Saturday, October 19, 2019

Comments by Sharon Cretsinger, XLISW

Showing 97 of 97 comments.

  • I was responding to that as well, Frank. And, I don’t believe I am known for my good religious values any more than you are. Unfortunately, I was unable to respond individually to any of the folks who addressed me.

  • I can’t seem to reply to bpd transformation or Frank or anyone up there who spoke to me. I don’t have much to say, except when you make a deal with the same devil twice, there’s not much anyone can do for you.

  • In the locked wards. In the ghettos of NYC where our people who have been court ordered to AOT have to comply with treatment in order to stay housed. Just around the corner, where you have never bothered to notice that your neighbor’s husband or wife threatens them daily with incarceration if they do not continue to eat truckloads of shit and domestic violence every day. In abandoned buildings in dying industrial towns where our people sleep alone rather than accept the services that demean them. The list goes on. It’s not hard to find the outrage if you know what it looks like. But, you won’t find it in the spaces of elitism and academia where oppressors who pretend to be allies demand “recovery” and create new agendas of silence and marginalization. Find it in the infected cuts of the “Borderline” and the screaming skulls of the “Schizophrenic”. It’s not hard to find if you want to look.

  • I’m feeling pretty brain dead, but attempting to put together a cognizant comment here as I can see we have just about everyone represented, including TAC. I didn’t make it all the way through some of the comments. I’m not sorry that a pages long narrative about some dude’s struggle to become more enlightened to the issues of women just simply does not impress me or hold my interest.

    There has been a lot of discussion on this topic recently. It is not a new topic. It is not a new dynamic. I have personally been talking about this for years. So, does anyone have the wherewithal to come out and say WHY WE ARE TALKING ABOUT THIS RIGHT NOW????? Because there is a reason. And many of you know what it is. As long as this topic is packaged eloquently and generally for public consumption, it hardly becomes a topic at all.

    My world is a little simpler than all of this. I don’t know if it is right to say I care more about psychiatric survivor issues than women’s issues, because I believe them to be inextricably linked, along with other issues of other marginalized groups. I’m not opening that can of worms, right now, though. I will make a few brief points and be done.

    –Many folks of all identified genders still do not understand either the theoretical or practical concept of emotional labor (I like to call it shit work). This is a concept that goes beyond who does the dishes and sweeps the floor at home when both partners have paid work outside the home. Emotional labor includes the smile, the request with please and sugar on top, the “extra mile” to make people feel good and cared about in many contexts. It happened to me just the other day when I was told in a job interview that part of the job was to “smile” and that “sometimes you need to be a mother” to the individuals for whom supports are provided. Let me be clear. I am not here to fucking smile so you can feel good. I am nobody’s mother, and since psychiatry robbed me of that opportunity, I have to assume it also relieved me of the related duties. I don’t need to provide anything with sugar, including your coffee, which I will not make for you. There is a huge deficit within our culture with regard to identifying and rejecting emotional labor; and, women bear some of the responsibility for that.

    –I often stand alone in my work and my opinions, and that is quite alright with me. I am happy to have comrades who are true equals, when they are available and willing, of any gender and stripe. And let me be clear on this also: If you show me you are not my comrade, if you treat me as less than, if you expect me to defer to you, if you think you can tell me how to behave in public, how to express myself, if you think you can verbally or literally bitch slap me just because you don’t like what I said or what I stand for, I will fuck you up. By any means necessary. I will make your snake pit look like a motherfucking country club. That is MY feminism. It is irrelevant to me who shares it, and while I would like a changed world, I am not holding my breath. I am focused on things I can actually impact in there here and now.

    –Too many of our people, including our women, continue to collude in systems that are inherently oppressive. This includes organizations that pander to the opposition by putting oppressive language such as “mental health” in their titles to, I suppose, better dialog with the oppressor so, I guess, if asked nicely, he may stop oppressing us? I end this sentence with a question mark because I am not really sure what is going on with that. I haven’t been asked to join any of those organizations. Again, I do not hold myself up as an expert on what women, mad people (and other groups) need to do. But I have taken back my language and I use it as I damn well see fit as a vehicle for my voice. It feels pretty good most of the time. So, I would have to say that if women want to be free of misogyny, they might consider their affiliations and perhaps walk away from some whose missions and language oppress others. For me, this includes any organization employing or training any type of clinical professional and/or Certified Peer Supporters. People who make their names and monies on the exploitation of our people like that are not better than sex traffickers; and, it is disgusting when they are women, other marginalized groups, and especially disturbing when they are actually OF our people. But that is a whole other rant for another day.

    I want a better world, just like many others here. I also recognize that our civilization is in decline and therefore progress is unlikely. If you want freedom, stop defending oppression. If someone is treating you with misogyny, kick his ass. All people need to stop the anti-intellectualism that is everywhere and really think about the choices they are making and what they mean on a larger scale. It is also necessary to consider what you are really willing to give up personally for the better world you think you want, if you believe it can happen.

    Sharon Cretsinger
    author at http://mildlydysthymicinamerica.tumblr.com

  • Yes, this last part is what I was thinking of the last time you and I had a dialog. I didn’t articulate it quite this well. NAMI and MHA are the organizations that are reaching the people on the ground who have yet to learn all of the politics (and, in fact, may not care about the politics, only about having a better life, which is more than fair). For those who are interested (and I am losing interest rapidly in having the entire course of my life from patient to clinician to activity defined by my diagnoses), this is, I believe, the question of the day.

  • John, I think your point about this is spot on. CBT has become the therapy of choice because new clinicians receive relatively little with regard to treatment modalities in their academic training. Most clinical professions here in the US require a practicum or other unpaid internship as part of academic training. As the focus of clinical work has increasingly become the production of billable hours, however, the “students” are often treated as unpaid billable hours rather than true students. This trend is supported by the fact that the student’s mentor or supervisor is most often not paid to provide mentorship, and is not excused from the production of any of their own billable hours in order to provide mentorship. CBT is a relatively rote treatment modality that can be taught to new clinicians or student clinicians essentially by instructing them to follow a set of handouts and homework assignments. Before I got out of practice, I lost count of the number of novice practitioners proudly proclaiming “I am a CBT clinician” without any knowledge of the history of behaviorism as a whole.

    Long time clinicians also known, anecdotally, for a long time that CBT loses its efficacy over time. Thus, it fills both the role of the “brief” therapy that has become so popular with managed care and the need for repeat customers to continue producing those all important billable hours.

    The popularity of CBT is also tied to the complicity of academia in the financial corruption of the mental health system. I describe more about academic complicity recently in my own forum.

  • I refer to myself as anti psychiatry, but have no issues with how others choose to define themselves. I also have no issues with being seen as someone who is against a concept without offering any positive, viable alternatives. Saying NO is the first step. If anything, I think this discussion supports that we are nowhere near a second step.

  • “But human beings are not things to be used. We are brothers and sisters, all of us, and we owe to each other caring, concern, and nurturing. That is the vision of the world I am working toward when I work in this movement, and I hope that is your vision too.”

    I think this is a lovely sentiment, Ted…my brother….

  • To anyone it may concern–

    I have a lot of criticisms and counter points with regard to peer supports as a whole, and massive problems with the idea of “recovery” and how its (loosely defined) presence or absence adds to or negates from the value of an individual.

    Would I ever take government money for work I do? Would any government funded agency even have me? Those of you who have seen recent photos of me know I have a solid 50 pounds of body mass to lose before anyone needs to get really serious about those questions.

    These people at W. Mass RLC are my friends. I respect the work they do. Right now, I am going to shut the fuck up and write the Massachusetts legislature. I encourage anyone who reads this comment to do the same.

    Sharon Cretsinger
    Founder, Director, International Center for the Advancement of Anti-Psychiatry
    [email protected]

  • I suppose I am in the minority (imagine that) but I am grateful for the things I cannot remember. The larger the chunk of missing time, the more grateful I feel. Now, there you go, you can no longer say I hate everything.

  • What can we do for John Rohrer? Below, I provide a few suggestions:

    –Call John on the phone and let him know you support him. Julie is apparently looking into providing his contact information. One of the most important aspects of this case is helping John to know he is supported in going forward. It has been a super long haul for him.

    –Cards are also appreciated, especially in this season.

    –Write a letter of support for John and forward it to his attorney for use in the case. Even one letter makes a difference, but I can also imagine that a stack of letters several inches high would have quite an impact.

    –If you are too far away to visit John personally and see the exact conditions in which he is living, visit someone in your own community who has been psychiatrically incarcerated for a long period of time. Listen to that person. Have them write down their story if they are willing. I don’t know what the publication criteria is for MIA anymore, but sending it in would be worth a shot. And, I will happily publish ANY stories on my personal blog.

    –Contact Ohio Disability Rights. Encourage them to support John’s case.

    –Be a presence at any public court proceedings. Take notes. Keep things honest.

    –Help John disseminate his writings.

    –While I believe it is well known that I have zero use for the so called leadership of the c/s/x movement, and have, in fact, divorced myself from the entire movement, John still needs the movement. Hopefully, there will be some recognition by the movement of the importance of this case, and some kind of effective action will result. If you consider yourself to be a visible and important leader in this capacity, mention this case at your next speaking engagement. Better yet, do something personally for John or make YOURSELF a presence at any public legal proceedings. If you can get yourself to Alternatives in Florida and the MIA Film Festival in Boston in the same year, it stands to reason you can get yourself to Ross County, Ohio.

    Thanks in advance for any support offered. Feel free to write me on any of the above.

    Sharon Cretsinger, Fired from Nearly Everything
    [email protected]

  • I don’t relate to most of this post. It is easy to asset that a person receiving services assumes the provider has no trauma history of his or her own. It is even easier to assert that the person with the trauma history has no experience as a provider or clinician who would “be strapped in the roller coaster seat”. Some people use the therapist as a target to “settle the score” and some don’t. I find the whole idea of a graphic accounting of the abuse history as an assessment tool to determine if the listener is an appropriate target for “predatory cravings” to be offensive, not to me personally (as I am one of the angriest, most predatory trauma survivors out there, at least in the realm of individuals publicly sharing and involved in these kinds of discussions), but as a generalization of trauma survivors as a group. In my previous experience as a clinician, I did not find this to be the case at all.

    And, I can agree with you, Sinead, that Mildly Dysphoric in America is giving *you people” what you want. It seems I have really offended you with a few words of criticism; and, I am not sure why, nor do I care to guess. But the predator in me is purring.

  • Who writes this beautiful poetry? Women whose prose has been censored, by their families, their lovers, their shrinks, their editors, their “peers” in the so called movement, and MIA. Humbled, in solidarity, with your words.

    Is this how you people want your account of Borderline? Fictionalized. Sanitized. From a doctor, who knows it from the outside in, who references clients and not people?

  • Call them what you will, the broken will never really be fixed. Our progressive recovery shrinks have now implemented a subculture in which they label themselves and set their own “objectives”, oppressing themselves so efficiently that they barely need psychiatric treatment at all. Broken, not borderline. Successful by their own standards. I have a piece of writing I did called Broken that explores trauma. But it is far too mad for Mad in America, which now has so many shrinks on board that its condition will soon be upgraded to Mildly Dysphoric in America.

  • I have personally built quite a lot, and continue to do so, on the simple premise that people have a right to be against or “anti” things that are harming and limiting them. I don’t (personally) see MIA as an appropriate forum for self promotion, but I would be happy to discuss how this has worked with you in a more private space, Corrina.

    Best, Sharon

    PS I don’t think you are “wrong”, but perhaps the quest for the perfect language does complicate things for folks at times.

  • Corrina,

    I always enjoy your charts so much. I hope I can learn the skill of making those at some point. But, I might be too old…

    With that said, I am completely anti-psychiatry and am not likely to stop saying so. I used to love language and linguistics before psychiatry got ahold of me; so, I can appreciate your passion for finding the right words to describe your experience. To me, anti-psychiatry means no compromises–not a little forced treatment, not a few sessions of ECT, not even a discussion about the possibility of any of these and other atrocities and a way of politicking with differently minded individuals. I am all for change in language, and am well aware it will change with or without my endorsement. I also believe the movement needs to be able to identify who stands where on these issues. Saying I am anti psychiatry is the best way for me to identify myself.

  • Most “psychiatric patients” have been insulted in so many ways that it the distinction between a “crude” insult and a “sophisticated” insult has lost its meaning. Let’s face it, women, their concerns and their thoughts are still marginalized by so-called professionals, whether it is expressed in terms of a Borderline diagnosis, an addiction, or simply characterized as a low level, unimportant concern that needs to be dealt with using as little energy and verbiage as possible. The voices of the women themselves are the ONLY ones that matter with regard to these issues; and, this is the last semi-professional article I will be reading on this, or any similar subject.

  • This is a beautiful piece, but I can’t quite relate to all of it. It feels prescriptive in its suggestion that everyone has to transcend and find meaning in order to have value. Fredrick Douglas is mentioned a lot in our literature. I don’t mind, but again, it seems to suggest that in order to find meaning, one has to transcend the beating in the woods to become something truly extraordinary in order to shed the spoiled identity of the labeled self. Some of us are survivors. Many of us never achieve anything beyond bare subsistence. We still have value. Those who have died in the woods have value. Those who remain in the woods have value and never do anything beyond remaining have value. Things that are not beautiful have value as well.

  • Hi Daniel.

    I don’t have any good answers to the question you pose above, although I have seen and experienced this issue from many sides and think of it often. I was an LISW-S in the state of Ohio for a number of years. My agency practice included a number of tasks that I will probably have to answer for at some point, the most horrifying of these being writing seclusion and restraint programs for individuals who are differently abled with regard to cognitive functioning (commonly referenced as “intellectually and developmentally disabled” in current, politically correct, clinical language). As another writer notes above, you can stop being a clinician; but, you can never escape the stigma. Any stigma I carry for the horrific oppression I was responsible for perpetrating on this already completely marginalized population is well deserved.

    In your essay, you talk about the relative limitations and advantages of both clinical practice and life coaching. I have one point that I want to add to your discussion. If you are a clinician, and you are “out” as a consumer/survivor/ex-patient, you will become a target for your colleagues. Not maybe, eventually. Definitely. And sooner rather than later. All of the expensive and time consuming licensure that you have worked for will be jeopardized. This feels completely wrong, I know. I thought the same thing a dozen or so years ago when I returned to work from a psychiatric hospitalization. I thought, “Well, I work in the field of mental health. My colleagues will understand. I will have a better understanding of those I serve. Surely I will be treated kindly and my knowledge will be valuable.” Wrong.

    Lived experience is still treated as a ticket to unemployment in many mainstream clinical settings. I returned to work, and immediately, another clinical person with my same first name began referring to us as “crazy Sharon” and “regular Sharon”. I went to a staff meeting of the department I supervised and was ready to run the meeting. Imagine my surprise to find that a junior clinician, many years younger and more inexperienced than I, had been promoted to my position while I was on leave. I had been demoted back to direct service. This was never discussed with me by administration. The Human Resources Director told me my supervisor stated I requested the change. To this day, I don’t know which of them was lying. Both serve as examples of the abusive hierarchy that you mention existing in much of agency work. It is very unfortunate that I was not in a good place to exercise my rights in that situation. I was also not in a good place to look for another job and remained in this abusive situation for a few more years. This agency, Blick Clinic, Inc., continues to operate in Akron, Ohio and continues to crank out seclusion and restraint plans for already oppressed individuals.

    Some years later, I left agency work and formed my own practice as a dissident clinician. Many people who came to me had experienced abuse in the mainstream system. I was openly critical of local mental health boards and related programs and continued to be a target of discrimination by my former colleagues. Eventually, one of them (I presume) filed a complaint with the Ohio Counselor, Social Worker and Marriage and Family Therapist Board. The board initiated an investigation and basically asked me to prove I was not impaired to practice. I told them to fuck off. Subsequently, the board barred me from ever practicing as a clinician in the state of Ohio again. It felt like no big loss, honestly. In retrospect, I believe that the actions of this board were another symptom of the discrimination that faces clinicians who are “out” as consumers/survivors/ex-patients. I believe it was probably illegal.

    In further retrospect, I see that the debacle with my clinical license was partially a sick drama that I created for myself because I did not WANT to be any part of that system any longer. I feel somewhat disappointed in myself that I did not own my power and simply walk away when I knew for sure, inside of myself, that I hated that system and needed to become an Activist and critic of the system. As I state at the beginning of this comment, I don’t know the answer to whether or not it is the right thing for you to walk away from your clinical credentials, Daniel. But I hope you make this decision on your terms, fully informed, with the dignity that you (and all of us) deserve.

    Best regards,
    Sharon Cretsinger, XLISW

  • I am in agreement that there should be an agenda for the conference that is pre-determined, perhaps with a bit of room for open discussion or late additions. As for a larger organizing effort, it is difficult for me to envision whether the larger organization can be assembled before the conference, or whether it might be an outgrowth of same. A few semi-random thoughts:

    Where? Somewhere inexpensive and accessible. Proximate to the APA meeting or other relevant event. I don’t think we are yet in a position to do multiple small conferences.

    When? Soon. Things just keep getting worse.

    Who? I think those who want to present should submit topics to some forum or email list. When enough topics have been collected, the agenda can be democratically assembled before the conference.

    I think we know who many of the people are. Some of you differ with my opinion. Others of you also think you know who the people are, and you and I are definitely thinking of different people. I certainly do not want to limit the possibility of some great idea coming from a voice no one has ever heard before.

    It is not too soon to be thinking of a topic for presentation on direct action or a related area for this conference. Let’s see some thoughts.

  • While it is true that many from our Movement may be at the MIA film festival, this event has unfortunately out priced many of the folks I have spoken to recently, including me. While all discussion and planning is useful., I hope that any discussion and planning happening at the festival can be followed by discussion and planning in a more socioeconomically inclusive venue. While it looks like there will be a great line up of films at the festival, it is somewhat unfortunate that the very term “film festival” smacks of elitism and exclusion.

    SC

  • The discussion about what this conference should and should not be is not one that needs to the discussion of its actual organization. Clearly, the moderates, the “credentialed” folks and those suffering from Iatrogenic Servile Disorder already have their conference. We have established that it is called “Alternatives”. Do we have a few credentialed allies who are trustworthy? Certainly they exist, but they are few and far between. Inclusion of non-survivor allies should be approached with extreme discretion.

    For this conference, we need our best organizers and our most unbreakable activists. I think we know who these people are. I think we also know who will pander, waver and toss around pseudo-professional terms like “compromise” and “diplomacy” in the interest of their own self-promotion for whatever ridiculous reasons they may have for wanting notoriety in a Movement that is not yet even a shadow of a blip on the radar screen of popular knowledge.

    This brings me to another point that is important about this conference. There needs to be some media attention with regard to the event, whether it is attention to the conference itself or to some action that may take place in conjunction with the conference. And, there needs to be some control of the media attention. We are all familiar with the mainstream media’s tendency to make our people look like a bunch of lunatics who are out to do nothing but buy firearms in order to shoot up schools and other public venues. The media piece is a part of both the organizing and the activism–connecting with sympathetic media sources and maintaining the resolve to hold our position regardless of possible adverse events that could possibly be out of our control.

    Personally, I get some flack from time to time about being “negative” and “unrecovered”. There is a time for positive thinking and positive action; but, let me be clear: OUR MOVEMENT IS NOT THERE YET. Before we can move on from the damage that so many of us have suffered under the boot heel of psychiatry, we need to be able to say NO to the things that are killing and disabling us. It is absolutely impossible to build better “alternatives” until we can be free to build them and choose them for ourselves. This is a process that has been started in the past, but, sadly, has been hijacked by capitalists and authoritarians. And, let me be clear on one more thing–some of the most “unrecovered” people I know are the strongest in their commitment to our work. This dynamic goes to the discussion above about living one’s life as if one was already dead (I quote loosely). Those of us who feel we have the least to lose are often willing to give the most because we live our lives in that way. For myself, I feel that everything from ten years ago going forward is borrowed time. There is no reason to break, bend or retreat on borrowed time.

    Lastly, I will make the point that this conference also needs diversity (although “diversity” is quickly becoming a human resources-type buzzword I hate). I’m reading the discussion above. I’m reading. I’m reading. I am reading (largely) elder white men. There is no reason to create a conference focusing on saying “no” to our marginalization if we are simply going to duplicate the gender, ethnic and socioeconomic dynamics of the power structure that has already killed us, maimed us and co-opted previous efforts toward change.

    This is what I have to say on the subject of this conference. I won’t be emailing anyone about my interest in this idea, but I do believe the Movement knows how to find me if it feels my ideas are of any value.

    Best Regards,
    Sharon Cretsinger
    Manager, Motel 6

  • I think the privacy settings for folks in these kinds of professions are called “common sense”. If a clinical person does not understand how to regulate privacy settings, they can always ask a teenager. Really, there is no excuse.

    Going along with this, we now have PTG (patient targeted googling), in which the therapist attempts to learn information about patients online. Lots of ethical questions around this one. I’m not sure why. It is obvious to me: just don’t.

    Are we so regulated and so ethically coded that a little common sense and a little restraint never cross anyone’s mind anymore? Ah, the good old days, before the internet, when I walked three miles to school, uphill both ways, and had to actually gossip to find private information about others.

  • Hi Andrew.

    I personally have an issue with the entire system of “mental health care”. For myself, I found it impossible to oppose psychiatry and affiliate with social work. I feel like they are all connected; and, often the practice of social work felt like an insult to my intelligence. Was I really supposed to believe that the MSW program approved by the Council on Social Work Education was designed to prepare people to provide compassionate and humane support for individuals in distress? When a whole course focuses on the DSM whatever number and the identification of “mental illness”? Really? Do we need one more social work student to be given the supposedly “creative” assignment of watching Fatal Attraction and deciding Glen Close is a borderline?

    We don’t need one more person coming out of that kind of formulaic indoctrination and pretending that they actually know how to do something besides fill time for billable hours and fill criteria for agencies that want to appear to be providing “talk therapy” along with drugging because the studies say the drugs work better than talk therapy.

    While I am here, Andrew, I will also apologize for referring to you as a “nice young man” or some such on another comment thread. My remark was obviously more of a projection on my feelings about myself as a bit of a relic than an actual criticism of your knowledge base or ability to essay and remark on issues important to MIA.

    Best regards, Sharon Cretsinger

  • I am reproducing here the same essay I added to the comment section of Phillip Hickey’s article, referenced above…it has relevance to this discussion also. I practiced as a a clinical person for many years and found the type of corruption I represent here to be the norm rather than the exception. The question of whether or not the general practice of medicine is as corrupt as the specific practice of psychiatry is not an area where I feel qualified to comment. I promise to stop posting this essay and write something new possibly in this same decade. Who knows what I might or might not accomplish without the help of a comprehensive treatment plan.

    Rather than writing about my frustration with the c/s/x survivor movement today, I have decided on a short piece about drugging, diagnosis and profit in the pharmaceutical and medical industries. Toward the end of my clinical practice, a part of what I did was seeing people in long term care facilities who also had psychiatric diagnoses. In each case, as was my habit, I conducted my own diagnostic interview without having read any of the previous diagnostic interviews, case notes or other background information. I found a variety of diagnoses, from those considered by the mainstream to be SMIs to those that fit the category of “adjustment disorders”–which really means that the person is feeling distress about something external that is going on. Because all of the people I saw in this context were Medicaid patients in long term care facilities, they had very little of their own power and very little to no control over external events. There was a LOT of adjustment disorder. When comparing my conclusions to those of facility psychiatrists, however, I noticed an almost invariable pattern of disagreement. Schizoaffective Disorder. Schizoaffective Disorder. Time after time. Case after case. I asked myself, why? Within a couple of months, the very disturbing answer became apparent. These individuals were being drugged for the convenience of the care facility and the staff. The diagnosis of Schizoaffective Disorder effectively justifies the use of any type of antidepressant, anti anxiety, or anti psychotic medication. And, the change in medication does not require a time consuming diagnostic revision when the primary diagnosis is Schizoaffective Disorder. This label covers both “psychotic” symptoms and “mood” symptoms such as “depression” or “mania”. This dynamic was easily observable to any person with clinical training who had access to the individuals and their records of behavior and medications changes. I recall meeting a facility psychiatrist who refused to talk to me and dismissed me from his presence with the statement, “I have over 3,000 patients.” At that time, I wondered how he could possibly have over 3,000 patients. Now, I know. Through the magic of a wastebasket diagnosis of Schizoaffective Disorder. No paperwork, no face to face contact, no conscience. Just drugs and money, money and drugs. Long term care facilities, psychiatry and drugs–all huge profit industries. Medicaid funded residents of these facilities–no power, no way to change what is happening, no way to even know how they are diagnosed, let alone how it is making other people rich from their suffering. My words, today.

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  • I’m responding to Phillip Hickey’s article with a short essay I have written on a similar topic. This essay is based on my personal experience in a “behavioral health long term care facility”.

    Rather than writing about my frustration with the c/s/x survivor movement today, I have decided on a short piece about drugging, diagnosis and profit in the pharmaceutical and medical industries. Toward the end of my clinical practice, a part of what I did was seeing people in long term care facilities who also had psychiatric diagnoses. In each case, as was my habit, I conducted my own diagnostic interview without having read any of the previous diagnostic interviews, case notes or other background information. I found a variety of diagnoses, from those considered by the mainstream to be SMIs to those that fit the category of “adjustment disorders”–which really means that the person is feeling distress about something external that is going on. Because all of the people I saw in this context were Medicaid patients in long term care facilities, they had very little of their own power and very little to no control over external events. There was a LOT of adjustment disorder. When comparing my conclusions to those of facility psychiatrists, however, I noticed an almost invariable pattern of disagreement. Schizoaffective Disorder. Schizoaffective Disorder. Time after time. Case after case. I asked myself, why? Within a couple of months, the very disturbing answer became apparent. These individuals were being drugged for the convenience of the care facility and the staff. The diagnosis of Schizoaffective Disorder effectively justifies the use of any type of antidepressant, anti anxiety, or anti psychotic medication. And, the change in medication does not require a time consuming diagnostic revision when the primary diagnosis is Schizoaffective Disorder. This label covers both “psychotic” symptoms and “mood” symptoms such as “depression” or “mania”. This dynamic was easily observable to any person with clinical training who had access to the individuals and their records of behavior and medications changes. I recall meeting a facility psychiatrist who refused to talk to me and dismissed me from his presence with the statement, “I have over 3,000 patients.” At that time, I wondered how he could possibly have over 3,000 patients. Now, I know. Through the magic of a wastebasket diagnosis of Schizoaffective Disorder. No paperwork, no face to face contact, no conscience. Just drugs and money, money and drugs. Long term care facilities, psychiatry and drugs–all huge profit industries. Medicaid funded residents of these facilities–no power, no way to change what is happening, no way to even know how they are diagnosed, let alone how it is making other people rich from their suffering. My words, today.

  • Hi Andrew. What a nice young survivor/writer you seem to be. As such, you would certainly, I believe, be willing to entertain a respectful, but direct, question about the content of your essay. If the message is that hope is present and recovery is possible, then that is what the majority of the voices will be saying. Still, there are some other voices in the middle distance, saying that those who have not felt the eternal sunshine of the spotless mind need to have a voice as well. If they do not bring the message of the hope and the tangibility of the recovery, are they still heard? Are they lone voices? Lone dissident voices? How long until they are drowned by the simple minded majority? Are they fragile and important? I’m interested in what you would think on these topics.

    Sharon Cretsinger, XLISW, Space Cowboy
    Kent Empowerment Center
    Kent, Ohio
    [email protected]

    (330) 608-2203 (Please email, my voice mail is filled and I have no immediate plans for clearing it out)

  • I am generally critical of CBT for a number of reasons. It is second wave behavioral treatment that was built on the foundation of Applied Behavioral Analysis (ABA), which is little more than a Pavlovian method to reinforce desired and accepted behavior while punishing unwanted behavior. CBT places the “blame” for the diagnosis squarely on the individual diagnosed, using terms such as “thinking error”. I personally find it disgusting to program an individual into making such a stupid and demeaning statement as, “I had a thinking error”.

    CBT has been around for a number of years, and has been discarded as a treatment for many “diagnoses” in favor of third wave behaviorism (DBT) and mentalizing by forward thinking clinical people, even within the mainstream. It is still widely popular, however, in community mental health centers as the treatment of choice for ANY disorder because of the ease of teaching the method to low level therapists who are largely inexperienced and unskilled. It has some short term efficacy, but, like simple reinforcement and punishment, the efficacy fades somewhat rapidly in the absence of the stimulus.

    Hearing Voices groups are state of the art with regard to alleviating the suffering of individuals who are experiencing unusual things, within or outside of a “diagnosis” of Schizophrenia. There is a great deal of research from Europe on these groups. More and more people in the states are also doing this kind of work as well. I am interested in hearing from like-minded individuals in Northeast Ohio who want to establish a true alternative to mainstream “treatment” for voice hearers and others who experience similar unusual events.

    Best Regards,

    Sharon Cretsinger, XLISW
    Kent Empowerment Center, Kent, Ohio
    [email protected]

  • Nice, Sera.

    Our public schools are more and more becoming institutions of coercion and indoctrination rather than places for intellect, questions and supporting the transition to a functional adulthood. My heart goes out to Kelsey and others in her situation who will learn that it is right for society to marginalize them, drug them and throw them away like human trash.

    As far as the Murphy Bill, I am disappointed (again) in the Movement’s efforts to coordinate a resistance.

    Best, Sharon

  • Dear Michael,

    Thank you for this engaging essay. The only part of my practice I really miss is the Jungian work with the dreams and the sand tray and such. I built my own sand tray a few years ago, and spent several months collecting adequate numbers of all the needed figures. I had forgotten until today how fulfilling it was to make the sand tray and utilize it in practice.

    Perhaps I feel a bit inspired to revive parts of my practice in a new and evolved way thanks to your essay.

    Best regards,

    Sharon Cretsinger, XLISW
    Kent Empowerment Center, Kent, Ohio

  • Dear Jack,

    I have been reading your stuff religiously ever since I discovered you were a fellow disillusioned social worker. Actually, in the state of Ohio, I am no longer allowed to call myself a social worker. But, I digress.

    Here, I just want to underscore a couple of your points, and open up the question of addiction to the Movement at large. At the very end of my imploding clinical career, I did about an 18 month stint as a drug counselor. I am the worst drug counselor on the planet. I cannot even keep myself clean and sober. Again, I digress. My point is that addiction CAN happen to anyone and it DOES kill. I believe I lost 6 individuals in 18 months. They were not movie stars. They were not at the height of their prowess in any professional field. Most had been effectively thrown away by our positive thinking obsessed culture, dying broke and alone. I’m not glad Hoffman is dead; but, I confess, I am much more indifferent to his death than to the deaths of the individuals I worked with in treatment every day. And, I think it is good and right that someone still stands for them. There are many others who need attention, help and compassion. They lack even 1/10 of 1% of Hoffman’s resources and supports.

    I hear very little about addiction in the Movement that is not addiction to Benzos or some other equally heinous psychiatric medication. Yet addiction is a part of the DSM we oppose, and like other categories covered in the DSM, big pHarma is making “substitute” drugs all the time and the government is funding community treatment centers to push them. “Don’t take Heroin, take Methodone…”

    Unbelievably enough, some people still ask me for advice on getting clean. I like to tell them, if you are going to do drugs, find something you enjoy and just do it. But take your drugs. Don’t take “their” drugs. Any other thoughts on these ramblings from Movement folks?

    Sharon Cretsinger, XLISW
    Founder, Kent Empowerment Center, Kent, Ohio

  • Nice article, Chaya.

    I have a really hard time getting behind government funding for the type of work you do, simply because I have seen how it becomes an incentive for people who are barely “qualified” to bill the system, as well as how much fraud and waste it perpetuates. Once the government becomes involved there will also inevitably be a license or similar qualifier for whoever is billing. I think the days when having lived experience becomes a qualifier in the eyes of our government are a long way away–beyond our lifetimes.

    I don’t really do anything useful anymore, except spout abrasive opinions on things I have experienced, seen or studied with regard to the Movement (if anyone really considers that useful). If I was going to again do any type of practice on a large scale, I do believe it would be outside of the money economy. With the advent of Bitcoin, it seems that our economy is changing rapidly.

    Sharon Cretsinger, XLISW
    Kent Empowerment Center, Kent, Ohio

  • I can say from my personal experience that people have been locked up for “rage” for a long time, under the label intermittent explosive disorder (essentially meaningless until subjectively defined by a “clinician” or questionable motive and qualifications). And, of course a dose of an atypical antipsychotic is going to shorten the “episode”. Those medications are powerful tranquilizers, in case anyone has not heard.

    Anyway, I cannot make enough public amends for the damage I caused in my former clinical career. I am way beyond caring what I “look like” as an activist, or what mainstream rules I might follow in order to be more acceptable and better heard. If Ted has to go to the rest room, I will happily hold his NAZI sign…

    Sharon Cretsinger, XLISW
    KENT EmPOWERment Center, Kent, OHIO

  • Hi Sera.

    I enjoyed this article very much and clearly see the sense in giving clinical folks the benefit of the doubt. I just want to share a little of my experience here, having been on both sides of the desk for many years (more than I care to count as I come up on another birthday). I remember when, as a “patient”, it first occurred to me I might become a “clinician”. Not that I might become a “better clinician” than the ones who were ineptly advancing my distress with every session, but that I could become a “clinician”; and, when I became “the clinician”, I no longer had to be “the borderline”. (The idea to be better than the rest and actually try to help people survive came a few years into my career).

    My story is FAR from unique. And why do we care? Because this dynamic sets up a division between clinicians and individuals served. “I am going to stay in this role so I don’t have to be in that role.” And many are so afraid of the “patient” role that they will do ANYTHING prescribed by the system to maintain status as a clinician. When I eventually came out, I cannot even count 1. how many colleagues divulged to me their similar histories and 2. how many of these thought I was even more unbalanced than usual to actually come out…

    So I am not going to go on about this one dynamic at length. There are many complicated dynamics in clinical practice. The interaction of the clinician and the lived experience person is fraught with tension in the Movement and the cutting edge modalities.

    Ultimately, I chose not to be an LISW with the accompanying rules and expectations and limitations. I am simply….

    Sharon Cretsinger, Space Cowboy
    Founder and Director of the Kent Empowerment Center
    Kent, Ohio

    Kent Empowerment Center’s First Annual Big Ass Gathering for Complete Equality and Inclusion. May 4, 2014. All who love the movement are welcome. Email [email protected] for more discussion.

  • Hi Michael.

    Thanks for the excellent article. I have just one question–for the “If you have nothing to hide you have nothing to fear” folks–

    Why do I have to hide my psychiatric history in order to retain my human rights, my professional credentials, my employment and my dignity. Truly, I have nothing to hide. And it has been a horrible ride at times.

    Sharon Cretsinger, Founder, Director, Psychiatric Survivor
    Kent Empowerment Center
    Kent, Ohio

  • Ron Unger is correct–many sources for error in this study; or, it appears so from the abstract. What is with having to pay for the full text? I’ve never seen such a link on MIA before, but perhaps I wasn’t paying attention due to being either stoned or schizophrenic at the time…

    Sharon Cretsinger, Whatever
    Founder, Director Kent Empowerment Center
    Kent, Ohio

  • Hi Michael.

    Thanks for your thoughtful article, with so much information about Dick Price. Much of this was enlightening to me.

    I do believe, in the wake of this conference, many individuals are asking the question: Is the movement now invitation only. After sleeping on my possible responses to your fine article, I came to me that the direct question might as well come from someone who respects you and your work.

    Do you mind responding?

    Best Regards,

    Sharon Cretsinger, Space Cowboy, Founder and Director, Kent Empowerment Center, Kent, Ohio

  • Hi Jonathan. I would respond as I have responded in the past–individually to each distinct case–by sitting quietly with the person, asking questions, reaching out to them energetically or letting the voices in my head talk to the voices in their head. It is hard to know what to do in any given situation without feeling the vibration of that specific situation.

    Now may I ask you, when you say that you believe the process needs to be radically overhauled, do you believe that such an overhaul can take place while titles and letters professional roles continue to define who is the expert and who has power?

    Best, Sharon

  • The movement has started to reflect the social constructs of the larger society that contains it, including aspects of the patriarchy. I don’t have to look any further than how the male activist next to me treats me in order to know this for sure. It is NOT a good thing.

    Sharon Cretsinger, ICON, Founder and Director, Kent Empowerment Center, Kent, Ohio

  • Good morning folks. Well, this is the first read of my Saturday morning; and, I have to admit to feeling a little stumped about what to think of it. Those familiar with my thoughts on the movement know that I believe the current, mainstream mental health system needs to be completely dismantled, and that those who work in any capacity to keep these cogs turning should not be a part of the c/s/x movement. So, I guess I will address this aspect. On the surface of it, Jonathan Keyes makes a pretty good and not terribly complicated case for my position: too much coercion in hospitals, forced treatment=bad, Soteria model=good. He also makes the case, however, that SOME of the former can be good, if only it were better delivered and policed. Here is where we diverge. Here is where we diverge.

    I will be having my 45th birthday shortly, and have spent most of my life as a mental patient. I also spent twenty plus years of my life as a therapist/social worker, so I am not unsympathetic to Jonahan in his clinical role. I was radicalized in the year 2003, during a particularly brutal inpatient hospitalization. In the year 2003, I was raped and beaten on the psychiatric ward at Akron General Hospital in Akron, Ohio. The “perpetrator” (and I use this term loosely because I actually consider the hospital the perpetrator) was someone who was under my care at an outpatient facility where I was working at the time. The attack happened (I believe) in the small hours of the morning, after I had been given a heavy dose of what I believe to have been atypical antipsychotics, or possibly Haldol. I could not find a staff person for the longest time. When I finally located “nurse Cathy”, she told me that “people get hurt when they throw themselves out of bed because they aren’t getting the meds they want”.

    I know my story is not unique. I know it is not as horrific. I simply offer it here in response to Kermit’s request for personal experiences. One more story from the other side of the desk, and I will leave you all to your Saturday coffee and post-black Friday shopping.

    One of my last contracts in my private practice was a smallish behavioral health nursing home type facility. Once I got in and started looking at the charts, I noticed that every single person there carried the diagnosis Schizoaffective Disorder. I started writing diagnostic updates because it was clear to me this diagnosis was incorrect in many cases. This was when I drew the wrath of the contracting Psychiatrist. Well, being that I am a little bit smart, I asked myself why he was so upset. It did not take too long for me to figure out that Schizo cover his Psychiatrist butt for any antipsychotics he wants to prescribe and Affective covers the full range of mood drugs: uppers, downers, so-called stabilizers, etc. So, basically, he could medicate the individuals however he chose from one day to the next without even doing the paperwork to change a diagnosis in support of the change. I later learned this doc had over 3,000 of these type of individuals on his caseload.

    So, in closing, abolish psychiatry and return the power to the people. Anarchy. Pride. Civil Disobedience. Now.

    Best Regards to all,

    Sharon Cretsinger, ICON, Founder and Director, Kent Empowerment Center, Kent, Ohio

  • Hi Andrew. I don’t think you can do it. Really, I just don’t . I am a former social worker; I have relinquished my license to a (almost police) state that wanted to demand I prove I was not impaired once I came out with my diagnoses. But, if you can continue to make a difference from within the system, please keep telling us how. Because I am at a loss.

  • Hi Sera. Yet another brave and super-relevant essay on a topic that most people still don’t talk about. We lived-experience folks experience so much more pressure than other aspects of society who are trying to move on. What’s that, you are an alcoholic and you fell off the wagon? Well, relapse is part of recovery, per the many AA platitudes. You fell off your motorcycle and injured yourself and you walked 500 more feet in physical therapy this week that last week? Good job! Excellent progress. Oh, you are an officially diagnosed mental patient and you have two big burns on your arm? (insert sad, worried face) You really aren’t any better than ever, are you? (insert head shake) I don’t even bother to explain that since I took the job as the Home Care Health Aide, I have had the chance to cook for people. This is a skill set that is particularly rusty for me and has accidentally resulted in some minor bodily injury. These dolts actually think I have self-injured in plain sight. Dolts.

  • I guess it is good to know that some of us “make it out” and can talk about suicide attempts that are twenty years old. However, not all of up are attractive and acceptable enough in polite society to come to where Leah has in midlife. Who speaks for people like me–the fat, ugly, aging minimum wage piece of garbage who is still living in hell?

  • I was trying to be at least somewhat centrist in my first comment. But, quite frankly, the whole “peer” movement in MOST of its forms, reminds me of when the Nazis got the Jews to start gassing each other.

  • Cat, the board that certifies CD professionals, which is now to be combined with the board that certifies MH professionals states that you have to have “2 years of abstinence from the abusive use of any substance” in order to be certified at any of the 4 levels. Leaves a lot of room for interpretation, no? If you are working at an agency that does not require a certification, it would have to be up to the agency to specify criteria for a recovering individual–a difficult task, I would think, since recovery is so individual. For the most part (I believe), outside of law enforcement contexts, the “A” meetings remain anonymous. There is also a nifty new thing called a recovery coach that is on a par with a peer worker in mental health. In my last “real” job, I was lucky enough to work with a recovery coach who took his role seriously enough to tell me exactly where to get off when I asked what I thought was an innocent question about how one of the individuals I served was getting along in an “A” meeting.

  • Hi Sera. I have been up and down and through the mill since I studied with you in May. I found out I was losing my license to practice in the state of Ohio shortly after returning from the HVN training. It has been gone since July 18. It is probably just as well, because most of the clinical people in that training clearly identified me as a person with lived experience (and not “one of them”), which is now exactly what I am.

    Jen Pardon, You and I have crossed paths on this particular topic before; and I meant/mean you no disrespect. In a personal sense, you have been really wonderful to me. You did let me know, in no uncertain terms, on another forum, that I don’t know anything about your programs, or the programs being studied/designed at your alma mater in Texas, and that I should subsequently keep my mouth closed on the subject.

    So, I will have a little bit to say about programs in the state of Ohio that I have been living with since the 90’s. I think we can all agree that Ohio was one of the first states on board with peer programs. Except that no one here knows we have peer programs. Why? Because the peer workers look exactly like mini-me clinicians and have since the beginning. They also experience all of the same discriminations that are found inside of the mental health system toward workers with mental health diagnoses. The peer workers focus on the same items contained within Ohio’s Mental Health Case Management rule, including medication compliance, crisis intervention (read coerced treatment) and others that have been traditional within the systems for decades. My basis of knowledge here comes from a lifetime as a “patient”, twenty years as a clinician and the role of treating clinician in the case of several peer workers who had been traumatized by the discrimination and abuse they experienced within the system. As a graduate student and a professor, I even taught research and participated in various evidence based studies. But I digress. My purpose in commenting here was not to give my resume’.

    I will sum up my comment by recounting an interaction I had with a clinical person from Asheville at the HVN training in May. She came over to me and commented that she felt there was some conflict between the clinical people and the lived experience people. I noted that I felt that if we were in a room talking about the HVN concept without any conflict, we would be in the wrong room. She then asked me if I was saying I was happy that the room was a safe place for conflict. I could not help myself, I had to ask her if that was what she would be comfortable with me saying. No response on that one.

    I remain comfortable with conflict in the area of radical mental health. I remain, also, unconvinced that most “peer” programs are fully aligned with the ideals and objects of radical mental health.