The Problems of Non-Consensual Reality

Sandra Steingard, MD
105
100

In a couple of weeks, I may see some of you at the MIA Film Festival. I am honored to be on a panel called “Re-Thinking Psychiatry” with two esteemed colleagues. In advance of the festival, I decided to write about what has been most central in my own “re-thinking”: my basic understanding of psychosis – when a person does not share consensual reality. It has been a fundamental re-think: how do we define it? how do we understand it? when do we intervene? how do we intervene?

When you are a doctor who believes that psychosis is the external manifestation of an altered brain state that best responds to a drug, you do everything you can to persuade a person who is psychotic to take the drug. People who experience psychosis are – at least in my experience of meeting and talking to them – often distressed. I have learned that the next thing I write will seem obvious to some and provoke anger in others: It can feel negligent, even cruel, to deprive people of a drug – even one fraught with many negative effects – if this drug will reduce the suffering.

Over the past few years, I have been in an odd situation. I still understand this perspective. However, I also have a deepening appreciation of alternative views. After taking a drug, a person does not always feel “better.” This is not exactly a new insight for me. Many years ago, I knew a woman who lived with a voice. She loved him – she was convinced this was the voice of a “him” – and she never caused trouble for others. She was content with her life. One day, however, he turned on her and in that moment she sought help. She was not so much looking for someone to take the voice away but for something or someone to sooth her broken heart. The initial help she was given came in the form of a pill. The voice went away, but with it went her zest for life.

At this time, I was working in a clinic where many believed in the benefit of psychotherapy for everyone. I was encouraged to meet with this woman twice a week for a long time. To be honest, I was never of much help to her. She was not so much sad as she was just empty. She did not develop an ability to transfer the love and connection she had for the voice onto someone or even something in the corporal world. I moved away and I do not know how things turned out for her. But she was the first of many people I have known over the years who, although better on a certain metric (quieter voices, for example), was not better in the way that matters to us – an improved sense of wellbeing.

But at the same time, there have been others who do feel better after taking the drugs I prescribe. They look back on their time of psychosis and do not want it to return. They recall it as frightening and believe it disrupted the lives they want to live. I reject the notion, proposed by some on this website, that those who espouse this view do so only because they have been overly influenced by others. It appears to me that these individuals have arrived at this belief empirically: they did not like the way they felt when they were psychotic and they prefer the way they feel when they take the drugs and share a reality more in line with others.

What brings this up is my experience over the past few years in talking to people about some of the questions I struggle with in psychiatry – in particular, the long-term effects of neuroleptic drugs. As I have described previously, I have been tracking my clinical work with people who choose to taper the dose of these drugs. I have recently reviewed the results from the third year. I have tried very hard to be honest and consistent in all forums where I talk about psychiatry. However, in this forum it would be easier for me to give the headlines of that report: In general, it seems that people can engage in a shared decision-making process. Most do not abruptly stop their drugs and we can work collaboratively on a plan. Families, when invited into the process, are often supportive and helpful to me and the person taking the drugs. Those who stayed with the taper for the three years have reduced their dose by 80% and most are doing fine. On a promising note, there is a suggestion that tapering drugs is correlated with an increased return to work. This conforms to what I want to believe and I wish it was the whole story I had to tell.

But there has been another side to this. I feel an obligation to report that it has not always gone well. There have been a few people who had a return of psychotic symptoms and for a couple of them, the collaboration we had – often for many years – disappeared. It was as if I never knew the person. This has been disconcerting, disappointing, and sometimes frightening. I have worried about the person’s judgment living in a world I could not fully understand. I have felt deeply sad for the person’s family and friends who in many cases became as extruded from their lives as I did.

Although this is not intended to be primarily about what this is like for me – that is the least important issue here – it does feel different when this happens after I have been working with someone to taper the drug. When someone comes to meet me for the first time because he is hearing voices or if voices return after he has chosen on his own to stop the drugs or even if it happens while he is adhering to all of my treatment suggestions, I am more purely in the helping role. But when this happens after we have worked together trying to reduce the dose, I feel complicit. Many of the people who write or comment on MIA wonder about psychiatric thinking. Although I can only speak for myself, I can tell you this is a terrible feeling and one I might choose to avoid. Some of this is related to my fears of being judged negatively by others but some of it is just because I feel sad and worried. In some instances, people risk losing things they have worked towards for years – an apartment, a job, friendships. And the pain for family and friends is agonizing. Heartbreaking. Right now I speak periodically to a mom who lives out of state. Her adult child has cut off all contact with her and me. Her call is just a plea – Have you heard anything? Should I send him a birthday card? Can you let me know if anything happens?

I have witnessed the serious harms the drugs can cause. I once knew a man who gained so much weight that he developed diabetes with severe complications. His self-care was poor despite our best efforts to coach and assist him. He died in his thirties. I also spoke then to deeply saddened parents.

The problem is that the uncertainty is so great. I do not know who will thrive on the drugs (yes, this happens) and who will not. I do not know where the road not taken would have led. But for me, I can not think about solutions to this problem without acknowledging this side of the story – that psychosis for some can lead to a rupture on many levels that is frightening. I am not talking only about dangerous behavior, although sadly that is sometimes part of the story. I am just talking about the rupture that a belief in altered reality can bring. People make decisions based on a rubric that I and others do not understand. Even in the absence of dangerous judgments there is just a confusion and loss of connection that is challenging even for people who are more than open to finding meaning, making sense, approaching the person with the utmost respect for his point of view. When someone shuts you out, you are stuck. Family members have said to me plaintively, you can walk away but I can’t. So I try to stay, even if staying only means answering the phone every few months to tell the worried mom “no, I haven’t heard anything yet, but someone saw your son walking on the street and he seems to be OK.”

Yes, there is a deep problem in psychiatry – in all of medicine. The profit-driven business of health care – from the drug and insurance companies to guild interests – has distorted the data so badly that is is hard for me to trust the so-called “evidence base” of my profession. This problem can not be understated.

To stand up to these powerful forces, we may be better served by acknowledging the conundrum of psychosis. In my experience not all psychosis is caused by drugs or poor medical care. In most instances, the cause is elusive.

So I will continue to study alternatives to the current system. I see so many ways we could improve. My ongoing study of Finnish Open Dialogue and the related reflecting therapies and need-adapted models has only deepened my appreciation and respect for this way of working. I am intrigued by the Hearing Voices Network and will be bringing this to my clinic in a few weeks. The highlight of my recent career has been in working with peers on a crisis outreach program. I am a person prone to doubt but I have none when it comes to my belief that people with lived experience are our most important guides.

But when I try to think about changing current treatment paradigms, I have to acknowledge this: it can be extremely hard to reach people who live in non-consensual reality. While we are trying to figure out how to make the connection, scary things can happen, families suffer, the community may be frightened or just put off. I know from previous posts that some may suggest that this is a reflection of my own limitations. If I were more empathic or less connected to the medical model or better trained in other approaches, it would go better. Maybe. But there are a lot of people out there who need help. If it takes extraordinary people to be able to make these connections, I think we have a problem. Experience tells me the world is filled more with plain souls like me than with the extraordinary ones.

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105 COMMENTS

  1. “It can feel negligent, even cruel, to deprive people of a drug – even one fraught with many negative effects – if this drug will reduce the suffering.”

    I know this was true of my psychiatrist when I requested an overdose from him. He knew it was a cruel denial.

    Given that I was suicidal as a result of the deprivation of my liberty by mental health services, it may have constituted a conflict of interest. Still, have to be careful when a man has a disagreement with his in laws, might constitute a “danger to self or other”. So lock him in a cage and provoke him for three days before he is seen by a psychiatrist, who can then prescribe drugs for the resulting trauma.

    No offense Dr Steingard, but the damage is occurring before they get to your office. I’m sure you perform your role as gatekeeper well, but there are those who are ‘prepping’ the patient for you whose behaviour is probably more worthy of your attention.

    You can’t poke a snake and use it’s reaction as justification for killing it.

    • Boans: You appear to be somewhat of a film buff. You previously referenced Brazil which is the best effort at skewering the school of Terrorology in the west. Anger Management encapsulates what you are driving at. The characters around Adam Sandler purposefully misconstrue his reactions in order to frame him for his anger issues. In my case my “manic behavior” was attributed to what is now concede even by psychiatric authorities to be a hoax-chemical balances. Am I completely blameless in my actions leading up to my involuntary commitment-no. But the inquisition and the chemical and physical torture that I was subjected surely makes the situation worse for most people. Fortunately for me I encountered a couple of decent and reasonable ancillary staff along the way that softened the blow.

      • Love Brazil chrisreed. Can’t say I’ve seen Anger Management but will check it out on IMDB.

        I’m not sure what the situation is like in the US, but here I’ve seen people subjected to forced psychiatry for the most minor reasons.

        Young woman who wasn’t cleaning her home to mothers standards and had a couple too many boyfriends. AMHP makes her sound like it’s a mental illness, subjected to involuntary detention, locked up, psychiatrist medicates for reaction to detention, and hey presto ten years of drug cocktails and still the house is dirty.

        Police chain a man up who is angry about his wife playing up on him, tell him they are going to pack rape him at the station, drop him off at mental health facility. Drugged before he even gets to see psychiatrist, and then further drugs and detention. When I translate what his story is to them they realise the ‘mistake’ but keep drugging him for the imagined illness.

        There seems to be more people using the system to abuse others than actual ‘patients’.

        Same is true of the court system, a good police officer is one who can have an innocent person convicted. Only way to get promoted is when you can fit up an innocent man. Psychiatrists and judges only see what can be fabricated before the ‘evidence’ is placed before them, and the corrupt acts that occur to bring that about tend to be overlooked. It keeps the system in crisis, and allows the corruption to flourish. From where I’m looking the problem is obvious, no accountability.

        While the cats away…..the mice turn to rats.

        • Watched most of Anger Management chrisreed, and it does explain some of what I’m getting at.

          The issue of what occurs before a person is presented to a psychiatrist, who then makes decisions that will effect the rest of their life, is probably best described by Philip Zimbardos Prison Study. The role played by mental health workers is one that leads them to (in some very subtle ways) prepare the ‘patient’ so that the ‘illness’ can be seen readily.

          Not unlike the people who worked in Abu Ghraib ‘prepping’ prisoners for interview. Sleep deprivation, playing on phobias of dogs etc. All quite natural given the circumstances, and quite easily explained if you don’t ignore what Zimbardo found.

          I know that if the hospital were prepared to provide me with the AMHP who destroyed my life for a few hours, with a pair of pliers and a blow torch I would have a person ready for involuntary admission for an ‘illness’.

          Was I a “danger to self or other”? I am now.

          • Actually it was interesting listening to the nurses speak about the guy who the police threatened with rape.

            They were explaining that it was like a ‘miracle’ the way the drugs had brought him back to reality. “Your so much better than when they brought you in”.

            Tends to happen fairly naturally when a man is drunk and stoned, sleep and some Vit B. Still, if they decide that a cocktail of drugs, 8 weeks incarceration, and years of withdrawals from the drugs are whats required, who am I to say.

            Aqualung my friend…..lol.

  2. Having read your reflections on the ambiguous nature of how best to help people in distress, I am encouraged by your willingness to recognize that there is no simple remedy for everything. It all depends, sometimes the magic works and sometimes it doesn’t, you can lead a horse to water and so on. No one knows everything about everything. My own challenge as a counselor is challenging the belief that putting children on multiple adult medications is somehow going to make them better. Skepticism seems like a good starting point for analyzing simple solutions, such as using medications as a first-choice for alleviating all forms of distress. Thank you for being devoting yourself to going beyond the easy answers.

    • Jorwig:Our culture demands simple answers to complex problems and immediate results. I can’t say that every decision I’ve made in life has been based on sound logic, and so yes it is a step forward that a psychiatrist admits that there innumerable unknowns and complexities. When I was first committed I was under the impression that I desperately needed to talk to the psychiatrist to get things sorted out. But really, very little of a patients time in the hospital is devoted to talking to the psychiatrist. Likewise, I kind of doubt that the typical psychiatrist understands the culture shock that one goes through when one is committed, let alone the life one leads with the albatross of “a mental health history” hung around one’s neck.

  3. Calmly and gently.

    Move and talk slowly.
    There’s no rush.
    Nobody is going to become more ‘psychotic’ because you’re acting in a calm manner.

    Put the doctor title away, forget about what you were taught in medical school, and treat the person ‘gently’.

    If this sounds like something a non-medical person could do… it’s because it is!
    It’s called common sense and treating someone as we would like to be treated.

    Duane

    • “It’s called common sense and treating someone as we would like to be treated.” Thank you, I agree, Duane. And my personal experience with psychiatry is that the psychiatric practitioners, I personally dealt with, did the opposite. The psychiatrists I dealt with believed common sense was “voices.” But you can’t “bring in the business,” and make a sane person question their sanity, unless you behave with complete hypocrisy and in a manner opposite of what is legal, moral, and ethical.

      But, of course, my psychiatrists actual goals, according to all my medical records, were to cover up easily recognized medical mistakes, complex iatrogenesis, medical evidence of the sexual abuse of my child, and the denial of the granddaughter of the head of the investment committee of the board of pensions of a major US religion a baptism, at the exact moment the second plane hit the second World Trade Center building on 9.11.2001.

      Sandy, I appreciate your sincere and honest attempts expand your viewpoint and to bring about change within the psychiatric community. But I have no doubt there is a very large problem of lack of ethics amongst most psychiatric practitioners, absolutely the psychiatric leadership, and of course psychiatry’s primary funders, the pharmaceutical industry, not to mention all those who profit from filling hospital beds with patients iatrogenically being made sick for profit.

      As to what is “psychosis,” I have suffered from “psychosis,” so may answer that question from my personal experience. My first “psychosis” was terrifying, it related to the 9.11.2001 terror attacks. It resulted in a “Foul up” confession in my medical records, and occurred two weeks after I was put on Risperdal (to treat the withdrawal symptoms from a fictitiously “safe smoking cessation med,” Wellbutrin).

      This “Foul up” then resulted in my being put on a couple combinations of six drugs, all which now have major drug interaction warnings according to drugs.com. This resulted in my getting the “voices” of the people who raped my child in my head for the entire three and a half years I was drugged.

      About six months after I was weaned off drugs, I suffered from what I now understand is drug withdrawal induced super sensitivity manic psychosis. For me, this took the form of an awakening to my dreams, or subconscious, and a mid life reflection on all the wonderful people I’d known in my life who did not agree with my psychiatrists deluded belief that my entire life was a “credible fictional story” and his ungodly disrespectful claims (while poisoning me) that I was “w/o work, content, and talent” and “irrelevant to reality.” (He did eventually look at my work and conclude it was “work of smart female” and that I was “insightful.”)

      This resulted in a sleep walking talking problem one night, where I was illegally (according to a paramedic) taken to the “Foul up” doctor’s hospital (despite my family switching to a different health insurance group due to the prior malpractice). I was inexplicably put on a hypnotic drug and shipped to a doctor whose now been arrested by the FBI for having lots of well insured patients medically unnecessarily shipped long distances to him, snowing patients, performing unneeded surgeries, resulting in lots of patient deaths.

      I was, of course, physically abused and snowed by this doctor, but eventually let out of the hospital because my insurance company refused to pay for a lifetime of inpatient care (thank God). But, of course, I got “voices” again because of the snowing and maintenance treatment by my follow up psychiatrist, who was completely unable to believe antipsychotics could cause psychosis in anyone, despite the medical literature proving this is known to happen dating from at least the year I was born (50 years ago).

      Finally, I quoted my oral surgeon to this psychiatrist, who stated, “antipsychotics don’t cure concerns of child abuse.” And this embarrassed this psychiatrist, who’d also been declaring all my real life concerns “odd delusions” in his medical records, and I was weaned off the meds again.

      The drug induced “voices,” again, went away once I was taken off the antipsychotics. But once, again, I suffered from another drug withdrawal induced super sensitivity manic psychosis. And, again, this psychosis also explained more about the story of my dreams and unconscious.

      The drug induced “voices” were evil, insane, incessant, and offensive. The drug withdrawal induced super sensitivity manic “psychosis” was actually a beautiful story of hope and love and the potential benefits to society of a collective unconscious.

      I’ll be showing some of the paintings and research I did, that describe the story of my iatrogenic “bipolar” and subsequent medical research, at the MiA film festival. And will have more of the write up of the actual content of the “psychosis,” if you’re interested in learning more. From my perspective, it’s a story of my personal spiritual journey.

      I wish the psychiatrists, as a whole, would learn that it is illegal in the US to coerce and forced medicate people for belief in the Holy Spirit and God, please. I hope to shed light on this “dirty little secret of the two original educated professions” unethical way to cover up medical and religious mistakes and sins. And I pray that the psychiatrists will stop creating “bipolar” in children and adults with drugs.

  4. To begin with, reality isn’t “consensual” illusions are. Such as the illusion that these “drugs” are at all treating a chemical imbalance that’s been proven to exist. In fact it’s ONLY illusions that need “consensus” in order to be believed, reality simply exists for what it is needing no consensus. That’s EXACTLY how people with a “mental illness” who are minorities, who suffer poverty, who suffer wars, how they are dismissed. And what a person expresses comes from who they are as a human beings not a “consensual” idea of how they should be according to set fashions and discrimination they might have to deal with would they not conform. If this weren’t the case then virgin sacrifices would actually be a means to appease the God’s and/or create bonding with an idea that some great act of commitment had been expressed. By some miracle that has ceased to be the fashion, although people still are expected to “sacrifice” their humanity to a whole list of things that can only be deemed “consensual reality.”

    Beyond that, you continue this idea that there is a need to see that the drugs might help someone, as if there isn’t still in the majority and everywhere a person is likely to turn, this drone, and those overtures that they need the drugs, and anyone wanting such “medications” can get them umpteen times easier than to find what would help them with a mind that’s NOT disabled by a chemical imbalance said to treat one, and which didn’t exist before “treatment,” all to “confirm” this “consensual reality” that there must be something wrong with someone’s mind and that is the cause, although science proves that damage is being inflected on the mind rather than it’s healed and there are MORE occurrences of this “consensual reality” idea of mental illness when implimented.

    Being that you’re trying to promote the idea that all methods should be accepted, I think you need to look at which methods (having the highest rate of recovery) are highly suppressed, methods a person isn’t even likely to hear exist, while being inundated with “consensual reality” statements that are associated with causing an epidemic rather than recovery. The difference also being, the methods that DO correlate with recovery allow for such open dialogue and simply state scientific facts so a person can make an educated choice, along with being able to relate to themselves and gain understanding of their emotional responses and what their brain in a healthy state (rather than a disabled state) is allowed to express, giving them the resources to relate to themselves (in reality without needing “consensus”) rather than how they are supposed to adhere – whether it’s their fears or society’s – to “consensual reality” in order to feel they are OK.

    It’s only logical that maintaining such fears of who a person really is, beyond how they might be coerced into behaving to fit into current fashions, this is facilitated with mind numbing, disabling controlled substances called “medications.”

    And again, informed choice needs to be there. This ISN’T going on when conversation involves an addicted retour to the same old “consensual reality” idea about “medications,” when the amazing results aren’t at all known enough to be apparent to anyone who follows your idea of “consensual reality.” The results aren’t known, are shared, aren’t acknowledged and are supported of methods that DO NOT involve giving a person a chemical imbalance while telling them it’s being treated, and pointing to the scary epidemic that’s going on as proof there needs to be more “treatment.” And thus saying you are supporting a variety of methods you suppress variety instead.

    Because this works some of the time (and corporate media makes it out to work all of the time, while it’s causing an epidemic, which is a drive for more of what works “some” of the time but in the majority makes thing worse) you can’t actually be articulate about what DOES work because it contradicts this “method” that’s already widely available, and might help a few people, although it’s already shown to make things worse for most of them. The result is that the variety of methods that do correlate with recovery are suppressed. If they were offered, not only in general, but YOUR results would be different, according to logic, rather than “consensual reality.”

    WHY you go on and and on about what’s already highly available and forced on people (which you yourself have admitted you HAVE forced on others, taking away their free choice to have a chemical imbalance or not, while what truly has shown to correlate with recovery is only known to those who have for some reason become accustomed to look for alternative healing methods!?

    Other people who post on this site offer true incisive information about methods that work, that help others (that don’t prescribe highly addictive medications and circular logic), that are true to what a human being is without needing their mind disabled for fear of what they might see or experience beyond “consensual reality.”. I’ll no longer be reading your posts here or looking to see whether you respond. It’s too time CONSUMING to go round in circles.

    It’s also quite easy to be as contradictory as you are, infuriate people, as it would anyone who knows beyond such “consensual reality” or fears, and then decide “those people aren’t looking at the whole picture, they are angry, they are shutting down conversation.”

    As I have already stated Sandra, YOU have forced people on medications, and THAT is where conversation is shut down. That you can’t relate to them in a way that they can relate to their own thoughts without their brain being disabled because otherwise YOU have to deal with things YOU don’t know how to deal with is worse than shutting down conversation; that’s preventing that it ever was allowed to begin.

    • edited from earlier post (same post edited):

      To begin with, reality isn’t “consensual” illusions are. Such as the illusion that these “drugs” are at all treating a chemical imbalance that’s been proven to exist. In fact it’s ONLY illusions that need “consensus” in order to be believed, reality simply exists for what it is needing no consensus. That’s EXACTLY how people with a “mental illness” who are minorities, who suffer poverty, who suffer wars, how they are dismissed. And what a person expresses comes from who they are as a human beings not a “consensual” idea of how they should be according to set fashions and discrimination they might have to deal with would they not conform. If this weren’t the case then virgin sacrifices would actually be a means to appease the God’s and/or create bonding with an idea that some great act of commitment had been expressed. By some miracle that has ceased to be the fashion, although people still are expected to “sacrifice” their humanity to a whole list of things that can only be deemed “consensual reality.”

      Beyond that, you continue this idea that there is a need to see that the drugs might help someone, as if there isn’t still in the majority and everywhere a person is likely to turn, this drone, and those overtures that they need the drugs, and anyone wanting such “medications” can get them umpteen times easier than to find what would help them with a mind that’s NOT disabled by a chemical imbalance said to treat one, and which didn’t exist before “treatment,” all to “confirm” this “consensual reality” that there must be something wrong with someone’s mind and that is the cause, although science proves that damage is being inflected on the mind rather than it’s healed and there are MORE occurrences of this “consensual reality” idea of mental illness when implemented.

      Being that you’re trying to promote the idea that all methods should be accepted, I think you need to look at which methods (having the highest rate of recovery) are highly suppressed, methods a person isn’t even likely to hear exist, while being inundated with “consensual reality” statements that are associated with causing an epidemic rather than recovery. The difference also being, the methods that DO correlate with recovery allow for such open dialogue and simply state scientific facts so a person can make an educated choice, along with being able to relate to themselves and gain understanding of their emotional responses and what their brain in a healthy state (rather than a disabled state) is allowed to express, giving them the resources to relate to themselves (in reality without needing “consensus”) rather than how they are supposed to adhere – whether it’s their fears or society’s – to “consensual reality” in order to feel they are OK.

      It’s only logical that maintaining such fears of who a person really is, beyond how they might be coerced into behaving to fit into current fashions, this is facilitated with mind numbing, disabling controlled substances called “medications.”

      And again, informed choice needs to be there. This ISN’T going on when conversation involves an addicted retour to the same old “consensual reality” idea about “medications,” when the amazing results of the alternative methods aren’t at all known enough to be apparent to anyone who follows your idea of “consensual reality.” The results aren’t known, aren’t shared, aren’t acknowledged and are supported of methods that DO NOT involve giving a person a chemical imbalance while telling them it’s being treated, and pointing to the scary epidemic that’s going on as proof there needs to be more “treatment.” And thus saying you are supporting a variety of methods you suppress variety instead.

      Because this works some of the time (and corporate media makes it out to work all of the time, while it’s causing an epidemic, which is a drive for more of what works “some” of the time but in the majority makes thing worse) you can’t actually be articulate about what DOES work because it contradicts this “method” that’s already widely available, and might help a few people, although it’s already shown to make things worse for most of them. The result is that the variety of methods that do correlate with recovery are suppressed. If they were offered, not only in general, but YOUR results would be different, according to logic, rather than “consensual reality.”

      WHY you go on and and on about what’s already highly available and forced on people (which you yourself have admitted you HAVE forced on others, taking away their free choice to have a chemical imbalance or not, while what truly has shown to correlate with recovery is only known to those who have for some reason become accustomed to look for alternative healing methods!?

      Other people who post on this site offer true incisive information about methods that work, that help others (that don’t prescribe highly addictive medications and circular logic), that are true to what a human being is without needing their mind disabled for fear of what they might see or experience beyond “consensual reality.”. I’ll no longer be reading your posts here or looking to see whether you respond. It’s too time CONSUMING to go round in circles.

      It’s also quite easy to be as contradictory as you are, infuriate people, as it would anyone who knows beyond such “consensual reality” or fears, and then decide “those people aren’t looking at the whole picture, they are angry, they are shutting down conversation.”

      As I have already stated Sandra, YOU have forced people on medications, and THAT is where conversation is shut down. That you can’t relate to them in a way that they can relate to their own thoughts without their brain being disabled because otherwise YOU have to deal with things YOU don’t know how to deal with is worse than shutting down conversation; that’s preventing that it ever was allowed to begin.

      • Nijinsky

        This was so brilliantly stated:

        “To begin with, reality isn’t “consensual” illusions are. Such as the illusion that these “drugs” are at all treating a chemical imbalance that’s been proven to exist. In fact it’s ONLY illusions that need “consensus” in order to be believed, reality simply exists for what it is needing no consensus.”

        I’ve had major problems with the phrase “consensual reality.” (I hope Paris Williams is reading these comments) I was going to comment on the inherent problems with this terminology, but Nijinsky, you said what needed to be said a thousand times better than anything I could have come up with.

        We must remember that throughout history beliefs such as:

        “The world is flat.” “Black people are inferior.” “Homosexuality is a sin and a mental disorder.” “Abortion is murder.” Capitalism corresponds to human nature.” “Mental illness” is a brain disease.” Psychiatric drugs are magic bullets.” “Premarital sex, or any sex for pleasure is a sin.” “Disobeying your parents, or anyone in authority, is wrong and must be punished.” “The war in Vietnam is virtuous and must be supported.” “The war in Iraq is……………………” “and on and on.

        It is a fact that for many people it is there own (very rational) contradictions with accepted “consensual reality” that creates the very extreme cognitive, emotional, and moral dissonance that gives rise to the “symptoms” that get labeled as “mental illness.”

        Nijinsky, I hope you hang in there on this one; I always learn from your postings.

        Richard

        • “Reality is that which, when you stop believing in it, doesn’t go away.”

          ― Philip K. Dick, I Hope I Shall Arrive Soon

          ..and that`s how i know psychiatry is real!!!

          I find these articles amount to the hand wringing brought about through being a practitioner of the normal police! Maybe “cognitive dissonance“. I mean you can`t put a nice face on this…inspite of your efforts.

          also brings to mind the elvis costello quote:

          “writing about music is like dancing about architecture“.

          so to me trying to help people in distress and with life problems with psychiatry is like dancing about architecture. good luck!!

      • It seems there’s disagreement on this blog regarding the meaning of “consensual reality.” At least I got the impression Sandy was intending it to be a non-medical / different phrase for “psychosis,” whereas others are defining it as essentially commonly held societal views. Am I correct?

        And belief in the DSM is both scientifically invalid and logically counter intuitive to all those who did not get indoctrinated or propagandized into believing in it. I mean most Americans grew up being taught you should treat others, as you personally would like to be treated. Therefore, would not innately believe stigmatization, tranquilization, and torture is “appropriate medical care.” And that is basically all the current “mindless” DSM / drugging belief system is about.

        “That [psychiatrists] can’t relate to [patients] … without their brain being disabled because otherwise [psychiatrists will] have to deal with things [they] don’t know how to deal with is worse than shutting down conversation, it’s preventing [healing to] … allow to begin. This is a very important point, Nijinsky. Especially since it’s now known that 85% of schizophrenics were actually dealing with child trauma issues that were covered up with psychiatric stigmatization and tranquilization, instead of actually helping the victims, and putting the child molesters behind bars.

        Doctors can’t actually help people if they don’t learn to respect and listen to peoples’ actual problems, rather than deny them, especially problems as deplorable as child abuse. I hope some day the psychiatric industry will learn that the proper way to deal with child abuse is bringing about justice for the abused, not defaming and torturing the victim. “Concerns of abuse are not cured with antipsychotics,” as my oral surgeon was intelligent enough to state. And thanks to that “future fisher of men,” for helping me get away from the insanity of the psychiatric system.

  5. Reality isn’t a matter of consensus. That’s why we have science and logic. If reality were apparent, or a simple matter of agreement, you wouldn’t need them (science and logic). Reality exists quite apart from any consensus on what it is. Flat-earthers and witch-hunters don’t have a premium on reality for this very reason. If creationism won the monkey trial, as it did, evolution won for posterity, as it has, at least, to date.

    I don’t doubt that your intentions, Sandra, are good, however I do have much doubt about the ultimate results. I admire that you credit “lived-experience”, and that you do see a value in open dialogic practices. I question though whether the results of some of your practices are all that positive, but I think it a good thing that you are looking at different ways of doing things.

    What knowledge I gained about psychiatric drugs came first from intuition. If the drug was so good for me, why did it make me feel so bad? Why did it have such adverse effects? That was the start. Then there were psychiatric survivors who had looked into the matter, and who had found out, no, the drugs weren’t so medicinal after all, they impaired and, in fact, damaged the brain. There were also professionals, too, like Peter R. Breggin, who told the truth. Telling the truth is such a rare thing in the psychiatric profession, that when a psychiatrist talks reality, a wince is my natural reaction.

    I see the alienation that is taking place everyday all around us, I just don’t see that there are any automatic fixes for it. Labeling it “disease”, and drugging it. I think we can demonstrate that that doesn’t work very well. Further alienation, well, I think we’ve got a word for that further alienation. Some people call it “deterioration”. When you “estrange” people, gathering them back into human fold can be problematic indeed.

  6. Sandra, I really appreciate the time and effort you have put into this post and in your practice.We all are walking in very troubled waters and I can appreciate your perspective yet having been in an alter mental state I understand completely the anger and outrage of those of us who have been hospitalized. I think we are dealing with a variety of issues that are put under the term psychosis. Where, what how, and why are still unanswered questions and it would be so nice to have the medical establishment say the truth and say we don’t understand the picture.
    That being said. when I was a mental health practitioner I was taught to actively stay away from the thought disorder. Boy was that wrong. Much of the problem between helpers and those with altered mental states is that those of us with altered states are too afraid to actually divulge what are actual thoughts are and the staff and professionals are to afraid to listen. Fear rules everything and we as patients are treated horribly.
    I think medication was helpful to me in the short term. The use of long term neuroleptics I think is wrong unless the person using them sees them as helpful. One could argue no for health reasons but at this point in time I think we should respect where folks are at.
    Of course some folks will relapse and I think you take on the codependency role. Ideally there should be places for folks to come out from the cold no questions asked with trained understanding staff. Few places or options right now.
    I still am trying understand how the medication helped or harmed way in a processed way. I would need to talk for hours with my tale and what and which meds I was on that sometimes helped but mostly hurt me.
    I am med free now and do not think I will ever need or even ponder taking medication again. I am back where I was before I started Ritalin which may have been the cause of all my hospitalizations and altered mental states.
    Please keep writing . It will be helpful to hear you acknowledge our pain. It is real and it has a long long history that has been actively suppressed. I never knew until yesterday former patients of Bedlam tried to change the treatment protocols there! Ancient but important history!!!!!!!!!!!!!
    I would challenge you to actively spend a day on an acute psychiatric ward away from your city. Take the time to observe really observe the incompetence of treatment.
    Then come back and write about it. Sometimes I think this will be the only way to break the logjam that we see hear. Black Like Me was an essential book for the civil rights movement. I think we need another John Howard Griffin to do the something for Mental Health Rights. Maybe you could play a role in making this happen.

    • I have Black Like Me right here next to me. Fantastic book. JH Griffin didn’t just observe, he fully experienced, subjectively. He felt what it was like to be Black in the 1950’s south, with no other identification, other than his connection to his soul and inner voice. He had no other fallback of which to speak, outside of his ‘alternate reality.’ He put himself courageously in that position to feel the range of emotions that become active under extreme social oppression and discrimination, fueled by extreme poverty, leading to despair, rage, and violence. That’s how we go IT.

      I believe many of us have done our jobs, here. We’re just waiting…

  7. One only has to get out a (any) history book to see the plethora of “consensual reality” beliefs that have existed. Whether it’s about what a woman, a child, diet, medical practice or what have you, you can easily see how contaminated with beliefs history has been that have nothing to do with reality except that they are “consensual,” and anyone going against them is punished, rather than the beliefs themselves can be supported with logic. That, in this day, such “beliefs” are “supported” with “medications” that say they treat a chemical imbalance, while scientifically causing one, and are associated with a spike in “mental illness” rather than a decline (but supporting the fact that anyone having dissident thoughts that cause difficulty with “consensual reality” has a “mental illness” and disabling their mind from thinking which involves unconscious questioning as uncomfortable as that is to consensual reality), is only a new fashion or method of trying to maintain “consensual reality.”

    This all is supposed to be excused because of well meaning intentions, ideology, etc… as if this excuses results.

    One might actually ask people to vote to determine how they would want a chemical reaction to turn out, but the results would probably be as disparate as the “consensus” psychiatrists have when diagnosing the same patient, who is supposed to have an identifiable illness, but they all come up with different diagnosis.

  8. Re: “You do everything you can to persuade a person who is psychotic to take the drug.”

    I didn’t react well to the standard injection threats and that reaction was used as proof I really needed the drugs. I didn’t know that those threats are “standard” and took it personal.

    It really pissed me off and had me really scared at the same time so there I was frightened and angry making my own threats at them in self defense, assault me with a needle and I will come back here one day and vandalize you and your cars out in the parking lot when this is all over. Be nice because we just may see each other outside this place on even ground.

    That may sound horrible like I am a monster but what other means of self defense did I have at the time ?

    Threat of a lawsuit ? ya sure, that has no bite or fright at all. Every other person was going to sue the place. I am going to sue this place… Heard that said by people 50 times at very least.

    My other choice was to take that overdose of pills, it was way way to much and I absolutely had to refuse it. I know how my body reacts to drugs well enough. That dose was dangerous. It was an evil rock and a hard-place situation.

    That standard injection threat ‘needle rape’ for drug coercion is just way over the top, way too frightening and should be illegal. It is illegal actually. http://en.wikipedia.org/wiki/Duress http://en.wikipedia.org/wiki/Coercion

    That van ride then strip search with squat and cough then threats of needle rape for refusing that neoroleptic drug overdose. What really sucks is I just walked right into this nightmare cause I thought it might be a good idea to goto the ER and get detox from my failed attempt at controlled drinking and nervous breakdown from the events in my life at that time. What a dumb ass I was.

    And stay away from UHS hospitals http://watchinguhs.wordpress.com

    • “When you are a doctor who believes that psychosis is the external manifestation of an altered brain state that best responds to a drug, you do everything you can to persuade a person who is psychotic to take the drug. ”

      That is indeed “consensual reality.”

      When you are a doctor who believes….

      SCIENCE on the other hand points out you are CAUSING a chemical imbalance (and brain damage), statistics point out there is more than compelling evidence you are CONTRIBUTING to a spike in mental illness, economics points out you are causing rising costs, which go to the profits of the drug companies that are promoting this “consensual reality,” which correlates with the increase in what those who are making profits say they are healing, and thus make more money when there’s more rather than less of it…

      THAT then is the “consensual reality” a person is supposed to be concerned about with the The Problems of Non-Consensual Reality.

      Perhaps “consensual reality” is a covert name for peer pressure!?

      Consensual reality also used to be that the world was flat.

      What pray tell, is it when you don’t find said movie star attractive, because you can actually see how artificial their lifestyle is but can’t quite put it into words yet??

      What is it when you do think they are attractive, but you think you aren’t?? Are there really scientifical sounding names for these things too?

      “Consensual reality deportment”

      “Non consensual reality perceptions”

      “Inability to emulate consensual reality desires”

      Of course we’ve moved into plastic surgery, here, and other such social games.

      “Zyprexa, a nose job, and rose colored contact lenses saved my life!”

      What “mental illness” has come to when a grown person can get a degree and go on about clouded terms for peer pressure!? And advertise as some kind of cruelty not to help people maintain such fears!

    • Copy Cat
      I understand where you are coming from and I value your posts . The strategy you used worked for you in the time and place you found yourself. Some of these staff in a lotta places will escalate right along with you in sometimes over the top draconian ways like even verbally threatening violence even in a justified appropriate situation can be in some places on staff side be escalated to electric shock treatments and they come in series of 15. I’ve been there . In your situation I might of done the same thing you did if I thought of it. Some places they don’t use ECT. I can’t see how anyone thats been around the block some could be anything but anti-psychiatry. Too bad psychiatrists don’t have the stones to throw it overboard and then attack it from the outside. Psychiatry ought to be called at best Coercion Incorporated . I think if Sandy wants to really learn she’ll have to risk losing her job and title .
      Fred

  9. Hi,

    My son has given me permission to share that he continues to feel well after we supported and connected with him through a very difficult (his words) 2 week period in early July ’14 with a modified Open Dialogue approach (since we did not have the capacity to do it the way they do in Finland). (I actually spoke with you about him during dinner at the Mind Freedom conference last July, Sandra). He considers what he went through to be what could be called ‘psychosis’ by medical model psychiatrists, yet he experienced it more like an existential crisis that led to overwhelming anxiety, insomnia and then to feeling very unsafe. We stayed with him 24/7, avoided hospitalization, all went to therapy together to look at family related stressors and used very few meds…mostly some benzos to help him get back on track with his sleeping…he came out of this period and is now back in college and doing well.

    I raise this example because I wonder, in fact I think I know, that had he been with a family that did not know about Open Dialogue and have access to a psychiatrist who was trained in Open Dialogue, he would have ended up in the hospital, diagnosed and put on neuroleptics. I don’t believe he would have worked his way through his extreme experience the way he did and have come out with the clarity he seems to have gained.

    We are humble about the future…life is hard, his extreme experience was very hard and took all of us working together to connect with him and each other through the 2 weeks it continued. Yet, the medical model’s reductionistic, one size fits all mentality …that also forces this paradigm on people …is always worse in my opinion. I think we need a continuum of support for people going through extreme experiences, with an understanding that these human experiences usually have deep personal meaning, may be related to past traumas or family issues (my son’s were) and that people do so much better when we do not further traumatize them with medical model labels or forced treatments.

    I value this site and the Mad In America community and hope to raise awareness and build Open Dialogue or similar approaches in this country for those of us who may go through extreme experiences…thank you for all of your work and honest struggle to find the best way to support people Sandra.

  10. Thanks for your post Sandy. I think a lot of what you say points to the complexity of helping people in severe crisis and psychosis. I have worked with people who were significantly helped by psych drugs and people who feel irreparably harmed by the treatment they received when psychotic.

    I think Truth in Psychiatry really affirms the type of care I would prefer to have for myself…lots of supportive round the clock care from loved ones, therapy and access to benzos for sleep. I would also add to that someone to cook really nourishing food and provide supportive and calming herbal teas.

    As you note on the post, once someone is on neuroleptics for a period of time, the tapering process can be really challenging in the best of circumstances. For some, they are able to significantly reduce or come off the drugs without significant problems. But for many others, tapering presents enormous challenges, even if done slowly.

    That is why if at all possible, I would personally feel better about taking intermittent doses of psych drugs as needed for periods of severe crisis and not continually. At the most, I would prefer taking a very low dose of only one neuroleptic for a short period of time.

    Sadly, the subjective nature of psychiatry allows for a very wide range of treatment protocols and I have continually seen people with psychosis prescribed multiple high doses of meds that lead to numerous health and wellbeing complications. I have also seen people’s meds radically changed, stopped and started, upped or reduced radically, all with severe ramifications.

    I guess all this is to say…I work with people in severe crisis and psychosis quite a bit in private practice and in a hospital setting. Once the drugs and multiple cocktails have been started, it starts a pathway that is very hard to get off. I envision a way to offer psych drugs that doesn’t lead to habituation and then the roller coaster ride of withdrawal psychosis, increased dosages and meds, hospitalization and rehospitalization ad infinitum.

    Is it complicated? Very. But we can do way way better. Thanks much for all the care you put into your thoughts and words Sandy.

    • Jonathan Keyes refers to “multiple high doses of meds that lead to numerous health and wellbeing complications” and also to “meds radically changed, stopped and started, upped or reduced radically, all with severe ramifications.”

      That reminds me of my own (quite long-ago) experiences and observations, of psychiatric “hospital” protocols, which led to my relatively brief (three-and-a-half-years) in the ‘care’ of psychiatrists.

      That sort of ‘medical treatment,’ which Jonathan describes, I recall unusually began with psych-techs pinning down “patients” and forcing neuroleptic drugs into their veins, via syringe.

      Those effects of those so-called “antipsychotic” drugs are unpredictable; they can have what are called “paradoxical” effects; i.e., they can create an apparent ‘psychosis’ where none truly exists previously.

      That is what happened in my case.

      (In fact, I was — twice in one day — forcibly drugged, in exactly that way; for, I’d been “hospitalized” against my will, having been called a “danger to himself”; that verdict came as a result of my answering “Yes” to this truly inane so-called ‘psychiatric assessment’ question, “Do you think you are going to die and be reborn?” Or, come to think of it, maybe the question was “Do you wish to die and be reborn?” Honestly, it was such a long time ago, I am finally forgetting…)

      “And yes,” explained Jonathan Keyes, in his first MIA blog post, “I have taken part in restraining individuals and delivering injections of medications to patients who become severely hostile, threatening or self-destructive.

  11. Dear Sandy,
    Your approach seems so modest, brave and direct, and your hands seem so tied, your options so limited as you try to help your fellows in extreme states and situations. If you had, up your sleeve, Rufus May’s puppets, Ron Coleman’s experience hearing voices, Jon Keyes knowledge of herbs, acupuncture skills, enough peer-run respite houses, Healing Homes, alternatives to suicide, tapering and spritual emergence peer-led groups to offer the folks who come or are sent to you, maybe then you could begin to do more. How much can you expect to accomplish by dispensing, withholding and tapering meds with a little open dialogue? It seems you are doing everything someone in your limited position could do to cause as little harm as possible and to work for change in a terrible system in the most honest and self critical way you know how.. See you at the film festival.

  12. Sandra,

    As you know, many of us greatly appreciate you. I certainly do, although we don’t always agree.

    IMO, one of the most dangerous aspects of psychiatry (and the doctors who practice it) is the idea that they must do SOMETHING…

    And I think what I have tried to say for years on this site is that it’s better to do NOTHING than to cause more harm than good. Really. I’m serious. Serious as a heart attack.

    What happens if psychiatrists begin to do NOTHING. I think you would see natural recovery rates go up – simply by providing shelter, nutrition and non-professional emotional support, and psychiatrists stepping out of the way.

    You openly admit to not having all the answers, which ironically places you in a position to help. Your colleagues…. not so much.

    Duane

  13. The other term/phrase, MO of diagnosis I’ve come across akin to “consensual reality deportment” is “adherence to statistical based norms.”

    Bother are of course sociological terms, having no bearance on an illness. They would refer to things like as poverty, war status, minority status and discrimination; not to symptoms of an illness.

    Other terms that might be used in other institutional setting are: adherence to a holy lifestyle, social skills, attractiveness and work ethic, but none of these terms apply as little to symptoms of a disease as “consensual reality deportment.”

    • edited:
      The other term/phrase, MO of diagnosis I’ve come across akin to “consensual reality deportment” is “adherence to statistical based norms.”
      Both are sociological terms, having no forbearance on an illness. They would refer to conditions such as poverty, war status, minority status and discrimination; not to symptoms of an illness.
      Other terms that might be used as a means to diagnose in other institutional setting are: adherence to a holy lifestyle, social skills, attractiveness and work ethic, but these terms apply as little to symptoms of a disease as “consensual reality deportment.”

      It points out to discrimination based on bias.

  14. Re: Reduce the suffering. It doesn’t always require drugs.

    My friend in the place got a nasty dose of trauma too, one patient knocked anothers tooth out and my friend didn’t react well to all the chaos that followed and was really scared. He ran to the phones and called family for help that said he had to stay for “help” you are getting “help” and that made him just really bug out. No where to run in a dangerous place.

    He was telling me he was there because he had stayed up on coffee and cigarettes for several days and he was psychotic I guess , he couldn’t deal with all the cameras in every room and had paranoia going on with the 1984 cameras theme to it.

    I got a hold of a crayon and fouled the lenses and that helped him a bit, see no one even looks through those things or they would come right up and clean them. And they can’t see through right now so chill.

    I think that’s the cruelest thing ever, putting people suffering from paranoia in a place with big ugly cameras all over the place with no idea who is on the other side of them.

    It’s like a room full of spiders to treat arachnophobia.

  15. Sandy,

    As always, I appreciate both your honesty and humility. It is the lack of both that I believe contributes to the damage done in the name of “mental health treatment.” I am the last to suggest that tapering is going to work for everyone, or that CBT is going to work for everyone, or that everyone even needs to do some kind of “therapy” that can be judged to work or not work.

    I have to acknowledge that I had the biggest challenges with people experiencing what would generally be termed “psychosis” when I was working with adults sent to the hospital for possible commitment. I believed and still believed it was due to a lack of understanding and skill on my part. It was very difficult to accomplish what I usually do, which is to develop a strong sense of shared reality and agreement with the client. I have been able to do this many times with people experiencing “psychotic symptoms,” but more often than not, it was difficult and I was often completely unable to accomplish it. But that doesn’t mean it couldn’t have been done by someone more skilled than myself at it.

    Even Open Dialog uses medication on something like 20% of clients long-term, so I am guessing there is no one way that is going to suddenly resolve all issues of psychotic experiences. But I think Nijinsky is correct in saying that the problem may relate to “consensus reality” itself. My biggest problem with psychiatry as practiced is not that it fails to help everyone it tries to help, but that it fails to recognize the possibility that eliminating symptoms may not be the ultimate goal. Perhaps it is more important to start with respect for the fact that all individuals have their own particular perception of reality, some aspects of which could be called “delusional” by others who disagree. Trying to force one “consensus” view of what is “normal” seems to be the central problem of the DSM and the mental health industry as a whole. Being able to acknowledge, as you do, that you don’t really have all the answers, and maybe aren’t even sure of the right questions, is increasingly a rarity in the field, in my experience. Until that kind of humility and openness becomes pervasive in the field, I believe the use of medications will continue to be extremely dangerous and lead to bad outcomes, because it will not be tempered by a proper understanding that medications/drugs are just a tool, one of many, many tools, and that it is pretty much a blunt instrument whose short- and long-term effects can be devastating if used in a careless or egotistical manner, as they most often seem to be used today.

    —- Steve

    • “My biggest problem with psychiatry … is … that it fails to to realize the possibility that eliminating symptoms may not be the ultimate goal.” This is actually a concern with the entire pharmaceutical industry biased medical community now, not just psychiatry.

      “Trying to force one ‘consensus’ view of what is ‘normal’ seems to be the problem with the DSM and the mental health industry as a whole.” This is a good point, Steve, especially since the DSM has no more scientific validity than a “bible,” thus psychiatry is really nothing more than the new state sanctioned “religion.” And, at least the other religions let you read their bible and teachings, and decide for yourself, whether you’d like to be involved in that belief system. Whereas, psychiatry forces their unknown “biblical” beliefs onto others, merely for psychiatric and pharmaceutical industry profits.

  16. Thanks so much for this thoughtful post, Sandy. I greatly appreciate your candor as just one person struggling humbly w/ complex issues. It makes me feel more hopeful.
    One statement you made – ” psychosis for some can lead to a rupture on many levels that is frightening.” that I’d like to comment on. I was talking to a friend who was removed from her home as a child when her father became psychotic and violent. She related how terrified she was and how she dreaded going home.
    We can become so focused on how extreme distress affects a person and how to try and help them – and occasionally overlook the many other people who are deeply impacted. No easy answers – that’s for sure. As you say – the problem of uncertainty is so great.

  17. Sandra, thanks for your honest article. I can appreciate the bind you find yourself in. I want to pick up on an idea someone has mentioned earlier and that is the problem starts a long time before the person makes it to the psych’s office. I have found a lot of mental health discussion focuses on what to do after the person has begun experiencing severe distress. This is good, we obviously need to support people on distress. However, there is little preventative care going on in the most broad sense, in the world. I want to talk now about why. From now o when I mention distress I am talking about any extreme feeling states: depression, anxiety, anger etc.

    Sandra, you say that people find their distressing experience overwhelming, life disrupting and just want it to stop and that’s where the drugs come in. It is obvious that you want to help once they are in this state.

    My feeling is that people become terrified of their distressing feelings because of two major factors. Firstly, society in general has swallowed the medical model and the discussion about emotional distress is on emphasising how it’s some random occurrence which can stroke with no cause or warning and then lasts a lifetime or that its some genetic defect you are stuck with for life. So already it sets up the person experiencing the distress to feel helpless. There is no encouragement of self reflection as to what could have caused the distress and that perhaps distress was an unfortunate but absolutely normal response to the circumstances and situation. I mean imagine if people were told that the flu was some terrible thing that needed a lifetime of medication, that no other remedy such as bed rest, fluids etc. Would help. How would the average person respond to the flu then? So already we set people up to feel helpless at the first sign of distress and they end up believing meds are the only solution.

    What compounds this helplessness is that often people who get to this severe distress have had their self esteem destroyed in traumatic relationships. So now even if you told them that this distress is normal and can be dealt with non medically they refuse to believe that they as an individual can because they have no sense of self efficacy. But if they believe that they have a biological screw up and they have no belief in themselves to handle difficult situations imagine how frightened they become when distressed.

    I met a man once who was in the mental health field and he told me that in over 20 years of practice he only put 5 people on medication and reluctantly so. In fact he helped countless people get off them for exactly that reason: taking a pill every day reduced their sense of self efficacy and hope to be able to overcome their difficulties on their own.

    I have recently become aware of how woefully we are lacking preventative education. This is especially needed among youth. Imagine if everyone was empowered with correct information so that if they ever did experience distress it didn’t scare or disrupt their lives as much as it does now. Imagine of everyone had a real and strong belief in their own self efficacy… 🙂

  18. Consensual reality or tyranny of the masses?

    Solomon Asch had a bit to say about the problems when direct observation failed. They turn to comparable others for validation.

    Given that you have a situation where staff are documenting everything as a ‘symptom’ of mental illness, what happens when a psychiatrist in ten minutes does not observe any signs of an illness? Let the person go? Or use the fabricated and unreliable evidence in the documents to validate the ‘illness’?

    I know which of these I’ve seen done regularly.

    I got a diagnosis of “psychosis” on the basis of a three minute interview, and the fabrications used by an AMHP to justify his detention.AMHP had to make it look like I was ill, committed fraud on the Form, and the doctor accepted his ‘observations’ on good faith and gave a diagnosis, and prescribed drugs to treat this non existent illness.

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

    • It really is worth considering Rosenhan, Zimbardo, and Asch in conjunction with one another.

      Rosenhan demonstrates how the liability issue results in a hypervigilance to detain. Zimbardo demonstrates how the culture of ‘jailors’ results in every minute ‘symptom’ is then documented as evidence, and in many cases is deliberately provoked. And then Asch shows how pressure is placed on a psychiatrist to further detain and drug based on the need to conform to information provided by ‘colleagues’.

      It would certainly explain how other patients can spot a ‘faker’ in the Rosenhan experiment. They are not being subjected to these pressures, and base their ‘diagnosis’ purely on observation.

  19. I noticed you responded to my post, however, I’ve not read it, am not going to, as I said I wouldn’t; and I don’t feel people should have to respond to someone who has had others force medicated. You make it clear that, although there are several people on this site who can, who I’m not going to name, you do NOT have the ability to relate to a person in psychosis, and relate to the necessary symbolism, the world more true than objective reality, because it involves how we create our own life beyond anything “objective” and thus we can become compassionate and understanding of what it is to be human, an innate condition that is in in everyone. And yet you have the privilege to force them onto treatment, without the ability to relate to them. This is what I see. I think you need to learn how to relate to a person in psychosis, because it ends up that most people in psychosis have to deal with those who do NOT understand, can confuse them even further or even worse can even force them to incur brain damage thanks to “treatment”. All this while there are a whole group of people who DO have the ability to relate, which statistics and clinical trials demonstrate.

    Fine, there are people who are happy with “medications” and as judged by society whether they are productive or happy are seen to do fine with them. There also are people who are happy being superficial, and who do not want to take the trouble to deal with their own trauma or inner mind and its to them uncomfortable reaction to the challenge of taking a look at life beyond “consensual reality”. Statistics show that those people are in the minority of those on psychiatric medications. That, those people seem to do well on psychiatric medications does not give anyone (or you) the right to force such medications on people. Neither does it make those substances medications. If you are so interested in promoting these “medications,” for people who say they need them, you would do better to become part of political activism which wants to make marijuana legal (which actually DOES have medicinal qualities that aren’t acknowledged although it is seen as a controlled substance) or Cocaine and other street drugs, the hallucinogenics (which certain people ALSO say they need in their life) – this has shown to create a safer society, actually cut down on drug use, and stop a lot of violence ( as is seen in Portugal). But to continue to erroneously list such controlled substances (psychiatric drugs) as medications (when marijuana which is listed as a controlled substance DOES have medicinal qualities) this is convoluted, indoctrinated and one can add that these “medications” are represented by drug companies that behave like syndicated crime cartels the way the drugs have been promoted (or forced on people) in criminal ways which involves billions of dollars of fines, which is just a small fraction of the illegal activity involving psychiatric medications or other medications sold by these companies.

  20. Russell Brand, Enlightened Man
    https://www.youtube.com/watch?v=_bKQXmvdr8o

    From 8:35-9:00 is particularly relevant, as it seems to me that the mental health world is for the benefit of an ‘elite,’ while it is supposed to benefit all, as is sound and JUST for any community. Somehow, in this world which I traversed up and down on all sides for decades, as a client and professional, including professional legal advocacy–and now that I am looking back on it all with new eyes, from a clearer perspective–one conclusion I can definitely draw from my experience is that the non-elite (clients) are sucked dry, and the rich and powerful get more rich and powerful…and downright mean and cruel and horribly stigmatizing, shaming, when pushed to truth.

    This must change, but of course, that’s the hardest thing to shift, for obvious reasons. How to get the elite to stop being so selfish and pig-headed, to feel with their hearts, rather than to observe with a limited perspective and draw ridiculously and insultingly false conclusions.

    We ALL have heart blocks from trauma. I make the generalization challenging anyone to come forth and say, “Hey, not me, I’ve never been traumatized, my heart has never been closed.” If so, I’d love to know how they operate, because that would be a joyous feeling. There are many ways to release heart trauma. Find your favorite loving and effective support and no need for drugs, or anything of the kind. Stop the madness.

    • AND, how to get people to stop emulating this! If one’s goal is to be rich and powerful, then you will miss out on the best life has to offer, and this is absolute truth, to my mind. Whereas if one’s intention is to find joy in life, then healing is a natural occurrence which takes no more effort than learning to feel joy.

      For some, yes, that can be tough, if one has been practicing a non-joyous reality for a long time, neural pathways are from habit. But if we make an intention to feel joy, then that path begins to unfold and if we can see it past our trauma and victim self, then we are on our way. This is how you change and evolve your reality, with your intention of where to focus. Many, many, thousands of references to this all over the internet, esp on YouTube. It’s well worth a look. Search ‘how to shift your reality.’

      Don’t try to convince closed hearted cynics, they are on another path.

      But from what I’ve learned, there is always light somewhere, and when our hearts can perceive it, there is joy.

    • Alex,

      I’ll confess that I lived to the age of 36, prior to ever being traumatized (then I was attacked by some nouveau-riche and their psychiatric “army”). But I agree, Russell Brand is onto something. My story, too, is about a oneness with the universe, and largely because of that, the importance of all humans being respectful and kind to all others.

      And that, truly, is where humans find peace, contentment, self satisfaction, and happiness. All this societal money worship, and disrespect for other human beings, will never bring about joy for those who practice such deplorable behavior. Life is not a competition, we need to learn to coexist and bring about a better world for all humans.

      We currently live in a world controlled by corporations, not people. And legally, corporations are required to behave as psychopaths – watch the youtube video, The Corporation. Our society is being controlled by corporate “psychopaths,” and that makes for a sick society.

      It’s rather bizarre, the corporate controlled media and Hollywood are spewing out garbage, but you’re right, youtube has a wealth of wonderful and creative documentaries and videos. I know I watched one not too long ago that pointed out that it was the former 2% – the intelligent, ethical, and generous in the population – that actually made this country great. Apparently, the 1% controls with fear, war, and psychiatric stigmatization and drugging. And the 2% controlled with wisdom, kindness, and justice. Perhaps we have the wrong people in charge right now?

      • So beautifully said, Someone Else. Exactly, all of it. Feels good to have a consensus about this 🙂

        I have a feeling that this is changing, we’ve reached the edge, as you know. That one percent is being called out directly, clearly, and articulately, as you are doing. Hong Kong seems to be a good indicator that people are fed up with this garbage. Let’s keep hope alive that the tide is actually turning, now that we do know the truth and have a consensus about it. The one percent is very challenged right now. Perhaps it’s time for that two percent to step up, with confidence!