Monday, December 11, 2017

Comments by MohiAhmed

Showing 4 of 4 comments.

  • Hi Matt:
    Thought to quote the entire comment I made on ISPS Listserv to your posting on this interview article with Paris for a wider readership here:

    ” Reading this, (your excerpts from the interview posted in ISPS) I found it to be a very inspiring testimony to human resiliency. 

     In spite of all kinds of traumas and adverse life circumstances, how do  some human beings overcome and make successful adaptations to their “painful life experiences” and  become productive and successful living beings?  A great question! 

    So much attention is being paid to the role of negative life experiences, but less  as to what makes many overcome such adverse experiences in life or even inspire them to achieve. This is  not to glorify in anyway such adverse life experiences! Then,  there are many who are adversely affected by these “experiences”  impairing their “adaptation to present living circumstances” and their “functioning.”  Why?
    Or is it a value judgement or  does it  make any “existential difference,” as we all go through phases of living and dying in different ways?   Who can say which one is better than others. We all in different ways process information as to what makes sense and how best to adapt to our individual life circumstances, and how we value in our own ways what “service product” is “helpful” or not at a given time of our life.   

    I think, adverse life experiences  (a causative analysis of the past)  and adaptation and resiliency  both need more understanding and attention.

    In an existential time dimension, the focus on the “present reality of experience” may be more important than the “speculative past” (which is nor Real anymore unless we make them so) in many ways.  From an existential perspective, it is the Present Reality of the Moment that we are consciously aware of.  

    I also think that the unusual gift of language and ability to articulate complex life experiences that Paris and Matt, and some others share, which  many others with “lived experiences” may not have had, or  the opportunity to express,  contribute to ours (“collaborative” team of  mental health consumers and providers, and the community at large) evolving  enrichment and  better understanding  of  the dynamics of people with  “lived and atypical experiences” and how best to move forward towards an  “egalitarian society.”

    Finally, where is this “ability comes from” and how is it stimulated, this is also something to consider in the understanding of “adaptation” and “resiliency.”  

    Mohiuddin

  • Hi Matt:

    Yes, I do have to struggle with English language, having required to learn Bengali, English, Arabic, Urdu – all at the same time, around age 6, with four different scripts (Roman, Sanskrit, Arabic, Persian) , and never really mastered any to a proficient level during childhood and early adulthood, but had to focus on mastering English as part of graduate school training and professional work in my adult years. I still needs to watch for typos, basic grammar errors, or use of long winded or vague sentence constructions!

    My primary work experience has been with people with severe psychological problems who have been in inpatient and outpatient for years. Besides seven years of work with developmentally disabled people, and some years of working with children and adolescents in and out of various work, my major work has been with what is described as persons with “schizophrenia,,” and almost all of them had this clinical label and have had consistent history of hospitalization or under some form of supervised community care programs , and on average have this for 10-20 years or so. Their “atypical thinking and behavior habits” can be considered to be of long-established and entrenched nature. This is that the group I suggested should be labelled as having Type 2 Psychosis,. I believe, it is a huge group of people being served in a variety of inpatient and outpatient and community support programs, as well as in prisons and nursing homes, and many could be homeless. I have taken a position, as you know, through the development and use of Mind Stimulation Therapy model ( which I pioneered through my years of work experience, and the model was further developed and refined through my years of collaborative work with Charles Boisvert, a former student of mine, and now Professor at Rhode Island College), that the use of past analysis may be counter-productive and may further reinforce the “illness-identified” persona, plus the fact the presumed causative factors in terms trying to find what they are by post hoc analysis by going back in time will always perhaps remain unknown or highly speculative., and may be Unknowable. Moreover this process of past analysis negates the need to explore and stimulate “intact and positive traits” that all these people, including all of us have within ourselves to figure out how best to manage our present life circumstances adaptively.

    From an existential time dimension perspective, it is the Present that is Real and counts, past is gone and cannot be retrieved, and Future is not there yet, and is Unknown.

    In my work, I have fostered the development of a new personal identity in patients, the every Now moment of our Existence, which we all do in a way. Fostering this, in my opinions, independent of what has or has not happened in the past , might be a better way to promote well- being for people that I have described.

    Moreover, many of them, I found, already have a lot of insights into their psychological conditions and history, if they are probed within a supportive listening framework. It is the long-standing emotional conditioning of agitation arousal to specific situational or emotional cues, and associated behavioral habits, plus how society and mental health agencies deal with them,( often from a standpoint of “blind leading the blind” in my view, as we don’t have real hard knowledge base yet, which we don’t want to admit), complicates the picture.

    Past insight oriented exploration is very much okay for what I described for the Type 1 Psychosis, where people are experiencing transient state of psychosis, and have the capacity to internalize therapeutic experiences from past explorations and able to effect meaningful change into their behaviors , with or without much external support. They may benefit from medications to stabilize their mood and vegetative functions, as many may have, and many are able move forward in their lives.

    In the YouTube vide I made in support of our Opinion piece in Psychiatric Services “Back to the Future” written in collaboration with two other ISPS members (https://plus.google.com/105275650416461653536/posts/Xy7gb64UmDf0 as well as my posting in debategraph Isps Issue: (http://debategraph.org/Stream.aspx?nid=437381&vt=spacetree&dc=1) both of which you may have seen through my posting on ISPS, but I am posting them here nevertheless.

    The other issue is that because of Western cultural values, much more emphasis has been placed on the role of operant condition model, beyond its actual role, where behaviors are guided by awareness of consequences. This perspective fits in with the Western sense of personal freedom and accepted values, but less has been made on the influence of associative process, a la classical conditioning paradigm, and of the use of active “redirection” away from negative thoughts and feelings that often influence much of our every day adaptive behaviors.

    We all live, in reality, in a compartmentalized values and behavior systems within us, some of which are guided operant principles, much more may be guided by this associative conditioning process. And emotions, faith and imaginations play much more role than logic and science in our lives. We try to highlight some of these aspects in the Mind Stimulation Therapy model, but I need to do more writings on this aspect in the future as to what I mean,

    Charlie and I are working on a follow up book to the one published on the model: Mind Stimulation Therapy: Cognitive Intervention for Persons with Schizophrenia, 2013. By the way, I was supposed to co-present with Charlie at the Annual Conference of ISPS in Boston on October 29, but because of a family commitment in Florida, Charlie will be doing that presentation. I will miss many people who I have been corresponding on the Listserv, including you, if you were planning to attend.

    My interests in existential perspective comes from early graduate training in both Western and Eastern Philosophy before I switched to Clinical Psychology. As I am writing this response, as I have done so in the ISPS Listserv, I am refining my understanding , and I am learning from various feedbacks. Yours is one of the postings, which often stimulate me to write lengthy posts as you may have noticed.

    Mohiuddin

  • Hi Matt: Since I just registered for Mad In America to view yours and others writings (Robert Whitaker did invite me to do so following our recent correspondence, which I did not get a chance to do until now), I thought I could copy and post here my response to your announcement of your Op-Ed on ISPS Listserv through which we have come to know each other and shared many opinions on some of the same issue you highlighted in your article. Appreciate that you had a chance to read my note and communicated a positive feedback.
    Here is my copy of what I wrote for the benefit of MIA readership on the ISPS Listserv on 9/25/2016 addressed to you:

    “Enjoyed reading your very thoughtful, well researched, and informative  stimulating piece on the issue of societal response to “extreme behavioral anomalies” of transient or persistent nature, (such as “schizophrenia” or “psychosis”, or any other label that one may choose  to identify), and the  controversy over  appropriateness for application of  “illness model “and use of  “medication treatment,” and  your strong advocacy for the need for change in social cultures and mores as how best to deal or help people experiencing such “extreme behavioral anomalies” drawing from your personal experiences.

    In my view, a part of the issue relates to uncertainty and risk management considerations that the “significant others” in the persons life” come to attribute to people exhibiting “extreme behavior anomalies”  as if  presenting  “at risk” behaviors  to  persons and/or  to society, with perceived impairments  in terms of  compromised   ability for “independent caring” (transient or not)  that are not consistent with   societal age norm or other accepted socially prevalent  criteria.  This  often  leads to all kinds biological and psycho-social interventions, which are not necessarily guided by “functional outcomes” or any evidence based benefits in terms of demonstrated improvement in the  over-all quality of life for people involved.   There is also  a  lack of acknowledgement in society in general about accepting  the reality that the present  science and knowledge, or societal values and responses have not evolved yet to a level  to address these issues meaningfully  to satisfy all stake holders involved.  So  often faith, beliefs, collective impulses  guide societal responses.  The  efficacy of a limited knowledge base that is available or validated through controlled experimental studies often  gets extrapolated to  many individual situations that may not be appropriate, or it may be appropriate for a for  given time or period of one’s life, but not  for always. The criteria, when and under what circumstances a finding found to be efficacious  is effective to a given individual  and when not,  given the immense variability in people,  are not well known yet.   And then there are the iatrogenic effects that compound the picture of any “outcome,”  be it biological or psycho-social, and  that any  “labelling stigma” itself has the  negative impact on one’s sense of wellbeing, vitiating one’s inner strengths and adaptive resiliency that are present to  a degree in all of us.  Use of a label  has often serves the perspective of the  service providers and not necessarily the  service recipients, as often the case in the mental health delivery system.  Now with the  increased empowerment of mental health consumers knowledge,  this dynamics is changing.

     The  “extreme behavior-experiential  anomalies” labeled as mental illness has been a  very complicated and  “challenging human experience” both in terms of people who experience them (In transient or in a persistent manner),  and people or the society at large  who must deal with others who are experiencing them. It  has been with us for centuries,  baffling  human mind, and it involves  multidimensional  and multi-focus perspectives.  So there will always  be expected differing opinions, as no one has the monopoly of the “truth,” but we all  need to move forward in  a collaborative exchange of ideas and opinions  within a mutual respect of each others to address these  issues.

     Sometimes, though, for the advocacy sake, highlighting only One Aspect of Reality, and use of  confrontational tactics do contribute positively to bring about changes!

    My sense is that  changes in our understanding how best to deal with this kind of mental health issues are happening  at a faster rate in our modern times  with  increased knowledge and  availability of communication media,  allowing for greater empowerments in terms of informed decisions  by all segments of mental health community: mental health consumers, advocates,  service providers, and other stakeholders. 

    So there are more exciting possibilities for innovative thinking, with younger people like you entering this collaborative “Dialogue” challenging the status quo.

    I also  had a chance to read some of your readers  comments on you Opinion Piece in Mad in America, which testify to my  positive comments about your contribution! 

    Congratulations on the writing piece, and keep it up, as many  already have encouraged you to do so.”

    Mohuddin (Ahmed) 

    http://www.psychologymentalhealth.com/