Note: This blog is adapted from Scott Byant-Comstock’s “Morning Zen” blog
on the Children’s Mental Health Network website.
Two weeks ago there was an editorial in the Wall Street Journal that basically eviscerated the Substance Abuse and Mental Health Services Agency (SAMHSA) while at the same time calling for support of HR 3717 – The Helping Families in Mental Health Crisis Act.
HR 3717 has elements that we agree with as well as elements we don’t. In addition, there are elements that are just plain confusing to us. If you haven’t already, I encourage you to read the Morning Zen post where we went through the bill page by page, identifying areas that raised red flags for us. We will be posting an updated more-detailed review next week.
Since then the introduction of the proposed bill we have read with great interest articles in the press, personal communication, and written testimony from past Energy and Commerce Subcommittee on Health hearings on HR 3717. Much of what has been written is definitely passionate and unfortunately sometimes vitriolic. In this post I want to address three of the most popular sound bites (two of which found their way into the WSJ editorial) that continue to come up again and again. It is interesting to note that these three provocative sound bites seem to have gone unquestioned in the popular press all these months, taken at face value for fact, creating an impression that might not be accurate. The other interesting aspect is that all three sound bites reference the Alternatives Conference. Some day I’m gonna have to go to that conference to see what all the fuss is about.
Note to readers: I have no monetary investment in the Alternatives Conference, nor have I ever participated in the Alternatives Conference.
Here are the three juicy morsels that keep making their way into the press:
- The 2013 Alternatives Conference included a session titled “Dance Your Way to Wellness and Recovery
- The 2013 Alternatives Conference included… a presentation from the “Hearing Voices Network,” which believes that hearing voices is a natural part of human experience…
- From WSJ article – SAMHSA underwrites the Alternatives conference, which in 2013 included a session titled “Dance Your Way to Wellness and Recovery” and a presentation from the “Hearing Voices Network,” which “believes that hearing voices is a part of human experience.”
- The 2013 Alternatives Conference included a session titled “Unleash the Beast.”
- Opening Statement of the Honorable Tim Murphy Subcommittee on Oversight and Investigations Hearing on “Examining SAMHSA’s Role in Delivering Services to the Severely Mentally Ill” May 22, 2013.“If SAMHSA were to use an evidence-based approach to identifying how to prioritize its resources – like other federal agencies do – would their record, not to mention their strategic initiatives going forward, look the same as they do now? For example, in 2012, an annual conference that has been funded by SAMHSA for many years – and at which the SAMHSA administrator regularly delivers a keynote – Alternatives, an hour and a half workshop was held, described as follows:Unleash the Beast is a mind/body fitness program that looks to the animals of the jungle for wisdom and skills that can benefit our lives in a myriad of ways. Through animal-inspired movements, behaviors, and expressions, participants are encouraged to shed layers of formal conditioning in order to return to their primal nature.While mental and physical health is important, I question the value of this exercise in advancing the treatment for mental illness in humans. And, I question if there is any scientific merit.”
In the most recent hearing on HR 3717 one of the expert witnesses was asked if he thought SAMHSA offering a workshop titled Dance Your Way to Wellness and Recovery was a good use of federal funds. I remember at the time thinking how I would answer. It would be something like “It depends on the context.” Realizing that I did not know the context I did some digging. Here now is some background on each of them.
Let’s start with “Dance Your Way to Wellness and Recovery”
It turns out that this “session” was actually part of the morning wellness activities offered to conference participants from the hours of 7 am – 8 am before any general session started. In addition to this offering, there was a yoga session as well as a silent meditation session. Like most Network faithful, I have been to many conferences that offered early riser exercise or centering sessions to prepare conference participants for a long day of sitting in sessions. I would be hard pressed to imagine any physician arguing against the benefit of exercise or centering activities before a long day of workshops. Think Zumba – one of the biggest conference crazes currently around. And why do conferences offer sessions like this? Because increasingly conference participants demand wellness activities so that they can get their workout or quiet time in before the workshops begin. But let’s peel the onion a bit more and look at the description of this session as printed in the conference agenda:
- “The Health and Wellness Fair is also offering selected wellness practices throughout the conference. These wellness activities are open to anyone at any fitness level. Activities are on first floor.”
Wellness Activity: 7:00 – 8:00 a.m. Dance Your Way to Wellness and Recovery (Foothills I)
Shining River (Sheilah Hill)”To watch us dance is to hear our hearts speak” (Hope/Choctaw). Dance for celebration, for wellbeing, for mental clarity, and healing. Learn how to release tension and discover new ways to listen to your body. No dance experience or ability is necessary for this free-form movement.
The description makes clear that the focus is on free-form movement – no dance experience necessary and also references the importance of dance to tribal nations, presenting an opportunity for some cultural learning as well.
With this important context, the accusation that offering this wellness activity is a poor use of money gets complicated real quick. It should be noted that the conference also conducted mini-health screenings where people could get their blood pressure checked, get a reading on their blood sugar levels, and get some ideas on getting and staying healthy. Sounds pretty reasonable to me.
Hearing Voices Network
Okay, on to the next oft-used phrase in this increasingly vitriolic dialogue, also referencing the Alternatives conference – “a presentation from the “Hearing Voices Network,” which believes that hearing voices is a natural part of human experience.”
Here is the workshop description:
- Discover the Hearing Voices Network (Foothills II)
Lisa Forestell, Marty Hadge, Janice Curtis, Becky Edwards
The Hearing Voices Network (HVN) believes that hearing voices is a part of human experience. The presenters are voice hearers and trained HVN facilitators who find support through community created around the HVN principles of inclusivity and non-pathological, judgment-free connection. This workshop will provide an overview of HVN and its principles and will provide information on how to develop new hearing voices groups across America.
It turns out that the Hearing Voices approach has been developed over the last 25 years in Europe and is now practiced in 23 countries across the world. Essentially it involves engaging the voice hearer about their experience and determining the meaning the voices have for them in relation to their lived experience, with the objective of developing long-term coping strategies.
One of the tenets of Intervoice, which is the international umbrella of the Hearing Voices Network, is to develop a close and respectful partnership between voice hearers – who are experts by experience and mental health workers, academics and activists – who are experts by profession. The group stresses the importance of both voice hearers and professionals engaging in respectful dialogue.
In context, this seems like a perfectly reasonable session to offer at a recovery conference. I get the fear amongst the psychiatric community that this suggests that there is never a role for psychiatric intervention but from what I read that appears not to be the case. This is undeniably a controversial discussion point from the medical community perspective but this is also a movement that is not going away. If anything it is picking up steam. Instead of shouting it down, it seems to me that the more fruitful approach would be to engage in respectful dialogue.
Here are two examples to illustrate further what the Hearing Voices Network is. The first is a Ted Talk by Eleanor Longden and the second is an interview by Allen Frances, MD and Eleanor Longden. The sub-title of the interview is appropriately titled “Reconciling psychiatry and recovery.”
Eleanor Longden, Hearing Voices Network
Eleanor Longden spent many years in the psychiatric system before earning a BSc and an MSc in psychology at the University of Leeds. She argues that schizophrenia is a “creative and ingenious survival strategy” that should be seen “as a complex, significant, and meaningful experience to be explored.” Longden is studying for her PhD and lectures and writes about recovery-oriented approaches to psychosis, dissociation and complex trauma.
Psychiatry & Hearing Voices: A Dialogue With Eleanor Longden
In this interview, Dr. Allen Frances and Eleanor Longden have a dialogue attempting to find common ground between psychiatry and the Hearing Voices Movement. Read the interview. And then, come back to this post – we still have more to cover. Dialogue is key, folks.
Unleash the Beast
On to the final sound bite, not in the WSJ article, but worthy of inclusion here in case you are asked about it. This is from the Opening Statement of the Honorable Tim Murphy Subcommittee on Oversight and Investigations Hearing on “Examining SAMHSA’s Role in Delivering Services to the Severely Mentally Ill” May 22, 2013:
“If SAMHSA were to use an evidence-based approach to identifying how to prioritize its resources – like other federal agencies do – would their record, not to mention their strategic initiatives going forward, look the same as they do now? For example, in 2012, an annual conference that has been funded by SAMHSA for many years – and at which the SAMHSA administrator regularly delivers a keynote – Alternatives, an hour and a half workshop was held, described as follows:
- Unleash the Beast is a mind/body fitness program that looks to the animals of the jungle for wisdom and skills that can benefit our lives in a myriad of ways. Through animal-inspired movements, behaviors, and expressions, participants are encouraged to shed layers of formal conditioning in order to return to their primal nature.While mental and physical health is important, I question the value of this exercise in advancing the treatment for mental illness in humans. And, I question if there is any scientific merit.”
Without the proper context one could draw the same conclusion. Unleash the Beast is such a provocative title I had to investigate this one. It turns out that the presenter grew up alongside an older brother with autism. At the age of 12 he was in a serious car accident and suffered a severe Traumatic Brain Injury. He spent three months in the hospital, relearning how to walk, talk and think. The next 15 years of his life were spent riding a roller coaster of success and setback dealing with severe physical, mental and social difficulties. Fast forward to today, he is a certified Life Coach, peer support specialist and works with individuals discharging from the psychiatric ward at a local hospital. His specialties include working with individuals who have brain injury, trauma/PTSD, bipolar, Autism spectrum/Asperger disorder.
Okay, he passes my test for a credible presenter. But what about the subject matter? I didn’t attend the session so I certainly can’t speak to that but it did get me thinking about mind/body work and the question of scientific merit. We should be aware that the National Institute of Health established the National Center for Complementary and Alternative Medicine (NCCAM) in 1999. Since that time they have been looking at alternative forms of treatment (meditation, forms of movement therapy such as yoga, etc.,) and are taking a refreshingly open view towards the efficacy of complementary and alternative practices that may not yet be considered evidence-based. Much of what has been discussed in this post most likely falls into the practice-based evidence camp instead of the evidence-based practice camp. It is encouraging to see that NIH is keeping an open mind about alternative practices, as we all should.
Watch this brief video announcement from Josephine P. Briggs, M.D. Director, National Center for Complementary and Alternative Medicine
One thing we know for sure, the Veterans Administration has embraced body movement practices with returning servicemen and veterans who are experiencing PTSD. At the Washington VA Medical Center, both Yoga and meditation are used to help veterans recover from trauma. Many treatment programs for veterans with PTSD as well as individuals with diagnosed severe mental illness offer mind/body therapies, equine therapy (remember the first sound bite – Spirit of the Horse?) and other expressive arts therapy, including the healing power of dance. For a fascinating read on how dance/movement therapy approaches were used to foster resilience and recovery among child soldiers in Sierra Leone who had experienced significant trauma, read the paper by David Alan Harris.
The Next Time You Read a Sound Bite…
The next time you are discussing HR 3717 with colleagues and one or more of these sound bites are referenced, hopefully you will be able to avoid the visceral reaction (pro or con), thoughtfully consider the context, and will be able to engage in meaningful dialogue about this proposed bill.
* * * * *
“National Alternatives Conference: Voices of Experts by Experience”
“Voices Matter,” video about the World Hearing Voices Conference in Wales
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
The alternatives conference is a thorn in the side of people who have bigoted attitudes against the diagnosed. We aren’t supposed to be dancing, discussing our experiences, or having fun in a way that promotes the health of our bodies and minds. We’re supposed to be sitting completely still in plastic chairs listening to lectures on medication compliance, answering a punch list of questions read off a list by a licensed professional, or alternatively, making collages with Elmer’s glue and pictures ripped out of donated magazines. Thank you for your article.
And don’t make any sudden moves. The compliant and conforming scare like rabbits.
Thank you for sharing this. I truly hope the massive drugging of America’s children will end soon. Especially since it’s been scientifically proven that the DSM labels are “lacking in validity,” the psychiatric practitioners are incapable of accurately diagnosing people, and the psychiatric drugs cause the symptoms of the serious mental illnesses in many. It breaks my heart the medical community is still actively creating mental illnesses in millions of children with the psychotropic drugs. Alternatives to psychiatry’s stigmatization and major tranquilization belief system are definitely needed.
I personally have been working on healing myself from psychiatric attack (to cover up an easily recognized iatrogenic artifact and the abuse of my children by a pastor and his friends) for years. And dance was very therapeutic, especially when suffering from the drug withdrawal induced super sensitivity manic psychosis. Regular moderate exercise (what my neurologist called “manic” behavior) was also valuable. I also try to avoid fast food restaurants, most processed foods, and try to come up with creative ways of preparing fruits and vegetables – in other words, proper nutrition is important. Painting, and art creation, was beneficial for me, as was keeping a journal. As to hearing voices, in my case, the antipsychotics caused me to hear evil voices in my head – I fear this may also be happening to many of the children put on antipsychotics. But both prior to and since getting off improperly mandated drugs, the only “voice” (and it’s not actually a “voice,” it’s more like gut instincts and dream recollections) I personally have, is what my misdiagnosing therapists claimed was the “Holy Spirit voice,” and that’s a benevolent “voice.” So, I agree, a well meaning inner “voice,” is infinitely better than the incessant and evil drug induced “voices” in one’s head. But most psychiatric practitioners do not seem to be able to comprehend that it is illegal in the US to torture people for belief in the Holy Spirit “voice.” And these same people are harming millions of children with toxic drugs, exactly as my doctors covered up malpractice and medical evidence of child abuse. Please help end the almost unfathomable iatrogenic harm of children, for profit. It’s heartbreaking.
I have already proposed it elsewhere but I’ll repeat myself: we need to make a better case for ourselves in the media. Although the mainstream may be more difficult I think we can take the effort and try to call in/write to some alternative and on-line media outlets and ask for our voice on the bill. I’ve already contacted Democracy Now! and TYT but my own lonely voice is unlikely to make it. DN! has a site dedicated to story suggestions from viewers:
Please, go there and ask for a story about “Helping Families in Mental Health Crisis Act” and suggest they invite speakers from the movement. And please do it now…
Also contacting your representatives before anything like that is passed would help. The petition from National Association for Rights Protection and Advocacy advertised by MindFreedom against this act got up to a whooping … 28a signatures. No wonder nobody listens. We could really do better…
Great suggestions B. Better and more media presence can really start things get moving in favor of peer recovery work and peer&professional co-delivered support braking down social barries through collaboration. It’s more engaging seeing people interact in diversity and embodied dialogical ways… than seeing statistics about drug consumption, hospitalisation etc. Reciprocal and fully humane recovery programs are also far more convincing than talk therapy only; who’d ever believed one recovers essential capabilities and interactive trust and skills by talking to a personally unengaged expert only?
Scott, Dialogue is a worthy goal and an essential tool when available, but I feel certain that criticism is the key. Psychiatry seeks to go unquestioned and most people are strongly influenced by pressures to conform and to validate existing social institutions with money and power behind them.
Also…I got a lot of helpful information from your post and enjoyed and appreciated the additional perspective and fact-checking moral of the story.
The Hearing Voices approach has been based on research, evaluated and is continouosly broadening the research in models of psychological, social and even neurodevelopmental factors of Hearing Voices. In practice there are approx 300 Hearing Voices groups worlwide, many co-facilitated by peers and professionals. The number of people who have recovered through psychological, emotional and social learning and empowerment in Hearing Voices groups is increasing ever more.
My ‘special interest’ concerns the ‘dance’ theme. Different forms of individual dance focusing on emotional awareness have long been part of the canon of ‘Gestalt therapies’ and of mental health services. Over the last decade there is a growing acknowledgement of social dance for embodied empowerment and hole health recovery. There is many essential healing and well-being qualities in social dancing – obviosly it directly improves relationship potentials over all dimensions: embodied, emotional, reactive.proactive, lived respect, partnership, agency, focus, balance, reciprocity AND can therefore transform even unconscious embodied levels of existence often weakened or disrupted in people with severe long-term distress and isolation. Folks wo ridiculise the healing and empowering characteristics of social dancing for people with SMI only demonstrate your ignorance.
Here is a video documentary of a collaborative social dance project from a psychiatric hospital in Switzerland, with patients and mh professionals dancing together. You wanna know what happened, how people were positively transformed by the experience, here go go: meet Pierre Dulaince dance classes in psychiatric hospitals in Switzerland https://www.youtube.com/watch?v=a-dKEKxD_5M
One of my fav hypothesis is that social dance is a powerful support for people tapering of drugs. This has to do with embodiment and implicit meaning making in social dance co-production and the supporting roles of rhythm and music. The day will come social dance and familiar activities will be systematically offered alongside talk and occupational therapies.
Upps, above it should read ‘folks wo ridicule social dance efficacy for recovery of people with SMI/severe distress only demonstrate their ignorance’
Music itself can have a great effect on people. Here is a short clip for a project which provides music to elderly with dementia:
It’s been well known for children with mental disabilities that providing them with good care and social stimulation allows for much better life quality and expectancy as well as better functioning and learning. I think dance is just one more aspect of that.
As far as I can see the “Alternatives Conference” has been a sellout project from its inception and I wouldn’t lift a finger to defend it. The larger point I wish to reemphasize, however, is that these are evil forces and corrupt, power-hungry people who cannot be reasoned with. Our educational efforts must be directed towards the people, not politicians and mental illness bureaucrats. The people will then put the necessary pressure on the legal system, which we can’t do all by ourselves.