Friday, May 24, 2019

Comments by Jack Carney, DSW

Showing 64 of 64 comments.

  • Good that you wrote this, Will. The presumed mental health advocacy movement appears to exist in a comfortable bubble of powerlessness, ignoring its debt to black Americans’ struggle for freedom and unaware of the need to make and maintain connections to those Americans — women, black, LGBTQ — who are continuing that struggle today. Without that connectedness, MH advocates and their organizations will remain powerless and marginalized.

  • How does it all come down to guns?, several readers have asked. Re-read the concluding section re “contradictions”, note my listing of two I consider fundamental, the historical unwillingness of Americans to grapple with those contradictions and the “existential consequences”, all of them illustrative of the U.S.’s use of violence with guns to avoid addressing the contradictions. I also make reference to a final contradiction, viz., the willingness of many American families to sacrifice their children to continuing gun violence in this country in service of supporting the NRA’s guns-for-all ideology. Could it be any clearer or might you have an NRA axe to grind? If you do, you won’t get what I’ve written. If you don’t, re-read it.
    As for an earlier comment re the 2nd amendment, it’s only been since the Roberts’ Court that gun ownership has been interpreted as a right and that all — ALL — attempts at gun regulation by localities, notably Washington, D.C., and Chicago, have been struck down. Prior to that, the traditional Constitutional interpretation re gun ownership underlined gun ownership as a privilege, and one that could be regulated by localities. It’s only since the Supreme Court, now followed by the House, adopted the Jeffersonian fantasy that an armed citizenry was needed to oppose and overthrow an oppressive Federal Government, that the historical interpretation of the 2nd Amendment, one nearly two hundred years old, was distorted to bestow universal gun rights on all Americans. Including home-grown terrorists on the FBI’s watch list.
    As I wrote above, if you have an NRA axe to grind, you won’t get or believe this. If you don’t, re-read the article + others I’ve written and posted on MIA that have been referenced above.

  • Hi, folks. Gratified by your comments. No, not an ideological article but one whose aim is to get readers to reflect on what’s really happening, what’s ultimately at stake.
    And I loved Kermit’s addition of George Carlin’s Yahoo video re the American Dream — more eloquent and certainly more entertaining than I could be. Thank you, Kermit.
    FYI! I go on at great length about the distortion of the American Dream by the one percenters (George’s “owners” ) in my new book of essays, Nation of Killers, now due for publication in early January.
    Great minds, etc., but the kudos go to the late Mr. Carlin — where he is now, now that we need him?

  • Happy that the article has kicked off so much discussion.

    One reminder, I don’t pose imprisonment as being more advantageous than being institutionalized in a psych hospital. For me, they’re one and the same for persons who get labelled as having a mental illness as re the forced deprivation of their freedom. Hence my phrase — “institutionalization along a continuum.”
    When they (the country’s ruling elite) closed down the hospitals, the prisons filled up; once they start shutting down prisons, the reverse will occur. Botton line, our white supremacist society is ever made uncomfortable by persons considered marginal; rather than make a place for these individuals in the larger society, they prefer to put them away, out of sight and mind. As per Russell Banks in “Dreaming Up America”, this is white America’s historic response to persons who pose conundrums that contradict American exceptionalism — kill them or, in this case, remove them and kill them as viable members of our society. Hence, DH Lawrence’s observation that Americans have the “souls of killers” and the title of my new book, “Nation of Killers …”

  • Hi, Noel. Thoughtful and provocative article. Appreciated your locating this issue in its political context. rarely done by folks involved in “mental health”. After all, power is the crux of what you’re addressing — who has the power to affix a usually pejorative label to individuals regarded as damaged and inferior? The phenomenon you described — professionals dissociating themselves from a label that might taint them and their work — is certainly not a new one. Those of us who have spent our professional lives working with poor, beaten up folks slapped with pejorative mental illness diagnoses, know that we and our work have been demeaned and ignored. In line with those we’re seeking to help. Simply, one’s professional status is determined by those whom you help … which is why the public mental health system is corrupt, overseen by leaders who have adopted a corporatist model that posits the objectives of its funders as paramount and to hell with the workers and their clients.

    I was surprised — and disappointed – to learn that renowned trauma clinicians and researchers were so leary of making a connection that’s self apparent to those of us who’ve worked with individuals labelled schizophrenic. Virtually every one of the thousands of case management clients we worked with over the years had lived lives of horror — just imagine any form of abuse and they had experienced it; and it became a sad, running joke that any black man who had admitted to any “psychotic” experience — usually “hearing voices” — invariably came to us with a label of schizophrenia, while any woman of color with a similar history was labelled “schizoaffective.” And here, the obverse of your article, no mention of trauma/abuse ever appeared in their referral packets.

    And so we’re back to square one — who does the labeling and who gets labeled? Equally important, what role do professionals play in this ugly game … aid and abet it with silence, by not speaking the truth we know, or opposing it and, as Hamlet would have it, end it? The risks are great, as your trauma professionals appear to know — Hamlet’s end was rather dire. But it begs the political question — to label or not to label: who gets to decide?

  • Another correction. It’s the Clinical Psychology Division of the BPS NOT the British Psychological Society itself that’s responsible for developing and issuing “Time for a Paradigm Shift.” The BPS signed off on it but it’s the CPD that is responsible for doing the deed. Again, my apologies to the parties involved.

  • Corrections: The Global Summit is an innovation of Division 32 of the American Psychological Association NOT the British Psychological Society.

    The Open Paradigm Project is NOT an innovation of Div 32. Mad In America and Dr. Dan Fisher are involved. I am in the process of ascertaining who else might be involved.

    My apologies for the misinformation. Thanks for your forbearance.

  • And DSM and APA, meet the brave new world, in which your worldview will be increasingly less and less credible.

    Next battle is over the ICD-10, scheduled for release next October (201$), which will also contain psych dxes. whose validity is totally suspect — why should they populate the new ICD?

    The objective is disruption of what has been — the predictability of diagnoses, of insurance reimbursement, of business as usual.

    The fun has only begun.

  • For me, whatever NIMH decides to do with its new proposed nosology is ultimately beside the point …. it will still be rooted in the biomedical model.

    More importantly, it represents a crack in the long-time collaboration between the FEDS, in the institutional presence of NIMH (and SAMHSA), and the APA. The fact that NIMH, which sees itself as a research entity, is actively considering its own alternative to the DSM indicates that the fierce criticism directed at the DSM is beginning to take a serious toll on the DSM’s credibility and its utility to the Federal Govt. Very good news, which needs to be summarily exploited.

    I’ve already posted suggestions for immediate f/u on the Boycott DSM-5’s FB page; I make them again below. For starters, go to NIMH’s FB page, locate the comment box for Insell’s article and comment away.

    I’d also suggest reading the article I posted on MIA on 2/26, where I discuss disrupting the APA’s relationships with Big Gov, Big Pharma & Big Insurance. looms like we have an opening to start with Big Gov.

    More on NIMH’s decision to distance from the DSM.

    My FB comments to Dr. Tom Insel, Dir of NIMH + a reference to my 2/26 MIA article which discusses the need to disrupt APA’s relationship with the FEDS.

    Dr. Insel. NIMH appears to have opened the door to re-examine its relationship with the APA and its DSMs. Those of us who are boycotting the purchase and use of the new DSM welcome your initiative. In truth, we do not share your apparent enthusiasm for the bio-medical model, despite the admitted continued absence of biomarkers, and we urge you and the NIMH to devote greater attention and resources to psychosocial treatment interventions that forego reliance on psychoactive medications. In the struggle for a treatment system that does no harm, Jack Carney, DSW, Coordinator, Committee to Boycott the DSM-5.

    First chinks in the armor. If pushed hard enough, NIMH might start re-thinking its relationship with the APA. Ignore the pundits + NIMH’s own hyperbole — this represents an opportunity; should be exploited. Have written exactly about this in my MIA post of Feb 26 ….

    The Politics of Systems Change: Lessons Learned from the Launch of the DSM-5 Boycott
    https://www.madinamerica.com/2013/02/the-politics-of-systems-change-lessons-learned-from-the-launch-of-the-dsm-5-boycott/May 3, 2013
    Jack Carney, DSW

    I encourage everyone on this list serve to address your comments re NIMH’s initiative to Insel, which might provide an opening to further weaken the APA and its relationship to the Federal Government.

    Here’s a link to Insel’s article.

    http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml#1

  • My last words on this …. a reader disagreed with what I had to say and labelled it “leftist.” Not a way to promote rational discussion. The first half of the article was devoted to a description of the effort of the country’s ruling elites to establish a National Security State and to secure the country’s acquiescence by scaring us half to death… the origins of the culture of fear that is paralyzing most of us to inaction.
    If that’s “leftist”, dear reader, you’re “red-baiting.” Have fun!

  • It’s my belief, supported by the historical evidence I presented, that the ruling elites of this country have purposefully created a climate of fear to intimidate ordinary citizens like us and undermine our willingness to discuss without fear of reprisal decisions that adversely impact our lives. In contrast to your contention, I take the position in the article that unequivocal statements of personal conviction are not, of themselves, exclusionary, but lend themselves to clarification of the issues at hand, allowing participants to take one side of the argument or the other and so discuss their differences. The common thread of much of what I say throughout is that authority, particularly governmental, must be viewed with skepticism if not outright distrust. Many folks in this country, regardless of their politics, would have no great difficulty agreeing with that; the question — and the challenge for us all — is whether we have the courage to voice that skepticism and risk the disapproval of persons in authority . Strong opinions, of course, surface disagreements and cause discomfort: are we, and our democracy, strong enough to tolerate the differences that will arise? Can we join together to resist the disapproval of the powers that be? Salman Rushdie, in an article published in yesterday’s NY Times, suggests we might not be. Which is why I always urge folks not to bitch and moan but to organize, join with others in opposition. And just one historical correction — the right wing in this country has always opposed the extension of civil rights to individuals who have been disenfranchised. I have no expectations that that will change in my lifetime.

  • On another note, let me add info courtesy Myra Kovary of CHRUSP correcting my UN stats : The number of UN Member States that you cited as having ratified the CRPD is incorrect. The correct numbers are:
    Ratifications/Accessions: 130
    Signatures: 155.

    The number you cited is actually the number of Member States that have ratified the Optional Protocol to the CRPD: Ratification/Accessions: 76
    Signatories: 91

    The website where you can find the correct information is http://www.un.org/disabilities/.

    And, to my knowledge, there are 193 Member States of the UN, not 168, as you noted.

    Courtesy Myra Kovary of CHRUSP.

  • I’d welcome Tina’s comments, too, since she knows more about this than I do. Nonetheless, as per my understanding, that underscores the importance of the CRPD ratification. If CRPD ratified, then the social model of disability — its social consequences, if you will — will take precedence over the circumscribed physical model. That’s what the struggle is all about.
    Thanks for your comments and questions — helped give me greater clarity about the issues at hand.

  • David. So glad you mentioned Murray Bowen. Was trained in Family Systems Therapy by his foremost disciple, Phil Guerin. I rely on folks like yourself to add what I might have left out or can’t readily include. Yes, systems change complex and, ultimately, very personal.
    I also recall Bowen’s multi-generational transmission process and its regressive nature, well evidenced in this country by our ready acceptance of oppression of others and of ourselves. Yes, we have a big rock to push up a steep hill.
    Thanks for adding an important piece to this article. Best, Jack

  • Thank you, Paula, for your generosity. We’ll get together one of these days and continue what you began many years ago. Thank you.

    We don’t claim anywhere in the text of any of the documents we posted that the ICD is the superior document — equally reductive and degrading. We added the recommendation that practitioners resort to the ICD as a bureaucratic alternative to the DSM. You’d be surprised how few folks in the mental health system know that the DSM is superfluous to the billing system — and, in practice, totally superfluous. We’re stuck with ICD by law and international treaty; so, until the system dramatically changes, better the ICD than the DSM! I know that’s not a terribly satisfactory response, but it’s the most apt for this moment in time.

  • Thank you, Belinda, for providing the background for Australia’s experience reining in gun violence. Unfortunately, as you appear to know, different country, different culture, intransigent and increasingly irrational NRA. We’ve got a long hill to climb. Thanks for adding the information you did. Much appreciated. Jack Carney

  • Not an afterthought, but not as central to the article as is my focus on the culpability of the NRA in promoting a culture of fear and violence. Without that, perhaps someone triggered to violence might be more likely to punch someone in the nose rather than shoot him or her in the head. Not to be endorsed but preferable. Ultimately, I do believe that guns have to be made less available and more tightly regulated. The presumed 2nd admendment right to allow anyone to have as many guns as he/she wants is an expression and an endorsement of this culture and needs to be given a new, communal as opposed to narcissictic interpretation, one which might allow folks to seek help that helps rather than ingest pills and shoot others.

  • Dan, by all means, take the lead on this; I’ll be happy to follow and take on whatever tasks you suggest. You seem to have clear ideas on how to pursue this and I defer to your judgment.

    By the way, I probably will be up in the Boston area (up from NYC) — in Newton, to be precise — the end of January, beginning of February — 1/31-2/3. May be we could get together, however briefly, to talk about this face to face (how unusual). If you’re up for it, let me know when you might be free during that time period and let”s see what we can work out. Happy holidays for you and yours. Best, Jack.

  • Happy, Jonah, you found what I wrote validating. I’d hate to be 19 or 20 or younger today. I’d be found out in a heartbeat. Actually, in Peace Corps training, my anti-authority attitude came to the attention of the program’s psychiatrist — you can’t hide from those who are looking for you. Fortunately, he wasn’t put off by a young man being rebellious. What else do young men do? So he covered for me and didn’t boot me out, which would have been a real blow for me. Sometimes you just have to be lucky.

    Best, Jack

  • As always, David, thanks for the kind words and support. The only way to “convince the general public” is to have folks tell their stories — and show they can still walk and talk at the same time. Next step is to use those narratives to leverage some political power. Just witness gays — to attain some political power is to have others view you differently. Same objective for psych survivors.
    Thanks for your continued interest. Best, Jack

  • Hi, Tina. What’s next? Gear up for the next Congress. Harry Reid said he’s bring the treaty to the floor again. As if you didn’t know!!
    Interestingly, I was ambivalent towards the treaty at first, principally because the U.N. is so maligned in this country that everything it does is suspect. For my part, I have followed with great dismay its “peacekeeping efforts”, which usually don’t keep the peace and often serve as cover for Western/U.S. imperialist adventures.
    What turned me around was a brief article I read by Bernadette McSherry, an Aussie, published in Psychrights earlier this year entitled “Time to Rethink Mental Health Laws For Treatment Without Consent,” a particular interest of mine, if you read my post on ending Kendra’s Law a few ticks south of yours. Ms. Mcsherry writes about the impact that ratifying the CRPD has had in Australia: “… mental health law is moving away from substituted decision-making by clinicians towards putting supports in place to help people make their own treatment decisions…” As you might recall, there was a short-lived push in NYS in the ’90’s to use “advance directives’ to serve that purpose; but that quickly faded away in the face of provider resistance.
    McSherry proceeds to write about developments in Northern Ireland since the Brits ratified the Convention: “Northern Ireland has signalled it will abolish its mental health legislation and instead enact one capacity law for all those with severe mental and intellectual impairments … ” Unclear what that will mean in practice, but as McSherry points out, “the U.N. Committee on the Rights of Persons with Disabilities called for the repeal of legislative provisions that allow for the deprivation of liberty on the basis of disability …”
    In short, there’s movement in the right direction. Passage of the treaty here in the U.S., despite claims of U.S. “exceptionalism” — again, a cover for imperialist adventures — will contribute to the examination and eventual repeal — we trust — of involuntary commitment laws in this country, inpatient and outpatient. Which is why I see ratification as important to building interest here in NY for a political struggle to end Kendra’s Law. Actually, if the folks who are beginning to talk about that could be recruited to assist your efforts, we would collectively benefit.
    Call for an assembly of all interested parties. Invite Dan Hazen; invite me; invite all your colleagues. Let’s get something going! As I usually end all my posts so I’ll end this commentary with “Don’t mourn, organize! Thanks, Tina, for taking the lead on this issue and understanding its significance from the outset.

  • Bottom line, there is an irrational bias against those individuals unfortunate enough to get a psychiatric label, similar to that experienced by all oppressed groups. When you’re seen as less than human, your civil rights will simply not be acknowledged. The personal, as I quoted above, is political, as is the struggle that has to be embarked upon. Thanks for your comments.

  • Unfortunately, Duane, lawyers have already gone that route, looking to declare Kendra’s Law — and by extension, all outpatient commitment laws — unconstitutional. The NYS Supreme Court ruled otherwise, citing parens patriae, the power of the state to protect its residents from doing harm consequent to poor judgment. So the fight to end Kendra’s Law and all similar laws is a political one, requiring such laws to be overturned legislatively, not via the courts. Makes it tough all around. Thanks for your comments.

  • In an earlier blog, I had suggested boycotting the purchase of the DSM-5; given extent the DSM has been integrated into mental health practice, difficult task but a tactic that could be used to generate publicity and further embarrass the APA. Latter has so far poorly handled the criticism that the new DSM has generated; usually pretty lame when confronted directly and publicly, as the Fast for Freedom strikers demonstrated.

  • Agreed, Ron. Sorry if I left the impression if I was advocating a hunger strike to combat out-pt commitment. Advocating for action on an issue that I believe most folks would rally around. Most effective strategy a matter for debate and eventual consensus; which is why I called on Harvey to call a meeting of NY and other interested advocates. Let’s see what happens. Thanks for your commentary.

  • Right on the money, Ted. Model I tried to lay out was the one used to pull of the 2003 strike — discussion, discussion, discussion, with all ideas on the table, with a gradual winnowing out to get down to those ideas and objectives most folks think are doable and in which they want to invest themselves. A long and difficult process. In the meantime, rallies and marches such as the one planned for 10/6 are very useful … keeps us on the move and in the face of the APA and its allies.

  • Very thoughtful comments. Thank you. I’ll only add that I tend to think “outside in” rather than the obverse. We are who are and do what we do consequent to the circumstances into which we were born and find ourselves in. Which is why my emphasis on external forces. No doubt re their interplay with our internal make-up, which I think of as the human dialectic.
    Most happy that you actually read what I wrote, as reflected in your commentary. Thanks again.

  • The article is about pervasive, institutionalized racism in our larger society, in the criminal justice and public mental health systems, with institutionalized racism defined as a concerted governmental, genocidal assault on African-American men. This racist assault goes beyond discrimination but does constitute a warning to all ethnic minority groups in this country that they, too, are at risk. My underlying contention is that institutionalized racism is so pervasive that it goes largely unnoticed and has left us with a paucity of language to express our outrage at its continued existence.

  • Thanks for all the data. Always helpful.

    Given Sibellius’s delay in authorizing use of the ICD-10 until 2014, the DSM5 crosswalk won’t be applicable until then. Gives psychologists and other like-minded professionals — which excludes most social workers, or at least their professional organizations — time to do the lobbying you’re suggesting. In the interim, don’t buy the DSM5.
    Best, Jack Carney