Comments by Pat Risser

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  • I won’t quibble but the 90’s were known as the decade of the brain (not recovery). I must ask, from what is it that folks are “recovering?” Certainly not the unproven phenomena known as “mental illness.” I contend that we recover our self. As my life spiraled deeper into the realm of mental patient, I lost more and more of my self. I lost my self-esteem, my self-confidence, my self-assurance, and all sorts of other aspects of self. For me, recovery meant to regain that which I had lost, some stupidly and voluntarily surrendered to authority and some forcibly taken by that authority. I had to regain my sense of self and the confidence to be my own expert on my own life.
    Think about it. Imagine two soldiers returning from war with a single leg. You go visit with them and one reports that he’s anxious to get out and resume his life to the fullest. The other batters you with his self-pity over the fact that he lost his leg. You might honestly report that one is recovered and the other is not and yet neither regained their leg. What then might you mean by “recovery?”
    One of my heroes is Tony Iommi, lead guitarist of the heavy metal band, Black Sabbath. Tony worked in a factory and the last day on the job before going full-time with the band, he lost the finger tips of his right hand. He would melt plastic and press the scalding hot material over his fingertips and then take a file to shape them to be able to play. He found he could no longer play right handed so he switched to playing left handed. Despite these handicaps, Tony became one of the best guitarists in the world and responsible for most of the heavy metal licks we hear today.
    Would you say he’s “recovered?” He certainly never got back his fingertips. I believe he’s recovered and that’s why he’s my hero. He didn’t let anything stop him and he’s living a full and productive life of his choice despite any so-called limitations. It proves to me that “recovery” is more about your attitude toward yourself and others than it is about anything physical like controlling symptoms.
    Tony is 68 years young and touring at the moment with Ozzy and the band. He’s overcome cancer and is a real model for hope and never giving up.
    I recovered my self. I don’t talk about “being in recovery” as if it’s a life-long process. I made it. That doesn’t mean that life won’t construct more obstacles to overcome but if those are “recoverable” then I’ll recover each of them on their own.

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  • Kermit, I appreciate your response. We may have to just settle for leaving me in a confused state. You speak of MIA as a forum for discussion or debate and yet I still don’t understand the boundaries. It’s like speaking of a table as a place for meals but without considering whether the guests you’ll be serving are Vegan or Muslim or have other dietary restrictions. It kind of feels like I’ve expressed that I’m strict vegan and you’re defending the right to serve me bacon. There’s nothing to reconcile. As I’ve said before, this is Bob’s forum and I respect that. It can take whatever shape he desires and I am free to participate or not, just as someone would be in a forum operated by me. Like it, stay and play; don’t like it, leave. I get it.

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  • I am as unclear as ever about the role, purpose, mission or reason for MIA. I cannot seem to figure out if there are boundaries and if so, what they might be.

    I think of the example of the man who seems kindly enough, doesn’t yell at or beat his wife or kids, doesn’t kick the dog, does a good job of upkeep on his home and property, goes to work every day and church on Sundays and in every visible way seems a good neighbor. However, I choose to not be friends with him and to judge him in the negative because he belongs to the KKK. To me, that affiliation means something. I feel the same way about affiliation with NAMI and all that they seem to represent. If an otherwise good person chooses to affiliate with them, it says something about the person.

    I know of a psychiatrist who is very good at speaking to the dangers of psychiatric medications. He’s a leader in the research and well written on the subject. However, he admits to there sometimes being a case for the use of ECT. So, while he sees the potential harm of drugs on the brain, he’s just as unwilling to admit to the harm of electricity on the brain.

    As long as I’ve been a part of the movement for human rights and against psychiatric oppression, we’ve drawn the line at ECT. Many will admit to freedom of choice regarding the drugs and even the most radical will often allow for their use in the short term but we’ve always agreed that ECT is brain damage and unacceptable. Does the good this psychiatrist performs regarding drugs somehow outweigh his stance on ECT? I don’t think so. I believe we should not affiliate with him at all, even as a potential ally.

    All around us are tough ethical situations to consider. It would be helpful if MIA were to clarify or present some guidelines or boundaries. If writers who support ECT are okay here then are those who favor involuntary commitment and involuntary outpatient commitment and other forms of force and coercion? There is, in the USA, pending legislation that most here find unacceptable for many reasons. Would the author of that legislation and the pro-force people who back that bill be accepted on an equal footing here? Please consider carefully because I may make my own choice regarding support or being part of this based upon a response. My boundaries may be different than those considered acceptable here.

    Thanks for all you do, you and the rest of this fine community.

    Pat Risser

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  • Of course, I understand that there is no “mental” except as an artificial construct and therefore you can’t have a “mental” illness.

    My point was that psychiatry is killing us with their “treatment” of drugs, drugs and more drugs. They do so by considering themselves blessed as a medical science. However, there is no science behind their labeling.

    Other social sciences use the term “illness” to describe concepts that may have more or less meaning in communicating with others in that field. I believe there is some validity to the trauma model of understanding human behaviors. However, I still struggle with things like “self-harm.” Where is that line drawn? Multiple piercings? Tattoos? Sky-diving? Mountain climbing? Extreme running? Extreme sports? Even “normal” sports? Overeating? Undereating? Eating the “wrong” diet (even if driven by poverty)? Are these things “self-harm?” And, do we have the right to judge others?

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  • I do an entire rant on how “mental illness” does not exist as a provable entity under the medical model. It does exist under other models of understanding human behavior. Some of the ways to understand “mental illness” includes, The Spiritual Model, Moral Character Model, The Statistical Model, The Disease/ Medical/ Biological Model (—Genetics, —Neuroimaging, —Neurobiology), Psychological Models (—Psychodynamic Model, —Behavioral Model, —Cognitive-behavioral Model, Existential/ Humanistic Model), The Social Model, Psychosocial Model (—Social Learning Model), Family Therapy Model, the Bio-psycho-social Model and the Trauma Model. There are many biological reasons why people may exhibit “unusual” behaviors (culturally defined and subjective) and if you scroll to the bottom of the page you’ll find a fairly exhaustive (albeit outdated) list of some of those.

    As for “mental health,” I have long lamented the fact that we have never sat down and defined mental health. Other than understanding it from the negative of an absence of illness, we haven’t yet set out to define what might constitute health. What does someone who is mentally healthy look like? What might be the implications for the system if we were to shift the discussion and change the paradigm to one of health instead of illness?

    If we were to define mental health, we might do more than look at the circular reasoning of an absence of illness. We would move toward the positive and look at those things present in someone who is mentally healthy. We might start by looking at an innocent and healthy baby. One of the things that we might note is the capacity to feel joy. While joy may not always be present, that capacity might become one of the pieces of a definition of mental health. Other pieces of the definition of health might include the ability to create and maintain relationships or the ability to find and appreciate solitude (can we live with our own inner voices or perhaps can we just stand the solace of quietude). We might discuss the ability to draw upon spirituality as a strength.

    Shifting the paradigm to mental health instead of mental illness would force us to view people differently and to refine our approach to helping others. Just as those in the trauma field have moved away from, “What’s wrong with you?” to, “What happened to you?”, we must move the inquiry toward the person and away from symptoms.

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  • If NAMI (National Alliance on Mental Illness), the “family member” group were to withdraw their support of the Murphy legislation, I believe it would dry up and go away. That’s why I point out that it seems so odd that families are supporting us dying. Unless, they are not and just need to be educated to the facts. Perhaps we can reach the families and win them to our side. I’d be happy to see the abolition of the “National Alliance of the Morally Inexcusable.”

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  • My experience with the mental illness system is that we’re not allowed to express any emotion. We’re supposed to have all feeling blunted out of us by the drugs. The system is especially scared of the big, scary emotions like anger. Expressing those feelings warrants more drugs. The Murphy legislation is designed to control us with drugs. That’s why he keeps making the false and misleading connection between us and various mass shooters.

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  • Yes, the system folks like to blame cigarette smoking without acknowledging that cigarettes offset and mitigate some of the horrible effects of the psychiatric drugs. They blame obesity without acknowledging that some of the psychiatric drugs cause almost insatiable cravings and an almost constant urge to graze. My heart was weakened due to too many years of too many psychiatric drugs. Blaming us is just another way of attempting to force compliance with killer treatment. Modern day euthanasia is upon us. But, like I said, where’s the outrage? Why isn’t every politician and family member in the country jumping up and down with outrage? Perhaps we really are considered expendable.

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  • I lived in the Bay area and got to know Leonard. He was complex. At the same time he was a man of great peace (and you could feel that in his presence), he was also a man of deep and strong passions. He could build to a great and fiery tirade against the oppression of psychiatry and it’s tools, shock and drugs. I loved his writings. Words were his tools and he was a powerful builder with those tools. I am almost struck speechless in my grief. Last Friday marks the fifth anniversary of the death of Judi Chamberlin. We’re just about two weeks away (Feb. 5th) from the 20th anniversary of the passing of Howie the Harp. We are losing our roots. I am very sad. Leonard knew, from the beginning, that we are a movement about human rights, not about “illness” or “recovery” or most of the other stuff people write about here. We are first and foremost about human rights. Leonard, I loved you and I’ll miss you.

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  • In Ohio, there is a young man, John Rohrer, being held on civil commitment in state hospital and who was forcibly medicated because he “lacked capacity.” Here is actual words from a transcript of a hearing to determine whether to continue the confinement and forced medication. The psychiatrist testifies in an interesting Catch-22. It’s sort of like, “Why is he crazy?” “Because he won’t talk to me.” “And, why won’t he talk to you?” “Because he’s crazy.” Bruce Levine talks about why psychiatry retains its power. It’s because they (psychiatrists and the larger system) remain blind to their own arrogance and ignorance.

    John Rohrer’s Attorney Dye: You based your opinion on the reports of others, correct?
    Prosecuting Attorney’s Expert Psychiatrist John Hamill of Appalachian Behavioral Health in Athens, Ohio: For the capacity assessment? No, the main thing is when we were talking is his refusal to talk to me, probably the principal reason.
    Dye: Okay. And did he tell you specifically that he was refusing on advise of counsel?
    Hamill: He just said it was his right to refuse. That’s what I recall.
    Dye: And it is his right.
    Hamill: Yes, and I acknowledged that.
    Dye: But because he exercised a fundamental right in refusing to talk to you, you believed that that gives the state the right to force him to take medicines?
    Hamill: We have to assume that he lacks capacity because if somebody with capacity would argue that, given an extreme example if I’m in a hospital talking to somebody who refuses to talk to me because they are in a coma, I can’t assume they have the capacity to make that decision. I have to assume based on what they are telling me, somebody doesn’t tell me there’s no reasonable options then to assume they don’t have capacity.
    Dye: So when somebody exercises their right to refuse to speak with you, you make the jump, the assumption.
    Hamill: I would make the assumption and then it would be up to him to get another person to evaluate him. But yeah, if he doesn’t agree to any capacity assessment evaluation, then the assumption has to be they lack capacity.
    Dye: And would you agree then if that if he did have that second evaluation from somebody he did talk with that would be in a better position to decide whether or not he had the capacity to refuse or not?
    Hamill: If he had one, yes. If he was actually willing to talk to somebody about the medications and about treatment options, that would be a good one. Of course the question would be why didn’t he cooperate with me? And reflects either paranoia or lack of insight. People with insight for capacity assessment, we explain to them what’s going on, and people who are really on top of it will say I understand this and they want to have the conversation, they want to tell me their side of things, and really the best ones can say I understand where you’re coming from doctor, they can explain my side to me and explain their side and why they disagree.
    Dye: Following your assumption a little but further then, if he had had this independent examination done, and that person would be in a better position to make this incapacity decision.
    Hamill: Perhaps, yes, but there would still be the question of why he didn’t cooperate with me.
    Dye: How about because maybe he already had capacity evaluation already done by somebody else and didn’t see a reason to do another one.
    Hamill: He did not mention that to me, but okay. I’d be interested to see that.
    Dye: Would that be a valid reason to, or at least get a (inaudible) assumption of incapacity?
    Hamill: Yeah, that would help, it would help, but I would still be suspicious as to why he … again, most people, most reasonable people are usually willing to talk to me, if they disagree with it then they would get another evaluator.

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  • I respectfully disagree. I would like to see psychiatry abolished as a profession. If I thought I had a problem with my brain, I’d seek the counsel of a brain expert, a neurologist. If I thought my problem were physical, I’d seek my general practitioner’s counsel. If I felt that my problem were emotional in nature, I’d seek the counsel of friends, family, clergy, or in a worst case scenario, I might even go to a psychologist. I believe that pretty much covers the gamut of potential difficulty. So, that leaves psychiatry as a redundancy that’s completely useless except as causing many of the worlds problems and working as pill pushing shills of the drug companies. To claim that there are a few who don’t let their overblown ego get in the way of doing meaningful work is like claiming that there were a few good people in a Nazi uniform so we should forgive all associated with that hated symbol.

    I’m really disappointed that this forum turned, first of all, into a pop psychology type of read and now it’s providing a forum for “good” psychiatrists to find haven and solace from critique. Unfortunately, I deal every day with the fallout of too many who believed they were “good” because that’s all their ego would admit. Please stop defending your profession and go seek an honest field of endeavor. If you don’t want to waste your education, go on into neurology and help people from that lofty perch.

    Sorry if I’m bitter but I trusted the profession and they got ten years of my life. When I stood up and questioned and challenged, I recovered and escaped the clutches of psychiatry but, it was too late and the damage had been done. I’ve experienced the damage of over ten years worth of psychiatric drugs as they weakened my heart. I have now survived five heart attacks and I’m dying of congestive heart failure. It will kill me but, not today. I was lead down a merry path by the psychiatric profession and will die for swallowing their pills and their hermeneutic attitudes. I didn’t hear a single good reason for this profession to continue to exist for another day.

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  • I respectfully disagree. I believe the study cited may be too superficial to be meaningful.

    I was raised in western medicine where I was taught from infancy that if there was a problem, to go see doctor, trust doctor, doctor will fix it. So, I was deeply brainwashed and had it imbedded in my belief system to seek out and trust authority.

    When I had problems, I went to the mental health system and sought their expertise. I did whatever they told me to do. I journaled. I went to therapy, group, individual and day treatment. I went into the hospital over 20 times and participated in partial hospitalization. I took a daily cocktail of over a dozen drugs for over ten years.

    When I didn’t get better, I didn’t blame them. Obviously, they couldn’t be the problem. The problem must lie with me. They were the experts and I was just someone who was messed up. So, I tried different drugs, more journaling, more drugs, more treatment. I figured that if I just tried harder, I would really be complying with what the experts said and I’d get better. I got different diagnoses as my magical thinking increased. I also got more frustrated.

    We all have many roles in life. I’m husband, father, worker, teacher, student, friend, neighbor, brother, and many more. The harder I tried and the more I did not get well, the more I blamed myself, the harder I tried, the more I didn’t get well, the more I blamed myself and so forth. The viscious cycle lead me to doubt myself more and more until I lost me. I lost my self-worth, my self-esteem, my belief in myself, my self-confidence. I became more and more, mental patient. My primary identity became mental patient. I was one of those who shuffled with stooped shoulders and eyes cast downward. I measured time from cigarette to cigarette. It was so tragically terrible that if my wife or kids needed something and I had therapy scheduled at the same time, I chose the therapy.

    There’s a lot of talk the last several years about recovery. What is recovery? Well, to me, it meant recovering that which I had lost. I recovered me. I regained that lost self. It happened ever so tiny at first. I questioned, meekly, something to do with the therapy. I trembled with fear. But, I didn’t disintegrate. I was still here and just the tiniest increment stronger. I questioned and then challenged and it took years but I finally regained myself. I recovered.

    Yes, a job and other things helped but it wasn’t the therapeutic alliance. I’ve since observed many hundreds of my peers and it seems to be almost universally true that it is necessary to question and challenge. That’s where real recovery, empowerment and growth occur. Maybe at some point a “working alliance” helps too. Maybe someone will find a research calling to dig a little deeper and find out.

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  • Thank you Leah. Kate, what alternatives have you tried? We already have civil commitment statutes on the books in every state. What exists is commitment to hospital. The Murphy Bill would create civil commitment to home? So, how will that help people better than what already exists? Kate, do you think another judges order will suddenly and miraculously grant insight? Again, thank you Leah. I appreciate all of your hard work and efforts. I also appreciate the difficulty in stepping out of your comfort zone.

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  • Mark said, “A key argument has been effectively made by the proponents of AOT that it actually reduces the amount of coercion these people experience because without AOT they are hospitalized and jailed more frequently.” The problem is that involuntary outpatient commitment always includes psychiatric medications. AOT considers it less coercive to allow a person’s body to remain free rather than locking it up. However, I consider it a greater intrusion to force medications, sometimes toxic, sometimes lethal, into a person’s body. Remember the notion of a chemical lobotomy? What good is it if the body remains free but the mind is lobotomized? Are you unfamiliar with this because you’re one of the good guys who never forces meds? Otherwise, how’d you miss this?

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  • Mark, I can not even begin to tell you how offensive it is for you to dictate to me and others: “The time for contentious advocacy aimed at stopping AOT has ended and the time for collaborative advocacy aimed at implementing AOT as well as possible is upon us.” You’re certainly free to give up the battle. After all, as a highly regarded psychiatrist, you’ve nothing to lose. However, my worst nightmare is someone knocking at my door with a loaded syringe. I consider the potential for that quite high and it is the worst sort of intrusion, into my body. How dare you tell me or anyone else to stop fighting and play nicely and collaborate. The Vichy government were great collaborators too.

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  • Monica, I have the greatest regard and respect for you and all you do. I certainly never meant to even imply that you are not doing enough or are somehow doing anything wrong. I wanted to say that there are other approaches than CIT. The examples I cited no longer exist. The pendulum of oppression swung the other way and these programs were abolished as NAMI and the proponents of forced drugging took over. Kind regards, Pat

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  • Years ago, I was working on an adult acute inpatient unit. While working night shift, I had one of the male patients come up to me every night and ask for a dab of Vaseline. I knew he was going to go off in private and “do his thing” but I had no problem with that so I’d grab the big jar of Vaseline from the nurses station and hold it out for him to help himself.

    One night, one of the day shift nurses was filling in and she saw this and asked me what was going on. I explained the situation to her and she was apoplectic! I wasn’t sure what upset her. Perhaps, I thought, she was thinking that maybe he was going to go eat the Vaseline. In any case, I knew she was upset and she didn’t speak to me the rest of the night.

    A few days later, I heard through the grapevine that I was in trouble. The nurse had reported me and word had spread like wildfire that there was going to be serious repercussions at the next staff meeting. Apparently, most of the other staff supported the nurse and felt that what I had done was wrong and inciting the patients to indulge in lewd and lascivious behavior inappropriate for patients on a psychiatric unit.

    When time for the staff meeting arrived, I was prepared to defend my actions. The nurse who was head of the unit called the meeting to order and then she immediately raised the issue. She had done a bit of research in preparation for the meeting. In reviewing the records, it turns out that in over a year on the unit, I was the only staff person who hadn’t been assaulted on the unit.

    She then reminded the staff that we were supposed to be helping ‘adults’ on this unit and that they are also sexual beings. She asserted that it was far better for the patients to “go off by themselves and do their own thing” than for them to “go off on staff.” With that, the other staff nodded thoughtfully and the matter was completely dropped.

    Another time, one of the large men on the unit had raised a chair over his head and was threatening one of the nurses. The chair was one of those sort that are designed to be so heavy that the patients aren’t supposed to be able to lift them. The other staff were in position to do a ‘take down’ and had the Thorazine injection ready. I approached the guy and while maintaining good eye contact, I said, “Do you want something to eat? Would you like a sandwich or a donut?” He looked amazingly startled and then he set the chair down and said, “yes.” I unlocked the doors of the unit and walked with him across the street where I bought him a cup of coffee and a sandwich. While he was eating, I said, “You looked angry back there. Want to talk about what was going on?” Well, we had a good talk and he was considerably calmed down by the time we returned to the unit. From then on, I was teased by the other staff about practicing ‘sandwich therapy.’

    I don’t think of it as “sandwich therapy” but rather as distraction. That young man never needed to “act out” in order to get his needs met. He learned how to ask someone he trusted. What he really wanted at the time was to be placed into restraints and seclusion but he knew staff would just smirk at him. He was afraid that he might lose control and he wanted to be safe. I told him to just ask me in the future and avoid all the hassle with other staff.

    Part of the problem with staff and police is that they’re trained to react and respond in a certain way and it’s hard for them to change. They also don’t understand from never having been on our side of the issues.

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  • Back in the mid-80’s, one of the things Paul Sherman did was to create Citywide Case Management in Denver. An integral part of the team was the Consumer Case Manager Aides, the first peer providers in the country. There were three different teams: the Acute Treatment Unit; the Homeless/Crisis Unit; and the Residential/Case Management Unit. After the six-month internship, I had the academic credential and went on to become a Case Manager. I later worked as a therapist on the Acute Treatment Unit, a locked inpatient unit. However, at first, I started with the Homeless Unit.

    The Homeless/Crisis Unit did two things. First, we’d go find the person. The people served were the H.U.G.’s (High User Group). Perhaps they’d be living under a bridge. We’d approach them and ask if we could be of assistance. We’d offer a sandwich, a blanket or even a new box in which to live. Often we’d be told to just go away and leave them alone. We would but we’d tell them that we’d be back tomorrow because it was our job to try and help them. Perhaps after several visits, we’d be tested and the person would ask for a new box to live in. We’d then drive all over trying to secure the best large refrigerator box we could. Eventually, as the person accepted more help, we could get them into housing and assistance including jobs and eventual independent freedom. This was completely free choice by the person. That’s the reason why I went into this story.

    The other thing we did was meet with the Denver police at every shift change. We made sure they all had our number and they’d call us first if they encountered a situation where they even thought the person might be one of “ours.” We made sure our Crisis team (part of the Homeless team) responded immediately. The officers never even had to get out of their cruiser. We’d often talk to the person, de-escalate the situation and send the person on their way. No hospitalization or meds necessary. No force and no coercion.

    The thing that made this all work was that we were empowered by the Mayor to release the officers back to patrol. They didn’t have to complete paperwork, they didn’t have to haul the person off to someplace else, they didn’t have to take the person into custody and then wait around to pass that custody off to others and they could get back on patrol to catch real criminals. The whole deal saved big bucks and everyone was happier and healthier. The only time I can recall out of hundreds of incidents that we needed the police was when the person was demonstrating super human strength and we figured that he was on PCP (angel dust).

    I tell you this because I think it’s a better approach than CIT. Cops are taught intimidation at the academy. Their uniforms, the badges, the guns, the body posture, the tone of voice all are very commanding of respect and intimidation. They can’t help it. CIT trains the officers in medical model diagnosis with the help of NAMI. CIT creates junior therapists of the officers as they judge and diagnose and otherwise discriminate against people. Then, the people are hauled off to “treatment” where they’ll no doubt get forced or coerced into being locked up and drugged. Also, as long as CIT is touted as being the best or only viable model, people won’t look at other possibilities such as that which I described above. CIT’s greatest claim is that they practice de-escalation techniques. That’s nothing new. They use the de-escalation techniques that have been in use for close to 100 years in the hospitality industry (hotels and restaurants). So, CIT uses intimidation to de-escalate and get people into “treatment” where we are dying over 25 years too soon.

    Please consider not supporting CIT but rather creating your own model that uses peers and supports choice without using force and coercion. I have given just one possibility for doing something different that doesn’t use force and coercion, that doesn’t require scary uniformed intimidation and that saves dollars and resources. De-escalation techniques were common when I volunteered at the Free Clinic in the 60’s and we also learned to just “be” with the person and to listen. Now those same techniques have new fancy names like “mindfulness” and “Intentional Peer Support” and “active listening” and DBT, etc. Please think about doing something other than CIT.

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  • Antidepressants: puppies, kittens, babies, comedy clubs, races (drag races and figure 8’s), old movies (W.C. Fields, Marx Brothers, Laurel and Hardy, Abbott and Costello, Spanky and Our Gang, Shirley Temple, etc.), exercise (run til you hit the “wall” and then keep going for the endorphine rush), sky diving, mountain climbing, volunteering at the homeless shelter or soup kitchen, music!, fishing, and on and on and on….no drugs necessary.

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  • Mike, it’s not a problem to identify what’s wrong. We can all pretty much do that. It’s more a problem of how to change and do what’s right and get others to do the same. The gun control folks are quick to piggy-back on the scare tactics of E. Fuller Torrey and others who claim that (horror!) we’ve got one in five with “mental illness.” I think SAMHSA and others should start using those but flip them in the positive. We’re doing a great job! We’ve got 80 percent who are mentally healthy. If we just work at it a bit more, we should be able to increase that number significantly! The whole thing isn’t about gun control. It’s about people control and we’ve got to fight this battle on all fronts. There is movement to destroy our privacy rights (by NAMI and other family members). There is movement to forcibly “treat” (drug) us in our own homes. Soon, there’ll be a national data base showing which of us fall into that 20% category and they’ll be showing up at our door with injections to keep us under control. At least until we die over 25 years too young. Can you say euthanasia? I hope all is well in California. I know of someone in your county who is homeless and looking for help to keep his sister from committing him to outpatient treatment. Where can he turn for help?

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  • I would approach a homeless person living under a bridge. I’d gently ask if I could get them anything; a sandwich, a blanket, a new box to live in, anything. He’d snarl at me to go away and I would. The next day I’d show up and ask the same thing. He’d snarl and I’d go away. Eventually, he’d get tired of me and he’d test by asking for a new box. I’d drive all over the city if necessary to find him a nice large refrigerator box and take it to him. He’d snarl a few more times and eventually, he’d let me give him a clean, warm blanket. With enough time and patience, he’s got a home a job, meaningful relationships and is living as a productive member of the community.

    The key was relationship. It had to take time to build and to develop the trust. If you get chased away once, don’t give up. Who knows what trauma they’ve experienced that made them chase you away? The shop person obviously had a “relationship” where the person knew they wouldn’t be hurt. On hospital units where they have done away with restraints and forced medication, they did so by learning how to build relationships and help people heal in safety. I wish others here could learn that.

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  • Jonathan,

    Yes, there is a way. I’ve said that I started by volunteering at a free clinic back in the 60’s. I’ve sat with many as they worked through a “bad trip.” Today, that gets called psychosis. We had docs who volunteered too. There are ways. I know of a therapeutic farm. I know of respite care. I know of many alternatives. What are some of the myriad ways that you know? Please share and let us know what you’re doing to implement those ways.

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  • We’re real dangerous. Do you know how we fight? While in a state hospital one time, the staff were giving one of us a hard time. Another “patient” who was known as very self-injurious, snuck away and broke the teeth from a comb and using the sharp remains, ripped and ripped the flesh from her arms. Staff immediately saw the dripping blood and rushed to “care for” this young lady. After roughly washing and bandaging her arms, they strapped her to the chair that was secured to the pole in the middle of the day room (for humiliation). She looked over at the rest of us consoling the friend who was the original target of staff and she gave a sly wink. She had drawn staff’s attention to her in order to rescue her friend. You may not be able to relate to that level of “fighting” for a bit of power on a psych unit but those of us with lived experience can understand. Jonathan, why do you want so badly to justify your use of power, even if it’s only in rare situations? If you didn’t have a loaded syringe, what would you do? Can you even imagine another way to cope with the situation?

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  • So then the task would be to confront their influence? Lies, no matter how believable are still lies. Join in discrediting their lies. If you want to do more, start a boycott of the Danbury Mint and their “fine collectables” since that’s where the Stanley Family Foundation gets their money to fund Torrey. Boycott (by refusing to attend their conferences) the National Council for Community Behavioral Health since they’ve endorsed the Murphy legislation. Boycott NAMI and other organizations that support oppression. I wish I could help you shift your point of view from that of “jailer” to “jailed” and help you understand why you get so much flack from folks here. Unless you’ve got lived experience coping with our sort of oppression, you may not be able to understand us.

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  • DJ Jaffe lies. E. Fuller Torrey lies. They make up “facts” to suit their purpose. What they’re advocating for is foolish. They don’t want “treatment” for the “worst” as they define it. SAMHSA already funds and supports a wide range of activities including help for the “worst.” What they want is ALL of it and that’s where they are foolish. It is folly to create a system of triage that only serves the “worst.” Imagine a system that only does heart transplants but does nothing less including prevention. Soon everyone would either be in line for a heart transplant or dead. DJ and Fuller are stupid. In addition, Fuller is a ghoul. After decades of collecting brains, he has not gotten a single iota of useful data. I can only presume it’s just to fuel his “brain” fetish. He has also been discredited for his theory that schizophrenia is caused by cat pee. Perhaps we should lock away all the kitties instead of people.

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  • Even “voluntary” patients are not truly voluntary. As long as the threat exists that their voluntary stay could become involuntary, it’s like having a sword hanging over your head. That comes through in attitude both on the part of the staff and the recipients. Everyone knows that there’s this little pretend dance going on and yet if someone even seems as if they might become upset, things can switch to involuntary almost instantly. I tried to sign out from a voluntary stay AMA and a quick call to the doctor kept me in but switched to involuntary before the door could be unlocked.

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  • When I worked on a locked psych unit, I was the only one never assaulted because they all knew I was one of them. I didn’t hang out in the nurses station talking about who’s doing whom on Saturday night. Instead, I hung out with the folks and played pool or otherwise sat and chatted.

    When I worked as an Intensive Case Manager on the streets of Denver in the mid-80’s we met with police at every shift change and made sure they had our number. If they even suspected something amiss might be one of our folks, they’d call us. They never left the squad car. We’d respond immediately. We’d talk with the person and deescalate the situation. We also saved the system much money because we were empowered to release the officers back to patrol where they could go get real criminals. They didn’t have to do paperwork or transport anyone. The only time we ever needed the police assistance was one time when someone was obviously high on PCP. Angel dust gives super human strength (or at least the appearance because there’s no pain). But, we didn’t abandon care of one of ours to the police. We went with the person and we’d sit with them all night if necessary. Then we’d talk about what the person would like to have happen if there was a next time.

    I guess that’s the difference. Perhaps we had police backup for dangerous folks but we didn’t just turn it over to the police and wash our hands of it.

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  • As requested, the complete Insane Liberation Front Manifesto:

    In 1969, in Portland, Oregon, our modern human rights movement was founded. Dorothy Weiner, a union activist and labor organizer put an ad in a local underground newspaper. Tom Wittick, a socialist political activist and organizer answered the ad. A shy young man who had just gotten out of Western State Hospital in Washington and was living in a half-way house was driven down to the meeting by his sister, Helen. That was Howie The Harp (Howard Geld), a homeless organizer. These three laid the groundwork for all that was to become our modern movement.
    Howie The Harp is the name to which Howard Geld had his name legally changed so that he’d have the same middle name as “Winnie the Pooh” and “Ivan the Terrible.” He learned to play harmonica from a fellow inmate once while locked up and found it to be a useful organizing tool and at times used it to support himself on the streets. In 1965, Howard Geld was a 13-year old patient in a psychiatric hospital. Often he could not sleep, and a night attendant taught him to play the harmonica. “When you cry out loud in a mental hospital you get medicated” – “When I was sad, I could cry through the harmonica.” He was given the name Howie the Harp on the streets of Greenwich Village, New York.
    They met regularly on Friday nights with a business meeting followed by social time. Sometimes they met in each others’ living rooms and sometimes they’d meet at a pizza house, the library or other gathering places. They’d have anywhere from 8 to 80 people show up for the meetings. They named themselves the “Insane Liberation Front.” At one point they were offered support by “Radical Therapists” who were a group of psychologists from the Air Force who had served in Viet Nam. The “Radical Therapists” published a collection of papers from the time and this is the chapter written by the Insane Liberation Front in 1971. The Manifesto is modeled after the “Ten Point Program” of the Black Panther party written in 1966.
    Insane Liberation Front
    We, of Insane Liberation Front, are former mental patients and people whom society labels as insane. We are beginning to get together – beginning to see that our problems are not individual, not due to personal inadequacies but are a result of living in an oppressive society. And we’re beginning to see that our so-called “sickness” is a personal rebellion or an internal revolt against this inhumane system. Insane Liberation will actively fight mental institutions and the brutalization they represent (e.g., involuntary confinement, electric shock, use of drugs, forced labor, beatings, and the constant affronts to our self-identity). Even in so-called “progressive hospitals” where many of the physical abuses do not occur, we’re still made to feel so low that our concepts of who we are, and our beliefs, are pushed down so far that we often end up accepting our jailer’s society. We will fight to free all people imprisoned in mental institutions.
    Insane Liberation plans to establish neighborhood freak-out centers where people can get help from people who are undergoing or have undergone similar experiences. We believe that the only way people can be helped is through people helping each other – people with hang-ups being totally open and sincere to each other. The majority of shrinks, on the other hand, set themselves up as all-knowing authorities and from their positions of power automatically assume that the so-called patient is sick and not the society.
    We demand, with other liberation groups, an end to the capitalistic system with its racist, sexist oppression and with its competitive, antihuman standards. We believe in a socialist society based on cooperation.
    Demands from Insane Manifesto
    1. We demand an end to the existence of mental institutions and all the oppression they represent (e.g., involuntary servitude, electroshock, use of drugs, and restrictions on freedom to communicate with the outside).
    2. We demand that all people imprisoned in mental hospitals be immediately freed.
    3. We demand the establishment of neighborhood freak-out centers, entirely controlled by the people who use them. A freak-out center is a place where people, if they feel they need help, can get it in a totally open atmosphere from people who are undergoing or have undergone similar experiences.
    “I see the freak-out center as a place where there will be people who know where people freaking out are at because they have been there and they won’t cut them off because they know how devastating that can be. The people that live and work there see themselves as no more sane than anyone that will come there. Everyone is insane and everyone freaks out.” (Insane Liberation, Portland, Oregon.)
    Insane Liberation plans to form freak-out centers immediately.
    4. We demand an end to mental commitments.
    5. We want an end to the practice of psychiatry. The whole “science” of psychiatry is based on the assumption that there is something wrong with the individual rather than with society. We see psychiatry as a tool to maintain the present system. Rebelling often means being immediately sent to a shrink because of “emotional disturbance.” We see that the majority of shrinks a) make money off our problems; b) see us as categories and objects. To them we are an “anxiety neurosis” or a “paranoid reaction” instead of a human being; c) foster dependency instead of independency by making us distrust ourselves and consequently look for answers in the all-knowing God, the psychiatrist.
    Many psychiatrists have already used their influences to discredit the revolutionary movement by calling it sick. We see that this will continue and get worse.
    6. We demand an end to economic discrimination against people who have undergone psychiatric treatment and we demand that all their records be destroyed.
    7. We want an end to sane chauvinism (intolerance toward people who appear strange and act differently) and that people be educated to fight against it.
    8. We demand with other liberation groups an end to the capitalistic system with its racist, sexist oppression and with its competitive, antihuman standards. We believe in a socialist society based on cooperation.
    9. “We demand the right to the integrity of our bodies in all their functions, including the extremist of situations, suicide. We demand that all antisuicide laws be wiped

    From “The Radical Therapist; therapy means CHANGE not adjustment”, The Radical Therapist Collective Produced by Jerome Agel, Ballantine Books, Inc., NY, September 1971, SBN# 345-02383-8-125

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  • Those who defend hospitals always seem to have some investment in them (like a paycheck). I’ve seen studies where people do better without going to the hospital (Texas Crisis Alternatives Project: Cost-Effectiveness of 9 Crisis Residential Modalities, May, 1996; SAMHSA Grant #SM47634-0351). Providing up front screening by peers who can also provide peer support would eliminate the need for psychiatric inpatient units.

    I’ve also seen many places that have eliminated the use of seclusion or restraints entirely. If these places can do it, so can this unit. It only takes the will to change.

    I started back in the 1960’s by volunteering at a free clinic. I was a good listener and I find that the same thing works today in the mental health realm. I have never needed force or coercion (a locked door, formal structure, medication, etc.). Back in 1970 in Portland, Oregon where our modern mental patient movement started, they issued a manifesto. Item 3 on the list was, “We demand the establishment of neighborhood freak-out centers, entirely controlled by the people who use them. A freak-out center is a place where people, if they feel they need help, can get it in a totally open atmosphere from people who are undergoing or have undergone similar experiences.
    “I see the freak-out center as a place where there will be people who know where people freaking out are at because they have been there and they won’t cut them off because they know how devastating that can be. The people that live and work there see themselves as no more sane than anyone that will come there. Everyone is insane and everyone freaks out.” (Insane Liberation, Portland, Oregon.)

    That sounds an awful lot like what I used to do in the free clinics. Modern peer support can provide this function without the rigid structure of an inpatient hospital.

    Inpatient hospitalization is traumatic. Jonathan might be kind and benevolent but, he’s a single individual. The entire staff are likely more grounded in the medical model. We’ve become a pharmacracy and hospitals are the worst. ( We have words to describe medical conditions but not an adequate vocabulary to describe the sorts of abuse, neglect and trauma from which people suffer. That doesn’t stop medicine from trying to medicalize these human feelings.

    Psych hospitals are not places of healing. They are confinement and containment at best. Healing comes from self-determination and in the context of community. The artificial nature of hospitals are not conducive to healing.

    Besides, hospitals are supposed to be those places where medicine is practiced; with things on the walls where oxygen and stuff comes out and fancy beds where the feet and head can be raised and lowered and where they bring you food and let you sleep or watch TV. They hand deliver medicine and let you refuse. If you spend too much time in bed, they’ll rub your back and help you with kindness and gentleness. None of that sounds like a psych unit. There you must line up for medicine like a cattle call. If you refuse, greater force is used.

    Yeah, defend them all you want but in my experience, psych hospitals are all hell holes. Some are nicely gilded with better beds, food and color on the walls but underneath, they’re all designed to force compliance with medication that kills us 25 years too soon. Somehow that’s not my idea of a place that’s very healthful.

    Pat Risser

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  • V,

    I am still worried about what I call medical ego. I still encounter doctors who think they know what’s best for someone.

    I believe there isn’t much “research” because we’re all individuals and withdrawal needs to be an individualized process. Different people will react in different ways.

    In some ways, we are the evidence. Kate Millet wrote in the book, The Looney Bin Trip about her experiences coming off of lithium. There are many other similar books and articles available. I guess that doesn’t qualify as research until someone puts it all into a compendium summary.

    Some I’ve known are able to quit cold turkey. Others have to titrate off slowly. Some have difficulty because they titrate off too quickly. I tell folks that if you’ve cut your pill in half and need to cut back even more, go to taking a half pill every other day or every third day.

    Another suggestion I give folks is to give themselves permission to go back up on a med for a while. If cutting in half is too much, go back up to full dose for a little while. Then go to half dose every third day or whatever it takes to make the adjustment.

    I also urge folks to find other coping skills. Use nutrition, meditation, exercise or whatever helps. The drugs don’t “cure” and only seem to mitigate some of the uncomfortable symptoms. I urge folks to find ways to minimize the symptoms. If someone wants to interact with voices, I tell them to tell the voices to come back another time (when it’s more convenient). I offer that if they interact with the voices in a loud and belligerent manner in a crowded store, they’re getting in other people’s “space” and will likely get picked up and locked up. However, if they go way back in the woods all alone and yell and scream, no one will care. So, I try to place the symptoms in a context and not label them as good or bad.

    When Courtenay Harding did the Vermont Longitudinal Study, she interviewed people until she found one woman who called her into the bedroom and pulled out the bottom dresser drawer. It was full of medications. The woman said it was just easier that way. Courtenay had to go back and re-interview all the other folks and found that most of us do quite well on our own, despite the thumb-fingered efforts of the psychiatric profession.

    Once, in the worst depression I ever had, I was very suicidal and placed in state hospital. I wanted to die and figured the easiest way was to stop all medications including my heart medicine. So, I became treatment resistant and non-compliant. Lo and behold, I started getting much better very quickly. It turns out that Inderal (a beta-blocker) for my heart has major depression as it’s number one “side-effect.” I’m convinced that if I hadn’t gotten treatment resistant and non-compliant, that I would have continued to spiral downward in depression until I successfully suicided. I’m also convinced that medical ego is what kept the doctors from figuring this out for themselves. Many docs missed it.

    Would you and your generation of colleagues have caught this?

    I respect that you’ve come here to Mad In America and put yourself out there to connect with us. Keep up the good work, growing and learning.

    Pat Risser

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  • Mentalism in Language

    “Decompensating” is an us-them term; under stress “we” may not do well; “we” may cocoon, take to bed, get bummed out, get burned out, get a short fuse, throw plates, scream, call in sick, or need a leave of absence. “They” decompensate.

    Part of the demotion from “us” to “them” is a loss of one’s designation as a person. One is suddenly no longer a person with a diagnosis, but “a schizophrenic” or “a bipolar… “a mental patient” or “a CMI” or “SPMI.”

    Medical illnesses are not associated with the negative assumptions and prejudices that are inferred from a psychiatric label. A “diabetic” is not assumed to be violent, unpredictable, or incompetent.

    Associate the term “patient” with discrimination, coercion, and oppression.

    Psychiatric personnel have continued to justify the use of the term “patient” because they see it as simply technical.

    Mentalist power dynamic: professionals are generally accustomed to being in charge and, as a professional once said, they’re “not about to be dictated to by a bunch of patients.”

    The power-up group is comfortable with the existing terminology and that comfort takes precedence over the feelings, wellbeing, and dignity of those who are power-down.

    If a diagnosis helps a person to understand her/his experiences and gain control over her/his life, it is a useful tool. If it stigmatizes, communicates contempt, and excludes the person from services, it is a weapon.

    If I describe someone as “a borderline with intense dependency,” “a non-compliant schizophrenic,” “an oppositional patient,” “a typical drug-seeking antisocial personality disorder,” “a manipulative, gamey manic,” am I seeking to understand, respect, and help, or merely pass judgment, feel superior, and assert my professional dominance?

    I hate that word “treatment.” It’s been twisted by the system and perverted beyond recognition. If they lock you up against your will, strip you literally and figuratively (of your rights) and force you into bondage and solitary confinement and then inject you with powerful and painful drugs, they call it “treatment.” In every other possible realm on earth, this is torture and not “treatment.” If they set a fifteen minute appointment for you to renew your drugs every two weeks or month, they call that “treatment” and they can bill your insurance for payment. I consider it fraud.” -P.R.

    “To be a mental patient is to participate in stupid groups that call themselves therapy — music isn’t music, it’s therapy; volleyball isn’t a sport, it’s therapy; sewing is therapy; washing dishes is therapy. Even the air that we breathe is therapy — called milieu. ” -Rae Unzicker

    “Normal behaviors are NOT symptoms. Normal people can have a bad day, an “off” week and even a “down” month. However, if we exhibit those normal behaviors on the job, we get labeled and we are asked if we took our medications or if someone needs to call our shrink.” -P.R.

    “There is no such thing as a ‘side-effect.’ There are only ‘effects’ from taking drugs. Some effects are desired and others are undesirable. Calling something a “side-effect” obscures and minimizes the resultant pain, suffering and misery that can be caused by psychoactive drugs and in doing so, it discounts our experiences and perceptions and thus sets us up as less than we are. It denies our reality. “Hey doctor, my eyes fell out and I’ve got big purple splotches all over.” “That’s okay, it’s just a side-effect.” -P.R.

    Psychiatric facilities are not “hospitals.” Hospitals are those places with oxygen coming from the walls, with private television, with beds that bend up and down, where folks bring your meals to you, where nurses deliver the medicine and accept if you refuse, where a nurse will give you a back rub to avoid bedsores. Psychiatric facilities are places of holding and containment that want to fool folks into thinking they have any medical purpose other than oppression and suppression. The quiet mental patient who causes no community disturbance is considered “cured” or “recovered,” no matter how miserable or incapacitated he or she may be.

    Pat Risser

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  • When you lose something and then after a period of time you relocate it, you are said to “recover” it. So, looking back, I thought about what it is I had lost and then “recovered.”

    I was raised like most in the Western world to trust authority. I was taught from infancy, if you have a problem, go see doctor; doctor will fix it. Even though I was part of the generation that was raised to not trust anyone over 30, that didn’t apply to doctor.

    So when I had emotional distress, I turned to the “experts” and expected them to cure me, to “fix” me. When that didn’t happen, I grew frustrated and yet I couldn’t blame them. They were “doctor” and the expert authority. They must not be wrong. The fault must be with me. Perhaps I needed more medication or more writing in my journal or more groups or more therapy or more hospitalizations or more whatever. I “knew” I needed to do more. The fault must be mine. It couldn’t be their fault that I’m not getting better.

    As I sank into a quagmire of self-blame, I started to lose my self. We each have many roles in life. I was husband, father, student, worker, friend, brother, son, neighbor, etc. However, my primary role evolved into and became “mental patient.” What that means is that if my wife or children needed something and I had a therapy appointment, I would choose to attend therapy. My life revolved around being a mental patient. It became almost all consuming. The more I blamed my self for not getting better, the more I lost hope and the more I became primarily a mental patient as that role became the dominant feature that defined my life.

    I contend that the more I sank into the role of “mental patient,” the more I lost my self. I lost my self-esteem, self-admiration, self-confidence, self-glorification, self-love, self-regard, self-respect, self-satisfaction, self-sufficiency, self-trust, self-worth, self-determination, self-exaltation, self-importance, self-assurance, self-important, self-interested, self-possessed, and self-pride. I lost hope as my identity became more and more just that of “mental patient” and my loss of self-pride resulted in a loss of self.

    At the time, had someone pointed this loss out to me, I would probably have been confused because I had always associated pride with that negative sort of excess that has been labeled self-absorption, self-worship, selfish and self-pity. My life revolved around my “mental illness” to the exclusion of everything and everyone else. I became one of those helpless, hopeless and overly dependent patients who lived from Big Gulp to Big Gulp and for whom time was measured from one cigarette to the next.

    Slowly it came to me that I had lost my sense of self. I had lost pride in myself and in my life. Pride is essential to our concept of self. A smart person could probably get away with stealing all of their life and yet most do not. Why not? Because of pride! “To thine own self be true, and then it follows as the night from the day, thou canst not then be false to any man.” A proud self-image is the strongest incentive you can have towards correct behavior. Too proud to steal, too proud to cheat, too proud to take candy from babies or to push little ducks into water is what separates us from the animals. A moral code for a community must be based on survival for that community, but for the individual correct behavior in the tightest pinch is based on pride, not on personal survival. This is why a captain goes down with his ship; this is why “The Guard dies but does not surrender.” A person who has nothing to die for has nothing to live for.

    One definition of the opposite of pride is shame. As I lost my self, my self-pride, I had grown ashamed. I was ashamed of my life. I was ashamed because I was weak and couldn’t work, I couldn’t support my family, I couldn’t support myself, I couldn’t do anything. Certainly, I couldn’t do whatever was necessary to “heal” myself. No matter how hard I worked at it, I was still suffering from ≥mental illness≤ or a disease or disorder. I had grown paralyzed emotionally because I lost my self. An enormous amount of shame comes with a history of abuse and trauma but, the system played upon that vulnerability and amplified my sense of shame by treating me as a mere mental patient, a chart number, a diagnosis.

    I had to liberate myself. I had to recapture some sense of pride. I had to “recover” my self.

    I began to question and to challenge. It was terrifying when I first stood up to staff and asserted my self. I felt that I could potentially lose their approval but worse, I could also be kicked from the program and perhaps lose my primary “self” identity as mental patient. My “mental patient” identity was so strong that to risk losing it was very frightening. I wasn’t sure what “self” I might have left if I were to lose my primary identity of “mental patient.” Who and what might be left? However, when I did question and challenge, I felt some small sense of pride. It felt good to stand up for my self somehow.

    With each episode of standing up and questioning and challenging, I felt better and stronger. I felt better as I became more self-determining. I slowly began to regain my sense of self. I grew stronger in my self-esteem, self-admiration, self-confidence, self-glorification, self-love, self-regard, self-respect, self-satisfaction, self-sufficiency, self-trust, self-worth, self-determination, self-exaltation, self-importance, self-assurance, self-important, self-interested, self-possessed, and self-pride. I acquired a renewed balance in my roles in life. Instead of my life being dominated by my mental patient role, I became more of a husband and father. I got into the workforce and developed a strong sense of pride in my work and even in my ability to work; something that had been missing for many years. That sense of self-pride grew to impact more and more areas of my life and the sense of accomplishment was tremendous.

    So, just as I had lost my “self” I worked hard to recover that lost “self” and pride was the key. In losing my “self” I lost my pride in who and what I am and I became “mental patient.” In recovering my “self” I rediscovered a sense of pride as I took pride in overcoming and recovering from “mental illness.” The saying, “One day at a time,” became prominent as I learned to control my actions and behaviors. Much of the time the saying for me was more like, “One moment at a time.” I learned that my thoughts, moods, feelings and emotions just are. They hold no magic power or ability to dictate my actions or behaviors. I learned that I might feel suicidal but I didn’t have to act in ways that were self-harming. As I exercised my abilities to control my actions and behaviors, I grew stronger and the unpleasant thoughts, moods, feelings and emotions grew less and less in both strength and number.

    I live today, as RECOVERED! I no longer claim a “mental patient” identity. Instead, I am husband, father, grandfather, homeowner, tax payer, voting citizen, and so much more. That’s “recovery.”

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