“My Ego Strength is Too Developed for Me to Ever Become Psychotic!”

Michael Cornwall, PhD
61
697

That was the emphatic response from my grad school psychopathology professor 35 years ago, after I’d stated in her class that anyone could become psychotic given sufficient life stressors, losses and trauma.

How many current mental health professionals, especially psychiatrists, also believe they have such strong egos that they never could experience extreme states?

In the absence of any bio-markers, blood tests, or diagnostic imaging to validate a psychiatric, disease-model based DSM theory of psychosis, we still are being asked to accept the diagnosis’ validity as a disease entity on faith. Faith that what causes — and is called — psychosis is what psychiatry says it is. But what if the disease model of extreme states grew out of, and contains, a phobic dread at its core? What if the disease model of extreme states is a codified expression of deep primitive fear of the irrational? An inchoate fear of the emotionally wild unpredictability of madness? A fear of the terrifying existential disintegration — that really may be the occasion for a deep reorganization of the psyche, if the extreme state process is not pathologized, but instead allowed to freely express itself and be nurtured?

To attempt to address these questions, the following conjecture is based on my work as a radical therapist after going through my own lived experience of madness, as well as my experience on treatment teams alongside psychiatrists every day for almost 30 years in a large public-sector mental health system where I specialized in serving people in extreme states.

From decades of conversations with psychiatrist co-workers about the possible causes and most effective treatments for psychosis, where I challenged their belief system with my radical views, my sense is that almost all those docs believed what the psychopathology professor believed – that they really were invulnerable to any form of psychosis.

It seemed they partly believed that this had been proven because their strong egos and “grasp on reality” had gotten them through the rigors of medical school, but also because, after absorbing the frightening disease model theory/dogma about what gets called psychosis that they were taught in psychiatric training, they felt comforted in believing that it could never happen to them.

They appeared to me to believe that their egos were so strong that they would always be safe from experiencing psychosis.

That stance looked to me like the possibility that some self-serving cognitive dissonance was at work. We sometimes come up with comforting stories to tell ourselves to ward off experiencing the fear of what we are really afraid of.

I remember a psychiatrist co-worker and friend telling me, with real anguish, that she hated starting children as young as six years old that she’d diagnosed as bipolar on Abilify and other powerful psych meds, but she believed she had no choice but to protect their brains from psychosis. She said that was what she had been taught at one of the best medical schools in the country; that every minute a person of any age was experiencing psychosis, their brains were undergoing irreparable damage.

I disagreed with her about that fatalistic and unfounded belief, and gave her research articles challenging the disease model of psychosis, but she still believed what she had been taught in her psychiatric training and what the APA constantly advances as scientific proof.

I think it’s possible that some of the often aloof clinical detachment and “othering” that negatively effects people in extreme states, people who need a warmer, compassionate response from providers, stems from the fear of extreme states that providers carry into their face-to-face time.  As I’ve noted, this fear is memorialized in the disease model that providers have been taught is true.

The failure of empathy, and the resulting lack of deep compassion for those in extreme states, may be a not-so-hidden unintended consequence of the belief – and hope – that psychosis is possible only for those who are fundamentally different than the provider; that the dreaded psychosis exists in potential only in people who lack the “ego strength” of the defended and emotionally distant provider.

Isn’t it more difficult to have empathy for someone if we can’t imagine ever being in their situation or ever experiencing what they are experiencing? Don’t we subjectively have more empathy if we recognize that there but for fortune would our own suffering take us, instead of believing we could never suffer that way? The compassion that someone in an extreme state needs to feel from others is limited if the provider isn’t first sufficiently engaged to feel a degree of empathy.

It seems to me that a subtle form of hubris – a.k.a. “ableism” – is present when mental health providers look at the people they serve and almost triumphantly say to themselves, “I could never be like you!”

I haven’t seen the psychopathology professor again in all these years, but I’ll never forget our exchange in her class that evening when she responded to my assertion that anyone could become psychotic given sufficient trauma, life stressors and loss. (Recent research, in fact, left the researchers “‘Amazed’ at the range of experiences associated with schizophrenia that were induced in ordinary people after just twenty-four hours of deliberately-induced sleep deprivation.”) I was surprised by how emphatically and personally she responded to me in front of the class –

“Michael, my ego strength is too developed for me ever to become psychotic. I have been through an extensive training analysis and nothing that could happen to me in my life could ever cause me to become psychotic!”

There was a long pause as the other students turned and looked over at me.

I replied, “Based on my personal experience, for your sake, I hope your ego strength is never put to that test.”

61 COMMENTS

  1. Michael,
    Unfortunate wartime experience and the twisted long-term experiment going on in our prisons’ practice of solitary confinement, etc show that most people put into solitary confinement, a hostage situation, etc. for at least a few months will start to have hallucinations, bizarre thinking patterns, delusions, etc.

    We simply need other people and need some degree of external security to maintain our homeostatic equilibrium and without it anyone can and will become “schizophrenic.”

    The truth is that the psychiatrists you met, had they suffered chronic constant abuse and neglect as children, could easily be inmates at the mental hospitals they run or inmates in real prisons today, rather than psychiatrists, if their past experience had been much worse.

    And sad to hear these stories about pathetic psychiatrists drugging children because they are taught lies about psychosis but then are unable to think for themselves when real experience of hopeful, healing approaches to extreme states confronts them. These “professionals” and their greed-induced ignorance are part of the reason why America is the worst, most backward country in the world for mental health care.

  2. Michael
    True and applicable. For me, I was shocked when I had my 4 month experience at age 21 but having grown up with my little neighbor who was hearing voices from age 4 (he was my best friend) I had a feeling that it could happen to anyone. At 21, though, I felt that the chances were pretty much near zero that I would have the same experiences. Had I not gone through it with him and myself, I fear that I would have fallen into the same denial/fear based mode of being impervious and kind of “protected” by my really good parents, my “ego strength” my ability to handle a lot of pressure. This attitude is, of course, discriminatory as most fear-based attitudes are but is something all professionals ( and others) need to be very aware of and question within themselves. The other factor is that the more you experience other people’s experiences and see them live through it and gain insight, the less fear there is and, of course, empathy grows. I think all who are going into the field must be with people who are living with and through these states although nothing compares with going through it yourself. Many of my colleagues don’t really get it and do have some empathy but that is not the same and it is not the kind of “understanding” that leads to complete and deep empathy

  3. How sad that someone in such a position can be so uneducated, especially that they don’t see their own lack of sensitivity! Funny even, that they hold on so strongly to what essentially is a delusion itself!
    During my own research on recovery, I was lucky enough to be involved, as a test subject, in a research project on the benefits of genetic counselling. Psychotic disorders are complex, involving genetic susceptibility, environmental stressors, lifestyle and nutrition and given my history I did not have a strong family background of psychosis. I asked the counsellor straight out whether it was possible to recover from psychotic symptoms and she said YES..totally! This statement opened up a whole new world of thinking for me. Since then I’ve worked up to appreciating my innate sensitivity and have weaned myself off medication for ‘bipolar disorder’ 🙂

    The greatest gifts of strength we can give anyone are hope and a sense of self empowerment. Empathy, as you say, is key.

  4. Michael, your story is synchronistic with an experience I had in graduate school with a psychodynamics professor. We had been assigned to write an experiential paper related to personality types using our own experience as examples. In that paper, I disclosed a diagnosis, which I felt was relevant to what I was writing about.

    I got the paper back with only a note written at the bottom, “Alex, please see me after class.” I did, and he proceeded to tell me that I would never have the “ego strength” to even complete graduate school, because according to him, based on what I had revealed in my paper, I would never have the capacity to work with people in distress.

    That, alone, tested my ego strength, and while he caused me a great deal of even more distress by going to my advisor and suggested I leave school, I stayed in his class (which was very challenging), completed the program with honors and a successful internship training practice, took my dark night journey through the system and off meds, and am now working with people in all states of distress, and doing a lot more than that. As for the professor, I just told everyone what he did and said, and many of us wrote negative evaluations. So he was not back on campus the following semester.

    That was my first stop on the ‘what the hell is this?’ train called the “mental health world.” My most neutral word for it is ‘dualistic.’ Purely. I think that’s the problem, not realizing that we’re all connected, all mirrors of each other, one consciousness divided up into myriad aspects of personality. At least, that’s my perception of humanity, and all that is. Sure levels the playing field, at least.

  5. A psychotherapist I gather Dr Cornwall is more effective because of going through their own psychotherapy before they get licensed. I think you have the advantage to have the psychosis experience which other professionals don’t. So they can never fully understand psychosis. They can come close to understanding it if they use an open mind and read all the stuff that is available such as can be found on this web site that describes it and makes sense of it hopefully. You make a very good point about it possibly being a phobia. It might also be that they feel better about themselves sticking to an “us vs. them” mentality where they are OK while the others are not?

  6. Hi Michael ,
    Before the age of 22 I was already a 6 year veteran in and out of 4 different mental institutions around a dozen times for individual
    lock-ups varying from 6 1/2 months (the first one) to as short as less than 2 weeks (considering having already escaped 5 times ). In Illinois , Ridgeway Hospital and Reed Zone Center , in Florida at Jackson Park Memorial Hospital and in Israel at Acre . Thorazine, Stelazine , halidol ,later lithium , one course of forced 15 bilateral electric shock “treatments” given one every other day over 30 days. The 14th one because of my own curiosity given before I was unconscious . Also in Israel became a subject for experimentation after escaping and being recaptured . In Acre only 2/3 of the people there came out alive in those years. I was locked in there in early 1968 .” My psychiatrist” there didn’t even speak English. I guess it really didn’t matter cause psychiatrists never really listen to people anyway. I didn’t get totally free from psychiatry (finally weaned off totally from the last of their “meds” ( haldol past my mid 50’s .Expensive advanced dentistry was the biggest helping factor .The most hurting factor was when they took away from me and my first wife who I met inside Reed Zone Center our only child when she was 1 1/2 years old in 1981. I’d learned a lot of stuff about psychiatry , life , sanity and madness and other people. How could I possibly not be anti-psychiatry. I think I’m different cause I’ll admit publicly in all honesty I also hate psychiatrists. Can you blame me . If anyone does, see the film Nazi Medicine in it’s entirety on Netflix . Then talk to me about it .
    When I first decided to comment I wanted to say Excellent Post ! Then to tell of a day in Reed Zone Center when a beautiful woman in her early 20’s standing by herself in the “dayroom” was suddenly for no apparent reason walked up to by another young woman and quickly kicked twice hard in the shins . Before anymore kicks were delivered to the defenseless woman I got up and and stood between them and asked the kicking woman why she was kicking the other lady . She didn’t answer but at least stopped kicking . Meanwhile a psychiatrist came into the dayroom , the girl that was kicked walked over to his side, reaching to him for help she barely touched his arm. The psychiatrist side skipped and almost moonwalked sideways to get away from the woman . By this time I was really laughing the loudest at the psychiatrist . I realized he was really nuts. Of course he had me placed in leather strap restraints for 24 hours on a bed and injected but I was still laughing at him in my mind . And I still am .
    In Solidarity , Fred

    • Fred, what you write is horrifying and inspiring at the same time. The fact that you prevailed, freed yourself from all this, is a testament to your spirit and strength. I did not think I could dislike mainstream psychiatry and its practitioners more than I already do, but your post made me loathe them even more.

  7. I think if we put your psychopathology professor through a excruciating series of highly developed “enhanced interrogation” techniques even she would confess to having a weak ego, but saying so, of course, is merely theory. After 35 years though, the experiment would, of course, come too late, if it came at all.

    There is this idea of, rather than seeing another human among humans before one, the object of one’s scrutiny becomes completely other, and thus, passes beyond comprehension. The tongue, despite constant wagging, has been amputated sufficiently to serve our purposes, doctor. I know there are lessons that don’t make sense however much they end up sinking in. This is why survival guides and military manuals have sections about escape and evasion. Fail at survival, and all aims are other anyway.

    Thanks for your post. Perhaps it will help somebody see a little of themselves in the human they are endeavoring, for one reason or another, to change.

  8. I know two people well who had psychotic epidodes after traumatic events. One is a man who had a breakdown in his 30s. He thought, among other things, that a tv talk show host was talking about him in code and some waiters were poisoning his food. He was working at the World Trade Center and was diagnosed as paranoid psychizophrenic several months after the destruction of the twin towers. He refused medication, eventually recovered, and has had no further breakdowns. The second is a man in his 40s who discovered his wife was having an affair, feared that she might divorce him and was terrified he’d lose his kids. He couldn’t sleep for five days. He started having crying fits, thought someone put poison gas in his car and that his house was bugged. The psychiatrist diagnosed him first as schizophrenic, then as bipolar and blamed his sleeplessness on his illness, not even considering that such severe sleep deprivation could cause psychosis. He took an antipsychotic briefly and stopped because he didn’t like the way he felt. His marriage crisis resolved and two years later he’s fine. I personally have no doubt that trauma can precipitate a psychotic event.

  9. Let them have one to many drinks at a party and get in a fatal accident that was or wasn’t their fault and deal with all that.

    That’s a common one above but for more just read the newspaper and see there there is lots of scary things that happen to people out of nowhere all the time or go to a homeless shelter and ask people what happened.

    But what about psychopaths, are they immune to psychosis ? Does that lack of emotion and caring and all that protect them ?

  10. Excellent points! I am drawn to comment because this so hits home for me. When I worked on an unit. The docs really liked me and said I had great ego strengths! Luckily this was back in the day when the care was at least adequate. I was well liked by staff and the patients though I didn’t know what I was doing many times and I regret my ignorance greatly now.

    You are right on target with your thinking profs really think they won’t get it. At that time I didn;t think I would get “it.” But I did and it was through a bizarre series of unfortunate non locus of control events – trauma in other words. YES YOU CAN get” it”. Anyone can regardless of past history – certain events and bong you’ve got it. What I didn’t know then but know now is that many cultures actively sought out this experience of whatever you want to call let’s say altered mental states. In my own culture this was down by burial for three days. Solitary confinement!!!!!
    The “otherness” factor and not we factor is one of the greatest sins of todays and many times yesterdays history.Until this is adequately nothing will change. I have tried my best and the wall is hard and solid and high.
    And btw after years of healing my states made perfect sense and my fears and thoughts were actually not that far off from reality. I just didn’t have the words or the time or the caring person to help me process them all. I was always just given drugs, driven to the ER or day treatment program , hospitalized despite my protest and of course very legitimate fears.

    So what to do? I am at the point of just living my own life and going from there. Lots of family stress. with all generations. If there was something else then venting and that would be safe I would be involved in a second. I just never,ever want to be caught in the system again.

  11. When I worked on an unit. The docs really liked me and said I had great ego strengths! Luckily this was back in the day when the care was at least adequate. I was well liked by staff and the patients though I didn’t know what I was doing many times and I regret my ignorance greatly now. What happened to those days? I was pretty uninformed in those days also but our empathy was there and it was appreciated more than any “expertise” so don’t regret anything!

    • And that is where we have a huge divide!!!!!!!!! Back then we were not supposed to really spend time with folks in active psychosis. I was told to wait until the meds kicked in. Those folks who had a drug history were felt to have permanent psychosis never to be rational ever again. The big thing was group and letting folks pour the pitcher because it helped them deal with the tremors. Some of the profs were kind and really wanted to help but in hindsight I don’t think anyone one really saw the whole picture and certainly patients weren’t not consulted.
      The good was there was OT and Art Therapy. I had none of these in my incarcerations. . I actually brought paint and made the nurse aides open the always locked and empty OT room so we all could use paper to paint.

      Back then truth – pts were allowed out on passes even in weird states. It was always a team decision. Folks went out through the hospital and into the gym and swimming pool. Not much like my stays.

      Folks could not take meds and staff would be frustrated seeing them again but not overtly angry.
      Money was still flowing then so there were actually good voc rehab programs.

      Staff was aware of the Psych survivor movement and became dejected when the fast happened saying it would destroy credibility. I foolishly not totally understanding bought this idea as well. One doc and one psychologist did stand out. They got it as much as they could.
      So now is worse but back then folks were still not listened to. The reasons for their breaks were not really listened to. Power and control still reigned even though one – may say and I feel i am stretchering here it was relatively benign as compared to now.
      With my experience I would do things radically differently. I would insist there would be peer workers fully apart of the team. I would have so many good groups like listening to voices. I would insist on Family Therapy. I would have an alternative to meds/drugs group. And I would listen to the whole story no matter how uncomfortable I felt. Professional kindness now matter how well intentioned does not equate with empathy when one deals with the steel jaw trap of stigma. I certainly did and at times still do struggle with stigma and prejudice. I was kind and considered more of a radical
      {([ I actually would do a childhood abuse history and yes many, many folks admitted to trauma of one kind or another). I was afraid to mention this didn’t know what to do and it was before Judith Herman’s work was published.Didn’t want to rock the boat since I already was rocking it in another area.

      but I was still was so very unaware as are most professional in the system were and are. Fear reigns in our hearts and until we all decide to admit to it and deal with it nothing will change.
      Let it go Margerie!!!!!!! Why you persist is beyond my understanding. What hole in the dyke are you trying to plug?
      Take Care All

  12. Michael, What a refreshing article. I worked in the field for 20 years as an LCSW including some time in the VA system. I experienced the attitudes among the psychiatric establishment as brick walls. I certainly knew of my own vulnerability to psychosis prior to going into the field and talked about it in depth for 5 years twice/week with my Psychiatrist at MGH. She chose to never suggest medications for me and felt that I had the ‘ego strength’ to work through and manage states of very high anxiety. I know now in retrospect that that anxiety did in fact break through. It was a struggle for me to maintain my own stability but I did…just barely for years. I did finally disintegrate under a highly unusual set of circumstances that I wouldn’t wish on anyone. Suffice it to say: “I know what a breakdown looks like and feels like from the inside…” It’s terrifying. I’m not out of the woods yet for sure. Life is a daily struggle and total abstinence from alcohol, drugs, cigarettes among other things is fundemental. It takes all of my skill and experience to cope day to day. So I appreciate your position and your emphasis on empathy in treatment and among professional peers. I would love to have worked with you in the field. It’s very difficult to find support among your peers when you’re working in the field. No one wants to touch the stigma of mental illness with a ten foot pole for fear of damaging their own professional facade. I knew the folly of that approach from day one and had to be careful with my boundaries along these lines. I was absolutely won over by Heinz Kohut’s view in ‘Self Psychology’ basically that all or most psychopathology stems from failures in empathy. I know this to be true from my own struggles combined with 20 years professional experience providing care at the in-patient and out-patient levels. I think the real reason most providers are steered away from empathic treatment of clients is becasue the system lacks the continuum of care that is necessary to properly assist someone from the crisis stage all the way through to the point where they can gain the skills and confidence to manage their own affaris and inner states. Our culture is not designed that way. Lack or Housing, education, medical, dental…etc, etc…people are stressed to a degree that cannot be helped in a clinical setting. And nothing is more frustrating for a provider trying to help a person when that provider can see so clearly how ovewhelming are the issues facing their clients. At the very least we should be able to treat them with the dignity and respect that owns up empathically to the reality that anyone immersed in misery long enough is going to break down somehow. Wishing you all the best. Thanks for your enlightened article. Peace

  13. Hi Michael, I like your post.

    I think most reasonable people would acknowledge that given the right circumstances they could have a breakdown, or “psychosis” as they call it. The professor might have been trying to reassure herself in the interest of pathology.

    What I’ve noticed also is that medical people tend to be very stigmatising in terms of ‘mental health’ – maybe because medical people are very vulnerable to ‘mental health’ problems themselves.

    Also, there are a lot of obviously very mentally vulnerable professionals
    employed in mental health, and ‘pathology’ can give these professionals a cover.

    • So true, what was initially declared to be my “psychosis” was actually a religious dream query and concerns regarding a nightmare that 9.11 might lead us into a WWIII. My psychiatric practitioners didn’t know the difference between dreams and psychosis.

      And I bet any amount of money I could make that professor of yours actually “psychotic,” just as my psychiatrists subsequently created actual psychosis in me. All you need to do is put the person on drug combos with any of the following drug classes:

      “antihistamines, antipsychotics, antidepressants, and antiparkinsonian drugs[3] as well as atropine, benztropine, datura, and scopolamine.”

      Combinations of these drug classes are known to cause anticholinergic toxidrome, which is known to make people psychotic.

      “The symptoms of an anticholinergic toxidrome include … delirium, … hallucinations, … memory loss, … psychosis, ….”

      “I remember a psychiatrist co-worker and friend telling me, with real anguish, that she hated starting children as young as six years old that she’d diagnosed as bipolar on Abilify and other powerful psych meds, but she believed she had no choice but to protect their brains from psychosis.” Abilify, and all neuroleptics, can cause psychosis.

      It breaks my heart the psychiatric profession is so incredibly deluded, and is destroying so many children’s lives. As Whitaker pointed out in ‘Anatomy,’ most childhood ‘bipolar’ is due to psychiatrists misdiagnosing the adverse effects of antidepressants and stimulants as ‘bipolar.’ And currently the most common trait amongst all “psychotics” / “schizophrenics” is ACEs or child abuse:

      http://psychcentral.com/news/2006/06/13/child-abuse-can-cause-schizophrenia/18.html

      And I will say my actual ‘psychosis,’ while suffering from anticholinergic toxidrome (‘bipolar’), was completely relevant to what was going on in my life, and gross. It was the ‘voices’ of the people who abused my child bragging about such incessantly in my head. But my drug withdrawal induced manic ‘psychosis’ / awakening was actually not scary at all, to the contrary, it was amazingly serendipitous and quite cool.

      It awoke me to the theory that we, as humanity, are all connected within a ‘collective unconscious,’ a theory similar to that of which Alex spoke. And my 2001 nightmare, regarding my concerns 9.11.2001 might lead this world towards a possible WWIII, and even my 2009 drug withdrawal induced silent, ‘psychotic’ reprimand of the Federal Reserve bankers, do now seem to be concerns shared my millions on the Internet today. My ‘collective unconscious’ inspired ‘psychosis’ / dreams / concerns do seem to have moved from merely my brain, to the real world.

      Is there any proof ‘psychosis’ is anything more than a drug induced problem, or an awakening to one’s subconscious thoughts and concerns? Too much “hubris” is correct. Thanks, Michael.

  14. At 19-20, following years of psychological and physical abuse from dear father, I had a psychotic break studying for my first community college exam, after having such low self esteem I never believed I could ever make it through college ( a few years ago when he came to visit he admitted to me he “never thought you’d (I would) amount to anything”). When the sun rose that morning, after my break immersed in a delusion all night without sleep, I recovered, went on to pass the exam that day, then continued on to be a clinical psychologist, retired, and thus far wrote and published 4 non-fiction books and the latest, a sci fi novel (http://jasenn.org).

  15. What an amazing article! An honest reflection of psychiatry and anyone under it’s umbrella of influence. They weren’t trained in med school. They were indoctrinated and then didn’t have enough intelligence to question any of it. Simply terrifying.

    Nothing will change with this lot until they are removed from the pedestal on which they reside. This can’t be done until the fantasy of psychiatry as “healer” is exposed for the sham it is and it’s corrupted ties to money (drug companies, universities that are given “research” dollars, the government from judiciary to social services, etc) are made evident.

    There is work to be done and I am most grateful for the revolutionaries like you Mike. Thanks!

  16. Great read! One of my favorite cable shows is the Discovery channels “Naked and Afraid”. On this show many tough people break down after just a few day due to the lack of sleep and protein. I know this seems like a simplistic example, but is it. We send a kid off to college and his eating and sleeping patterns change dramatically. Off to the pdoc for some speed to kick it on the next assignment and the pdoc hands out a prescription of Adderall – no background, no advice, just take it and its all better…Right! This further exacerbates the problems. This story is running as we speak.

  17. Michael

    “What if the disease model of extreme states is a codified expression of deep primitive fear of the irrational?’

    When I read this I thought of the Bacchic rites that came out of the early history of Greece. The frenzied rituals certainly let people get in touch with the irrational. But eventually these rituals and celebrations were suppressed, especially by the Roman Church as it grew and consolidated its power over all areas of life. The Church attacked such rituals and practices with a vengeance and stamped them out at all costs. it made religion into some kind of head trip and stigmatized the emotions, feelings, and the body.

    The Western mind cannot deal with anything that is irrational, everything must be forced into acceptable boxes and consensus thinking. Most people become very uncomfortable when faced with the irrational parts of life, and there are many such parts. I for one believe that you’re absolutely correct when you state that the “disease model of extreme states is a codified expression of a deep primitive fear of the irrational.”

  18. I love this article. The “othering” I have seen all throughout society on many levels. For instance, in the church I attended the members prided themselves on their monetary donations to various charities, most of them funding “those people” who lived far away. Yet they refused to associate and befriend those members who were poor or otherwise marginalized. What I then found was that their claim of being “welcoming” only applied to the few. If they had been truly welcoming I would have been seen as human instead of some skinny subhuman.

    I don’t know what to do about the occasional “othering” here on MIA. I don’t think we should be “us and theming” here. But this does happen. I am still dismayed at the number of published articles by people with letters after their names. I guess that subconsciously prompted me to add my own letters, even though my degree is not in the privileged sciences, but in creative writing. At the same time, we need to recognize that the “us and them” attitude has been drilled into patients for so long that it’s one of the hardest parts of the brainwashing to shake. Many of us are very angry, and that needs to be honored and not seen as disorder, but of course understandable. From personal experience I know anger should be seen the same as grief. Allow us to be as angry as we need to be for as long as we need to be. Rushing forgiveness won’t work. To say, “Just get over it and forgive,” is in fact forcing ideas on a person. This isn’t a moral issue nor an issue of quality of character. Or “ego.”

    On units, I first noticed the attitude of “subhuman” when I observed the way staff treated those patients who came from abroad and did not know English. These patients were ignored, as if they had no feelings or that they weren’t quite human. This also happened to elderly people who were hard of hearing. They were assumed to have low intelligence and they “didn’t matter.” To some extent this also happened when a person had been imprisoned in a hurry and had not had time to grab her reading glasses. Unable to read handouts in groups, she, too, was “other.” I was shocked to see just how long it took for the administration to hire or bring in a translator. These patients spent, I’d say on average, an extra month in the hospital that was completely unnecessary. Apparently a woman once showed up who mixed up “breast” with “chest” due to knowing very little English, and that took the staff, who claimed to be insightful and “strong ego,” a full week to catch on.

    Overall, we patients understood each other much better than the staff understood us. We had no notion of superiority nor were we deluded into thinking we were morally superior. We accepted each other. Maybe there was something to that, eh?

    One of the worst lies ever told to me I heard in 1981. Someone asked one of the day treatment staff what the difference was between staff and patient. The staff person said, “The only difference is that the staff have their act together. Patients do not.” This was hardly true. The difference was that staff were paid, carried keys, and retained their rights.

    • Julie

      Your post reminds me of one of the men who was held on the unit of the state “hospital” where I was a resident for almost three months. He was a tribesman from the Dyak people of Indonesia. What a Dyak tribesman was doing where I live is anyone’s guess but he was here and he was held in the “hospital” because of his supposed schizophrenia. he was probably labeled as such because of the huge disconnect that has to exist between his culture and ours; it must have been extremely difficult for him to deal with on a daily basis. His people come from the jungles of Indonesia and still use bows to hunt their food and fight their enemies with. The interesting thing about the Dyak tribes is that they spend their entire lives covering their bodies with tattoos since they believe that they cannot come before God until they’re totally covered because this makes them beautiful in the eyes of God.

      As you point out, he was shunned by the staff but not so much by the rest of us who were his fellow “patients”. He and I developed a bond because I am also extensively tattooed. We got along quite well although neither of us could speak one word of the other’s language. We would sit and show one another our tattoos. Sounds strange I know but if you are tattooed you understand completely. We shared something in common which bound us together.

      As for the “staff” having their act together”, we “patients” used to sit and watch all the antics of the staff and then would look at one another and say, “And they call us the crazy ones!!!” We can’t keep staff at the state “hospital” where I was held and where I now work because they have so many issues of their own that they haven’t Worked on at all and trying to deal with the “patients” just throws their own stuff back in their face all the time. They can talk the talk but they can’t walk the walk because they’ve never worked on their own stuff. How dare them step onto any of the units with the idea that they’re going to be responsible for the healing of anyone when they haven’t healed themselves. What’s the saying, “Physician heal thyself.” Every month our new employee orientation numbers in the high 20’s, which is phenomenal for an organization of our size. So much for staff having their act together!

  19. Of course it makes so much sense – that genetically superior beings- as attested to by fact they have passed through the special forces boot camp known as “med school” – will have superior ego strength, since ego of course, is a purely biological function of a health brain organism

    Just another case of othering by those handed the brass ring and unaware of there own privileges and biases – and how that blinkers their insignt while revealing their utterly superior stupidity..

  20. I really appreciate this article. What goes hand in hand with this topic is the fact that psychiatrists have breakdowns, M.D.s have breakdowns, etc., frequently. But they have their own private and highly confidential treatment programs that will never be discussed openly. This furthers the old myth that only people with feeble minds enter into extreme states. And these private groups are defined largely by economic status. There are private AA, NA & ADD groups, etc. that most people never know exist because they are held only for a select group. We are all capable of psychosis, and we are all capable of strong egos just as well. Additionally, it appears that one path to psychosis is the strong ego itself, untethered and flying high!

  21. “Strong” Ego shows by itself the existencialistic (mis)conception. We should value ourselves around “reason” instead of “strenght”. So the main cause of psychosis as I can tell by my own experience is about language and how it is used in order to achieve any goals. But in the end it’s also upon us, because the other side is our relation to fear and death. The whole process ist what we make ist and it can be a way to spiritual enlightening that may make us stronger and much more reasonable than these idiots. So think positive, because that’s the only logical way. 😉

  22. Reading this (and the sleep study) has led to a sudden re-evaluation of my mental hospital story. Sh*&t. Maybe all I needed was a couple nights of sleep. 🙂
    Who knows what I would have started to figure out after that.
    Somehow the spell of the mental hospital is so strong, that even with all of my beliefs about the nature of psychosis, which are very much aligned with yours, there is still some background way in which I thought, “oh, that must have been necessary”
    I only noticed it for a momentary glimpse after reading this article – it was like a brief fresh new light on my past. “oh, that was totally arbitrary.”
    Thanks Michael!

  23. You’re right – it’s not more than a spell. It’s up to you to break it. Humanity is doomed to become reasonable or go to hell of whatever mindless robots kind. There is a logic and there are arguments. If they don’t work, draw your own conclusions, judgements and consequences. Reasonable humanity by the way means egalitarian humainty and that should also be a hint to the nature of problems that we face.