Friday, December 4, 2020

Comments by cabrogal

Showing 26 of 26 comments.

  • Why is it their label?
    Because they coined it?
    Why would I accept their authority as language enforcers when I don’t accept it as scientists or medical practitioners?

    English doesn’t have an Academy. It’s defined by its usage. If enough people use ‘bipolar’ outside any pretensions of medical diagnosis it will cease to be seen as such a term.

    It’s not a disease or disorder. It’s arguably not an impairment; at least for some. But it is a disability because of society’s (particularly the medical profession’s) insistence that it should be. And by leaving the label with professionals who’ll pretend it’s objective and scientific you’re denying everyone else the right to engage with it on their own terms.

    I’m not disabled with bipolar because of mood swings or psychotic breaks or any of the other symptoms on the checklist. I’m disabled because our society no longer tolerates how I present as being within acceptable variation. In the 80s and 90s I was enabled by my bipolar and Asperger’s because the IT industry thought some of my ‘symptoms’ valuable enough to put up with the others and hand me big pay cheques for them.

    It’s not labels like ‘bipolar’ or ‘autistic’ or ‘hysterical’ that are the problem. It’s the attitude people have towards what they think they represent. By leaving the labels as professional jargon you’re not only denying people with lived experience under the label the right to define it as they see it, you’re giving everyone else an out when it comes to their own attitudes towards it.

  • That said, I kind of do have a problem with psychiatric labels, truth be told.

    But so do shrinks. They need to keep changing their meanings, making up new ones and ditching the old ones they’ve worn out.

    It’s not hard to reclaim a term like ‘nerves’ (neurasthenia) from them and give it to the community to use to reconnect with us crazies instead of leaving it to ‘experts’ to sew psychobabble straight jackets for us.

    And let’s face it oldhead, if consumer culture is allowed to control our language it’s gonna be inherently abusive no matter what words are being used. Same if we let it control our social interactions or eco-systems. But those are separate (huge) battles. I don’t see why we shouldn’t go for tactical victories while we gird ourselves for the strategic ones. Good for community building and morale I reckon.

    If I’m gonna get abused I’d rather get it straight from my neighbours than by proxy via a pseudo-scientific ‘objectification’ of someone’s subjective judgement.

  • I dunno if I consider myself reclaiming rather than just claiming it, so the question of prior usage doesn’t come up.

    But it seems personally empowering to me and it’s hard to see how it wouldn’t be to strategic advantage to have a lot more people not feeling disabled by the names people call them, no matter how quickly they adapt them to acceptable euphemisms. (There’s a scene in The Curious Incident of the Dog in the Night-time in which the ‘autistic’ child protagonist is followed down the street by bullies chanting “Special needs! Special needs!” It works because kids know what insults are and don’t need to pretend.)

    If you want to call me bipolar, fine. I’ll accept that. You’ve just made me the expert. You theorise about bipolar. I live it. Now I’m going to tell you a fucking thing or two about it.

    Why accept their authority to define the labels you wear with pride?

  • Well I am a black person with mental illness labels, so I figure I’m allowed to call myself that. Though as an Australian black person I’m more likely to call myself (and my Aboriginal friends and family members) ‘boong’ than ‘nigger’.

    And I have no problems at all with people calling me ‘autie’ or ‘bipolar’ – which I also call myself. I get far more pissed off with real haters who thinly veil their contempt with PC euphemisms than with normal people applying the words they’ve been taught to use but which have been deemed inappropriate by some.

    A lot of today’s ‘hate speech’ was yesterday’s ‘correct’ terminology and frankly I can’t be bothered keeping up with the fashions.

    If someone is trying to beat me about the head with a word I just take it off them and use it as I see fit.

  • “a girl from Cabramatta??”

    Nah. But I get that a lot. Here’s the explanation.

    “If ego death is a “curative” factor for some using psilocybin (and other entheogens) might there be a non-drug way of achieving this? ”

    Yes there is, but in my experience the states that bring it about are difficult to predict and maintain. They’re generally very beautiful and rewarding in their own right, but I can’t see how they’d be applied ‘therapeutically’ to a specific task. Nor do I feel it would be appropriate to attempt to do so.

    The drugs take care of the altered state for me, freeing me to explore it in a semi-volitional manner. (I’m using language here, which is inherently dualistic and egoistic. I hope you can get around words like ‘I’, ‘me’, ‘attempt’ and ‘volitional’ to what I’m trying to say.)

    I’m kinda down on Descartes too, though in my ignorance of Latin I often wonder if ‘cogito ergo sum’ begs the question a little less than ‘I think therefore I am’. But while I agree that linguistic and social conventions reinforce the ego construct I don’t think they cause it, but rather it causes them. IMHO the ego is implied within the fundamental dualism of subject-object and that precedes both language and society.

    Schopenhauer was influenced by the anatta of Buddhism and Hinduism’s Tat tvam asi. (I reckon the no-self of Buddhism and the Self=Brahman of Hinduism are the same non-dual thing, though a well known Buddhist scholar has tried hard to disavow me of that notion.) Western philosophers are johnny-come-latelies when it comes to egolessness. And it’s not like you can say much about it. Neti neti …

  • Incisive yet again oldhead.

    But the alternative path is to seize the labels from the quacks and wear them with pride, as other communities suffering bigotry have done with words like ‘queer’ and ‘nigger’. Of course you’ve got to start by owning them. As in “I am not a person afflicted with bipolar disorder. I’m bipolar. It’s part of me.”

    And the fact is, no serious deviance from the accepted consumerist mean is ever accepted in production line capitalist culture. Unless you toe the line and drink the Kool Aid they’ll just find a new label to beat you about with. That’s why you should always gush over reality TV shows that promote consumerism as mental health therapy.

  • You’re right that the cops are the big danger. Just laughing at them can be ‘threatening behaviour’ and things can go downhill fast from there.

    And you’re spot on with setting too. I won’t go into the details online but the participant is expected to have a big input into co-developing a safe space, both physically and in terms of personal boundaries. That’s especially the case after the low dose ‘test run’. If we don’t feel relaxed and safe in each other’s presence in a co-designed safe space then we don’t go ahead unless/until we both feel that way. ‘Safe space’ has always been an important part of how I deal with my own extreme states so I try to be sensitive to the need in others and the various concepts of how it’s ‘constructed’.

    And I dunno about you oldhead, but my impression of apparent ego death in both myself and people I think I’ve been with in such states is that it’s usually existentially terrifying the first time (or few times), regardless of the space. The difference with a truly safe space it that it’s easier to push through that without it spiraling out of control from negative sensory and emotional feedback.

    Yeah, I’d allow that certain prior experiences – whether spontaneous or the result of some kind of practice – would prepare some people for it. But the fact ego death isn’t physical death is irrelevant at the time. Your ego is where your existential fear of death lives. It’s what you think ‘you’ are until the concept of ‘you’ goes away. And yeah, loads of people think they’ve overcome that but speaking from personal experience, not all of them are right. Not the first time at least.

    So unless I’m with some kind of spiritual adept or experienced psychonaut or someone with a long history of learning to deal with extreme states then I’m gonna assume that coming to the peak of an ego-trashing trip is gonna scare the bejesus out of them at first – especially if you use a substance or dosing method that brings it on fast. I don’t *think* my own expectations and prejudices pre-configure those observations; but I wouldn’t, would I?

    And that’s the bit where the rubber hits the road. The most important part of my function in this is to get them through that without something happening that imperils either of us physically, psychologically or legally. It’s not necessarily to calm them down or reduce their distress. Depending on prior arrangement and my own gut I might even be encouraging them to go deeper into their fears. But if there’s behavior (or volumes) that are going to breach our agreements regarding mutually safe space then I have to be ready to deal with that. And I need to be mindful of safety, ethics and trust when I do.

    It’s generally only the first hour or so that you need to worry about that sort of thing, but some people get flashes of paranoia through most of the trip too. If that happens at low dose it contraindicates a high one, IMHO, though I wouldn’t rule out being convinced that someone had learned to deal with it.

    And yeah, it occurs to me that the experience of traumatic entry into the boundless could be a mythic one, configured by our stories of death followed by purified rebirth. And that maybe if we could find something else to viscerally believe in – or not – we could change our myths into something less traumatic or somehow let go of them entirely. But I think that’s beyond my pay grade.

  • “It is not necessary to have a guide once one is familiar with the new psychic dimensions opened up by the psychedelic agent.”

    Agreed. But most of the people I work with have never experienced high dose psychedelics before and, as I’m sure you’re aware, the first time your ego shrivels and dies can be very traumatic. You need someone you trust and have developed rapport with to help you through that.

    The biggest single danger with this is that someone will lose it on the way up to the peak and trigger a police response.

    And I’m quick to dissuade anyone who starts treating me as a guru, in psychedelics or any other arena. I leave that sort of thing to Charlie and the shrinks.

  • “The data indicated that 54% of those receiving the treatment remitted (no longer met the criteria for depression after four weeks). Still, there was no placebo-controlled group to which the results could be compared. The placebo response rate for depression is usually estimated as falling between 40% and 50%, but some studies have found placebo responses as high as 70%.”

    Yeah, but check out the change in HAM-D scores for those who’ve had psychedelic treatment for depression compared to those for antidepressants or placebos. It’s chalk and cheese.

  • I agree psychedelic ‘therapy’ isn’t a medical intervention. But neither is psychiatry, though it purports to be. And yeah, testimony is anecdote, not data. I’m speaking of my own experience here, not making universalised claims about efficacy. Maybe I’ve just been lucky.

    But I’d also assert that few of the problems people receive psychiatric treatment for are medical. They’re mostly social but often have a large spiritual dimension too, so ritual interventions are probably more appropriate than medical ones in many cases.

    The Synthesis Institute in the Netherlands calls its psychedelic interventions ‘ceremonies’. I call mine ‘sessions’, not therapy. I definitely *don’t* call myself a therapist, counselor, coach or shaman. I’m just someone with extensive experience of being with people who are tripping.

    And I’m sorry to hear about your son. I take as much medical, family and personal history as possible before agreeing to a session – particularly legal and illegal drug use – and reserve the right to refuse if I see any red flags or if it just feels wrong. I start with a low dose test session to see how someone will react but also to give them a better idea of what it’s about before deciding on a high dose session. I also check BP prior to a session because of the hypertensive risks. And because I’m not a professional and don’t see what I’m doing as a commercial service I don’t accept payment. But I’m still not entirely comfortable with the risks of what I do, especially the legal ones. NSW police regularly kill people who are under the influence of psychedelics.

    I think there’s ethical questions about representing this as therapy but, as Sami Timimi recently pointed out, psychiatry is more closely aligned with the pseudo-religious ideology of scientism than with medical science and that’s resulted in a society that thinks misnamed ‘therapy’ is the only legitimate way to address many kinds of life crises.

    I sincerely think the risk:benefit equations of guided psychedelic sessions are significantly better than those of psychiatric ‘therapies’ for many of those problems, even in jurisdictions that haven’t legalised or decriminalised them.

  • Firstly it’s dose related. The ‘therapeutic’ dose is meant to bring about mystical experiences and/or ego death and is much higher than a usual recreational dose. Due to emetic chemicals in mushrooms a lot of people will have trouble holding down enough of them to get that sort of dose. In clinical trials the psilocybin is purified or synthesised so you don’t get that problem. You can also moderate the problem by thoroughly drying the shrooms before use; at least if you’re using psilocybe cubensis (gold top) shrooms.

    Secondly there’s quite a few things that can moderate the effect due to competition with the 5HT-2A receptors the psychedelic chemicals act upon. These include cannabis and, ironically, antidepressants. So unless they withdraw from their pills first a lot of the people going for these therapies are going to get a reduced effect.

    Also, psychedelics produce instant tolerance. If you take a mind bending quantity of shrooms or acid then take a similar dose the next day you will get very little effect. It takes 2-3 weeks for tolerance to get back to normal levels.

    And the people doing this ‘therapeutically’ are aware of the importance of setting. It’s not done in a normal lab or office but something set up more like a chill room at a rave. Often the subject is lying down in an eye-mask and headphones listening to music meant to help set the atmosphere.

    The ‘therapy’ consists of preparation, which helps the subject approach the trip in a constructive, open manner (often involves learning meditation/relaxation techniques and how to ’embody’ emotional experiences), guiding/sitting during the trip to help them through difficult parts (ego death is often existentially terrifying), and post-trip integration. A strong trip brings about experiences so far outside most people’s prior experience it’s generally impossible to express in words (ineffable) and can’t be incorporated into narrative memory, so it slips away like a dream. Integration is meant to ‘fix’ the insights gained during a trip so they can inform later work the subject does on their issue, whether emotional, psychological, social or spiritual.

    It’s not the chemical that does the job. What it does is temporarily knock down your ego defences that can be keeping you locked in a self-defeating mindset. Having hopefully seen through whatever thought patterns are sabotaging her the subject can then, hopefully, ‘cure’ herself. That’s why you don’t need to keep taking it as with psychiatric drugs. One or two experiences will generally be enough for years or a lifetime. Nor do you generally need long term follow-up therapy. A few post-trip integration sessions suffice.

    And as oldhead points out, people are hyper-suggestive when their ego defences are down and subject to manipulation, though as the CIA discovered during MKULTRA research, it can be difficult to manipulate them in a predictable way. So unethical or ignorant practitioners can do a lot of harm with this sort of stuff.

    And no, what I know about this isn’t just theoretical. I can testify to its effectiveness personally and from the feedback of those I’ve guided. Mostly I’ve used it in addiction work (nicotine and alcohol) but I’ve also seen excellent results in people suffering trauma related anxiety. I also use it with people experiencing spiritual crises or blockages, with more mixed results. The insights gained during a trip can be incompatible with some spiritual outlooks and bring about a crisis of faith, though many people consider their first high-dose trip to be the most spiritually significant event of their lives (even if they’re atheists).

  • If your spiritual journey ever takes you past Buddhism maybe you should check out anatta.

    I’ve found letting go of concepts like the “real me” or ‘being myself’ has made me far more accepting of my emotional swings. It’s all just life. Grist for the mill. Dukkha, as the Buddha put it.

    Ditching the value judgements of my own emotions has meant I don’t get the existential despair and suicidality that came with the down swings anymore. Or the grandiosity of the ups.

    Of course letting go of the ‘self’ also means letting go of notions like “I am an empath”. But hey, who needs labels, right?

    And if you want to get an intellectual handle on anatta it’s probably better to skip Tibetan Buddhism and try Theravada or Zen. The Tibetans don’t really do anatta. Lamaism and all that.

    But intellectual grasping of anatta barely scratches the surface. It’s no more helpful than having an intellectual understanding of how to play the piano. Actually getting it takes practice, practice, practice; though very large doses of psychedelics can give you a peek at how it looks (not recommended for people prone to psychosis who aren’t accepting of that state).

    BTW, I don’t consider myself a Buddhist but I’ve found many of its ideas and practices quite helpful.

  • So there’s at least two levels of selection going on here.

    One is that you only had access to (or even knew about) the participants who went to air. Presumably the ones who had less patience than Mr Reddy with any abuse they suffered would have refused to co-operate with the crew and the episode wouldn’t have been completed. I’d be surprised if the producers would have aired any completed programs that hinted at negative outcomes either.

    The second was the self-selection of those who responded. I’d imagine that those who resented their treatment might have been less willing to speak to someone they thought might be writing a puff piece on the program. And, to take one example, how you quote Ms Castellucci’s homage to Karamo as some kind of saviour figure immediately after Mr Mixon’s statement that he thought the show was specifically (and misleadingly?) edited to create that impression (i.e. tending to invalidate his critique) makes it pretty clear this is a puff piece. You even titled your article from Ms Castellucci’s panegyric.

    I have no doubt you’re correct when you say this is ‘good TV’ (albeit the oxymoronic nature of that term). But I don’t think you’re in a position to say it’s good therapy. Or good ethics.

  • “This is why I addressed up front my own skeptical questioning of tidy narratives”

    I can see in the article where you question whether the format is cliched, but I see no questioning as to whether it’s abusive.

    I’ll tell you what is cliche about it. A reality TV program gaining ‘consent’ from vulnerable people then subjecting them to televised abuse in the quest for ratings and advertising dollars while pretending to be motivated by a desire to help them. Many exhibits in these human zoos have later told of how their lives were ruined by the experience. Some have committed suicide.

    I can see how Bob may be right when he says your article honours the experience of *some* of the people who were on the show. But I’d sure like to know how those particular participants were selected.

  • “So what the story does is this: It asks people who consented to being on the show what it was like for them (and they could have said it was horrible, but they did not,)”

    My first question would be how did you get the contact details for these people? Were they selected for you by the show’s producers? Did you ask what happens if someone withdraws consent when they realise what they’re up for? Did you ask if you could interview some of the latter?

    Imagine this. Someone is walking down the street when they’re suddenly accosted by a group of strange men. They try to run away but to no avail. They’re caught by the gang and repeatedly touched despite their protests. The laughing group responds with statements like “You don’t like being touched?” and “I can tell you don’t take a compliment well”, while continuing to touch them. The whole thing is recorded by the group and later publicised for the entertainment of others.

    Now imagine that person is your daughter. Does it still sound alright to you?

    We’re told the targets give their consent.
    We’re told nothing is staged.
    We’re told Mr Reddy tries to escape and voices clear objections to how he is being treated.
    Is it just me who can’t make that add up?
    There’s people serving long prison sentences for refusing to honour withdrawal of consent.

  • So an exploitative, commercial reality TV program barges into your life at the behest of your ‘friends’ and/or family an starts inflicting its ‘therapy’ on you regardless of your objections until, under the glare of camera lights, you finally ‘consent’. I wonder how much tape doesn’t get to air because the ‘hero’ maintains righteous outrage at the media invasion of his/her privacy and refuses to be ‘fixed’. I wonder how many respond with justified hostility and aggression, prompting the crew to call cops or mental health teams on them. I wonder what a 12 month follow up of the ‘successes’ would show as they try to maintain the expensive inner city hipster lifestyles prescribed for them.

    There’s a possible viewer response other than “Cue happy tears”, Amy.
    Utter disgust.

  • “That the relationship between self-concealment and suicidality is ‘partially explained by unmet personal needs in a non-clinical sample of young adults'” sounds reasonable to me, especially if you consider the links between bullying and youth suicidality and how that might effect capacity to reveal inner turmoil and seek support. But I’d guess there’s causal relationships in both directions.

    Revealing suicidality is stigmatising and likely to result in disempowerment and unwanted (and potentially harmful) medical attention. You can make a lot of rights disappear with the magic words “danger to oneself”. School children are under increasing surveillance for ‘signs’ of suicidality and mental illness (Hogge and Blankenship may have some experience of this). By and large they aren’t stupid. It would be a bit surprising if a lot of them aren’t concealing needs and feelings that might be interpreted as symptoms of something.

  • I find this review encouraging.

    I suspect we’re seeing a response to the steadily increasing outcry against gamed RCTs in which trials aren’t pre-registered and drug companies farm out a large number of small trials; relying on publication bias to ensure the ones that find their way into journals are the ones that are ‘successful’ purely by chance. Then a meta-analysis comes along, only finds the ‘successful’ ones, lumps them all together and viola, p<0.05; a significant positive result.

    These days meta-analysts are doing more checking for publication bias (e.g. scattergram the effect size on X, the sample size on Y and if your Bell curve is truncated on the left you've got biased data) and the old tricks are fooling fewer people. So now we're seeing larger studies with weaker results.

    We've still got a long way to go before the reputation of RCTs is rehabilitated but it's a start.

  • From what I have read it’s psycho-state is far worse than ours.

    There’s swings and roundabouts.

    On one hand we don’t have insurance plan driven hospitalisation that provides incentives to keep someone locked up until their coverage expires, so by and large, forced hospital stays tend to be shorter if you haven’t been accused of a criminal offence.

    On the other hand, here in NSW (where Woy Woy is) the usual mantra for tossing you into a loony bin – “danger to oneself or others” – is deliberately left undefined in legislation, with guidelines suggesting it includes danger to your finances, reputation or relationships.

    For a colleague with a bipolar diagnosis what this meant is that when he was feeling energetic, buoyant and chatty and wanted to go out and talk to people, but his mother was afraid he’d embarrass himself and the family unless he stayed home until he was mordant, fatigued and almost mute again, she called his former psychiatrist. As a result he was handcuffed and bundled into the back of a police wagon on the main street of his small town right out front of the store where he bought his groceries in full view of friends, neighbours and acquaintances. He spent the following weeks in a locked ward many miles from home without his closest friends knowing where he was.

    That’s how the NSW Mental Health Act protects the reputation and relationships of those with a mental illness label.

  • Hi Anthony.

    Like you I’m a voice hearer from Woy Woy (are you related to my WWH class of ’79 classmate Neil Murray?).
    Like you I’m interested in Buddhism and am very skeptical of Scientology.
    I’m also a member of a Sydney based social justice activist group that specialises in trying to address the human rights abuses perpetrated under the Australian mental health system.

    If you want to contact me to open a dialogue leave a comment on my blog (about anything you like – ‘Hi’ will do). That will give me your email address and I’ll be in touch.