The real question is whether the âbrighter futureâ is always so distant. What if it has been here for a long time alreadyâand only our own blindness and weakness have prevented us from seeing it around us and within us, and kept us from developing it
âVaclav Havel, The Power of the Powerless
How do we talk about mental illness in a world gone crazy? When mundane events increasingly take on the character of the surreal or the apocalyptic, what does it mean to be normal or sane? I believe these kinds of questions will shape our understanding of the future of mental health.
Sober scientists now tell us that human civilization is in imminent peril. In the US, life expectancy is declining, and tens of millions of people, including children, are taking antidepressants and other psychiatric medications in an attempt to deal with ordinary life. We have become a sick society, and the signs are all around us.
Yet these things are not acts of God. They represent catastrophic failures of governance. This was preventable. Our ruling institutions have betrayed us for a profit, and they have lost any claim to legitimacy.
What then must we do?
Weâre living in a moment when the public discourse around mental health increasingly relies on terms like âcrisisâ and âepidemic.â The headlines announce a âdepression epidemic,â a âsuicide epidemic,â or a âyouth mental health crisis.â Additionally, we hear about an âopioid epidemicâ or an âoverdose epidemic.â This proliferation of terms tends to obscure the larger overarching pictureâthat of a society in deep distress. Whatâs going on here?
If we step back for a moment, it is impossible to avoid the conclusion that our various mental health âcrisesâ are part of a larger pattern of interlocking national and even global crises. The prospect of global ecological collapse has created a generation of futureless youths. Extremes of inequality and downward economic mobility have stirred fascist movements around the world. And perhaps the most telling statistic is the declining life expectancy here in the US, likely driven in part by âdeaths of despair.â All these factors have to some extent been exacerbated (and obscured) by the COVID pandemic, but all were in place well before that.
From a public health perspective, an epidemic is usually met with efforts of prevention. Causes are isolated, and mitigation programs are put in place. But nothing of this kind can be found in relation to an epidemic of âmental illness.â Public health literature regarding mental illness usually confines itself to projects directed toward expanding treatment. The underlying belief seems to be that we could heal a broken world if only we could pump out enough psychiatric medication.
The inability to see and name the root evils of our society pervades our institutions and profoundly affects the practice of mental health care. We may call it institutional corruption, or we may call it collective insanity. But the result is that our systems of treatment almost invariably start from a premise of individualized psychopathology. The very concept of epidemic mental illness has not entered the lexicon. Those specific methods of treatment that are most appropriate in an epidemic have not been identified or studied for their feasibility in addressing issues of mental health.
Where does that leave usâwe who are suffering? If we go to see a psychiatrist, the psychiatrist immediately reaches for the prescription pad without any deeper inquiry, maybe telling us about a âchemical imbalance.â If we go to see a psychotherapist, the psychotherapist has his or her own theoretical biasâcognitive, psychodynamic, etc.âand confidently tries to fit our suffering into his or her system.
But what if weâve just caught the thing thatâs âgoing aroundââthe epidemic disease? What if weâve spent our whole lives surrounded by others, starting with primary caregivers, who were themselves anxious, depressed, distracted, isolated, and emotionally shut down? What if weâve spent our days of work and play staring into electronic screens? What if every dimension of our lives is controlled by huge, faceless bureaucracies that could at any moment take away our livelihood or refuse to pay for needed medical care? What if our life consists, as Chris Hedges said of the poor in America, of âone long emergencyâ? If our existing systems of care cannot even name these things, how can they treat them?
The exact nature of the factors behind the epidemic is complex and has yet to be more clearly explained. Wilkinson and Pickett in The Spirit Level have shown the pervasive psychological effects of economic inequality. Economists Case and Deaton have explained the behavioral health aspects of downward mobility in their work on the âdeaths of despair.â The ACES research shows the extent of the profound mental and physical impacts of trauma. Existential factors endemic to modern society include social isolation, loss of meaning, and disempowerment.
One theory now gaining some currency holds that smartphones are a primary culprit. While this may satisfy our need for simple explanations of what is going on, it is far too reductive to account for the broad scope of the crisis. However, the problem of smartphones is in some ways particularly emblematic of the perverse dynamics of our technological society. Almost every advance in technology makes corresponding demands on the human person. The servant becomes the master.
From this standpoint then, the systemic and institutional failures of mental health care are just reflections of a larger catastrophic failure of vision and governance that touches almost every aspect of modern life. These failures have been extensively explored in the pages of Mad in America and elsewhere. The same kinds of forces that make the larger system so resistant to change also block worthy efforts at reform in mental health care. If we canât even see the need to save the planet, how can we be cognizant of the need to reform psychiatry?
On the front lines of the battle to stave off climate disruption, many are now reluctantly acknowledging that the window for preventing disaster is closing and that we must shift our focus to local efforts at mitigating the worst impacts. In the same way, local communities cannot wait for institutional mental health care reform to become a reality. Instead, they must begin the urgent work of mitigation of the worst mental health impacts now.
If it proves impossible legally to compel the ruling power to change the ways it governs us, and if for various reasons those who reject this power cannot or do not wish to overthrow it by force, then the creation of an independent or alternative or parallel [society] is the only dignified solution…
âIvan Jirous, Parallel Polis: An Inquiry
In the second half of the twentieth century, in the Communist states of Eastern Europe, the concept of parallel society emerged as a response to totalitarian systems of governance. Rather than directly confront the oppressive power of the state, a variety of grassroots, non-state institutions grew up outside of official control. Something similar is now happening in the field of mental health. Already a series of initiatives are taking shape outside the field of professionalized mental health care as communities begin to take ownership of their own healing. The goal, then, is not to reform the existing practice of mental health care, but to make it possible for individuals and communities seeking mental health support to be able to opt out of the institutional system.
[The parallel society] began in spontaneous acts of mutual self-defense in different parts of society. Those who take part are active people who can no longer stand to look passively at the general decayâŚrigidity, bureaucracy, and suffocation of every living idea or sign of movement in the official sphere. And because these people sooner or later recognized that efforts to bring about the slightest improvements in the official sphere were exercises in futility, it was only a matter of time before they said: Why not invest our talents, abilities, goodwill, and enthusiasm into something that no one will be able to corrupt, that we will be able to decide about ourselves in the end.
âIvan Jirous, Parallel Polis: An Inquiry
This emerging âparallel mental health careâ is remarkably diverse in its origins in a variety of academic disciplines, social movements, and cultural influences. For the same reason, it remains painfully fragmented and siloed. Its different elements often exhibit tremendous growth and vitality in their isolation, but they appear to have little awareness of each other. And any notion of joining and integrating these diverse elements remains purely speculative for the moment.
These elements include the following:
- Peer-led initiatives: Peer respites, for example, are now an established alternative to acute care psychiatric hospitalization in some communities. Also, Community Bridges or level-of-care transition programs by peers have demonstrated success. Support groups are a common element, including specialized support group formats like the Hearing Voices Network.
- Trauma and resilience initiatives: Drawing largely on the research into adverse childhood experiences (ACES) and emerging primarily from a social work milieu, these projects focus on raising community awareness of widespread trauma and its effects, as well as various paths to mitigation. Projects like the Community Resilience Initiative are showing how we can teach effective nervous system regulation practices to groups. Examples like the Self-Healing Communities Model in Washington State demonstrate that these approaches can be effective on a large scale. Bob Doppeltâs work on Transformational Resilience provides a blueprint for how communities can organize themselves to build resilience in the face of climate change.
- Psychedelics: While still controversial due to a welter of legal, cultural, and safety concerns, it now seems unavoidable that psychedelics will be part of the mental health care of the future. Further, it will be impossible to restrict them to a professionalized container, as many would like to do. Even as legalization proceeds apace across the country, ayahuasca circles and similar events can already be found in many communities. Initiatives like Medicinal Mindfulness in Boulder, Colorado are teaching how groups and communities can safely use psychedelics for collective healing.
- Recovery education: NHS-funded Recovery Colleges in the UK and similar programs in the US take an education-based approach to mental health challenges that is loosely based on a recovery model. These typically involve some significant degree of peer leadership.
These and perhaps many other threads will come together to make up the new parallel mental health care. The current challenge is to begin to integrate these into a viable model of community-based and peer-led mental health support that can function outside of the institutional framework of regulation, licensing, insurance, professional norms, and so forth. Dutch psychiatrist Jim Van Os and colleagues, in a visionary paper looking to the future of mental health, have suggested that âthe concept of recovery may serve as the organizing and integrating principle for the novel mental health serviceâ of the future.
They further describe a vision of a âlocal healing community fostering connectedness and strengthening resilience in learning to live with mental vulnerability. Peer support, for example, organized at the level of a recovery college, may form the backbone of the community.â In the future, perhaps these community mental health education centers will offer, in one location, classes and support groups on topics like individual and collective healing, trauma and resilience, safe psychedelic use, mental health lifestyle and self-care practices, and so forth. It will also be necessary to make clear to people that their suffering is not the product of an idiopathic broken brain syndrome, but is a result of living in a toxic culture that has reached its breaking point.
Here it is necessary to confront an uncomfortable truth about the creation of these parallel initiatives: mental health professionals, even the most enlightened, will almost invariably be an obstacle. Experience shows that professionals resist any suggestion that they may not be absolutely essential, or that their services may be flawed or lacking in anything regarding mental health treatment, or that there are alternative models that donât include them or that challenge their guild interests.
Two points need to be made in this regard. The first is that conventional mental health interventions are not very effective. In a massive 2022 study of studies paper, John Ioannidis and colleagues conclude:
In summary, a systematic re-assessment of recent evidence across multiple meta-analyses on key mental disorders provided an overarching picture of limited additional gain for both psychotherapies and pharmacotherapies over placebo or TAU. A ceiling seems to have been reached with response rates âĽ50% and most SMDs not exceeding 0.30-0.40. Thus, after more than half a century of research, thousands of RCTs and millions of invested funds, the âtrillion-dollar brain drainâ associated with mental disorders is presently not sufficiently addressed by the available treatments. This should not be seen as a nihilistic or dismissive conclusion, since undoubtedly some patients do benefit from the available treatments. However, realistically facing the situation is a prerequisite for improvement. Pretending that everything is fine will not move the field nor will findings conforming and producing more similar findings. A paradigm shift in research seems to be required to achieve further progress.
They go on to clarify that these statistically âsmallâ effects may not even be at a level to be clinically detectable.
The second point is that effects observed in these studies are not attributable to the technical aspects of the interventions. While these are sometimes understood as the âcommon factorsâ of psychotherapy, Van Os and colleagues point out that this also applies to pharmaceutical interventions. In short, the same effects appear regardless of the character of the intervention. They conclude that âwhile the diagnosis-EBP symptom-reduction model is framed in terms of technical skills and specialized knowledge, the evidence also indicates that a good case can be made for the relational and healing components of ritualized interactions mediating clinical improvement.â The further implication is that these ârelational and healing componentsâ can be removed from the context of professionalized mental health care and administered in community, peer-led, and paraprofessional settings.
Above all, these parallel mental health initiatives must position themselves as correctives to the dehumanizing effects of techological society and Darwinian capitalism. Like the proverbial frog in boiling water, weâre oblivious to what is actually afflicting us. Rarely do we question the assumption that we should meekly take our antidepressants and soldier on in the face of the ever-escalating demands of modernity. This questioning in itself becomes a radical act. It is one small step in the greater project of reforming a society based on profit, and creating one based on love.
Weâve created a complex, expensive monstrosity of a system that just doesnât work very well. And it is in the nature of such a system run by specialists that humbler interventions are neglected in favor of something elaborate that justifies the salary of the specialist. The basic therapeutic principle that one should start with the most conservative interventions and work toward the more aggressive is forgotten. The perversity of the situation is captured in the observation that physical exercise often works better than medication for relief of depression. But the psychiatrist does not mention exercise before prescribing. This is a disservice to the patient bordering on malpractice. The specialist is incapable of explaining and exploring options with the patient. What you get is what they do. You go to the psychiatrist, you get pills.
The system has at every turn evolved to meet the needs of the specialists for complexity, like a therapeutic hammer devising an ever-evolving taxonomy of nails. Part of the function of the local healing community, then, is to protect patients from the system: to make sure that they understand their options, to help them to fully explore conservative interventions, to provide some guidance on how to think holistically about their situationâspiritually, existentially, physically, emotionally, and so forth.
Of course, professionalized mental health care is not going anywhere. It is now widely reported that there are shortages of mental health professionals in many communities. This in itself is one of the strongest arguments for the creation of a parallel system. According to some recent statistics, nearly one in four Americans is taking psychiatric medication. And the numbers keep going up. Furthermore, it seems that Americans can scarcely bring themselves to question the authority of the mental health profession. A âcult of expertiseâ prevails in matters of mental health, so that individuals have come to feel that they are not competent to deal with their own most intimate possession â their own minds.
But Americansâ faith in their ruling institutions is declining, and for good reason. The spell of the literal and figurative priesthood has been broken. Just as it has become increasingly common for individuals to declare that they are âspiritual not religious,â I hope and believe that it is only a matter of time before people turn against the psychiatric priesthood and find that the answers are within themselves and within their own communities.
Great stuff.
I think what Ethan describes here parallels the Protestant Reformation, something in no small measure spurred along by the invention of the printing press. Only these days we’re lucky enough to now have the electronic printing press, better known as the internet, the fortunate consequence being it’s no longer possible for “mental health professionals” to hide behind their iron curtain of pretention, aka “professionalism”. Likewise, the leaders of the catholic church went to town having people believe they needed a priest to absolve them of their “sins”, which was, of course, a load of pious bullshit. And now people are finding out just what the “experts” in “mental health” have been up to, which consists mainly of pledging allegiance to a biased system the dynamics of which are best describes as intractably narcissistic and therefore more beneficial for those who work in it.
IMHO.
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“Teal Swan Brutally Dissect Modern Therapy & Healing”, from the I Wish I Knew Podcast
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“8 Hidden Dangers of Reframing Your Thoughts”, Teal Swan
“Stop Trying to Regulate Your Emotions!” Teal Swan
“Accept This Truth to Experience True Happiness”, Teal Swan
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It’s high time for the piece of shit paradigm of “talk to me and pay me money” be given the boot.
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CLARIFICATION:
Itâs high time the piece of shit paradigm of âtalk to me and pay me money because I know better than youâ be given the boot â
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You mean prostitution with or without the sex?
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It doesn’t matter what you call it. The dynamics of psychotherapy are not the stuff of healthy relationships.
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Thank you for speaking so much common sense, Ethan.
“But Americansâ faith in their ruling institutions is declining, and for good reason. The spell of the literal and figurative priesthood has been broken. Just as it has become increasingly common for individuals to declare that they are ‘spiritual not religious,'” which is also for good reason.
“I hope and believe that it is only a matter of time before people turn against the psychiatric priesthood and find that the answers are within themselves and within their own communities.” Let’s all hope and pray for the day.
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Thanks Ethan
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It’s nice to see an article on Mad in America which foregrounds the total global crisis and a total global social-historical system that is out of control, that no-body can steer, and that is heading off a cliff, but two fundamental distortions in your perspective blind you to the full and clear picture, which you almost have. First of all you chalk it all down to a failure of governance, which is so easy to do. How do you explain this failure of governance? Is it a spontaneous and inexplicable eruption of either poor quality candidates, or candidates with poor morality? If so how do you explain this? You see – you have formed a convenient conclusion which has prevented a deeper, penetrating perception of the problem, so let’s take this idea of poor governance away and approach it dispassionately without prejudice.
This is what I see. The poor governance, the insanity of psychiatry and psychopharmacology, our own destructive and stupid socially conditioned lives and industries, and the derangement of our health, instincts, emotions, hearts and brains are not in any way seperate problems at all. They all express the limitations and dysfunctions in the total social consicousness of humanity which is manifestly, self-evidently in crisis. Symptoms include the record drug and alcohol deaths, the record homelessness, the record mass shootings, the astonishing rise in mental health maladies of every kind, the appalling rise of deranged conspiracy theories scrambling the brains of half of America, the increasing poverty and depravity of our politicians and our politics, the stupification and destruction of intelligence that has been going on now for over a century – we have a human consciousness in crisis which produces a world in crisis. Now, do you think parallel mental health care is going to do anything about this massive, vast crisis that already HAS destroyed the Earth and all our children’s futures? Obviously not. Do you think voting democrat is going to stop it? Do you think launching an invasion of China, Russia and the Middle East and rolling out environmental and climate initiatives etc are going to be the solution to the vast human crisis that has already destroyed everything worth living for? OBVIOUSLY NOT. So there IS no social or intellectual solution to this vast crisis – and there cannot be hope at all in anything but admitting this painful fact, and letting that fact transform us.
The only immediate problem for us now is to DARE TO SEE, ADMIT AND RECOGNIZE THAT THERE IS NO HOPE AT ALL, socially, or intellectually, that we ARE in a car crash that no-body can stop, and it’s just a question of the body count and whether or not humanity and the Earth can survive this car crash at all. Can you possibly deny this? Then can you admit this, and if so, why not? TELL ME IN WORDS. Don’t shirk this. Let’s have it out. We all need to know.
And who are the insane, really? Those that are crushed and destroyed by this stupid, brutal and fatally destructive social-historical process that has enslaved the whole Earth and humanity only to destroy it, or those who still have ridiculous hopes in this total process that has destroyed everything worth living for?
And do you see the triviality of returning to the issue of mental health treatment after discussing this total crisis? Sure, as a way of exposing the vaster problem a critique of psychiatry and mental illness ideologies have validity, but to imagine we can procure yet another attempted solution from the social process is idiocy beyond measure if you just use your eyes and your sanity rather then referring to your non-factual hopes, ideas and opinions.
I hope I have robbed all the words from your mouth, and you are quiet with me. Otherwise, spit them out. We need to argue this thing out TO THE END and nail down the truth. Nothing else is important but the facts, the truth, the actual. If we can all acknowledge what actually is then there’s something that we can all agree on, but opinions are the fraudulent form that destroys our capacity to see what is clearly and diverts our intelligence down dead end lanes like parallel mental health care. That’s like having a priest on a concentration camp to comfort the doomed. It’s nice to have comfort from a priest but it doesn’t compare to destroying and escaping the concentration camp, or to die trying.
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Thank you No-one for once again calling out the overeducated half-wits who to me seem almost congenitally unable to stop themselves from believing that answers to psychic healing can only lie in the minds of those trained in the excesses of academic gobbledygook, aka “research and treatment”, a bureaucracy all its own.
Here’s what they refuse to see: that healing is found in the spontaneous, heartfelt connection between like-minded individuals who have no financial or egoic (narcissistic) agenda. In other words, between clear-minded people who don’t have to be paid money to actually give a goddamn about someone else.
In all fairness, though, this author does say this in his conclusion: “I hope and believe that it is only a matter of time before people turn against the psychiatric priesthood and find out that the answers are within themselves and within their own communities.”
FWIW, I personally believe the spiritual revolution is well on its way.
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Amen Birdsong. You say: “Hereâs what they refuse to see: that healing is found in the spontaneous, heartfelt connection between like-minded individuals who have no financial or egoic (narcissistic) agenda.” This is not something I felt but now you mention it I see there is an indespensible part of human healing that comes from connection with exactly as you say, like minded non-egoistic, non-extractive/exploitative relationships, which I find to be such a rare thing in this world. The best relationships I had had moments of this, sometimes moments which predominated for a certain period of time but basically this dysfunctional ego is something that cannot help but sabotage these moments.
I do often wish I could know one or two people without ego at all. I do have some of the energetic and thought movements of ego, but they are very different then most people because the brain sees them as hostile and false movements that drain it’s energy rather then a real me, and they arise as defensive mechanisms against other egos largely, or else as vehicles to express energies that are hostile or sabataging, and these energies derive from environment, other people and possibly parts of the consciousness that do not support the spiritual process that’s taking place, and I agree, or know, there is a revolution taking place, but the idea that this revolution is going to sweep the whole of humanity, which Eckhart Tolle rediculously implies, is absolute bullshit if you ask me, as the whole world proves. Definitely most of humanity will never understand this process that you’re talking about and at the moment would think this was our insanity, and it would or will utterly shake their world to discover it, because you can’t just click your fingers and hey presto, the ego problem is gone, because that ego has conditioned your whole structure of your life, your neurology, your desires, your relationships, everything, so to discover the truth too late I would imagine would destroy people. I have such a sense of impending horror about many things. The human apocalypse is one thing: but the spiritual apocalypse is what I fear.
But anyway, what i wanted to say is that it is this self-defence and security seeking that is the last bastion of the ego for me, but if I were in a community as you describe I feel that it would have no role at all, so what you say is thought provoking. Having said that, I am not certain if I will ever know such a community in my life time. If it were to happen it’d be a miraculous event because really, the kind of community you describe in such simple terms would be the seed of a whole new humanity the likes of which has never been known. And it’s so simple. However, our brains have been thoroughly conditioned by mellenia of domination and bullshit, and it is far from simple clearing up this bullshit. The how is very simple – be aware of the bullshit all of the time, but the doing of it is so much harder because the effective of this bullshit in our heads IS what we call ‘mental illness’, but the watching of it is meditation and in that there is healing. But I still need to drink and take drugs to get through this crazy social reality I live in – the mental illness is now outside of me. It’s called society and it’s the worst psychosis imaginable. It’s like watching paint dry compared to a real psychosis which is like watching saints fly. Anyways, always lovely to read your comments Birdsong. I think you’re the sanest voice on here, you and Steven Macrea, also Richard Whittaker if he were to write on this. He’s sane but he’s too vanilla. He needs to crank up the volume and become enraged. He’s also delusional about the extent of horror that is psychiatry and mental health treatment and society. But your relentless critique is not negativity – it’s sanity and truth. You deliver it in a cool way but it’s a devastating and true assessment you have of the whole grift. Anyways, have a nice day Birdsgong and America! I can’t read Mad in the UK because the UK is too depressing. It is far more sane then America though, hence we’re all depressed. đ
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Dear No-one, thank you for your kindly complements as I do appreciate them.
I think having a healthy ego, or strong sense of self, is an imperative for every person, as long as it doesn’t become inflated. When I use the word ‘egoic’ I’m referring to egocentric individuals. As for community, I’m not quite sure what Ethan is referring to, but for me this just means a greater number of people around the world finally seeing psychiatry for the grift that it is.
I’ve found that coming to terms with an imperfect world is not out of reach, and may even be simple, as long as I remain true to myself first.
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“Non Reactivity is Not Necessarily an Indication of Health or Enlightenment”, Teal Swan
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Thank you for this comment. To assume there is a one size fits all solution to mental health issues, and in fact, all of humanities issues, is fool hearty. To open oneâs eyes and make careful decisions along the way is the indeed the key. Claiming that society can solve issues on its own, unchecked, is a recipe for disaster and what will follow is cults, extreme religions, or the like, in which results in someone wanting the ârule the worldâ. Have you ever seen âLord of Flies?â
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She dreamed of many eggs and many seeds. They are the same thing really. We are the same thing dropped on many different soils. You’ve been dropped on a cabbage patch: she’s been dropped on a hill. They in a forest, and me, always having to be different, was dropped in a volcano. You’ll be the flower of tomorrow and Ill be the coal. You’ll witness the apocalypse and probably I’ll be the energy behind it. And I’ll be glad to ruin you’re days. But you can keep all of you’re tomorrows. They are yesterdays anyway, just in a different guise.
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We dream of rotting meat with many flies. We’re the same thing really. Infested by past failures and hopeless desires, they screech out of us and confront and torment us as these relentless foes, these merciless karmic devices, these red and black flies. And we are being eaten also by the purple and olive green magots we created who no longer even care if we’re still alive. It is the revenge of lost and voiceless children who were never known, who blinked in and out of existence like pitch black night flowers, who haunt our unconscious today as they once haunted dark corridors of the Earth. Now they come back to Earth through the corridors of our dark minds. Our ancestors had to throw them a carcass, and they threw them us. We just want to rein again anyway in puddles full of tomorrows yesterdays. I say break this egg and let ourselves drain away. That’s what I did. It turns the brain and consciousness into a kind of multichannel TV. It is black with rainbow colours and only the light is watching.
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This article seems to be saying capitalism bucks without saying it directly.
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I think the problem is that there is a diluted mental health system with too many people thinking that being a therapist can be done by anyone. It is a science. It should be data-driven & it is not just talking to someone & each therapists should be trained in multiple modalities to tailor treatment that is best for each individual person. That is what anyone who has had improvement in therapy & a good quality trained therapist knows. To add to this few psychiatrists are adequately trained to do anything more than prescribe medication. I am a psychologist for many years and have seen the failings of our mental health system across many systems (jail, hospitals, outpatient clinics, private practice) but three things appear to be the major problems: 1. Insurance companies not valuing mental health care leading mental health care professionals (who are not from wealth) unable to support themselves if they take insurance. 2. Accordingly, people who want to be a therapist choose the short non-science-driven route to training in order to avoid debt & choose for-profit only roles and insufficient cheaper education resulting in far too many improperly or under-trained mental health care providers and 3. Articles like this one that give over-simplified misinformation & encourage people to avoid mental health care due to lack of confidence in the system⌠& given #1 & # 2, I can understand why. The problem is we need articles that tell people what to look for in obtaining quality mental health care (i.e., how to avoid garbage providers) & to increase insurance reimbursement to make quality care more accessible. I am all-for people doing whatever works but I already see a for-profit slippery slope with community efforts that become misinformed & âcult-likeâ followings & a waste of time also accordingly. In short, capitalism does suck but alas it is what we have to live with in this country. I also see a huge wealth disparity in education. Coming from a low income upbringing, I was the only person my age (i.e., older due to having to work & save several years to pursue a doctoral degree) & having much student loan debt in my cohort. I chose the route I did because I believe in science-driven care having personal experience with a good kind quality psychologist (who took insurance) when I was a troubled child. However, as I indicated, I understand why going a well-trained route is not appealing to people who stand to make the most difference (i.e., those who have the lived experience of struggle). I also choose to practice being keenly aware of how EVERYONE should have access to quality mental health care and take insurance and I work on a giant sliding scale. Because of that, Im also well into my 40s & canât even save enough to buy my own place despite being full on clients & working 12-14 hours a day doing therapy. The point is money is the problem, as it is with all things. All this article does is say that & deters people from actually looking for real quality help ⌠which again, is really hard to find because of wealth disparity resulting in lack of a access, lack of training & lack of fair reimbursement for people trying to counter those things. What we need is more information about what you should look for in a therapist, a move to make education affordable in this country (I did 10 years working in public service to get my loans forgiven which limited my income & ability to save or live a decent life BUT did help me help people who really needed it which was worth it), as well as creating fair reimbursement for insurance rates so that more highly trained therapists take insurance & make good therapy accessible for anyone with insurance. I myself had to engage in my therapistâs post doctoral training program in order to afford her because my insurance only pays $60 a session. I really think we need reform to encourage better care & not to spread more misinformation that deters obtaining care, which is also biased based on the agenda of the writer who cites carefully selected research after insinuating research is all biased.
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I can’t really agree with you here. It seems to me that providing therapy is more of an art, though it should be informed by science. There is no way to train someone reliably to be a “good therapist,” and I have seen many competent counselors who have little to no formal training. There is an element of having “Done one’s own work” to be emotionally available to a client which is simply not a factor of hours of training or scientific findings. The proof is in the pudding, and many therapists with advanced degrees are mediocre to poor therapists, and many of the best therapists have come to it via alternative routes (I had an undergrad in Chemistry and a MS in Education, as an example). It is not such a black and white “scientific” question!
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Thank you Ethan.
Your article is inspiring. My wife and I are Medical Doctors beginning a grass roots initiative just like you have described right here in Eastern Pennsylvania.
We solve the mental health crisis by first showing people that mental health is actually just a function of brain health. Then we offer discounted or free services to physically rejuvenate the brain using the power of a new FDA cleared and insurance reimbursed brain health therapy called deep transcranial magnetic stimulation.
Our theory agrees with yours with one addition.
We believe that the brain thrives in an environment with stimulation. When the stimuli are all stress inducing or even if they are not stress inducing but just repetitive, our brain neurons are not getting the type of stimulation they need to stay healthy. We believe that many mental health conditions are actually early manifestations of neurodegeneration. Use it or lose it as they say.
Deep TMS works directly on the intracellular components of brain cells called mitochondria, which are the organelles within cells that make energy. With deep TMS we are able to create more intracellular ATP. ATP is the cellular currency of energy and life itself, and can be used anywhere in the cell, first to repair damage and then to improve function. Even a single three minute TMS session can make an impact that is noticeable for weeks after.
Our funding now comes from patients who have insurance or can pay full price, however success breeds success and we expect that our community at large will begin to support our initiative once we show the gains we are making.
Deep TMS, when provided in an inspirational setting such as ours, has the power not just to influence mood but to influence life trajectories. And when the life trajectories of numerous individuals within a mid-size community like ours begin to turn in a positive direction, the impact is massive.
Thank you so much for your inspirational thoughts. We will be using your work to guide us.
You can find more out about us at mentalstrengthritual.com
Adam
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Hey people I can get a counselling degree from the internet even if I’m a psychopath.
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I can gladly produce a certificate or degree poster that you can put behind your desk to make you look like an authority…..or at the very least someone who knows a little bit about being crazy…low price and very impressive looking….great for web based therapy…
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Thank you Ethan for this essential blog; so many vital passages throughout that deeply resonate with me. I too no longer trust or have faith in expertise, nor the suffocating and negating (power) narrative’s “experts’ cling to maintain their status and institutional objectives-to be overly diplomatic about it. I avoid the experts as I would a high crime neighborhood, the actual mugging from the expert having far, far greater potential for catastrophic personal harm than that of the prototypical street mugger. I wish I had more time and energy to weigh in on this vital area of crisis in our world. Suffice to say, I feel grateful to be old and well-off enough to be able to stay safely away from the expert class. As far as I’m concerned, I would bid them farewell on their way to bourgeoise careerist hell, if not for the fact they seem perfectly intent on imposing that hell on everyone and every last corner of our world…
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I’m glad I’m not the only one fed up with “the experts” in the field of so-called “mental health”.
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Well Birdsong, as tenuous and risky as mental health experts most certainly are, I’m afraid that the expert-class crisis extends way past that corner of society; of which my gratuitous rant meant to imply as much. There’s plenty written and opined on this subject by many formidable thinkers and public intellectuals. I probably should have just cited those sources and spared this forum my indulgent rant…
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I liked your rant. It made sense to me.
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Thank you Birdsong! I appreciate the sentiment, as I’m ‘still’ learning to trust and express my true feelings, of which, over the course of my lifetime, I’ve overly stifled and suppressed through intellectualizing…
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Iâm happy for you!
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Bravo!
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Hi, my name is Elijah Jenkins. I’m reaching out to you in regards for what’s happening in the state of New Mexico with mental health. A coalition of 41 organizations plus mental health experts was recently formed in order to halt a special legislative session back in July of this year. I’ve personally reached out to the Governor’s team, as well as legislators to no avail. It seems they have no clue on how to go about this, and for some reason they have refused to hear out the perspective of “mental healthcare providers, direct service providers to those experiencing homelessness, or even anyone who themselves have dealt with or is currently dealing with those issues.” How can someone who has lived decadent and lofty ever understand what goes on down here? They can’t, and this is why I’m reaching out to you. My goal is to get the people of New Mexico, and the people on the front lines dealing with this to know we don’t have to rely on our government for their assistance. Because when people do join forces, that’s when we can accomplish anything. Believing in our fellow man and helping eachother to survive, that’s what redeems us! That’s what makes us who we are! Makes us worthy! That’s what gives us our real power! In order for this to work, someone has to be a focal point in all this and no better person for that than someone who’s been put through the wringer here in New Mexico. Someone who has done years of introspection and succeeded in the transmutation process, in a situation that has been insoluble. That person is me. If you can help me get my story out, so these organizations and the common folk can have a template to understand, with the help of everyone we can put this nightmare behind us and start making real progress here. Once we can make this happen, in one of the worst states in the US, we can duplicate that template nationwide, then eventually worldwide. I have alot more to share, especially evidence I’ve accumulated over the years to validate what I’ve personally gone through in order to help others going through the same. I’m also trying to get multiple individuals with the proper credentials to reach out to the non profit organization rare impact fund. If we can successfully request a partnership inquiry with them then we can restore power to the people, and re-teach them how to rely on one another. If you have any questions or concerns please do let me know. Thanks for your time.
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Fact is I am so awfully hungry I need to be fed up. Bring it on! Breakfast I mean. Being gas-lit by psychos is not my cup of tea.
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What’s real is hunger. And what I need to “Engage” is food. Stop discussing cockroach bait.
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What’s real is hunger. What I need to “engage” is food. Stop discussing cockroach bait.
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Ethan excellent well written piece thank you and good luck with everything
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As a parallel practitioner myself and a personal biohacker by necessity, wondering if anybody is using AI to gather knowledge from far and wide to serve people in sidestepping the expert class and successfully resolving issues either for themselves or by becoming better providers…
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