Uncomfortable Relations: Reflections on Learning From Psychiatric Survivors

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I consider myself a friend and ally of psychiatric survivors and someone who has lived with, and tried to support, close family members and friends through psychiatric crises. I have been a mental health activist, a development worker in a service user-led project, and a researcher and teacher. These are some reflections on my experience of learning from psychiatric survivors over the last 30 years.

Binary distinctions between ‘service users’ and ‘professionals’ or the ‘mad’ and the ‘sane’ are often unhelpful as we all experience distress at some point in our lives. Having said that, it’s fair to say there is a kind of critical threshold that some people reach which leads them to respond markedly differently to the way most people generally handle situations in their lives. While some of us voluntarily access mental health support at certain times, this is qualitatively different from being diagnosed, forcibly treated, detained, or requiring ongoing support from mental health services. These experiences can have a profound effect on one’s identity, sense of self and position in society. In addition, it is one thing to have had a psychiatric history, it is another to be ‘out’ about that history.

Recognising these differences is important if we are to forge much-needed alliances with users and survivors. Yet, there are also complex dynamics of power and oppression which further upsets any simple distinctions between ‘oppressed’ psychiatric survivors and ‘oppressive’ professionals or carers. For example, in relation to workers or carers, survivors may be socially advantaged in other ways, such as in relation to their age, gender or social class. This is not to get into a ‘hierarchies of oppression’ debate, but to recognise the nuances and complexities of our social situations (what is now called ‘intersectionality’). Whilst mental distress, and psychiatric intervention, often has a negative impact on psychiatric survivors, it can also have a profound effect on people around them too.

My own distress, and especially my ongoing struggle with anxiety, was formed in the context of living with the fear, sadness and shame of mental health difficulties in my family. Like many activists, I objected to campaign slogans such as “Just because you’re not mentally ill, doesn’t mean you can’t suffer from mental illness” (from the SANE organisation in the UK). Slogans like this seem to pathologise and demonise the ‘mentally ill’. Yet living with people who are experiencing severe mental health difficulties can be difficult, scary and painful, especially as a child. Psychiatry might provide temporary relief and respite for families, as well as for the person designated ‘mentally ill’, but it can create other problems in the long term. Unfortunately, there is little support available for families or friends who want to adopt alternative frameworks of understanding these difficulties. There is probably even less alternative support for them than for users and survivors. And that’s saying something. In these circumstances, perhaps it is not surprising that people often turn to psychiatry for assistance.

I have often wondered: if there were genuine alternatives, not only might my family and friends not have suffered for so long, but perhaps my own distress might have been alleviated too. In my view, we need mental health services, perhaps even psychiatry, but they need to be democratised, informed and transformed by survivor knowledge and expertise. This is beginning to happen, slowly, if only on a piecemeal basis. We have a long way to go.

My experience of working alongside psychiatric survivors has been profoundly unsettling and challenging, but ultimately rewarding. Survivors have been some of my most important critical and respected allies. I believe if we are open enough, we can learn a lot from survivors: about ourselves, our common humanity, and our social world. We can learn about coping with oppression and other difficult experiences from people who have learned to deal with extreme states and mental suffering. For example, self-harmers can teach us to reflect on our own coping strategies; and voice hearers can prompt us to think about how we deal with our internalised critics. But whilst we have learned a lot from hearing voices and self-harm movements, the transformation in our understanding of madness and distress is far from over. It is very much an unfinished project.

I increasingly think we can only reach greater understanding by working through our own experiences first, and then, if we can, alongside survivors. That will help us become more open to survivor knowledge. For example, we may need to work through our own need for control and understanding. It’s helpful to consider our own reactions to distress or madness — in ourselves and others. How do we respond when people break social and emotional conventions that we take for granted and that help us feel safe? It can be disturbing, frightening and deeply unsettling to not be able to understand or control behaviour which feels strange, unintelligible and dangerous to us.

Anxiety and fear are painful emotions, so we often try to find ways to defend ourselves from feeling them. Medicalising, psychiatrising and diagnosing are socially sanctioned ‘defences’ against these feelings, and they place a social and moral distance between ‘us’ and those we designate ‘mentally ill’. This can be an understandable way of coping with these situations, especially as it appears to relieve us of any responsibility and blame. However, it also cuts off alternative ways of understanding people’s distress or madness. Staying open-minded is one of the hardest, but most important, things we can do.

Medicalization isn’t the only way we can defend ourselves against our fears and anxieties. Sometimes, as mental health activists, we can hide behind radical sounding rhetoric, theories and grandstanding statements — we are ‘pro rights’, ‘anti stigma’, ‘against the cuts’ or whatever. Whilst these aren’t necessarily wrong, they are sometimes expressed in ways which over-simplify the complexities and difficulties at stake. For example, I don’t think everything can be reduced to mental health stigma, discrimination or sanism, and I don’t think more funding and services would necessarily solve these problems either (although it would certainly help).

I’ve mobilised these defences myself and hidden behind radical rhetoric, especially when I’ve felt unsure or uncertain. In recent years, I’ve noticed an increasing number of ‘critical’ mental health conferences, texts and events. On the one hand, this is very welcome. But I’ve also witnessed a corresponding decrease in alternative support services available to people. I’m not saying there is a simple causal relationship here, but perhaps it’s easier to retreat into sloganeering or theory than engage in the messiness and difficulties of working with survivors to create genuine alternatives.

After all, being survivor led isn’t always easy or straightforward. We don’t necessarily have shared ways of understanding and ‘being in the world’. If we experience the world differently, especially during a mental health crisis, it is likely we will respond to it differently too. However, because we often expect people to share our way of being in the world, and the things we’ve found helpful or harmful in our lives, we sometimes unwittingly impose this on others. This is the problem with universalising from our own personal experiences. Rather than pretending we don’t see the world through our own experiences — we all do this — perhaps it is better to be open and honest about this.

Over the years I’ve tried to make sense of my own reactions and frustrations, and not assume I know best, even if I think I have the ‘right’, ‘radical’ or ‘survivor focused’ response. When trying to support people I’ve tended to make all sorts of assumptions about what being ‘radical’ or ‘survivor-informed’ is. It is about being informed by the collective wisdom of psychiatric survivors; an individual or a particular group of survivors? Of course, survivors can radically disagree with each other, and sometimes even with themselves (as we all do at times).

For example, I recently faced a situation of trying to advocate for someone’s advance statement that they had carefully drawn up themselves, only to reject it when they were in crisis. I was accused of interfering and controlling their lives, despite the fact that they had explicitly requested this intervention, if this situation arose. Which is the genuine ‘survivor perspective?’ The one written down or the one in front of me now? Abiding by their advance statement would have resulted in coercion, which most (but not all) survivors oppose. We are both still learning from this experience. Many years ago, when I worked for a user-led organisation, I booked a well-respected figure from the survivor movement to talk about survivor-run crisis services. The members were distinctly unimpressed, as they wanted to develop a more conventional drop-in facility. The irony of this situation is not lost on me now, as day services have been closed and run down.

I’ve also witnessed families and mental health professionals be criticised by users and survivors, as well as other professionals, and even disciplined by authorities, for refusing to prescribe medication or use psychiatric diagnosis or the powers of the Mental Health Act.

In addition, users and survivors sometimes demand psychiatric diagnosis, medication and treatment. Some people find these things helpful in understanding themselves and alleviating their distress, and diagnoses can be essential in accessing specialist support services and disability supports. I don’t think it’s sufficient to suggest this is some kind of ‘false consciousness’. We need to be careful not to replace one psychiatric orthodoxy with an ‘alternative’ which we claim is radical or ‘survivor led’. After all, one person’s orthodoxy might be another person’s lifeline.

I’m not giving these examples as a reason to reject radical survivor informed practice. Far from it. But I think it’s not as simple and straightforward as we sometimes suggest. If we teach people it is, and brush these difficulties under the carpet, we’re setting ourselves up to fail. In order to continue to learn from survivors I think we need to find more ways of talking about these conflicts and tensions, without resort to pathologising and blaming. This is not just an issue for allies, but for all of us, survivors included.

If we feel silenced — either by dominant medical narratives, or by alternative ‘radical’ or even ‘survivor led’ ones — perhaps we are more likely to resort to defensive practices. To paraphrase Kathryn Church, the process of survivor engagement is not complete whilst silence exists around the places where it has rubbed us raw.

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116 COMMENTS

  2. Well said, Helen. It is clear that we need an evolution in how society treats those who have different experiences from what is (arbitrarily) deemed “normal”. It seems to me that there aren’t clear answers, either, because we live in complex societies which can cause distress on multiple levels–families, schools, churches, government institutions, mental health facilities–can and do create additional stress and trauma in peoples’ lives. I do believe we should get away from the medicalization of mental distress for all the reason’s MIA has articulately pointed out over the years. Burning all DSMs and stopping the practice of prescribing pills to everyone for just about anything would be a huge step forward.

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  3. ‘ ….users and survivors sometimes demand psychiatric diagnosis, medication and treatment.’ No, they need drugs, they may have their reasons. I do not care, I need chocolate ice cream and sometimes beer and cigarettes, but I do not call it treatment. You can take what you want, but do not call poisoning yourself–treatment.

    The fact that the same drugs and dehumanisation by diagnosis killed their fellows, means nothing for them. Completely lack of the character, the need of drugs and alcochol makes them feel more numb, what for? They already are. Moreover psychiatrists should show respect for psyche, because psyche is not the property of medicine, this is mythical imagination far beyond medicine world and beyond apollonian ego claims. Psychiatry representong apollonian ego claims delegalized psyche for their own purposes, for money, for authoritarian purposes, for materialists for the power of spiritualism and religion over psyche. Apollonians know nothing about the psyche, they ridiculed it and propagate NAZI theories about psyche, brain BS iwthout any words about the phenomenology, the need of depression or psychosis….. Apollonian inhumane claims destroyed the HUMAN state in the same manner inquisition have destroyed it.And now we can’t even imagine the state in which psyche is something REAL. Psychopathology, DEPRESSION AND PSYCHOSIS is STH HUMAN. To accept human psyche you must to disprove APOLLONIAN EGO FETISHES –SCIENTISM AND ITS PARENTS -MONEY AND LIES. Apollonians do not have knowledge about the psyche, they do not have empathy, wow, at least they have kids….

    Psyche is not the brain, I want to legalise it and punish those who represent DSM not the human psyche. YOU ARE THE REAL PARASITES—YOU HAVE STOLEN PSYCHE phenomeology AND MAKES PEOPE GUILTY OF HAVING some kind of brain impairement, YOU APOLLONIANS. YOUR EGO WILL ROT.

    RE- visioning psychology James Hillman

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    • They don’t just “need drugs”, but they also need housing, transportation, income, etc., most of which are dependent upon a “mental health diagnosis” and “treatment.” Without either of these latter two, most people will not qualify for SSA, DHA, Human Services, mass transit, or other basic needs (if they are poor). Secondary gain, or basic needs, is why many people seek out and/or “demand” psychiatric diagnoses.

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  4. I have a little problem with the way you have framed these matters in that I don’t see any place for a person like myself within that frame. First, you describe yourself as a “mental health” activist, and I am anything but a “mental health” activist being an antipsychiatry human rights activist. I don’t advocate for the pathologising, drugging, and treatment of physically healthy people. Second, I don’t equate psychiatric treatment survivors with psychiatric service users. Every “substance user”, for example, is more of a potential “substance use” casualty than they are a potential “substance use” survivor. Not ingesting harmful substances increases ones chances of overall survival greatly. Paternalism has always been a big part of the problem. Rather than buy into the paternalistic system that we’ve got, some of us would opt out of it entirely. The biggest problem with this system is the presumption of–what would you call it–wrong, defect, “illness”, “trauma”, “stress”, etc. Psychiatry used to call denial of “mental illness” a defensive mechanism and say that people “in denial” of such were “sicker” than people who weren’t “in denial”. Now it has come up with a separate disease category lifted from brain injury regarding what it sees as “lack of insight” into the nature of one’s “illness”, anosognosia. Bunk! I never wanted “treatment”. End force and I’m happy. As far as “treatment” goes, or “service” is the word they use nowadays, is it not? In my case, just put down n/a.

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    • I am not sure I fit in either Frank. During a revolutionary war there is one side more or less happy with the way things are and the other wanting a change.

      During the American Revolution there were the Tories as well as those who wished to kiss the Crown of England good bye.

      I have nothing against the grateful consumers but they embrace the status quo and love the Way Things Are. What can they possibly have in common with our movement? They already have havens in NAMI, SAHMSA, and the DBSA. There’s a reason escapees of Ye Olde Madhouse don’t join these organizations.

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      • Darn tootin! Those organizations you mention, they’re the ones filling the madhouses. That’s something that should make any escapee uncomfortable among them. “Real people”? Oh, yeah! You mean those that don’t work in the “mental patient” detainment, er, “treatment”, business. Sometimes, in those holes, co-conspirators can be hard to find.

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  5. i sense a separation here between them and us…
    i don’t like it…i want to belong…i don’t want to be alone…
    and i definitely hate forced anything…
    how can anyone be a survivor in this awful world..
    and we all have to die…

    i am a person with a mental illness…

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    • hey littleturtle,

      this world isn’t so bad – though it can look like it at times
      I really agree with what you say and I think it’s beautiful and incredibly poetic

      but I think ‘survivor’ can mean different things to different people – sometimes it can be a matter of “I’m still standing” or even just “I’m still me”.

      I’m not a person with mental illness. I never have been. – t’s really important to me to be allowed to say that. But for some people it’s important to say they are – that or something else. That’s ok.

      Like you say – I too hate anything forced.

      And I think that all of us on this planet belong.

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  6. ‘democratic psychiatry’

    Psychiatrists method of killing (almost all the German psychiatrists killed their ‘patients’) informed the Nazi’s mass murder techniques. Even Hitler eventually tried to stop the murdering in the ‘Mental’ hospitals but from what I understand they continued to murder after the war.

    For me, the only word next to psychiatry should be abolish.

    “Nazi Medical Crimes at the Psychiatric Hospital Gugging” by Herwig Czech –

    https://www.youtube.com/watch?v=LPxXE-1klkQ&feature=youtu.be&t=579

    The “Euthanasia “ Program in Nazi-Psychiatry Dr Michael Von Cranach:

    https://www.youtube.com/watch?v=4YU6CHaTWb0

    Peter Breggin, MD – Psychiatry and the Holocaust–The Violence Initiative – Part 1

    https://www.youtube.com/watch?v=MQZdUmxG1Es

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  7. Dear Helen,I appreciate the effort but not there yet.
    To quote TS Eliot – that is not what I meant at all-
    When I suggested dialogue in an earlier post. I meant like Gail Collins and Bret Stephan’s weekly writing. A dialogue – could also be more voices now and then.
    The divide is not broken until listening occurs and is internalized and oh light bulb moment occurs.
    I am reminded at one hospitalization at Windsor Laurelwood they had a student nurse give us patients a talk.
    One patient asked her if she was afraid of getting contaminated by us- this was after for me 15. years as a LISW with time in the inpatient and outpatient worlds of mental health system.
    Her reply is classic and should be put down in Capitol letters in the first/ next M H system tell all book or even better Medical and Nursing and USocial Eork text books on what not to say to folks.
    Her reply was no because she had asked her parents if anyone in the family had issues and they assured her no- no one in her family had issues so she felt safe.
    I wanted to stand up and shout- you lie!
    Anyone but anyone who has worked in the system know almost all profs have had some family experience or the old sawhorse shrinks kids are the most troubled of all doctor kids. And I would say anyone who has a doc as a parent needs a 12 step program just for that.
    Another Social Worker who went on to a PhD in academia – name available upon request- discussed this. But we both were unaware – oh our dads were vets- obtbey could do great work but yikes their trauma issues really played out at home. And it doesn’t mean just Vets. All and I mean All are survivors of various types and forms of trauma.
    Until that is put up front – the bridges are still down and waters still troubled.
    The aide? Staff member – one of the great ways control is used in inpatient units- one never knows the education level. Aide? LPN? Intern?
    RN? Roving Staff? Hired help? Student working while dealing with single parenthood and school and another job?
    The aide who called me a crazy bipolar bitch probably was not just calling me that there were echoes of a past or present she was presumably unaware of.
    So please better ways of dealing with power and control. Again as porrviste the effort. You all can do better.

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  8. I’m always very wary of such “it’s nuanced and complicated” arguments. There is something at the heart of the system that is dishonest, damaging , over-powerful and corrupt: psychiatry. This much is simple.

    The question of “is a diagnosis a helpful thing” is best answered with honesty. A phoney diagnosis has to be a bad thing.

    I would throw on a cheer for carers who are really important for blindingly obvious reasons. They know the person, often a child, so they are much better placed to put it all in context, and yes they do need help and respect. Our experience was rather Alice on Wonderland with the psychos misunderstanding our fundamentally good family and even trying to suggest that we might be part of the problem, although “you guys are doing so well”. It seemed bunkum to us . They didn’t seem to have a clue, we need help from someone independent of those note taking, meeting going, scared little people who are never there when things go pear shaped. Sorry that’s just my experience.

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  9. “Binary distinctions between ‘service users’ and ‘professionals’ or the ‘mad’ and the ‘sane’ are often unhelpful as we all experience distress at some point in our lives.”

    I agree with you that – in real life – these distinctions are inaccurate and simplistic because as people we exist in all kinds of ways. We go through periods of suffering more and less, and of helping others, and of being helped.

    However, even though the binary is artificial, it also happens. We are dreaming if we are to ignore the binary that we have created. Say you enter a psychiatric clinic or hospital, you will need to either be on the giving or the receiving end of treatment, and this will decide your experience (where families fit into this is a whole other story). In these settings though, the “professional” group will gain money and job satisfaction out of the interaction. Decision-making power is given to them freely. Meanwhile, the “patient” group may be pathologized, disempowered, and will often leave the interaction with a treatment that may help or may completely derail their life and health. It’s terrifying and there’s no free movement between the groups. Voluntary or forced, if you try to explain to the nurse on the psych ward or in the clinic that today you feel more like providing than receiving, you won’t get anywhere. Your role was decided upon when you walked in.

    Then afterwards when we are not in that environment and we are talking to people, we sometimes like to explain which part of the binary we were forced into, so then we may identify ourselves as professionals, patients, ex-patients etc. It can be helpful to know also what angle a person is coming at this from. For some people at certain points in their life (such as me right now fighting for personal liberation from the system), it could even be dangerous to try and ignore the binary and to trust professionals as regular people. Overall though, I agree with you that it would be nice for both our interactions with each other and our views of ourselves to be more natural and fluid.

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  10. It sounds like you are an empathetic counselor that provides valuable assistance to the marginalized. However, I disagree with the implication of following statement: “Binary distinctions between ‘service users’ and ‘professionals’ … are often unhelpful as we all experience distress at some point in our lives.” I believe that different life circumstances naturally produce radically different intensity of distress and that few experience the intensity of emotional pain experienced by the least fortunate in the community. Thus describing some people acting “markedly differently to the way most people generally handle situations in their lives” discounts their unusually distressful experiences.

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  11. “Binary distinctions between ‘service users’ and ‘professionals’…are often unhelpful….”

    I read a YA novel back in the 90’s. Winter of Fire.

    A race of slaves called the Quelled were forced to mine coal for the Chosen. But the Quelled and Chosen looked alike.

    So…every Quelled child at age five would have his/her forehead marked with a red hot iron. This branding, creating a binary distinction, was not helpful to the Quelled. But the Chosen found it very helpful indeed.

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  12. No offense but this is how I see it:

    I think that the medication is the one variable you have to get rid of, if you ever want a dialogue between professionals and patients to be on an equal basis. They are destroy any connection there would be between patient and doctor or therapist. The main concern is to get the medication correct and they don’t give a damn what circumstances the individual is facing. And the directive is, “well if you want help with homelessness, being poor, having no job, having no support system you can fall back on, take your meds, show up to all therapy sessions, be a good little patient and maybe we can help you down the road.”

    To me that’s blackmail. I’ve seen and heard from these patients and they can’t possibly hold jobs on most of the medication prescribed. They are forced on disability. When the medication gives the side effects that would scare the living daylights out of anyone, they are told to go to the emergency room. There you go! Let’s rack up another 50 to 100K of inpatient treatment to their already miserable existence. And here comes another diagnosis or an additional diagnosis to cover up the incompetence of the whole system and of course more medication or more powerful ones.

    Oh well, there is some solace, in ten years the medication will lead to brain damage and they will need to be on it. To bad they won’t have the ability to take care of themselves but hey, that’s life in “mental illness”.

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    • I was a “good” consumer for over twenty years. They promised me that if I took my “meds” and did what the “experts” told me to without question I would become well enough for gainful employment and my personal relationships would improve. Instead my messed up thinking alienated friends and family and made working impossible. I couldn’t even clean my room!

      When I found out the truth it made sense. Crack, meth, and heroine don’t make people better friends/employees/spouses/etc., but they do provide short term benefits by relieving emotional pain.

      After being drug free for a year I’m keeping my apartment clean, making friends outside the MI System, and looking for part time work. And I blog more regularly too.

      I’m very angry. I never would have taken street drugs to cope with my problems. By lying to me about a non-existent chemical imbalance they tricked me into going against my conscience and turned me into an addict.

      A lot of other people would feel the same way if they knew and accepted it. They have the right to know too.

      Like selling cocaine to a diabetic by pretending it’s insulin!

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      • Rachel,

        This puts it all in a nutshell.

        “I’m very angry. I never would have taken street drugs to cope with my problems. By lying to me about a non-existent chemical imbalance they tricked me into going against my conscience and turned me into an addict.”

        I’m glad you made it out and you should be angry. They not only wasted precious time. They talked you into helplessness. And all in the name of greed. It should be illegal.

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        • Learned helplessness is probably the thing that the “mental health system” promotes the most. If you get people when they’re kids or teens then you can form them just about any way that you want and this is exactly what the system does to people. It also teaches people to never trust their own feelings or ideas or opinions and they must always look to professionals in the system to figure out how they should feel and think. It’s disgusting. It’s criminal. It’s inhuman.

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          • “Its disgusting. Its criminal. Its inhuman”
            Its profitable.
            Glad you point out the learned helplessness nature of the whole system Stephen. When you look at the attributions surrounding the ’cause’ of these ‘illnesses’, who are the ones that do best? The whole process is about psychologically assaulting the person until they are like Seligmans helpless canines.
            Seriously, talk to any compliant patient and they all attribute their ‘illness’ to and internal, stable and global cause. Its uncanny really, and yet makes complete sense when you see it for what it is.

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          • I guess so Rachel777 if you are of the opinion that there is nothing you can do to escape your situation (the electric shock in the case of Seligmans canines). The situation is hopeless is a form of insight.
            During the 7 hours I was being tortured (in the strict legal sense of the term) I did not once believe that escape was impossible. The coercion used after my complaint about being tortured was something else. Driven to insanity for the sake of a preferred consensus reality. Still, imagine how they all felt about calling Noah mad when the rain started falling lol.

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          • Insight was a jab at a psychiatric term. The opposite of the so-called disease of “anosognosia” or disagreeing with the label your quack assigns you.

            A consumer with Insight is helpless, subservient, childish, unquestioningly believes everything the shrink says and unquestioningly does everything they are told even if it kills them. And it has killed some friends of mine. One was 29.

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          • Ah I understand now.

            What Cool Hand Luke called ‘gettin his head right Baus’. In other words seeing things from their point of view. And until you do understand their ‘failure to communicate’ leaves them feeling inadequate.

            Sorry to hear about your friends Rachel. The exploitation of a position of trust is an evil deed, and personally I pity anyone who knowingly does such an act. There’ll be the devil to paye to use an old nautical phrase.

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      • Rachel,
        Yes, we all should be angry by the “treatment” you received. Isn’t it strange that often people feel better once getting away from “treatment”? So many of my clients tell me that they have felt “drugged up” and “out of it” on these legal drugs that the docs prescribe. I don’t understand why these supposedly educated and smart doctors keep harming people but convincing themselves it’s “medicine”? Maybe, money? I’m sure some of them really think it helps, but it is just a pure rationalization I guess. I’m glad you got to a better place in your life away from the system.

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        • I had one good psychiatrist who wanted to help his patients. Dr. Guilley. My guess is he had been sold a bill of goods. Probably Dr. Pies would call him uninformed.

          Dr. G. was very excited last time I saw him. He had discovered that by putting patients on the smallest amount of drugs possible they rapidly improved. I feel sorry for those like him. If and when they realize the truth they must really suffer from their consciences–though they are far less guilty than those in the know. The “well informed” guys.

          Something tells me Dr. G. has left conventional psychiatry.

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          • Reminds me of school. Sure there were “good teachers” and “bad teachers,” but the very essence of the system was to teach kids that they have no power and need to kowtow to their superiors. Good teachers made it more bearable, but the school was oppressive from top to bottom, and no “good teacher” could really change it.

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        • I think that keeping people on the drugs has a great deal to do with the egos of the people forcing the drugs on others. It legitimates them as real “doctors”, which has always been the problem of people who opt for psychiatry; none of the other medical specialties accepted them as real doctors when all they did was psychotherapy. I don’t know how they see them today since I’ve never asked any doctor outside of psychiatry.

          And I think that a lot of it is money. Look at the nice SUV’s they drive and the nice big houses they own in gated communities, and the nice big bank accounts. It’s very lucrative for them and they couldn’t make nearly as much money by doing talk therapy. They can do four “med” checks in one hour as opposed to one person with talk therapy. But in the end they are essentially snake oil peddlers, plain and simple.

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          • I have no ethical problems with counseling as long as it’s between consenting adults and free from abuse. Counseling does not help you if you bear the SMI label though since they view you as hopeless and remind you of the “fact.” Self fulfilling prophecy!

            IMHO, a good life coach could probably do at least as much to help you through rough life choices. Which raises the question: Why get a doctorate or MSW with intensive certification when a 12 week course could work just as well?

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          • Rachel,
            The basic skills any good counselor possess does not come from good schooling. I think they either have empathy and compassion or they don’t. We have master’s programs because it legitimizes the field and state boards require it. But frankly there are many excellent healers and listeners out in the world who have no formal education in this area. In my graduate school we learned stuff that most of us will never use in our careers, like psychological testing and career guidance.

            Any good helper will empower and remind the person that they aren’t defined by any label (and that the label is BS). A good helper will listen and not give advice (mostly). A good helper will work to instill hope rather than hopelessness.

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          • Stephen, I don’t disagree with any of that. Money, ego, etc., all factor in to docs over prescribing and over diagnosing. Also, their education teaches them to do this, so of course this will be there practice! Thanks big pharma and academia!

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          • It’s generally NOT that the counselor laughs, “Broo ha ha! I will gas light this helpless individual and make sure she never recovers!”

            More likely the counselor honestly wants to help, but even if he/she looks beyond the diagnostic label the client cannot because the new identity gets drilled into them through day treatment/clubhouse/NAMI meetings/case worker sessions/10 minute interviews with psychiatrist/controlling family members…The client lives down to this new identity. Yes, the drugs bring some relief–at least short term–for many. But they dull emotional pain by shutting down ordinary brain functions. This makes it harder to make intelligent, mature life choices.

            The therapist sees the clients continue to do stupid, immature things and gets frustrated since he’she has a personal investment though it is primarily professional. The doctor at the center says the “meds” seem to be working. The client is compliant–perhaps even forcibly injected–so there can be no doubt.

            Why isn’t the consumer happier or more productive? Why can’t they find gainful employment, make friends, or get along with family members?

            Perhaps the therapist will say things like, “Only babies want a change.” It’s easy to imagine how this can happen. One of my therapists cried out in frustration, “You just aren’t trying hard enough! The medications can only do so much.” He was one of my favorites too.

            You weren’t the only one confused and frustrated Kevin! 🙁

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          • The problem with psych meds, like many other legal and illegal drugs, is it numbs people out. I guess most humans like that feeling at least occasionally, because life is hard. Unfortunately, people who get stuck on these meds for a lifetime usually don’t function better in the world. I would rather see psych meds used in the short-term, like less than 6 months, but that rarely happens. Docs have no problem prescribing meds that they think is helping the client in some way, as long as they don’t think the person is abusing them or getting high. There is so much wrong with this way of doing things, but that is how they are trained.

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        • When I was held in the “hospital” there was a young woman on the unit with me who was pregnant. Because of this the psychiatrist refused to give her any neuroleptics for her “schizophrenia”. The amazing thing that many of us, her fellow “patients” began to realize was that, as the weeks went on she began to get better! We began talking about this among ourselves and continued to watch her. Granted, she still had difficulties but as time went on she became progressively better in her approach to things around her. She seemed to have fewer and fewer hallucinations and she was able to interact with the rest of us better than when she was first admitted to the unit.

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          • Were the psychiatrists impressed by this “spontaneous remission,” or did they ignore it and act as if she was still “ill” as she had been before? Or did they somehow take credit for her getting clearer without their magic pills?

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    • There are “housing first” programs developing in a few places and they have shown exactly what you say – providing logistical support reduces “symptoms” (whatever THAT means!) without any kind of “treatment” at all. Forcing people to accept drugs in order to get a home is not only morally offensive, it’s proven not to work!

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      • My solution? Say you get “treatment.” Then don’t. One good lie deserves another.

        HUD housing is often a slum. They know they can cut corners on basic maintenance and still get government checks from piling warm bodies in. Because of impossible standards of cleanliness–even for many not on “cocktails” of disabling drugs–the slum lords can blackmail tenants into accepting horrible living conditions.

        My place is swarming with vermin. I can’t even eat here anymore. It’s that bad. Management refuses to do squat and blames me for the problem. Only dirty folks attract roaches; so you must be dirty. My housekeeping is now a 5 out of 10. It used to be a 1, but this is the only place I’ve had this problem. When I was moving my stuff in I saw a big cockroach climbing the wall. So it was like this when I got here.

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      • Housing First is an excellent model but it is terribly underfunded. And Rachel is correct that many subsidized housing properties are terribly run and infested with bed bugs and other problems. In my community we are building one or two new subsidized properties a year, but this is wholly inadequate. We need 100x this many built but you know poor people aren’t an important political constituency.

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        • There need to be more local authorities supervising these projects too. Often they are funded by some bureaucrats who never even visit. They send a flunky or two. Everyone cleans up to hide the roaches and mold. The flunkies leave. Back to normal. Continue receiving fat checks for visiting the office 8 or 10 hours per week. 🙁

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  13. Hi,

    Thanks for your post..

    There are some thought’s it raises.

    “In recent years, I’ve noticed an increasing number of ‘critical’ mental health conferences, texts and events. On the one hand, this is very welcome. But I’ve also witnessed a corresponding decrease in alternative support services available to people.”

    I haven’t witnessed this – quite the opposite. I’ve seen a huge increase and diversity in both literature and alternative models and in professionals who are willing to follow these. I’ve also seen a huge rise in the number and type of supports available to people. Including ‘wellness colleges’ or other similar models that allow anyone to attend and don’t require ‘illness’ as a prerequisite.

    “I’m not saying there is a simple causal relationship here, but perhaps it’s easier to retreat into sloganeering or theory than engage in the messiness and difficulties of working with survivors to create genuine alternatives.”

    I think there are a lot of reasons that people retreat into ‘sloganeering’ – or other defensive behaviours – but I don’t think it’s very helpful. It might be equally fair to say “It might be easier to retreat into spewing out unregulated anger at our loved ones…” – something which is also a defensive behaviour, if we are being fair. But, as you’ve pointed out doing such things is something that is quite damaging. So is sloganeering. It’s something that might equally been seen as caused by unregulated, or ‘maladaptively’ regulated emotions.. But I’m not a fan of such dehumanising terms.. for anyone.

    As for theories, I’m personally not against theories. But in a genuine field of inquiry – a multitude of theories abound, and they are recognised as being only theories. In the history of what has been the ‘mental health field’, until very recently there has been a hegemony of a way of looking at things that isn’t even a coherent theory. That’s a fair thing to recognise, in it’s own right.

    “I increasingly think we can only reach greater understanding by working through our own experiences first, and then, if we can, alongside survivors. That will help us become more open to survivor knowledge. For example, we may need to work through our own need for control and understanding. It’s helpful to consider our own reactions to distress or madness — in ourselves and others.”

    I agree, but I also think its very important not to be too narrow in what we understand to be ‘madness’ – or who has it – or who doesn’t, and when

    “How do we respond when people break social and emotional conventions that we take for granted and that help us feel safe? It can be disturbing, frightening and deeply unsettling to not be able to understand or control behaviour which feels strange, unintelligible and dangerous to us.”

    One thing that it is very, very important to understand is that when someone lands in a psychiatric setting, they are suddenly surrounded by people who are breaking those very emotional and social conventions (and connections) that make us feel safe (and that’s true without including any of the other patients). And yes, in such a situation, it can be disturbing, frightening and deeply unsettling not to be able to understand or control the behaviour of those people that feels strange, unintelligible and dangerous to us. Especially as they have complete control over us. There are also (many) people who can land in such a setting without having broken a single social convention – just being extremely frightened in quite a timid sort of way.

    Another thing that is worth looking at is – just whose behaviour are we trying to control? Our own? Or someone else’s? As someone who has been around some very scary, unpredictable behaviour (in persons who have never and would never be diagnosed with ‘mental illness’), I can relate to the desire to control others’ behaviour. But control is not really a good thing for one person to do to another. It’s more likely to worsen things – for one thing it breaks from those emotional and social conventions that make us feel safe.

    I think the hope is that people will see that the binary needs to break down. I agree with Steve Spiegel’s comment above:
    “I believe that different life circumstances naturally produce radically different intensity of distress and that few experience the intensity of emotional pain experienced by the least fortunate in the community. Thus describing some people acting “markedly differently to the way most people generally handle situations in their lives” discounts their unusually distressful experiences.”

    Rachel777’s comment is also very apt, in it’s entirety.

    Everyone above makes some very good points. Decision making capacity should never be taken from one person and handed to another. Even when it is entirely well intentioned, it tends to end in disastrous consequences.

    People who have had experience – as family members or as carers – of people who experience difficulty with managing and understanding overwhelming emotions and behaviour, who have been labelled with ‘mental illness’ often forget that there are a lot of people who have extreme difficulty managing emotions or behaviour who will never be labelled with ‘mental illness’. Or that for those who have been labelled, there is often a lot of fear and distrust behind their difficulties (as with those who aren’t).

    We also hide, as you may have implied but not explicitly stated, behind ‘socially accepted’ or ‘socially sanctioned’ behaviours. But those are fluid concepts – and sometimes terrifyingly flawed. What the critical conferences and papers and avenues to speak and be heard provide is a means to influence what is ‘socially sanctioned’. It should never be ‘socially sanctioned’ to act violently towards another person, for example, – yet these have been ‘socially sanctioned’ in psychiatric wards. In both official ways (legal violence) or unofficial ways (illegal but denied violence).

    The reality of human beings is that being placed in increasingly powerless situations does not breed power over one’s situation or emotional life. There can’t be healing in any environment where one group of people exerts power over another group of people. There also can’t be increased ‘regulation’ – if you want to call it that.

    I don’t think there will ever, or should ever, be ‘one voice’ on what is helpful for people, that will always vary widely from person to person, hence people should be able to pick and choose from a wide variety of things on offer. But I think there are some things that it is fair to agree upon as basic human rights. And I think it’s fair to say that these have been widely violated. That isn’t going to help anyone (on any side of the artificial ‘binary’). Because as we violate those ‘rights’ (or ‘conventions’) that other people in society take for granted, we create more powerlessness, and hence less ability to ‘regulate’ – ie. feel safe.

    One theory I quite like to toy with (though it’s by no means a catch-all) is ‘polyvagal theory’ – in a nutshell, this theory encapsulates ‘flight or fight’ – the sympathetic nervous system, ‘feed and breed’ – the parasympathetic nervous system, and ‘freeze’ or ‘shut down – the dorsal vagal complex. In humans.

    Looking through this theory: if environmental cues signal extreme danger, the ‘feed and breed’ system – which is also facilitates higher-level thinking and social engagement systems goes off-line. Fight-flight or freeze responses are available but not social engagement. Of course our psyches, minds and brains are adaptive. So as we encounter more and more terrifying and powerless situations, we become more highly attuned to ‘danger’ cues in the environment. Again by ‘we’, I mean humans.

    The basic message is that, according to this theory, when a person is acting out with fight-flight behaviour and can’t seem to think straight, it is because they are terrified. That terror can be a reaction to a genuine threat in the immediate environment (which might be a genuine danger to some people – and not to others). Or it might be a reminder of past terrors. (One way the amygdala was explained to me was “imagine you were once savagely beaten by a man with a handlebar moustache….”). These are ‘primitive’ structures in our brains – they learn in ways it made sense for our evolutionary ancestors to learn. And we all have them.

    Setting up that binary between ‘sane’ and ‘insane’, ‘well’ and ‘unwell’ is one of the ways in which we create ‘worlds within worlds’. Just like a house-cat might live in the same neighbourhood as me but face infinitely more dangers, a person who has been labelled ‘mentally ill’ and co-opted into ‘the system’ (even if that person were hypothetically sane and rational at the time they were labelled) faces infinitely more dangers than a person, in the same neighbourhood or even with exactly the same “starting behaviours” as someone who has not been labelled.

    Rosenhan’s very famous “Thud” experiment in 1973 demonstrates that it is not at all unrealistic that a ‘sane and rational’ person could be – and has been – so labelled. Whether or not a person gets sent home from emergency or admitted and labelled is, even today, not dependent solely on that person’s inner – or even outer appearance of – ‘mental health’. It’s far more dependent on whether or not the person ‘assessing’ them is able to ‘understand’ or ‘relate to’ that person or not – and different people are better at this than others. People who are able to make others feel safe and accepted are also more likely to elicit more ‘socially acceptable’ behaviours from the ‘patients’ they are ‘assessing’. As the saying goes “no man is an island” – we all affect each other subtly and importantly, even more so when one or both persons are very afraid.

    “Polyvagal theory” is just one of many theories out there – theories that are still theories but tend to try to shed some light on what can happen for humans when they are very afraid, or powerless. Theories that, unlike psychiatric ‘diagnoses’ try to generate testable hypotheses, and then test them. That doesn’t make them ‘scientific fact’ – there is no such thing. Science in any discipline is always, and must always, be evolving and open to the understanding that there are other explanations for findings than those posited by the theories which prompted the experiments. As well as acknowledging that there may be other, entirely different, but equally valid ways of looking at any system, or part of it. – Or any person or society, or part of it.

    My position is that we are all in this together, nobody is either ‘sane’ or ‘insane’ and even the most explicable and frightening behaviours make sense once we have ways to understand them. There is no ‘one way’ to understand another person’s entirely subjective experience. But there are clear ways that will make most people unsafe. Powerlessness is one of them. Structures that give one person power over another require powerlessness. We don’t need those structures.

    Once we start to unravel the positions of people who believe in a binary, there are often a lot of personal hurts and betrayals, fears and conflicts-of-interest that hold those beliefs in place.

    “it’s fair to say there is a kind of critical threshold that some people reach which leads them to respond markedly differently to the way most people generally handle situations in their lives. ” – I think anyone can reach this threshold. At any stage in life. It’s also true that people can reach this threshold and start ‘acting out’ but be careful to only do so towards people or in situations where they can ‘get away with it’. That’s how I understand abuses I’ve suffered from some troubled psychiatric staff in times gone by. Abuses that were genuinely illegal, even under unjust laws – and highly ‘dysregulated’ but denied. It’s also something that might explain a lot of domestic abuse by people who have never, and would never, be diagnosed with a ‘mental illness’.

    If we are serious about helping each other in this world – and not sacrificing that genuine aim to keep job descriptions, ‘reputations’, ‘social roles’ (including ‘mad’ or ‘ill’ vs ‘sane’ and ‘healthy’) or systems that, if we are really honest, for many, it would be less fair to call a failure than an abuse – we need to start genuinely understanding the pressures that push people to such a threshold and doing something about them, skilfully. Lessening those pressures in society and learning to help people learn how to avoid and alleviate them in their own lives, when they come to us for ‘help’. That means understanding them – the people and the pressures. General psychiatric services, as they stand today, unfortunately add to those pressures, they don’t remove them or make them more workable in any meaningful way. They also don’t make any (or nearly enough) effort to understand them.

    Those ‘critical’ conferences that you mentioned increasingly don’t just criticise the status quo – they offer alternative ways forward. Ways that are multiplying, as they should. It will never be a ‘one size fit’s all’ world. Nor should it be.

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    • One aspect of psychiatry that you’ve mentioned in this comment Fred77, is something that I believe separates ‘survivors’ from others who who care and who seek change. It is the experience that is unique to being in a situation of powerlessness in which others in “caring” or policing roles can behave as they will and get away with almost anything in relation to the powerless person.

      ‘Survivors’ can have a unique perspective of humanity because of this situation. We have often have experienced degradation, cruelty, dishonesty, exploitation, humiliation, or just callous disregard from apparently ordinary or well-respected others who are not designated mad, that those who have never been in this situation could not imagine, and would mostly prefer to not believe.

      We have seen two faces of the ‘lovely and concerned carer’, the public kindness and the ugly private face of what they will do in situation in which they can get away with egregious abuse with no danger of being found out. Many of us have found ourselves in a dangerous and sadistic cat-and-mouse situation if we try and avoid that person, protect ourselves, or worse, tell the truth.

      Another, related aspect is not this kind of cruelty, but the everyday experience of a lack of normal human caring in response to suffering, and also ordinary and authentic human to human interaction between staff and patients. Those who enter a hospital as a medical patient where their identity as a mental patient is not known, could spend a day trying to describe the difference.

      I just wanted to say something about this because I believe it can be an important element of a divide between these two groups.

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      • Very well said and very true, sadly. Thanks so much for your words, it’s good not to feel alone.

        One of the hardest things for me has been how very absent it seems to be from the literature. I know there have been studies, and have participated in studies and surveys of abuse and violence in state wards. I don’t see any of them coming up in published literature. They all seem to go into ‘government reports’ that get read, and then disappear. I’ve seen someone coin the term “betrayal trauma” to talk about the shock of people who seek help from who they expect to be a ‘safe’ and ‘trusted’ person or social body eg. go to police about sexual assault or come back from a war to face a “bureaucracy” in the way of access to services. But nothing on mental health wards… Those studies really need to come out in the literature if we are ever going to move forward.

        The reports haven’t been completely lost, and have informed policy on things like “trauma informed care” – which has involved among other things an attempt to restore that authentic human to human interaction. It was really, really palpable for me to experience a ward where the nurses (at least) all talked and interacted with me as though I was what I was – a human going through a hard time.

        But there was still seclusion and restraint being practiced on that ward and the psychiatrist I had (though he was a nice person and not cruel) really didn’t have a clue and only had medication as a tool – nothing else. Although did eventually listen agree medication couldn’t ‘fix me’ and ‘let me out’ – despite still being “delusional”.

        It was time with family and friends, and some of their their patient and humble explanations that inspired me to ‘let go’ of – well as my friend put it “making connections between things that weren’t connected and then drawing a whole lot of conclusions really really fast, based on those connections”. A few days of deciding those (very fear-based) connections weren’t real and doing ‘luminosity’ like brain-training and they were all gone. I was scared and shellshocked still and it would take months (and still going) to feel safe in the world again. But there were no more connections being drawn that weren’t there, fast or otherwise.

        The fear in that experience didn’t come simply from that experience of that ward or at least not that alone – though it was a place I kept running to that didn’t feel safe, how could it? I couldn’t think straight and I was expected to negotiate for my safety – only narrowly avoiding a depo shot of the same medication I was taking for them at the same dose. (For them, not me, I knew it wouldn’t make a difference to my fear-addled brain but needs-must when it comes to ‘compliance’).

        I had to break that logic down for the psychiatrist – same dose, same medication, no ‘compliance’ issues – why on earth do you think a depo shot will work? You wanted to try a stronger medication I tried it just to make you happy, but as I predicted I still couldn’t sleep. I’ve told you I have a long history of being ‘resistant’ to medications – you need to accept the fact that I have “thought” my way into this situation and I need to “think” my way out. To his credit, he actually did. And organised me the social support I’d been begging for (and refused) for a year.

        The fear in this case came from a whole cascade of things that started with domestic violence and knowing I would need some genuine support – but not being able to find it and being terrified of what I would get instead. And it escalated, of course as fear does when there is no safe place to turn and all the ‘safe’ places are dangerous. Even when nobody there means it to be, and genuinely think they are helping.

        There were nurses in that ward that I spoke to (after they secluded other patients) who genuinely thought that seclusion was a form of ‘treatment’. It is sad, because even though I saw no “angry violence” from the staff on that ward (only ‘sanctioned violence’) and they all really were doing the best with what they knew. What they “knew” was based on supreme misunderstanding. They were terrifying, with no understanding even that they were – let alone why or how or what they could or should do about it 🙁

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        • Fred77,
          I did spend some time in a medical hospital recently and the difference makes me feel like crying. I felt safe and respected. I was ‘seen’ and responded to as a fellow human. I was in a lot of pain and that humanity made it manageable.

          We were working together in the sense that my experience was always part of the knowledge, – the feedback loop in finding a solution.

          This was a severley underfunded and understaffed public hospital. Yet there were smiles, jokes, calling back so I didn’t think I’d been forgotten about. There was compassion and awareness of, and respect for my dignity and autonomy. I agreed to every action, with explanations and alternatives offered. There was even droppings by to say goodbye and wish me well because the person’s shift was over.

          It wasn’t about any kind of perfection, just common humanity. Yet the suffering and fear i was experiencing was so much less than during my time with psychiatry.
          I can only imagine how much worse my fear and pain could have been made if I hd been treated as I have been by psychiatry.

          Some people don’t believe fish are feeling pain as they thrash around when they’ve been caught. Sometimes it feels like psychiatric staff have the same attitude towards patients – we may look like we are suffering but they are too ‘smart’ to believe we are capable of it.

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          • Nope. We don’t feel pain since mental illness renders us incapable of suffering. Ergo if we weep or openly grieve we must be manipulative. They respond by diagnosing us with Borderline Personality Disorder.

            If you prick us do we not bleed? If you tickle us do we not laugh? If you poison us do we not die?
            Shakespeare. The Merchant of Venice.

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  14. I believe that in the human experience, regardless of who we are or what is our cultural or social identity, accessing our own innate wisdom and making moment to moment choices is how we (in the world) can move forward in any respect. Relying on others for their information creates dependence. Relying on others to do the work on our behalf is equal to giving away one’s power.

    Self-empowerment comes from trusting our own unique path guided by our own unique inner voice. Life brings people together as it does. Trying to manipulate or control others via deceit and misrepresentation (fraud) is how the system was created.

    We access our own wisdom by healing ourselves. I believe everyone has this capacity. It’s just a matter of discovering it. That is what I would call taking the journey of life, growth, and evolution. I can’t think of a single exception to this. I believe it applies to everyone.

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    • Alex,

      I agree with you entirely. It’s just that for me sometimes it’s not just about wisdom or understanding. It’s about the simple matter of feeling safe with, and being able to trust, my fellow human beings.

      After enough of them have left me feeling truly terrified and powerless over a period of time – they all start to feel terrifying. I know, intellectually, that this is not true and try to encourage myself to spend time with them. But if they aren’t people I’ve known for a long time – even if I intellectually know they are ‘safe’ that is not how the body feels.

      Being able to ‘work with’ people who support and respect me changes that over time. I know they are there, they won’t deliberately betray me and any individual misunderstandings can be worked out. For me, there has been so much interpersonal terror that I need to retrain in trusting other people. That’s why it helps me to have their support. Particularly when they are in ‘professional’ roles and they are genuinely helping me – that helps me trust my society again. I know that society is far from perfect. But I can see that there are people in it who are genuinely listening, genuinely changing. That creates hope, realistic hope. It also creates ‘pockets of safety’ for me that are outside my living room. It helps me feel more brave to meet other people (I live in a different state from all of my old friends and family) and slowly feel brave enough to go back to work.

      Not everyone’s situation is the same and while it’s amazing for those for whom their own inner wisdom and self reliance is enough. That isn’t everyone. Safe places should be safe. They shouldn’t ever be places of harm.

      I’m still seeking my own inner wisdom. And for me picking up other peoples ideas and toying with them finding ideas I might develop myself or aspects that match my inner experience has always been part of that. I still reject what doesn’t suit my experience and I’m still seeking my own understanding. But being safe to do that with other people who don’t contradict me helps to ‘counteract’ all those years when I was quite literally forced to say the words ‘I am sick’.

      There’s a big difference for me between “knowing” I wasn’t ‘sick’ and feeling and being known – not feeling alone or powerless anymore. It’s huge.

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      • Trauma can compromise our feeling of safety in the world because it creates neural pathways that signal “terror” to the body, based on past time events. Healing trauma means not only coming fully into present time and discovering long suppressed aspects of ourselves, but it also means re-routing neural pathways so that we can discern what is internal vs. that which is external.

        “Is the fear justified or am I reliving trauma?” That is very powerful in depth inner work to be done, and in doing so, the body and mind come to work in synchronicity, rather than split and in conflict with each other. That is where we can feel our power, and where we will know our wisdom, without a doubt. Takes time, patience, and integrity.

        We can know whether or not we are on our path with each step, if we tune into our intuition, above and beyond fear. That is where we find our path to healing and relief, following our emotional signals along the way. Discern as you go, see what happens.

        The only thing I know to trust inherently is my own process and that which is greater than myself, which is where I find my peace and inner guidance. Call it The Universe, God, Source energy, whatever you wish.

        That energy speaks through everyone, we are all aspects of this one collective consciousness. It is up to us to discern when we are being tricked vs. when truth is being revealed. Often, it is the same thing and when this clicks, we are on our power.

        I agree with you. It is hard to trust people. Although I have learned to refrain from judging because one thing I know with certainty is that our society is filled with the walking wounded, and that can make people all sorts of crazy, especially right now, when our country is covered in a haze of toxic smoke–literally and figuratively. This is the time to heal, for one’s own salvation. Our society is crumbling big time. Watch the news lately?

        But I do trust my own sense of truth, that is my intuition. And I can feel this in my body with clarity when I am in synch with myself, following my own truth and no one else’s. Trusting my process.

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        • Read this satirical yet truthful (in its message) article, which makes a very clear point about gas-lighting from the White House, and you’ll see why lack of trust in others is justified in this day and age.

          Here is a picture of the emperor with no clothes, all his cronies, gatekeepers and minions around him (that he is using only to throw away when they are no longer useful) speaking from their well-practiced scripts. Indeed, it is fiction, but I believe it is based on a powerful and evident truth we are experiencing right now, as so many of us see it.

          https://www.yahoo.com/news/trump-shot-michael-cohen-broad-080038116.html

          The good news about all of this, imo, is that it seems the codes have been cracked. We see it, are calling it out, and not taking it anymore. This is the Great Awakening from the ever-illusory “American Dream.” Now we can get real, once and for all.

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  15. I imagine there is a lot to learn from psychiatric casualties, too, but that learning is more along the lines of what not to do. Silence, however, must tend to suffice. Compliance with treatment plans can kill you, but objecting to such compliance (or treatment anyway) only creates more complications. One gets through the matter, in very many cases, by submitting, and once released, continuing one’s private resistance. It can’t though become public, can it? If it were to do so, one might be accused of being ‘anti-medication’, or worse…I diverge from many people here in that I don’t expect any real benefits to come from human services, or psychiatric treatment, or the whole “mental health” BS racket. There is much more good to be found in self-reliance, in my humble opinion, than is ever to be found in a very over-extended childhood.

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  16. Seriously?

    Binary distinctions between ‘service users’ and ‘professionals’ or the ‘mad’ and the ‘sane’ are often unhelpful as we all experience distress at some point in our lives.

    It’s probably “unhelpful” as well to note that one of these groups gets paid, and the other gets taken from.

    I don’t understand why only Little Turtle seems concerned about the othering process reflected in this article. Who is this “we” to which the bulk of the article is addressed, as differentiated from “survivors”?

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    • I only got about halfway through the article, myself. It seemed very unfocused to me, as well as the general sense of ‘ick’ that I felt while reading it. I liked Rachel’s response to the quote you pulled from the article, about the YA novel she read that told of a world where they branded the children who were born essentially enslaved, and the usefulness of the branding to those in power.

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    • The “othering process” is problematic but I believe that the following statement is more problematic; “we all experience distress at some point in our lives” This statement erroneously implies that distressful experiences are similar- that the distressful experiences of community leaders are similar to the distressful experiences of the marginalized and disenfranchised. I believe that this false assumption provides psychiatry with substantial false legitimacy and should be criticized whenever possible.

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      • No argument with Steve; “distress” is a normal human reaction to unhappy circumstances. The fact that we all experience it is not a cue for psychiatry to step in with its fraudulent “diagnoses” and false “solutions.”

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      • I felt a similar recoil when I read that sentence. I agree that it is unfair and insulting when someone compares a temporary unpleasnt experience from a position of privilege to feelings related to severe marginalisation and disenfranchisement.

        I’m not sure that this was what the writer meant here, even though there were a few things that set me to bristling in the piece. I think she has done a good job of describing the complexity of the bigger picture, the fact that there are a multitude of people and perspectives involved, including people who genuinely care and may feel responsible for protecting the person in distress, and may also be asked by that person to be responsible, and also conflicting feelings and persepectives within an individual when in crisis, and amongst different people in distress.

        I’d like to give her the benefit of the doubt and assume she meant something like- it is human for most or all people to feel extreme distress and lost to themselves sometimes, and regardless of external status and circumstances, that pain is real and one of the things that connects all people (ideally – but such common humanity seems to be deliberately erased by psychiatry) and makes external or binary distinctions between people disappear.

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  18. Do I check myself in voluntarily? If yes, I know that ANY “doctor” can & likely will prescribe me a typical antipsychotic drug. Once this is done, I CANNOT refuse the drug without the following happening – Physical restraints then Haldol & Ativan injection. If they want my urine or blood & I refuse? Mechanical restraints & maybe I can flex my muscles hard enough so they can’t draw the blood from one of my forearms. Then they will try to get blood from my other forearm.

    If I choose not to check myself in voluntarily – I feel so much rage & fierce anxiety that I will not be ABLE to contain it. I’ll never be able to beat up an innocent person though.

    These are my choices???

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    • I hear you, Joshua7.

      Are you sure you definitely cannot control your rage? You may be right. But it’s worth asking yourself this question.

      I feel my anger at least as intensely now off my drugs. BUT ironically I can harness it for good now–or at least keep from hurting others. (By hurting I mean saying cutting things, harsh criticisms, etc. Not violence.)

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      • I was sure I could not contain the rage. I picked up an adult, carried him through the house & tossed him on to the front lawn. I was boiling over for weeks. It was just to difficult. I walked with my brother across town & checked in. They held me for 52 days against my will. There they took my citizenship & driver’s license away from me. I totally win though. Cuz now, 19 years later, I gots me SSI & SSA & HUD & MEDICAL & MEDI-CARE. I’m retired at 44!! Ha ha haha.. heh he heh

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        • I’m sorry. I know what it’s like to be full of out of control rage. Psychiatry was powerless to help me. I finally took things into my hands and did something odd by our society’s standards.

          I got help from a clergy member and got the nasty stuff out of my life. Pretty grueling and scary. My choice though. The preacher did it for free. More respectful than any shrink I have dealt with.

          This might not work for you though. And till I managed to go drug free it was still hard to keep my temper. Catch 22. 🙁

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    • I’d like to suggest that there are other things you could do with the rage than either a) contain it, or b) beat up an innocent person. Chopping wood comes to mind. Or an intense workout with weights (think bench press). Or scrubbing the bathtub, which is my go-to if I give a shit about being productive. Or hurling garage-sale saucers onto the asphalt, if I don’t give a shit about productive and just wanna make something “explode.” (If you do hurl saucers,though, mind the flying ceramic chips and protect your eyes.)

      Rage is such intense energy that it takes something really physical to release it from the body. Personally, I have found that suppressing my rage is VERY detrimental to my being, on all dimensions (physical, emotional, spiritual) so I only ever contain it just long enough to get myself to a space where I am safe to release it.

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      • I don’t know any activists who do not experience rage, and in fact, I believe that when we can focus, that rage is what fuels activism, in general. Activism begins with feelings of powerlessness, which is where I believe the rage originates. This is why we fight back, to regain our power.

        There’s always the option of communicating the rage, using our voice to speak our truth. I think when we are focused and know exactly what is causing us to feel the rage, and when we can take a moment to find the words to express exactly what we’d want to say, opportunities open up for expressing ourselves in a way that feels relieving.

        For example, I’ve used Yelp on several occasions to communicate in hindsight to clinicians and agencies who caused me to feel enraged. The trauma caused by these places and the fact that we’re talking about a closed system makes it tricky, which is why the rage builds up. And more than likely, there is no response to expect.

        Still, it has definitely made me feel better in the long run, because once I say what I wanted to say to the person I wanted to say it to (or I do the best I can in this regard), I definitely feel a release of this, it’s not so intense any longer. I get a lot of clarity after this, and a bit of peace.

        This is the review I left for my last and final “case manager/therapist” before totally leaving the system behind. This was a few years after the fact, given that this kind of post-traumatic stress does take a while to heal so we can find the clarity we need to finally get the picture, the truth of what happened–

        “My experience with “Mission Mental Health” was abysmal and only created further trauma for me, out of sheer frustration with a dishonest, betraying, and backstabbing “case manager/therapist.” Basically, emotionally abusive. I found this out when I requested my case notes, which is everyone’s legal right to do. I highly recommend checking out what your “therapist” is writing down about you, and NOT discussing with you.”

        My intention was for this to ripple and awaken people to their power of having the option to request their case notes, and to hopefully recognize when they are being gaslighted and betrayed, so they can save themselves from all that. I have gotten 1 “useful” vote so far on this review, so at least I know I was heard. My hope is that everyone requests a copy of their notes as one way to take charge of these power-imbalanced clinical relationships.

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        • Yes! Here it’s called “HIPPA”. I found out I have diabetes 2 in 2011 after getting my mental health records in 2015. My mean psychoitrist diagnosed me & kept it secret. It’s super easy to get your records. Do this – 1.) Call your psych center. 2.) Ask for the records office. 3.) Tell them you need your records mailed to you. 4.) Do it though. lol :’0)

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          • Yes, it is super easy and by law they cannot refuse. You do have to sign a release, however.

            I called this case manager and said I wanted a copy of my notes, and then went to the front desk where a release had been prepared for me to sign, and they gave me a manila envelope marked “confidential,” with my entire history of case notes.

            When I read them, I realized they showed not only an extreme distortion of me, but also, a whole host of projections coming from this case manager, which explained why I had been feeling so increasingly uncomfortable with him in this weird and murky way, but couldn’t quite put my finger on it. I just knew he was saying off-base things, and wouldn’t seem to budge when I reflected this back. It was more than merely aggravating, it was rather disorienting.

            When I read the notes, it became clear to me why I was feeling what I was feeling. Those notes were like the scarlet letter “A” of stigma, and only that. I did not see myself in them, but instead, saw the dark heart of this clinician, as well as his delusional version of reality. Unmistakable.

            If someone perceives me inaccurately based on projections (and this is easy to tell, I know myself well enough to tell when I’m being projected onto), then I would say that their entire perceptions of reality and of humanity are distorted. They’re not seeing me, they’re not seeing themselves, so through what filters are these clinicians perceiving people? I believe we all know the answer to that question.

            What garbage. Although it is dangerous and seriously damaging for people–and a rampant practice–which is why I’m talking about this.

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        • For me, rage is, by definition, blindingly intense, meaning I cannot access words and cogent arguments. Rage is the primal stuff of cavemen. Once the burning-hot rage has cooled to merely anger, I can use my words to release anger. But rage? Vocalizing that would only ever come out as SCREAMING and be quite counterproductive to actually communicating anything that could be received. I cannot release something as white-hot as rage via something as civilized as language.

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          • For the record, I am going to disagree with the notion that rage is, BY DEFINITION, blinding. I do see, LavenderSage, that you wrote that for you this is the case, and I know you are not alone in this, but I do not feel this is universal, and I think that’s important to say, for reasons of permission.

            I believe rage can be channeled in a way that is creative only, and neither destructive nor hurtful. Although sometimes the truth might feel painful, initially, but that is not the same as someone deliberately hurting another, in order to avoid their own feelings. When we smart from the truth, healing opportunities are before us.

            I’m not talking about just anger or righteous indignation. I know what rage feels like. The system relentlessly attempted to render me powerless and they were damn stubborn about it. Reason never, ever worked, so I fought and healed my way out of that, but they did not make it easy.

            However, it did lead to my true soul path, so I have gratitude for my experience and see it for what it is. But there is residue from all that crap, as we know. I’ve turned it into my life’s work.

            I’ve also had a process of waking up to sabotage from my own family, which they never got that this was wrong, on their part, they would first, deny, and then, justify it. And even my partner caused me energy-draining grief in many ways. We’ve since worked it out, that took years of deep healing work separately and together, and now we work together in our creative business, in service.

            But these awakenings and the absolute stubborn refusal on the part of abusive vampires to change, even when it is SO OBVIOUS what is going on and clearly what these relationship dynamics are all about, all of that together piled up as a huge fireball of rage in me, and it was under my skin for years, causing minor health issues here and there which were easy to address naturally. But I knew it indicated I still had some leftover energy from all this running around my body, this is insidious energy.

            But my mind was clearing up and my heart was healing, so I never, ever took it out on someone else randomly nor did I ever destroy anything. I was crazy with rage, but never blind. Letting out a scream in a neutral and safe direction feels good to me, but I know what I’m feeling and why, and what I’m wanting to say about it, once I find the words and relax my nervous system a bit.

            I usually know exactly what I want to say that is truthful, but the challenge is finding words that others are willing to hear in a tone of voice which will not intimidate them, and then they have to be willing to look at themselves in the mirror but I don’t have control over that. My job is done once I’ve spoken my truth.

            That can be a helluva challenge, and often quite impossible to be heard, for a lot of reasons. But if I were to get enraged every time this happens, then I am giving away my power. I’ve learned to see it from a different perspective now, as the guides doing their work. There is light on every situation, if you can find it, feel it, and follow that thread. I imagine you know what I mean here, I’ve seen you talk about energy and shields, etc. I work with the guides, part of my process.

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          • Please don’t take offense, Alex, but I don’t think you and I are assigning the name “rage” to the same experience. From the way you describe your experience of “rage”, it does not resemble mine at all.

            In my experience, rage must be “bled off,” so to speak, in order for the intensity of the energy to be dissipated enough to be approachable. Like I said, once the rage is cooled to merely anger, the energy is then accessible to be worked with productively. I’m not random with my rage, it’s too powerful to project it willy-nilly! Once released, the energy returns to its source, of that I have no doubt. Chickens, as they say, do indeed come home to roost.

            And, I find destruction quite useful, actually. I rip old clothing to shreds, for instance, in order to create the strips of fabric I can then weave into rugs. Destruction is an act of transformation!

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          • Of course no offense taken, LavenderSage, we are different spirits and we have different experiences of emotion and how we channel them. I believe that is the diversity of the human experience, on the whole. It’s why, when it comes to healing, one size doesn’t fit all in any respect.

            I do agree that destruction is a step to transformation. My personal preference is to bring light in order to create, and when shadow lights up along the path of creation, it only serves to keep lighting up the path to the new while the old caves in on itself from its own sabotage energy and renders itself obsolete. For me, personally, that is more fulfilling and it’s kind of a catch-all, takes care of everything at once. But I do believe that to allow for the new, the old must be released, or at the very least, transmuted.

            When it comes to social transformation, the way we talk about in here, I believe we each have a role in this, and we end up playing the roles which we are most naturally inclined to play, based on who we are and what we believe, and to where our life path has taken us so far.

            I also believe this is flexible, we can change roles if we want to. Our perspectives can shift drastically during a transformational process.

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      • I love the saucers on the asphalt plan! I used to volunteer to do glass recycling and would throw the glass bottles as hard as possible into the glass bin. I found the shattering most satisfying, especially a nice, thick olive oil bottle into a big wine jug. Crash!!!!

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        • Thanks Steve! I used to keep a stack of throwing saucers on top of the fridge when my kids were toddlers. The house we lived in had a backyard full of spearmint (mint is very aggressive and will take over a whole yard if you let it, and I let it!) and the alley behind our house was my “hurling range.” Used to keep a broom propped against the back fence to sweep up the bits of shattered rage. Satisfaction smells like mint! I’ve been living urban for many years now, and have no safe “hurling range” nearby anymore. Pity.

          I know the CRASH sound, enjoyed it, ceramic is more dull/deep than bottles. But it was the feeling of power being transferred, flowing out of my hand into the rage object as I hurled it into the asphalt, and the rage energy shattering as the saucer exploded into bits on the asphalt that was so satisfying, not so much the sound per se.

          I have a special love of shattered glass, though. Have bins and buckets of it in my art space. I choose a larger piece to be the base, grind the edges smooth, and arrange and layer smaller chunks and slivers, along with bits of found objects — like shiny foil candy wrappers, or a strip of holiday tinsel, or a twisted piece of wire– on top of the base. I seal it with epoxy, and voila! I wish I could post a picture here so you could see, because my description does not do it justice.

          The sound of the shattered glass tinkling as I sift through a bin, or the soft roaring sound it makes if I tip/twist a bucket of glass shards to watch the cascading bits and wait til just the right one catches my eye, is the sound of creativity. It’s the doorbell signaling that the Muse has arrived! Well worth the blood sacrifice – I almost always get a small finger cut, it’s the price of playing in broken glass!

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  19. I think back to the response in parliament from the Minister for MH when asked about the results of a survey that suggested that 45% of women patients in hospital settings had been subjected to sexual assault. “You can’t listen to them, they’re mental patients.” Maybe she would hear a complaint about there only being two flavours of jelly with dinner?

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  20. I took the path of meds. That was 19 years ago. You people here are better than I am. Zyprexa gave me diabetes. I hate my life. I an addict alcoholic. I’m only 44 & I’m almost dead from chronic pancreatitis & cirrhosis. I have chronic nerve disease. I lost.

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  21. If I may? Zyprexa did & does help me. Soon after taking it, I got such a relief from my quantum voices. They came back five years ago, but they are more interesting now, than they are confusing & paralyzing. Zyprexa may cause diabetes, death, & obesity – but it sure helps me. Peace

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  22. “the messiness and difficulties of working with survivors” I could say the same thing about being a survivor trying to work with psychiatrists, but would have to add danger to the list.

    I liked your essay.

    It is a mess, we can’t work together. I agree. Just wish that “difficult” wasn’t so quickly attributed to survivors. Wish there was less truth to it. are we really more difficult than you? if we did a study?

    Would I be my old professional self, reputation for being great with people, if I was a paid professional again? I don’t know. I didn’t act up and out until i was a patient. ANGRY.

    Don’t be weird, or too much, or too mad, Don’t make the professionals scared or uncomfortable or confused. Push for change, but don’t push? I don’t know what is needed from me. My intensity is rational if you consider that 1. I am expected to work with MH professionals who remind me of past life threatening traumas. 2. There is a lot riding on this for me… like my life and the lives of my friends. 3. I really want to belong to something meaningful, not as a client, but as a friend. An equal.

    If a survivor is truly viewed as equal would our feelings change?

    If a survivor had proof that they were equal and respected as such, would I still be so afraid of what you could do to me? Or of losing you?

    Maybe the wise ones are the ones who get away. The ones who get out and just disappear.

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