This is the letter I sent to my Federal representatives and every legislator in Nevada in support of Open Dialogue: A Confluence of Circumstances Our mental health system is a failure. It will continue to be a costly failure as long as its focus is on drugging patients and hindering rather than aiding recovery. Better ways exist, and have been in use for more than 30 years. Open Dialogue was first developed in Finland in the 80’s and is now being replicated in various countries, including at the University of Massachusetts Medical School (UMMS). In one five-year study 83% of patients had returned to their jobs or studies or were looking for a job, 77% did not have any residual symptoms, and only around 20% were still taking antipsychotic medication at 2 year follow-up. (1) While Open Dialogue was not part of my treatment regiment, it could possibly have shortened the time I spent on Social Security Disability Insurance from about ten years to two years. Significant cost saving should result from adopting this strategy, not to mention quality of life improvements. Most people, apparently including members of Congress and those in the bureaucracy of Health and Human Services, seem to be lost when it comes to mental health issues. Below are a few items to keep in mind when this topic is discussed: “Mental health and ‘mental illness’ (and different types of mental ‘illness’) shade into each other and are not separate categories.” (2) “By concentrating on smaller and smaller fragments of the body, modern medicine often loses sight of the patient as a human being, and by reducing health to mechanical functioning; it is no longer able to deal with the phenomenon of healing. This is perhaps the most serious shortcoming of the biomedical approach. Although every practicing physician knows that healing is an essential aspect of all medicine, the phenomenon is considered outside the scientific framework; the term healer is viewed with suspicion, and the concepts of health and healing are generally not discussed in medical schools. The reason for the exclusion of the phenomenon of healing is evident. It is a phenomenon that cannot be understood in reductionist terms. This applies to the healing of wounds, and even more to the healing of illnesses, which generally involve a complex interplay among the physical, psychological, social, and environmental aspects of the human condition. To reincorporate the notion of healing into the theory and practice of medicine, medical science will have to transcend its narrow view of health and illness. This does not mean it has to be any less scientific. On the contrary, by broadening its conceptual basis it will become more consistent with recent developments in modern science.” (3) “All three of these broad classes of possible cause of psychiatric experiences (psychological, social and biological) are important and interact with each other.” (4) “Traditionally, psychiatry has taken a more biological tack, reflecting the medical basis of the profession. This pattern is changing, however. Some psychiatrists are rapidly becoming more focused on social issues. Many are becoming champions of Cognitive Behavior Therapy (a form of psychological therapy) and are therefore increasingly examining psychological causes of their patient’s distress. “ (5) “Key Points • There is evidence that psychotic experiences can sometimes follow major events in someone’s life, either negative (for example bereavement) or positive (for example winning the lottery). • Many people who have psychotic experiences have experienced abuse or trauma at some point in their lives. • The possible role of family relationships in the development of psychotic experiences has been a subject of debate over the last 40 years. For obvious reasons this has been an area of great controversy, with strong feelings on both sides. • There is evidence that if people who have had mental health problems live in a calm and relaxed home atmosphere, their problems are less likely to return”. (6) “In the stress-vulnerability model, it is suggested that vulnerability will result in the development of problems only when environmental stresses are present. If the vulnerability is great, relatively low levels of environmental stresses might be enough to cause problems. If the vulnerability is lower – the individual is more resilient – problems will develop only when higher levels of environmental stress are experienced.” (7) In the United States, even a ten year recovery period is considered rare. Most seem to be under the impression that recovery is not possible, and a government bureaucrat will be needed to second guess every decision made by someone with a mental health diagnosis for the rest of their lives. No wonder many prefer to remain untreated and homeless rather than endure the stresses and abuses the mental health system considers treatment. I had advantages most who receive a mental health diagnosis do not. I didn’t develop symptoms until I was in my 30’s, I had receive training in troubleshooting and problem solving, I had insights into what had triggered my problems, and early on I decided to look at my circumstances more as a research project than anything else. The onset of my mental health problems began shortly after I found out that one of my brothers (a police officer) may have been involved in the deaths of the individuals accused in the shooting of our father, also a police officer. However, this was not the only circumstance which could have resulted in the development of my symptoms. As a pre-teen I had been diagnosed with epilepsy. It wasn’t until my late 20’s that tests were run that showed the seizures resulted from an injury to the right temporal lobe of my brain, which I had sustained some months prior to the onset of seizures. One of my parents also had an anger problem, which escalated to rage all too often. During the time I had active mental health problems, I found myself getting arrested all too frequently, as well as bouts of homelessness, living in a board and care facility, as well as several admissions to psychiatric facilities. While I was young, my seizures were quite infrequent. However, in my 30’s they became more common and severe. However, I was fortunate. During my early 40’s, tests, repeated at least four times, no longer showed the scar tissue which had been the cause of my seizures. “Many mental health programs are not staffed with physicians practiced in medical diagnosis and thus are unprepared to detect a large proportion of physical diseases in their patients. As described elsewhere, California’s state mental health programs fail to detect many diseases that could be causing or exacerbating psychiatric disorders” (8) The seizures stopped, and my mental health problems substantially decrease. In what is probably a unique event, a visit from an FBI agent, at least indirectly, helped reduce my symptoms even further. I shook in relief when he left. All too often in the then recent past, law enforcement officers had arrested me, mistaken my seizures for illegal drug use. While I didn’t understand it then, this shaking is quite similar to what David Berceli, PhD describes in his book, The Revolutionary Trauma Release Process: Transcend Your Toughest Times as well as he induces as in his trauma recovery programs. (see http://www.traumaprevention.com for more information.) The program of cognitive therapy – which is about learning better ways to deal with stress – I was in the finishing stages at the time of the FBI visit also helped rid me of the various symptoms. While my circumstances are unique, and some will be quite skeptical of the veracity of my story, I do feel I have some responsibility to help those who have also been labelled as ‘mentally ill’. As I understand it, Open Dialogue helps individuals address the various stressful or traumatic circumstances encountered in life. I don’t know if Open Dialogue practitioners utilize the various non drug trauma treatments available, such as Trauma & Tension Releasing exercises mentioned above, Somatic Experience http://www.healingtrauma.org , and Eye Movement Desensitization and Reprocessing http://www.emdria.org or the Cellular Memory Release (http://www.cellularmemory.org/index_english.php) process which teaches one to transform negative emotions, habits and patterns, but I believe they may be able to increase the effectiveness of their program should they decide to do so. Please keep this in mind when mental health topics are being discussed. Also, please view my website http://shakugoukaku.com/ for more information on recovery from mental illness. Thank you, – – – — – – – – – – 1. Five-year experience of first-episode nonaffective psychosis in open-dialogue approach: Treatment principles, follow-up outcomes, and two case studies, Psychotherapy Research, March 2006; 16(2): 214_/228 2. Recent Advances in Understanding mental illness and psychiatric experiences – A Report by the British Psychological Society Division of Clinical Psychiatry, June 2000, Pg. 4 3. THE TURNING POINT, by Fritjof Capra, © 1982 (pgs. 123 – 124) Simon & Schuster / Bantam edition 4. Recent Advances in Understanding mental illness and psychiatric experiences, pg. 21 5. IBID pg. 22 6. IBID pg. 28 7. IBID pg. 28 8. A Medical Algorithm for Detecting Physical Disease in Psychiatric Patients, Hospital and Community Psychiatry Vol. 40 No. 12 Dec 1989, Pg. 1270 by Harold C. Sox, Jr., M.D., Lorrin M. Koran, M.D., Carol H. Sox, M.S. , Keith I. Marton, M.D., Fred Dugger, P.A., Teruko Smith, R. N.