, in other peoples comments. I try to perceive what they are trying to illuminate from within.

    You suggest I make it very clear that I’m writing about “affective psychosis,” while, perhaps rather childishly I assume that nickname of bipolarbatesy will infer that I’m writing about affective psychosis, particularly with my consistent references to the meaning of the term ‘affect.’ Example:

    “Education of The Senses:

    By examining the “affects” experienced in judging another, one learns a great deal about how the illusion of self-containment is purchased at the price of dumping negative affects on that other. The level of “affective transmission” is marked in terms of how one party carries the others negative affects; his aggression is experienced as her anxiety and so forth. By means of this projection, one believes oneself to be detached from him or her, when one is, in fact, propelling forward an affect the other will experience as rejection or hurt, unless the other shield’s themselves by a similar negative propulsion, in a passionate judgment of their own. (p, 119.)

    Discernment, in the affective world, functions best when one is able to be alert to the moment of sensation, which allows the negative affect to gain a hold within. Any faculty of discernment must involve a process whereby affects pass from a state of sensory registration to a state of cognitive awareness, this does not mean that the process of cognitive reflection is without an affect itself, just that this affect is other than the affect which is being reflected upon.

    In our illusion of self-containment, reason and passion or affect-emotion and cognition keep appearing in binaries, despite arguments for their separation. Such binaries attempt a distinction between the ego and a faculty of discernment, between the affect-passion and the “other I” which reflects on them, as in the palpable experience of being pulled in two directions. One direction feels more passionate, the other, more reasonable.

    The point of affective discernment though is in the work of the senses, (touching, hearing, smelling, listening, seeing) and the expression of the senses, affectively, accurately, in words, often defined and limited by traditional vocabulary. The naming of feelings is one thing, but the ability to discern the affective world within and without, requires more. Such an investigation requires a conceptual vocabulary and some means of circumventing the “affects” combined distractions. (p, 120.)”

    Excerpts from “The Transmission of Affect” by Teresa Brennan, PhD.

    I will try to clarify further my inclusion of reference paragraphs and statements in my comments. A bottom of the above reference is states “Excerpts from,” meaning that these are excerpts from a book, which I feel are particularly pertinent to the debate on what mental illness is. I feel that each selected paragraph or statement, can be contemplated individually, for their relevance.

    Perhaps readers are confused, subconsciously ‘expecting’ a comment to follow a rational narrative style?

    Hence I write above “You may be aware of the concept that the brain & nervous systems operate below conscious awareness, in a “pattern matching” way. Hence the natural anxiety of the lived moment is better defined as an established *expectation* rather than a clear perception of reality “as it is.” And why I continue to suggest that in our time pressured lives, we scan these word symbols, unaware of unconscious processes, which only allow to perceive what we already know. Perhaps a subconscious mechanism of our limbic region within the brain, known to some as an “association” region.

    Its interesting that you’ve not found the time to address a pertinent question about your self-awareness? My question above:

    “Here is your expression of internal mechanisms of distress;

    “And, by the way, please know: my sense of disappointment, as conveyed to you, in my comment, was enlarged by the stress and sleeplessness of the family health issues I briefly mentioned – and by my laying awake, recalling having been traumatized by medical-coercive psychiatry, decades ago. It came directly from all that; and, this was quite clear to me, as I felt it; but, it didn’t occur to me, to say so, to you.

    Perhaps, I should have said so? But, I had no energy or will to articulate myself, that way — and, instead, expected you to automatically understand that my distress and my feeling unable to get to sleep was a matter of all kinds of issues; so, I apologize if my disappointment was conveyed in a way that seemingly suggested you should feel disappointed in yourself — or suggested that I might view you as the ‘adversary’; and, oh, thanks, too, for being momentarily nerdy. As a kid, I enjoyed the first Star Trek series – but never saw anything of the subsequent ‘generations’ of shows and films. (Though, I appreciate good sci-fi; and, yes, I do get the idea behind the ‘Borg’ characters; the theme is germane to our discussion, you must well realize.)

    Wikipedia explains, “The Borg are a collection of species that have been turned into cybernetic organisms functioning as drones of the Collective, or the hive. A pseudo-race, dwelling in the Star Trek universe, the Borg force other species into their collective and connect them to ‘the hive mind’; the act is called assimilation and entails violence, abductions, and injections of cybernetic implants. The Borg’s ultimate goal is ‘achieving perfection’.”

    You are *not* really a Borg (you only play one at Star Trek conventions). You are against being a Borg, in reality; that is clear from your caring expressions.”

    Please explain to me, just how and where you express an awareness of internal function, in the above?

    As for myself and my improving self-regulation through increased ‘internal’ awareness. it has come through digesting new knowledge with the practice of experiential integration, having, like many of my fellow travelers here, faith in my innate intuition. Hence I write to such a fellow traveler;

    “I have always trusted my “intuition” over my often confused rationality, and increasingly accept the evolved wisdom of my body and its ability to know, what “rationally,” is “unknowable.”

    Although I don’t favor their rather commercial approach to science, the folks at HeartMath Institute do point out some great science of the heart, and practical ways to use it.

    “The heart’s nervous system contains around 40,000 neurons, called sensory neurites, which detect circulating hormones and neurochemicals and sense heart rate and pressure information. Hormonal, chemical, rate and pressure information is translated into neurological impulses by the heart’s nervous system and sent from the heart to the brain through several afferent (flowing to the brain) pathways. It is also through these nerve pathways that pain signals and other feeling sensations are sent to the brain. These afferent nerve pathways enter the brain in an area called the medulla, located in the brain stem. The signals have a regulatory role over many of the autonomic nervous system signals that flow out of the brain to the heart, blood vessels and other glands and organs. However, they also cascade up into the higher centers of the brain, where they may influence perception, decision making and other cognitive processes.

    “Since emotional processes can work faster than the mind, it takes a power stronger than the mind to bend perception, override emotional circuitry, and provide us with intuitive feeling instead. It takes the power of the heart.” (McCraty, Atkinson, Tomasino, 2001).

    Ram Dass, and other spiritual leaders are saying the same thing, from a spiritual perspective, IMO. So it does seem, that beyond our thurst for melodramatic headlines and highly conservative “paternalistic controlisms,” science and spirituality, are converging?

    Be well,

    http://bipolarbatesy.blogspot.com.au/2012/02/mad-visions-or-mental-illness-part-1.html

    You too Jonah,

    Be well.

    • P.S. I apologize for the time delay’s in my replies to you Jonah. But we are on opposite sides of the planet, even though we’re on the same side of the debate.

      Like how we both called for ‘transparency’ from the operators of this webzine last year. Both of us posted private email communication on our own blogs, in an effort to point out the nature of behind closed doors ‘paternalism.’

      Elitism works privately, keeping precious knowledge in the family, so to speak. As they say, all groups have their ‘in group’ and outsider members. Behavior ‘rationalized’ in a need of displacement or projection, away from the reality of internal motivation.

      Best wishes,

      David.

      • David,

        IMHO, no need to apologize for time delays in responses — nor even any certain need to respond, really.

        Ideally, we are here to post thoughtful comments on a blog post and/or, in some instances, to address each other’s comments. Occasionally, that turns into relatively extended back and forth dialogue; that has happened with you and I, at least a couple of times previously; however, ultimately, this isn’t a chat room; hence, IMO, rapid-fire responses are wholly unnecessary.

        Respectfully,

        ~Jonah

    • “Please explain to me, just how and where you express an awareness of internal function, in the above?”

      David Bates,

      OK, you weren’t trying to be sarcastic in a mean way; you really didn’t have to explain that you weren’t trying to be mean. I get that; great.

      But, you were being a bit sarcastic, I think; and, you are offering me way too many things to think about; I am overloaded by your way of presenting yourself; I’m needing a break from the Internet now. No kidding.

      I asked you to, please, be concise — not to be ‘paternalistic’ toward you — but, to, hopefully, prevent you from overloading me…

      Question: Are you determined to prove that I have limited awareness of my internal processes?

      If so, fine.

      But, in any case, despite my being as clear as I can be, in my writing to you, you are not getting me (it seems to me).

      You’re reading my words in a very selective way.

      On June 13, 2013 at 9:28 am, to you, I wrote,

      I suggest you read my comment (on June 11, 2013 at 11:36 pm): https://www.madinamerica.com/2013/06/a-critical-psychiatry-network-call-to-cancel-charles-nemeroff/#comment-26113

      I added,

      See, especially, all that I wrote in the second half of that comment, beginning with, “You shared your sense of ‘overwhelm’ and where it comes from. I think I know what you mean…”

      I said, “See, especially, all that I wrote in the second half of that comment…”

      What does this phrase, “see all…” mean to you? (It should mean, ‘see everything…’ Correct?)

      For whatever reasons (probably unconscious), you decided to read some of the second half of that comment, of mine — not all of it.

      IMO, the second half of that comment, of mine, expresses a fair amount of self-awareness. If you want me to detail more of my internal processes, how much more?

      You want me to talk about a tightness I may have been experiencing in my sphincter maybe? I don’t care to talk about my sphincter. You can talk about yours, I won’t object.

      Meanwhile, I am tiring of our dialogue, David.

      Frankly, I feel it’s going nowhere.

      It’s time for me to take a break.

      Please, don’t take offense.

      Respectfully,

      ~Jonah

      • P.S. — David, for me, if/when I may have a lot on my mind and am unable to sleep one night, that’s not the worst thing; if I miss a few nights sleep, there’s probably some underlying anxiety that needs addressing; if I’m, in fact, addressing the source of the, and it persists, then it’s time to reduce anxiety, by simply getting out and taking a long hike. Exercise (in particular, aerobic exertion) — and healthful eating — are both key…

        My ability to sleep inevitably returns after an extended hike and a few good meals (containing lots of fresh, raw veggies).

        If I can get out, on a long hike, a couple of days in a row, then I’m literally guaranteed to get my sleep cycle back in rhythm.

        It never fails.

        Does this have anything to do with “polyvagal perspective” which so inspires you? (I have no idea.)

        Respectfully, ~J.

        • Dear Jonah, you write;

          “Meanwhile, I am tiring of our dialogue, David.

          Frankly, I feel it’s going nowhere”

          Please consider an emotional “systems” view of our dialogue;

          “The concept of differentiation of self is important. At the more differentiated end of the scale is the person who can “know” with his intellect, and who can also know, or be aware of, or feel the situation with his emotional system. He has reasonable ability to keep an operational differentiation between intellect and emotions and take action on the fact of intellectual reasoning, that opposes his feelings and the truth of subjectivity. Only a small percentage of the population has this level of differentiation.

          A person can have a well functioning intellect but intellect is intimately fused with his emotional system, and a relatively small part of his intellect is operationally differentiated from his emotional system. He can accurately “know” facts that are personally removed, such as mathematics and the physical sciences, but most of his intellect is under the operational control of the emotional system, and much of his total knowledge would be more accurately classified as an intellectual emotional awareness, without much differentiation between intellect and feelings.

          The person at this level of differentiation does not commonly have a clearly formed notion of fact, or differences between truth and fact, or fact and feeling, or theory and philosophy, or rights and responsibility, or other critical differentiations between intellectual and emotional functioning. Personal and social philosophy are based on the truth of subjectivity and life decisions are based more on feelings and maintaining the subjective harmony.

          A triggered person characteristically defends or counterattacks which adds emotional fuel.

          To summarize the process, it begins with emotional tension in a bipolar situation, it spreads by involving emotionally vulnerable others, it is fed by emotional reactiveness and response to denial and accusation and it becomes quiescent when emotional energy is exhausted.” _Murray Bowen.

          With all due respect Jonah, your doing what Bowen predicts you will do, as you reach the limits of your self-awareness.

          Our “psychological” awareness, our MindDominated sense of self, lacks an ability to sense the internal nature of “stimulation.” Our conscious awareness, stays with an understanding of itself, as the “response” side of an external/internal feedback-stimulated-response.

          Of course, we are not raised to be aware of the “unconscious” aspects of feedback-stimulus, reaching maturity, having long forgotten the time before we learned to think and were “taught” our common vocabulary.

          As Bowen points out Jonah, if readers look carefully at your comment replies, your exhibiting a “postural” attitude to life, as you don’t see what I’m saying, because you understand your “affective” nature, and how your affective “judgement” is stimulated from within.

          Please consider, if you can slow down enough to take the time required of knowledge digestion:

          “From a functional point of view, bodily/sensate feelings are the compass that we use to navigate through life. They permit us to estimate the value of the things to which we must incorporate or adapt. Our attraction to that which sustains us and our avoidance of that which is harmful, are the essence of the feeling function. All feelings derive from the ancient precursors of approach and avoidance, they are in differing degrees positive or negative.

          Sensation-based feelings guide the adaptive response to (e)valuations. Emotions on the other hand, occur precisely when behavioral adaptations (based on these e-valuations) have failed? Contrary to to what both Darwin and James thought, fear is not what directs escape; nor do we feel fear because we are running from a source of threat. The person who can run freely away from threat does not feel fear. He only feels danger (avoidance) and then experiences the action of running. It is solely when escape is prevented that we experience fear. Likewise, we experience anger when we are unable to strike our enemy or otherwise resolve a conflict. (p, 327)

          Working at Columbia University in the 1940s and 50s, Nina Bull conducted remarkable research in the experiential tradition of William James. In her studies subjects were induced into a light hypnotic trance, and various emotions were suggested in this state. These included disgust, fear, anger, depression, joy and triumph. Bull discovered that the emotion of anger involves a fundamental split. There was, on the one hand, a primary compulsion to attack, as observed in tensing of the back, arms and fists (as if preparing to hit). However, there was also a strong secondary component of tensing the jaw, forearm and hand. This was self-reported by the subjects, and observed by the experimenters, as a way of controlling and inhibiting the primary impulse to strike. (p, 332)

          In addition, these experimenters explored the bodily aspects of sadness and depression. Depression was characterized, in the subjects consciousness, as a chronically interrupted drive. It was as though there was something they wanted but were unable to attain. These states of depression were frequently associated with a sense of “tired heaviness,” dizziness, headache and an inability to think clearly. The researchers observed a weakened impulse to cry (as though it were stifled), along with a collapsed posture, conveying defeat and apparent lethargy.

          When Bull studied the patterns of elation, triumph and joy, she observed that these positive affects, did not have an inhibitory component; they were experienced as pure action. Subjects feeling joy reported an expanded sensation in their chests, which they experienced as buoyant, and which was associated with free deep breathing. The observation of postural changes included a lifting of the head and an extension of the spine. These closely meshed behaviors and sensations facilitated the freer breathing.

          Understanding the contradictory basis of the negative emotions, and their structural contrast to the positive ones, is revealing in the quest for wholeness. All the negative emotions studied were comprised of two “conflicting impulses,” one propelling action and the other inhibiting (thwarting) that action. (p, 333)”

          Excerpts from “In an Unspoken Voice,” by Peter Levine, PhD.

          Please look carefully at what Brennan is saying about our common lack of “internal” awareness and our subconscious “judgement” of each other, in our NEED of self-empowerment.

          “By examining the “affects” experienced in judging another, one learns a great deal about how the illusion of self-containment is purchased at the price of dumping negative affects on that other. The level of “affective transmission” is marked in terms of how one party carries the others negative affects; his aggression is experienced as her anxiety and so forth. By means of this projection, one believes oneself to be detached from him or her, when one is, in fact, propelling forward an affect the other will experience as rejection or hurt, unless the other shield’s themselves by a similar negative propulsion, in a passionate judgment of their own. (p, 119.)” _Teresa Brennan.

          Hence, when I first began to read Allan Schore, with a knowledge that psychiatrists labeled my experience as an “affective disorder,” I was struck by the power of this statement;

          “The attempt to regulate affect – to minimize unpleasant feelings and to maximize pleasant ones – is the driving force in human motivation.” (Schore, 2003).”

          As I’m struck by your constant NEED to be a critic, to project your ‘affective state” onto the external world. Freud called this “displacement,” and I do understand the paradox of traumatic experience, which keeps us “stuck” in our MindDominated sense of self, as a flight from PAIN, and the BODY. I understand how painful it is to relive the past, and the reality of how “the body keeps the score.”

          “The Limits of Talk:
          For more than 20 years, Bessel van der Kolk has been in the forefront of research in the
          psychobiology of trauma and in the quest for more effective treatments. Now he’s touched off
          an intense debate about the role of scientific evidence in finding ways to alleviate suffering and the future of the traditional talking cure itself…….”

          http://www.traumacenter.org/products/pdf_files/Networker.pdf

          Just like last year, when we got into a conversation where you did exactly what Bowen predicts “The words used in triangular emotional exchange, based on rational thinking, are usually not heard by the other except to defend or prepare a rebuttal.”

          This emotional systems view, explains why we continue to round the same old Cartesian Circle, in a rationalized debate, which is “primarily” about managing “internal” affects.

          Too many people “think” that intelligent critique is constant criticism of something or someone, beguiled by their capacity for an eloquent description of a displaced NEED.

          What does the metaphor “I see you” from the movie Avatar mean to you, Jonah? According to Jake’s friend, it means “I see into you.”

          is there a common lack of internal awareness, in fact even a dire resistance to internal knowledge, which prevents us from really understanding each other?

          I believe that I’ve attempted to answer questions you put to me, while readers may note, how you’ve neatly avoided answering questions I put to you. Example:

          “Also please consider this perspective, even though you will no doubt feel that I don’t do this;

          “The versatility of my intellectual interests made me realize that “everyone is right in some way” –it is merely a matter of knowing “how.”

          This, in my humble opinion, is what is missing in our “counteracting” debate. Hence the general confusion about biology and neuroscience.

          Respectfully

          David.

          • “With all due respect Jonah, your doing what Bowen predicts you will do, as you reach the limits of your self-awareness.”

            David Bates,

            You believe that I have reached the limits of my self-awareness, really?

            How can you possibly even *begin* to presume to know what are or are not the limits of my self-awareness?

            When it comes to, perhaps, discerning what might be my degree of self-awareness…

            By way of reading these exchanges with you, here, in MIA comments, all that anyone can reasonably do (at best) is *s-p-e-c-u-l-a-t-e* upon the quality and nature of my self-awareness — as I am not necessarily mentioning much of that which comes to my attention, as I am replying to you.

            My observations may appear limited because, frankly, I have no interest in ‘publicly’ sharing most of what comes to mind, in terms of self-awareness, in the midst of offering you my replies.

            But, who does openly share anything even remotely approaching the full extent of his/her self-awareness, ever?

            It would be impossible to do so — especially, in comment, on a website like this — even if one wanted to; and, really, most people don’t care to try to share that way.

            Most have neither the time nor the interest to convey most of what is coming to their attention, in their own inner worlds — usually, for good reasons.

            If you care to do that, David, you won’t find me objecting; however, need I do it? Need other commenters do it?

            David, I read your comments; and, very often, I sense that, in so many ways, you’re asking from commenters what would amount to a more complete personal divulgence, of their inner lives; but, who could convey the sort of divulgences, which you are calling for without going so far afield, as to lose sight of the blog post, at the top of each Web page?

            Furthermore, how can you and I even continue this back and forth — without losing track of that topic, at hand?

            Soon, we shall draw the ire of the moderators, who (rightly) care to keep their commenters on topic. (I say that is “rightly” their aim, as I truly sympathize with that goal, of theirs.)

            We should stay on topic, IMO.

            Nonetheless, because Murray Bowen is, again, on your mind, now, momentarily, I shall draw your attention to these first lines, of a brief explanation, of Murray Bowen’s theory of ‘triangles’ (or, ‘triangulation’) appearing in Wikipedia [from all you say, you are quite familiar with this theory, but other readers might not be]:

            In family systems theory, whenever two people have problems with each other, one or both may “triangle in” a third member. Bowen emphasized the idea that people respond to anxiety between each other by shifting the focus to a third person, triangulation. In a triangle, two are on the inside and one is on the outside.

            David, I refer you back to that issue, which you’ve raised — of ‘triangles’ …as I genuinely wonder whether you were aware of how *you* were triangulating — Murray Bowen style — with your comment to me, of roughly twenty-four hours ago (on June 15, 2013 at 5:47 pm)?

            [Note: I was not going to mention this, to you; however, now that you claim Murray Bowen predicted *my* behavior, suddenly, I can’t resist pointing this out, to you; if readers find it an indulgence, on my part, hopefully, they can forgive me…]

            IMO, David Bates, whether you did so consciously or not, you did, indeed, attempt, in that comment, of 24 hrs ago, to create a special sense of alliance with me, by painting the “the operators of this webzine” as the outsiders — who are (in your view) supposedly forwarding a kind of “elitism”.

            You hearkened back to an incident of last year (an incident which I feel is long past), and you concluded,

            Elitism works privately, keeping precious knowledge in the family, so to speak. As they say, all groups have their ‘in group’ and outsider members. Behavior ‘rationalized’ in a need of displacement or projection, away from the reality of internal motivation.

            David, probably, you’re not aware that I do not see the moderators of this MIA site as ‘elitists’.

            [In fact, I only had a problem with one moderator; that was many months ago; I’ve offered small peace-making gestures, since then, conveying my ultimate sense that he was learning and that I don’t hold that incident against him, at all.]

            Though they have made some mistakes, IMO, the moderators are doing a very fair job of moderating, IMO.

            Meanwhile, your own behavior, David, in these comments, demonstrates a *lot* of projection, IMO — and a considerable degree of elitism, too.

            IMO, you are being *elitist* — not least of all, from this point of view, that you’re posting such a plethora of *esoteric* academic material, it’s hard even for me to wade through and decipher. (And, I consider myself to be someone with a *relatively* advanced ability to decipher academic material, usually, when it comes to these issues…)

            I can typically understand academic materials regarding the issues raised on this website.

            Probably, I could decipher the meaning of these many ‘authoritative’ passages you are providing; yet, my time is limited — as is my energy.

            And, clearly, much of what you’re posting is going to be *impenetrable* to most readers.

            Have you no interest in speaking to ‘common’ people, I wonder?

            How does your “polyvagal perspective” help the average Joe (or, Josephine)?

            Can it possibly help me or anyone else I know?

            (In truth, I am not seeking ‘help’ on this site; yet, I do always care to find new ways of helping others; and, I seriously wonder: How might your views help anyone — as you *frequently* speak of the “polyvagal perspective” …while not making sense of it; so far as I can tell, you have never translated it into *simple* terms, of plain English).

            “Polyvagal perspective” means nothing to me.

            It’s an empty term, when I hear it.

            Would you be so kind as to offer a simple definition?

            Respectfully,

            ~Jonah

            P.S. — I beg you, David: Please, don’t reply to this comment by providing yet more ‘authoritative’ quotes; ideally, what I’d like to get from you is the briefest, most concise, clear statement, on what is the “Polyvagal perspective”.

            Plain-speaking, straightforward English — as concise as possible please.

            I leave you with a favorite, *brief* quote…

            Evil is the product of the ability of humans to make abstract that which is concrete. ~Sartre

  12. For the record, Dr. David Healy was never invited to the Catholic Church event he refers to in this article and I am familiar with all his work.

    As the organizer, I never had any communication with him about this program, so it is perplexing as to why he would write such a statement…

    He also links his phrase, “But now when Churches are scared of pharma…” to his footnote regarding his statement that he was “disinvited”. Does Dr. Healy really think that the Church is scared of pharma because HE was not a participant?

    We had the most extraordinary team for this conference which concluded with many promising results.

    • “For the record, Dr. David Healy was never invited to the Catholic Church event he refers to in this article and I am familiar with all his work.”

      MBarbacki,

      Thank you for providing your brief but highly informative comment.

      It’s quite significant comment, in my opinion, as it points to a serious — self-aggrandizing — fabrication, on the part of David Healy.

      Hopefully, MIA readers will read your words carefully and make note of them.

      As your user name may not be immediately recognizable, readers should be made aware that you are the writer recently featured on this website; that blog post is titled, “Leading Experts to Speak at the Vatican about the Controversy of Children and Psychotropics” (posted June 4, 2013).

      This is to say, readers should be aware: you are, “Marcia Barbacki […] a practicing occupational therapist for 30 years with experience working with children, families and older adults in the clinical as well as home setting.”

      https://www.madinamerica.com/2013/06/leading-experts-to-speak-at-vatican-about-the-controversy-of-children-and-psychotropics/?utm_source=rss&utm_medium=rss&utm_campaign=leading-experts-to-speak-at-vatican-about-the-controversy-of-children-and-psychotropics

      It will be interesting to see if David Healy responds to your comment.

      Respectfully,

      ~Jonah

      • Dear Jonah,

        Please consider how you may have “missed” the real stimulus for your comment, “MBarbacki,

        Thank you for providing your brief but highly informative comment.

        It’s quite significant comment, in my opinion, as it points to a serious — self-aggrandizing — fabrication, on the part of David Healy.”

        I believe MBarbacki’s clarifying comment was stimulated by sighting this;

        “I have recently been disinvited from a Catholic Church linked meeting on psychotropic drugs and children apparently for using an analogy between child abuse in the Church and pharmacotherapy abuse in clinical care.” _David Healy.”

        It was my misattribution of MBarbacki’s disinvitation which prompted the need for his clarifying comment here.

        Perhaps, with a deeper contemplation of the hidden mechanisms of your stimulus-response behaviors, you come to understand, how the eye and attention which is externally focused, can be deceiving? Because there is too little “simultaneous” internal awareness.

        Respectfully,

        David.

        • P.S.

          I’m hoping that someone will respond to a mistake in my comment, to further highlight these “hidden” feedback mechanisms of our “affective states” of awareness.

          IMO Its not a different way of seeing the world “out there” that is so desperately needed now, but a different way of seeing ourselves. For example, how the serpent in the garden of eden, is a metaphor for our spinal column and brainstem.

          Hence, my inclusion of references to neuroscience research, which points to just how “the body keeps the score” in “bottom-up” processes which as Schore points out “occur beneath levels of awareness not because they are repressed but because they are too rapid to reach consciousness.”

          Its also notable, perhaps, that in our development, its the heart & nervous systems, ie,(the spinal chord) which develop first?

          Regards to all,

          David Bates.

  13. Dear Jonah, you write;

    ““Polyvagal perspective” means nothing to me.

    It’s an empty term, when I hear it.

    Would you be so kind as to offer a simple definition?”

    I guess, this IS the whole confusing point in the mental illness debate. There IS NO simple definition, despite the way we all crave it.

    Many, Feel good entrepreneurs make a fortune from peddling phrases which although invoking warm and wonderful sensations, explain almost nothing of the “how” & “why” of our sense of life.

    The “chemical imbalance” metaphor finds general acceptance, because it appears to provide a plausible explanation for our distressing experience. We crave a “self-soothing” stimulus for our need to “minimize unpleasant feelings and to maximize pleasant ones – (which) is the driving force in human motivation.” (Schore, 2003).” In brackets mine.

    How do I sum up six years of intense self-education and its transforming effects, in a simple statement of straight forward English, when the general language is mismatched to our internal reality?

    I understand how unfamiliar the language of neuroscience is, to you and other readers, and understand the “reaction” to my seemingly “arrogant” statements. All I can do, is ask people to ponder, how it might be that a reading of science has enabled my transformation?

    It it an impossible stretch of the communities imagination to consider that science too, might have an explanation as to the nature of the psyche, comparable to Paris Williams more poetic formulation? Consider;

    “So, we finally arrive at the final and perhaps most important question in this discussion: “Why would an individual’s psyche intentionally initiate psychosis?”

    In other words, how can something as chaotic and as potentially harmful as psychosis act as a strategy to aid someone in transcending an otherwise irresolvable dilemma? To understand this, it helps to use as a metaphor the process of metamorphosis that takes place within the development of a butterfly. In order for a poorly resourced larva to transform into the much more highly resourced butterfly, it must first disintegrate at a very profound level, its entire physical structure becoming little more than amorphous fluid, before it can reintegrate into the fully developed and much more resourced form of a butterfly.”

    https://www.madinamerica.com/2012/08/op-ed-schizophreniapsychosis-brain-disease-or-existential-crisis/

    Yet how do we understand this common metaphor “psyche” and how can I explain how neuroscience gave me clues to understanding the internal NEED for my expereince of “mania?” Consider (and yes Jonah, I do understand that this comment is read by others too);

    A second core assumption of systems theory is that self-organization is characterized by the emergence and stabilization of novel forms from the interaction of lower-order components and involves “the specification and crystallization of structure.” This mechanism also describes how hierarchical structural systems in the developing brain self-organize. Developmental neuroscience is now identifying the “lower” autonomic and “higher” central brain systems that organize in infancy and become capable of generating and regulating psychobiological states.

    Developing organisms internalize environmental forces by becoming appropriately structured in relation to them, and by incorporating an internal model of these exogenous signals they develop adaptive homeostatic regulatory mechanisms which allow for stability in the face of external variation. The regulation of the organism, which maintains internal stability and output regulation and enables effective response to external stimuli, therefore depends on the formation of a dynamic model of the external environment. Self-organizing systems are thus systems that are capable of generating new internal representations in response to changing environmental conditions. (p, 94) (1980?)

    The human is a nonlinear dynamic system, an inherently dynamic energy-transformation regime that coevolves with its environment, one that self-organizes when exposed to an energy flux. The infant becomes attuned to an external object in its environment who consistently responds in a stimulating manner to the infant’s spontaneous impulsive energy dissipating behaviors. (p, 95)

    The nonlinear self acts “iteratively”, so that minor changes, occurring at the right moment, can be amplified in the system, thus launching it into a qualifiedly different state. Indeed energy shifts are the most basic and fundamental features of emotion, “discontinuous” states are experienced as “affect responses,” and nonlinear psychic bifurcations are manifest as rapid “affective shifts.” (p, 96)

    One of the fundamental characteristics of an emotional episode… is the synchronization of the different components of the organism’s efforts to recruit as much energy as possible to master a major crisis situation (in a positive or negative sense). (my mania in 1980) I suggest the principle applies to the developmental crisis that must be mastered as one moves along the lifespan. The continuing growth spurts of the right hemisphere that mediate attachment, the synchronization of right-brain activities between and within organisms, thus occur as the developing individual is presented with the stresses that are intrinsic to later stages of life, childhood, adolescence, and adulthood. (p, 172)

    Vagal tone is defined as “the amount of inhibitory influence on the heart by the parasympathetic nervous system.” (p, 301)

    In light of the principle that birth insult and stress interact and impair later stress regulation , early right-amygdala function, including olfactory contributions to proto-attachment communications, should be evaluated in the perinatal period. (p, 304)

    Affect dysregulation is also a hallmark of Bipolar Disorders that involve manic episodes. Manic depressive illnesses are currently understood to represent dysregulatory states. The developmental psycho-pathological precursor of a major disorder of under-regulation can be demonstrated in the practicing period histories of infants of manic depressive parents. I suggest that the necessary gene environment condition is embedded specifically in practicing period transactions. (P, 410).

    Noting the commonalities between elation as a basic practicing period mood in infants and manic symptomology in adults, Poa (1971) observes Elation as a basic mood is characterized by an experience of exaggerated omnipotence which corresponds to the child’s increasing awareness of his muscular and intellectual powers. The similarity between the two is striking. Manic disorder has also been described in terms of a chronic elevation of the early practicing affect of interest-excitement; this causes a “rushing” of intellectual activity and a driving of the body at uncontrollable and potentially dangerous speeds. (P, 410-411).” (Schore, 2003)

    Please note the my reference to mania and its implications for Paris’s more eloquent formulation, of psychic transformation. There is even a reference to vagal-tone and birth insult, as the hints which enabled my transformation of birth-trauma, conditioned FEAR, into a more joyful approach to life, now that I understand, the internal and external, mechanisms of my FUNCTION.

    I’m sure you will react with assumptions of “intellectual masterbation,” although you may prove me wrong?

    Which reminds me of the esteemed Harvard PhD, who travels to India and meets a Guru. He spends three days explaining his theory of mind to the Guru, and asks ‘what you THINK?

    ‘Feels like intellectual masterbation to me,’ says the Guru.

    And of course the PhD is outraged, he doesn’t even hear the “operative” word “feels.”

    Readers might wonder how is it, that my earlier, deluded self-referential ideation of Messiah-ship has been transformed to an understanding of the human race, as a Messiah species? Consider if you will, beyond your understandable reaction, that I’m into “a serious — self-aggrandizing — fabrication” ;

    “A Messiah Species? Existential Meaning in Metaphors?

    A messiah is a saviour or liberator of a people in the Abrahamic religions. Or a metaphor for our species?

    Savior or Saviour may refer to a person who helps people achieve salvation, or saves them from something. Or a Species Redemption of Light Matter Energy?

    A metaphor is a literary figure of speech that describes a subject by asserting that it is, on some point of comparison, the same as another otherwise unrelated object.
    Is it time to turn our awareness inwards, to the existential meaning of spiritual metaphors, in all the world’s mythologies?

    “Perhaps some of us have to go through dark and devious ways before we can find the river of peace or highroad to the soul’s destination.” _Joseph Campbell.

    This is one of those posts in which I’m attempting to express my experience of euphoric mania and the inuitive sense of existential meaning which always infuses my psychoses? Please consider;

    The Evolution of Light, God & Existential Meaning?”

    http://www.bipolarbatesy.blogspot.com.au/2013/01/a-messiah-species-existential-meaning.html

    I do understand Jonah, how you NEED to protect your image of REASON, and just how much you will resist any awareness of the real nature, of the serpent in the garden, and how God and the Cosmos, is within you.

    Be well my friend,

    Respectfully.

    David.

    • P.S. Jonah, you write;

      “you’ve presented your positions by incorporating lengthy passages of others’ writings — and in such a way that it may take numerous readings to figure out exactly who is saying what.”

      As an analogy as to my own metamorphosis (to use Paris Williams term about transformation through the process of psychosis), it has taken much reading and re-reading of the science references I include in my comments, to deepen my self-awareness.

      In analogy, its like watching your favorite movie for the fourth & fifth time, and noticing things that had slipped past your attention, in previous viewings. Also in analogy, this is perhaps why people of religious faith, read ancient texts, over and over again. The metamorphosis process. summed up in Joseph Campbell’s advice;

      “Sit in a room and read–and read and read. And read the right books by the right people. Your mind is brought onto that level, and you have a nice, mild, slow-burning rapture all the time.” _Joseph Campbell.

      As for your asking me about practical help;

      “Have you no interest in speaking to ‘common’ people, I wonder?

      How does your “polyvagal perspective” help the average Joe (or, Josephine)?

      Can it possibly help me or anyone else I know?”

      I do this on my own blog and I have given a simple explanation of the polyvagal perspective, in response to the same question on this webzine before. Consider;

      “HEART TONE EXERCISES:

      Lay down on your tummy like the lady here, sinking down into the bed or floor as much as you can. It is important you try to feel as much of the fabric beneath you as possible. Try to feel your internal organs dropping or pressing down against the fabric texture.
      Feel the area of your heart, feel the muscular tension there in your chest. As you make contact with body sensations notice any tingling in your toes & finger tips. Try to feel and not think, let go & sink deeper into your body, falling down, way down. As you let go of tensions in this area of your chest relax any tension in your face.

      Focus a felt awareness on your chest, the area around your heart, let go and sink down, letting go any tension around your mouth, your jaw and in your tongue. If you can focus on sensing your heart and the muscles in your chest, you should notice an involuntary deepening of your breath. Notice any increased sensations from your limbs, your fingers and toes, any spontaneous relaxing of tummy muscles. These sensations are your auto nervous system at work.

      Observation of Felt Sensation: As you continue to feel your heart soften, letting go of muscular tensions, notice any slowing & deepening of your breath. Notice further relaxing of regions of your body where contact has usually been outside your minds awareness. You should notice an increased awareness of your limbs and your posterior, with the sphincter muscle of your anus letting go of autonomic constriction there.

      Notice the temptation to escape body sensations and return to a thought based energy discharge, when you try to feel your body in this way. Practice for a few minutes the sensations of coming into relaxed body states, and the habitual flight into mind of an unconscious, autonomic response, your normal comfort zone. This gradual experiencing of unconscious defense, the tensions, the habitual thinking, will bring you into contact with your autonomic nervous system’s reactions and its affect on the vagal tone of your heart.

      On first introduction to this practice, try for a few minutes each day to get a feel for the difference between your habitual autonomic nervous system tensions, and the more relaxed heart tones possible through thoughtless relaxation? As you go about your daily routine try to spend a few seconds now and then, relaxing every muscle you can feel within your face. Relax any tension in your jaw, around your eyes and let your tongue lie relaxed in your mouth, your lips allowed to part as you inhale with relaxed chest muscles. Feel the feedback signals from your muscles that have maintained this autonomic activity below your conscious awareness.

      3. New Mind-Body Experience:

      Building a new mind-body experience is a process of getting to know your hidden auto nervous system through observing internal sensations as described above. Practicing control over pressured thinking by relaxing internal tensions, brings a felt sense of the role of the ANS in bipolar symptoms. A short period experimenting with this tension release method of easing racing thoughts, will bring you into a new awareness of your internal mind-body function. Practicing a new felt awareness will bring you into direct contact with the bipolar catch 22 of avoidance of body sensations.

      Resistance to deep muscular relaxation is common for mental illness sufferers and is evidence of an unconscious internal threat. Understanding how this unconscious of sense threat is maintained by habitual tensions, we can begin to re-condition the nervous system with new experiences. With acceptance that the auto nervous system is deeply involved in bipolar symptoms, raised awareness brings a new observation of internal sensations.

      Acceptance of auto nervous system function by a felt experience of sensations, allows the conscious mind its craved for sense of knowing. It is the conscious experience of ‘not knowing’ that ensures the cyclic trap of bipolar disorder, with conscious concern providing fuel for the unconsciously perceived threat. Escape into the mind is the common denominator in all mental anguish, and it is crucial to understand this fundamental avoidance of felt sensation at the root of mental illness. Once we accept the autonomic nervous system and its crucial role in our experience, we can pay it due respect with a mind that observes, knows and allows this vital auto pilot of our lives to do its job.

      Example: As I write this page I slip back into an habitual tense posture for concentration, its unconscious and automatic. As part of my new mind-body experience, a half hourly alarm is set to remind me to relax unconscious muscle tensions and allow a healthy auto nervous system response. Over the past two months of daily writing my old intense posture of concentration has softened, as I re-condition my auto nervous system with new experience. At end of each writing session I deliberately trigger my desired auto nervous system state using an NLP kinesthetic anchoring technique.

      After only a weeks practice using a physical anchoring technique I now trigger my desired nervous system state just by pressing my finger and thumb together?. Such anchoring techniques are used by people in all walks of life from sales to entertainment and sports performance. In health therapies such techniques are taught as grounding exercises to help people suffering de-realiztion or de-personaliztion sensations. In all these cases the autonomic nervous system is the unconscious mechanism, affecting the changes in internal sensations.

      NLP kinesthetic anchoring technique: I find an implicit memory of balanced nervous state, feeling a rising intensity of body sensation, particularly the increased feedback from fingers and toes described above. Such increases in body awareness are my surest sign that I’m dropping out of my habitual freeze response, when attention is focused through the mind too much. As the grounded sensation of autonomic balance increases I press my thumb and index finger together creating a specific sensation of pressure which becomes associated with this nervous system state.”

      http://bipolarbatesy.blogspot.com.au/2011/07/bipolar-recovery.html

      You may find this comment from a reader illuminating;

      “As someone diagnosed with bi polar years ago and living medication free I recognise the idea of unconscious threat. For me this manifests in teeth gritting (during sleep and whilst awake), tense shoulders, fist clenching and a tendency to be quick to anger. To be frank it is like living on a knife edge of panic. I am much ‘better’ now and use mindfulness practice but truthfully this notion of reminders to simply relax facial muscles etc. is simple yet powerful. Already as I unclench I feel an immediate mental change. Thank you.”

      In a very practical sense, you see how these Heart Tone Exercises relates to the above comment on a burgeoning science of the heart;

      “I have always trusted my “intuition” over my often confused rationality, and increasingly accept the evolved wisdom of my body and its ability to know, what “rationally,” is “unknowable.”

      Although I don’t favor their rather commercial approach to science, the folks at HeartMath Institute do point out some great science of the heart, and practical ways to use it.

      “The heart’s nervous system contains around 40,000 neurons, called sensory neurites, which detect circulating hormones and neurochemicals and sense heart rate and pressure information. Hormonal, chemical, rate and pressure information is translated into neurological impulses by the heart’s nervous system and sent from the heart to the brain through several afferent (flowing to the brain) pathways. It is also through these nerve pathways that pain signals and other feeling sensations are sent to the brain. These afferent nerve pathways enter the brain in an area called the medulla, located in the brain stem. The signals have a regulatory role over many of the autonomic nervous system signals that flow out of the brain to the heart, blood vessels and other glands and organs. However, they also cascade up into the higher centers of the brain, where they may influence perception, decision making and other cognitive processes.

      “Since emotional processes can work faster than the mind, it takes a power stronger than the mind to bend perception, override emotional circuitry, and provide us with intuitive feeling instead. It takes the power of the heart.” (McCraty, Atkinson, Tomasino, 2001).

      Ram Dass, and other spiritual leaders are saying the same thing, from a spiritual perspective, IMO. So it does seem, that beyond our thirst for melodramatic headlines and highly conservative “paternalistic controlisms,” science and spirituality, are converging?”

      And lastly, why do I post such esoteric comments?

      Because they relate to the nature of the God conflict in our Christian psyche, and how I believe that church may have forgotten how to read a good metaphor, or at least, do not yet see how our rising knowledge, is confirming ancient metaphors, about the human condition.

      Perhaps, its time to realize, that “psychosis” is not what Hollywood’s rather adolescent emotionality, makes it out to be? And I have posted a lot of material which relates directly to this “religious metaphors” issue. Perhaps the church is confused about its role in the mental illness debate, because the hidden truths, in the nature of emotional distress, are to close to home?

      As a certain French philosopher puts it, ‘there is an assumption of reason on the one hand, and madness on the other, yet reality suggests, “unreason & madness,” in a real-life continuum of human experience,” or words to that effect.

      Best wishes to all,

      David Bates.

  14. Greetings to all!

    The winner’s trophy for ‘Sheer Mass of Verbiage’ on this page (featured in bold print, below) goes to David Bates.

    David Healy’s June 10, 2013 blog post amounts to 1,503 words (including footnotes).

    In one week’s time, 10 readers have posted comments, totaling 25,059 words.

    David Bates posted 15,877 words (more than 10 times the verbiage of the featured blogger’s blog post).

    The runner up, BeyondLabeling, came in a distant second, posting 5,703 words.

    John Hogget, the third place winner, posted considerably less than half that – just 1,778 words.

    Joanna Care barely gets honorable mention, with 745 words.

    Johanna (not to be confused with Joanna Care) posted 328 words.

    FYI (yours truly) posted 180 words – all included in this comment.

    In Need Empowered Collective Local Focused posted 159 words.

    MBarbacki posted 110 words.

    Theinarticulatepoet posted 88 words.

    Eli Silly (Oli) posted 74 words.

    Discover and Recover, 15 words.

    Blogger, David Healy, remains the very embodiment of MIA – in the old sense (‘Missing In Action’). That should come as no surprise… considering the bombshell comment left by MBarbacki.

    🙂

    • Well done FYI, right on cue, with a predictability that might suggest you are unaware of your need for ‘judgement’ rather than perception?

      As I suggested above;

      “I’m sure you will react with assumptions of “intellectual masterbation,” although you may prove me wrong?

      Which reminds me of the esteemed Harvard PhD, who travels to India and meets a Guru. He spends three days explaining his theory of mind to the Guru, and asks ‘what you THINK?

      ‘Feels like intellectual masterbation to me,’ says the Guru.

      Perhaps you may consider how unaware you may be, of how you function internally? Please consider;

      And of course the PhD is outraged, he doesn’t even hear the “operative” word, “feels.”

      Perhaps you may consider an unconscious process of “affective judgement,” and how it pertains to “affective psychosis? Perhaps you may consider educating your sense of self, with an exploration of your internal environment?

      Please consider;

      “Education of The Senses:

      By examining the “affects” experienced in judging another, one learns a great deal about how the illusion of self-containment is purchased at the price of dumping negative affects on that other. The level of “affective transmission” is marked in terms of how one party carries the others negative affects; his aggression is experienced as her anxiety and so forth. By means of this projection, one believes oneself to be detached from him or her, when one is, in fact, propelling forward an affect the other will experience as rejection or hurt, unless the other shield’s themselves by a similar negative propulsion, in a passionate judgment of their own. (p, 119.)

      Discernment, in the affective world, functions best when one is able to be alert to the moment of sensation, which allows the negative affect to gain a hold within. Any faculty of discernment must involve a process whereby affects pass from a state of sensory registration to a state of cognitive awareness, this does not mean that the process of cognitive reflection is without an affect itself, just that this affect is other than the affect which is being reflected upon.”

      Excerpts from “The Transmission of Affect” by Teresa Brennan, PhD.

      Perhaps, like most people, you are oblivious to, just how your affected by others, not really perceiving others, but rather, only being aware of your consciously taken for granted, response to “affect.” You may consider my quote from the movie Avatar, and contemplate why we don’t really “get” each other?

      What does ‘I see you’ really mean? Jake’s friend in the movie suggests it means ‘I see into you?’

      Can you contemplate the paradox of “we are all different?” Can you tell me just how different your internal organs are, to mine? Can you consider that on some level, we are all the same? One species, one family?

      I’m impressed though, with the trouble you went to, to score a point, and I hope it has helped you to feel good about yourself? Perhaps you’d care to expand on your personal points of perception?

      Be well my friend,

      Respectfully,

      David Bates.

      • Batesy,
        I also enjoyed the Avatar meaning. I’ve been meaning to ask you if you had a chance to watch/read the book entitled “Cloud Atlas” While the critics were lukewarm, I absolutely loved both the book and movie, though for different reasons. I think you would enjoy either if you haven’t had a chance to read/watch them yet.

        David

        • Hi David:))

          Yes, I watched it twice and absolutely loved it, one those movies so dripping with existential meaning, I think I could watch it six times and still notice, aspects of meaning I didn’t catch previously. Depending on my “physiological” state, at the time of sitting?

          As you’ve pointed out before, we are in dire need of such food for thought.

          Regards,

          D.B.