Comments by Ron Unger, LCSW

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  • Jules Evans is a guy who has experienced both benefit and harm from psychedelic therapy, and he is a leader of THE CHALLENGING PSYCHEDELIC EXPERIENCES PROJECT He thinks we need more understanding of the possible benefits and harms of both psychedelic experiences and of ecstatic experiences achieved by other means. He gave a great talk on a lot of those issues recently, see

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  • Thanks Richard. It is so interesting how thinking about these states gets so compartmentalized and polarized! I appreciate your efforts toward a more integrative approach. You might also want to check out this recording of a talk by the philosopher Jules Evans on The Mysticism/Psychosis Continuum at Mysticism / Psychosis Continuum at

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  • Thanks Terry for this very articulate and coherent summary of the problems with traditional approaches, and of the possible role of IFS in getting us onto a more helpful track! Those of you who liked this article might want to check out a talk I did about integrating IFS and parts work with cognitive behavioral therapy for the experiences that get called “psychosis” –

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  • It’s interesting to read about the role of “moral indignation” in developing the career direction of people like Benedetto. It makes me wonder, why don’t we see that more often, and what could be done to make it more likely that people working in the field would find and act on their own moral indignation?

    I also think about the excesses of capitalism – it’s hard to organize efforts to counter poverty and associated marginalization, because that goes counter to how power is organized in our world. Approaches like drugs and shock may work poorly, but they don’t contradict capitalism, so they fit our existing social structures.

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  • I really appreciated this article!

    One thing it could have gone into a bit more is how with psychiatry currently, there is nothing like the “separation of church and state” and so psychiatry is able to use the power of the state to impose its views on people.

    Also of interest is how religions, when they are misinformed, can lead societies into destructive action. For example if one is convinced as many religious people are that God controls the weather and so humans don’t have to worry about creating climate change, then they will oppose taking action that may be essential. And persuading millions to take drugs that in the long term make their mental health worse is another very destructive action based on “religious” misinformation.

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  • I get what you are saying about how “feeling that I am being watched” is not proper use of the term “feeling” even though it is a common way of talking. (And it’s not that much different from saying that something “feels real” as “real” is also not a feeling.)

    Someone might also say “I strongly sense (or intuit) that I am being watched” or “I just know I am being watched” – it kind of means the same thing. It’s interesting that if we start questioning some of what we sense as real, if we decide that our sense of reality may be unreliable, that brings into question other things we might sense as real, and there may be a question as to where we should stop, or if we should stop, in that process of questioning!

    I’m certainly not offering any fixed answer to these questions, just suggesting people and societies can find a lived answer to them, an answer they go with until it is time for a change, a renewal. I do hope you find something that works for you, I believe it is possible!

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  • Hi Joshua,

    My sense is that everyone’s thinking is defective to some extent, my own included, we all have only parts of the truth, and are mistaken in some ways.

    There’s a Zen saying I heard once, “Open mouth – already a mistake!”

    At the same time, there often are truths worth fighting for – even while it might be unclear where any “barricades” should be.

    I see value in dialogue, in people talking things through. In my view at least, it isn’t all about fighting, a lot of it is developing the discernment to have a sense of what battles are worth fighting and how. It’s OK if I can’t convince you of that, but I just want to be clear about how I see it.

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  • You bring up a lot of points and I won’t address them all, but maybe a few of them.

    I agree with you that there are as many different forms of mental problems as there are people, and just knowing the DSM category of your problem is very limited information! And I agree with you that having intelligence is little defense against madness, it can happen to the most intelligent.

    You bring up the problem of things “feeling real.” A big problem in the mind is when to believe our feelings, and when to be skeptical of them, and to see them as just feelings that may have no relationship to reality. A key skill is learning to be open to and accept all our feelings while developing the discernment to only be persuaded by them when there is good evidence for their accuracy. So we might “feel we are being watched” – that’s just a feeling, we still need to figure out if it is likely related to a situation where we are actively being watched, or maybe just a feeling of strong self consciousness that we can learn to understand and soothe.

    Minds are of course much trickier and more complex than anyone is able to articulate in a blog post. I think people are not to blame for getting tricked by their minds, but they always have opportunities to learn how to recover from being tricked. One book I would suggest that can help with this is Relating to Voices using Compassion Focused Therapy: A Self-help Companion by Charlie Heriot-Maitland & Eleanor Longden, see

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  • I agree with you that the DSM does a very poor job of framing the problems caused by abuse, and the link you included touches on many of the problems. But I don’t think that prevents any mental health worker from ever being able to provide adequate help to survivors of abuse: there are lots of therapists I think who just find a code to bill in the DSM, and then they ignore the DSM and focus on doing what is needed to facilitate healing. Of course there are also lots of people in the mental health profession who are doing lots of things wrong, but it seems to me it’s a bit mixed.
    One other point: while I agree with you it’s terrible for mental health workers to ask people to give up all faith in the integrity of their own minds, I think it can be helpful to do something along those lines that is more limited, and that is to ask people to consider the possibility that they might be making some mistakes, to maybe have less faith that they have everything figured out correctly. This is easier when the mental health workers have a dialogical approach, because then the mental health workers are also modeling that kind of uncertainty about their own views, and everyone can join in being human and fallible.

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  • Hi Joshua,

    I agree with you that we all need those comrades, people who will join with us in changing things about the world that need changing!

    But unlike you I also see value in people talking about their minds and emotions, and even paying people to help them sort out that kind of stuff when they are especially troubled. I have found it helpful to go to a therapist, and I work as a therapist and it seems to help some people. I agree that it doesn’t help to frame the problem as an illness, but just seeing that our minds and emotions can be tricky and we can use some help with them is enough to justify having something like therapy at times.

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  • It’s certainly interesting to think about the role of the body in madness, and the role of being out of touch with the body, but I don’t think it is simple. Often being in touch with the body is a good thing, but the body is also where a lot of trauma memories live, and people can feel trapped inside trauma inside the body, and want to get out of that. Going to other spaces, other worlds, can be an escape from that, but as you say, we can then get so out there we lose our minds, and getting back to our body can be necessary.

    I think there’s some value though to be found in getting out of our body and out of our minds, though only realized once we also come back – it’s the dialogue between going out and coming back that has perhaps the most value.

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  • Thanks Robyn for your work on this! I’m someone who had something like “psychosis” but was lucky enough to escape psychiatric intervention – it was essentially a crisis in meaning, but I always feared it being seen as meaningless or just an illness, when it was about everything that is most essential!

    These days I also use another description, that of a “revolution within the mind” as I did in this talk “Revolution Within the Mind: A Common Factor in Psychedelic Experience, Madness, and Spiritual Awakening”

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  • Thanks David, I enjoyed the article, and also your follow up comments.

    I thought it was interesting how you mentioned that “Whyte seems to have viewed people and events around him with perpetual curiosity, interest, and astonishment.” One mental state (that some might call madness) that I’ve been proud of is the ability to see things with fresh eyes, from way outside of normality.

    Gary Warne is no longer with us, but he was a key founding member of the San Francisco Suicide Club, a not very normal group that I was part of as a young person. He wrote a very short essay called “The Clown at Midnight” which touched on some of that. You can read more about Gary at

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  • I did a presentation on understanding “psychosis” as an attempt to solve problems, you can access it at

    Here’s the description for it: While psychosis is commonly understood as something going wrong within a person, and while many treatment approaches attempt simply to stop that process, this workshop focuses on an alternative view that sees psychosis as resulting from attempts to resolve problems that preceded the psychosis. In this view, psychosis may be initiated by a dangerous type of experimentation or creative process, where people (especially young people) consciously or unconsciously try out new ways of seeing, believing and behaving to address life and spiritual dilemmas caused by their stressful or traumatic experiences. These are dilemmas which they were not able to master using tools provided by their family and their cultural background. Psychosis can deepen when this process of experimentation leads to errors in beliefs, perceptions and behavior, resulting in more trauma and distress, and then typically more misguided responses by self and others, in an increasingly severe vicious circle. There remains however the possibility that with assistance by people who understand this process, and with continued experimentation rather than suppression of experimentation, both the original difficulties and the difficulties resulting from attempted solutions that backfired can be resolved in ways that lead to personal and possibly even cultural renewal and health.

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  • I don’t expect it to make any immediate impact, but I would caution everyone to be careful with their generalizations.

    An immediate example is the statement Daiphanous Weeping just made, “All atrocities are conducted in the name of “we”.”

    One doesn’t have to think very far to find contrary examples – the recent shooting of children in Texas is a recent one.

    Our statements seem more powerful when they make some black and white generalization, but if that generalization is not true, they don’t help us understand our actual difficulties.

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  • Great article!

    Just one point I think could have used some additional attention. You wrote that “I am not wrong or faulty, my painful emotions often indicate that something is wrong, which I’m supposed to listen to, understand, and potentially act upon’.” The tricky part is that painful emotions can arise in situations where acting upon them would not be a great idea. For example, a person may have experienced some trauma, now something is reminding them of the trauma, creating feelings of wanting to take extreme evasive action, even though such action would be detrimental to the person in that situation.

    Commonly, this makes the person want to deny or suppress the feeling since acting on it would be unwise, but since the original trauma was terrible and part of the person wants to avoid anything similar at all costs, that part fights back against the suppression, and now the “psychic civil war” is on!

    The solution is to accept the feelings but also to slow down enough to not act on them till more is considered. So one has to find a way to notice the resemblances to the original trauma but also the differences, to chose appropriate responses in the present. One can accept and be kind to parts of oneself that are terrified by resemblances to an earlier trauma, without letting those parts drive decisions.

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  • Thanks Richard for sharing this! Readers may also be interested in recent reports about those who try withdrawing from antipsychotics, here are two:
    Factors Predicting Antipsychotic Discontinuation in the Maastricht World Survey

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  • My sense is that while some of the points Chuck makes are valid, his overall conclusion is misguided and unhelpful.

    I do think this issue is complex, because people can be harmed in two opposite ways around the issue of what they are told about disability.

    People can be harmed by telling them they will continue to be unable to do something when in fact they could easily learn to do something. That’s the harm the mental health system does with its idea of lifelong mental illnesses, that people are told to expect to continue to have and then they become dependent etc. That’s real harm, and I appreciate that many of us, including Chuck, want to avoid that kind of harm.

    But another way to harm people is to tell them and the people around them that they are able to do something, when in fact they are still lacking something they need in order to be able to do it. The harm there is that the person will be held accountable for failing to do something where they actually could not do it, when they will continue to not be able to do it until they obtain that missing ingredient, which might be a change in belief, perspective, learning how to handle difficult emotions and traumatic memories, etc.

    What I would propose is that we frame mental and emotional disability as always possibly temporary, because they can be remedied by learning, or organizing our minds differently. But they are also real, and sometimes both the person and those helping them don’t know how to help the person organize differently – as with a person who continues to be psychotic despite the best services of even programs like Open Dialogue. In those cases, recognizing the disability as real for as long as it continues is key to any kind of humane treatment.

    Of course, if we lived in a society where everyone got their basic needs met whether or not they worked jobs etc., then we wouldn’t need to be trying to figure out who is disabled and who isn’t. But in a society where help with basic needs is only extended to those seen as disabled, then calling people “not disabled” when they are in a mental state that is stopping them from being employable, is simply cruel.

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  • Hmmm, ignoring messages about what’s happening is certainly and instant mood improver, but my sense is in the longer term it only works if the messages one is getting are false or exaggerated, it doesn’t work so well when the message is true. And my read is that the media actually are doing a terrible job of informing people about the threat of global warming: the media likes to focus on threats at are about tomorrow or next week or next month, and climate change isn’t like that. But when people do wake up anyway to the fact that we are making the planet incapable of supporting human civilization and stable ecosystems for our kids and grandkids, they do have an emotional reaction, and at a certain point playing “let’s pretend it isn’t happening” doesn’t work anymore. We do need to collectively figure out how to handle facing the reality without entering unhelpful mental states.

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  • Thanks for this post, it is a very important topic, one that often flies a bit “under the radar” of what people usually notice and think about.

    One tricky bit of it has to do with the “individual responsibility” thing. I agree that this can be over-emphasized, and lead to ignoring the more systemic and central issues, but I think individual responsibility can also be under-emphasized, leading to people for example berating the big companies that sell them fossil fuels while they fill up their gas guzzler and then head to the airport to use more fuel to jet around the world.

    We live in a society where people are on average quite poor at taking individual responsibility for doing their share to solve collective problems. We struggle to address even the most simple of these, as when people don’t want to wear a mask or get immunized to do their share to protect others. Therapists, who are used to helping people find ways to not feel bad, are sometimes too quick to help people not feel any burden to care for others, and that can be part of the problem.

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  • It’s said that the coverup is often worse than the crime. And the problem can often be not just people actively covering up a crime, or abuse, but people that just fail to create and support systems to hold people accountable. I think a lot of what Will points to is that the psychedelic field has not done enough to confront abuse when it has existed. So it isn’t enough to say “well I don’t abuse people” – are you taking a role to fight abuse when it happens? To hold people accountable? If you aren’t, and if you instead attack Will for trying to hold people accountable, then you are part of the problem.

    (Just like it isn’t enough to say “well I’m not a racist” – we need people to be anti-racist, anti-abuse.)

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  • Great article! Thanks for taking the time to share it. I very much agree with you that trying to repress gay feelings can lead to being mad. I never experienced the kind of oppression you did, but I still found I was induced to turn against my own feelings in a way that contributed to madness.

    And thanks for pointing out that psychiatry in the US has still not apologized for pathologizing gay people. One more sign of lack off accountability.

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  • I think some of the better therapist training these days does encourage therapists to share more of the weird workings of their own minds, because that does help put things in perspective. Or also to share just how common certain mental phenomena is – even if the therapist doesn’t experience it. Without this kind of sharing, people can end up feeling kind of helplessly different, rather than maybe only needing to change a few things to get moving in their valued direction in life.

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  • Hi Lauren,

    Thanks for sharing this piece! We need more people to speak out about how getting outside of our usual minds can be quite valuable, in both spiritual and creative ways – even if it can also be confusing and disruptive of our “normality.”

    I’ve written about that same subject, for example in

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  • One bind people get into with say paranoia is seeing it as too big a deal if they are wrong. So they suspect a plot against them, and then start seeing only two alternatives, either that the plot is real, or that they are crazy. They don’t want to feel that they are crazy, so the plot must be real!

    My specialty in therapy is working with people who are seen as having “psychosis” and the better approach to therapy in such cases is to normalize making errors and being wrong some of the time. So the therapist may share stories of when they suspected something in error, and then talk about how our brains are tricky, and the social world is tricky and confusing, and the person may have been tired and lacking sleep and disturbed about other issues etc., and it is easy to make mistakes.

    If this works, someone can see a third possibility to either the plot being real, or the person being “crazy” – they may have just made an understandable mistake they can then recover from. This isn’t the therapist telling the person they have made a mistake, just opening up that possibility for consideration as the issue is explored.

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  • Hi Rebel,

    You bring up some interesting points, that touch on some deep issues. Some have pointed out that not only do we not know what will be right or wrong for other people in the long run, we don’t know what it is for ourselves either. Because, as you point out, there can always be unanticipated twists and turns. See for example the story of the Chinese farmer, as told by Alan Watts

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  • Interesting the shades of meaning around “wrong.”

    I think in the mental health field, we commonly see people who are distressed. If we tell them, “there’s nothing wrong with you, it’s just that you’ve experienced oppression” they may like to hear that, but in the long run it may just keep them stuck, because they can’t change their past, and you’ve got them thinking that there is nothing about themselves that should be seen as involved in creating the current distress.

    I agree that therapists should not be imposing their ideas about what is right and wrong on people. But I think most mental health problems result when people have a goal and then are doing things that actually get them going in the opposite direction without their awareness of that. Like the person who wants to get to the Pacific but has gotten turned around and is driving east. We may avoid the word “wrong” if that would seem too confrontational, but our job really is to help them question their current direction and to find a way of proceeding that will actually get to where they want to go.

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  • It seems you would try to get them to notice that they might be thinking or doing something they would want to change, without ever using the word “wrong?” But really “wrong” just means something that isn’t “right” for a given purpose – so you really would be trying to get them to consider that there might be something wrong in their approach, you just wouldn’t be saying it that boldly. I too would often take the more subtle approach, it’s less pushy, more reflective. But what this discussion started with was whether it makes sense to do the opposite – to tell people there is nothing wrong with them. I continue to hold the position that this isn’t helpful, at least not all the time.

    It is also true in a sense that we are all completely right just as we are, and that the world is completely fine just how it is! That’s the position of radical acceptance, finding everything OK just as it is. It’s a valuable perspective, and is completely true, in a sense. But as soon as we have a goal, there starts being a right and a wrong way. “I’m trying to get to Pacific Ocean” “Well you are headed in the wrong direction, you need to go west, not east!” (I would prefer the guy who tells me I’m heading in the wrong direction in that case.)

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  • I agree with you that belief systems are not as easily evaluated as blood pressure, and also that there is something wrong with people thinking they should simply be able to impose their beliefs on others (and something wrong with any belief system that tells them this is OK!)

    But I don’t think belief systems are just something subjective, like one’s favorite color, about which no one else should ever weigh in. Let’s say for example that you have a belief system that tells you that you are always inferior to others, or always superior to others. This will create problems in your interactions with others. It makes sense to me that others might tell you “Steve, I think there is something wrong with the way you are looking at yourself.” Dialogue with someone who respects you and your right to form your own belief, but who also challenges your current belief, may really benefit you.

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  • Thanks Megan! There is a lot of truth in what you write, and I appreciate the ferocity with which you confront what might otherwise seem to be innocent attempts to be helpful! (And I appreciate that you do see that some things are attempts to be helpful, even if they are thoughtless and likely to cause lots of damage.)

    I do wonder though about one assertion you make, and that is that “there is nothing at all wrong with any of us.”

    It seems to me that there are two extreme views in mental health. One is the psychiatric view, that people who seem to be troubled have problems that exist entirely inside them. The exact opposite is the view that people are troubled because of things that are outside of them – there is nothing wrong with the person themselves.

    Both views seem to me to be wrong and unhelpful. If we are quite sure there is nothing wrong with us, that all our assumptions, beliefs, habits, etc. are perfectly fine, then it seems we become unable to do the kind of self-examination that is needed to adapt, to heal after we have been injured, etc. Of course, if we are too sure there is something wrong with us, we will always be blaming ourselves and will never be able to stand up to oppressive people and systems.

    So I think the truth is complex, and it pays to stay curious, attempting to discern when it makes more sense to try and change ourselves, and when to seek change in what is outside ourselves. Of course, as our culture behaves in ways that are more and more toxic and even suicidal, there is much more outside of ourselves that obviously needs attention.

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  • Thanks Max for sharing on this tricky topic! I will bring your article up at one of our upcoming peer support specialist group supervision meetings.

    I do agree with what someone said, that confusion, stress, getting in an unhelpful state of mind, whatever you want to call it, can of course happen to people who haven’t been previously diagnosed with anything as well as those who have. And I also don’t think it’s right to think that those who have had these kinds of problems in the past – leading to the “peer” designation – are necessarily at high risk of slipping back into trouble. But trouble can happen, and when it does, it helps to have thought ahead of time about how to handle it in a healthy way.

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  • Megan writes that diagnoses do not “reflect anything in reality” and that “In any other industry, the word for using a name for something that does not actually exist in order to get reimbursed by insurance would be fraud, right?”

    I disagree with that, up to a point. The person coming to see the therapist is typically doing so because they have some kind of real problem. It is true that the diagnoses themselves are not “real things” – the actual problem is unique and involves a complex interaction between the person and the systems in which they are embedded – o the diagnoses might best be understood as somewhat or sometimes very misleading labels that get put over real complex problems.

    Anyway, since something real is going on and because help for the situation should arguably be paid by insurance, there isn’t anything like fraud going on. I think we need ways of talking about that which acknowledge that mental and emotional problems can be real even though labels and much of the “help” offered is unhelpful: otherwise we come across as advocating for a colder society where it would be harder for people to reach out for help of any kind, and might seem we are lacking interest in finding the kind of help that would truly be helpful.

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  • When I referenced finding “the meaning” I meant finding the kind of meaning that is common in a society or in those who consider themselves “sane.” I think there are many other varieties of life affirming meaning to be found.

    Regarding the contention that we should never categorize anyone who has been abused beyond the general category of abuse survivor – I think that isn’t quite right, because people find themselves in different states post-abuse. Some continue to be highly distressed by the abuse lives on within them, while others find or perhaps are helped to find ways of making sense of what happened that leave them free to focus on moving their lives forward. That’s an important distinction to talk about, whether you do it by talking in terms of DSM language (with all its flaws) or some other, hopefully more nuanced approach.

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  • I came at this a bit the other way around – first I got my MSW degree and started working, then I started posting stuff online, including my own story!

    I haven’t been hassled about that, but I have an especially friendly work place.

    I think it’s important to note that the code doesn’t say we will never post information about ourselves online, just that we will be aware it has an impact that may be unhelpful. But if what we are posting can also be helpful, we can definitely justify doing it despite the fact that it could also cause a problem.

    And it’s true that what we post might make some people not willing to work with us. But knowing that doesn’t mean we have to shut up. I’ve seen something as simple as my posting something in my office about available support for LGBTQ people make someone not want to work with me, because they then perceived me as LGBTQ supportive. But that doesn’t mean I was wrong to post something.

    Anyway, there are lots of contradictions to think about in social work ethics, even without bringing peer work into it. The whole thing about attempting to be some neutral clinician doesn’t sit that well with what social workers also sometimes like to think they are, social justice advocates!

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  • Steve, I don’t know about you, but I don’t usually put a lot of effort into changing something I’m doing unless I think there may be something “wrong” with it, something that is leading to less than an ideal result.

    I certainly do agree though that the goal should not be some presumed “normality” especially since, as David Oaks likes to point out, normal people are destroying the planet.

    So if we don’t want to tell people that they are wrong and should think like others do and value what others do, what should we tell them?

    Should we tell them that however they think, and whatever they are valuing, is completely right?

    That has its own problems, because the way the person is thinking or processing or valuing may be setting the person up for difficulties and distress down the line, or may be heading them towards harming their loved ones, etc.

    I think the best therapy approaches this as a kind of inquiry or dialogue, exploring possibilities, it does accept that people will have to decide for themselves but doesn’t presume that those decisions will always be for the best – instead it is constantly questioning.

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  • It seems like most of those who have commented on my comment emphasize how people should be able to work out for themselves what is “disorder” or not. I would agree with that – I would also point out that “post traumatic stress disorder” is generally not a label that people have forced on them, it’s usually a case where someone knows they have a problem and the PTSD label connects the problem with the trauma that happened earlier.

    I agree with Steve that it is important that people get the message that any disorder may be temporary, rather than some “judgement of insufficiency” that is not expected to change. And there is a problem where some people (professionals or not) just expect PTSD to last forever. But that isn’t inherent in simply saying that the person has troubles or a disorder that are a reaction to bad things that happened to them.

    I didn’t see anyone respond to what I think is a more crucial part of my comment, where I pointed out that if we get too caught up in denying that there may be anything “wrong” or “disordered” in someone’s reactions, we may actually be harming them by making them more helpless, by convincing them that their troubles are just an inevitable result of what happened to them, and there is no possibility of them changing their reaction to something else and so getting more control over their lives.

    I would argue that we have to watch out for people doing things they think will be helpful, but that backfire, at each stage of the process of reaction to trauma. For example, when people experience trauma, they might feel threatened by thoughts about what happened and try to push them out of their mind, but this may backfire when the thoughts pop back in later in the form of flashbacks and they get caught up in an endless war of trying to suppress thoughts and memories. Professionals may then try to help, but at times their drugs or other approaches will backfire and make things worse. Then those critical of professionals may jump in and try to make things better – but there can also be problems with how they put things, especially if, as I have pointed out, they make people feel their reactions to the trauma are the only reactions that are possible for them.

    This may seem a little complex and tricky, but I believe (as a trauma survivor who had to work through my own disorder, as a therapist, and as a critic of our mental health system) that this is just the nature of the territory.

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  • I think we can go too far in trying to emphasize how reactions to trauma are normal, and trying to deny that there is anything problematic about them. The problem that is caused by doing this is that people might start thinking that their reactions are inevitable, and there is nothing they can do to change them – which means they are stuck with them. We’ve just induced helplessness.

    If a hurricane hits my house, it throws stuff around, stuff isn’t where it would have been. So it’s a normal reaction. But it’s also fine to call it disorder. Calling it disorder reminds me that it doesn’t have to be that way, it can be rearranged into order again, I don’t have to leave things the way the hurricane left it. Trauma can be that way too – it throws everything around, or we throw ourselves around in trying to cope with it, that’s normal, but they way it leaves things is a disorder when it comes to trying to go one with life, so there’s some need to reorganize.

    I agree with Paula though that huge problems come when we assume that disorder means illness means the person needs drugs or some simplistic one size fits all “treatments” that don’t address the full spectrum of people’s humanity.

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  • I appreciate this article, and all of Joanna’s work. But I’m bothered by one sentence: “Further follow-up studies show that people who take long-term antipsychotic treatment for psychotic episodes have worse outcomes than those who do not (e.g. Moilanen et al 2016; Wils et al, 2017).” The problem is that the Moilanen citation doesn’t seem to support that assertion: instead, that article suggested a mixed result, and reported that people who stayed on antipsychotics with no drug-free periods were the ones with the best scores on the Social and Occupational Functioning Assessment Scale [SOFAS].

    Anyway, if the data really is more nuanced, I think we would do well to reflect that in our statements, so we can so to speak take the “scientific high ground.” Any thoughts about that? Am I misreading anything?

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  • We definitely need to abandon simplistic models of “mental health” I have often stated that “stability is a false god of the mental health system.” When we are facing a big threat, like climate change, the last thing we want to be is stable overall, and just keep on with business as usual. But we do need to be stable in some ways, so we don’t fall apart and can take wise action.

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  • I like the observation that some of these statements, like the “it’s not about you” may be helpful if they are said by someone with less power than a therapist.

    I am a therapist, and I’m aware that it’s important to be careful about what I say! One thing that helps when one is in a professional role is to say things more tentatively, as in “I wonder if it may help to think that it isn’t about you, or that at least much of it is not about you.”

    This makes it easy for the person to reject the idea if it doesn’t fit. Also it helps if the therapist asks if anything they are saying doesn’t seem quite right, and acknowledges they may say things that don’t fit for the person and asks to be informed when that happens.

    Regarding moderation, I much like the Oscar Wilde version: “everything in moderation, including moderation!”

    And there is the tricky matter of the sense in which any statement is understood. I like the Discordian saying that “all statements are true in some sense, false in some sense, and meaningless in some sense…..” We don’t always know how our statements will come across, so we have to be aware they might come across quite contrary to what we intended.

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  • Climate change is certainly one big reason to question the idea that “positive emotions” are necessarily good! I think of the Katrin Meissner quote: “It scares me more than anything else. I see a group of people sitting in a boat, happily waving, taking pictures on the way, not knowing that this boat is floating right into a powerful and deadly waterfall.”

    Still, there are lots of “mentally unhealthy” responses to climate change. One is just denial – refusing to know, even when we have reason to know. Or people are aware it’s happening and are traumatized, and they respond by trying to avoid reminders of it, watch the news less, etc. Or they despair and use drugs or other distraction.

    Whether it’s mutual aid, professionals working with individuals, or public health efforts, we need to be aware it’s a tricky balance to find a constructive approach to big challenges. It’s not about trying to just be happy, or squashing the “upsetting” emotions, but it is about finding a way to not be demoralized and shut down by the threat and finding some kind of positive path.

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  • Hmmm, I think this is a complex topic. I would agree that I wouldn’t want mental health professionals doing things like deciding who can run for political office, but I do think they may have opinions worth considering (to the extent that mental health professionals know anything at all – many of them seem to know less than the average citizen!) I would rather hear the opinions of people like Bandy Lee rather than have them shut up by the Goldwater Rule – though they are just a perspective. Regarding mass delusions, I think they are a kind of public mental/social health issue – I’m not sure what the best treatment is, but I sure hope we come up with something good before we exterminate ourselves!

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  • I’m not sure where you are getting this idea that counselors can’t bill to help child abuse survivors. They definitely can, whether they call the resulting problems “PTSD” or some other diagnostic category.

    And while some counselors cover up abuse (and some are even abusers), many others are very active in increasing awareness of the dangers of child abuse and of the needs of survivors.

    In fact, some counselors have been too willing to believe that their clients were abused. They have asked leading questions, been too sure that even dreams of abuse were the beginnings of recovered memories of abuse, or they’ve been willing to completely believe even fantastical tales of abuse (where supernatural things happened, for example.)

    I work as a counselor, and I know that these issues are not always black and white. Sometimes people do not have clear memories, and it is necessary to just hang out with the uncertainty. I have seen things like someone over the course of weeks start to remember that a certain family member abused them, then get uncertain about that, then recall it as a different family member (all without pressure from any other family members, who were not told about the memories.)

    False memories are not impossible, but it is also terrible to just assume that something is a false memory when it may be quite accurate. Counselors may not be able to know for sure what happened in particular cases, but they can be trained in ways to interact with people about their stories and their memories in ways that are sensitive and respectful, and help people on their own search for what is true.

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  • You make some good points. Here’s a little of my thinking:

    Having everyone believe the same thing can create social cohesion within a group: “we all think Trump is going to save us from an elite group of pedophiles and cannibals!” So why do some people come up with their own unique beliefs? I think it’s also for the purpose of cohesion, but that of cohesion within the person. When people are confused and distressed, they may organize internally around some weird belief, and having that internal coherence may seem more important than whether or not they match up with anyone else.

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  • While judging only some beliefs as “rational” is indeed problematic, failing to do so also causes problems, often ones that are more severe.

    By “rational” I mean “in proportion to.” So a “rational” fear would be in proportion to a threat, while an “irrational” one would be out of proportion to the threat. We can also have “irrational” lack of fear, as when people aren’t bothered at all by the threat of climate change, etc.

    People do indeed have “different realities” in the sense of different perceptions and different maps of what is going on. But these perceptions and maps apparently exist inside a world that has effects on us whether or not we believe in those things to start out with: so people who think Covid is a hoax can still die of it.

    This especially becomes a problem when we need people to take collective action, for example, to stop systemic racism, Covid, or climate change. We need some way to respect the fact that no one has an absolutely correct perspective, and everyone needs some slack to make sense of things for themselves, while also pushing people to “face facts” that may be essential to survival and to social justice.

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  • In this article they talk about people’s “mental disorders” but it might make more sense if they just talked about people’s mental and emotional troubles. Because Steve is right, if you are going to take a “transdiagnostic” approach, you don’t really need the idea of diagnosis. I think it makes more sense to try to understand the complex factors that might have pushed someone into some kind of trouble or other, and then also look at what might be changed to help them reverse some of the trouble and become less distressed. The diagnostic categories don’t much help with that, and often just confuse people or lead to discrimination.

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  • Well, if the article only said what you are saying, I wouldn’t have any problem with it. I definitely agree that if the therapist comes off as insensitive, as unwilling to listen to what the person is dealing with and suffering from, and if the therapist makes it sound like all of the problem can magically be solved, it won’t go well!

    Situations where we have to let go of controlling some things and focus on what we can still control are often situations of loss – like when we have to let go of trying to put out the fire and just control what we can, which might be getting out of the house before we burn up too. In such situations, there is real loss, but focusing on what one can control is still an important way to reduce losses.

    What bothered me in the article was when it made much stronger statements than you made, such as when it was asserted that “Telling individuals to stop focusing on “what they can’t control” is not only gaslighting, it’s inaccurate.” I get it that Megan wanted to critique therapists who might be suggesting that their clients pay no attention to broader social factors that cause oppression, but I think trying to figure out what you actually can control is also important for social activists – we are always trying to figure out where it is we might actually be able to make changes, and to avoid beating our heads against walls and getting nowhere!

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  • It seems to me that being either positive or negative can get overblown, or “toxic.” The tricky thing is to be just as positive, or negative, as what fits the situation! And we are always trying to figure out exactly what we are up against, especially when the threat is something new, like Covid 19.

    As for trying to focus on what one can control – it seems to me that is basic to any kind of problem solving, it’s not part of “toxic positivity.” It makes sense even in very “negative” situations – so for example one might be dying, but decide to focus on what one can control, like sending a kind message to loved ones. I do get that it may be annoying or wildly inaccurate when someone else is telling you what you should think you can control, but that’s another issue.

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  • Hi Steven,

    It’s great to hear about your continued work! There is so much that needs to be changed, but community organizing like what you are doing does open up cracks, through which some people will escape from oppression, and through which some light will get in.

    And thanks again for having me speak in your church, on the topic of When Minds Crack, the Light Might Get In: A Spiritual Perspective on Mental and Emotional Breakdown – (The whole talk is available at that link.)

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  • Hi Fiachra, thanks for posting the link to the video! And thanks for joining us for the webinar itself. I hope lots of people do check out the video and then try practicing what Rufus talks about. You are right in a sense that there is nothing too mysterious about how to help people with troublesome beliefs – but we do have to unlearn a lot of what is conventionally taught about them, as well as to overcome what are pretty natural impulses to just get more rigid in response to encountering beliefs that seem to us seriously wrong.

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  • Yes, I think that’s why it’s so important that we start training professionals differently! People should be able to turn to “the system” and find that it is helpful. I’m reminded of someone Daniel Mackler interviewed who lived in the area where Open Dialogue is practiced – this person compared the mental health system with the system which delivers water to each house: reliable, of good quality, and available when needed!

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  • Yes, I think that move from less helpful “delusions” to a more resourceful creativity is something I experienced in my own life and that of close friends, which I wrote about in and in

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  • I agree with you that a psychotic break is a natural reaction, though it may have very unhelpful aspects. In that way it is like other natural reactions: for example, I might see a spider, jerk my head back to get pull away from it, and in doing so bash my head into something behind me. Quite natural, but also painful! Regarding antipsychotics and psychiatry: my sense is that not all use of antipsychotics, and not all psychiatrists, are the same. For example in the article I talked about one person’s interaction with a psychiatrist, where at first the person felt just like a target for the psychiatrist’s drugs, but when the psychiatrist talked respectfully they were able to form a collaborative relationship. I suspect there may be times when antipsychotics may be helpful to a person, at least for a bit, to help the person avoid over-reacting when they don’t have a better way to do that. Though I believe in always looking for a way to do it without the drugs wherever we can.

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  • Hi Fiachra, I think you make some good points.

    Regarding the “two types of delusions” thing: I’ve noticed something along the same lines, that some express fears, while others are more an attempt to counter fears and make things seem OK or even great. Though it is also true that the emotional meaning often gets mixed. For example I asked one guy who was constantly bothered by and scared of people who seemed to be constantly monitoring him, how he would feel if that stopped or if he found out it wasn’t happening, and when he really thought about it he noticed he would feel unimportant and alone. So the belief in being monitored was both organized around fear and his hope of being important enough for someone to pay attention to.

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  • Thanks for this great article on a difficult topic! A few thoughts of mine about that:

    I think there is a danger, not just of psychedelics being framed and used in a narrow way that just reinforces a dominant and too-narrow culture, but also in them being used in a way that is too open, or open to the wrong kind of dynamic.

    That perspective fits with that of many traditional understandings of Spirit generally – that when we open up to Spirit, things can go in a good way or a bad way, which is why it is good to have helpers nearby, a positive connection with community, that helps sort out which way to go.

    There are people right now using psychedelics in ways that totally fit with capitalism – as documented in articles like . There are people using them in some very dark ways – as Charlie Manson used to – some of that is documented in this article And there are people who are using them skillfully to promote healing, and to look outside of cultural forms which are clearly too narrow.

    Anyway, I think we need to be aware that the outcome from increased use of psychedelics is very much dependent on how we go about using them and integrating that use.

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  • Great article! Some thoughts:

    Carl Jung was aware that there really isn’t any limit to what we might find in as we go deeper beneath consciousness. (First there might be our subconscious, then our personal unconscious, which is understood to be deeper, then Jung thought we could encounter the collective unconscious, which includes all of the mental forms which are possible for us, and contact with all sorts of characters who are “not us” but part of what we can access in our minds.)

    Of course, that relates to the idea that “mind” is not really something that has clear boundaries – in some sense there is just one mind.

    And any kind of creativity requires stretching in some sense beyond what we previously have know as our selves – because what we previously thought of as our self hadn’t done or said what we are now creating.

    I think many writers find the process is often more like being dictated to, at least at times. Your process seems more so than most, but not an entirely different kind of thing.

    Lots of us in dreams find there is something very creative in us that is very different from our conscious mind. For example, I know nothing about making music, yet in my dreams I have sometimes heard very impressive music that did not seem to be anything I had heard anywhere: it seems that my mind had composed it. Too bad I could not recreate it while awake!

    Leonard Cohen has written about the sense of not being the writer, for example as in the following lyrics from “Going Home”:

    “I love to speak with Leonard
    He’s a sportsman and a shepherd
    He’s a lazy bastard
    Living in a suit
    But he does say what I tell him
    Even though it isn’t welcome
    He just doesn’t have the freedom
    To refuse
    He will speak these words of wisdom
    Like a sage, a man of vision
    Though he knows he’s really nothing
    But the brief elaboration of a tube”

    Anyway, I really agree with Russel Razzique when he says the function of the mental health system should be to help people with any distress they may be having without dismissing the spiritual or creative value of what they may be experiencing – the point should be to help them find ways to hold on to what is valuable in their experience while reducing the trouble it is causing them. If they find a way to do this, then it no longer makes sense to consider them as a person with a mental health problem.

    Last year I put together an online course “Addressing Spiritual Issues within Treatment for Psychosis and Bipolar” which is my attempt to convey this message to the mental health field….

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  • Hi Sam,

    I certainly appreciate your not wanting a therapist to decide how you should be organized or exactly what you are supposed to be, or making you be something without your consent. And I know that different words resonate differently for different people, so I appreciate that “fragment” doesn’t resonate well for you. I’m not sure there are any perfect words: but I do know many people did things to cope when they faced trauma that are no longer working for them months or years afterward, and the idea that change is possible, especially change toward what feels to themselves like being more “whole,” can be liberating. I know that was true for me

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  • A few years ago the local Christian college was trying to both have a counseling program and refuse to respect the rights of LGBT students. But lots of the local agencies decided they would not accept interns from that college till the policy changed. It did. But it does take people standing up and refusing to go along with stuff.

    I have also heard of really dysfunctional psychology or counseling education programs. I went to social work school, it was mediocre but was at least mostly friendly and relatively reasonable.

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  • Thanks for this article, connecting the DSM fiasco to some deeper realities that are hard to write about!

    I think the notion of “dialogue” is so important in mental health, because it allows for multiple viewpoints, which are necessary to address complex and contradictory realities.

    One tricky thing is that we do sometimes need to go from dialogue to action, and as you also point out, “Complex, contradictory things or identities do not have impetus and are more conducive to stasis than progress.” Especially when we feel threatened, we feel like we need to decide what is right, and it needs to be something simple we can act on!

    The way this is dealt with in Open Dialogue is to let ideas for action emerge out of the dialogue, and to avoid coming up with big plans – instead, just decide what to do till the next meeting. And to deliberately hold back on drastic actions, like taking so-called “antipsychotic” drugs.

    In Zen they talk about “not one, not two.” There is always a dialogue between our complex/contradictory totality, and our ability to stand up for an be something specific, this and not that. It would be nice to see that more appreciated in the mental health field.

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  • Hi Oldhead, like you do I imagine, I find the way that word “appropriate” is used is mostly very obnoxious, where someone is claiming the right to tell someone else what they should be doing and what is OK or not!

    What I was referring to, and what Aristotle was referring to I think, is more about what works to accomplish goals. As an example, let’s say I love someone, but they do something to offend me. If I just tell myself “anger is good, let them see my anger!” I may show anger in a way that makes my partner feel unloved and even decide to break up. Which was not what I wanted! But anger expressed more skillfully and artfully may leave my partner still feeling loved, but also understanding what the offense was and how it upset me. Does that make sense?

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  • I agree with the criticism of the “anger is a secondary emotion” claim. I agree that anger is as valid as any other emotion. However, I also think that for any emotion, it can help to get in touch with the wants and needs that are behind it, and it can also help to review the evidence for whether it is really justified, etc.

    I like Aristotle’s saying on this: “Anybody can become angry – that is easy, but to be angry with the right person and to the right degree and at the right time and for the right purpose, and in the right way – that is not within everybody’s power and is not easy.”

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  • Hi Derek, I appreciated the nuances you were able to articulate as you told your story!

    As an active member of ISPS though, I was disappointed to hear about the negative side of the experience you had with that therapist.

    I wonder if you would generally agree with the following: that the good side of many schools of psychoanalysis is their interest in deeper meanings and relationships, while the problematic side is the way they typically gives way too much power to the professional?

    I am told that there are branches of psychoanalysis which attempt a kind of shared exploration and consciously try to avoid this “power over” kind of dynamic, but I am less familiar with those.

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  • Steve, I think you are jumping to a conclusion that this study doesn’t support, when you say the study suggests the treatment has no positive effect. The study’s outcome could also be a result of the treatment having positive effect, but insufficient positive effect to prevent all of the suicides that might otherwise result.

    It’s very hard to convince people that forced hospitalization never has a positive effect, when there are so many stories of people who were about to kill themselves, but got hospitalized and in the hospital quit being suicidal and then got out and weren’t suicidal anymore.

    what many of us wonder about though is the bigger picture. Is it possible that the dragnet of forced treatment pulls in many more people who wouldn’t have committed suicide if they hadn’t been hospitalized, but who as a result of the trauma of forced treatment, do end up committing suicide? I think we can agree that we need an answer to this question, but I don’t think we yet have data that can answer it.

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  • While this is interesting, I don’t see it as convincing evidence that forced hospitalization leads to more deaths (or even as proof that forced hospitalization doesn’t save lives.)

    The problem is, this study doesn’t seem to have a way to rule out the possibility that those who were forcibly hospitalized were a group that had gotten to a place, pre-hospitalization, where they were way more likely to kill themselves, and so hospitalization may have reduced the suicide rates but wasn’t effective enough to prevent all of the suicides.

    A more effective study would randomize acutely suicidal people to either get forced hospitalization, or simply be offered treatment on a voluntary basis. Then we could compare outcomes between the two groups. This would be a difficult group to get approval for (since those who believe in forced hospitalization would see it as unethical to not forcibly hospitalize people who seemed to be at high risk of suicide, while those who are opposed to it would see it as unethical to do even as part of a study like this.)

    Anyway, I just want to see all of us on MIA being careful about our logic, and to avoid convincing ourselves we have proof of something when we aren’t quite there yet.

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  • Thanks Anita – you tell your story very well, and I’m happy to hear of your work to bring more understanding to others!

    My only reservation about the way you frame your story is that by saying you were “misdiagnosed” with schizophrenia, this suggests that there are others who fully deserve this diagnosis! And it’s also true that, according to the DSM, if you did have enough of certain “symptoms” to match the checklist, then you did qualify for the diagnosis – the DSM doesn’t actually say it’s a misdiagnosis if the cause is trauma.

    I think it’s better to bring attention to how labeling something “schizophrenia” is just a way of not trying to understand what is really going on. Not everyone who gets this label is responding to a distinct trauma, but they still have a story and deserve to have people try to understand it rather than just have it all attributed to an imagined “psychiatric illness.”

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  • Lewis Mehl Madronna is a Native American doctor who has thought a lot about how to bring indigenous wisdom into healing practices. One interview with him is at . Or you could check out this talk, which includes a lot about using traditional stories to assist mental health recovery

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  • Steve, thanks for your comment about the diversity of what therapists do. That matches what I’ve seen.

    A couple comments though. You said the goal of being “normal” is abhorrent. I would agree with you if we were talking about trying to be “normal” overall, because that is both usually undesirable and impossible, but I do see some value in helping people figure out how to regain “normal” abilities they may have lost, or never had to start out with. So somebody might not know how to engage with random people in a friendly way, or how to experience “normal” physical affection without feeling freaked out, and they want to be able to do that. It makes sense that a therapist might join with them in working toward such a goal.

    I know when I had some really different mental experiences, I often had to struggle a bit to regain “normal” kinds of things I used to be able to do. But I definitely never had the goal to overall become normal…far from it!

    Also, I think it is possible to work as a therapist and still piss off psychiatrists. I’ve done quite a bit of that, and I only got fired once from a minor job. But most therapists don’t do that openly, for example lots of therapists used to tell David Oaks they agreed with his criticisms of psychiatry and would talk to their clients about the problems with drugs, but they wouldn’t speak in public. Maybe some avoid it because they are intimidated, but it seemed some were just too shy about speaking up in public in general….maybe they needed therapy for that?

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  • There is a middle ground between solving a problem for someone and leaving them to solve it for themselves, and that is to collaborate with them in solving the problem, but encourage them to do the part of the problem solving that they are able to do, and teach them the rest as you go. So instead of rushing in with the solution, you ask them to get going on solving it, then only when they get stuck you maybe help out a bit, but also with an eye to helping them learn how to get to their own solution next time.

    I would definitely agree with those who would say the more we can get people solving their own problems without the help of therapists, the better! But I would still suggest having therapists available for when that isn’t happening.

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  • Hi Steve, I’m not clear on how what you are trying to say is different from what I said. I certainly never said people can’t be or shouldn’t be proud of surviving adversity of various kinds! But pride is still something to be used with caution – for example I may have survived an adverse situation by learning to be very distrustful, but if I’m too proud of my habit of distrusting people, I might never work on “recovering” from that, and starting to notice more when some people might be worthy of trusting. That’s where discernment comes in, in my opinion.

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  • My point was not that people with mad pride never want to change their lives or themselves, but rather that people don’t want to change what they have pride in. So if a person is always proud of how they do things, they won’t acknowledge (and recover from) mistakes that they make, they will be proud of them instead.

    I think what people need instead is discernment, sometimes being proud of their actions and reactions even when society might call them mad, and sometimes working on recovery instead. I know that’s a little tricky to explain, it’s not a fixed answer, but it is what I think works best.

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  • Thanks Annette, I appreciated hearing about the complexity of the experience of you and your family, and how participating in Open Dialogue was helpful.

    As you might have noticed if you read my recent blog post, I’m trying to re-educate professionals to be willing to talk in an open minded way about experiences that are seen as spiritual – and not to assume that all experiences that are off the beaten path are detrimental.

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  • Larry, I’m having a hard time following what you are saying.

    Are you trying to say for example that you think I’m wrong to propose that feeling fear, or being organized by the emotion of fear, can sometimes be helpful?

    And then, whether or not we agree that fear can sometimes be helpful or not, it seems you are asserting that people can just freely choose what to feel by altering their beliefs? While I would agree that beliefs do influence emotion, the process of changing beliefs is not so straightforward. For example I might know that I could feel more content if I could believe that our society is headed toward a completely wonderful future, but then find I have a hard time believing that is true.

    I think a lot of people feel fear for example, and would like to choose not to feel it, or not to feel so much, and have no idea of how to go about making such a change. Or they try, and what they try actually makes it worse. So it often isn’t simple.

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  • Hi Julie, I think Oregon, maybe especially Eugene, may be a better place to be poor and looking for a therapist. I for example work mostly in a non-profit agency that sees mostly people on Medicaid, some on Medicare. People on Medicaid don’t have to pay anything themselves. We do have to diagnose people with something, but we try not to diagnose people with anything they find unacceptable, and most of us at least don’t believe that diagnosis is useful beyond putting people in a category so the insurance company can make sense of it (one of the cofounders of the agency has openly compared the DSM with the Malleus Maleficarum, the book that was used to determine who was a witch.)

    One other thing: as a therapist I try not to tell people what their problem is – the idea instead is to explore what’s going on together, and see what the possible avenues for change might be. But if people don’t have the ability to change their external situation (however problematic), then we usually do end up exploring what they might change about themselves, either how they see things or how they behave or both. Because I think as humans few of our problems are “all external” – we have to decide how to respond to our situation, and we seldom find the perfect response right off the bat. It takes experimentation, and what is needed changes over time. People come to therapy usually because they want to find better ways of responding to their situation. And one possible response of course is working to get into a better situation, where that is possible!

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  • I certainly agree that it’s bad for society when the idea is spread that only professionals can be helpful – really, effective interpersonal support is something that should be woven throughout the fabric of society. I do think though that it makes sense to have people who study how to be helpful in situations where everyday supports or unpaid supports are not working.

    As for Soteria, it was a collaboration between people who did have some professional training and people who did not, professionals like Loren Mosher and Voyce Hendrix did a lot to set the frame for what was done there. Open Dialogue uses people with a high degree of training (training that is different of course from what is mostly offered in the US).

    Professions can be a source of both good and bad. Professions can get corrupt, and it’s really important that they get criticized and this corruption is brought to light. I still see value in them however. They are like governments, they sometimes need to be overthrown, but then you find yourself still needing a government.

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  • I certainly agree that often people do find effective ways to help themselves all by themselves. It’s just when they can’t find a way to do that, or even more when they stumble into ways of trying to help themselves that inadvertently makes things worse, that they may need external help.

    I don’t agree that everyone who turns to external help will lose trust in themselves and their own ability to solve problems. Often, when we watch someone help us, we figure out what they are doing and realize we could do it next time for ourselves. I know some people do become dependent and some people especially some professionals encourage dependency, I don’t agree with that, but it is not inevitable.

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  • Yes, it is very unfortunate that healing has to occur regarding what was offered as “help.”

    I do think it is interesting though that the way people try to help themselves can also turn out to be unhelpful. For example someone betrayed by important people in their lives might withdraw from society in an attempt to protect themselves, but as a result their life might fall apart and they end up not having any social support etc. It can be overprotection that causes damage, which in some ways parallels the way the mental health system can think it is protecting people but do way more damage than help.

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  • Hi manymore, I’m glad you are finding your voice, and you are speaking up!

    It is certainly worth questioning what “being lost” as an individual means, especially when we live in a society that has overall lost its way and seems bent on destroying its own future.

    But it does seem to me that some people do get lost in ways that can even be life threatening, even before any bad treatment becomes part of the picture.

    Regarding “first episode psychosis” treatment, I’m not opposed to it, if it’s done well. Open Dialogue is for example an approach designed to make early intervention, they try to respond within 24 hours of an initial report. Of course, a very important part of what they do is try to hold off on using “antipsychotic” drugs. I don’t know of any early intervention programs in the US that make that attempt to hold off on using “antipsychotics” but there are some that do attempt to keep the doses low and at least some of the time will suggest that people try reducing or coming off the drugs after they have been stable for a while (this sometimes happens in Oregon for example.)

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  • I think my comment might have disappeared for a moment, but it’s up there now right below your original comment.

    I agree with you that mental and emotional problems often get exaggerated by the mental health system, but I think that if we had no mental health system that there would still be some mental and emotional problems, some of which would be extremely serious or disabling all by themselves. Certainly we are all entitled to our humanity, but part of being human means we have tricky brains and live in a tricky & often traumatizing world, and we sometimes need help, and sometimes from helpers who have to know more than the average person.

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  • I agree with you that there are no “bad emotions” in the sense of emotions we should never have, but I don’t agree that people have trouble with emotions only because therapists see a problem! It’s so much more complex than that.

    Take fear for example. In many ways it’s a great emotion to have, it can save our lives, push us to avoid danger. But people can get in huge trouble with it, when fear is overgrown people can become afraid to leave their home, afraid to interact with other people, their lives can be ruined. All that can happen without ever going to a mental health professional or taking a psych drug – that’s why I think people are really dreaming when they imagine there would be no “mental health” problems if there were no mental health system.

    At the same time, it is an unfortunate truth that for many people, their problems were not so big before they turned to the mental health system and got “help” that made things way worse.

    I would like to imagine a society where, when people have been traumatized or when they run into other sorts of mental or emotional problems, they can turn somewhere and get help from other people that is really helpful. It’s in some ways a simple dream, but I don’t think we can ever get there if we keep imagining that bad “help” is the only kind of problem out there.

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