Why “Stabilizing” People is Entirely the Wrong Idea

Ron Unger, LCSW
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If human beings were meant to be entirely stable entities, then “stabilizing” them would be an entirely good thing; a target for mental health treatment that all could agree on.  But it’s way more complex than that: healthy humans are constantly moving and changing. They have a complex mix of stability and instability that is hard to pin down.

All this relates to one of my favorite subjects, the intersection of creativity and madness.

It is a curious fact that people seen as “psychotic” or “schizophrenic” may show sometimes more creativity, and sometimes less creativity, than “normals.”

A good example of this was a test done to see how

“. . . people ‘guess’ which of two alternatives (e.g., ‘left’ or ‘right’) will occur next, when in fact the order of outcomes is random. We can analyze the sequence of guesses and quantify their entropy (unpredictability). Healthy people tend to have a Gaussian distribution of sequential guesses, with most responses at intermediate levels of entropy, and fewer very redundant or very entropic responses. In contrast, people with schizophrenia tended to show both more redundant (predictable) and more entropic (unpredictable) responses; longer periods of predictable behavior were interrupted by very unpredictable behavior.”

That comes from an interesting little article, Creative Cognition and Systems Biology on the Edge of Chaos.

What the guessing game test, and other research tends to show, is that people diagnosed with psychosis are often both too “unstable” at times, but also overly stable at other times (actually more of the time).  This corresponds to the way people experiencing “psychosis” can be both very flexible and innovative in the way they understand things, and also often very rigid and uncreative in other ways or at other times.

When I was a young guy going through a somewhat “mad” period, I identified as being very creative, while I saw “normals” as being more like robots or insects or something.  The truth at the time was that I myself was often too much like the robot or whatever – I would fall into ruts or various sorts of “false selves” that weren’t very connected with anything alive within me, and then here and there I would be very weird or random in efforts to break free of those ruts. 

This was creativity in a sense, but not really all that useful a kind of creativity for most audiences.  (When I shared my writings in a creative writing classes, a number of the other students thought it sounded like “mental illness” rather than anything of value, though the teacher was willing to see it as fitting into some trends in creative writing that were themselves chaotic and irrational, like Dada.)

The authors of the article point out that “the combination of novelty and utility . . . is the hallmark of creativity.”  Getting to the utility part requires some stability, so successful creativity requires being on the edge of chaos, not “over the edge.”

Here’s another interesting paragraph:

“We believe this model conforms with the inverted-U model relating creativity with psychopathology traits and genetic risk for psychosis (Richards et al. 1988) and with existing literature showing examples of exceptional creativity in individuals with mental illness, even though the aggregated  results tend to show no overall increase in creative achievement for those with severe mental illness (Abraham et al. 2007, Eisenman 1990, Jaracz et al. 2012, Rothenberg 1983). Consistent reports suggest that healthy relatives of those with schizophrenia, and those with schizotypal traits, may have elevated creativity; we suggest that these individuals may have a tendency to greater network flexibility, but additional traits help protect them from developing schizophrenia (Abraham and Windmann 2008, Batey and Furnham 2008, Karimi et al. 2007, Kinney 2001, Nelson and Rawlings 2010, Schuldberg 2000). Consistent with this are Kinney’s (2001) results showing higher levels of  creativity in people with intermediate levels of schizotypal or schizoid traits, relative to those with  lower levels of these traits and relative to those with overt schizophrenia.”

I think to be really good at helping people with psychosis, we need to be better at helping people avoid being either too wildly chaotic (the “novelty” part of creative) but also to avoid being too stable, as being “too stable” is just part of the setup for then trying to get free by being too chaotic again.  Most modern treatment aims at “stability” without any recognition that there can be too much stability.  So treatment is deadening, and then people rebound toward more chaos, but no one notices that the treatment is partly responsible for the urge to rebound or to go too far in the instability direction.

Better treatment would help people get better at hovering at that edge between stability and chaos, madness and sanity . . .

I think it would be interesting to study creativity in people who have successfully recovered after having, for some time, fit the criteria for a “schizophrenia” diagnosis: How did they learn to find that middle ground between too much stability and too much instability or novelty?

Another interesting area to study would be the interplay or conflict between the desire for stability and the desire to rebel from it.  Looking back I can certainly see how this played a role in my life – I would try to break out of all the regular patterns of thinking and reasoning to avoid being dead or robotic, etc., to transcend everyday life, then I would overwhelm myself and others and have to be very dull in order to get back into some kind of manageable order or pattern. Then my resentment of this very dullness would provoke more chaotic bursts within thinking, speech, and behavior.

Accepting that we need both the stability and the instability, the order and the chaos, the sanity and the insanity, is the key to finding some kind of “healthy balance.”  We need to find ways to incorporate this acceptance into every stage of mental health treatment so that people get the message that their own “instability” has value, even if it may do better if also tempered with an appreciation of stability at various points as well.

Anyway, here’s another article of possible interest that also touches on biological and brain function stuff in both creativity and madness related stuff; Creativity and Schizotypy from the Neuroscience Perspective.

I’m curious to hear any other thoughts about these issues . . .

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26 COMMENTS

  1. “So treatment is deadening, and then people rebound toward more chaos, but no one notices that the treatment is partly responsible for the urge to rebound or to go too far in the instability direction.”
    wow, that’s what anti-psychotics (which I took under a disguise of “mood stabilisers”) did to me. I felt so bad, zombie like on them that I consciously pushed myself to act out and behave mad only to escape the way they made me feel. In fact I was actively fighting against what these drugs did to me.

  2. Forgive me, I haven’t read through all your links, I don’t have time right now, but I’d like to give my impression (as an artist) about what I have read from the Creativity and Schizotypy article, because it points out what I perceive as a larger problem with today’s “evidence based medicine” approach.

    The DSM, and the classification or stigmatization, of certain “types” of people is a very “modern” level of consciousness way of thinking, right brain only, materialistic. I think most artists have likely moved beyond such a primitive way of thinking, and utilize both their left and right sides of their brain. According to the theory of spiral dynamics, beyond the “modern” level of consciousness, is the “post modern” and “integral” levels of consciousness, an intuitive level of consciousness.

    Medicine used to be considered an art. If you look on the career testing pie charts given to children in the US after being given 8th grade standardized testing, historically artists and mainstream doctors are right next to each other. Doctors and artists have the same basic skill sets. Psychiatrists tend to be better at dealing with people, theoretically, but are not as good with ideas or concepts, as doctors and artists.

    I think it’s important for the field of medicine to move beyond only the “modern” way of thinking, “evidence based medicine,” and once again realize medicine has historically been largely an art. And trying to type caste all artists into one box, a box that psychiatrists (and apparently neurologists) are seemingly not even aware exists (because they are at a lower level of consciousness) is quite sincerely insulting and demeaning to the artists. And it is an attempt doomed to failure. The medical community needs to learn to trust and utilize both sides of their brain again. Medicine is an art, “evidence based medicine” appears to be primarily a marketing tool used to sell drugs.

    • “‘Evidence based medicine’ appears to be primarily a marketing tool used to sell drugs.”

      Correct: There is little evidence to support any of the methods used by psychiatric medicine, or at least there is just as much–if not more–against it, but most mainstreamers are quick to invoke “EBM” as justification for discrimination.

  3. It is a curious fact that people seen as “psychotic” or “schizophrenic” may show sometimes more creativity, and sometimes less creativity, than “normals.”

    I beg to disagree. Normal is uncreative by definition.

    I think that in the future we are going to have to see the links that exist between disablism, oppression, and culture. The problem we have right now is that when you use science for your stamp of invalidation, what you are invalidating is culture, and potential culture. Acknowledging and valuing that culture is in itself a revolutionary act.

    An outsider is a marginalized person. With outsider art and culture, you already have a strong creative force that has always been under recognized and under acknowledged. It will come, but only with the revaluing of devalued humanity.

    When you’ve got courts of law declaring people “lacking in capacity” or, more directly, “incapable”, you can see where the problem comes from. If a person declared “incapable” does something worthwhile, what then? The courts have declared they can’t do so.

    • I agree, we live in a society which completely devalues all creativity, including that of artists trained at the best art schools in the country, in favor of fictitious “sciences.”

      I just got out of one of my daughter’s English classes (it’s parents weekend at her school) and they were discussing what I think was a Norton’s Anthology short story called “The Stranger.” It was a discussion based totally on the concepts of outsider and marginalization. The entire function of the psychiatric industry is creating marginalized persons and outsiders. Do we need such an industry?

      The psychiatric industry claims the artists are “irrelevant to reality,” as they poison us. It seems, because we possess creativity and insight they can’t even comprehend. I say again, do we need an industry hellbent on destroying the best and the brightest within our society?

      • This is extremely well described in “Zen and the Art of Motorcycle Maintenance.” It is written by a scientist-turned-teacher-turned-philosopher who eventually becomes psychotic and is “treated” with electroshock that essentially deletes his entire prior personality. The author takes us back through his road to rediscovering who he was and is, and meanwhile does an amazing job of pointing out how and why we have divorced science/technology from art, why it’s destroying our culture, and what we might do to help reintegrate them. It is one of the best books I’ve ever read on any subject, but he attacks this issue head on and with tremendous impact, at least for me.

        —- Steve

        • I read that book when I was just being weaned off drugs, so my recollection of it is kind-of foggy. And no doubt, one can’t pick up on the subtle, but brilliant, nuances when either on neuroleptics or shortly after being weaned off them. I’ll have to reread it. Thanks for the recommendation.

          But I do agree, creating a society where either science or art (or religion) alone dominates, does not make for a well balanced society. Rather than stigmatizing and drugging those who choose careers that don’t pay well in our current lopsided society, we really need to rework our society. And get back to a point where it’s considered appropriate behavior to respect all people, of all professions. In the US, it seems that currently the only decent paying jobs are in the cut throat and disingenuous financial industry, or the medical industry. That does not make for a healthy society.

  4. The assumption by people is that those zombifying drugs return unstable people back to the state of “stability” when in fact all it does is replace the what ever condition is labelled “unstable” with a condition of zombie disabled unmotivated sedated anhedoinia.

    It’s horrible, when I had my nervous breakdown and they attempted to “stabilize” me all it did was add to the stress because those wicked drugs made it even more difficult to think and work out a solution to my problems and self “stabilize”.

    And of course when I objected to taking these drugs that were anything but “help” I was then subjected to psychiatry’s usual coercive threats of forced injections ‘needle rape’ and the state hospital and the stress of being subjected to threats of violence and violation of bodily integrity by the people in charge of “helping” me just made things 100 times worse.

    Wile that word “stabilize” is surely fraudulent, It just makes me want to vomit when I read posts by families in those mental health forums using the word “help” to describe what psychiatry does to “loved ones” behind it’s locked doors .

  5. Also whats really really scary, insidious and downright diabolical is how outside observers will look at the person “stabilized” and say they look better. That has alot or maybe everything to do with why psychiatry’s barbaric and damaging practices continue.

    Outside observers will often contradict a person complaining of the pleasure from anything in life robbing effects of these drugs with the argument that they seem so much “better” wile taking them. I guess that’s also why so many people buy into all that bull about psychiatry’s victims “lacking insight”, when it’s the outside observers who really lack the insight.

    I also think many of those parents of mentally ill children and adults are just selfish and are motivated by there own selfish needs to have the child ‘fixed’ or simply shut up and shut down by psychiatry regardless of how damaging it is to that child. The rest of them just buy into psychiatry’s marketing lies and false premises and can’t really be blamed.

  6. Great post, as usual, Ron. A couple observations;
    Dan Siegal (the Developing Mind) discusses most mental difficulties being the result of 2 extremes – too chaotic or too rigid. Well worth the read
    My second pt is you address stability from a intra-psychic POV. When most people consider instability, they may be thinking inter-personal (IMO) stability. Can loved ones, co-workers, neighbors handle someone acting intense, strangely, not sleeping, bizarre? Intra psychic instability can be tolerated and celebrated – interpersonal instability makes people call hospitals & police
    What do you think?

  7. Stabilizing people is a quick fix certainly, most of the time it applies to the vulnerable who are children, young adults, and the poor. Many of our population is mentally ill, they just are financially powerful so money masks their illness. However their children, and the poor, aren’t as lucky and they need to be stabilized because they don’t have money to treat their mental problems and still appear functional to society. It’s really sad that quick fixes are necessary because comprehensive therapy that includes all parties in the family and community responsible for someone’s mental illness cannot be addressed.

  8. It is all about balance isn’t it? About fitting in without loosing your real self. What is “normal” anyway? It might also be about self-confidence, self awareness, self-respect and self-control. In my experience society and your nearest and dearest are often out to destroy them.

  9. It is a curious fact that people seen as “psychotic” or “schizophrenic” may show sometimes more creativity, and sometimes less creativity, than “normals.”

    Are you certain this is a fact? No offense but this is just a trope….. mad people are creative and all that…. my fear that this a way of saying th.at people who get caught up in the dragnet of the mental health system are somehow different to people who manage not to come to the attention of the system and avoid their turn sitting at the bottom of pile…..

    I’m not keen on othering people in this way…….

    Just saying…..

  10. Just a question, since the psychiatric industry utilizes major tranquilizers to “stabilize” people, isn’t the term “stabilize” just being used as a “politically correct” term for tranquilizing others?

    The bottom line is, I agree, “stabilizing people is entirely the wrong idea.”

  11. Psychiatry, and the mental health system at large seem to have no respect for homeostasis:

    “a state of equilibrium, as in an organism or cell, maintained by self-regulating processes”

    There’s an attempt by psychiatrists to jump in, and fix someone… oftentimes, ending in disaster.

    I have no problem with the term ‘chemical imbalance’, because I think it’s quite possible that the brain of someone in acute emotional crisis could have such a temporary imbalance. It cannot be proven, nor dis-proven.

    My problem is with the chemical fix. To quote Dr. Joseph Mercola, it’s “like trying to kill a mosquito with a cannonball.” It doesn’t allow for homeostasis to naturally take place. And the long-term use of psych drugs injures the brain, rendering the person involved disabled.

    Duane