Recently, the Murphy Bill in the United States Congress has resurfaced as a tangible threat to the civil liberties of individuals labelled “seriously mentally ill.” As many others might relate, my reaction was one of rage, sadness, and utter bafflement. Usually when I become incensed I am inspired to write. But, how much more can be written on this topic? Although I have a decent amount of knowledge regarding this bill, the deceptive ideals contained within it, and the actual evidence base that should give reason for extreme caution to those considering supporting this bill, people far more competent and knowledgeable than I have already done the work of refuting the rhetoric with facts and figures and offering alternative solutions and methods of action. (see: http://www.ncmhr.org/downloads/NCMHR-Fact-Sheet-on-Involuntary-Outpatient-Commitment-4.3.14.pdf; http://www.ncmhr.org/press-releases/12.12.13.htm; http://www.bazelon.org/News-Publications/Press-Releases/12-12-13-Murphy-PR.aspx; http://www.madinamerica.com/2015/03/eugenics-2014-murphy-bill/; http://www.madinamerica.com/2014/04/murphy-bill-violates-civil-rights-increases-government-intrusion-ignores-scientific-research/; http://www.madinamerica.com/2013/12/tim-murphy-mental-health/; and http://www.madinamerica.com/2014/04/mental-health-social-justice-issue/)
Yet, here we are. Having defeated the bill once, it is back like herpes. After my frustration and anger dissipated a bit, I pondered this and was hit with a “duh” moment. Politics is not about facts; politics is about power, money, and playing on the emotions of society. I realized that it is imperative that we understand and tease apart the issues in society that not only allow such a bill to sustain attention, but seemingly needs such a bill to exist. Perhaps if we can come to a better understanding, then we might be able to offer alternatives that simultaneously honors human dignity and assuages the fears and concerns of the larger public. While putting forth the rational argument of research and evidence, which is on our side, we need to also understand that this is not a rational game. It is an emotional one, and so we need to come back on that same level; though not in the way we want (Hey, folks on Capitol Hill! I’ve been hurt and you’re hurting me more!). In our efforts to fight back and prevent a return of the dark ages, it might behoove us all to attempt to address the fear, the helplessness, the need to scapegoat, the genuine concern, and/or the natural human selfishness that people have which might lead them to support the bill in the first place.
People are Afraid
Since the beginning of time, humans have used imagination, force, law, and religion in efforts to extinguish anxieties related to uncertainty and threats to life. Today, we have added the mental health system to the mix. People who are different, who do not conform, who force others to see that which larger society wishes to hide, who trigger feelings of vulnerability, and who threaten our beliefs that the world is just are those who are castigated and shunned by society. Not to mention that chaos is frightening. Violence is frightening. Uncertainty is frightening. Witnessing someone else’s pain and terror is frightening. Hearing about child abuse, racism, and discrimination is intolerable. The world must have order, make sense, and be just. Bad things happen to bad people, and bad people must be punished. If someone is behaving in violent or unpredictable ways, then we must lock them up, get rid of them, burn them at the stake, castigate them to the fiery pits of Hell. We all do this. Everyone reading this right now does this. Perhaps you are not condemning those labeled as “mentally ill” to the realm of evil and undeserving of compassion, but I can guarantee you are doing it to some group of people. Shoot, maybe you’re even doing it to me. Much as I wish I could say otherwise, I know I do it too. That’s probably why I am writing this blog in the first place.
We feel bad when we are angry or hateful, as we rightfully should. But instead of doing the seemingly impossible work of finding compassion for those we hate, we mask it. Or worse, we justify it. Our modern day society has made overt acts of physical retaliation and outright hatred politically incorrect and even illegal. So, instead, we want to “help” those we hate with “harmless medicines.” We want to simply ignore those who cause us trouble. We want to blind ourselves to the reality of the horrors of the world. We believe that those whom we harm deserve it or even benefit from it. This is human nature, and no human is without this instinct. There is a reason that only a handful of people throughout time can be considered as Saints or reaching Nirvana or any other name of the same. People are afraid and anger is a powerful emotion that somehow makes us feel safe. What alternatives can we propose to help society feel safe? And those methods of healing that we know work, but take time (eg., peer respites, psychotherapy, finding meaning)…what do we do for those people in society who say “I need something NOW!”?
Additionally, challenging the beliefs of those folks who say “We are fighting real diseases with real medicine!” makes them even more frightened and more likely to react irrationally. Not that we should not challenge these beliefs with facts, but as many of us who have experienced altered states where our beliefs might be considered delusional have proposed, we must first seek to work within their world. This is particularly so when they are in a reactionary, frightened state, as are most who are supporting this bill. Remember, the Murphy Bill is purported to be a response to mass shootings, homelessness, and crime; regardless of the reality of the base upon which this proposal stands, these fears are real and people are reacting. How can we meet them where they are at, and help them feel safe and understood? Being angry and self-righteous (which I find myself doing quite often) feels good, but rarely gets us anywhere.
People Feel Helpless
When bad things happen, when people are afraid, when people see other people suffer, it is only natural to be overwhelmed with the urge to DO something. Many reading this now are in that head space regarding the Murphy Bill. WE MUST DO SOMETHING! People want action, not to be told that “Sometimes bad things happen because bad things happen, and if we work to decrease poverty, increase social services, decrease materialism and greed, and work on building social cohesion and inclusion most bad things will stop happening.” Or better yet, “If you stop allowing the public to amass an arsenal of military-grade weaponry, perhaps we won’t have mass killings anymore.” Not only do these things require the angry person to sacrifice, but these things take time and don’t really feel like highly active suggestions. The Murphy Bill plays on that urge: Fight extreme circumstances with extreme action. It is the American way. It is the human way. That is why we continue, as a species, to repeat the past over and over and over again. What can we offer that can feel like people are not helpless and allows them an outlet for their anger?
People Need Scapegoats
Black people engage in rioting because they are black, not because they have suffered centuries of systematic discrimination and prejudice. Immigrants, particularly Hispanics, are freeloaders and stealing jobs (that, of course, no one else wants to do), not trying to escape unimaginable violence that the US created in the first place in its illogical war on drugs. Terrorists are terrorists because they are bad, evil people, not because their people have been terrorized and oppressed by the most powerful nations in the world for the last 2 centuries. Women cause men to rape them because of the way they dress or because they “led me on”, not because some men have problems with violence and impulse control. And mentally ill people are sick with an evil, bad brain disease, not because they have suffered chronic trauma and developmental disruptions within the family and society.
We must have someone or something to blame and, lo, it cannot be us (whomever “us” may be in any given scenario). Someone must take the brunt of our fears and frustrations so that we can go on with our lives. The status quo must be maintained because it provides routine, comfort, and safety. The world is a just place, so someone must be to blame when things go wrong. And, almost always, if someone is victimized or suffering, it is their fault (or their brain’s fault).
If we believe, for a moment, in the idea that extreme emotional distress, bizarre behaviors, and even violence occurs for a reason, then we must logically look for what those reasons are. If you are a family member or even a victim of someone who is engaging in unpredictable and frightening behaviors, which explanation is easier to tolerate: “This person is doing this because he has suffered trauma or harmful family dynamics and knows no other way to express himself”; or, “This person is doing this because he has a broken brain and cannot help it.” The first reason requires compassion, understanding, and, often, an ability to look critically at one’s self. It takes time to work through the messy dynamics that “crazy” behaviors begin to make sense in, and to heal long-standing wounds. The second reason requires taking the “crazy” person to a doctor, getting a pill, and fixing him. Now, forgive me, for I am being trite and overly simplistic here. But, the point is that the broken brain theory saves people from vulnerabilities and uncertainties and provides quick and easy answers and solutions. The nuances of how life circumstances leads to extreme states requires greater effort, painful explorations and realizations, and action to change not just our immediate environment, but society as a whole. And that, well that is terrifying. Who, then, is to blame? Us? No one? Someone must be to blame. Better to blame the abstract “genes” or “brain” then. And, if it is the brain, then we must lock the sick person up for his own good to protect not just us, but him from this evil brain disease.
People Do Genuinely Care
Perhaps I should have put this section first, so as not to insinuate that all people who support the Murphy Bill do so out of hatred and fear. But, whether people wish to acknowledge it or not, I do believe these negative emotions of hatred and fear to be the main driving force. The fact of the matter is, there are already laws in place that will forcefully remove a person who is threatening or violent, regardless of mental health status, and will confine those who have committed real crimes. This bill is about more than that. It is a defensive maneuver that will allow for the detention of anybody who MIGHT become agitated, violent, or unpredictable. Further, it traps them for life in a psychiatric prison of deadly pills and life-long dependency. And it allows for “experts” who have deluded themselves into believing that they have the ability to predict the future to make such determinations of who gets taken prisoner through interviews and questionnaires. This bill, in large part, is not about people who genuinely care.
At the same time, I also believe that many people supporting this bill do have genuine empathy and care for those who are suffering. These are the people who are desperate and who want alternatives but cannot find any. These are the people who are willing to sacrifice their own selves to provide care and compassion, and do not act as martyrs or seek praise for doing so. These are few and far between, but they do account for a large percentage of the population interested in this bill.
It should not be the responsibility of one individual to care for someone who is in crisis or has become lost in the world. Humans are designed to live in social circles, not in isolation. Our society has created a deep loneliness and shame for those persons who seek connection, help, support, and shared responsibility. Our society has created an illusion of connection and replaced genuine care and relationships with material goods and governmental agencies acting as paternalistic rulers of ourselves. This has been happening for centuries, and it is only getting worse. In fact, this isolation and oppression is what underlies much of what we call mental illness in the first place!
When a family member, partner, or friend genuinely wishes to provide that connection and support for someone in deep pain and suffering, they find themselves lost and overwhelmed because WE ARE NOT SUPPOSED TO DO THIS ALONE! The mental health system, then, becomes a surrogate social support system because we live in an isolated, fragmented society. When a family member or friend seeks out the support of the mental health system, they are then shunned and castigated for doing so. But, where else are they supposed to turn? This, I believe, is the most important area that needs to be addressed in order to garner widespread support to defeat the Murphy Bill. Where do we turn? What do we do?
What’s in it for Me?
But, trying to implement alternatives to hospitalization is a catch-22. Funding gets cut for successful alternatives, for peer support, and for community organizations due to financial and political interests. Part of this is because of the corporatocracy in which we live that honors the powers of pharmaceutical companies and psychiatry over non-profitable, unglamorous houses of respite and support. There is also the problem of greed, rigidity, and narcissism within these alternatives as well, which quickly gives them a bad reputation because people are just looking for a reason to dismiss them. How many stories have you heard of a peer who insisted that “this is the right way” or “you must do X”, leading the family and “patient” ever more hopeless. Aside from fear and a need for survival, humans are bound in their actions by the tenet of “What’s in it for me?”
Providing a lost soul with love and support, family counseling, Open Dialogue-type approaches, the Hearing Voices Network, or peer respites is a difficult venture for one major reason: there is no big money or ego-boosting incentives in these approaches…mostly. Inherent in these approaches is the message of empowerment, autonomy, learning to work through life’s problems with the help of one’s family and social circle (or building one if it doesn’t exist); the plain message from any peer or clinician providing this type of “treatment” is “you don’t need me”, and this is one of the reasons they are not widely accepted. People want to feel special, like they are doing something and “helping” someone, and they want to make money doing it. Trying to tell an entire profession that there alternatives that work, and they don’t necessarily need the involvement of said profession is a threat to one’s selfhood and survival. The second a psychiatrist or other mental health worker tells me that they are volunteering their time and working for free and have no investment in getting personal credit for someone’s recovery, then that person can tell me to shove off and not accuse them of certain degree of selfishness and grandiosity. As I stated in the beginning, there are very few human beings on this planet who have sacrificed themselves and their ego so sufficiently so as to be considered a Saint or enlightened. I sure am not one of them. In thinking about it, I’m quite certain that I am not writing this blog hoping that no one reads it. It is not anonymous. I am also a clinician, and probably find an equal measure of pride and grandiose feelings knowing that I’m somehow “different” than other clinicians. It is human nature to be rewarded by feelings of accomplishment, appreciation and acceptance.
Who among us really does not enjoy feeling praised, respected or proud? Really? It takes great effort to fight the swell of grandiosity and narcissism, particularly for those who work with “patients” everyday who frequently worship their therapist in a god-like fashion. Psychiatrists are not evil, they are human. Tim Murphy is not evil, he is human. Think about how difficult it is for some to even consider that possibility. And then re-read everything I wrote up to this point.
Defeating This Bill Once and for All
The facts are out there, and there is plenty of rational debate that has been had and still must be had. But, to play in politics, we must play their game. We need to address people’s fears. Better yet, we need to turn the table and play on these fears… will “they” be next? What if “they” were to become despondent or crazed after some traumatic incident… would they want care and support or to be locked up and tortured without having committed any wrong doing? With 25% of the population exhibiting some kind of behaviors or feelings that warrant a DSM diagnosis, the prospect of being locked up against someone’s will is a very real one with the passage of this bill. It is a threat to the larger society precisely because you don’t have to be an imminent danger to anybody, there just has to be a suggestion that it’s possible. Remember back in the day when women were put in institutions by powerful husbands who wanted to be free to be with their mistresses? These are the media campaigns that need to coincide with the facts. This is the only way to defeat this bill.
It was the pictures of Abu Grab that got Americans willing to fight against the war in Iraq, not the facts. It is the images and videos of innocent black men being shot down by callous police officers that have the country enraged and talking about race. People don’t care about facts, they don’t want to have to think, they need to know in an instant what is happening and what it means. I despise rhetoric and tautology about as much as I do this bill in the first place. Unfortunately, our own need to believe that the world is just is standing in our way. An honest, fact-based approach is not enough. In the age of Twitter and Instagram, where pictures of dead children can instantly be spread to millions of people with a caption mentioning mental illness, the game has changed.
The people who are running campaigns to fight the poor, sick mentally ill need to be seen as altruistic and good. They believe themselves to be the omnipotent helper who is rescuing a child-like, incompetent victim of his own brain, and in so doing is rescuing all of society. This image must be struck down and called out for the delusion it is. I imagine a campaign with a picture of an abused child on one side, and on the other an adult who is shackled and chained with people in nurse’s uniforms pouring pills into his mouth and injecting him with an enormous needle with a white-coated doctor in the background taking notes. A caption could read: “The Murphy Bill: Ensuring your abused children will be punished FOR LIFE.” I say this in jest, but only a little. It’s about as realistic as the front-page photos of a crashed plane with the caption “Hundreds dead, pilot mentally ill.” The facts are on our side. We need to do something to get people to start listening.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.