Sunday, September 19, 2021

Comments by Marian B. Goldstein

Showing 164 of 164 comments.

  • If the pink house is entirely gone, annihilated, does not exist anymore, then who is this “I” commenting here?

    That said, to a certain extent I agree with you on “recovery”. In the sense that, indeed, what is gone cannot be recovered. But does it have to? I hear a lot of labeled people wish they could go back to what was and who they were before they encountered their crisis. I for one am grateful that what is gone is gone. Even if I could, I wouldn’t want to go back. After all, what has been was what made crisis a necessity. You have to start from scratch when you can’t recover, that’s true. But there’s just so much to discover, when you can’t recover. Though, I’ve never had a pink house to begin with, so what do I know.

  • “Some people may like to see themselves as having an illness because it conveys a certain level of suffering, and that it is not something they are choosing but rather something that happens to them. In this way some may find it is quite validating of the level of distress or confusion they at times experience.

    In an individualistic society people who fail are often blamed for their failures, to be ill means you can seek some refuge from this blame. On the other hand, the other side to this exemption from blame is that the identity of being ill can lead people to feel helpless in the face of their emotional and social difficulties.”

    One of the most important questions my therapist asked me was “Do you believe this is something you yourself do, or that it’s just happening to you?” My immediate gut reaction was, it is something I myself do. And so I can choose to stop doing it, and do something else instead. My choice, my responsibility. At that point in time blissfully unaware of modern psychiatry’s groundbreaking research findings, it had never occurred to me that thoughts and emotions could be anything but meaningful and fully understandable responses to life. It made a world of difference.

    Blame, self-blame — Initially, I did blame myself. Or, I was angry with myself. Very angry, and sad. That I had allowed the people in my life to drive me crazy. I had never been the invincible, invulnerable creature I’d imagined myself to be. A, at first, very painful realization. I’d failed. On the other hand, it confirmed that, indeed, I was a human being, I belonged to humanity, there was a place for me in the world. I had been hurt, and I had reacted protecting myself in the best way I could. I had been a pretty strong human being, actually. I hadn’t failed, after all.

    Bio-genetic explanations may seem guilt-reducing, at first sight. But they certainly don’t reduce shame. Time and again, I see people who believe they are “mentally ill” be stuck in a state of being deeply ashamed of, allegedly, being profoundly different from humanity, lesser-than-human, not belonging in this world, a burden, most efficiently prevented from the healing process of grief and forgiveness, eventually arriving at embracing one’s own human nature. And I don’t think, any “anti”-stigma campaign that holds on to the concept of “mental illness” will ever be able to remove the shame that inevitably follows the belief that one’s innermost human nature, one’s self, is a disease.

  • Bob1999, you might as well have said that calling people names is something that will never go away, that it is a necessary tool that we humans use every day to make sense of and communicate about the world. And that all we can do is work to erase the negative stigma, emotions, and self-doubt associated with “mental illness”.

    I’d agree that calling people names is a tool to make sense of and communicate about the world. Necessary, though, it will only seem to me to the extent that, for some reason, true understanding represents a threat which projection and scapegoating are perceived as tools to save the person from. Or, if it’s your issue (or shadow, in Jungian terminology), it’s not mine. Or, if I can label the other “mentally ill”, i.e. as not making any sense, it isn’t me who has a problem with true understanding. And for the labeled person herself: In as far as I don’t make any sense, I can avoid having to work towards understanding myself and having to take responsibility for myself.

    Erase the negative stigma, emotions, and self-doubt, and what you get is a tool that doesn’t work anymore according to how it initially was invented to work. A useless tool. What we usually do with useless tools is that we toss them out and replace them with new ones that do work, so the whole circus can start all over again. And it won’t end, unless we realize that, whenever we blame the other, or this thing, “mental illness”, for whatever the misery, what we’re actually dealing with, and would have to look at, in the mirror, is our very own problems with making sense of and communicating about the world.

  • “But, at what point does a little bit better actually become a whole lot worse?” Thank you so much for that! “Peers” have recently started to become very popular here in Denmark, too. — “Oh, look how well this works in the U.S., we should have that, here too!” — I saw a job ad some time ago, by the regional mh services. It explicitly stated that applicants had to have a bio-genetic understanding of “mental illness” to be considered for the job. Need I say more… But, of course, they’re not stupid. Nothing can convince the uninsightful who toss out their “meds” all the time and insist they’re not diseased that, indeed, they’re suffering from an incurable brain disease that needs life-long medication like a “peer”, someone who’s had the experience themselves. You can argue with theoretical knowledge, but who can argue with lived experience?… — “It’s tough, I know, I’ve been there myself! But look how well I‘m doing now that I have insight into my illness, and do as my p-doc says taking my meds every day as prescribed! I even got a job!” — That’s where I see the little bit better become the most whole lot worse.

  • Nobody needs a psychiatrist to prescribe a sleeping pill, any physician, no matter the speciality, can prescribe one, and a sleeping pill for someone in distress who hasn’t been able to sleep for some time,is about what I’d accept in terms of psych drugs.

    I disagree that we couldn’t do without a wannabe-medical speciality dealing with what aren’t, never were, and never will be medical conditions. Humanity has done without it for thousands and ten thousands of years, and mostly with far better outcomes than those produced by psychiatry.

    And apropos of the outcomes, what I observe, time and again, is that it is those who reject psychiatry, its labels and its “treatments” who have the best long-term outcomes. I’m with Jacqui Dillon on this, who says in her excellent talk “The personal is political”, “I’m not mentally ill, never was, never will be.” Back when I experienced my last and most serious crisis, and my therapist tried desperately to persuade me to go and see a psychiatrist, the guerrilla inside of me said, ‘You’re not sick. Why on earth would you want to go and see a medical professional? No way!’ I’m glad that the guerrilla won, that I held onto this conviction, and didn’t give in to the pressure from my therapist and the victim inside, back then. And I’m glad that my therapist eventually respected my decision. Victims don’t recover. Guerrillas do. Psychiatry nurtures and nurses the victim, and fights the guerrilla. With everything it does. Right from its start, it has been designed to do so. Saying “no” to life, and producing victims is, has always been, and will always be psychiatry’s very essence.

    Open Dialogue works for a lot of people because the role psychiatric practice plays in it is as limited and peripheral as it is. It might work for even more people, if all psychiatric involvement was removed from it, i.e. if there were no elements at all in the approach that in any way feed the victim, instead of the guerrilla, or survivor, or whatever you want to call this energy inside all of us and its unconditional “yes” to life.

  • “On the other hand, severe mental disturbance can be prolonged and disabling. Looking at hospital records from before the days of modern drugs, some people never came out of it, and spent their lives in a state of extreme confusion and degradation, unable to perform the most basic functions, or to communicate with anyone around them.”

    If there’s anything I would take issue with in this blog, it’s the above quoted statement. I work at an acute crisis center, located in the same building as a residential facility with whom we have some collaboration, meaning that I, at times, have been working at the residential facility, too. Some of the residential facility’s residents never came out of it, and some will never come out of it, spending their lives in a state of extreme zombification and not only psychological but also physical degradation, unable, also physically, to perform the most basic functions or to communicate with anyone around them (other than a 3-year-old communicates). What has changed? How have “anti”psychotics actually done anything good? As far as I can see, all they’ve done is that, today, it’s a different group of those who experience “psychosis” who ends up institutionalised, all the while there still are quite a few who end up institutionalised, probably as many as in the pre-neuroleptic era. And while today’s residential facilities aren’t called “hospitals”, I really don’t see the big difference to the back wards of the past.

  • Chrys, unlike what a lot of parents themselves think is their right in relation to their children, I’m not advising parents how they should act or what they should feel. But whenever a grown-up person tries to tell me they don’t have a choice, they’re the victim — of the system, of its deception, of its lack of alternatives, or, on the other hand, of Whitaker, of “mental illness”, of their “mentally ill” sons and daughters, and whatnot — and that that’s what causes all their pain and suffering, I always draw their attention to the fact that, while their pain and suffering is real, it’s also theirs, which means that they do have a choice in terms of what to do with it. I’ve never seen the “I’m in pain because I’m a victim, and therefor I can’t do anything but being in pain and being the victim,” lead to anything constructive. On the contrary, I’ve seen it create nothing but havoc not only for the person who refuses to own their pain and take responsibility for it themselves, like a truly grown-up person would do, but also for everybody around them, their children very much included.

    In the first chapter of “Why People Don’t Heal and How They Can” Caroline Myss describes an incident she once witnessed at Findhorn. One member of the community asks another whether she would be able to show some visitors around on a certain day. A “yes” or “no” question, that doesn’t get answered with a “yes” or “no”, but with a rather long speech about how it is impossible for the person to show anyone around Findhorn that particular day, and actually equals an insult to them that they were asked about it at all, because they have their incest support group meeting on the same day, and they’d never ever miss that meeting, because blahblahblah… read: I’m a victim! How dare you question my victim status, asking me to do something else on the day of my incest support group meeting (which, never mind, the person asking had no idea was on that same day), and treat me like I was, well, just a person, an ordinary human being, and not a victim, entitled to be handled with kid gloves and special attention?! Which again translates into: How dare you inflict even more pain on me who already is in so much pain?!

    We can choose to engage in this kind of communication where we use our respective pain as a “street currency”, as Myss calls it, buying ourselves entitlement with our wounds, and as a consequence we’ll never be able to heal. Or we can take ownership of and responsibility for our wounds and pain ourselves, and heal.

    I for one have chosen to prefer the possibility of healing, so I don’t accept pain as a currency. “Parents are already in so much pain, so let’s give them some slack,” won’t work with me. Neither will the “You’re not a parent, you have no idea!” thing. I’m a human being, and as such I know pain. I don’t need to be a parent to know it. “My pain is greater than yours”? Won’t work with me either. Or maybe you can tell me exactly how many grams heavier your pain is than mine? Or how many inches longer than mine it is? Let’s be honest, Chrys, you can’t. And it’s not a competition to start with, or is it?

    However, I’m not interested in cultivating wounds and pain. I’m interested in healing. And when somebody chooses to cultivate their wounds and pain in plain public, and with an option, maybe even an invitation like on Pete Earley’s blog, to respond, well, I may respond. To keep my response civil, and the contents relevant to the subject is my responsibility. What the person does with my response is theirs. I can’t and certainly won’t force anybody to take it as good advice, if that’s not what they want to do. Healing doesn’t come from without, it comes from within. But that doesn’t mean that no one is allowed to challenge the victim who’s in love with their pain.

  • Chrys, I agree that judging people isn’t the way. But, frankly, the only ones I see really judged in all this are the people who get slapped with a psych label. I posted the link to this article: in our discussion on Facebook earlier today. To say that somebody is traumatized isn’t the same as judging them. It’s to say that they are human beings.

    As for trauma, yes, it results in people getting emotionally stuck. If it doesn’t, it’s not trauma. But getting emotionally stuck doesn’t mean that one necessarily remains emotionally stuck for the rest of their life, and that there’s no way how they could get unstuck. Actually, I regard crisis, “psychosis” or other, an attempt to get unstuck, and thus exactly the opportunity to journey, transition, and become a stronger, more conscious and whole person than one was before, and maybe even than the average, “normal”, person ever has the chance to become. It’s not either – or, it’s both – and. One can’t get unstuck unless they have been stuck. And nobody has yet embarked on a journey to transition because they were perfectly happy with their life. It is pain and suffering, or at least some sort of discomfort that has people embark on such a journey.

    Cutting some slack on parents who are in pain because of, according to them, their child’s “mental illness”, is doing them quite a disservice, IMO. These people’s pain isn’t caused by their children’s “mental illness”. It’s been there long before these people became parents, and also long before their children started to behave “mentally ill” and got labeled so for it. If they are to ever get a chance to heal from that pain, they need to understand that it’s their pain, and therefor their responsibility. Not their children’s, or that of this “mental illness” thing. And unfortunately most people won’t understand this as long as holding their children, or this “mental illness” thing responsible for their misery works for them. The more we cut some slack on them, the more we make it work for them.

    I’m not a parent. I’m a daughter who clearly sees the pain her parents were in. But it wasn’t my pain, and so it wasn’t my responsibility. No matter how much they tried to make it that in their vain efforts to get some relief. The only way out of suffering is through taking ownership and responsibility for one’s pain. And this is not done by blaming others, if it’s Bob Whitaker, a son, a daughter, a “mental illness”, whoever or whatever.

  • Chrys, I didn’t say parents do it on purpose, intentionally harming their children. I’m with Loren Mosher here, who said: “’With rare exceptions, I think parents do their best. They try. But there are a lot of ways in which they can go astray. One way is if the parents themselves were raised in homes where they didn’t learn to think straight. They grew up, and they can think straight enough to get along, go to school, whatever.’ But when a person with this kind of communication style marries someone from a similar one, ‘You can get two parents who are just loose as a goose.’” None of us is perfect. One kind of imperfection is when there’s a lack of consistency in our communication, when we don’t say what we mean, which in most cases, and although it’s the inevitable result, isn’t done with the intention to confuse the other, but because we ourselves are afraid of and confused about what we actually mean, our own truth. The parents of people labeled with “schizophrenia” are some of the most confused, insecure and scared people I’ve ever seen. At the same time, and without being aware of it, they do whatever it takes to hide their own confusion, insecurity and fear from others as well as from themselves, as it would be too painful for them to face the fact that they’re traumatized human beings themselves.

    The hell I’m talking about is that of “mental illness”. Not the one of not being able to find real help. Too scared to face their own trauma, parents have asked psychiatry to come up with an explanation for children’s reactions to their parents’ trauma that allows the parents to keep denying their own trauma. That’s what psychiatry has done in creating the concept of “mental illness”. Now the very same parents who asked for “mental illness” to be created in the first place keep lamenting the suffering their children’s “mental illness” puts them through. And the maybe strangest thing is that whenever somebody suggests that this “mental illness” thing that puts them through such unbearable suffering might just be an artificial construct, more or less pure fiction, that in reality things might look a lot brighter, there immediately is an outrage, you’re hung, drawn and quartered for just suggesting that the suffering could come to an end. Another inconsistency in these parents’ communication that makes one wonder what it actually is that they want. Do they want to suffer, or not?

  • Whether we’re talking individual illness, or not, symptoms, or not, pathology, or not is, to put it mildly, debatable. So far, no individual pathology has been proven to exist, and even professionals are divided on the question whether “mental illness” is real illness, or rather a healthy reaction to “sick”, metaphorically understood, circumstances like family dysfunction. I’d say, the proof is in the pudding, i.e. in the outcomes of the different approaches to “mental illness” which are based on their respective view of what “mental illness” actually is. So far the individual “illness”/”symptoms”/”pathology” view and approach have failed greatly.

    I can’t see anything “stigmatizing” in acknowledging that human beings can be traumatized by life, with trauma causing the person to be stuck in their emotional development. The only “stigma” I see are the labels that define people’s reactions to life as “pathological”, an “illness”, something that shouldn’t be.

    You can’t agree that it might turn out problematic, if somebody whose emotional maturity is that of a child, has children of their own? Are you saying that?

    The quotation marks have come to stay until the day a pathology for “mental illness” has been scientifically proven to exist.

  • I agree that healing cannot be accomplished without the insight that parents who pass on trauma to their children are traumatized themselves.

    Nevertheless, healing for the person in crisis starts with having their pain and trauma recognized. Labeling people with “schizophrenia” or other “mental illness” doesn’t recognize any pain and trauma. On the contrary, it denies it. Also, who is actually labeled “defective”, locked up, and (forcibly) drugged with life shortening, brain-damaging substances? Who is put through both psychological and physical abuse (once again)?

    The hell parents with labeled offspring, like the mother, go through, is largely a self-created and self-perpetuated one. The parents usually are the ones who think of themselves as reasonable grown-up people. If they really are, they start asking themselves, seriously, what it is about themselves, their attitude towards their children, that causes their children to react “insane”, and they take responsibility for their pain and trauma, instead of trying to blame their children for what in reality is their own undealt with pain and trauma. Also, if a parent manages to keep their child dependent on them into adulthood, they can’t blame Whitaker, or anybody else for that sake, if they lose control over them. It’s their, and only their, responsibility to stay in control of their — grown-up — child. You can’t have your cake and eat it. Only narcissists think they can.

  • What happened before your friend turned into an adolescent? The foundations for “schizophrenia” are laid in early childhood, not in adolescence. And both overprotection and neglect may communicate the message “You’re useless/worthless.” A father who suffers from “schizophrenia”, and who, since he, as I suppose, thought of himself as suffering from “schizophrenia”, hasn’t taken responsibility for himself, is a kid having a kid. Kids having kids is a certain recipe for disaster.

  • I didn’t say that you were claiming that family dysfunction causes “mental illness”. I said it is what I’ve experienced.

    “I will say that if we’re going to claim that the causes of mental illness are entirely environmental and that the family is usually culpable, then we also need to acknowledge that this is most likely an intergenerational problem passed down through trauma, upbringing, etc,…” I agree. Still, people who think they’re grown-up enough to have children of their own should also be prepared to be grown-up enough to take responsibility for whatever they pass on to their children.

  • “her son hasn’t been able to function and take proper care of himself”

    The question is, how he ended up unable to function and take proper care of himself. The pattern I’ve seen time and again play out in families with offspring that gets labeled with “schizophrenia” is that the offspring more or less constantly and from early childhood on was/is told — through words and/or actions — that they are unable to function and take proper care of themselves. Whatever they try, it can never be good enough. Why others, namely the parent/-s, need to step in and take control. People don’t learn how to function and take proper care of themselves by having others control — and criticize — every move they make.

    Isn’t it thought-provoking that an approach that recognizes family dysfunction as the cause of “mental illness” has the by far best outcomes? It’s got nothing to do with attacking anybody. But becoming a parent doesn’t miraculously turn people into small gods, perfect human beings who never make a mistake. Like every human being, parents usually have “issues” too. We don’t do them, neither, a favor if we support them in their denial of these “issues” and their projecting them onto their offspring. “Mental illness” in a family can be a breakthrough for everybody involved. But only if everybody takes their part of responsibility for the creation of the “mental illness”.

  • One thing is that Stucker only quotes one single person who thinks he would be dead had he not been committed. I hear these statements actually all the time, “Had I not been committed/forcibly drugged/restrained, I would have died!” Would have. Subjunctive. During my last crisis, almost 10 years ago, I often asked myself, ‘What am I going to do, if I get locked up/forcibly drugged/restrained?’ And I was pretty sure that the answer was that I’d off myself at the first occasion. Especially in case of forced drugging, as I was convinced I wouldn’t be able to live with myself not being me anymore. But I wasn’t committed/forcibly drugged/restrained, and so, if I’m honest, I can’t tell with the absolute certainty I see expressed in statements like the one quoted by Stucker what I actually would have done, what would have happened — subjunctive. And so I wonder where such absolute certainty about the outcome of something that never happened comes from.

    The subjunctive IMO is of no further interest to a factual debate. Which is of interest are the actual results of what actually happened. And while people in crisis sometimes, and probably also more often than the average person, do make bad choices, there are at least as many who’ve died while under involuntary psychiatric “care”. Add to these all the many many people who end up severely re-traumatized by it. And frankly, somebody trying to tell me that torture and abuse was what saved their life, I can’t help it but I always smell a big fat Stockholm syndrome rat…

  • Greg, it wasn’t my intention to say that it’s an all or nothing dynamic per se, and that to criticize someone’s actions, beliefs, etc., one has to attack them. In fact, I believe attacking people is pretty unlikely to open their minds to whatever the critique of their actions, beliefs, etc.. What I was trying to say is that it is my strong impression that the mother in question here out of her own powerlessness has developed a set of coping strategies which includes the conviction that, whatever it is that doesn’t pan out in her life, it is somebody else’s fault. She isn’t responsible for any of it herself, she is the incarnation of perfection, she’s never wrong, or makes a mistake. And if things go wrong, if anybody dares to doubt her perfection, the 100% correctness of her beliefs to be the one and only truth, doesn’t agree 100% with her, doesn’t follow her orders to the letter, she is always the Victim, and the Victim only. The possibility that she might be just another imperfect human being, like everybody else, doesn’t exist in her universe. People who employ this set of coping strategies usually have an exceptional ability to twist and turn things that makes even the most polite and compassionate critique look like the worst personal attack on them. Never mention what happens when you, matter of fact and straight forward, unravel what they’ve made an effort to obscure and mystify, and see right through their tactics. I’ve quite some experience with trying to debate these people. It’s plain impossible.

  • This is in reply to Berit, 5:22 am. I’m not sure that it’s because African Americans are more skeptical to authority. But theirs is a very different culture than modern western civilization one of whose main characteristics I see is the worship of the individual and the general alienation it brings about. Psychiatry is a product of modern western civilization. Its labels and drugging target the individual, the identified “mental patient”. Believing that all things and all beings in this world are connected, which is an accepted truth in many cultures, actually can be interpreted as a “symptom” of one’s “illness” in modern western civilization. Because it threatens the delusion our culture, modern western civilization, suffers from that the individual would be the be all and end all, and that community, connectedness, and social accountability mean nothing. Among African Americans, and other people from a cultural background different from modern western civilization, you’ll often find a somewhat higher developed sense for the community, and if you value the community at least the same as the individual, and maybe even higher, you’ll almost automatically look for answers/solutions to the questions/challenges you face in the community, instead of in the individual, as modern western civilization increasingly does, also by labeling and drugging the individual.

  • Greg, IMO the mother is not just the victim of the psych industry you picture her to be. She writes in her letter that she was worried when her son wanted to go and listen to Whitaker’s talk. Why would she have been worried, unless she knew what the talk would be about? And if she knew what it would be about, it means that she’s known, probably for some time before the NAMI convention, that there’s a different story out there than the one she’s chosen to buy into, and to sell to her son as the one and only truth. If it really is her son’s wellbeing that is her main concern, why wasn’t she curious to learn more about this different story? Why didn’t she discuss it with her son (all she mentions is that he heard about it from others)? Why didn’t she start to educate herself about psych drugs, withdrawal, different views of what “mental illness” is, etc. etc., and get her son interested in these things too, like Rossa for instance has done? Why is it as important to her as it obviously is when you read the passage in her letter about Open Dialogue working for some, but not for “any one else”, read: not for her son, to maintain the belief that her son is brain diseased and in need of “medication”, no matter what? Why does she, although she knows about Whitaker and his message keep dismissing her son’s voices that told him “we were devils, our house was haunted by evil spirits and we were trying to poison him. He said God was commanding him to not live with us anymore,” as “nonsense”, when actually these voices become pretty meaningful seen in context with what the science, quoted by Whitaker, tells us about neuroleptics, and we know that the mother doesn’t support any attempt by her son to come off them, actually even tries everything to keep him from even thinking about it?

    She’s had her possibility to question. She didn’t make use of it. IMO misinformation from the psych industry alone doesn’t explain this mother’s rejection of anything but the “it’s a brain disease that needs to be medicated” stance. There are other forces at play. It is my experience with the forces that I see at play here that the only chance one has to comment and not offend the person under the influence of these forces is by agreeing entirely with their point of view. Anything else they will regard a personal attack on them, no matter how respectfully and compassionately one words it, and the way they know how to appear as the Victim, capital ”V”, will probably even make others see a personal attack where there really only is a pointing out of what the person herself already has reveiled herself. So, one has the choice, critique their point of view, and risk to be seen as the ”bad guy”, even by others, and even by those who otherwise share your opinions, or – well, if you can’t agree, do nothing, don’t comment, don’t critique, unless you want to be the ”bad guy”. Which means that, once again, the facts are hidden away, can’t be mentioned and talked about openly. It’s a win-win situation for her. At least to the extent that people buy into the ”I am the victim here!” thing.

    I wrote this several hours ago, but had no chance to post it before now. Reading Seth’s comment, I wholeheartedly agree, you might as well talk to a wall. Still, I think Rossa’s comments are important. Not because I would have any hope that they could change the mother’s mind in any way. But it is this kind of stonewalling that drives people crazy, and understanding what drove you crazy in the first place is the first step on the road to recovery. So, somebody following the thread at Pete Earley’s blog and reading Rossa’s comments might be helped by them. Even if it’s not the mother.

  • It has always amazed me how, to people like Pete Earley, death seems to be acceptable, maybe a little tragic, but still acceptable, as long as it occurs as a ”side” effect of psychiatric ”treatment”, while the mere possibility of a fatal outcome is unacceptable as soon as it occurs in context with free and informed choice.

    We’re not born into this world knowing everything about how to make the most constructive choices. We have to learn it, and we all learn it by making our own choices. But nobody can make constructive choices if they’re denied access to all the information important to the specific choice. Keeping information from people, lying to them about the facts, will almost inevitably lead to ”bad” choices being made. What I find particularly interesting here — alongside with the phenomenon that in fact grown-up people consistently are referred to as “children”, i.e. human beings who still haven’t learned enough about this world to be able to make constructive choices concerning all parts of their lives — is that, in general, I experience quite a bit of secrecy, mystification, outright lying, and sweeping things under the carpet in the families of labeled people. Usually more than in other families. And it doesn’t start with, or is limited to keeping for a truly constructive choice important information about, well not just psychiatric ”treatment”, but the nature of the labels themselves, hidden from the labeled person. It starts with the family secrets, the skeletons in the closet, the elephant in the living room, the existence and nature of which the ”bad” choices of the labeled person threaten to reveil, which again has earned the person in question their label. The secrecy, closedness and lying toward labeled people Pete Earley and his likes openly advocate for indeed are necessary if the family secrets are to be kept secret, the skeletons are to be kept inside the closet, the elephant in the living room is to be kept unseen. And so ”bad” choices and, in the end, fatal outcomes are passed on from one generation to the next. If anybody has ”blood on their hands” it’s these people, who’ve decided that being able to continue and live their lie is more important than facing the truth and being able, they themselves as well as everybody under their influence, to make constructive choices on the basis of it. If their offspring is “mentally ill”, i.e. keeps making “bad” choices, choices that don’t take all the important information about the subject into account, then these people should ask themselves who it is that kept important information hidden from their offspring, who it is that kept their offspring in the dark, and about as educated about the world as the kindergarten child they themselves fancy to reduce their, mostly, grown-up sons and daughters to.

  • Sandra, there’s one issue, related to what Stephen writes below, all of which I completely agree with, I would take with your comment above. If we are to be that respectful of people’s experiences, wouldn’t we then also have to respect it if someone chose alcohol, or recreational drugs above psych drugs? And why aren’t we, usually? Why do we even apply dual diagnosis, and double-up the psych drug ”treatment”, instead of saying, “Oh wonderful! This person has found a way to treat their problem all on their own”?

  • Sandra, where I have the impression, upon reading this post and the comments, that we disagree is in our respective fundamental approach to the subject, and maybe even in our view of what life is all about in general. I’ve been looking at D2 receptors, GABA, and whatnot of the kind, me too in the past, and I still sometimes look at it, although my neuroscientific/psychopharmacological knowledge isn’t as profound as yours, or some of the commenters here. I must admit that right from the start I didn’t expect that looking at these things alone could give any satisfactory answers to the questions that are most important to me, and which I believe differ slightly from the questions that seem to be most important to you.

    I usually tell people who come to me asking for help with their existential problems, many of whom (unfortunately) assume that they have something wrong with their brains, their D2 receptors, or their GABA, or whatnot of that kind (because they’ve heard about brain diseases and chemical imbalances somewhere in the media), that I am willing to try and help them learn how to navigate life, the painful aspects of it included, but that, in case they for some reason don’t think they can learn this, or don’t want to learn it, I unfortunately can’t help them, and they’d have to go see someone else. Now, I’m not a medical professional, and don’t have prescribing rights, so even if I believed psych drugs to be a solution, I couldn’t help people who asked for the quick fix — or, as I see it, in many cases for just another way to remain the victim in their lives, and to self-harm — and would have to send them to go and see someone else to get some. On the other hand, even if I was a medical professional with prescribing rights, I would prescribe psych drugs as much as I would recommend a bottle of whiskey (or two) daily to people in emotional distress. I’d rather go back to working as a stable manager. Honestly (although some people have this romanticized idea that it’s all about stroking and hugging horses all day, it’s hard physical work, nothing much romantic about it, believe me!). What made me arrive at such a, probably in your view rather radical, stance towards psych drugs isn’t that much knowledge about their effects on D2 receptors, GABA, and whatnot, as it is simply seeing what they do to people on an existential level, and what they, in a wider perspective, do to mankind’s self-understanding, and to the world.

    So, while I agree that it is of importance that we learn about these drugs’ effects on our physiology/neurology, to me the more important question is what do they do to us in existential terms. That’s why I would like to see more qualitative research done that goes (far) beyond just asking people whether they feel helped by these drugs, or not. I’ve always been of the conviction that science without philosophy, while it may have some entertaining value, won’t get us anywhere. Especially not in a field like the mh one, which IMO primarily is a philosophical and political, not so much a scientific, one. I mean, upon Andreasen et al.’s “discovery” that neuroleptics cause brain shrinkage, we’ve seen researchers claim that maybe brain shrinkage is what’s needed to successfully treat “schizophrenia”. More quantitative research that shows these drugs to cause brain damage will hardly be able to counter that argument.

  • “In any given person, however, it is impossible to know what is placebo effect and what is a drug effect.” Exactly. I’d think that whenever you give somebody who experiences extreme states of mind any substance with especially tranquilizing properties, they may experience more of a reduction of their “symptoms” than if you give them a pill with no active substance at all, or even with something like caffeine for instance. Simply because the substance does something, and the something it does is that it slows/shuts down the higher brain functioning necessary to stay alert and keep thinking (creatively, on one’s own, as opposed to more or less indifferently engaging in parroting conventional “wisdom”). Quite a few people use alcohol and recreational drugs to calm themselves down (so-called “self-medicalization”). But we don’t refer to alcohol and recreational drugs as “antipsychotics”, do we?

    Personally, I have a hard time imagining that any of the chemical substances we know would be able to read the mind of a psychiatrist and target specifically the thoughts s/he views as “symptoms”, while leaving all others intact. The only way of drug action that, if it was possible, then would make for a specific antipsychotic effect. I have a hard time imagining it, and I must say, I haven’t seen it happen yet with any of the people on “antipsychotics” I know. All I see is in fact “tranquilization”, i.e. generally slowed/shut down ability to think.

  • Sandra, your reasoning here implies that there would be no such thing as the placebo effect. The thing is, the placebo effect is real, very real. Especially with psych drugs. And some people have more faith in the magic powers of a pill than others — who probably end up labeled “treatment resistant”.

  • Matthew, I believe the people having (had) the experience do know, and they’re telling us clearly and unmistakably about it in their “psychotic ramblings”. The primary fallacy of the whole psychiatric experiment IMO is that our society and a group of people, the professionals, have decided to label certain people “insane” for their experiences and behavior, and to define “insane” as “not to be listened to/not to be taken seriously”. IMO the “we don’t know” statement is counterproductive as it, too, is dismissive of the voice of the labeled person herself, especially the voice of those who haven’t yet learned to see themselves through the eyes of others (psychiatry).

    As I see it, the problem we’re having in this discussion here (and have had in others before) is not so much that some people believe in one cause, and others in another one, but that it obviously is extremely difficult for some people to consider the possibility of different causes, among these also non-medical ones, why they seem to have a hard time respecting the voices of those who know that their individual experience is/was caused by non-medical factors, that indeed their experience is/was not the expression of some sort of malfunctioning on their part, which is what the labels suggest, but a meaning- and purposeful reaction to life. Why they would prefer to not have their experience labeled in pseudo-medical terms like “psychosis”, “schizophrenia”, “bipolar”, etc.

    So, while I am glad to see that there is some respect from the particular commenter toward the fact that some people know existential, spiritual, psycho-social, whatever you want to call it, factors caused their experience, I unfortunately don’t see that respect displayed toward those of us who don’t want their, by existential, spiritual, psycho-social,… factors caused, experience labeled an “illness”, “psychosis”, “schizophrenia”, “bipolar”, or other. Thus, once again we’re denied our voice.

  • Thank you, Seth!

    I’d like to add a question for Maria: What would you do if somebody told you they were hearing the voices of a bunch of bullies that they’ve actually been stalked by in the past? Would you send them to a hospital to have multiple testings for somatic illness run, until something, anything, a bad tooth, whatever, was found, because something definitely must be wrong with a person who reacts to life? What would you do, if the voices didn’t disappear although the medical problem had been solved? Start all over again, because it can’t be life, there are no dysfunctional relationships, no bullying, no abuse, no neglect, no violence so extreme in our society that a reaction as extreme as that which gets labeled “psychosis” would be perfectly meaningful and understandable? Start all over again, although the person told you that they know they aren’t sick, but reacting to past traumatic experiences?

    To answer your question below what I would do if I, or someone I know, experienced extreme states of mind: I’d do the same that I’ve done before, and that I today continue to do in my workplace, and ask: What has happened to me/you? It has worked for me, it has worked for innumerable people, and it continues to work for innumerable people. The proof is in the pudding. As Seth quotes: Open Dialogue, 80%, 83% to be precise, recovery.

  • “I find this blog a hard read.” Me too! It reminds me of the client my therapist once told me about, who was afraid that if he had a knife, he wouldn’t be able to control himself and would hurt her. What did she do? Remove anything from her office that only remotely resembled a knife? Got him committed? No. The next session she put a knife on the table between him and her, easy to grab for him and actually hurt her, who due to a disability couldn’t even jump up and run away. He didn’t. She neither got me committed although she knew I was pretty much “suicidal” — make that convinced I would have to rid myself of my body in order to save myself, if that makes sense. Of course she was taking a risk, in both instances. But life is risky by nature, isn’t it? And nobody has yet learned to take responsibility for the risks they take, the choices they make, their life, themselves, by having others take responsibility for them. Fear doesn’t make the world a safer place. Trust does.

  • Nine out of ten, yes. And I would have been no. 10, unable to put my finger on anything traumatizing in my life. Okay, a few things maybe hadn’t been that much fun to experience. But hey, I was untouchable, wasn’t I! Yeah sure. So much so that I wasn’t even one of these pitiably fragile human beings. — “Delusions”? Or just a desperate attempt to keep up a sense of self in the face of annihilation? — That, after all, I was one of these pitiably fragile human beings, and pretty much hurt, shattered actually, on top of it, was an excruciatingly painful realization. I do understand why sometimes labeled people have a hard time letting go of the illusion of the perfectly happy childhood: “Trauma?! What do you mean, trauma?! I wasn’t traumatized!!” I guess, we’ve all heard that one. Often vocalized in this quite telling, somewhat indignant, aggressive manner. The sad thing about this is that you can’t put the pieces (back) together and heal, unless you realize that you were born neither untouchable nor with a broken brain, but simply as a human being, pitiably fragile maybe, but also with an unlimited ability to heal.

  • Jonah, thanks. Yes, I totally agree. I was only and solely referring to grown-up people who, even when they have a choice, still choose the greater misery over the lesser one. And I maybe also should add that “choice” isn’t quite the right word here, as it usually isn’t the person herself making that choice, consciously, but the victim inside who derives a sense of identity and legitimacy from the experience of misery, and for whom therefor misery becomes the desirable.

  • Even that “psychosis” would be some sort of distinct entity, clearly distinguishable from — uh, what? “No psychosis”? “Normal”?… — by some sort of clearly discernible pathology, which, in case, would make for a valid diagnosis, is a false claim. “Antipsychotics” are about as beneficial to those labeled with “psychosis” (or “schizophrenia”) as they are to anybody else. I.e. if you wish to be turned into a gibbering wreck, they are beneficial. Whether you have a psych label, or not. However, most people experience other drugs as doing the job in a far more pleasant way, why they prefer these to neuroleptics. The exception are those who prefer to escape from the unpleasantness of life not into the pleasantness of a drug, but into its unpleasantness.

  • “With regard to schizophrenia, I have seen people who were very frightened during their delusions and hallucinations. They looked like they were suffering.”

    Have you ever been very frightened while thinking certain thoughts? Did you look like you were suffering while being frightened thinking these certain thoughts? Now you will probably object that, yes, but your experience was very different from “schizophrenia” in that the very frightening thoughts that crossed your mind, and thus caused you to look like you were suffering, were based on reality, and thus meaningful, while those of “schizophrenics” are not. At least, this is the argument usually brought up by the proponents of the “it’s all some brain stuff gone awry” perspective on so-called “schizophrenia”. But how can you know? How can you be sure that what you call “delusions” and “hallucinations” isn’t based on any reality at all? Have you always, in each and every case, fully explored each and every imaginable interpretation of these “delusions” and “hallucinations” before you arrived at the conclusion that they’re not based on any reality? Or is there a possibility that the label, “mental illness”, i.e. meaningless, not based on reality, maybe made you jump to the conclusion without further investigation whenever something didn’t immediately fit into your own concept of reality? Is it maybe possible that “meaningless madness” actually more is a problem of somebody not being able (or willing) to understand than of somebody not making sense because of a broken brain “gone awry”?

    I’d encourage you to take a look at other than the biomedical, positivistic reductionist, indeed, perspectives. Perspectives such as Finnish Open Dialogue’s, or the Hearing Voices Network’s (Rufus May, who somebody already has mentioned, Jacqui Dillon, and Olga Runciman are all prominent representatives of the HVN and its perspective on altered states of consciousness, and they’re bloggers on this site) which all view “schizophrenia” as “just part of being alive”. I’d especially encourage you to take a thorough look at the outcomes of these approaches, and compare them to the outcomes of the biomedical, broken brain “gone awry” approach. The HVN’s outcomes aren’t documented other than in personal accounts. We believe that personal accounts, qualitative research so to speak, are what counts. We are the evidence: It may not be RCT-based evidence, but nevertheless, and like Olga Runciman says in this interview:, we see people recover when we sit down and engage in a dialogue with them about their experiences, and maybe even with their voices, while we don’t see them recover in a system where the best they can hope for is that somebody comes by and offers a little distraction, for instance in the shape of playing a board game. The question I think is whether you regard life to be just another RCT, or whether there maybe is a little more to it. A collection of personal accounts can be found in the book “Living with Voices. 50 stories of recovery” ( Anyway, the outcomes of Finnish Open Dialogue are well-documented according to the standards of quantitative research (the recovery rate is actually 83% — somebody quoted 80% — achieved by providing human support, to use your own words), and thus a little easier to access for somebody who, as I presume, hasn’t been looking at these things before.

    I do understand how it can be quite comforting to try and establish and maintain a sense of safety in the face of the complexity of life in trying to understand life as merely being the sum of its material parts (you might also be interested in Paris William’s brilliant essay “Rethinking Mental Health, Part 1: From Positivism to a Holistic/Organismic Paradigm”, recently posted on this site), which we, if only we can get to see them all on a CT or fMRI scan, then would be able to gain complete control over. Unfortunately, I think, it is a false sense of safety this denial of the complexity of life has us gain, and as such all it will create is an ever growing and, no matter how much knowledge we gather together, forever unsatisfied need for control, which on its part will create not less, but ever more suffering. — And isn’t it that we can see this actually happen, not least in the mh field: the more we label (categorize) and “treat” (control) the greater and the more widespread the suffering becomes. — A true sense of safety is based on trust, and the wisdom that has you trust in life. It is not based on knowledge gathered together in order to gain control over what more often than not are our very own, deepest fears. Without doubt, there is a somewhat entertaining quality to looking at CT and fMRI scans. That there would be any value beyond the entertainment to it when it comes to understanding existential suffering, I seriously doubt.

  • I haven’t observed any healing going on neither in the brains nor the minds of people who are on neuroleptics. I’ve only seen the outer manifestations of increasing brain damage, and a mind that, due to the damage done to its tool the brain, got trapped in one-way thinking. In order to work through and heal from their trauma, people need to have their mental capacities left intact, which on its part requires that these capacities’ tool, the brain, is left intact and functioning. Put the mind’s tool, the brain, out of action, and what you get is somebody who can no longer react to life. That certainly is convenient for a society that can’t/won’t deal with people’s reactions to it where these represent a challenge to its at any time agreed upon norms and values. But it’s got nothing to do with “improvement”, or even healing. Actually, suppressing brain activity, and by doing so the person’s ability to react to life, only adds to the initial, trauma-caused stress on this person’s brain and mind. Just because you’ve succeeded in making it difficult, or even impossible for the person to react to the stress they experience, and just because you maybe even have succeeded in getting the person detached from their stress, that doesn’t mean you’ve succeeded in reducing the stress itself.

  • You don’t need a neuroleptic to get some sleep. A simple sleeping pill can do, if nothing else works. But neuroleptics do indeed have a place in a society that does not offer non-drug support, and where the only “alternative” to, “voluntarily”, inflicting brain damage on yourself is being forcibly brain damaged by others, often in combination with a locked-ward sentence of unknown length. Worrying to me is that Joanna Moncrieff leaves this context out of consideration in her post. Thus, all we learn is that neuroleptics have a place. Not why, when, where. And so we’re left with the impression that, well, some people just need them. No matter what the circumstances. I for one will never consent to that consensus. Nobody needs brain damage.

  • “I am a good mother; probably better than many who can’t admit these sorts of truths and struggles.” You sure as hell are. If you ask me, what essentially makes for a NAMI mother is exactly the inability to admit (painful) truths and struggles — to oneself as well as to others.

  • I’d find it relevant in other contexts than the one that is constantly looking for a chemical quick fix, if it could help us better understand trauma and what it does to people on an existential level. I don’t see, though, that studying the neurobiological consequences of abuse and neglect necessarily helps us better understand the existential consequences of trauma. Relating to the traumatized person does. I agree with Loren Mosher here, who wrote in his “Letter of Resignation from the American Psychiatric Association” ( “that it is very difficult to have a relationship with a neurotransmitter”.

  • From the abstract ( “Identification of the neurobiological substrates that are affected by adverse experiences in early life should lead to the development of more effective treatments for these disorders.” Two things here: 1. Why on earth do we need to identify “the neurobiological substrates that are affected by adverse experiences in early life” in order to be able to develop effective help for trauma survivors, unless the “help” we have in mind is of the chemical kind? 2. “Disorders”? Who said reacting to abuse the best way somebody knows equals a “disorder”? And, since we’re looking for “effective treatments”, which, I guess, means effective help for trauma survivors, exactly how effectively helpful is it to tell a trauma survivor their survival mechanisms represent a “disorder”?

    Also, from the abstract of a related study by Nemeroff, “The Neurobiological Toll of Child Abuse and Neglect”, 2009 (”Although early life trauma elevates the risk of psychiatric and medical disease, not all exposed individuals demonstrate altered HPA axis physiology, suggesting that genetic variation influences the consequences of trauma exposure.” Aha, here we go: “not all exposed individuals”, read: only the genetically flawed, or neurologically unfit as Steve says above, ones.

  • (I hope, this comment ends up in the right place, beneath Steve’s where there’s no reply button.)

    Sandy, I want to add to what Steve has said — and I couldn’t agree more to everything he’s said — that I meet people who tell me they feel sick all the time. But there’s a huge difference, although it may not be that obvious, between feeling sick with sadness, anger, confusion on the one hand, and calling the sadness, anger, confusion a symptom of some alleged illness on the other.

    I can feel sick with sadness (or anger, or confusion, or hearing voices, or or or), and still know that there probably is a good reason why I have this intense experience of sadness. And knowing this, I will focus on the reason, trying to find out what it is, to understand it, and, if possible, act upon it so that it won’t cause me more sickening sadness. At the end of the day, my ability to feel sick with sadness actually has taught me something about myself and my life, helped me to make wiser decisions, and improve my life circumstances. So, basically, it turned out that my sadness was my ally in terms of my survival and wellbeing.

    If I refer to my sadness as a symptom of some alleged illness on the other hand, my quest is over. My sadness will be my declared enemy, which I will fight to the bitter end. Without ever realizing that what I’m fighting against actually is myself, my own vitality and survival capacity. So, whenever I meet people who not only tell me that they feel sick with sadness (or or or), but actually symptomatic with sadness (or or or), it’s pretty clear to me that somebody (a professional, a relative, the media,… ) sadly has managed to turn the person against herself.

  • If we were to leave the lies behind, we would have to start by acknowledging that the DSM categories aren’t illness, disease and/or disorder categories, i.e. that they are not collections of symptoms. They are collections of certain behaviors, emotions, ways of understanding oneself and the world. The moment we judge and define these behaviors, emotions, and ways of understanding oneself and the world as ill, sick and/or disordered, we’re already telling a lie.

  • Medical model, or other, psychiatry, today just as 200+ years ago, is the result of our society neither being able nor willing to accept responsibility for its own dysfunctional mechanisms, why it, when a certain group of people, who saw, and still today sees, a chance to make a living by promising to remove the reactions to society’s dysfunctional mechanisms, reminding it of its responsibility, from society’s view, happily embraced, and still today embraces, this group of people and their offer to help — society, not those who challenge its grandiose self-image. Something that is the direct result of such thorough narcissism on the part of society, and that is founded on nothing but this, society’s thoroughly narcissistic need, can impossibly ever be anything but disrespecting, oppressive and abusive toward the other.

    I think, we’re fooling ourselves if we believe psychiatry can be changed. Psychiatry, the institution, is synonymous with totalitarian oppression. That’s what it was designed and created to be, and that’s what it is: totalitarian oppression, silencing those who challenge society’s status quo. When we’re talking about wanting to change psychiatry into something that would really be of help to people in emotional distress, what we’re saying is that we want some sort of respecting, empathetic and kind oppression. Respecting, empathetic and kind oppression… Take a moment to think about that.

    That said, I’m talking about the institution, not the individual working in it. There have always been, and there still are, individuals among the professionals, who know how to, and do help people in emotional distress. Instead of helping society get rid of these people. But unless they’re willing to compromise, to sell out, to betray themselves and the people in emotional distress they want to help, they will, sooner or later, have to leave the institution psychiatry, the institutionalized oppression, and do their work outside of it.

  • Faith, I couldn’t agree more. The self doesn’t stop developing. Eventually, it’s the self that brings about crisis in an attempt to have us realize that who or what we’ve been so far was built upon who or what others expected us to be, not who or what we really were. But if you’re forced to deny, or at least repress your true self, and asked to, instead, identify with a false self, constructed according to others’ expectations, the process of becoming more and more conscious of your true self automatically is interrupted and brought to a halt. That’s what trauma does to people. If it didn’t, if traumatic experiences couldn’t prevent us from integrating our true self in our consciousness, crisis wouldn’t occur.

  • Just to clarify and prevent misunderstandings: I don’t think anybody ever is the same after a crisis, one or the other kind, and I don’t think it’s the meaning of a crisis, one or the other kind, the meaning of life in general, that we should go “back to normal” achieve a state of unchangeability, of perfect stability in this “normality”. But what I see, more often than not, is that the emotional development of people labeled with “psychosis”/”sz” has been interrupted and brought to a halt even before these people ever had a chance to develop a sense of self, while most people labeled with other psych labels at least had a chance to develop some sort of sense of self before whatever experience/trauma put an end to that development, too.

  • It could be interesting to look at why so many parents seem to think that they’re inadequate as parents, leaving where unconditional love should have been a vacuum in their children that they then, loaded down with feelings of guilt, try to fill with treats of all kinds. A parent who is capable of really seeing their child, instead of seeing an object to fulfill their own unmet needs with, doesn’t need to buy his child’s “love” (if it’s bought, it ain’t real love) through treats.

    I understand how it can be extremely tempting to look for the cause of “mental illness”, and all other kinds of problems that manifest discontent in the absence of love, everywhere else but inside ourselves. But if a change of diet for instance was all it took to prevent or cure “mental illness”, then how come we don’t see it actually work for more people?

  • One man’s pain is another man’s gain, comes to mind. At least, this is what I see in Denmark: a huge, and ever growing, “recovery industry”. And I guess, you have it in the U.S. too, probably even more literally an industry than in Denmark, where it’s mostly a public, taxpayer money financed enterprise, not that much a private one like WRAP for instance. It secures a lot of jobs in the public and mh sector, and even creates new ones, with every new “recovery project” that gets launched. And of course, since that which all of the innumerable “recovery projects” — faithfully sticking to the biopsychiatric dogma — aim at is keeping people “in recovery” for life, people never really “recover”, and what we need are ever more “recovery projects”…

    The more I look at the mh system, the more clear it becomes to me that what it labels an “illness” is life itself. Or being an alive human being. — IMO, it’s no coincidence that the “better” the “treatments” psychiatry comes up with, the shorter people’s life expectancy and the more reduced their aliveness while not yet dead become. — Consequently, no one can be “recovered” unless they’re dead. Everybody still somehow, somewhat alive must be “in recovery”.

    To me “recovery” means becoming aware that one never was “ill”, “diseased”, “disordered”, or anything along those lines to begin with. It means being able to let go of the labels and accept life in its entirety, the enjoyable alongside the painful. This unconditional acceptance to me marks the end of the “recovery process” and the beginning of (one’s) life.

  • Rossa, I believe “DD” stands for Developmentally Disabled, “r” for retarded, and “c” for consumer.

    BTW, thank you for your comment to Deron above. I meet these parents all the time. No matter what I suggest as a possibly viable alternative to having their children hospitalized, labelled and drugged up to the eyeballs, it’s never good enough. It may have worked for me, it may work for some, but in the particular case of their child it certainly won’t. Their child is just too sick. And no matter how many details of my own experience I provide, I clearly was misdiagnosed and never really sick at all, or I’m one of the lucky ones whose disease went into remission… Never mind the reaction when I suggest a completely different, much more hopeful view of the crisis the offspring in question is experiencing than the medical one. That’s when I’m in for getting hung, drawn and quartered.

    “I have learned the value of facing my fears”, Deron writes. Earlier today I witnessed a mother of a labelled person on the internet attack somebody with lived experience for suggesting a more hopeful approach. It was like watching a young kid throwing a temper tantrum because somebody stole his candy. If you’re too afraid to face your own fears, your own inner demons, you will inevitably project them onto others. Thus, whenever your child mirrors your own fears, you will inevitably blame the child. S/he is “mentally ill”, brain diseased. Fear is not what creates love, parental or other. “Fear is the path to the dark side”, as Yoda says in Star Wars, it leads to anger, hate and suffering, for everybody involved.

    mcoma, “an umbrella of social action and justice cover all disabilities”. I’ve received a couple of psych labels, and I’m a voice hearer. That doesn’t make for a disability in my world. The first in my world is an attempt at discriminating against me, the latter I regard a gift.

  • -Anonymous, I absolutely agree. And if anything really makes me cringe, each and every time I see it, it’s these detailed descriptions of the beliefs and reactions of those labelled “psychotic”/”schizophrenic” to illustrate just how crazy, how “thought-disordered”, and how dangerous they are. The interesting thing is that most, if not all, of the alleged craziness, the alleged “thought disorder”, and quite a bit of the perceived dangerousness tends to disappear once we get to know a little more than the usual “He had a happy childhood!” nonsense about the allegedly “thought-disordered” person’s upbringing.

    Psychiatry blames those it deems “thought-disordered” not capable of understanding things metaphorically. All the while it consequently chooses to understand literally, and thus as a clear sign of sheer meaningless, “thought-disordered” craziness, beliefs in alien abduction, other people being able to read one’s mind, thoughts of having to kill one’s mother, etc., that, if understood metaphorically and in context with the person’s life story, will seem to me to make perfectly sense. Who is it actually, who’s incapable of understanding things metaphorically?

  • Belinda, “I would also say that the systems response to the symptoms we are displaying is also a massive problem.” Exactly. The system’s response is an entirely fear-based one. If you’re already more than terrified and at a loss of what’s going on, it certainly is of no help that you’re met with even more fear and an even more profound lack of understanding. Our society has appointed the people most afraid of, and therefor least capable of and willing to understand extreme states of consciousness to work with people experiencing these states. That’s a foolproof recipe for disaster.

  • “(W)hat was the purpose for inviting them?” IMO, it was clearly an attempt by certain people in the HVN to whom the acceptance of mainstream psychiatry for some reason seems to mean more than the HVN as such, to brownnose mainstream psychiatry in hopes that mainstream psychiatry might deign to throw the HVN, or the people in question, a few crumbs (of influence and power) from its table.

  • Marilyn, thanks for the clarification! I was in doubt, because in your first paragraph you write: “For this reason, the diagnosis of schizophrenia should not be applied lightly and not without a thorough understanding of the patient’s family and wider circumstances.” (my italics) Of course, a truly “thorough understanding of the” person’s “family and wider circumstances” will in every case lead to the conclusion “complex/post-traumatic stress”, rather than “schizophrenia” or any other “mental illness”. But I’ve seen too many professionals claim to have investigated the person’s family and wider circumstances thoroughly, and still they arrived at “schizophrenia”, or some other “mental illness”, and when you write that “schizophrenia” shouldn’t be applied lightly, it came across as meaning the label actually should be applied in certain cases, just not too lightly.

  • “Tragically, however, schizophrenia is sometimes confused with psychological problems like severe anxiety or depression that are understandable reactions to disturbing life situations like loneliness, isolation, and/or family issues.” I’m flabbergasted. Should this be understood as: “schizophrenia” has got nothing to do with people’s life story? And if it is, how do you support this view of so-called “schizophrenia”? How do you explain the, compared to medical “treatment”, significantly better outcomes of approaches, like Open Dialogue, that do view and treat “schizophrenia” as psycho-social problems?

  • Also, Joanna, these experiences can be extremely distressing, yes. But most, if not all of the distress isn’t caused by the experience itself, but by not understanding it, and consequently not knowing how to deal with it. It’s kind of a law of nature that whatever it is which we don’t understand causes us distress. Without the distress there would be no reason for us to make an effort and try to come to an understanding of whatever challenge we face. And without that effort we’d all remain at kindergarten level in terms of our personal, emotional development, and we’d never learn how to navigate life.

  • Joanna, me too, I’ve had the experiences that psychiatry calls “hallucinations”. So I don’t deny their existence. Which I’m strongly opposed to, both on the basis of my own lived experience and on the basis of working with others who experience among other things “hallucinations”, is psychiatry’s medicalization of these experiences. “Hallucination” is a pseudo-medical term that intends to turn a perfectly healthy and understandable reaction to life into a symptom of illness. I always encourage people to let go of this pseudo-medical, utterly alienating lingo, and to describe their experience in their very own words.

  • Jonah, while I appreciate your approach to Murray’s talk stressing what admittedly at first glance makes Murray look more open to a survivor’s perspective and like a moderate but nevertheless critic, IMO you’re missing a very important point.

    At the core of the human rights violations committed by the mh system isn’t the question whether there should be CTO, or not, whether there should be fewer or more “hospital” beds available, whether there should be fewer or more staff employed at psych “hospitals”, whether people should have access to CBT alongside the inevitable, dopamine-reducing drugs, or not, whether we should say “schizophrenia”, or rather “psychosis”, and so on, and so on. At the core of these violations is the assumption that there would be such a thing as meaningless madness, turning people’s experiences and beliefs into “hallucinations”, “delusions”, and other “symptoms” of the meaningless madness, thus completely and totally devaluing the beliefs and experiences and stripping the person of her humanity. Murray is pretty clear about where he stands concerning this one.

    Personally, I perceive Murray as far more “dangerous” than E. Fuller Torrey for instance, exactly because Murray, contrary to Torrey who at least shows his disrespect for survivors openly, manages to divert people’s attention from the fact that he does not respect people’s own definition of themselves and their experience by focusing on what we all can agree on, but what in fact also is of minor importance.

  • Ha! Those were exactly my thoughts at the congress. Why I left the room after the first couple of minutes. I tried to go back in about half-way through the talk, and all I heard was “dopamine, dopamine, too much dopamine”, so, turned around and left again. — I did watch the entire talk here, from the somewhat more “safe” position of sitting in front of a computer screen.

    Sadly, I think, Murray has a lot of experience of being with people who have unusual thoughts. But prejudice, yes, has probably more or less always made it impossible for him to recognize his own prejudice that “delusions”, “hallucinations”, and “psychosis” as in “meaningless madness” actually does exist, for what it is, i.e. no less “delusional” than George Bush’s and Tony Blair’s beliefs about Iraq, or whatever belief he, on the basis of his own prejudice, has decided to be “delusional” in any labeled person.

    To me the most disturbing about this talk is that it is given in front of an audience whose main conviction, and Murray can impossibly have been ignorant of the fact, is that whatever the experience, whatever the belief, it’s never a sign of “meaningless madness”, while Murray doesn’t touch on this obvious and decisive difference of belief with one word, but, simply by completely ignoring the different belief of his audience, adamantly insists on his own belief to be the one and only truth. In Murray’s own understanding: too much dopamine, anybody?

  • Licinia, where in Scandinavia? Even a professional as diplomatic as Alice Keys wouldn’t have a chance in Denmark. Also, access to therapy is limited to certain labels only, while all that others secure you is drug “treatment”, and maybe some “psycho-education” teaching you about your “illness”. Without a label nothing goes, and social workers have the nasty habit of sending just about everyone, no matter what their problem, to a psychiatrist, because, as we all know, if you’ve lost your job and/or your home, or whatever else misfortune you’ve experienced in your life that make it necessary for you to ask for benefits, the reason must be that you are “mentally ill”. And sure the psychiatrist will find that you are, and write a prescription, which the social worker then can use to tell you that if you don’t pop the pills, you can’t get benefits…

    “Welfare” is a beautiful word, but as the saying goes, don’t hold everything as gold that shines like gold.

  • Nijinsky, March 1, 6:53, I totally agree. As long as people are stuck in their trauma and suffering, and won’t/can’t let go of it, no real growth, no true insight will happen. We don’t need trauma and suffering to grow and gain insight. All we need is to be challenged. Trauma is kind of a meta challenge: you face a challenge, and are told “You can’t!”, or even, with Laing, “Don’t!” That’s what gets people stuck in suffering.

  • “Both Laing and John Weir Perry contended that the suffering seemingly caused by schizophrenia is largely caused by the way it is treated by the “mind-police,” as Laing called them.”

    Exactly. And it doesn’t start with how extreme states, or the people who experience them, are treated, but already with how these states are commonly perceived and defined — namely as an illness, something that shouldn’t be — in our society. Much of the fear I myself initially experienced during altered states wasn’t caused by the altered states themselves, but by the idea that is our society’s that I shouldn’t be having the experience, that it was a sign of something being profoundly wrong with me. Once I’d come to the conclusion — after reading Laing among other things — that nothing was wrong with me, which enabled me to say “yes” to the experience, even the fear wasn’t frightening me anymore. Sadly, the vast majority of people I meet in my work were indoctrinated to fear their experience — themselves — more than death. Their suffering is indeed immeasurable, and only endurable while under the constant influence of more or less heavy sedation.

  • “(S)hort-term or as-needed” it reads to me, not “on a regular basis”. There’s a true benzo panic going on here in Denmark, and I imagine elsewhere too. The result is that people are put on neuroleptics, preferably Seroquel, for things like sleeping problems. I have to say, I don’t know which I think is worse, a drug with a high addiction risk, or a drug that very likely may make you heavily overweight in no time, diabetic, suffering from parkinsonism, and will cause your brain to shrink quite rapidly.

  • Hi Dan, just wanted to let you know that I really enjoyed your post here. Also I was thinking, what if we, society, instead of panicking in the face of what immediately may seem incomprehensible and unpredictable — and therefor dangerous — and running away screaming “Lock them up!” (earlier literally, today in chemical prisons), could be a little more humble, not blaming our lack of understanding on the other, but taking a critical look at our own ability (or inability… ) to understand that may be the real problem, and curious. Curious of course always involves a risk. On the other hand, I believe it’s the only way toward growth for all parts involved. As long as society keeps running away from whatever immediately seems incomprehensible it’ll never come to an understanding. It will remain imprisoned by and in it’s fear of the seemingly incomprehensible as long as it seeks to imprison, not understand, the seemingly incomprehensible.

  • Nijinsky — February 28, 9:18 pm — “any ‘difficulty,’ even social anxiety”. That’s my point. Nobody indeed is innocent. We all run into difficulties, even social anxiety, every now and then. It’s called “life”, and it needs our attention. It needs that we learn how to navigate it in the most constructive way possible. What the difficulties we run into tell us is that we haven’t yet learnt everything, that there’s still room for improvement, learning, growth.

    There are two ways for us to act on the difficulties we inevitably run into, each and every one of us: we can try to ignore them, deny them, in case the difficulties can’t be entirely ignored/denied, resort to scapegoating: “None of all this is my responsibility! It’s everybody/everything else’s (for instance, but not only; the possibilities are innumerable; the system’s, the drugs’, the withdrawal’s,… )!” Or we can embrace them as the unique opportunity for us to take responsibility and learn they are.

    Unfortunately, we have created a culture of denial and scapegoating, a culture of “innocent” narcissists who, whatever the difficulties they run into on their path, are not to be held responsible. It’s the system, the pharmaceutical industry, the drugs… In other cases it’s one’s genes, one’s “mental illness” that you have no agency over (that for instance left the refrigerator door open; it’s truly amazing what “mental illness” is capable of!), in other cases again it’s the trauma that, and this is the decisive part, left you incapable of taking any responsibility for the rest of your life; the possibilities to maintain denial and scapegoating are in fact infinite. But what denial and scapegoating creates is more and more, not less, difficulties.

    What are we going to do about it? Are we going to remain sitting motionless, like a helpless child — and children are the only people who are innocent — and simply extend the denial and scapegoating to whatever new difficulties we run into? And this indeed is what the institution of psychiatry was created to do: to put helpless children in grown-up bodies, the result of our culture’s denial and scapegoating, for whom the denial and scapegoating no longer works out of sight. Or are we finally going to listen to what our increasing difficulties have been trying to tell us for a long, long time, are we finally going to grow up and take responsibility?

    I know that this is a messy, and very inconvenient subject, and I’m not blaming anybody. I’ve just seen, and myself, having been and sometimes still being a helpless child in a grown-up body, experienced — believe me, each time I choose this “solution” difficulties only increase, it doesn’t make them go away — too much harm done by denial and scapegoating. It’s also a very complex subject, and maybe too complex for a comment thread here. Nevertheless, I think it’s important especially in context with the subject of psych drug withdrawal.

  • Jonah, of course there’s never any good reason to drug anybody up on psych drugs, huge or small amount. Psych drugs, just like recreational drugs, do one thing only, they help repression and denial, neither of which has ever got humanity anywhere. So, I wholeheartedly agree that there is no good reason for these drugs to exist at all (I’m a radical in this), and I’m certainly not saying that there could be any. What I’m saying is that nobody whose life actually is all beer and skittles, who has no difficulties dealing with life ever, ends up psychiatrized.

  • Nijinsky, I agree that it is often the people who are labeled and drugged who really are one step ahead of those who label and drug them, since it is my firm belief that, in order to bring change about, it needs some sort of crisis, suffering. If everything is just beer and skittles, then why change anything? However, when you say that people who “were prescribed anti-depressants; just because they encountered what anyone else would in life” you ignore the fact that people are individuals and have individually varying reactions to what anyone encounters in life. Actually, yours is the “argument” professionals often employ: “Trauma?! Oh, shut up. What has happened to you has happened to millions of others, and they didn’t go insane!” People have to get up from the couch, leave the house, and go somewhere to get a prescription for the drugs. At least they have to take and swallow the pills when they’re offered to them. Nobody does this completely without any reason. Or everybody would be on these drugs by now. And I can only say that it is a very, very sad thing to witness people end up in the system again and again, just because they think there’s nothing else in their life they would have to deal with than drug withdrawal.

  • “Actually, people often end up medicated to the gills for no good reason.”

    I haven’t met any of them yet. What I have met, though, is people with serious physical health problems being given SSRIs “preventively”, because we know that many of these people have a tendency to get depressed because of their serious health problems. And I’ve also heard how this “preventive” drugging in some cases has been the start of a long career as a psychiatric “patient”. Anyways, even in these cases, to speak of “no good reason” is a little naive, bordering to denial. The question is whether drugs are the answer, or whether things could be dealt with in a different, much less harmful way.

  • “Allow me to explain why tapering, and not support, should be the focus of a withdrawal program.”

    Allow me to explain why I think, the focus should be, as it is in Daniel’s post, on both equally. No matter how carefully planned and carried through a taper, if the issues that underlie the problems the person was prescribed the drugs for in the first place aren’t addressed properly, there’s a good chance the person will end up in dire need for those very same drugs once more. I see it all the time, people who believe their only problem in life to be their psych drugs, and if only they can get off of them safely everything will be just beer and skittles. The bigger the surprise then, when things don’t turn out just beer and skittles. Let’s face it, shall we: people hardly ever end up labeled, and/ or drugged for no reason at all.

  • Layla, that comment is an analogy, not a personal attack on you. It was meant, I believe, to explain to you how people here feel about biological psychiatry, what it has done to them, and what, because of what it has done to them, a defense of it does to them. It is meant to explain to you why you see the reactions to your comments here that you do see. Here’s a friend of mine, Olga Runciman, chair of the Danish Hearing Voices Network, and soon-to-be psychologist, explaining why it actually is a very to-the-point analogy:

  • @madincanada “The reason for this is that the psychiatrist sees the person when they are at their best,…” Not true. Hardly anywhere else than locked up at a psych ward and forcibly “treated” do people feel more (and righteously) threatened, and react with more desperation defending their life (= “psychosis”). Psychiatrists are at least as, if not more, afraid of extreme emotions and reactions as anybody else. Actually, some of the people I’ve seen who were most afraid of these were psychiatrists.

    “As for the person with psychosis he doesn’t remember his psychotic episodes so in retrospect he doesn’t think he was sick.” Definitely not true either. If your son doesn’t remember his “psychotic episodes”, there are two possible explanations: his “episodes”, whatever they are, aren’t “psychotic”, or there’s something not quite functioning in your communication with your son, why he may have decided that the easiest way out is to tell you that he doesn’t remember. A medical/neurological check can exclude the first. If it’s the second, start listening to your son, and try to understand. You may want to stop telling him that he’s sick, which inevitably translates into: “I don’t want to hear what you have to say”. Then maybe, he even will recover.

  • Amen, and thank you, from here, too, Steve.

    And to Layla: it seems to me that you’ve misunderstood something. You keep telling us that we should work to improve biological psychiatry, not criticize it as such, and work to have it replaced with something completely different. But in order to wish for an improvement of biological psychiatry, instead of a wish for something completely different to replace it, we would all have to subscribe to your belief that our biology is the be-all and end-all in our lives, that everything else is secondary to it (if at all it exists), and that whatever got us psychiatrically labeled was a result of “brain processing gone awry”, i.e. meaningless madness. I for one certainly never will subscribe to that belief, as it runs entirely counter to my own experience, and as I far too many times have seen the absolutely devastating effect it has on people’s lives. And I suspect that I’m not alone in this here. In the introduction of your first comment here you give the impression that you respect Laura’s experience. If that’s really what you want to do, respect Laura’s, and so many others’, experience, you stop asking us to deny it, and buy into the “it’s all just biology” belief of yours.

  • Since there’s no reply button below, this is in reply to Layla’s comment, February 26, 2:33 pm: I wholeheartedly agree that our relationships, our life experience, shape the wiring and functioning of our brains. However, there’s a problem with your reasoning, and it’s about the same as with the reasoning of the researchers in the TV program about “depression” that I watched the other day. It’s not the weather or the latest fashion that is talked about in Open Dialogue’s network meetings. The aim of these network meetings is to uncover dysfunctionality in interpersonal relationships, and have an open and honest, a functional, dialogue about them. If the team succeeds to bring the dysfunctionality in the interpersonal relationships to light, and the involved individuals find words for what before didn’t have words, there’s no more need to express it in a metaphorical, “symptomatic”, way. The “patient” is “cured”.

    According to your logic, whether there has been any not-spoken-of dysfunctionality/trauma, or not, in the labeled person’s life is of no further relevance. Neither is it of relevance whether you then, in therapy (or in network meetings), talk about the never before talked about trauma, or about the latest fashion. All you, as a therapist and in addition to talking about the latest fashion, have to do is ask the ”patient” to, please, rewire their brain. This is what cognitive-behavioral ”therapies” try to do. In the short term, these ”therapies” seem to work, sometimes even better than other, trauma-informed therapies that, obviously, take a lot more time. However, in the long run the cognitive-behavioral ”please rewire your brain!” therapies produce a relatively high relapse rate. Simply because what got your brain wired in a certain way in the first place never got resolved. All your ”therapy” provided you with were a few new ”coping strategies”, new ways to repress, respectively deny that which the coping strategies you had developed on your own no longer were sufficient to suppress, respectively deny, why you ended up in crisis. Those new coping strategies may save you for a while, they may work for a while. But if you think the unconscious can be tricked with a few new coping strategies, you have no idea of its power. Its power goes beyond all human imagination. No one and nothing tricks the unconscious.

    If you want to live your life in fear of the unconscious, trying to trick it, running from it, calling it a ”mental illness”, or if you at some point maybe muster the courage to turn around and face yourself, your real self, well, that’s up to you. It remains a fact though that it is the people who’ve stopped running and fighting – and trying to explain away –, the people who turned around and were no longer afraid of understanding the meaning in their madness in a life-historical context, the reason for their ”brain processing gone awry”, as you call it in another comment here, the people who understand that it wasn’t any brain processing gone awry causing their crisis, but their mind’s outstanding ability to have their brain produce the for their survival necessary reactions to life, who recover fully.

  • “I am a person who suffers from mental illness; I am not the illness.” People suffer from real, somatic illness, and they are not this illness. Unfortunately, there’s a problem with this when it comes to so-called “mental illness”. In one of your comments above you state that our behavior, our emotions, our thoughts, the sum of which is who we are in the world, is shaped by our brains. If this is so, a diseased brain inevitably will shape who you are in this world as a manifestation of the supposed disease: you are the disease. And of course the staff at the hospital and elsewhere told you so; by labeling you. Nobody needs to say literally to another person, “You are your mental illness”. It’s perfectly implicit in the labels themselves that you are your label.

  • In addition to cannotsay2013, here’s an interesting piece about “mentally ill” animals:

    And, Layla, you too, in a rather desperate attempt to justify psychiatry and its “treatments”, mention “schizophrenia”, psychiatry’s holy cow, “If this isn’t a brain disease, then what is?!” You’ve missed to look at the most important thing, before you jumped to the conclusion that there can’t be any other explanation for such an extreme behavior as that which psychiatry fancies to label with “psychosis”, respectively “schizophrenia”, than that it must be caused by a broken brain: the outcomes. If so-called “schizophrenia” was a brain disease, and not an extreme but still natural and in light of the person’s life story perfectly understandable reaction to her life, how do you explain that drug “treatment” produces outcomes that are by far worse than both no treatment at all, and even more worse than the outcomes of alternative approaches like Open Dialogue, which view crisis, aka “psychosis”, as a very understandable reaction to dysfunctional relationships rather than a “symptom” of a brain disease, and treat it accordingly with, well, dialogue, talk? It’s worth remembering that the proof is in the pudding. Read Anatomy of an Epidemic, as NigelB suggests, and read Judith Herman’s Trauma and Recovery to get to a real understanding of extreme human behavior — and the extreme life circumstances that make it a necessity for survival, not a brain disease. And if the extremes of our humanity scare you so profoundly that you need to safeguard yourself against understanding them with labels and stories about broken brains, the profession of a psychologist, i.e. a helper for those experiencing extreme reactions to an extreme life, may not be the best choice for you.

  • I was watching a program about “depression” on German TV yesterday. Which was puzzling me was that, one moment, they put people into scanners to observe the, according to the researchers, “faulty” brain structure and activity that, according to the same researchers, *caused* the “depression” — read: out of the blue, for no outer reason these peoples’ brains were “diseased”, not functioning in a correct way, but producing a “depressed” state of mind where there, according to the researchers, shouldn’t be one — just to, in the next moment, tell us that talking with a therapist actually could correct the brain structure and activity. So, there it is, right in front of these researchers’ eyes: proof that human relationships and our experiences in them shape the wiring and activity in our brains. But do they see the obvious? I felt like asking them, “Ok, guys, what’s it going to be? Brain wiring and functioning shaping our experience of the world, or our experience of the world shaping our brain wiring and functioning? Are we created in the image of the computer, or did we create the computer in our image?”…

    Brilliant post, Laura.

  • To me the fact that a lot of hurt people react with a certain amount of anger and suspicion to the hurt seems to be a lousy excuse for not wanting to listen to what these people have to say. Especially when those who don’t want to listen are parents, i.e. people who more often than not tend to think of themselves as truly mature and wise people, who certainly can’t be held responsible if their offspring bears witness to their immaturity and foolishness.

    What are we going to do as a society? Are we going to have an open and honest exchange about the hurt people feel, and make healing from it possible for them? Or are we going to stick to business as usual, and ask hurt people to shut up and keep their anger and suspicion to themselves — if necessary assisted by a little “medication” — because any mention of it might scare those off who don’t like to hear about responsibility? Are we going to keep up the denial, and leave people stuck with their hurt indefinitely?

    Except for that I don’t see the bullying and vilifying of parents in the comments here, only an interesting exchange of strong opinions, even if there was bullying and vilifying going on, how come it’s always those labeled “insane”, i.e. immature and foolish, who are blamed of bullying and vilifying — those whose actions got them labeled — and asked to, maturely and wisely (?), shut up, while it is regarded a perfectly legitimate thing for the allegedly “sane”, i.e. mature and wise, to bully and vilify the labeled (even more) if they don’t? That’s a bit upside down, isn’t it? Where’s the sanity, the maturity and wisdom in all those parents who choose not to get involved in the MiA community, because their feelings might get hurt, that would allow them to listen and accept their responsibility?

  • Not a book, but a movie, based on and very accurately illustrating R.D. Laing’s research findings, is “Family Life” by Ken Loach: (1. part of 8) Actually a masterpiece as it almost appears to be a documentary portraying the life of a randomly chosen British family, not the carefully scripted production where every word is an equally important piece of the puzzle creating the whole it really is.

  • Thanks, Rossa. Now that I’ve watched the second half of the vid above, I see that, unfortunately, Paula Caplan has the same inconsistency in her argument as Jeffrey Poland. If there is such a thing as “mental illness”, then why wouldn’t there be “schizophrenia”, “bipolar disorder”, “depression”, etc. etc.? And if we can agree that there’s no scientific basis for any of those labels being objectively valid, then how can we, at the same time, claim “mental illness” to be an objectively valid concept?

    Of course existential suffering is real. It’s an essential part of the human condition. It’s always been, and it will always be (the day Big pHARMa invents a pill that cures us from all existential suffering we’ll be history). But is it an illness? Is it something *wrong* with the person? Is the person in some way as a human being flawed, defective? Or is what we call “mental illness” maybe exactly what is the most *right* with the person? Is reacting to life an illness? Something wrong with us, something that should not be? Or is it maybe an ability necessary for our survival, and furthermore for growth and development?

    Yes, I’ve read Laing, and it was indeed the only thing I could read, actually read from cover to cover almost in one day, while in crisis without feeling so totally and utterly *in*validated as I felt trying to read some of the mainstream-bs on, well, “mental illness”. Never mind that Laing does make use of the terms “schizophrenia” and “mental illness”. But he uses them in the framework of existential phenomenology. Not in that of some psychopathologizing sort of would-be medical science or the like. Huge difference.

    IMO, if somebody feels validated by being referred to as “mentally ill”, with or without greater specification, it should have our alarm bells ring. Telling somebody they’re *wrong* isn’t validating them. It’s validating their invalidity. The victim inside may feel good. The survivor will feel assaulted, demeaned, ridiculed.

    I wonder, whether Paula Caplan — or Jeffrey Poland for that sake — ever have had the chance to hear a survivor like Jacqui Dillon speak. If not, I highly recommend it.

  • I’ve just read Jeffrey Poland’s chapter “Bias and Schizophrenia”. Absolutely brilliant. Except for one thing: “…critics are not denying that there is such a thing as severe and disabling mental illness;…” Not true, some are. And while people regularly get angry with me because I tell them that *something* has got them labeled and drugged up, and, in case, also committed, that it didn’t happen for no reason at all, I’d say calling this *something* for “mental illness”, “severe and disabling” on top of that, is no less harmful, demeaning and disempowering, than calling it “schizophrenia”, with “schizophrenia” being just one of several possible synonyms for “severe and disabling mental illness”, and the term “severe and disabling mental illness” doing exactly the same in regard to the biases listed by Poland in his otherwise excellent piece, as which the term “schizophrenia” does. So, while Poland successfully deconstructs “schizophrenia”, he fails to realize that if at the same time he wants to maintain a belief in “severe and disabling mental illness” as a valid concept, he renders his previous deconstruction virtually null and void.

  • Chrys, I couldn’t agree more! And about 3 years ago I’ve had a short exchange with Peter Stastny on the matter, . However, today, after 2 years of working with people who’ve been (additionally) severely victimized, infantilized, traumatized, and brainwashed by the system, apart from also being physically/neurologically more or less severely damaged by long-term drug use, I would also agree with Peter Stastny that the “window of opportunity” unfortunately often is a lot more closed for people who’ve been in the system for years, or even decades, compared to the window of opportunity of people, who experience their first “break”. It needs a somewhat different, much more complex, approach, a lot more support put in place, and a rather profound knowledge about psych drugs and withdrawal than what for instance the original Soteria House can provide to help these people. Nevertheless, I still think, access to the “first break”/”young people” approach shouldn’t be restricted to people who are actually experiencing a first “break”, and are “young”. In my own case for instance, not even the 24/7 intensive Soteria House approach was required. To me it makes a lot more sense to distinguish between people who are hooked on the drugs (and would need a sophisticated withdrawal program), and have swallowed the system’s messages hook, line and sinker, and those who are/have not. No matter how many “breaks” they’ve had in the past, or what their age. It isn’t necessarily one’s age or the number of “breaks” which determine how open the window of opportunity is. In spite of several “breaks” in the past, and 42 years of age (certainly not “young” anymore), mine was wide open, while I would have been turned away (and drugged up by the traditional system) by any kind of help that used “first break” and “young” as its access criteria. Luckily my therapist didn’t use these criteria, but used “motivation” as hers.

  • In reply to mjk: “2. behaviour that appears to be motivated by contradictory or conflicting principles”. It “appears”. To any unengaged observer, like an mh professional for instance. It may also “appear” so to a parent whose need to himself appear as the perfect parent isn’t met by a child who reacts to the parent reflecting the parent’s imperfection. A psychiatric “symptom” is a reaction to life that is taken out of its context with life. Thus the cognitive dissonance doesn’t happen in the person who’s labeled with “mental illness” on the grounds of psychiatric “symptoms”, but in those who label.

  • Rossa, I agree that it’s counterproductive to demonize, vilify, blame, and, yes, a lot of the reactions I’ve seen to Jani’s parents have been demonizing, vilifying and blaming them. But I don’t see that happening here on MiA. All I see is facts being quoted that are undeniable, and which most of Michael Schofield himself has admitted to openly. Not being allowed to talk about these facts is asking people to engage in the same denial that Jani’s parents are engaging in (and denial, in fact, is something that I do see in a few comments here). And denial is just as counterproductive as demonizing, vilifying and blaming.

  • Rossa, for once I have to disagree. Nobody vilifies Michael Schofield. Nobody has to since he’s doing an excellent job at it all by himself. I agree that both parents are in desperate need of help, no less than their kids are. But they’ve been offered help, many times, also from the Intervoice community. So far, they’ve turned every offer down immediately, except for the actually least helpful offer of them all coming from bio-psychiatry. We all make mistakes, yes. We need to make mistakes, or we wouldn’t learn a thing, ever. But when the reaction of others to our own actions as unmistakably show us that our actions were a mistake as Jani’s reaction to her parents shows them that their actions were (and are) a mistake, we have an obligation to face this, and take responsibility for our mistakes. Especially when others depend on us like children depend on their parents. It’s not perfection that makes us grown-up people fit to be parents. It’s taking responsibility for our imperfection that does. I don’t see much taking responsibility for anything looking at Jani’s parents. All I see is that they stop at nothing to avoid responsibility. That’s what kids do, who haven’t yet learned to take responsibility: “It wasn’t me throwing that stone that smashed the window! It were the fairies!” or, in this case, it was “mental illness”!… And kids having kids is the safest recipe for catastrophe.

  • mjk, I think, before we have the right to single out an individual, never mention a child, point fingers at them, label them “defective”, genetically or other, and feed them neuro-toxic substances, we ought to have proof, valid scientific proof, that they really are defective, that this “schizophrenia” thing actually exists the way psychiatry imagines it to exist, and also that the neuro-toxic substances in fact do any good to them. Don’t you?

  • Sinead, you’re jumping to conclusions and making a lot of assumptions about people. Just because Rossa, mjk below, and I have an interest to know why things like the shooting happen, an interest that goes beyond the usual suspects like “mental illness”, and think the question deserves some more thorough investigation, that doesn’t mean we don’t have compassion with the victims. We’re not asking the question because we want to find an excuse for what Adam Lanza did. We’re asking because we don’t want more children, more people, to be shot. If we wanted an excuse, “monster” or “mental illness” would serve the purpose perfectly, and we’d settle for it.

    To answer your questions: what I would say to Adam Lanza in front of his victims is “Why?”, and, of course, witnessing any kind of violence, I do whatever possible to stop it.

  • Sinead, it sure is most politically correct to damn the murderer, call him/her/them (a) monster(s), and to never ask, “Why?” while prepared to face the honest answer, “Because of you.” I know having compassion only for the victim(s) is the most politically correct to do. I’m not here to be politically correct. Actually, I don’t see it as my “call” in life to be politically correct. I see it as my “call” in life to be honest. And to be honest, I don’t see how anybody can have true compassion for a victim, as long as they deny one single perpetrator the same compassion.

  • mjk, did you ever reach to read Michael Schofield’s, Jani’s father’s, blog before he deleted the posts where he described how both he and his wife beat up Jani, and starved her as an infant? You may say, well, they did this to her because she was born “different”, difficult, and they were powerless, couldn’t deal with her, and didn’t know what else to do. She, an infant, was driving them crazy, and made them, allegedly grown-up people, do this to her: “You made me do this to you.” The abusers “excuse” par excellence. And indeed, it’s how Michael Schofield back then tried to “excuse” his and his wife’s abuse of Jani. But when we’re talking an infant on the one hand, and two allegedly grown-up, allegedly mature enough to have kids of their own people on the other, there is no excuse.

    Both parents identify as “mentally ill”, “depression” and “bipolar”. I.e. both parents identify as everything else but grown-up and mature enough to have kids of their own people. They should never have had any. Not as long as they kept trying to excuse their profoundly immature and irresponsible behavior with “mental illness”, their own, and their daughter’s.

  • Another story, this time not personal, but taken from Sabine Bode’s book “Kriegsenkel” (as far as I know the book is not translated into English, the title means “Grandchildren of War”), a story about 9/11: a man, a chef who’d been working at WTC, went to one of the crisis centers that were set up following 9/11 to get help with sorting out things in regard to him having lost his job. He took along his daughter, a preschooler. While her father got counseling, she stayed at the center’s “Kids Corner” where she immediately started to paint a picture of buildings in red, yellow and black coloring. Asked about the picture she explained it was the WTC burning and collapsing. Her father had worked there, and he’d narrowly escaped being killed, and that he’d suffered asphyxiation. The thing is, her father hadn’t even been near WTC on 9/11. He should have been, but he’d changed shift with a colleague, who’d died. Her father suffered from massive feelings of guilt, nightmares, etc., but of course he hadn’t talked to his preschool daughter about any of it. He didn’t need to, one might say, his daughter had picked up the signals anyway. Unconsciously. Kids do. This girl got a chance to talk about it, sort things out, understand. Lots and lots of kids never get that chance. If it’s 9/11, war, things like Newtown, domestic violence,… if it’s “just” growing up with traumatized parents who haven’t dealt with their trauma and therefor are acting it out in ever so subtle ways, it doesn’t matter. It’ll leave the kid insecure and fearful. And undealt-with insecurity and fear are the breeding ground for aggression.

    To me, two things are interesting in regard to Adam Lanza. One is the account of the hair stylist, who’d noticed that he didn’t ever react to anything or anyone but his mother (‘s commands). The other is that his mother was a teacher at Sandy Hook Elementary School. Two observations/facts that might lead to some kind of understanding, if we took a closer look at them. What happened behind closed doors at the Lanza’s home, in the relationship between him and his mother? Unfortunately, we, society, prefer to shout “evil!” or “mentally ill!”, which both equally efficiently block for any further attempts to understand, the final explanations for someone’s behavior they pretend to be. Understanding how we relate to each other, how our relations to each other, our experiences in these relations, shape our reactions, ourselves, it’s of no importance to us it seems. All which is of importance in our society is that we can say, “It’s not my responsibility! It’s got nothing whatsoever to do with me! It’s all your/his/her/their fault!”

    The really interesting thing about this is that a philosophy that presupposes that we all are equally responsible, that “no one is an island”, and that leaves no room for pointing fingers at individuals, scapegoating them, is at the root of the by far most successful approach to crisis in the western world: Open Dialogue. Thought provoking, isn’t it?

  • Excellent article, Rossa, and I can only second what you write in the comments in reply to Sinead.

    The Holocaust… I was born in Germany in 1961, to parents born in Germany in 1925 and 1933, the year Hitler came into power. In school, from 5th grade on, and continuously throughout the rest of our school education, we learned everything there was to learn about Nazi-Germany, the Holocaust, WWII. The idea was, of course, that this should never ever repeat itself. We learned everything there was to learn – from one perspective. And I looked around, and wondered, did we actually learn anything? Has humanity learned anything, from the atrocities committed by the Nazis? Has humanity actually ever learned anything from its own history? Somehow, looking at humanity, its history, all I could see was a bunch of arch idiots, shouting ”Never again!”, while they were busy preparing themselves, and everybody else, to make the same mistakes all over again. And again and again and again… Even in the way they were shouting, ”Never again!” Because while they were teaching us everything there was to learn about the atrocities that had happened, from one perspective, they also kept silent about other, taboo, perspectives, and if ever anybody, like Alice Miller for instance, ventured to suggest a different perspective, , one that might have lead to some sort of understanding of “what prompted the state of mind that conceived”, in Hitler’s case, the Holocaust, they shouted even louder, “Evil! Inhuman! Monster!”

    In 2002 the German (controversial) author Günter Grass published his novel ”Im Krebsgang” (Crabwalk) that stages the taboo: Germans as victims. To start with, reactions were, of course, critical to outraged: Germans weren’t and had never been victims! They were Nazis. Murderers, criminals, monsters. Guilty! The 12-year-old, living in a German city that was virtually completely destroyed in 1944 and 1945 by massive airstrikes and firestorms, was a perpetrator, not a victim. – He never talked about it, BTW, not a word, as if he hadn’t existed prior to the early 1950ies, as a teenager. I only know because I googled the name of his hometown and “1945”. — So was the 19-year-old who was raped and nearly beaten to death by soldiers of the Red Army, when they caught up with her, and many, many others, who’d had to leave everything behind and run. – She did talk about it, hints, fragments, when she got angry, using her victim status as a street currency. She changed subject whenever asked about it out of interest. — Anyhow, after 57 years the silence eventually had been broken, and the more people started to talk, the more they also started to understand, to grieve, and to forgive. Where there’s no understanding, grief and forgiveness, history will inevitably repeat itself.

    There’s a whole generation in Germany, and I’m one of them, who grew up with severely traumatized parents (and teachers… ), for whom it wasn’t only the trauma itself making it difficult to understand, but also a collective taboo, a collective denial, following the trauma. There’s a whole generation in Germany, and I’m one of them, that has experienced and can testify to how trauma is passed on from one generation to the next, to how a victim indeed can turn into a perpetrator themselves, unless their trauma is recognized, too, and dealt with openly. Violence can only be prevented by looking at what actually generates it, which is – violence. Monsters can’t be understood. Just like ”mental illness” can’t be understood. Human beings can, and human reactions to life can. And sometimes life is monstrous, causing human beings to react in monstrous ways. They’re still human beings, and can be understood, need to be understood if the monstrosities are to end.

    We can make ourselves the powerless victims of inhumane, evil, incomprehensible monsters, like parents can make, and NAMI-parents usually do make, themselves the powerless victims of evil, inhumane, incomprehensible “mental illness”. It’s tempting, because it lends us the victim’s power (!) to say “no” to personal responsibility. But we have to realize that the moment we say “no” to personal responsibility we become perpetrators ourselves.

    The most terrifying thing in life isn’t monsters. It’s the fact that every “monster” at the core is a human being like you and me, and that every human being, you and me included, has the capacity to react in a monstrous way, if only their life is monstrous enough. We all have a personal responsibility to try and understand what it is in this life that could prompt the state of mind that conceives atrocities like the Holocaust, or the mass shooting Adam Lanza went on. Only if we take that personal responsibility we do have a chance to prevent ourselves and others from passing on the trauma and conceiving atrocities in the future.

  • Maybe I’m too pessimistic, but while I do see change, I don’t see it happen in the mh system. Yes, they’ve eventually started to talk about “recovery”, for instance. They hardly talk about anything else these days. But how do they talk about it? What has “recovery” become to mean after they started to talk about it? Does it still mean being able to live without this thing called “mental illness”? Well, no, not in the mh system’s interpretation of the word. And actually I regard their colonization of the term even more dangerous than if they’d never started to use it in the first place. Because now, with them hardly ever talking about anything but recovery this and recovery that — “illness management recovery” is the latest fad in Denmark, OMG! — we can’t even ask them to start talking about it anymore. Because they already are talking about it, all the time. So, what more do we want?! I see the same problem with the mh system replacing the term “schizophrenia” with “psychosis”. Where does it actually get us that they replace the s-word with “psychosis” when what is meant remains the same?

  • You don’t necessarily have to change what you think and say about psychiatry. Even if “mystifying individuals (and everybody else, I’d add) about the origin of their emotional pain” is the actual purpose of psychiatry — and I for one am convinced it is — that doesn’t mean it’s done consciously, on purpose, by the individual practitioner. And only if it’s done consciously, it makes for “deliberately nasty”.

    IMO, psychiatry is the logic consequence of modern western civilization’s ongoing efforts to have its — warning, label ahead! — narcissistic needs met. Modern western civilization is the culture, or cultivation, of “toxic mimicry”, with Derrick Jensen. And in perfect alignment with what we can see this culture do in all other areas of life, also in the area of help for people in emotional distress it has turned the meaning of the word “help” upside down, creating a huge discrepancy between the word, what is said on the one hand, and the actions, what actually is done on the other. Whenever you have a discrepancy between what is said on the one hand, and what is done on the other, which counts is what is done. However, that which is said serves to turn that which is done into its opposite, in your own mind, and in that of others. It serves to delude both yourself and others about what actually is done. The narcissism that creates these delusions is always unconscious. Once narcissism becomes conscious of itself, it’s gone, together with the needs that come along with it: no more need for an institution that labels certain people as “lesser than”, so that the rest of us can feel “better than”, because deep down we feel absolutely miserable about ourselves. Many of the mh professionals I’ve met were people with zero self-love, self-respect, and self-esteem.

  • I’ve noticed the shift among mh professionals away from “schizophrenia” to “psychosis”, me too. Anyway, which hasn’t changed is the assumption that, whether it’s called “schizophrenia” or “psychosis”, it equals a chronic brain disease. People can’t be psychosis, no. But they can be psychotic. And that’s labelling the person.

    As to what to replace dehumanizing pseudo-medical terminology with, I haven’t read the article John Hogget mentions, so I don’t know if Lucy Johnstone maybe has an even better idea, but I like Loren Mosher’s suggestion: “Why not call it a severe personal emotional crisis? Or a severe psychological crisis?” ( )

  • It doesn’t really make sense to me. Treating “symptoms” is like rewording psychiatry’s circular argumentation illustrated in Lucy Johnstone’s, BTW brilliant, article above as “Clearly, the reason people hear voices is because they have ‘schizophrenia’. And how do we know they have ‘schizophrenia’? Because they hear voices, of course!” as “Clearly, the reason people hear voices is because they hear voices. And how do we know they hear voices? Because they hear voices, of course!” If anything, that’s even more nonsensical than the article’s/psychiatry’s version of the statement, which at least pretends that there’s a cause and an effect. Doing away with the labels, while we keep thinking of people, their emotions, thinking, behavior as diseased, “symptomatic”, won’t end the stigma. Realizing that people’s emotions, thinking, and behavior aren’t “symptoms”, aren’t signs of some kind of underlying individual defect, but, like everybody else’s, perfectly healthy reactions to life, will.

  • Me too, I think dragonfly’s is an excellent reply.

    The question is what is meant by “recovery”. Danish “Capital Region Psychiatry”, i.e. the psych system in the Copenhagen area, recently came up with an interesting concept that everybody is totally mesmerized by: Illness Management Recovery. Uh, wait a minute, WHAT?! you may ask. Yup, you got that right: Illness Management Recovery. In one breath. Finally, psychiatry officially acknowledges that recovery is possible, and Capital region Psychiatry now even pushes for recovery, hooray! Or does it?? Let’s be honest, “illness management” on the one hand, and “recovery” on the other are mutually exclusive. It can only be either or. Not both and. But any such criticism is immediately, and often successfully, stifled by the argument that recovery is “deeply personal” (cf. Anthony), so nobody has a right to define what it actually is except for the person experiencing it. While the mh system of course sees to that all the deeply personal definitions of recovery it quotes are those of “insightful patients”, i.e. people who’ve internalized the mh system’s definition of recovery — so much for “deeply personal”… — as meaning “living a satisfying, hopeful, and contributing life even with limitations caused by the illness.” (cf. Anthony). If that’s recovery then what to call it when people actually end up “living a satisfying, hopeful, and contributing life” without any “limitations caused by” any “illness”, as it clearly falls beyond Anthony’s/the mh system’s definition of recovery? Well, I never really liked the term “recovery” anyways, since I don’t quite see how it fits in where there was no illness to begin with.

  • And, don’t jump to conclusions! Politically, I’m in no way far right. I’m all for social accountability. Which is about the opposite of blaming the individual by labeling them defective, and shutting them up with drugs, if ever they should venture to react to others’ narcissism. I’d love to see my tax money be spent on some real help for people who don’t know how to take responsibility. Unfortunately, I have to watch it get wasted on psychiatry instead.

  • Not complaining doesn’t equal to keeping one’s mouth shut and “suffer in silence”. It just means that, instead of wasting one’s time and energy moaning and groaning one’s unjust fate, one takes responsibility, and one’s life into one’s own hands. Like it can be expected from grown-up, mature people.

  • I wonder what pain a child can inflict on his or her parents other than the pain we all feel whenever somebody, through their reactions to us, reflects our own shortcomings. Since when are children responsible for their parents’ emotional well-being? Who’s actually the grown-up here, the child or the parent?

    Several months ago, Danish TV ran a series about a “treatment” facility for troubled kids and youths. There was this 13-year-old girl, whose mother had had ever changing relationships with a number of violent men during most of her daughter’s childhood. At several occasions the girl had witnessed her mother getting beaten up. She herself had been sexually assaulted by these men. But were it these experiences that had caused the behavior that eventually landed her in the “treatment” facility? Oh no! It was her “ADHD”, which the professionals at the “treatment” facility had labelled her with, that her poor, poor mother just couldn’t deal with anymore… A 13-year-old feeling responsible for her mother, and profoundly guilty for both what her mother’s boyfriends had done to her mother and herself, and for the additional suffering she, with her “broken brain”, her “ADHD”, had put her mother through. Goodness gracious!

    Should mothers know better than complain? Sure they should, the responsible and respectable grown-up people they want everybody to believe they are. Complaining doesn’t get anybody anywhere but deeper and deeper into the very same misery that’s complained about.

  • Well, I think the “poor parenting skills” and the “low level asinine way” can be read as an attack, if ripped out of the context both are written in: “The mother is the one who needs help here to learn to handle her son more intelligently.” Seen in their proper context, both are observations — which I, too, made — that hardly can be avoided, if we really want to help kids like Michael.

    Reading Liza Long’s piece, I got the very strong impression of somebody, who, probably out of helplessness, would do whatever it takes, if it is putting very personal details about her son known to the world — something I would have had a very hard time forgiving had my parents done this –, to make herself appear blameless, the perfect mother, the victim whose helplessness is alone the fault of her son/-s “mental illness”. The fact that she goes as far as she does in this attempt, and obviously feels she needs to (ab)use somebody else, her son, to make her own star shine even brighter, somehow has me sense the abysmal extent of self-loathing that got her to write this piece in the first place. Self-loathing doesn’t make for good parenting skills. But sure as hell it can buy you your 15 minutes of the world’s sympathy, if you manage to project whatever you hate about yourself on somebody else and make you their victim. It’s just that 15 minutes are only 15 minutes, and what then? What’s next?

  • “Why do some children cuddle and warmly conform to embraces, yet others stiffen and pull back from the same overture? Why do some children smile and actively engage a new person, while others avert their gaze and withdraw?”

    With all respect to, especially, Peter Levine, I think, no whatsoever advanced neurobiological theory can give a more clear and convincing answer than Olga’s piece here.

  • I couldn’t agree more, Stephen. Unfortunately, the “helping” professions, especially psychiatry, the way they work in our culture, serve as the perfect platform for projecting and acting out one’s trauma rather than as an opportunity for self-examination and -reflection. That’s probably why they attract especially those, who are the most afraid of confronting their own issues.

  • Jeffrey, you’re caught up in the idea that only what can be grasped by our rational mind is communication. Although I can see how that is a very reassuring and comforting idea when life is confusing and having us feel insecure, it is not so.

  • It is my experience that whenever our immediate reaction to something is, “This is crazy!” what we’re actually dealing with isn’t another person’s craziness, but a block in our own consciousness, usually produced by fear.

    We can quote studies and statistics, and understand with our rational mind, “This or that percentage of all children in any age group experience/have experienced abuse.” So what? It’s just a number, statistics, purely rational, technical language, stripped of all emotion. That’s why we can quote the numbers and statistics without putting ourselves at risk, emotionally. But real understanding doesn’t happen unless we also understand on an emotional level, unless the numbers in the statistics have become real human beings, and we’ve listened to them, and overcome the block that our fear has created, allowing ourselves to feel what the words of the real human beings do to us, emotionally.

    The numbers and statistics are out there, it’s not difficult to find them. Even psychiatry itself has no big problem quoting them. What it does have a huge problem with is when the numbers in the statistics become real human beings expressing real human emotion: “You are crazy! Incoherent! Mentally ill! Psychotic! Now, take your meds (= shut up, because we can’t deal with the emotions your words stir in us, because we can’t deal with our own pain)!”

    Quoting the numbers and statistics is important. But on its own it won’t do much. Real change will only be possible if we can overcome our fear of our own pain and hurt, and allow ourselves to feel it.

    Olga’s words go deep on the emotional level, indeed so deep that some will have to protect themselves against them: “Crazy!” I’d say, take that as a compliment, Olga. Your post hits home. And, if your writing here is really crazy, then so is Herbjørg Wassmo’s Tora trilogy, for instance.

  • To me, the questions run a little deeper: is it about patient rights, or human rights? Does the health system, the so-called mental health system (it’s really the mental illness system, isn’t it) included, need to change, or the culture that medicalizes emotional distress?

    Well, I know what my answers to these questions are, and I won’t compromise on them. While it may be fine as far as real health problems are concerned, “participatory” is nowhere near what I think I’m entitled to when it comes to existential matters.

  • Not sure that Open Dialogue would be the answer here. Psychiatry doesn’t only mess with people’s brains and their minds, it also messes up their social networks. People often become very isolated. And I don’t know if a network meeting with the case worker, the prescribing psychiatrist and… and… who else? really would make for an Open Dialogue network meeting. Open Dialogue seems to be designed primarily for “first break psychosis”, just like Soteria. I imagine something like the approach of the Family Care Foundation to be much more efficient when it comes to helping “chronic mental patients” recover.

    Great post, Daniel! While it respectfully shows us the limitations of Soteria, it also, and at the same time, shows us how much damage the biomedical paradigm actually has done and continues to do. Not just on an individual level.

  • A part of me wants to agree with you on your second point. There also was a CBT therapist from the NHS/NICE speaking at the World Hearing Voices Congress in Cardiff, and one of her main points was exactly this: “You don’t have scientific evidence! You need scientific evidence, if you want to convince the world!” I don’t know. It’s true that the world, the so-called civilized part of it at least, doesn’t really acknowledge anything that isn’t randomized double-blind controlled. The question to me is whether it will lead to our experiences being acknowledged when we reframe them in randomized double-blind controlled terms, or whether it will, once again, reduce them to a percentage in a pie chart, a number in some statistics.

    Pie charts and statistics have their value, but when it comes to life as such, to the human experience, to human nature, their value in terms of understanding these phenomena seems extremely limited to me, and, indeed, they seem to me to be a huge part of the alienation we (modern western civilization) are victim of. We’ve confused knowledge (as in randomized double-blind controlled and pie chart) with wisdom (as in lived experience), and personally, I don’t think real change in the mh field is possible without a radical cultural change. In that regard I also see that the entire culture in Western Lapland is radically different from that in other parts of the western world.

    How to meet people in crisis and their family and friends under the current circumstances… that’s a difficult one, yes. I’d say it depends on whether there’s an openness towards a different perspective. Invite people to sit down and talk about what’s going on, ask them what has happened, instead of what’s wrong, what’s the problem. With people who are or have been in the system, ask them, too, about what’s happened to them in their life. Most people who end up psychiatrically labelled have a horrible life story, it can make one wonder how they survived at all, and often no one has ever asked them about it, and had had the time to listen. With this life story, you can reframe their “mental illness”, their supposed weakness, as the strength it actually is. Not everybody will be happy about that. Most have fought a long and tough battle against themselves, before they finally succumbed to the pressure, and showed “insight”. Don’t expect these people to easily and happily give up on what they had to fight such a long and tough battle, denying themselves (once again), to obtain. But my experience is that most people actually are relieved when their experience gets “normalized”, and talked about in everyday language, instead of in clinical terms.

  • Anonymous, I couldn’t agree more.

    I watched Rufus May speaking “Giraffe” at the World Hearing Voices Congress in Cardiff last week. Before I got an interest in the mh field, it was horses. There was Monty Roberts practicing “Join Up”, Michael Peace was doing “Think Equus”, Bent Branderup the “Aacademic Art of Riding”, and and and. The list of fancy methods is endless. But in the world of horseback riding as well as in the mh field I see one thing, and only one, determine success and failure, and that is if it is common sense, or not. If it is awareness, or not. If it is consciousness, or not. Michael Peace once said that about 90% of the audience watching him working with horses didn’t get it. Because they saw only him, and not the horse. They wanted a method, a recipe, a sciencey-polished packaging to cover up for their lack of self-/awareness, self-/consciousness.

    Isn’t it sad, just sad, that we are so alienated from our own human nature that we need to sell it to ourselves wrapped up in sciencey-polished packaging as “Giraffe”, or “Join Up”, or “Think Equus”, or “Open Dialogue” for that sake, applicable to both our own human nature taken to its extremes and still not recognizable for us other than if sold to us in sciencey-polished packaging as “psychosis”, respectively as what we fancy to call “problem horses”? Is it really “psychosis”, respectively a “problem horse”, or is it our own alienation? Personally, I’ve never seen a “problem horse”. All I’ve ever seen is myself having a problem understanding the horse (and the horse trying to tell me about it, loud and clearly, like in “psychosis”).

    In this context: I applaud Sandra Steingard. It’s not often that I’ve seen professionals actually opening up to new perspectives. Thought-provoking, though, that it needed other professionals to bring about this opening-up. The voice of a few professionals still seems to be more important than that of thousands of experts by experience. The sciencey-polished package, which the real life experiences still seem to have a hard time comparing with.

    How about next year in Melbourne, too?

  • I’m skeptical, me too, and very much so. Earlier this year, to be more precise in June, we’ve both seen a couple of those getting through the cracks. Among them Michael Petterson, who tosses people labelled with “schizophrenia” into one and the same category with those with “autism, mental retardation, dementia” (cf. slide 26 of his presentation), understanding “schizophrenia” as a chronic disease, another Louise Kolbjørn, who enthusiastically announces that the “Knowledge Center’s” canteen (!) at the planned gigantic schizophrenia factory at Slagelse also will have a few jobs to offer for “patients”. According to the motto: we’ll kindly let you sweep the floor and do the dishes, yay!, but don’t expect us to let you have any influence on what kind of knowledge the center is going to collect and disseminate! That’s for “experts” only!

    There’s not just the pharmaceutical industry and a handful of (wannabe) medical specialists living (or should I say preying… ) on “mental illness”, but also a huge and growing governmental machinery, local, regional and national. Their jobs depend on keeping us oppressed, i.e. chronically brain diseased, disabled, and in dire need of one fancy rehabilitation project after the other. So far, what I see is that the reform primarily serves their interests, not ours. And as long as the powers that be refuse to look at why psychiatrised people end up qualifying to be tossed in one and the same category with people with “autism, mental retardation, dementia”, this will not change.

  • Chrys, especially in Germany there’s a growing interest in the medical field in general to look at even, at first glance, purely physiological problems from a more holistic perspective, and to, also!, see the body, the entire body, as a metaphor. So, in a way what they say is that even something like hormonal turbulences may in part be due to things like psychological stress. Unfortunately such a view carries the risk in it that, all of a sudden, whatever the physiological problem, it’s all in your head, and so in Denmark for instance an extreme version of this view that tries to bridge the dualistic mind-body gap, has led to a troubling trend to send everybody who complains about physiological problems without the doctors being able to provide an easy diagnosis and treatment, to a psychiatrist… who then will tell you that, whatever your problem, it’s your brain that’s broken. Which is paradoxical as it, once again, denies the existence of the mind as fundamentally different from (although inextricably connected with) the body, so it’s not bridging anything, but, once again, reducing what would be an actually holistic approach to a totally limited, purely technological one.

    I think, what we need to do is to sit down and listen to people as they speak about their problems in their own words.The more we try to reframe everything exclusively under the technological paradigm, the further we will move away from an actual understanding of life and ourselves. And it’s not that I don’t appreciate technology. It certainly is of importance, especially in regard to physiological problems. But I think that if we believe we just have to view everything, if it’s hormonal disturbances or ACEs or whatever, from a technological perspective, doing tons of randomized, double-blinded this and that studies that live up to all those technological standards, and, voilà, we’ve understood its true nature, we’re fooling ourselves big time. But maybe this, our tendency to hold on to an almost exclusive view of life and ourselves in technological terms is just another “adversity” thrown in our way for us to learn how to overcome, once it causes us enough suffering to have us look for different solutions…

  • “We know that by themselves, ACEs cannot simply be said to cause mental illness. And we know that mental illness can occur in the absence of ACEs.”

    I’m not so sure that we actually know this, and the statement seems to me in itself to be a little simplistic. Just like saying something like, “We know mental illness is genetic”, or “We know childhood trauma is at the root of emotional distress”. The question is, what gets called an “ACE”. Is it having been beaten up several times a day, having been sexually abused, suffered obvious neglect, massive bullying, etc., during most of one’s childhood? And if no such obvious ACEs are reported, does that automatically mean that the person’s childhood was just perfect? And that if they develop what gets called a “mental illness”, it must be genetic?

    What I see looking at people labelled with a “mental illness” is, to put it in a simplistic way, somebody who hasn’t learnt to deal with one or the other, or several, aspect(s) of life in a grown-up manner. These people lack the tools and skills to deal in a grown-up manner with life, so they, of course, resort to whatever tools and skills are at their disposal, which are a kid’s tools and skills. What I see is people making use of the tools and skills we all would regard appropriate to use for a kid, but not for a grown-up person. And I also see a stunning correlation between which age-specific tools and skills people use and what their life story reveals at what point of time in their life an “ACE” had them get stuck in their personal, emotional development, which is what trauma does to people.

    The world isn’t perfect. Our culture isn’t perfect. Human beings aren’t perfect. None of us is ever born with the complete tool kit and the perfectionized skills to use it that enables them to navigate whatever life might have in store for them in the most constructive way imaginable. We all have to learn how to navigate life. One’s childhood may seem perfect from the perspective of a world, a culture, that tends to view itself/themselves as perfect, but that nevertheless in reality is pretty much imperfect, and from the perspective of whoever is looking at it – be it the person herself – who’s a member of this world/culture, and thus conditioned to view it as more perfect than imperfect. But if somebody ends up psychiatrically labelled, they have for one or the other reason not acquired the tools and skills necessary to navigate life without getting labelled. And whatever it otherwise is called that prevents people from acquiring these tools and skills, it is, essentially, an “ACE”, if it gets reported as such, or not.

    It is through the adversities we encounter in life that we learn, that we achieve personal development and growth. But sometimes we encounter adversities at a point of time in our life where we don’t have the necessary personal maturity yet to deal with them, and/or of a kind that would demand us to own extraordinary tools and skills, if we were to deal with them in a constructive way, and the result is trauma, i.e. we get stuck with this unresolved situation, i.e. we experience “mental illness”, our personal growth and development is stunted, and we won’t be able to move forward unless we find one or the other viable resolution for the situation we were overwhelmed by, which is what “recovery” is all about.

    An “ACE” isn’t easily defined. Although even the ACE-studies themselves seem to think they are. And in a way the ACE-studies, too, like virtually all the research in the field, fall short in that they, too, try to apply a somewhat narrow technological view on what life is, what it means to be a human being in the world (cf. the technological language used both in the above article, and especially one comment to it, in the ACE-studies themselves, alongside virtually all research in the field, and that we’ve become so used to ourselves that we hardly realize anymore how it dominates the discourse, let alone manage to free us from it). But at least the ACE-studies acknowledge what biopsychiatry entirely fails to take into account: that, while our experiences may and do shape our biology, too, who we are as a person is not our biology, but our experiences: mind over matter.

  • Just to make that clear, since the comments around here tend to be (mis-)taken as personal attacks: my question is not meant as a such. I think it is extremely important that we all ask ourselves this question, before we judge others. Especially those of us who have the power to rule over (and potentially ruin) others’ lives with our judgements.

  • “I would point out that “normal response to abnormal events” does not establish what you seem to want. For instance, the normal response to being hit in the head with a baseball bat is a concussion, which is surely a disorder.”

    Wrong. What happens after someone got hit with a baseball bat in the head is not a disease, disorder, or illness, it’s the body trying to heal the damage done, i.e. the concussion. If you want to use medical allegories, you’ll have to distinguish between a) the harm done by a disease process, or accident, or assault, and b) the body’s own immune system at work, trying to heal whatever harm was done. Now, what we (psychiatry, society, you) call “mental illness” isn’t the disease, the accident, or the assault itself, but the attempt to heal the harm done.

    And, “A Beautiful Mind”… Really, that was lame. How does the idea that the mind is something that can be broken make you feel better?

  • “How about they are variations on the phenomenon of THINKING!” — I so agree. As I, in part, do with your criticism of the HVN (which I’m a member of). The point is, the HVN has, at least to some extent, the same problem that “the movement” in general has: its members represent all kinds of views on their experience. So, when you, as a member of the HVN, state that you view your experience of hearing voices as a way of thinking, there will always be a number of other HVN members who will tell you that they view their experience in a different way, that they don’t quite agree. On the other hand, the HVN still stands somewhat stronger than “the movement” in general, because its official message is that the experience of hearing voices, no matter how it otherwise is interpreted, is a meaningful one seen in context with the person’s life story. While “the movement” in general can’t even agree on the basics, i.e. whether to believe in meaningless brain diseases, or meaningful reactions to life.

  • David, good point on your part, the one about psychotherapy. Virtually zero training in talk therapy is also what I have heard. Additionally, time and again, I hear psychiatrists bash talk therapy, loud and clearly. With the exception of CBT, which most of them admit can be effective in teaching people “insight” and “treatment adherence”, especially those who do not respond satisfactory to psycho-education alone, and still show some signs of independent thinking. It’s actually quite hip and trendy among at least Danish psychiatrists to go and get some training in CBT for the mentioned reason. Additionally to their training in psychiatry. Nope, not even the basics of CBT are included. However, I for one wonder whether CBT applied for this purpose deserves the name “therapy”, or whether another description maybe would be more appropriate.

  • Decreased stigma: fact is that “stigma” hasn’t decreased, but increased since numerous efforts have been made to tell the public that emotional distress is caused by biological brain diseases. People can relate to a person’s life story. They can’t relate to imbalanced neurotransmitters. Also, enquiries have shown that if people avoid to seek out professional “help”, they do so not because they fear the “stigma”, but because they don’t expect the “help” offered to be of any help to them. So, if more people seek out “help” today than ever before, it’s not due to decreased “stigma”.

    Assuming chronicity: you write that “(c)lassically, mental illness” has been thought to be chronic and irreversible.” What do you mean by “classically”? Fact is that classically, “mental illness” has been thought to be the opposite of chronic and irreversible. Bockoven and Solomon, quoted in Anatomy of an Epidemic (p. 100): “the majority of mental illnesses, especially the most severe, are largely self-limiting in nature if the patient is not subjected to a demeaning experience or loss of rights and liberties.” Just one of many statements back from the time before the massive drugging of emotional distress took off that clearly shows that classically, “mental illness” was not seen by professionals as chronic and irreversible before this massive drugging turned it chronic and irreversible. So, your reasoning here is backwards. “Mental illness” was not assumed to be chronic and irreversible until drug “treatment” actually turned it chronic and irreversible.

    You may have a point when you say, basically, that “mental illness” never before in history was marketed as it is today, through the media, drug ads, awareness and “anti stigma” campaigns, etc. etc.. But this does not account for the growing number of people who actually are, physically, neurologically, disabled, supposedly by “mental illness”. People who “fake” “mental illness”, for whichever of the reasons you mention, will hardly end up physically, neurologically disabled, unless it is the “treatment” they receive for their supposed “mental illness” disabling them. Fact is, the vast majority of those who do receive psychiatric “treatment”, whether they actually can be said to have a “mental illness”, or not, end up physically, neurologically disabled.

    I’ve seen many people with a label of “severe mental illness” on drugs, and I’ve seen many with the same labels off them. The difference, the disabling effects of the drugs, is glaringly visible. I don’t know how anybody can be blind to it.

  • Hi again Ron,

    accidentally came across this again, and recalled that I didn’t intend to let you off the hook this easily.

    I think each time we acknowledge biological, genetic factors to play a causal role, no matter to which extent, we stand a little weaker. What I think we need to do is to re-define “trauma”. Say “trauma”, and people associate “obvious, gross abuse and neglect”, and “done on purpose”. That then, of course, is offensive to parents, and also sometimes a threat to the person in crisis herself. If somebody is dependent on another person, they’re only as strong as this person is. So, by protecting one’s parents from being seen as imperfect, “weak”, a child protects himself from feelings of imperfection and weakness, and ultimately from the overwhelming realization of his own mortality (cf. Rethinking Madness). My observation is that the more trauma there was in childhood, as the more perfect people tend to describe it, and the more upset they’ll react, if you ask them whether there maybe, just maybe, have been experiences that, one or the other way, could be interpreted as showing some imperfection in their parents/their upbringing. I find what a Danish woman, labelled with “schizophrenia” (and identifying with the label) states on her website (in Danish) very telling: “I don’t recall much from my childhood other than that it was a good one.” (She then, btw, goes on to describe a series of experiences that seem less “good”, at least to me… )

    While we probably can’t avoid denial entirely — since absolute perfection is an illusion — I also think that, if we do not question it when it gets challenged — like when someone experiences extreme states of mind themselves, or when somebody who was/is dependent on us experiences these states — we miss out on an opportunity to grow, or broaden our window of tolerance, to use Williams’ terminology, and actually get stronger, navigating life.

    If there’s a meaning to life, to me it is this personal growth process (toward perfection, though never reaching it), learning to navigate life in a constructive way, and each time we resort to denial without being aware that it is denial (!), we throw away another chance to grow. Parents too.

    “Trauma” to me doesn’t (only) mean “gross harm done to somebody/on purpose”. It means being imperfect, making mistakes, also in our relationships with others, it means a challenge to learn to navigate life in constructive ways. Being a human being in this world in itself is “traumatic”, and a challenge to grow (so, basically, a positive thing, rather than a negative one).

    Unfortunately, we have created a culture that cultivates denial as the perfect solution. Defining individuals who challenge this denial as somehow biologically, genetically not as perfect as those who manage to live in denial of the denial, is just another expression of the denial. And each time we acknowledge that these individuals might actually be somehow biologically, genetically different, we’re supporting further denial. Instead of challenging it, and facilitating growth.

    Anyway, this is a complex matter, and not easy to explain in a comment. But the conclusion is that maybe we need to find another way to talk about it, rather than keeping, if only partially, silent about it, which I don’t think will change anything. And I’m quite certain that what we need is a cultural change on a fundamental level, a change of our most basic norms and values in life, and of our most basic conception of what life is about. For now, our culture worships deadness (perfect denial) as the ultimate goal in life. Psychiatry is just one of many “symptoms” of this “cult of deadness, or denial” that, if we don’t challenge it, eventually, will be fatal for humanity.

  • I find it problematic to put the by indoctrination colored “intuition” of somebody who is an onlooker above the intuition of the person who’s actually having the experience. My intuition as the person who was having the experience was unambiguous: I wasn’t sick, I didn’t need a medical professional, and I certainly didn’t need drugs. Thankfully, I listened to my intuition, although all the mainstream information contradicted it, and my decision to listen to it was respected. What I often hear from consumers is: “I can’t trust my intuition, my emotions, my thoughts, myself.” That’s the only “illness” here, not being able to trust in oneself, because others have defined you an illness, and by doing so destroyed that trust. Maybe the profession should start to listen to the intuition of their clients, those who are not yet brainwashed into not trusting their own intuition, those who say “No! I’m not sick!” They might be right.

  • Exactly. Although I would be careful with the concept of “normality”. Lots of people live not-so-“normal” lives, but they still have a great quality of life. Especially among those who’ve experienced crisis, and have escaped the psychiatric system, there are quite a few whose crisis has taught them that “normal” actually doesn’t necessarily equal a good quality of life.

    The research focusses on “symptom reduction”, and equals it with increased quality of life. To me it is incomprehensible how a reduction of life, or aliveness, ever could produce an increased quality of life. Obviously, if somebody’s aliveness is a problem to themselves and/or others, reducing it might solve the problem, though only if death is regarded the desired outcome: the operation was a success, (but) the patient died…

  • I must admit that I was suspicious toward DID, me too. Mostly because I saw too many people on the internet who were what I would call “bragging” about having it, while at the same time these people also made a very big deal out of emphasizing that they were not “crazy”, they did not have “schizophrenia”, they were traumatized, not genetically defective, brain diseased not-quite-human beings. I have to say that, as someone who both herself has experienced extreme states of mind, and got a “psychosis”/”sz” label, and who works with people labelled with “psychosis”/”sz”, this kind of us-and-them thinking that I see a lot of in the DID-internet community puts me massively off.

    Anyway, my doubts about the existence of DID vanished in a split second one day at work where I saw myself confronted with it. And my contact with the person was both long and close enough to leave no doubt in me that she was dissociating to a DID extent.

    Now, DID is not an officially recognized label in Denmark, so the person in question was labelled with “sz”, and, if one regards psych labels in general as valid categories, which I for one don’t do, in the absence of a specific label for extreme dissociation like “DID”, “sz” was the correct label. Hearing voices and having visions is a form of dissociation only one step from the form that adds different personalities to the voices that then can not only control, but take over the “I”. Same phenomenon, different intensity.

    As for brainwashing people into believing they dissociate when they don’t, I believe it is possible, and that it unfortunately does happen. But I also believe that, just like with false memories, it’s absolutely possible to separate the sheep from the goats, even without brain imaging, and that a “good” therapist anyway never tells the client what s/he thinks has happened/is happening to them, but lets the client tell/show him/her.

  • As I read it, and I’ve just skimmed through the study, it’s the latter, i.e. that “real” DID, dissociating unconsciously to the extent that a person takes on a different personality, does exist, and is not something people fake, as it manifests in the brain in a different way than faking dissociation does.

  • I wouldn’t recommend entrepreneurship for somebody who identifies as a “psychiatric patient”. — “Psychiatric patient” is almost a full-time and often life-long career in itself, isn’t it? — I wouldn’t hesitate though to recommend it for somebody who’s rejected this identification, even if they actually did experience crisis. Some of the toughest people on this planet, indeed. You may want to read “Rethinking Madness” by Paris Williams.

  • Well, my take on it is that these so-called “symptoms” of “mental illness” are altogether reactions to life. Pretty meaningful, and pretty healthy. But unfortunately very much misunderstood, both by the person in crisis herself, and everybody else. What you don’t understand, you risk to get overwhelmed by. Come to an understanding of it, and it won’t overwhelm you anymore.

    The biggest problem with the research in the field is that it, ignorant of its own misunderstanding, focusses almost exclusively on “symptom reduction”. While it should focus on misunderstanding reduction — maybe its own first and foremost — instead.

  • Maria, whether the “medications” work, or not, depends on what is regarded their desired effect. These days, we witness something of a scandal here in Denmark, where it became known to the public that certain psych “hospitals” in the Copenhagen area feed their “patients” more than double max dosis of Zyprexa daily (some were given up to 120 mg a day, 40 mg is max), and an add-on benzo-type of drug if needed, to bring down the number of incidents where “patients” are restrained. And, yes, this practice has brought down the number of reported incidents of restraints at the “hospitals” in question. So, in the eyes of the staff, the drugs do work. The question is whether the “patients” think that the drugs do work, making them feel better. I doubt it.

    If the aim is to render somebody mentally and physically incapacitated, then the drugs do work. If the aim is to reduce “symptoms”, then they don’t. Lead poisoning, or not. “Antipsychotics” do not act antipsychotic. They’re major tranquillizers, nothing else. Clinicians know this, that’s why they don’t listen. Their aim feeding people these drugs is an entirely different one than what they tell everybody it is. I like that the psychiatrist in the vid is quite open about this, although I don’t understand how anyone, at the same time as they know that the drugs do nothing but mask the problem — they aren’t even the easy way out, as they aren’t a way out at all, but rather deeper in –, and as they probably also know that they, especially long-term, both chronify the problem, and add numerous other problems to the initial one, still chooses to make a living force-/feeding people these poisons, and even enjoys it.

  • Maria, you haven’t offended me. I just have some difficulty understanding what you want to say posting that link. Certainly, what we witness in the vid is a lot of suffering. But does anyone ask what this suffering is caused by? Well, the vid tries to tell us it’s caused by this thing called “mental illness”: “Look what a horrible thing mental illness is!” And I guess, that’s what you, too, want people to believe, isn’t it? That’s a little too simplistic for my taste. But, yeah, without doubt it is very convenient for everybody who doesn’t want to look at the true causes of emotional suffering.

    Maria, fear-mongering doesn’t work with me. I’ve seen stuff like what we see in the vid happen irl. What I see isn’t “mental illness”. It’s ignorant, scared people assaulting others who are reacting to the ignorance, fear, and violence they are met with by the former.

  • Maria, see, your last sentence here is exactly where I very strongly disagree with you. Another way to word your sentence is: “You are not your mental illness.” Read: “But you do have one!” We all know, at least I do, whose motto this is, and, indeed, I’ve seen you team up with these people time and again, the NAMI mommies, the pro-force crowd.

    You say that “unless you go through it yourself, you can not understand the internal torture of a psychotic state can have,” — also this btw one of mainstream psychiatry’s and its supporters’ “arguments”: “It’s unethical to leave people untreated, we have to treat them, if necessary by force, because of their horrible suffering! Now, everybody, don’t be so ungrateful that we take your human rights away, it’s for your own good!” — and you seem to imply that the people who comment here haven’t gone through what you call a “psychotic state” — while I for one prefer a less medical and less alienating language to refer to these states of mind. — It actually pays off to be picky about language. Nothing is more disempowering when it comes to crisis than referring to it using the medical discourse. — Well, I have. While I think, if memory serves, and please correct me if I’m wrong, you actually haven’t. At least not that you are aware of it, because fact is that these states are very common, naturally human responses to life, and every human being experiences them at one or the other point of their life, to one or the other extent.

    I agree with you that if somebody hasn’t either gone through these states, and I mean really gone *through* them, and not having been prevented from going through them by one or the other medical intervention, and by having been told how to perceive their own experience by others, or hasn’t at least listened without any prejudice or attempt to define the person’s perception of their experience, to people who have gone through them, or are going through them, they are not really qualified to judge and define the experience. And, yes, you read that right, I do have the arrogance to say that even labelled people themselves, if they’ve bought into the it’s-something-that-shouldn’t-be thing, don’t know what they’re talking about when they’re talking about crisis, or “psychotic states”, if you want.

    Anyway, “You are not your mental illness” is bs. Because “mental illness” affects precisely a person’s being in this world. So, yes, if we buy into the idea that “mental illness” exists as a phenomenon that renders the “mentally ill” person’s emotions, thoughts, and reactions disordered or diseased, i.e. wrong — as in “hallucination”, “delusion”, etc. — people are their “mental illness”. This, and only this, is btw the reason why we, as a society, think it’s ok to take away the human rights of those labelled “mentally ill”. If these people weren’t regarded being their “mental illness”, nobody would venture to strip them of their human rights. The way we perceive and react to the world defines who we are in the eyes of the world. If our perceptions and reactions are defined as symptoms of an illness — “hallucinations”, “delusions”, etc. — we are this illness. The slogan “You are not your illness” when it refers to what is called “mental illness” is nothing but a poor attempt to pull the wool over people’s eyes, and make them feel a little better about being discriminated against, respectively about discriminating against others.

    Listening without prejudice to people who go through a crisis, or who have gone through one, and were neither interrupted and kept from going through the entire process by well-meaning but nevertheless glaringly ignorant and scared busybodies, but who had their process respectfully supported, has left everybody who has tried it with a very different perception of what crisis actually is than the one that says it’s an illness, a disorder or a disease, and something that should not be. Crisis, unless it is a symptom of an underlying, real medical condition, is not an illness, but an attempt to heal from an “illness”, an attempt to find a solution to an unbearable life situation. As such it should be validated as a “pathway to growth” (Rossa Forbes), not feared, dismissed, and fought as something that shouldn’t be.

    As for the suffering that often, though not at all always — German Dorothea Buck for instance did not suffer during her periods of crisis, but actually enjoyed the experience itself, and only suffered under the “treatment” she was subjected to, with the reaction of their environment actually accounting for a more or less huge part of the suffering people in crisis experience — accompanies crisis, I think nobody would seriously claim that life, and especially a process of major transformation, always should be easy and painless.

    I agree that there always should be checked for a possibly underlying medical condition when somebody experiences extreme states of mind. But that’s about where my agreement with you ends. As somebody who’s gone through crisis without being interrupted and kept from going through the entire process.

  • The unusually sensitive person, and/or the one who had nobody in their lives to help them make at least a little sense of the — emotional — confusion trauma causes.

    I recently watched a documentary about Lisbeth Zornig, the ex-director of “Børnerådet”, a government agency working for the rights and protection of children. The title of the doc was “My childhood in hell”, and that says it all. Lisbeth Zornig didn’t go on to get a psych label, or resorting to alcohol and street drugs, like her brothers. But she was also the only one in the family who, when she was about 7, 8 years old, was invited to live with one of her school teachers and her husband, who saw what was going on in Lisbeth’s family, and wanted to help her. They even wanted to adopt her, but she got picked up by her mother and dragged back home after 6 months, because the state had threatened to cancel the maintenance payments for Lisbeth that were desperately needed to buy booze from… Anyway, 6 months in a different, and a lot more functional environment than her own family were more than enough to have Lisbeth Zornig realize that, indeed, her family was dysfunctional, how it was dysfunctional, and that another, a lot less dysfunctional way of living was possible.

  • Duane, Hoffer’s results have not been replicated. This is not to discredit his approach entirely. If the choice was between pop tons of vitamins, and pop Zyprexa, I know what I would choose, and also recommend to others that they choose (to everyone who thinks I give medical advice, and that I shouldn’t: I don’t, but I do tell people everything I know about different approaches’ side effects, and that then, indirectly but nevertheless, makes for a recommendation of vitamins over psych drugs). But the choice is not just between these two, and I’ve seen too many people who’ve tried Hoffer’s approach and for whom it has failed to work.

    The main issue I have with Hoffer is that, regularly, I sit with people who tell me about having experienced more or less massive abuse/neglect (physical, sexual, emotional, …, you name it). I cannot ignore this, and tell these people they have a vitamin deficiency, if what they go through without effort can be seen as a very meaningful response to their life story. If I did, it would make me no better than bio-psychiatry.

    Hoffer’s approach, just like bio-psychiatry’s, denies psychological trauma, which means adding insult to injury for the individual, *and also for our entire culture*:

    “Perry (John Weir Perry) pointed out that there is an aspect of the renewal process that is crucial for the health of a society. Once an individual has gone through a very profound reorganization of their inner culture, they sometimes emerge with a vision of reorganization for the culture at large that is uncanny in its timeliness and its effectiveness in bringing about just the reform that society needs in order to continue its existence. (…)

    (…) If Perry is correct, then not only is it a very sad irony that our very attempt to support these individuals may actually be one of the main factors in preventing their recovery, but the implications this has for our society as a whole are also quite grave. In a time when our society isin desperate need of the guiding values of love, compassion, and wisdom, suppressing the very process that attempts to renew these values in wounded psyches and in our society at large could be very detrimental indeed.” -Paris Williams, Rethinking Madness, p.102

    IMO, we, as a culture, do ourselves an enormous disservice by defining crisis as a medical problem. If its in the shape of chemical imbalances in the brain, in the shape of vitamin deficiencies, whatever of that kind. Unless we have proof of somebody’s crisis to be physiological, medical in nature, I think we’d do better, for our own, our entire culture’s, sake, to be aware of the often existential and also highly political nature of crisis. Looking at crisis from a medical point of view alone is like peeing one’s pants: it’s cosy and warm for the moment, but it gets perishingly cold over time. Medical explanations absolve everybody from responsibility. But if we don’t take responsibility, it may well mean our end as a culture (and with the extent of dysfunctionality and destructiveness of modern western civilization in mind, it may well mean the end of humanity/life on this planet).

  • Maria, the DSM is about *mental* disorders. The categories you list clearly are valid ones, but they would indeed become even more valid, if they weren’t listed in a book that by and large, and except for the categories you’ve listed, is scientifically invalid. Chapter VI, respectively XIX, in the ICD would be the proper place for these categories.

  • Rossa, I wholeheartedly agree. I’d just liketoadd toyourlast paragraph that the word “lifestyle” mentioned in context with the wide-spread puzzlement about those labelled with “severe and persistent mental illness” suffering from a variety of very real, physical health problems, and dying on average 25 years earlier than the general population, is more and more becoming a red rag to me the more it is (ab-)used to make everybody believe that it is the supposed “severe and persistent mental illness” that has the labelled make bad lifestyle choices that then lead to physical health problems and early death. Strangely, physical health problems and early death have not always been as huge a problem as they are today, and they aren’t as huge a problem in cultures that don’t apply the medical model. What has changed, and what is different in cultures that don’t apply the medical model? Is it the “severe and persistent mental illness” itself, somehow? Or?… How can we expect people to make healthy lifestyle choices when first we’ve made them passive, physically unable to stay awake for more than 3 or 4 hours at a time, not to mention do any efficient exercise, and neurologically/psychologically unable to experience satisfaction — other than maybe from chain-smoking cigarettes in a desperate attempt to re-establish the brain’s natural dopamine activity level? The answer is, we can’t.

    Mostly, the lifestyle of the labelled is not their own choice, but it is forced upon them through the “treatment” they are exposed to for their supposed “severe and persistent mental illness”.

    I want to add that, of course, the misinterpretation of what the unconscious tries to communicate using metaphors in a literal way, which is what I see is one of the main characteristics of crisis, may lead to “bad lifestyle choices”, too. For instance if somebody takes the idea of being poisoned literally (which actually wouldn’t even be a misinterpretation in a psychiatric setting…), and therefor stops to eat. On the other hand, even such misinterpretations, in less extreme forms, may also lead to a healthier lifestyle, if they result in the person picking their food very carefully, maybe even growing their own, organic veggies, and avoiding all kinds of processed junk, as well as, whenever it can be avoided, being fed psych drugs, ha!

  • David, I couldn’t agree more. That’s why I use quotation marks. There is no such thing as mental illness other than understood metaphorically. And not even then would I call an attempt to “heal” (to get to an understanding) an “illness”. If there are neurological, physiological causes for someone to experience altered states of mind, it is still somatic illness, altered states of mind, or not. Like Creutzfeldt-Jakob disease is a real, somatic illness with a known physiological pathology.

    In Maria’s example, the case of the 45-year-old woman, the woman complains also about blurred vision and gait difficulty. This should immediately have any medical professional’s alarm bells ring. Blurred vision and gait difficulty are not “symptoms” of any “mental illness”. Except for that they very well may be symptoms of drugged “mental illness”. But in that case they are still not “symptoms” of the supposed “mental illness”, but of chemical intoxication.

    I agree with Maria that there is an almost criminal tendency among especially psychiatrists, but also among other medical professionals, to overlook physiological causes whenever someone experiences one or the other kind of symptoms that just remotely match what’s in the DSM. IMO though, that’s just one more reason to get rid of the DSM and psychiatry: they are unable to recognize real, somatic illness when there actually is one, and they’re just as unable to recognize when there is none, which then has them “treat” the latter in a way that inflicts almost exactly the same symptoms on people as those of the real, somatic illnesses that they otherwise are unable to recognize when confronted with the “real deal”, and claim that, indeed, they “treat” real, somatic illnesses… Mind-boggling.

    Where I don’t agree with Maria is that overlooked vitamin deficiencies and things like Creutzfeldt Jakob would be the problem in more than a very small percentage of people who get psychiatrically labelled. I guess, I’ve met too many labelled people who clearly were more or less severely traumatized and reacting to that, rather than that they were suffering from vitamin deficiencies. Or Creutzfeldt Jakob disease.

  • Rossa, I’ve met quite a few people by now who’ve tried the pop-tons-of-vitamins, avoid-gluten-and-dairy-products, etc. approach. For some of them it did make a difference, not necessarily an earth-shaking one, but at least a little (placebo effect, anyone?), for most it didn’t. If it does, and it enables people to avoid having to pop tons of psych drugs, great! Go for it! But all in all, I think Hoffer fooled himself in the same way conventional psychiatry fools itself — and everybody else — in that he only “saw” those who did get a positive effect of his approach, and not those who dropped out because they didn’t.

  • Did Michael McEnvoy suffer from an underlying medical condition? If tragedies like this one regularly happened at alternatives, because one or the other underlying medical condition was not recognized, Open Dialogue would have been shut down ages ago.

    The chances, that a possibly underlying medical condition is actually recognized are in fact a lot greater at an alternative that listens to people, and takes them seriously, than in a setting that says “It’s all in your head!”So, no these alternatives are no more dangerous than conventional psychiatry, rather a lot less.

    Some time ago, a young man walked into our crisis center, together with his mother and sister. For some time he had experienced states of mind where he, from the reaction of his surroundings to judge, might have said and/or done “weird” things. From the reaction of his surroundings to judge. I asked him if he had any recollection of what he’d said and/or done. No, not really. Now, previous to experiencing these altered states of mind, he’d been working towards some important exams, and had been isolating himself quite a bit. His family had had difficulty contacting him. But they’d accepted his wish to be left alone to study. Unfortunately, he’d fallen ill with a virus during this period, nobody noticed, he spent a week or so in bed, a couple of days almost unconscious with high fever, and he didn’t get any treatment. The altered states had started after this illness. A shrink would have heard: exams, stress, isolation, altered states, “weird” behavior = psychosis. I heard: “I can’t remember,” and high fever to the point of unconsciousness, untreated. So, I didn’t recommend talk therapy, a hearing voices group, or anything like that. I recommended a thorough neurological exam.

    “Real psychosis” or “mania” does differ from “psychosis-” or “mania-“like symptoms caused by physiological conditions. The difference may not always be that obvious, but if somebody knows “real psychosis” or “mania” they have a good chance to recognize it when they see it. The problem is that conventional psychiatry does not know “real psychosis” and “mania” because it, unlike Loren Mosher, John Weir Perry, the people at Open Dialogue, etc., refuses to get to know it (cf. btw Kraepelin defining the criteria for “schizophrenia” after having observed mainly people suffering from everything else, such as encephalitis lethargica, but “real schizophrenia”). Just recently I overheard a professional in the field, though not a psychiatrist, state that “the mentally ill” don’t know when they experience altered states. This is just not true, and it is an outstanding example of how glaringly ignorant the entire profession is of what they claim to be the field of their expertise.

    Maria, just like most of what Kraepelin observed and then categorised as “schizophrenia” wasn’t really “schizophrenia”, but something entirely different, what you are talking about is not “schizophrenia”, but something entirely different. “Mental illness” is not physiological. If it is, it is not “mental illness”.

  • Certainly, a healthy life style, avoiding junk food, getting enough sleep, etc. is of importance. Nevertheless, it remains a mystery to me, how on earth it is possible that alternatives like Soteria and Open Dialogue can achieve the recovery rates from not least “mania” and “psychosis” without lab testing for vitamin deficiencies, intoxication, etc., and then feeding people tons of supplements, and/or putting them through one detoxification program after the other upon the testing. Somehow, it will seem to me that, just like conventional bio-psychiatry, neither Hoffer&Co. were/are capable of thinking “deficiency” and “intoxication” in a metaphorical way, and I wouldn’t be surprised to find that Hoffer&Co.’s inability to understand things other than literally is caused by the same reluctance to face one’s own (or society on the whole’s) dysfunctionality, and the same reluctance to take responsibility for this dysfunctionality, that accounts for bio-psychiatry’s vehement reluctance to acknowledge psychological trauma.

    I remember the first article about Hoffer’s approach I came across, shortly after I’d started to investigate the field of psychiatry a little closer. It was written by a nurse, mother of a son labelled with “schizophrenia”, and devoted follower of Hoffer’s approach. “Schizophrenia is caused by a chemical imbalance in the brain,” it said in the very first paragraph. Ah, ohhh… Really?

    No different from conventional psychiatry’s explanations, Functional Medicine attempts to find the fault with the individual (‘s biology). And no different from conventional psychiatry it, by doing so, is “no-fault insurance against personal responsibility”, to quote Loren Mosher.

    I don’t take issue with people deciding for themselves that they want to believe in chemical imbalances, whether caused by “faulty” genes, or vitamin deficiencies. Whatever works for you. What I do take issue with, though, is when these people, whether they’re conventional psychiatrists, and their devoted followers, or whether their last name is Hoffer, and their devoted followers, claim to have monopoly of the truth. And I especially take issue with it, when neither the science, nor the personal experience of quite a few people, the empirical evidence, supports their “truth”.

    I’m looking forward to the day when people’s experiences are no longer dismissed as caused by a malfunctioning of their own brain, caused by a vitamin deficiency, or “bad” genes. I’m looking forward to the day when these experiences are acknowledged as valid and meaningful, and indeed, as Paris Williams points out in “Rethinking Madness”, as constituting a great potential for personal growth, not only on the part of the person herself, but, as Rossa’s journey shows us, also on the part of everybody who manages to journey with an open mind together with the person in crisis.

  • Excellent analysis, Jonah! Thanks!

    Ken, do you remember Carlat’s piece “Dr. Drug Rep” that appeared in the NYT back in 2007? Don’t fool yourself. It does matter where the money comes from. Even if you make a very conscious decision to not let it matter to you. Nobody is all the time 100% conscious.

    Another thing: is there maybe a third option between hating NAMI on the one hand, and having Tuesday dinner with the NAMI mommies? Is it maybe possible to do a thoughtful analysis of NAMI, like Jonah’s here for instance, and then, upon this analysis, to politely but firmly decline the dinner invite?

    Last thing: there is a number of inconsistencies in your piece of which Jonah already has mentioned a few. The one that struck me the most is when you write: “In those days, Peggy recalled, NAMI families were at odds with the psychiatric establishment, who still blamed families,…” and you seem to agree that this of course was just so wrong of the psychiatric establishment. At the same time, you say you work for the trauma-informed distress model to be acknowledged. But if families are not to be “blamed” — and let’s face it, families were held responsible, yes, but I can’t see where for instance Laing, Basaglia, or even Theodore Lizd, *blame* families, and I can even less see how it is supposed to be outrageous to as much as touch on the possibility that family dynamics as much as might have contributed to the person experiencing crisis, not to mention to call somebody a “schizophrenogenic mother”, while it seems perfectly ok, even to you, to call the person in crisis “mentally ill” — then where does the trauma come from? If everything in the environment of the person in crisis is just beer and skittles, and always has been, then there can’t be any trauma, can there? Joining the NAMI mommies for Tuesday dinner, and, for the sake of peace and quiet — also one’s own inner, since nothing is better suited to stir up one’s own inner victim’s feelings of guilt than a NAMI mommy’s indignant “You don’t want to insinuate that it is my fault, do you?!” — and reconciliation, reassuring them that, oh no, no way it is their fault! just doesn’t add up with the trauma-informed distress model. You can’t have your cake and eat it. That said, I agree that hate, and blaming people telling them it’s all their fault, is not constructive. But it is just as little constructive to not *hold people responsible* for the *mistakes* they’ve made because they didn’t know better. In fact, it is actually hurting them, because it leaves them with the illusion that, because they already are perfect, they can’t do any better, that they can’t “recover”, and go on to help those, whom their mistakes have hurt, to recover.

  • An absolutely brilliant piece that ought to be read by every parent/relative of a labelled person, as well as by every professional who cheerfully dishes out these labels, accompanied by the no-hope messages about biological brain disease.

    “a self-serving platform on the profession’s part” — I went to this meeting on Friday, of a relatively new, and some would say élitist, Danish organisation, a branch of WAPR, World Association for Psychosocial Rehabilitation. A club of hot-shot bureaucrats and other theorists in the social and mental health sector. Somebody commented that it was a waste of my — precious — time having spent an entire day listening to these bureaucrats and administration theorists proudly (naively/self-satisfiedly) — and somewhat frenzied — presenting their latest projects for “the mentally ill”, to get them psycho-socially rehabilitated. Like for instance the planned center for research and training into psycho-social rehabilitation, located at the planned oversized “schizophrenia factory” at Slagelse, Sealand — finally, after decades of de-institutionalisation and de-centralisation, we’ll get the asylums back, hooray! — that, apart from providing research and teaching top-job opportunities for an army of, well, bureaucrats and other theorists, also will offer “consumers” the chance to make a career in doing the dishes at the canteen, for instance. Magnificent! And how revolutionary!… Anyway, I don’t regard it a waste of my time. It was really an eye-opening experience listening to these people desperately trying to give the impression that this, their latest idea, their latest cutting-edge project, definitely will solve all the problems they themselves, by buying into the disease model, are considerably involved in the creation of, and which their fancy cutting-edge projects without doubt will do nothing but feed into, having them grow more and more out of proportion and control. — With a psychiatric term this behavior probably would be called “manic”. — A Leviathan that on the one hand they need to keep alive and thriving, because it justifies and guarantees their top jobs as bureaucrats andother theorists in the field, while it on the other threatens to get completely out of control, overwhelming and eventually crushing the very system their top jobs as bureaucrats and other theorists depend on, too. Self-serving, indeed, like the day program. Self-serving, and spiraling out of control at an ever greater speed.

  • I think it’s a misconception that pills cure anything (or save lives, or…) . Basically, there are 2 types of “pills”, or medical treatments. Those that strengthen the bodies own immune system, and those that destroy whatever has caused the disease (bacteria, etc.). In both cases the healing nevertheless is done by the body itself. Not by the treatment. The treatment only paves the way for the body to be able to heal itself. The problem with psych drugs is that they are designed to attack, suppress, and — especially with long-term use — destroy what is perceived to be the symptoms of a disease, but which in truth is the “immune system”.

  • Not great, no. Because, as far as I can see from the abstract at least, it tosses religion and spirituality together. Religion is to spirituality what bio-psychiatry is to something like Open Dialogue. Religion believes in God as a power located outside oneself, spirituality recognises this power inside oneself.

    Interestingly, I’ve often observed that people who believe they suffer from a brain disease — like in being hit by a strange thing, “mental illness”, from the outside — also tend to be more religiously than spiritually oriented, maybe not literally believing in an old man with a long, white beard sitting on a cloud, but close enough to. While those who believe in their experiences to be reactions to life, coming from themselves, from within, tend to have more interest in spirituality than in religion. I find both, the belief in one’s experiences to come from within, and spirituality utterly empowering. On the other hand, nothing seems to me to be more disempowering than a belief in brain diseases, as well as in some power controlling one’s life from the outside, and without oneself having much agency in one’s own life.

  • This is maybe the most fascinating thread on MiA I’ve seen so far — although my interest admittedly dropped a bit at about comment # 100 or so –: somebody, “anonymous”, makes a critical remark about the article’s author (at least, that’s what I presume it was, it was already removed when I first came here), and, instead of doing what everybody preaches, i.e. discussing the article itself, ignoring the remark, The Drama is on, with everybody happily participating in it to the same extent.

    Personally, I can’t quite make myself believe those of you, who say you want to discuss the article, not the person Healy, as long as what you, too, do is discussing the person Healy. Whenever words and actions disagree, it’s the actions that count, as a friend of mine, and blogger on this site, Olga Runciman, uses to say. Maybe worth keeping in mind.

    Off topic in regard to the article, I know. I’d just so wish, people would think twice.

  • Basically, what it says is that dissociation in what is called DID, i.e. split-off parts of the self that take shape as different personalities, and dissociation in what is called schizophrenia, i.e. split-off parts of the self that take shape as voices, are very similar, and difficult to distinguish from each other with the currently available tools. Interestingly — though not surprisingly — the researchers seem to think that developing newer, more precise tools will make it easier to distinguish between what they presume is “real” dissociation, caused by trauma (as in “DID”), on the one hand, and “false” dissociation, caused by some brain defect (as in “schizophrenia”), on the other. It doesn’t occur to them that what they have studied might be two slightly different, although also closely related, types of very “real” dissociation, both caused by trauma. Cf. Ron Unger’s slides for a presentation, “When Trauma and Psychosis Mix”: Especially slides 29 – 33/34

  • Hm, I don’t know about the “parented reasonably well”. I haven’t met anybody yet who was parented reasonably well, and then went on to experience the kind of existential crisis that is called “psychosis” by the system.

    That said, the not-so-reasonably-well parenting isn’t always obvious, and sometimes it is really difficult to catch eye of. To the average observer, as well as to me myself, it definitely looked like I was parented “reasonably well”. The question is what does “reasonably well” mean? Does it mean not having been beaten up several times a day, not having been sexually abused, not having been yelled at and called names constantly, not having suffered any material privations, not having been neglected in terms of food, clothing, etc.? Does it mean “reasonably well” as our, quite narcissistic (!), culture defines it?

    To me it means first and foremost to be respected and unconditionally loved for who you are. People can put up with a whole lot of adversities, if they’ve experienced to be unconditionally loved. If they haven’t, they don’t know how to love themselves unconditionally, they won’t trust in themselves, and they become insecure and afraid (of losing themselves). And then it doesn’t take that much adversity for them to experience suffering and crisis.

    There was a link to a study on MiA the other day that said that people “at high risk of psychosis” had an “impaired stress tolerance” compared to the controls. It also said that “(l)ife events were comparable in patients and controls”, read: life events don’t put people at risk of “psychosis”, biology does. I don’t buy it. 1. “comparable” doesn’t equal “identical”, 2. without having read the study itself other than the abstract, I doubt that the researchers were thorough in their investigation of the study participants’ life events (cf. above, trauma isn’t always obvious, sometimes not even to the traumatized person herself), 3. Ron Coleman comes to mind: who would tell somebody they don’t have a really intimate and trusting relationship with, they maybe have never met before, like a researcher, about deeply traumatic events they’ve experienced in life??? I certainly wouldn’t have done that either. And 4. Jacqui Dillon also comes to mind: how much of possibly reported traumatic events was believed by the researchers to have actually happened, and how much was believed to be pure fantasy, or delusion? Lots of factors here, in especially this part of the study, that may have distorted, and probably did distort, the results. To match the researchers’ opinion in favor of the stress-vulnerability model with stress tolerance being biologically/genetically determined.

    I think that Lydia is right to point to the double bind, and its essence, the narcissistic inability to love unconditionally, as ultimately traumatizing. The double bind is the expression of being unaware of the conflict, and thus acting the dichotomy out, instead of being aware of and in acceptance toward the paradox. And I think it is the extent to which someone has been exposed to this unaware acting-out — which a narcissistic culture like ours doesn’t really recognize as what it is, but usually confuses with love, or reasonable parenting — during the stage in life where our egos and the conflict start to take shape, and the stress this exposition then creates, that determines whether someone will be at a greater or smaller risk to experience crisis.