Thursday, 15 May 2008

Labels vs. your own story

I originally wrote the below post for Outsideren's blog, where you can view it here. The below version of the post is a slightly edited and expanded one of the original. "Epidemic" relates to my earlier post at Outsideren's blog "Er epidemien biologisk eller kulturel?" (Is the epidemic biological or cultural?), which is (not) a review of E. Fuller Torrey's book "The Invisible Plague. The Rise of Mental Illness from 1750 to the Present". The reason for me to mention the cat in my comment on Gianna's post is that Fuller Torrey advocates a theory about close contact to cats, especially their droppings, being the cause of "schizophrenia". Many things can be said about this man, but he certainly doesn't lack imagination!

Diagnoses, life stories and some more epidemic

Gianna did it again (so good to see, that she anyway is up to share her pearls!): she wrote another thought provoking post.

Apropos of epidemic: yes, also the number of grown-ups labelled "bipolar" has increased throughout the past about 15 years - in the U.S. Maybe the U.S.-American version of "bipolar disorder" is more infectious than the one that attacks people in other parts of the world?? An especially infectious variant of the virus?? Do I really dare to go on a trip to the U.S. (hopefully next year) and drop in at some of the most infected places such as Freedom Center and MindFreedom under these circumstances?? I can vividly imagine all the Outsiders draw back in terror: "Get thee hence, until we're sure you aren't infected!" I wonder, when would that be? The day I'd drop dead without ever having been the least "manic"?? Uhm.

However, it seems it isn't that much about an epidemic in "bipolar disorder" as it is an epidemic in what you might call "psychiatric bipolar-diagnozing-madness", a subtype of OCD that, as the name implies, only affects (infects) psychiatrists - in the U.S. So, no fear, unless you're a psychiatrist - living in the U.S.!

The magnitude of the U.S.-American "bipolar"-explosion is about 100%. That is, the number of "bipolar" labelled people has doubled throughout the past 15 years. A recent study now suggests that 50% of all people labelled "bipolar" are misdiagnozed. The actual rise in the cases of "bipolarity" thus is - let's see - 0%. I guess, I can safely go on my trip...

Well, among several other thoughts, Gianna's post for my part provoked some thoughts on labels, and I commented:

"Labels, well, I haven't been labelled officially, but if, it would "without any doubt" have been a "schiz"-label. It helped in one single regard: through my knowledge of the ideas and experiences of people like Lacan, John Weir Perry, Laing or anyone else who ever has tried to understand what really is the nature of the problems, psychiatry fancies to label "schiz" (and that's that - no further understanding required), I finally was able to ask myself the right questions and get to know myself a lot better, which on its part got me on the road to recovery. In any other regard I experience the label as an assault on my humanity. Actually, while in a state of acute sensitivity, I wasn't even able to write down the word (I virtually couldn't get the pen down on the paper or hit the keys), not to speak of having to listen to my therapist saying it, without feeling myself, or: my self, being reduced to something near zero. A trauma on top of a trauma.

Neither here: no family history of "madness". Only an abusive, over-controlling mother (whom I haven't forgiven: kids mean responsibility, also the responsibility to critically examine one's qualifications as a parent from time to time, especially when things start to go wrong), and an evasive, absent father - the "classical" setting, you might say. But, oh, I almost forgot: we did have a cat!..."

Now, my reluctancy toward the label hadn't escaped my therapists attention. As we all, my therapist included, know, "lack of insight" is a widespread "symptom" of exactly this "disease". The word wasn't said but a very few times. As the aim in this, therapeutic, context wasn't, as it unfortunately often is in a psychiatric context, to get me definitely reduced to something near zero.

But: of course, even in this, therapeutic, context the "insight" had to be checked for and preferably attained. So, my peace of mind in regard to this matter was continuously disturbed: "What do you think, your problem might be?", "Do you think, it might be severe?" And so on, and so on, in the same style. I stood my ground for weeks: "I don't know.", "No idea." All the while I became increasingly annoyed: "Why don't you just stop lumbering me! Say it yourself if you think it needs to be stated!" But, nah nope, that wouldn't have done in regard to the "insight", would it?!

About at the same time when I was working up my comment on Gianna's post, also Pablo sat and wrote his own comment:

"(...) Everyone needs to make sense of their own life. Human beings are creatures that occupy time as well as space - other creatures live much more in the moment with little sense of past and future. We need to construct a topography of time, a map of life, and this is our story. This is where our fascination with stories and storytelling comes from - this need to map time and locate ourselves within it.

A diagnosis is a substitute for a personal narrative. It’s an attempt to give someone a story when they can’t make sense of their own, but it’s inherently unsatisfying. It puts that person in a box and makes the individual fit the story instead of the story fitting the individual. Part of the recovery process is the process of reclaiming your own story - the story that makes sense of your life, not someone else’s. (...)"

I want to complement Pablo's comment with Grace Jackson's answer to Larry Simon's question about the causes why emotional crises that often lead to lifelong, chronic "illness". Apart from mentioning both social and biological (drug-related) causes, Grace Jackson talks about psychological causes of a chronification of crisis: " can become very attractive to a person who has no other identity in life, or no other - capital M - Meaning, an existential reason for existing, to actually assume some role which is giving meaning not only to oneself but to others. So, if I in fact become important to Nanny or to Chad, or become important in my family, or become important to my psychiatrist, because I assume this role, which everybody says I have, and I am assuming certain value because of accepting that label, then there are psychological reasons for having it be lifelong, or more chronic."

By the way, Larry Simon's so far two interviews with dissident-psychiatrist Grace Jackson are real highlights in his series of also otherwise exceptionally interesting and worth listening to radio-blog shows "Stories We Live By". Find and enjoy them here.

Annoyed, afraid and angry, and incapable of writing down the word I became because I, who all my life had been living others' stories, exactly the moment I'd started to claim my own story, once again was asked to live someone else's story - and renounce my own one.

To ask for "insight", the way the system does, i.e. via the identification with a label, is the same as to ask the individual in crisis to reduce him-/herself to something near zero. Once again.

I gave in, then. It hurt unspeakably. Even though the context as mentioned wasn't "official". And even though I deep down did as I've always done whenever self-reduction, or more precisely: self-denial, has been demanded from me, and shouted to myself: "NO!!!" No deep down "no", no matter how loud it is shouted, can ever make the written word unwritten. When I'm writing, I'm writing my own story. I'd been asked to write the word, and thereby someone else's story, into my own story. Once again. A trauma on top of a trauma, to quote Dianne.


Gianna said...

excellent the way..."Pablo" is my husband! He's pretty cool. I'll share your thoughts with him.

Marian said...

Thanks Gianna! "Pablo" seems to be the kind of person everyone in crisis would deserve to be surrounded by. Instead of being steamrolled by the ignorance and indifference of those who usually, and without any mercy, throw themselves on you while you're more or less completely defenceless.

Reminds me of: I guess, I'll soon have to write something nice about my therapist. Before people get the impression that she is a stupid bitch - which she certainly isn't! - who did nothing but mess up - which she certainly didn't! Indeed! Now I've written something nice about her...

Marian said...

Whoops, can be misunderstood: she DIDN'T MESS UP, I mean, of course! :)

Lia Govers said...

My story is another story of recovery from the so-called 'schizophrenia'. You can read about it in my autobiographic book: 'Healing from schizophrenia. A personal account' by Lia Govers, publisher Available on Amazon-sites, on the Lulu-site and on other libraries on line.
I recovered in North-Italy with the help of several years of a psychodynamic psychotherapy.