“Whitaker clearly believes that schizophrenia should be treated without medication if at all possible. However he fails to focus any attention on the fact that on any given day in the United States half of all individuals with schizophrenia, or about one million people, are not being treated. This is a huge natural experiment to test his thesis. Many of these individuals are found in public shelters, sleeping under bridges, in jails, and in prisons. If Whitaker had spent more time in these settings observing the outcome of this natural experiment, instead of delivering lectures on his vision of the impending antipsychotic apocalypse, he would have written a very different book.”
As most of you know, E. Fuller Torrey is a psychiatrist, one of the strongest proponents of involuntary treatment, and a supporter of outpatient commitment — the process of mandating that individuals take psychiatric drugs for extended periods of time after being released from a hospital setting. In the quote above, he accuses Robert Whitaker of ignoring the plight of the homeless “mentally ill” who he believes would be better served by the modern mental health system and forced psychiatric drug treatment.
But before getting to Torrey’s argument, let’s first take a look at how those who are poor and homeless and suffering severe emotional distress are generally treated in the community. Often those who are suffering distress will be brought to a hospital setting by police or community members, or come in of their own accord voluntarily. Once hospitalized, they are almost invariably prescribed psychiatric drugs and often are prescribed antipsychotics.
They then follow one of two tracks. A large portion of this population returns to the streets within a week with a prescription or a short-term supply of these drugs. It is estimated that upwards of 50% of people who are prescribed antipsychotics stop taking them. There is no survey for homeless individuals but I would guess that the rate of “non-compliance” is significantly higher among them. Folks like E. Fuller Torrey would suggest that anosognosia — damage to the brain caused by mental illness leading to a lack of understanding that one is ill — is the primary cause of non-compliance. In essence, Torrey suggests that homeless people stop taking their meds because their illness makes them believe they don’t need them. He believes that if they only knew what was good for them, they would happily take these drugs.
However, there are numerous more understandable reasons why the homeless population stops taking these drugs. For one, the drugs all have serious side effects such as akathisia, dystonia, constipation, loss of libido, sedation, confusion and weight gain. The homeless population are also generally uninsured. Even if they are insured, they need to still come up with co-pays for these drugs when they have limited — or no — money. Finally, many come to disagree that taking routine doses of major tranquilizers will help them feel better.
In essence, this segment of homeless people who come to the hospital are started on potent psychiatric drugs and then quickly returned to the street — where they more than likely stop taking them. The stopping and starting of these powerful neuroleptics can lead to serious withdrawal symptoms that include severe anxiety, agitation, insomnia and psychosis that can be mistaken for underlying mental illness.
A percentage of the second group of homeless individuals who appear more severely emotionally distressed, with signs of severe psychosis and mania, will go before a judge in a civil commitment hearing and then will be involuntarily committed if they are deemed a danger to themselves or others. At this point, a decision can be made to force the homeless individual to take antipsychotics and mood stabilizers even if they don’t want to.
Forced compliance. The term is loaded with ethical issues and also presents a serious challenge to the constitutional right of individuals to choose how they live their lives as long as they are not harming others. These are not criminals, and yet we treat them worse than criminals by suggesting that they may in the future commit violence and therefore we must protect against them by keeping them in a permanent state of government sanctioned sedation.
Torrey makes the argument that he is acting humanely because the State is also protecting these individuals from themselves. But as evidence mounts that the long-term use of neuroleptics damages the brain and causes long-term health problems, the State is not actively protecting these individuals; it is complicit in causing these people long-term harm.
So: two avenues. One is the hospitalization merry-go-round in which homeless folks are started on strong drugs and then discharged to the street where the lion’s share stops taking them, leading to severe withdrawals.
The other avenue is being involuntarily committed for a prolonged period, and made to take neuroleptics if the individual will not take them willingly. Many states also have assisted outpatient treatment (AOT) laws, wherein an individual who is released from a hospital setting is usually forced to take a long-acting antipsychotic shot every week or two out in the community. This is something Torrey and his organization the Treatment Advocacy Center strongly promote.
On his website, Torrey makes some powerful arguments for assisted outpatient treatment.
He says that in studies AOT has reduced hospitalization, homelessness, incarceration, violence, “treatment noncompliance”, and caregiver stress. Let’s take him for his word that these statements are true.
But, let’s look at it this way; I bet I could get the same statistics if I physically restrained someone for months at a time. They wouldn’t be hospitalized, or incarcerated, or stress out the caregiver, because they would be restrained. I could also get the same results if I lobotomized these individuals. No need to worry about them being violent, because they have been surgically altered.
The act of long-term involuntary “treatment” is a form of chemical restraint that causes long-term brain damage. It is a severe threat to a person’s health and well-being. No matter what sort of “humane” results you get from AOT, it is completely negated by the implications of the State injuring people in the process.
Recently, Representative Tim Murphy introduced legislation that would sharply increase outpatient mandatory treatment, even for people who did not pose a threat to self or others.
As we move further into this Orwellian world, if this law passes, the State will be able to force drugs on individuals who may be suffering severely from emotional distress who present no inherent danger.
Every year 7.6 million people go through inpatient psychiatric hospitalization. A significant percentage of these folks are impoverished and homeless. For many of these individuals, they have experienced a high level of trauma due to their socio-economic condition. Instead of being served by the medical establishment, they are often traumatized further. We spend an enormous amount of money on the process of hospitalization. The average cost of each visit is about $5,700. The average length of stay is 8 days.
As a therapist working part time in an inpatient setting, I often joke about the cost of care with patients. When they find out their stay will cost many thousands of dollars I offer them a fantasy alternative; I say, “Hey, instead of coming here, we could have flown to Hawaii and stayed in a hotel, ate at gourmet restaurants and gone scuba diving and surfing all day.” They say, “Yeah, I bet I wouldn’t feel nearly as depressed if I did that.” It seems funny until you realize the massive misallocation of resources going towards paying for very expensive medical care instead of examining alternatives.
For the homeless population, my hope is that at some point we shift from spending such an enormous amount of money on emergency “care” and shunt more of those resources towards long-term assistance and services for the homeless. One of the best social programs to develop over the last two decades is the policy of “Housing First.” In this program, people who are homeless are offered an apartment first before addressing other concerns such as their mental health. Recently in Vancouver, this model was developed with good success. From an article in The Vancouver Sun,
“The Housing First philosophy rethinks the traditional model of addressing homelessness among people with mental illness, which first treated the illness, getting the patients ready to go into the community and then finding a place for them to live. Workers were often surprised and disappointed when the individuals were back in the hospital a few months later. “It was a revolving door,” Bradley said. “With Housing First we don’t make unrealistic demands on people.”
The new model provides them with a safe place to live and “after a while people begin to think about their substance-abuse issues and their mental-health problems when they don’t have to worry about being warm,” she said.”
I also think it is key that we turn away from medicalizing economic disadvantage and trauma. When someone is homeless, they are under an enormous amount of daily pressure to get enough food to eat, find a place to sleep at night, remain warm and dry in changing weather conditions and stay safe from people who would harm them on the streets. These are stressors that often lead to symptoms of severe distress such as depression, prolonged anxiety, and for some, spiraling symptoms of confusion and disorganized thoughts. For an in-depth look, Social worker Jack Carney gives a detailed explanation of the intertwining of poverty and people who are labeled with a mental illness. Activist and survivor advocate Will Hall also talks extensively about how those who are poor are more easily labeled mentally ill in this interview here.
Pathologizing these symptoms of distress and labeling them as an underlying untreatable illness further traumatizes many of these individuals. When they interact with health professionals, they are then offered “medications” to “treat” their illness. Instead of offering drugs to these folks, let’s offer what they really want, and need; access to better shelter, food and safety.
Jonathan,
IMO, this is not a bad post you’re offering here; really, it’s good, I think, in many ways.
(Surely, it’s much better than your first post, IMHO — as you’ve done better fact-checking, I believe.)
But, were I you, I would never have said this (in regards to E. Fuller Torrey):
“Let’s take him for his word that these statements are true.”
(Or, had I been your editor, I would have suggested leaving out that one sentence — and would have recommended that you provide links to any number of studies which indicate that “AOT” is not working as promised, by its promoters.)
After all, Torrey (the world’s foremost individual promoter of “AOT”) is a notorious teller of untruths and half-truths.
So…
About the very questionable ‘effectiveness’ of “AOT,” I suggest checking out the following link, to an MIA comment (posted in June of last year) by Dr. Toby Watson…
http://www.madinamerica.com/2012/06/tuesday-dinner-with-the-nami-mommies/#comment-12172
Also, I most highly suggest you check out this following link, to an MIA post, titled “Community Treatment Orders Don’t Work”
http://www.madinamerica.com/2013/04/community-treatment-orders-forced-treatment-dont-work/
(Note: ‘Community Treatment Orders’ are, of course, the U.K.’s equivalent of “AOT”.)
The conversation on that page refers to a Lancet article, which explains that, “the psychiatrist who championed [CTO’s] is calling for their immediate suspension.”
Finally, I can’t help but point out, that I remain troubled by this fact, that you would force drugs on some people.
(That you’ve done so would be forgivable, I feel… but, only once you’ve clearly renounced the practice, consigning it to past ignorance.)
Because you show know sign of renouncing that practice, I can’t help but wonder, as you speak of the ‘homeless’:
What do you really mean, as you conclude, “Instead of offering drugs to these folks, let’s offer what they really want, and need…”
Upon reading that, I think, ‘OK, fine and good…’; however, then I’m suddenly reminded of your position on forced drugging; and, so, I wonder: Once you’ve given them a place to live, what then?
E.g., what if some formerly ‘homeless’ resident comes to seem violent (or, perhaps, even seems to threaten what you might call “severe violence”)?
You have said that you believe, ideally, “hospitals” should forcibly drug people who exhibit what you call “severe violence,” instead of calling the police.
(As you know, I cannot agree with such policy, at all.)
In fact, you indicate that such “patients” may have come from the jails.
Therefore, from reading you, I gather, that: Despite your criticisms of long-term psychiatric drugging (criticisms which I know are sincere), you do think that the police should be used to bring supposedly “ill” people to psychiatric “hospitals” to be “treated” with drugs — if those supposedly “ill” (ostensibly, ‘psychotic’) “patients” are threatening “severe violence”.
In deed, you seem to say that the police should never be allowed to take “ill” people to jail.
(I believe that’s what you’re saying, after all, in your preceding blog post and accompanying comments, but I’m not sure, and you did cut the dialogue short there, so…)
So, here I can’t help but wonder…
Should your plan for the ‘homeless’ be trusted to offer just what is needed and wanted by such individuals, really?
I mean…
Would you or would you not recommend that housing administrators, who take in ‘homeless’ people, should call for any seemingly “violent” residents, to be sent to “hospitals,” instead of being formally arrested and charged with a crime???
Hopefully, you do not read my comment here (nor my questions) as being overly-personal.
Please, take all the time you need, considering a response…
Respectfully,
Jonah
Thanks so much for the discussion. Social work is filled with people unaware of this angle on clients’ welfare.
Hi Jonah, thanks for your comments. OK yes, to start out with- when I said “Let’s take him for his word that these statements are true”…I was essentially saying- even if these words were true (which I agree are highly suspect), that his argument that AOT is therefore humane falls flat because long term use of neuroleptics often cause severe health effects. And yes- a number of people have written excellent articles about problems with AOT. Thanks for mentioning their work.
In terms of the issue of violence, this is a deeply difficult subject that we explored in the first post I wrote. In answer to the question, how to respond to someone who is experiencing extreme emotional distress and becomes violent in a hospital setting?
There is no easy answer to this. My first response would be, what conditions have led up to the violence? Is there anything staff could have done to help the person before there was violence? Did they need to talk? What are they mad about? Is it something staff could help with? Sometimes people need to have intense emotions, yell, throw things, without the need for any intervention. Allowing a person to be in a safe place to vent intense emotions does not require intervention.
But yes, there are times, when violence occurs, that staff have run out of options. It has now become an issue of staff and other patient safety. We have a duty to protect others as well. So, what to do?
We reached an impasse on this one Jonah, and I don’t know if we can find full common ground. I have said something that makes a lot of people deeply uncomfortable here- and I understand why it is a very hard thing to say. I support the limited use of force and IM injections when someone threatens the safety of others. Are there other options? Yes. We often try moving someone to a place of safety away from others if at all possible, but sometimes it is not. Other options? Restraints, calling police and risk the use of tazers, bean bag guns and guns. All bad.
Like I said, I want hospitals to use force, or self-defense if you want- very very rarely, and only in the case of imminent violent danger. I want there to be community oversight so that the abuses that continue are ended. And I ask again, how do you respond to violence?
Very tricky questions and I really appreciate you bringing them up. I think there are a multitude of reforms that could happen around how force, or self-defense, is used.
Jonathan,
Thank you for your reply.
You’ve offered seven brief paragraphs, never once touching upon the focus of my concerns. (I.e., you don’t address my ultimate questions.)
Yes, you addressed the first part of my comment (in the initial paragraph of your reply); but, really, that was just an ice-breaker, that I was offering you.
(And, sure, we agree that “AOT” is an abomination and that Torrey’s claims must not be taken at face value. That is our established common ground.)
But, you missed the real point of my comment (as might a politician) — mainly by reiterating your own questions.
(E.g., you say, “Like I said, I want hospitals to use force, or self-defense if you want- very very rarely, and only in the case of imminent violent danger. I want there to be community oversight so that the abuses that continue are ended. And I ask again, how do you respond to violence?”)
Jonathan, I, too, want community oversight…
I want that anywhere and everywhere that people are being imprisoned (and, of course, that includes the locked wards of psychiatric “hospitals”).
After all, as I’ve already told you (in numerous ways, on the MIA page with your first blog post), my first hand experiences with psychiatric “inpatient hospital” all led me to realize, forcing psychotropic drugs on “patients” is wrong — even and especially as a means of supposedly controlling violence.
(Forced IM drugging, to you, seems a legitimate means of providing safety to staff and to “patients,” and some few people do look back on such ‘treatment’ gratefully; but, in countless ways, it can become perfectly counter-productive, really a massive hindrance, to the process of establishing ultimate peace, health and well-being, in the life of the target — the victims — of such drugging. And, though it may make some “patients” feel safer, when they see a “patient” being ‘taken down’ for a forced drugging, I assure you: Most “patients” find such events to be extremely frightening.)
In your critiques of long-term drugging, you repeatedly refer to the negative effects of “sedation” — and that’s good of you; however, doing so can be misleading; it may lead your readers to mistakenly presume, that the short-term effects of forcing IM drugs on people is mere sedation…. when, in fact, the effects of forcing such drugs on people can be far, far, far worse than merely sedative; it can drive individuals into a kind of ‘brief madness’ — really, a temporary, total derangement — that exceeds, by orders of magnitude, any sort of suffering they’ve ever previously experienced.
(That was my experience, of being forcibly drugged.)
Because I do know, all too well, how extremely aversive that iatrogenic ‘madness’ feels, I deeply believe that such ‘treatment’ can actually lead (and, I presume, has led, many times) to “patient” suicides — as well as to (more rarely) “patients” seeking revenge.
Hence, I would deal with claims of severe violence (and seeming threats of violence), anywhere, with means that do not ever require forced IM drugging.
In any case…
Perhaps, you misunderstood the brunt of my comment.
You have posted a blog (above) which ultimately discusses your desire to provide ‘homeless’ people, who have been identified as “mentally ill,” with housing.
You explain that you appreciate the principles of “Housing First.”
Well, my understanding of “Housing First” (albeit, my limited understanding of it) is that it eschews coercion.
Now, I know you are against some forms of coercion (e.g., the coercion in “AOT”).
But, you support IM forced drugging, which you claim is sometimes necessary for providing safety in “hospitals”.
So…
I was, quite basically, wondering whether the housing which you say that ‘homeless’ people who are supposedly “mentally ill” should receive, would also subject them to the possibility of being forcibly drugged; when housing administration staff might perceived threats of violence coming from certain residents, would they call for needles?
Would they refuse to call the police — even in the cases of what you might call “severe violence”? (You say that, in “hospitals,” even “severe violence” should not bring the police.)
Or, would you, perhaps, recommend calling the police — but only to take the seemingly threatening individual to a “hospital”?
I ask these questions, as it seems to me you are bent on keeping people who are tagged “mentally ill” in line, by forever wielding the threat, that they will be forcibly drugged if they seem violent (or, when they threaten what you call “severe violence”); and, really, I am wondering, are you the best person to promote such housing programs?
Given that you are a supporter of forced IM drugging, it seems to me that you are probably going to be maintaining the threat of medical-coercion, wherever you provide your recommendations and your services as counselor/therapist.
That’s highly problematic, IMHO.
In my humble opinion, those who support of forced IM drugging will not serve as good messengers for “Housing First”; if I were you, I would drop the defense of forced drugging, stick to your counseling/therapy practice — and let others do whatever dirty work they think they have to do, to protect themselves.
Be brave. Find non-violent means of defending yourself and others.
Let people who are truly, severely violent face the criminal justice system.
My bottom line (as I don’t expect you to answer my original questions):
Your support of forced IM is completely antithetical to the original spirit of “Housing First,” I believe.
Respectfully,
Jonah
Hi Jonah,
I’ll try and answer your questions here.
Jonah: “I was, quite basically, wondering whether the housing which you say that ‘homeless’ people who are supposedly “mentally ill” should receive, would also subject them to the possibility of being forcibly drugged; when housing administration staff might perceived threats of violence coming from certain residents, would they call for needles?
Would they refuse to call the police — even in the cases of what you might call “severe violence”? (You say that, in “hospitals,” even “severe violence” should not bring the police.)
Or, would you, perhaps, recommend calling the police — but only to take the seemingly threatening individual to a “hospital”? ”
I would assume that pretty much any housing facility would not have staff on board that could respond to a violent incident and that they would call police. Police sometimes take people to jail and sometimes to a hospital setting depending on the situation.
When police deal with vioelnce and dangerous situations out on the street, their tools are limited but often involve tazers, bean bag guns and occasionally lethal force. Here in Portland, police have paired up with an organization called Project Respond who have staff that are muich more adept at interacting with people who are severely agitated and are going through psychosis/mania.
That relationship has greatly improved how police work with this population and there are far less reports of abuse.
But lets get to the meat of the matter. When police bring people in to the hospital who have become violent, how do staff respond?
I get that for you, and many many others, the idea of an IM injection is abominable. I get this. And yet for others, the thought of being thrown into a jail cell is a horrible abuse for someone going through emotional distress. For others, restraining and isolating someone is abusive. And on and on.
We talked about the idea of having some sort of mental health advanced directive that could state…”in the event that I become violent, I would prefer to…”
So really, you are asking some really deep and important hard questions…but I have yet to see how you would respond to someone who is in severe emotional distress and then becomes violent. What would you prefer to do?
Finally, as to letting someone else do my dirty work? No way. My job first and foremost is to see that this happens extremely rarely. How? By interacting, making contact, listening, hearing and responding to needs as best as I can. And if someone does become threatening, I want skilled people there who can listen, help someone to find a place to vent in a safe way, to help deescalate the situation. An enormous amount of people come to inpatient psyhciatric every year. They should not be abandoned to someone who sees it as dirty work.
So, I have tried to answer your questions as best as I can many many times. And I understand why you aren’t, and likely never will be satisfied.
But I’d like to start with asking you more about your response to violence when someone is emotionally distressed. Perhaps that way we can have a better dialogue if you describe your alternatives.
Jonathan,
Again, thank you for your response.
Now, you have, in deed, addressed my main question, that regards how you’d expect any perceived threats of violence, to be dealt with, in “Housing First” type housing (which is for people who’ve been called “mentally ill” and who would otherwise be ‘homeless’).
You figure no on-site workers would be authorized to handle such situations; hence, no one would be immediately on hand, to forcibly drug anyone.
You explain,
You’d expect any seeming threats of violence, on such premises, to be handled no differently from seeming threats of violence, on the street.
(It’s helpful to know, that such is your thinking.)
Still, I wonder if you’re being realistic, in that sense? After all, mightn’t the facility staff be highly inclined to recommend “hospitalization,” in such instances?
Their residents have been deemed “mentally ill,” have they not?
I don’t expect you to know all the definitive answers, to such questions, regarding how a “Housing First” operation works; however, it is a concern that comes to mind, that these residents have apparently been called “mentally ill” at some point; hence, they presumably have ‘psychiatric histories’; that makes them particularly vulnerable to “involuntary hospitalization”; i.e., they could very easily be forcibly “hospitalized,” in any event, of being brought to a psychiatric “hospital” — or, even ‘just’ an Emergency Room — for seeming to be violent (and, even for seeming to threaten violence).
I mean, they could quite quickly become officially deemed “a danger…as a result of mental disorder,” by any E.R. psychiatrist(s); and, that would legally ‘justify’ at least days (if not weeks or months) of “involuntary hospitalization” and ‘treatment’.
(In your preceding blog post — and in one of your comments under that post — you mistakenly indicate that people on ‘holds’ cannot be forcibly drugged.)
It seems to me, that anyone deemed “mentally ill” who take free housing, is putting himself/herself at risk of being forcibly drugged — especially, if s/he ever displays any anger.
For, anger is often perceived as a threat of violence — and all the more so, when it’s expressed by someone who is known as having been tagged by psychiatry.
Individuals who have been tagged by psychiatry, in almost any way, have fewer rights than everyone else.
Their right to due process cannot be guaranteed.
They can be captivated and ‘treated’ with drugs — for seeming to be ‘violent’ — and for seeming to be ‘dangerous’.
Our society has been convinced that such is all for the good — exactly as you have, apparently, been convinced that it is.
And, note, you say, in your comment,
NOOOOOOOO.
(Jonathan, how many times do I have to keep correcting you, on this point? How many times must I tell you that, I did not say that? Really, you must not be reading my comments very carefully, at all — as you are repeatedly misquoting me, on that…)
In truth, I cannot bear to repeat myself yet again, on this point; please, just read my comment to you (on December 13, 2013 at 8:21 am), which begins, “P.S. — I forgot to address this… Jonathan, you began your final reply with a passage that suggests to me, you’ve not read my comments carefully, as you are apparently misunderstanding my main point, regarding advance directives.” You’ll find that comment via the following link…
http://www.madinamerica.com/2013/11/inpatient-hospitalization-inside-perspective/#comment-34482
So…
OK, here I have begun replying to your reply, by starting at the top of your comment and working my way down; I could continue, on that same path; however, I would like to get two points quickly clarified.
The first point, is about your stating,
Jonathan, my formulating an answer to that question (which I know is a very important question, in your mind) depends entirely on your carefully addressing these two question:
1. What do you mean by “emotionally distressed”?
2. What do you mean by “violence”?
If you could clearly describe (in some detail) what you mean, when you use those terms, in this context, that would be great. Then, I can answer you.
Meanwhile, there’s this second point, that also requires clarifying: I had written, “if I were you, I would drop the defense of forced drugging, stick to your counseling/therapy practice — and let others do whatever dirty work they think they have to do, to protect themselves.”
…And, in response, you’ve explained,
There, you are largely missing my point, in two ways:
Just consider, how you have left out this fact (that was mentioned in your previous blog post): You, Jonathan, are sometimes participating in forcibly drugging “patients”; you are, thus, what I consider to be a perpetrator of extreme ‘medical’ violence.
(Actually, it is psuedo-medical, but surly you get my meaning…)
I mean, it is a totally overwhelming use of force (really, totally and completely overwhelming force… and a most terrible violation of ones body and mind, IMO), that you have administered to “patients”.
(That is ‘just’ my opinion, but it is based on my having been the victim of such violence, more than once — more than twice…)
Thankfully, that was so long ago, now I am able to discuss it without fully ‘re-living’ it emotionally (i.e., after these many years, I have developed an ability to be fairly calm and reasoned, while writing about those experiences).
Hence, here I say to you, Jonathan (calmly): You are not merely there, on hand, to minimize the chances of forced IM druggings. You are (by your own admission, in a preceding blog) at times, a perpetrator, of such drugging, which I consider a most pernicious form of rape.
[Note: These days, we can read many survivors of such ‘treatment’ referring to it, as “brain rape,” and it’s very good that they do, IMHO. It’s perfectly accurate, IMHO. But, it was not too many months, after my first period of psychiatric “hospitalization,” that I was first able to very well understand and describe my experiences, of having been forcibly drugged, as rape. By that point in time (well over a quarter-century ago), I had never read nor heard of anyone, who was describing forced drugging that way. Simply, I had, on occasion, in various settings, come to hear more than a small handful of female victims, of rape describing the overall after-effects, the traumatization, of those experiences, and I realized: Such was precisely what I was experiencing, too. Absolutely. Yes. I had been raped, with needles delivering neuroleptic drugs, into my veins. I was terribly traumatized by those experiences. It was the direct result of being repeatedly, forcibly drugged, in “hospitals”. (Still, I am traumatized. E.g., in all these years since that time, I have rarely ever been able to sleep in a bed — because, of course, one who is forcibly IM drugged is strapped to a “hospital” bed. To me, it makes no sense whatsoever, that a person who supposedly, truly wants to minimize incidents of that — who sincerely cares to avoid forced drugging — would also be a perpetrator of it. IMHO, what you’re doing, in that respect, makes no sense to me. In my humble opinion, one cannot hope to prevent any particular kind of violence, while simultaneously allowing himself/herself to resort occasionally to that kind of violence. You seem to be a perfect example of someone who should not be resorting to such ‘techniques’ — given your expressions of opposition to abusive psychiatric drugging practices. That’s why I am so highly inclined to question you, with comments, Jonathan…)
So, please understand: I see forced IM drugging as dirty work, absolutely. I do.
And, I feel quite certain (and have read more than one good study on this point): Many psychiatric “hospital” workers (certainly, not all, but many), when pressed to be perfectly honest about this, do agree with this sentiment. It is dirty work.
So, note: There are plenty psychiatric “hospital” workers who do such work, as it is required of them, if they wish to keep their jobs; however, they wish they didn’t have to do it — quite naturally… because it really is dirty work.
On the other hand, I know there are quite a few “hospital” workers who get a real thrill out of doing it.
I know that to be true, too.
(In the “hospitalizations” which I experienced, I saw with my own eyes, quite clearly, there were “hospital” staff who got an huge thrill out of ‘taking down’ “patients” to forcibly drug them.)
Finally, for now, Jonathan, considering I’ve gone on and on (and, considering I have asked you to, please, clarify exactly what you mean by “emotionally distressed” and exactly what do you mean by “violence,” in the context, of your question), I will leave off…
As there’s nothing more for me to say now, I feel.
Respectfully,
Jonah
Jonah, I am open to you suggesting your definitions of emotional distress and violence that would require action. And then please describe what that action would be.
Jonathan, what kind of reply is this, that you’ve offered me???
Jonathan,
What are you wanting from me, at this point? Are you joking?
It seems that maybe you would like me to formulate definitions for your the terms in your question?
You seriously think I should???
(Would that not be a totally absurd way to dialogue?)
Jonathan, that would be me dialoguing with myself.
So, here I am, with my full intent of dialoguing with you; you indicate that you have an interest in dialoguing; you seem to have a pressing question for me; yet, this is your way of formulating that question: You want me to define its terms?
This is not making sense to me, at all…
You offered a question for me regarding what you called “emotional distress” and what you called “violence”.
But, you offered no indication whatsoever of what those terms mean to you.
So, I told you that I would sincerely care to answer that question, for I appreciate the chance to dialogue, on this issue, of forced drugging in psychiatry.
But, how you’ve responded is, IMHO, utterly absurd.
I mean, what in the world are you talking about now??? (I have not a clue.)
I thought you were being vague before…
(Such is why I asked you to, please, define those two terms, in the context, which you’re aiming to apply them.)
Now, you’ve become roughly ten zillion times more vague.
I mean, could you possibly be more vague than you are now being? (I don’t think so, really.)
Is this deliberate obfuscation on your part? Is it laziness? Maybe you are just tiring of this conversation.
Please, do tell me if that’s the case.
I look forward to your response, with great curiosity…
Respectfully,
Jonah
________
P.S. — Jonathan, perhaps, your response can be posted at the bottom of the page, as we seem to be running out of reply buttons up here.
Ok…ill take it on down to the bottom of the thread…
This is not really a comment, but a question. You said somewhere in this article that 7.6 million people experience psychiatric hospitalization every year. My understanding is that it is more like 2 million. Could you tell us your source for this? I actually think if your number is correct, in the long run it could be a good thing, because the more people who experience this, the larger the proportion of the population it is, the more likely the public in general will pay attention to these issues.
A couple places Ted… http://www.medscape.com/viewarticle/731044 and http://psychiatryonline.org/data/Journals/PSS/24313/pss6307_0666.pdf
It’s a pretty huge number of folks. I wasn’t able to find it but it would be really interesting to know how many folks are civilly involuntarily committed each year. I know the number has been declining but I can’t find exact figures.
The Medscape article was not available to non-subscribers. The other one displayed, but I think the larger figure referred to “secondary diagnoses,” meaning I suppose that admittees were given a psychiatric diagnosis but it wasn’t the reason for the admission. This is very interesting in itself, though, since it showed how willing even “regular” doctors are now to pin a psychiatric label on people.
If you or anyone else has any more info about this, I would very much appreciate hearing about it.
medscape does not require a subscription. You just have to register on the site.
DJ Jaffe lies. E. Fuller Torrey lies. They make up “facts” to suit their purpose. What they’re advocating for is foolish. They don’t want “treatment” for the “worst” as they define it. SAMHSA already funds and supports a wide range of activities including help for the “worst.” What they want is ALL of it and that’s where they are foolish. It is folly to create a system of triage that only serves the “worst.” Imagine a system that only does heart transplants but does nothing less including prevention. Soon everyone would either be in line for a heart transplant or dead. DJ and Fuller are stupid. In addition, Fuller is a ghoul. After decades of collecting brains, he has not gotten a single iota of useful data. I can only presume it’s just to fuel his “brain” fetish. He has also been discredited for his theory that schizophrenia is caused by cat pee. Perhaps we should lock away all the kitties instead of people.
Actually, it’s cat poop. Toxoplasmosis. The brain collection is tellingly ghoulish.
Sadly, Fuller and Jaffe are very influential. The recent proposed Murphy legislation is evidence of that. Wish it weren’t so.
So then the task would be to confront their influence? Lies, no matter how believable are still lies. Join in discrediting their lies. If you want to do more, start a boycott of the Danbury Mint and their “fine collectables” since that’s where the Stanley Family Foundation gets their money to fund Torrey. Boycott (by refusing to attend their conferences) the National Council for Community Behavioral Health since they’ve endorsed the Murphy legislation. Boycott NAMI and other organizations that support oppression. I wish I could help you shift your point of view from that of “jailer” to “jailed” and help you understand why you get so much flack from folks here. Unless you’ve got lived experience coping with our sort of oppression, you may not be able to understand us.
do you have a link where this toxoplasmosis theory is discussed? Boy does that sound easy to shoot down.
This articles sums up my daughter’s painful experience. Thank you for putting it in words.
My daughter is under civil commitment in Oregon, forced to receive an injection called Invega monthly She is only 24 years old, a beautiful sweet spirit who has been held down by force, restrained, and basically raped in the name of ‘medicine’. She is not violent but she has been so traumatized by her ‘treatment’ I marvel at her courage and dignity. She makes her jailors look tiny in comparison.
You can’t imagine my horror of hearing Dr. Torry’s name mentioned under any circumstances, knowing that he is, at this moment, exploiting the horrific crime at Sandy Hook to make it easier to take away my daughter’s constitutional rights.
Dr. Torrey’s literature is available on the website of the hospital where my daughter currently is at; it is listed as a ‘resource’ for gullible parents who are starved for consolation regarding their children. It is scandalous that patients can access NAMI’s literature and books by Dr. Torrey at these institutions but they cannot access literature from MindFreedom.
Since Dr. Torrey would like to make it easier to take away people’s rights, warehousing them in institutions, cooping them up with hundreds of other individuals suffering various degrees of mental and emotional trauma, forcibly medicating them with harmful medications, I no longer feel like a citizen in this country.
The hospital is run like a giant prison. Everyone is being chemically restrained. It is like Dante’s hell. Is it any wonder that people would rather live on the streets?
Our whole family has been traumatized by my daughter’s experience. To hear people like Dr. Torrey spout their ignorant hateful and condescending views of what my daughter is going through and what she needs is like vinegar in the wound. Are they unaware of how much pain the current policies are causing, yet they want to expand this suffering to others?
Thanks for sharing your story. I am so sorry this is happening to you and your family. Dr. Torrey needs to spend a few weeks in some of the nation’s worst institutions. He’d be begging to sleep under a bridge.
That’s a heartbreaking story madmom. And indeed Torrey is one of the key national figures promoting this. But Oregon, along with 43 other states have willingly agreed to this. These are extremely challenging issues when it comes to parents. Doctors and the State all say this is what is best for the individual. That it is treatment. They don’t talk about the side effects and the long term health implications of these drugs.
Voices like yours will help send a message that this is absolutely untenable.
Whenever I hear the privileged talk about this stuff, they always do it with a tone and language that feels eerily similar to other historic bigotry. They talk about persons experiencing economic distress and persons experiencing emotional distress about like people used to talk about “the coloreds.”
It’s “those people” this and “those people” that. It’s talking ABOUT others from a position of privilege rather than listening to and talking WITH other human beings about what their needs are and how to be compassionate human partners that is at the root of the problem.
As long as Dr. Torrey and those like him continue to justify their own bigotry, and as long as the public continues to allow and accept it, very little good can happen. The attitude that persons in the working class are stupid while persons in the privilege class are wise and learned is as much a root cause of the these ills as anything else.
We rightfully talk about all of the injusticies of psychiatry and the mental health system towards persons labeled “mentally ill.” But we don’t talk enough (in my opinion) about the fact that it is really poor people labeled “mentally ill” who experience the bulk of the coercive treatment and abuse. If you are rich, you are far more likely to only ever be known as “eccentric” rather than “sick.” And even if you are ever labeled with a “mental illness,” if you are rich then you get to CHOOSE your “treatment.” Don’t like what a psychiatrist is telling you? You fire that psychiatrist and go pay to see someone who will give you the designer “therapy” you want. Rich people don’t end up civilly committed, generally speaking. It’s not rich people who are filling state hospitals or locked down in secure treatment centers. During the year I spent working in an involuntary psychiatric center (before I quit in protest) – there was only ONE person in the entire time who came there who did not receive public economic assistance and have income below the poverty line. That one person was only there because he had committed a felony and was mandated by the criminal justice system. Short of committing a crime, the wealthy just aren’t subject to this system.
So when we talking about abuses in psychiatry and mental health that’s important, and we should all keep doing that. But there is another issue that is even more foundational – class. Not all persons experiencing emotional distress have the same horror stories in mental health, and the difference between horror stories and healing stories can usually be determined by no other factor than how much money you have. Sad, but true.
On the other hand, if you are poor your experiences with “mental health” are overwhelmingly bad. Our society is completely comfortable with the most paternalistic and bigoted attitudes imaginable when it comes to the poorest members of our society. So it should be a shock to no one that homelessness is used as an excuse to justify paternalistic, coercive treatment because the problem as seen by the privileged is a disgusting, ignorant, less-than-human underclass that inconveniences or threatens the day to day of privileged people – that is the problem that people like Torrey try to “solve” from their privileged vantage point.
I’ve recently been talking about how the mad are like canaries in mines. Look at who is going mad and you see who is most oppressed in a society. It’s the poor, ethnic minorities, LGBT people and people who have faced immense trauma usually caused by abuse of power.
I went to a workshop on privilege recently and I raised this.
The other thing about homeless people is that my impression is that they are much more likely than most to have suffered early trauma such as child sexual assault and family violence. That makes dealing with the everyday difficulties we all face much more difficult and so homelessness becomes a bigger risk. I do not know if this is true but I’d love to read some research on it. So maybe the same problems that increase peoples risk of madness also increase their risk of homelessness.
John and Andrew, I entirely agree. most of the folks who go through who inpatient psychiatric hospitalization are poor. When it comes to hospitalization, this is very much a class issue. These are people who often have been abused by society and dealt with trauma that compounds their emotional distress. And then this distress gets pathologized, medicalized and labeled. Drugs are used to control the emotions connected to this trauma and oppression.
Homelessness requires the same qualities that would get someone hired or promoted in another context. Does anyone exhibit a stronger will to survive, or grapple with more existential and practical dilemmas, than a person who must craft or pursue a “home” (and, in most cases, who remembers having one), on a daily basis, with no real means of doing so–all the while regarded with as much fear and hostility by those in better circumstances?
Obviously, survival of the homeless isn’t the goal of forced drugging proponents like Dr Torrey, CBS, pharmaceutical companies, or our government with its arrogant funding of “brain” research and self-serving censorship. We have met the enemy, and they is us. Whose brains exactly should be examined first?
Perhaps Torrey should spend more time–a long duration, in fact– “visiting” those dank places where the homeless schizophrenics are hiding out, with no access to a support system–perhaps while heavily medicated (it wouldn’t matter if he “needs” to be, after all, since merely being homeless would qualify him, not to mention that the system he shills for has rendered diagnoses essentially meaningless except as a way to separate Them from Us). Perhaps he would learn some things about people other than himself, other than that he would rather be him than them.
That was actually one of things I forgot t mention. If you are homeless out on the street, one of the last things you would want to take is a major tranquilizer. If you are too sedated, it is much harder to find shelter and food, and harder to protect yourself from people who would hurt you.
I’ve said it before: It’s an injustice that professionals take massive amounts of tax dollar money in total to supposedly “help” societies most disadvantaged people, but in doing so they just wind up putting that money in their pockets and throwing the “mentally ill” people back on the streets.
We’ve had homeless people in this country, for generations, who could honestly say “I may be homeless, but society has spent MILLIONS of dollars over the years supposedly trying to help me.”
Even when the person has housing, it’s still obscene when you consider how far apart the patients and professionals are economically. Being a poor person living in poverty and being forced to have to comply with “treatment” services that you know costs many thousands of dollars… produces just horrible feelings. As if to say, “Society wont pay next to nothing to actually help me, but they’ll pay these guys 6 figures a year to just shut me down, and then have the nerve to call it help…”
Indeed. Very well put. By help, most of them receive psychiatric drugs that they stop taking, causing increased emotional distress, leading them to return to the hospital. The professionals get paid well for this merry-go-round.
Boy can I ever attest to that. We have a revolving door in Admissions in the state hospital where I work. When this is brought up in public discussion the blame for this is always placed on the backs of the so-called “patients.” “If they’d only take their meds they wouldn’t have to keep coming back” is the response that I always get. when I try to bring up the role of trauma in peoples’ lives and how it isn’t resolved by taking pills the powers that be quickly move on to more pressing topics.
We do not have any rich people in our hospital. The rich people have “breakdowns” and go to the two private psychiatric hospitals in the city, or they can afford the very few psychiatrists who actually do any kind of talk therapy for $250 an hour. Only the poor and the homeless come to our institution. And the revolving door in Admissions keeps turning and turning…….
In many hospitals a doctor is not salaried but given a fee for admitting and doing an initial H and P (history and physical). A significant amount of people are admitted one day and discharged the next. The doctor receives a very large fee and the patient receives a prescription, or some take home meds.
We see these folks over and over again…this is a sane health care model?
Stephen:
Part of me agrees with you and part of me disagrees. The worst treatment that my daughter ever received was at a private psychiatric hospital. Force is force whether it takes place in a public hospital or a private hospital. As my son says,
‘Mom, you can’t polish a turd and expect it to smell any better.” But I agree with you that there are very few privileged individuals in a public hospital. Anyway, thanks for letting me post and vent in this blog.
Thanks for letting me post in this blog
“Society wont pay next to nothing to actually help me, but they’ll pay these guys 6 figures a year to just shut me down, and then have the nerve to call it help…”
How truthful this is. The State here recently shut down a way-ward girls home whose method of treatment was solitary confinement. I estimated they spent $90,000 per girl to house and drug them.
They city meets to cry about the jobs lost. Who crys for the girls?
I don’t doubt that many people are making a living as middlemen in this process. But the real money that drives the current process is Big Pharma, I suspect. They have the most ot gain from this model, obviously. On the other hand, if Big Pharma disappeared tomorrow, a legion of Nurse Ratchetts would step in and find some other way to keep the system going.
Hi Jonathan,
I think you make some very interesting points here, not just for homeless people but anyone on AOTs (or CTOs here in the UK).
In particular, the ethical issues e.g. why do we treat mental health service users worse than violent criminals, who do not have to be forcibly given a chemical lobotomy when out of prison!
It’s not just anti-psychotics that can go on a CTO, but lithium and valproate too. For mania, Valproate is the same as placebo for long term prevention of mania:
http://www.thementalelf.net/publication-types/systematic-review/cochrane-review-finds-limited-evidence-to-support-valproate-as-a-maintenance-treatment-for-bipolar-disorder
There is a logical fallacy that Psychiatrists use despite no evidence of long term benefits (and evidence of harm) of such drugs:
1) We have to do something;
2) This (e.g. Valproate) is something;
3) Therefore, we have to do this
It’s a bit like the logical fallacy:
1) All cats have four legs;
2) My dog has four legs;
3) Therefore, my dog is a cat
Surely, if Psychiatry claims to be a legitimate medical profession it must be evidence based!
There is no evidence of chemical imbalance theories, yet this does not stop them for prescribing harmful drugs in the long term. I’m not anti-drugs, as there is a place in the short term for them (particularly minor tranquilisers).
Regards,
Mike
Very true…the we have to do something and this is something therefore it is good fallacy.
In essence I don’t really blame the doctors entirely. I really blame the insurance world that pays for ineffective (and often destructive) “care”. They have bought the 10 minute consult drug prescription model.
If we want to change the system, we have to change the payment structure. Follow the money.
I thought I had posted this, but evidently it did not hit the board? Housing First sounds like an excellent and caring program, and one that actually addresses homelessness. I have friends who work in area shelters. The residents are required to meet specific and often extensive demands, such as performing chores and attending job training. If they are “mentally ill,” they are sometimes unable to meet these demands and can not stay at the shelter. They also can not stay if they are actively addicted to alcohol or street drugs. If we want people to be safe and to not be homeless, first we need to provide them with a safe place to live. If the alternative is an unsafe or abusive environment such as a locked institution, people will “choose” to live on the streets.
And it was pioneered by a psychiatrist? Talk about a faith restorer.
Jonathan,
I enjoyed reading what you had to say – both in the blog post and with your comments. Thank you.
Duane
Thanks Duane!
Here’s a short exercise: how much funding does E Fuller Torrey get directly and indirectly from pharmaceutical companies with a vested interest in continuing and increasing Rxs of psych meds? And how much funding did R. Whitaker get from anti-psychopharm sources before and when he was researching and writing Anatomy of an Epidemic? Given that, whose motives are more credible?
The Canadian programme is excellent – though interestingly no one has mentioned the Finnish program that merits a whole chapter in Anatomy of an Epidemic. They use short courses of low doses of psych meds, when needed, in addition to intensive support and psychotherapy with obligatory involvement of family.
Of course, the Finnish don’t have rich-poor divide of U.S., and they believe in redistributive taxation in which everyone contributes financially to the common good of their fellow citizens.
All in all, it is a sad state of affairs. Emphasis on sad, as in “heartbreaking.”
Homelessness, I often ask why anyone should have this problem when I am walking in home depot or the sears tool section. Look at how much better the power tools have become, lightweight fast lithium batteries no more cords… 10 guys can build a rather nice house start to finnish in a week these days.
I saw some show on Netflix where they had this grand idea to give out housing vouchers or some sort, what ever.
I think the solution to the homeless problem is to build some damb housing !!! Not wasting the dollars on “services”.
“Services” = paperwork or at least 90% paperwork.
Last I checked you can’t live in bureaucratic paperwork, or eat bureaucratic paperwork or drive bureaucratic paperwork to the store to buy office supplies to make more bureaucratic paperwork.
Everyone would be richer if there were more people building actual things and less people doing bureaucratic paperwork.
When I attended a social services day treatment group therapy center in San Francisco for several months, I became friends with a lot of people who lived on the streets and got along in life as panhandlers. Their stories and reasons for being on the streets were varied, and their personalities were diverse.
One thing that was clear: they were mentally gifted, some of the sharpest and most aware people I knew in the city, and extremely insightful. They were savvy, tough, and sensitive to the feelings of others. A few of them I knew spent a lot of their vast spare time in the library, reading the news and watching documentaries, since they could do this all for free. They attended groups and other services where they could, so they could enjoy some company and interesting, intelligent, and hardy conversation.
So why were they on the streets? They hated society, couldn’t stand the bullshit–the duplicity, hypocrisies, the expectation to conform, the compromise to their spirit and heart, the judgments, and on and on. At least some were very clear about this. Life is a game, and they were playing it their way.
Certainly, this is not the case for all people on the streets. Many fall into this lifestyle because their basic soul needs have been neglected for too long, and they got emotionally violently knocked out of their connection to their natural intuition, which is what guides us through life.
I once spoke at a city supervisor meeting at city hall against involuntary commitment and forced medication, and a social worker asked me, “What about the guy eating out of a trash can and covered with sores and feces? He wouldn’t be in that condition if he would have just taken his meds. Shouldn’t he be required to take them?”
I answered that question bluntly, that she is way off in her cause and effect analysis, and not at all taking responsibility for what we, as a society, have created collectively. I pointed out to her that she is putting all the social ills on the homeless, when, in reality, it is her attitude that is the social ill, and is in large part responsible for what she is looking at, when she sees people digging through trash cans. She got mad and abandoned the conversation. I can understand that, but still, I felt she needed to sit with that for a while, and let it sink in.
Alex,
Excellent and important comment. Thank you for sharing it. Your experiences and observations, in regards to that segment of the ‘homeless’ population, which you have known, are enlightening. They correspond well to what I have observed…
(Hence, note: I say ‘homeless’ — because many people who are without personal physical shelter, do nonetheless have a home, a sort of meta-physical dwelling, in their hearts and minds, that they carry with them, wherever they go. Though, of course, it’s also true what you say, many “have been neglected for too long, and they got emotionally violently knocked out of their connection to their natural intuition, which is what guides us through life.”)
I encourage MIA readers to thoughtfully consider all that you’re saying here, in this comment, of yours — especially at the end, where you relay the attitude of the “social worker” at the city supervisor meeting — because, from all that Jonathan Keyes (our blogger) is saying, by this point (in this blog post and his previous blog post), it seems to me that, despite his staunch opposition to long-term psychiatric drugging, as it’s promoted through “AOT” laws, he is still a strong advocate of short-term forced IM drugging of “patients” who are seemingly threatening violence.
Hence, the services he recommends for ‘homeless’ people who’ve been labeled “mentally ill” might not appeal to many would be candidates for such services.
(One comes to this conclusion, naturally, when one is considering the really extraordinarily high intelligence of much the ‘homeless’ population — i.e., really that segment of the houseless/apartmentless population which rightly shuns psychiatry and all its connected forms of paternal control.)
Though I could be misunderstanding Jonathan (and, I would be more than happy to have him correct me, if I am misunderstanding him), it seems to me, that his views of people tagged “mentally ill,” is that they are not deserving of protection against psychiatric medical-coercion, forced drugging (as is the rest of society).
To Jonathan, violence can well be prevented with hypodermic needles.
Hence, I believe his views are somewhat comparable to E. Fuller Torrey’s views.
And, in my capacity as a vocational and avocational counselor, who has had the unfortunate experience of being forcibly drugged (long ago though it was), I, for one, would highly recommend avoiding such ‘services’ as Jonathan is promoting.
I would recommend, to anyone who has even the least self-respect and desire for justice: Steer clear of medical-psychiatry and all the guises in which it appears… (including all falsely advertised ‘free’ housing, which supposedly comes with no strings attached).
People deemed “mentally ill” wind up living on the streets, quite often, because they have been deemed ‘violent’ in “hospitals” — and, thus, were forcibly drugged… and, in the process, were utterly humiliated.
Their friends and family thus come to know them as ‘needing’ psychiatric drugs.
They reject such drugs and wind up tossed out, on their own…
I would not recommend that accept the “mentally ill” identity, as a prerequisite for free housing. Much better to remain houseless/apartmentless — and carry ones home in ones own heart…
The ever-creeping and expanding paternalism of medical-coercive psychiatry is more than evident, in all talk that supports forced IM drugging.
That is just my humble opinion, as inspired by your very thoughtful/insightful comment.
And, by the way, I should add, Alex: Your recent MIA comments are all catching my attention, as you clearly have much experienced wisdom to offer.
Great to know you’ve been out there, speaking up and standing up for what you know to be true.
Respectfully,
Jonah
Thanks for this confirmation, Jonah. It’s gratifying to know that my posts have been speaking to you, it encourages me.
I’m especially moved and in complete agreement with what you say, here:
“…many people who are without personal physical shelter, do nonetheless have a home, a sort of meta-physical dwelling, in their hearts and minds, that they carry with them, wherever they go,”
along with,
“ I would not recommend to accept the “mentally ill” identity, as a prerequisite for free housing. Much better to remain houseless/apartmentless — and carry ones home in ones own heart…”
It’s a relief to read this. That is a reality that some segments of our society cannot even fathom, it’s such an enlightened perspective of personal responsibility. Our hearts are powerful creators of our experienced reality. And yes, many people who have found themselves marginalized from dominant society do know this truth. Those who’ve had it relatively easy in a material sense (e.g., not ever homeless) cannot.
While, of course, some choose the label to receive services and housing, and it’s understandable, I think, from fear. In so many cases, they do discover soon after the dehumanizing and socially (et al) tortuous pay off.
I saw this repeatedly, even mention it as an example in my film (my ‘favorite’ quote from a social psychotherapist upon hearing one particular complaint from a guy having trouble in his housing–“take your meds and don’t make waves.” Were I to ever write a book about the plethora of social service ills which I encountered and witnessed as I went through the system and then again, in advocacy, this would be my title. Says it all).
Overall, when you say we carry our homes in our heart, that’s what I would call a really high spiritual truth, and it defines our power to own our experience, no matter what. It’s how I crawled out of this mess, I had some really good teachers who taught just this, as the way we actually create our reality.
As I attempted to heal while in the system and voc rehab, and move forward from disability, I would stand up and they’d knock me down, and I’d stand up, and they’d knock me down, and I’d stand up, etc…
I knew enough to know what they were doing was wrong, illogical, and illegal (non-ADA compliant), but, of course, being branded ‘the client’ brings on powerful stigma, rather unbeatable, in a social and professional sense–not ‘respectable,’ so literally, no respect. My word meant spit (and ‘you’re being paranoid’), regardless of how incredibly obvious their prejudices were, and I had plenty of evidence of discrimination, point blank. It’s impossible to know the feeling of this, unless one has experienced this crazy-ass second class citizenship thing, first hand. It’s a feeling beyond description.
My experience in the system, following graduate school and MFT training, was both eye-opening and soul-feeding. As far as learning humanity at the core, it’s heart and soul, this education far exceeded any of what I learned in graduate school. To say that my formal education was all merely academic is an understatement. It’s hardly relevant to any of the reality on the streets, or about mental illness and disability, if at all! I’m willing to be proven wrong, but at this point, I feel I can say this with certainty. It could practically be an experiential research paper, the way I lived it.
What I infer from your words is that the answer is always in the truth of our hearts, that is our most powerful reality and creator. Once we know how to hear and trust that, we don’t need anyone recommending anything to us. We know ourselves what it is we want, and we’ll know how to get it, once we trust our hearts.
That’s incredibly hard work, to make this heart connection with ourselves, when we’ve suffered in certain ways, especially due to chronic betrayal, misguidance, and really negatively mirroring, especially in subtle ways that make us walk away not quite sure what happened and why we feel anxious. Now I see, it was because I was feeling demeaned.
Once I got out of this mess and complete separated from the ‘mental health’ world, I had to heal from chronic patronizing–like really seriously patronizing–voices in my head. It was insidious. I had to re-route a lot of neural pathways myself, in states of meditation, once I disengaged from this world. My self-perception was tremendously messed up. Better now, thank God. Those are hard voices to wake up with in the middle of the night. It healed, though, eventually. Personally, I believe everything can heal, even our lives. One of the pearl I picked up along with way, although I’m aware that this is something else that much of society cannot fathom, but why would I want to listen to that? Good to know where we have choices about things, like where we tune in for our guidance…
“Good to know where we have choices about things, like where we tune in for our guidance…”
Alex,
That’s a great last line, and thank you for the reply. I am encouraged by your determination to free yourself from the ‘mental health’ system.
For me, it seems, there are always more layers of residual, habitual dissembling, which, I’m noticing, it left in my life.
My life ‘contracted’ as a result of the ‘treatment’ that was forced upon me…
I mean, though I was only involved with psychiatry for three and a half years, it left a massive impression — such that, I am still recovering from psychiatry.
I.e., really, I’m not at all fully healed from the havoc it wrought, in my life.
So, like you, I continue to work on myself; one way I do that, is with music…
Here is a song, on Youtube, which I like quite a lot…
http://www.youtube.com/watch?v=qO2utn3lDag
[Ben Harper – I Will Not Be Broken (Live on Letterman)]
…Musical preferences are a matter of personal tastes, which are very individual’ so, of course, you can take it or leave it…
Respectfully,
Jonah
Jonah, thanks so much for the link. That’s very moving, and I hear you!
I’ve heard many people say we’re all broken, one way or another. Personally, I think exactly the opposite, we are never ‘broken.’ We’re on a journey. Hokey and new agey as that may sound, I believe it hardily and heartily, and I live that way. Every day is a new day and every moment is a new moment. Anything can shift at any one moment. Our hearts can heal the moment we choose to let go of resentment, and then there’s a process to clear the mind from those negative impressions. Seems to me you are so on the right track!
I feel good about where I am, too, moving forward, healing from negative introjections from that emotionally hostile environment. Indeed, it leaves an impression quickly.
I’ve been working for the last 5 years years with students in a healing meditation class I created . I just finished with my group this morning. That was our theme today, healing negative voices and self-perception. Lots of layers to this, it affects us profoundly, in many kind of wicked ways. This is how I healed from the stigma issues. I feel very removed from the system now, MIA is the only place where I still participate in that world, and that’s because I feel these issues affect all of us on the planet, one way or another, no doubt in my mind about that.
My film where 6 of us tell our stories of going through the system has been accepted to an online film festival called Spirit Enlightened, sponsored by a group called Culture Unplugged and just started playing, so it seems I’ve made my transition. I feel very attuned to the spiritual world now, rather than to the academic world.
Challenges are what they are, and what we make of them. Social ills do, indeed, make life seem impossible, but that is what I yell most loudly about, when I choose to yell. These social ills we talk about here are what create the perception that something is wrong with us, or that we are broken. Certainly, they make people feel really badly about themselves, which makes for easy targets for abuse, oppression, and being controlled and manipulated.
This is where standing in one’s own truth is not only powerful, it’s the most practical thing we can do. That way, we’re impervious to the negative projections of others, even from an entire society. It’s how a new society is being created, from these novel and refined truths that are being unearthed now, from those of us who have experienced social ills in the health care system. I can’t imagine anything more harmful than that. No way the world can stay the same at this point.
Finally, back to music, when I was really down and out, my nerves frayed and my mind filled with crap and nothing but, as I detoxed from all those meds, about 10 years ago, music was also my salvation, so I really get you on this. I had a CD I listened to over and over and over, the only thing that could reach my heart at this time. This was on it. Singer is Linda Eder, Broadway and cabaret singer (I’m a theater guy). As you said to me, don’t know if it’s your taste, but this song in particular, was my voice:
http://www.youtube.com/watch?v=pE0yiKoR0zk
Jonah, the reason I asked you to talk is that I’m tired of writing out my responses. Instead, I’d love to hear more about what you have to say on this issue in terms of alternatives. Do you want me to give concrete examples of violent behavior? I suppose I could but there are so many varied possibilities that that is very hard to do. Each situation, each person is unique.
Ill say again my philosophy but then after that ill stop because I have repeated myself many times. But I haven’t heard much from you. I’d like to stop writing and hear your thoughts.
Ok so…
My philosophy is always preemptive. Violence doesn’t often come out of nowhere. Make contact. Listen. Try to respond to needs. Avoid titles and hierarchy. Be genuine. Offer a place to vent, to rage, that is safe. Offer food and drink if wanted. Give some if wanted.
If all measures fail, and a person starts harming another person or staff, intervene with the least force necessary. Hold a person without harming the person. If possible move them to a safe place where they won’t harm others. The last, and hopefully very rare measure is to either restrain them or give a forced shot. It’s awful and absolutely a terrible thing to have to do. I don’t take it remotely lightly. But I also believe it is my duty to protect others from someone who is attacking others.
That’s it. I really want to hear your thoughts. Please don’t ask me to give examples of emotional distress or violent behavior. I feel at this point that that is dodging. Really describe your philosophy so I can understand it.
Jonathan, I know you are addressing Jonah, here, but since my comment helps to support what Jonah has been attempting to communicate to you, I’m going to stick my nose in here in respond to one thing in your post directed at Jonah.
When you say, “Violence doesn’t often come out of nowhere. Make contact. Listen. Try to respond to needs. Avoid titles and hierarchy. Be genuine. Offer a place to vent, to rage, that is safe. Offer food and drink if wanted. Give some if wanted…,” you are neglecting one most likely possibility for that client’s rage and their alleged violent impulses: more than likely, they are being addressed by pure stigma, being looked down upon, thought of as marginal, needy, can’t take care of themselves, etc. Often it is not a conscious thing on your part, or on the part of your colleagues, but the walls of the system breathe this, it’s in the oxygen. If you are to remain employed by the mental health system, having this attitude somewhere inside you is a requirement.
When I was going through the system, no matter with whom I was dealing, in every case over a period of 10+ very long years–100% of the time, no matter who it was–it all felt demeaning. It was very easy to pick this up from every single staff member, no matter how helpful and ‘agreeable’ they may have seemed at first. It’s an attitude that permeates the system. After all, the public system is the government, and what on earth does the government know about mental well being?? Especially these days, that would be the absolute last place I’d go for support with my health and well being.
You environment is fear-based, that’s all that ‘preemptive’ means–“I fear I or others will be attacked.” As I said above, people who have been through this are highly sensitive to the feelings of others, and what they mostly pick up is prejudice in denial. This is what causes them rage. They have been stripped of their personal power. That’s more important than food because when a person is in their personal power, they don’t have those kinds of survival issues, they can manifest their own food, housing, etc. But the system makes them believe they have no power nor authority over their own lives, and that it is up to you all to be their rescuers and saviors. That’s why their enraged. This is what they feel coming from you, and they’d be right.
This is a complete and total illusion perpetuated by the system which you feel can be reformed and saved, because now people are ‘having discussions.’ People have had these discussions forever! That’s not progress, that’s feeding the stuckness. While you all are getting paid to ‘have discussions,’ thousands fall by the wayside daily because these philosophical discussions have become endless, with no evidence at all of real change, not anywhere.
I’m not even part of this system any longer, but I can still feel the division you have in your head between you and your clients. People can protect themselves. Your job is to own your prejudices and do that inner work on yourself. Perhaps then, you would begin to see a favorable shift in your environment.
So that would be at least my answer as far as alternative to restraining clients in any way, shape or form. Own your internalized stigma and prejudices, that social hierarchy which is part of your creative vibration, then the client won’t become enraged in the first place.
Thanks Alex for the comment. Basically I agree with almost everything you say. The hospital setting by nature is a hierarchal setting where the staff have essentially all the power and the patients have next to none. By it’s nature, the hospital system can be enraging due to this vast power imbalance.
As a staff member I also own that I carry this “authority” that by its nature can feel demeaning, no matter how “compassionate” I appear or how much I am open to listening.
I would also continue and suggest the architecture of most hospitals, the idea of locked doors and seclusion areas…can lead to a deepening sense of despair and anger. And finally, I would also suggest that the psychiatric drugs themselves can lead to further feelings of anxiety, frustration and anger.
I have seen situations where an individual is given a benzodiazapene to “help someone with their anxiety” and when it wears off the person becomes ncreasingly anxious and “edgy.” Essentially for some people, the hospital is iatrogenically engendering the potential for rage.
So yes, agreed…on many scores. I think this gets down to…why would I stay in this environment? My feeling is that millions of people come into a hospital setting every year. This is ground zero for where those who are homeless and poor often come. In my best case scenario there would be a completely alternative non-medical setting for helping most people. But there is not.
So here is where I disagree. You say I feel ths system can be reformed and saved because people are having discussions. No. I don’t think the system can be “saved”. If it is medical in nature it will never be saved. But, yes…I think it can be improved. And really, what is the other answer? To ignore the system? To not examine it and see what could be better?
How can we reduce hierarchy and the power imbalance? How can we advocate for patient’s rights more effectively? Can we inform people better about the adverse and sometimes extremely damaging effects of psychiatric drugs? How can we interact better? Listen better? Use our language in a way that is less demeaning? Create a space for better alliance?
I’n my job often what I do is listen. Listen to stories. I try and make connection to people when they are confused and feel lost. There is no great change. There is no massive shift where everything becomes better. But sometimes in those small moments of human to human connection, there is a release, a sense that a gap has been bridged. Maybe it’s through telling a joke, or offering some warm food, not turning ones back on someone who is in the midst of deep psychosis.
And maybe that’s all there can be within a hospital. Simple small acts within a larger system that is by nature is deeply flawed.
Jonathan,
I am very glad that Alex jumped in, where he did, to offer his thoughts. I appreciate what he’s said. And, considering what you say in reply, here I’m jumping in, to offer just one brief point (then, later today, I’ll have time to address your preceding comment, which was addressed to me).
So, my one brief point… is about the fact, that here you’ve explained,
“I think this gets down to…why would I stay in this environment?”
No.
Here I feel I must emphasize, that’s, as far as I’m concerned, really, that’s not the crucial issue, at hand (it may be for Alex, but it’s not for me); after all, I see that there are people, whose work in psychiatric “hospitals” I can fully respect.
They are people who very deliberately refuse to put themselves in a position of forcing themselves upon “patients” — those who, most certainly, never forcibly drug anyone.
(Of course, there are not many of those people, but they do exist, including one frequent commenter, on this website…)
My opinion of your work would be quite different if your were one of those people — e.g., being strictly a counselor/therapist, who talks with “patients” — or else, perhaps, a hospital chaplain.
I.e., if you really don’t care for the ‘medical’ aspect of your work, then don’t forcibly drug people.
And, meanwhile, of course, in any Emergency Room, people must be prepared to defend themselves and others from attack — especially, because people are brought in to ER’s, by the police.
Naturally, many times, those individuals will be quite riled up…
Any basic form of self-defense and defense of others, that is necessary to ward off an attack, need not require forced drugging, IMHO.
But, the resort to forced drugging is incredibly convenient for “hospital” workers who care to totally immobilize someone…
It’s convenient, but it does not encourage self-responsibility, and it can be incredibly traumatizing (I know).
So… I do not begrudge you the right to mount a defense, with your hands, if/when that may be necessary.
My issue with you, exists in the fact that you forcibly drug people into submission.
Forcibly drugging people, presumably as prevention of violence, represents a TOTAL FAIL, in my book…
In my humble opinion, no one should be doing that, least of all any counselor/therapist.
Everyone should have a right to refuse psychotropic drugs, always.
But, as long as forced drugging continues, the “patients” should, at least, be able to turn to the counselor/therapist and confide how traumatic such experiences have been.
No offense, but I could not, in good conscience, recommend that any psych survivor seek your counsel, as I believe you are failing to realize, that: you, personally, are a perpetrator of extreme violence, against some of various “patients” in your midst.
That’s my ‘assessment’ of you, as long as you remain a participant in forced druggings.
Sorry if this comment seems too personal.
Respectfully,
Jonah
Good music… IMHO.
(Jack Johnson – Buddha)
http://www.youtube.com/watch?v=vY1tyOfna9s#t=177
Jonah,
What do you mean by mount a defense with your hands, if/ when that may be necessary? What does defending from attack mean?
Those are the hard questions I would like you to explore. I have stated pretty clearly a number of times what I think…I have yet to hear a clear answer from you.
“…I have yet to hear a clear answer from you.”
Jonathan Keyes,
I find it amusing, that here you are saying that I’m not being clear.
(Is it possible you are failing to read my words carefully?)
It seems to me, that I’ve been quite clear.
And, Jonathan, you have been much less than clear, IMHO. One might even interpret you as being somewhat obstructionist, IMHO.
E.g., you wrote (in that comment, which I will reply to later),
As soon as I read that, I find myself scratching my head; that’s a very curious thing for you to say, I think; I am still pondering it…
(You suggest that I am “dodging,” as you refuse to explain what you mean, when you use those two terms? You offer no details or definition, no explanation of what they mean to you, as you’re using them, in your primary question.)
Well, I will continue, as best I can, with what I gather, from your words…
And, as I did explain, in my comment, that, later today, I shall be responding to your preceding comment to me. (I thought you’d hopefully understand, that I have a more thorough reply to offer, it is forthcoming.)
You shall receive my reply to that comment of yours (i.e., your comment of December 20, 2013 at 10:04 pm) no later than this evening.
I need time to carefully consider that comment; I said I’ll do that later today, and I will…
Maybe you were impatient for that reply…
So, here I offer you the following…
I.e., just briefly, as for your saying this,
Actually, I don’t believe I need to explore them a whole lot further than I already have, as I’ve spent most of my lifetime exploring such issues.
But, who knows, maybe you’re right, maybe I do need to explore them somewhat further; and/or, maybe you mean to say, that you would like me to further discuss these views of mine, with you?
(That’s how I’ll choose to interpret you here — unless or until you correct me.)
So… OK… Just briefly now, as I haven’t a lot of time…, and I will answer your preceding comment later…
As far as my mentioning what I believe is naturally everyone’s right to use ones own hands to defend against an attack…
Certainly, I am speaking of personal, physical attacks — as in someone is physically abusing another person, hitting or kicking, biting, etc..
It seems to me that, especially as police bring people into ER’s who are more or less amped-up on the latest ‘designer’ street drugs (and, because those people may be, effectively, under-arrest yet are there because they’re seriously wounded, having been apprehended while in the midst of fighting, etc.), the ER is a place that can become dangerous…
The impulse desire to feel relatively safe anywhere is quite natural, and the impulse which leads anyone to want to defend oneself and/or to defend others whom one cares for, from attack, is a universal impulse.
To me, Jonathan, in all fairness, it seems self-evident, that everyone should claim a right to defend themselves and defend others from physical attacks — at least, with their hands.
Of course, that does not mean that I believe all other ways of mounting a defense are somehow necessarily unacceptable or unjust (each way of ones mounting a defense requires some scrutiny); nor either do I mean to say that every way in which hands could be used must be considered a ‘rightful’ use of them. (I am talking about defensive uses of hands, and there are certainly ways of using ones hands which are not defensive; some uses of hands are clearly, purely wrong, practically speaking for purposes of defense — as they may be quite lethal; and, from the point of the law, they may be illegal. E.g., professional boxers are very strictly prohibited, by law, against using their fists… in ways which others are not.)
Simply, I believe that everyone should maintain a right to use his her hands, in an act of self-defense.
That is, using hands in a measured way — without weapons — to defend oneself and/or others; that, IMHO, should be anyone’s right.
But, of course, that isn’t everyone’s right; for, people who have been captivated by authorized agents of government automatically lose all sorts of rights (or, at least, they have all sorts of rights suspended).
People who’ve been captivated (whether for just or unjust reasons) always lose a number of rights.
That’s what happens automatically, in “hospital” settings.
Really, those settings become an extension of the government, in many respects.
But, my main point here is this: I believe you can and should maintain your right to defend yourself and anyone else with your hands, at any time, Jonathan…
That is in very stark contrast to using hypodermic needles.
Sadly, some people (such as yourself) in “hospitals” are given the legal right to forcibly drug people (you defend that legal right, ostensibly on ‘rare occasions’ only to prevent ‘violence’); but I don’t believe that you or anyone else has a moral right to do so…
Furthermore, I believe that the act of forcibly drugging “patients” should be considered most completely unconscionable (hence, immoral) for anyone who’s working as ‘counselor’ or ‘therapist’.
And, finally, for now: I firmly believe that, here in the U.S., such legal rights (of “hospital” workers) have always been based on extremely flimsy laws — i.e., laws which are demonstrably un-Constitutional.
Respectfully,
Jonah
Ok it still isn’t clear to me what defending oneself using your hands means. Do you believe that police officers should only se their hands? What if someone has a weapon? What if the person is extremely strong? What if a person is attacking other patients? Defending yourself sounds nice…but it also sounds like another, more gentler way of saying using force.
In another post I said that if all other measures have been tried, then we do use our hands…to hold people who are striking others. But what happens when you let go and they continue to strike?
“What if a person is attacking other patients? Defending yourself sounds nice…but it also sounds like another, more gentler way of saying using force.”
Jonathan,
Who is completely against any and every kind of force???
(Certainly, I am not.)
Yet, in these comment discussions (with me and with others), you frequently say things, which indicate that you apparently believe you’re arguing with people who oppose any and every use of “force” — whether in “hospital” settings or in ‘respite’ settings…
Jonathan, I repeat (yet again), emphatically, that: I am opposed to forced psychotropic drugs, that’s what I’m opposed to, primarily — what you’ve called forced IM (intramuscular) drugging.
So…
With me (as with some of the others who’ve commented, addressing you), you should, please, realize: You are not addressing someone who is strictly against use of force.
Again, emphatically: I am strictly against forced psychotropic drugging.
(That line is in bold print for a reason, eh?)
IMHO, anyone who would argue for “no force of any kind” in an ER (or in a psychiatric “hospital”) is living in a dream world — not in reality.
I don’t believe in medical-coercive psychiatry should exist (i.e., I am opposed to that, too), but I accept that, for now, it exists, and I sometimes offer suggestions for how to work in its midst, in the hopes that my words can lead to a reduction of harm…
My #1 suggestion: End all forced psychotropic drugging.
And, generally speaking (in regards to all kinds of conflicts), I am opposed to maximum use of force.
I propose minimum need use of force — for purposes of self-defense and defense of others.
I am completely against all deliberately lethal force, as that is the most maximum use of force, and the targeted individual cannot possibly recover from it.
About guns: I believe that adults who prove themselves capable of safely using guns, should have a right to own them.
But, I, personally, have no desire for guns.
Hence, I believe many police (if not all) should carry guns — at least, here in the U.S., where so many people own guns.
I would not work as a police officer, if it meant I had to carry a gun.
When called to register for the draft (during the Carter Administration), I registered C.O. (conscientious objector).
But, I am not opposed to gun ownership.
I just care to live my life doing all I can to avoid killing people… because I believe in the dignity of life… and I believe in a ‘live and let live’ way of life…
But, I do realize that, sometimes, a person may kill someone in self-defense, and circumstances left no alternative to that; the movies are full of such scenarios, of course…
My bottom-line, I completely oppose any deliberate use of lethal force, which is clearly not an act of self-defense (e.g., the death penalty, death by lethal injection, etc.).
And, frankly, Jonathan, I believe that, the lethal force in lethal injections is somewhat akin to the forced IM (intramuscular) drugging that you do; it is rarely immediately lethal; but, it does drive some to suicide; it is extremely humiliating and, certainly, in any “hospital” setting, must be considered a maximum use of force, that I know of…
Finally, regarding this next (your last) question,
I will reply to that question, later this evening, in the course of replying to your early reply, which (I keep telling you), I’ll need time to get to…
Please, hold off on offer more replies right now; or, at least, realize I can’t reply any further now…
Of course, I know no one is forcing me to reply. 🙂
I really say this for my own sake (to peel myself away from this conversation, to take care of more immediately pressing responsibilities, to make myself get up off my butt): I can’t reply to any more replies now…
Respectfully,
Jonah
Hey yeah, no problem with taking a break..I look forward to your comment when you’ve had some time.
Just to add one more comment before you respond. I get that you see a forced IM as the worst type of reaction to violence. And I agree that it is awful. 99 percent of the time staff and myself can use skills to deescalate a situation before it comes to that. A portion of my work is to try and make sure that that doesn’t happen.
And I understand that you consider an IM the worst abuse. But I ask you to reflect on people who think being touched and “handled” is very abusive…or that restraints are worse than a shot, or that being made to stay in isolation is much more abusive. Though you may say it is at the high end of abuse, others may differ.
I believe the fundamental goal should be non-coercive de-escalation and that all other further measures are simply awful. You say that a therapist should never be involved…and I ask…who should be the one doing non-coercive dialogue to deescalate the situation? A nurse? Some do very well, others don’t. A doctor? Sorry to say it never happens where i work.
Or should it be people trained in listening, offering help, in not reacting poorly to very tense situations and intense emotions. And to preempt violence, you need people willing to make connection, listen, be supportive. Do you believe these folks should abandon the situation if it becomes violent and endangers others?
So we return to the rare time when everything goes wrong, when physical intervention becomes avoidable. I wait your reply to ow to handle that. thanks Jonah,
Jon
Jonathan, thanks for your thoughtful reply.
You ask, “What is the other answer? To ignore the system? To not examine it and see what could be better?”
The system has been plenty examined, and I feel the conclusion is air-tight: it’s making people insane and chronically ill, at best, and killing them, at worst. In between, it’s a complex and absurdly bureaucratic fabric of stigma, oppression, and discrimination. I don’t at all feel I’m exaggerating. I think that’s pretty clear by now, to anyone who is paying attention with open eyes and ears.
Where could it be better? I think, overall, a good start would be that it could have a better perspective on itself. This quote comes to mind, by Jiddu Krishnamurti:
“It is no measure of health to be well adjusted to a profoundly sick society.”
I think the system and all its tangents are a profoundly sick society. How can I buy anything it’s trying to tout? It is not a trustworthy system, too much special business interest to be authentic. Personally, I think it’s a house of cards at this point, but I’m open to being wrong about that. Time will tell…
I re-read your response, Jonathan, and this stood out to me this morning, so I wanted to add one more thing:
“The hospital setting by nature is a hierarchal setting where the staff have essentially all the power and the patients have next to none.”
This is the issue–staff has the *illusion* of power. You, just like my colleagues while I was training (before I defected from this field to discover, apply and become trained in what actually DOES promote healing and wellness), really buy into this ‘power’ thing.
You have no more power nor authority over anyone than anyone does over you, unless you naively give it to them (or they to you), out of fear.
As far as patients having ‘next to’ no power, I disagree. That’s obviously your belief, and what you want them to believe, but I think that’s terribly naïve.
You may want to sit with this identification you have with ‘power,’ and perhaps you’ll be able to see your ego attachments, here. That would be very healing for you and your clients.
At present, I’d say you are functioning in a holographic existence. Once you become aware of this and are able to see past the illusions you’ve been buying into, you’ll notice a lot of things changing, both internally and externally. One goes with the other, that is the true nature of our reality.
Alex, I’m not sure what you mean. Do you not believe that a hospital is a hierarchal setting? That there is a power. Imbalance between staff and patient?
On a deeper level I agree with you. Staff certainly has the illusion of power. At a core level, staff have absolutely no more power than those coming to a hospital. But the structure creates a power dynamic just as the societal structure creates a dynamic where being a white male gives one more privilege.
So I’m not sure what you mean by “buying” into the “power thing.” I acknowledge the structural reality that creates imbalance in that setting.
“Do you not believe that a hospital is a hierarchal setting? That there is a power imbalance between staff and patient?”
I believe these are very well crafted illusions perpetuated by the master manipulators of society. I believe that this division of power has been insidiously imposed upon people who are humble, authentic, and trusting in asking for help. The result is an illusory reality that favors those who stand to profit from it all, by aggressively exploiting vulnerable, hurting people.
I feel that people in positions like yours, playing this game of illusions of hierarchy and delusions of power, are merely pawns in service to the system. In that sense, where is your power? There are a lot of people above you in that hierarchy you perceive, that have a lot of power over you, and they’re counting on you selling their bill of goods, for their profit.
Your clients have the power to make you angry, fearful, and defensive. They have the power to make you question your beliefs in everything, and to shake you at your core. At least, if you’re truly present with them and humble, this would be the case. Your clients—every single last one of them–are mirrors of your various aspects, so the only power struggle, in reality, is you with yourself.
“On a deeper level I agree with you. Staff certainly has the illusion of power.”
Yes, I’m glad we agree, here, although it seems to contradict what you say initially. Hierarchy and power: illusion or universal truth? (To me, reality is what is universal and eternal, by nature. All else is transitory and illusory, it all comes and goes).
“At a core level, staff has absolutely no more power than those coming to a hospital.”
Correct, and it is core level reality that is universal and eternal, so it’s really the only reality that matters, as this is our blank slate and ground zero, what connects us as a global collective of humanity. It’s true for everyone, always, at the core.
“But the structure creates a power dynamic just as the societal structure creates a dynamic where being a white male gives one more privilege.”
Correct, it is ‘the structure’ that creates these privileged classes and power dynamics. This is a free-will creation that goes against nature. The rift between the culture of this structure and nature is abundantly evident from all the dissidence regarding this structure.
So I say, bulldoze the structure, and you’ll free a lot of people from these ghastly and illness-creating illusions. The structure is neither universal nor eternal. It’s a fabrication of those master manipulators. It needn’t exist. To so, so many, it is grossly undesirable. So why is it still here? Who is it serving? Your employers, that’s who. Corruption is, by no means, power. It’s cowardice.
“So I’m not sure what you mean by “buying” into the “power thing.’”
Seems to me you believe that some people have power over others. At the core, I don’t believe that for a minute—not for you, not for myself, nor for anyone. You do. It’s an illusion, and you buy into it. You live it and embody it, at your job, from what you have described in your posts. That’s what I mean when I say ‘buying into power.’
We’re real dangerous. Do you know how we fight? While in a state hospital one time, the staff were giving one of us a hard time. Another “patient” who was known as very self-injurious, snuck away and broke the teeth from a comb and using the sharp remains, ripped and ripped the flesh from her arms. Staff immediately saw the dripping blood and rushed to “care for” this young lady. After roughly washing and bandaging her arms, they strapped her to the chair that was secured to the pole in the middle of the day room (for humiliation). She looked over at the rest of us consoling the friend who was the original target of staff and she gave a sly wink. She had drawn staff’s attention to her in order to rescue her friend. You may not be able to relate to that level of “fighting” for a bit of power on a psych unit but those of us with lived experience can understand. Jonathan, why do you want so badly to justify your use of power, even if it’s only in rare situations? If you didn’t have a loaded syringe, what would you do? Can you even imagine another way to cope with the situation?
Ugly. Horrible and abusive. Just awful. Yes I can think of myriad ways of dealing with that better. I don’t doubt that abuses like this continue. I agree that a hospital setting is by nature a hierarchical severe power imbalance. And yet I wonder, should we abandon the millions who go through these doors? Is there a place for change without “getting it all”… meaning a complete abandonment of the medical hospital model? Should we talk to doctors who work there? Nurses? Other thereapists?
One of the most amazing things I saw recently was Will Hall speaking to a number of psychiatrists at OHSU and talked about some of the fundamental reforms he would like to see. He has been horribly abused by the system and yet he was willing to see if changes could be made.
Here is a video of that talk…
http://beyondmeds.com/2013/05/27/will-hall-at-ohsu-psychiatry/
Jonathan,
Yes, there is a way. I’ve said that I started by volunteering at a free clinic back in the 60’s. I’ve sat with many as they worked through a “bad trip.” Today, that gets called psychosis. We had docs who volunteered too. There are ways. I know of a therapeutic farm. I know of respite care. I know of many alternatives. What are some of the myriad ways that you know? Please share and let us know what you’re doing to implement those ways.
Hey Pat, somehow I missed this. Yes alternatives such as respites, peer directed centers, free clinics are great and I wish there was a fabric of intertwined alternatives that could really take the place of hospital settings for the millions of people that go there.
In my own practice as a therapist and an herbalist, I work with my wife who is an acupuncturist. Often, we see people who are looking for a completely different way of envisioning healing. Our fundamental approach is towards nourishment instead of “fixing” anything.
Jonathan,
I have just now finished watching that video of Will Hall (which you recommended to commenter PatRisser, above).
While I have utmost respect for Will Hall (IMHO, he is an amazing person), I wonder:
What do you, personally, find amazing about that video?
Please, don’t get me wrong, as I ask you that question; I would just care to know what exactly is so amazing, in that video for you?
As I ask you that question, I should add that, for me, there was nothing new in the talk he offered. (I mean, there was no new information for anyone who is familiar with Robert Whitaker’s work and who is, likewise, familiar with Will Hall’s work.)
Though, it was interesting to watch how he dealt with that one perfectly classic, extremely skeptical state hospital psychiatrist, when fielding questions, at the end!
(Really, he handled that guy well; he hardly missed a beat, and I am always impressed by his communications skills.)
As for how the video may or may not apply to the discussions raised in this comment thread, I saw that Will takes about ten seconds (not more), to mention that some people report forced ‘treatment’ has been helpful to them.
(IMHO, that cannot be considered an endorsement of forced drugging — especially because, he make a point of explaining, that he does not equate ‘treatment’ with the the prescribing of psychiatric drugs.)
Also, he proposes “getting police out of the equation with mental health response,” but he doesn’t expand on that thought, and I’d be interested to know, does he believe that everyone who is called “mentally ill” should be immune from arrest?
Note: Will Hall clearly believes there is usefulness in the ‘mental illness’ construct and in the ‘schizophrenia’ construct and in the ‘bipolar’ construct. I don’t find them useful, I find them endlessly misleading (but, I well realize that some people do need assistance in living, which they can’t get without accepting such psychiatric labeling).
Should no one who is tagged with such labeling ever be convicted of crimes? Or, perhaps, never be convicted of violent crimes?
Has he ever fully articulated his views on this? (I don’t know.)
I figure that, whatever Will means to say, there, may be similar what you’re saying; however, I don’t really get your position; you say you would not even call the police to a “hospital” in instances of “extreme violence”; to me, that makes no sense whatsoever.
To me, it seems “extreme violence” is precisely what the police must be called for…
Maybe “extreme violence” means something completely different to you, than it means to me?
I dunno…
And, I dunno what he is saying, on those briefly mentioned matters, of policing, as he concludes by (so very vaguely) explaining, that we should “stop using the criminal justice system in the way that we’re using it.”
Well, I don’t know what that means.
Anyway…
Having asked you that one question, at the top of this comment (which was the real point of my writing this comment), I will go now and write my response to your earlier reply to me (that was posted roughly 24 hrs ago). It has been in the back of my mind all day…
(Estimated time for posting that response… roughly one hour from now.)
Respectfully,
Jonah
P.S. — Jonathan, please excuse me, I see it was “severe violence” that you referred to (not “extreme violence”). You mentioned, you would be opposed to calling the police, to a “hospital,” in the event of “severe violence.”
Hey Jonah- well in terms of the Will Hall piece- really there were a lot of things he suggested as essentially “reforms” of the system, but in general I was responding to Pat about what I see as really important- and that is creating bridges between Survivors and “the system”, to broaden dialogue to try and make systemic changes.
I guess what I appreciate is the desire on Will Hall’s part to try and create a space for meaningful change within the system while also looking to create alternatives outside of the system.
Jonathan,
Oh, you see as important,
Good luck with that… (Please know, I say that sarcastically, as I don’t figure that’s going to happen.)
You are well-meaning, Jonathan; you’re not a bad guy, at all, IMO; simply, you’re being terribly naive, IMHO.
Please, when you get a chance, see the post I just posted (below).
Respectfully,
Jonah
Jonathan,
You write (on December 20, 2013 at 10:04 pm),
OK, here’s my response; your philosophy can’t work well, IMHO; after all, it begins with an expectation of violence.
Whatever we begin by expecting, we wind up creating.
So, your philosophy will create violence.
And, this rule, “Avoid titles and hierarchy” …cannot be practiced in a psychiatric “hospital” — plain and simple.
No way can it be practiced therein…
Really, IMHO, you’re just fooling yourself, to think it can be practiced in any “hospitals” — and, especially, “hospitals” of the psychiatric kind.
You yourself admit that those environments are structured hierarchically, they’re highly authoritarian environments.
It’s simply ridiculous to think you (or anyone else) is going to significantly change that reality, sorry.
(That is just the beginning of my response.)
Next comes the description of my philosophy, which you’ve requested (no one has ever previously asked me for that, I have never before encapsulated it, in writing, and I find your request a positive challenge).
My philosophy “Let’s live and let live, to the very best of our ability, with liberty and justice for all…”
Wow. I guess you could call that a creed.
(You are probably familiar with it; it’s derived of three clauses, two which are quite well known, the first being “live and let live,” the third being “with liberty and justice for all…” (That’s taken from the end of the ‘Pledge of Allegiance,’ which was recited, by myself and all my classmates, when I was in elementary school and junior high.)
The middle clause (“to the very best of our ability”) is just straight up encouragement to do our best; I guess that’s inspired by The Four Agreements. (Maybe you are familiar with that book? If not, see: http://www.toltecspirit.com/ )
Really am glad that you prompted me to come up, with that…
(I’ve thought about it previously, many times; though, never before have I written it out…)
OK, so…
To expand on my philosophy…
IMHO, here are five realities (A through E) that we absolutely must diligently strive to incorporate, into our current understandings, of what it is to be human…
A) Everyone has an intrinsic enlightened nature. Everyone.
B) Manifesting that enlightened nature, on a regular basis, requires the development of a strong belief in that enlightened nature itself.
C) All of the most seemingly insoluble problems, which humanity faces, are effects of this one fact, that: By this point in time, far too many people are failing to manifest their enlightened nature, on a regular basis.
D) Effective solutions to all our most seemingly insoluble problems do exist, and these solutions can be widely adopted, but their adoption is dependent upon many more people manifesting their enlightened nature, much more frequently, than is typically the case, currently.
Obviously, then…
E) It is imperative that, we, who care to be humanity’s most effective ‘problem solvers,’ must, first and foremost, find effective ways to encourage one another, to realize, that: We do all have an intrinsic enlightened nature, which shall be accessed, on a regular basis, the more we believe it exists…
Now, what happens if millions of people adopt a philosophy which suggests that very large numbers of people, in every society, are ‘mentally ill’ — even permanently so…?
(Note: everywhere that the ‘mentally ill’ concept exists, there is that ‘chronically mentally ill’ notion, in tow, likewise existing; truly, the latter is derived from the former, historically.)
Of course, there have always been some few who’ve claimed that ‘recovery from mental illness’ is possible, yet the vast majority, of the countless millions of believers in that ‘mentally ill’ notion, will not buy in to notions of what might reasonably be called ‘full recovery’ (which could also be called ‘cure’) …Rather, most tend to believe that very many (perhaps, most) ostensibly ‘chronically mentally ill’ people shall surely always be ‘ill’; that widespread belief inevitably drive down the number of people who might, otherwise, believe in the intrinsic enlightened nature of such individuals.
After all, most folk are naturally led to strongly believe, that, even if there is an intrinsic enlightened nature, in a supposedly ‘mentally ill’ person, it cannot be regularly manifested…
And, note: You, Jonathan, yourself, admit, that psychiatric “hospitals” will not produce dramatic improvements, in people’s lives…
Those places will just engender endless believe in ‘chronic mental illness.’
Here, let me come back to your philosophy.
I find it fascinating that you begin with this line, “My philosophy is always preemptive.”
IMHO, that does strike me as being a ‘fear-based’ philosophy.
Alex kindly took you to task, on that point. Now, I will go just a few steps further — e.g., by reminding you of the definition of “preemptive”.
Google “define preemptive,” here’s what comes up, at the top of the screen…
Think about that definition, just a moment.
From the time, that the George W Bush Administration decided to declare a ‘preemptive war’ against Iraq, I have viewed the so-called “War on Terror” as an operation that parallels, perfectly, the somewhat lesser known “War on Mental Illness.”
Do you know that preemptive war?
Check out the following link, when you have a moment…
http://lmgtfy.com/?q=%22War+on+Mental+Illness%22
As I’m growing sleeping, I think it’s time to sign off, for now… I’ve offered you enough for this evening.
(Though, it seems to me, that there are some questions you’ve asked, which I’ve not yet answered, I must get some sleep.)
In deed, I’m off to sleep.
Respectfully,
Jonah
“Whatever we begin by expecting, we wind up creating.”
I believe this is universally true. The good news, is that we can change our expectations, that is our choice, we have free will here. Our minds are malleable, we can shift our focus any time we want, wherever we are in life at any given time. Therefore, in reality, we can create anything we want, because we can choose what to expect.
So why all the insidious and toxic turmoil in the mental health world? (of all places–it’s just so hard to get past the tragic irony of it all). From what expectation did this madness become a reality?
Hey thanks Jonah, for expressing your philosophy, or creed, as you call it. And thanks for taking the time to articulate your differences from me. I think I’ve said more than enough and I’m going to take a break for a while on this one. Even though we may disagree, I feel heartened by the discussion. And as you said of me…you think I’m not a bad guy, just terribly naive…I will leave saying I just think you are a good guy…smart, very well intentioned and passionate.
Respected people of MIA,
I would like your opinions on what I’m about to write.
1.)I once saw a woman on the street (in fact, I keep seeing her from time to time). She used to live in what was a small bus stop. She would not wear any clothes. She would sometimes be seen touching feces. She would shout at things which were not there, and her hair was very dirty and matted. I was so intrigued by her behaviour, that I approached her (but I kept my distance) and tried to ask her what her name was. Next thing I knew, she took a brick and was running behind me trying to throw it at me. All I did, was to try and ask her, her name. If a psychiatrist had seen her, she would have definitely been given the label of schizophrenia. The amazing thing was, I would also sometimes see her go to a nearby shop and buy little things to eat. She was fine with the shopkeeper.
2.)I once met a guy with a diagnosis of bipolar disorder. His behaviour was very peculiar. A certain person went up to him and said, “Good morning”, and I don’t know what this person with the bipolar label perceived, but the next thing I saw, this guy with the bipolar label, held his collar and threatened to beat him up.
****
The people I mentioned in point 1 and 2 were extreme cases. I have also met people with labels like schizophrenia and bipolar disorder who have masters degrees and doctorates in various fields ( science, engineering, law, literature etc.). Many of these people were quite intelligent, very articulate, and had full insight into their problems.
When people in society see the kind of people I mentioned in points 1 and 2, it is sort of natural that they want these people locked up and “treated”, and if not “treated”, at least isolated from society. This fear obviously stems from people wanting to be physically safe.
How can these people be isolated or “treated” without any force whatsoever, especially when they believe that they are completely okay?
Also, I find that psychiatric labels are dangerous because they are very simplistic descriptions of complex behaviours that people exhibit. Once a person has a label, a person is often treated by many as though he has a hard disease and the causal factors that go into that person exhibiting those behaviors is often ignored. That is, most people might say, “This person has schizophrenia or bipolar disorder, and this is why he/she behaves this way.” Usually, only people who have experience with psychiatry would think, “This person behaves in a certain way or has exhibited certain behaviours in the past. We do not exactly understand why. We do not know the life experiences this person had. We do not understand his innate biology properly. We don’t know how his/her innate biology and life experiences together culminated in him/her exhibiting these behaviours. Some of these behaviours could have also been drug induced. It is because of this person’s behaviours or symptoms, that this person was given a label of schizophrenia or bipolar disorder.”
There’s a huge amount of difference between people with the same labels. Some of them have barely any insight into their behaviour while others have full insight into it, with some others coming in between. Some people may lose insight but only during certain moments, i.e. it is episodic. But insight also comes with experience and insight is a powerful tool in preventing or even eliminating further “episodes”.
Because of the fact that these labels are used on huge numbers of people with varied behaviours and levels of insight, the sort of “treatment” and consideration that society gives to extreme cases also trickles down to people who are insightful and reasonably intelligent. It is unfortunate and there must be something done to change this.
****
Coming back to my main point, how do we make other people feel safe from the extreme cases, without any form of coercion at all? It’s a question that I find is very complex. Also, I find that this notion of being involuntarily treated because you’re a danger to yourself or to others is fraught with complications.
A person should be allowed to be a danger to himself/herself, when this is done with full insight (again, insight has to be judged by another person which is again fraught with complications). Whatever the law ( a man made construct which keeps changing because men and their ideas change) says, if one wants to terminate his/her life because he/she deems that it is not a life worth living, it’s completely up to him/her. And if it’s not up to him/her legally, well….it should be.
Now, when you’re a danger to others, it’s different. Steps must be taken to ensure the safety of other people but then it should also be properly assessed why this person has come to the stage that he/she has become a danger to others. That is, all causal factors should be probed.
****
I was given labels too. OCD and Bipolar Disorder (Bipolar 2). When I first saw a psychiatrist, I had depression and obsessions (I was only given an OCD label first and also “adjustment problems” or something of the sort). I was given an SSRI which made be hypomanic and I subsequently got labeled bipolar. I don’t have any obsessions any more (read my comment here: http://www.madinamerica.com/2013/09/cognitive-behavioral-therapy-beats-antipsychotics-ocd/#comment-34781 ). The only reason I feel depressed is because I have psychiatric labels and a history as a psych. patient. I live in fear of what being labeled and having been a psychiatric patient might do to my life because enough people know about it. I wonder if they have a pill to make the labels go away. I don’t take SSRIs (or any medications any more). Since I don’t have any obsessions or compulsions, scratch the OCD label. Because I don’t take SSRIs, I don’t experience hypomania. So scratch the bipolar label. Now, I feel scared and depressed precisely because I got involved with psychiatry.
I can’t blame psychiatry for everything though. A lot of it was chance I think. It’s just that I got involved in a field with so many grey areas, both in it and associated with it, that it’s scary. I like distancing myself from the “antipsychiatry” label though because of all the connotations associated with it (like not being scientific, believing in scientology etc.), nor will I say that psychiatry is totally useless for everyone. I just think that psychiatry is a field which helps some but hurts others because of all the grey areas in it and associated with it.
That being said, this diagnosis of bipolar disorder based on hypomanic reactions to SSRIs is disgusting. Jeff Fisher has written about this and I’ve commented on it as well ( https://www.madinamerica.com/2013/02/bipolar-by-definition-2/ ). This is how you turn temporary problems into chronic ones.
“How can these people be isolated or “treated” without any force whatsoever, especially when they believe that they are completely okay?”
Don’t you see the woman as already isolated? In fact, she’s some sort of caste.
“Caste is a form of social stratification characterized by endogamy, hereditary transmission of a lifestyle which often includes an occupation, ritual status in a hierarchy and customary social interaction and exclusion based on cultural notions of purity and pollution.” ~ wiki
In her instance, she is exclusion and pollution and you don’t know the rules and the ways of the street (technically, you were in the wrong for making unsolicited contact with her. I understand why she was going to defend and protect herself – by throwing a brick at you).
Treated? To what end, transformation? There are at least two instances of “treating” somebody. The first is relational and behavioral, the second is “medical” and “therapeutic”. When we treat people like shit and garbage we can effectively turn them into shit and garbage. At that point, being nice or respectful or kind is cruel.
“When you live in the shit you become the shit.”
A woman like that belongs to the Earth, not to the world.
Yes, I do get that she might have thought that I was a threat to her, though I wasn’t.
You were something of a threat because you entered her space, uninvited.
Should she have treated you as if you were an Angel or savior?
Should she have been accepting of you? What would that look like, lunch at the corner diner? I’m not being sarcastic.
You were intrigued but she had no interest in “entertaining” you, and why would she? I’m curious, what did you think or expect would happen? What would it look like if things went your way, instead of hers?
I suppose it is difficult to think of yourself as a threat when you weren’t there to stab her to death or throw a net over her and drag her away somewhere. And likely, she knew that.
Did you intend to become a regular contact for her? If she would have engaged you, would you have established some sort of “help” relationship? And if so, to what end? To get her into “treatment”? Some housing, medicine and TV service? Some friends at the local mental health services community, people who can relate to and identify with touching feces and talk about it in group?
Please understand, I’m not being rude and you’re not being charged or faulted but it was truly naive of you to have approached her. “schizophrenia” didn’t make her chase you with a brick. YOU are what made her chase you with a brick. If you understand.
Nice post mjk. I understand that it was my going up to her that provoked her to chase me with a brick.
I did not want to save her, or get her “treated” or anything like that. I just found her intriguing and wanted to talk to her and find out what she thought. I wanted to delve in to the mind of such a person, wanted to know and understand her ideas and beliefs. It was my selfish curiosity that led me to approach her.
“I wanted to delve in to the mind of such a person, wanted to know and understand her ideas and beliefs.”
She’s probably loaded with knowledge of Hell (terrors and horrors, and worse).
Some things people do not know they do not want to know. I call it black knowledge.
O No Now Know
Once we know something we cannot unknow it.
We can be “guilty” of knowledge and knowledge CAN harm a person.
This is why people want to shield and protect kids (and sometimes, adults) from “truths” and “knowing”, at least until they’re mature enough to tolerate and handle certain truths and realities about life, people and the world (“the way it is”).
Knowledge can wreck a mind. Doorways and windows, of the mind, accessing mental spaces, mental dimensions… Heaven and Hell are both internal AND external conditions.
When that woman closes her eyes to sleep, she might go to Heaven (inside) and there’s no knowing what that Heaven is for her. She might go to Hell and there’s no knowing what that Hell is for her. No knowing, unless she tells. She quite likely isn’t ever going to take somebody inside and show them around. But who knows, maybe there are a LOT of people already inside of her. Maybe she does take people in. Do they ever get out, though.
And what if she isn’t even a resident inside of her own self? What if she resides inside of somebody else? I wonder who knows how to call a soul back into its own body. Or evict souls and spirits where they trespass. Maybe she’s a haunted house. Predators, parasites and vampires.
I’d wonder about the things that never cross her mind…
But all in all, what’s her lot in life? And why’s it gotta be shit and bricks? Whose plans and purposes does she serve, if not her own? Could be the shopkeeper’s.
Here. Imagine if you’re Robin William’s character in What Dreams May Come and you come upon a woman in Hell.
“In Hell, there’s real danger … of losing your mind.”
http://youtu.be/HwrmILnrzbk
@mjk:
“Don’t you see the woman as already isolated? In fact, she’s some sort of caste.”
Sure she was isolated. Imagine if someone asked her to move out of the small public bus stop that she made her home, just for a while so they could clean it. If she responded to the cleaner by trying to throw a brick at him, she would obviously have to be forcibly restrained, if only for a while, so he could actually clean the place up.
How can you completely avoid force in situations like that?
I doubt she’d respond like that in that instance. If anything, she’d probably just ramble and bitch and yell and complain. She knows how it is, she’d move along and either come back or find a new spot.
@mjk: “If anything, she’d probably just ramble and bitch and yell and complain.”
Likely, but this might not always be the case.
The guy with the bipolar label I talked about went after someone because that someone wished him a good morning.
“Likely, but this might not always be the case.”
Correct.
Life cannot be totally controlled. What will be will be. There is always risk and chance (danger) and no amount of security measures can ever make each one and all always so safe.
This is one of my favorite examples of what *should* be a safe place (and a “safe” person) but in this instance is the most dangerous. What interests me so much about this video is how the woman recognizes the danger she’s in and she’s trying to escape.
http://youtu.be/hxgNKNEtk18
The bus stop woman might someday be bludgeoned to death or might maim someone’s face with a brick. Should there be a mission to get every such person off the street and locked away in their cage or box, so no crime or tragedy can ever occur?
As I type this, police and ambulance pass by the house and their sirens always get my attention. We live in a sick and dangerous world (constant pursuit of Safety and Health). Coercion, force, violence, disease, disorder…
It’s all an endless conversation.
I would approach a homeless person living under a bridge. I’d gently ask if I could get them anything; a sandwich, a blanket, a new box to live in, anything. He’d snarl at me to go away and I would. The next day I’d show up and ask the same thing. He’d snarl and I’d go away. Eventually, he’d get tired of me and he’d test by asking for a new box. I’d drive all over the city if necessary to find him a nice large refrigerator box and take it to him. He’d snarl a few more times and eventually, he’d let me give him a clean, warm blanket. With enough time and patience, he’s got a home a job, meaningful relationships and is living as a productive member of the community.
The key was relationship. It had to take time to build and to develop the trust. If you get chased away once, don’t give up. Who knows what trauma they’ve experienced that made them chase you away? The shop person obviously had a “relationship” where the person knew they wouldn’t be hurt. On hospital units where they have done away with restraints and forced medication, they did so by learning how to build relationships and help people heal in safety. I wish others here could learn that.
I do have one suggestion though. This is an idea I got and subsequently implemented. I asked the psychiatrist who was seeing me to show me my file. I was a little alarmed by some of the stuff written in there. Many of the assessments were quite subjective, and some details were even erroneous. So, I told him that I wanted to put my own notes into the file. My own version of my experiences, about my agreements and disagreements with the assertions about me in the said file, my problems with the notion of SSRI induced hypomania being used to make a bipolar diagnosis etc. I was allowed to do this.
I think in addition to the notes of psychiatrists, patients should be able to put their own notes in their files. This makes the power equations between psychiatrists and their clients better. If a third person reads the file, it also makes for a more objective assessment.
Anosognosia – a term used when a client/ patient fails to be properly subservient and the psychiatrist has such a grossly overblown ego that he/she is deeply hurt and offended. – We need respite centers where individuals can go when they feel like they may be going downhill. A place to stay for a while without being locked in, and being able to leave when they feel they are up to it. Someplace where they don’t loose their rights, where people won’t have to lie about being suicidal or have people exaggerate incidences so the person get into a facility. Places where everyone isn’t considered to be on the edge of committing violent acts. Places where people are treated with respect. (Another word for this is peer centers.) If facilities weren’t so demeaning there would be fewer people avoiding ‘the system’. “The mental health system simply offers you a few token favors if you keep your worker happy by always taking your drugs and doing what they say, and if you don’t, you get scolded. Keeping people on drugs seems to be the main focus, not helping people lead a happy and meaningful life. You need to act in your enlightened self-interest, and do the work needed to bring greater happiness to your life.” (a line from my new play -Sugar Daddies- which will open in Reno in December.)
Florida lawyer and pro bono advocate of the rights of the psychiatrized, Wayne Ramsay, has compiled a series of essays that comprise a useful online book providing an excellent introduction to the critique of psychiatry: primarily an anthology of quotes with bibliography sprinkled with cogent insights of his own, often from a legal perspective.
http://wayneramsay.com
But in the second last essay ‘Why Psychiatry is Evil’ he mentions a conversation he had with Thomas Szasz about Torrey:
“It is impossible for me to believe someone who so eloquently and convincingly debunked the concept of mental illness, including schizophrenia, as Dr. Torrey did in ‘The Death of Psychiatry,’ could be sincere now when he promotes these very ideas. In 1990 at the Thomas S. Szasz Tribute Dinner in New York City in a face-to-face conversation with Dr. Szasz, author of ‘The Myth of Mental Illness,’ I asked Dr. Szasz, ‘Whatever happened to Fuller Torrey?!’ Dr. Szasz answered with a single word, ‘Funding’, and suggested I ask another psychiatrist who was with us that night, Dr. Ron Leifer, who gave me the same answer. Dr. Szasz wrote an article about Dr. Torrey’s turnabout titled ‘Psychiatric Fraud and Force: A Critique of E. Fuller Torrey’ in the Journal of Humanistic Psychology (Vol. 44, No. 4, Fall 2004, p. 416).”