Thursday 31 July 2008

"Schizophrenia" - the end of the myths about a sick society?

Groundbreaking news: Once again, science is just about to have found the cause of "schizophrenia". Yesterday, July 30th 2008, the Danish news media tv2 nyhederne could tell that a European group of scientists had found a mutation in certain chromosomes to be very likely to increase the risk for an individual with these mutations to develop "schizophrenia".

The article "Tættere på skizofreniens årsag" (Closer to the causation of schizophrenia) quotes the Danish psychiatrist and researcher Thomas Werge:

"Schizophrenia has been surrounded by many myths, for instance that it was a reaction to a sick society. For 20 - 30 years now we've known, that schizophrenia with great probability is conditioned by genes. But the myths stayed alive. Thus it is very gratifying, that we now finally have documented concrete changes in our gene-pool, that imply a very strong risk for an individual to develop schizophrenia." (my italics)

And why would this be gratifying? Of course, because there's nothing more disastrous for a society, that both regards itself to be infallible, and also wishes to be regarded from the outside as being the best of all imaginable societies, than that the infallibility becomes questioned. For instance by some of the members of this society reacting with "schizophrenia" to the alleged infallibility.

The article further states, that if the new findings prove to hold, this could create a basis for easier diagnosis, better "treatment" and even "preventive treatment for those, who are at high risk to develop the illness".

"Preventive treatment"? I have a hunch, that we're here talking about taking one more step towards a "brave new world".

Yah, we've heard and read it many times before, throughout the past 20 - 30 years, that, hurray! now science has found something. Last time it was about "schizophrenic" mice, just as an example. And, by the way, what happened to those??... Last in the article, Thomas Werge thus hurries to backtrack: "Now we know, that some concrete mutations imply an increased risk for schizophrenia, but this isn't to say, that it can explain all cases of schizophrenia, because it doesn't."

I feel like asking: Well, what of it? Has science found the cause, or hasn't it?

But there's another, quite different aspect to the matter, I will have a closer look at in my next post.

Saturday 19 July 2008

The other side of "bipolar disorder"

Wednesday, July 16th 2008, The New York Times ran an interactive feature article on "bipolar disorder", "Patient Voices - Bipolar Disorder", that includes nine audio clips with people who are labelled "bipolar", one of them being Steven Morgan. Steven brings in the refreshing perspective of someone who doesn't identify himself as "mentally ill", as a "disorder", as well as he points out the often denied facts, that recovery, even from " severe mental illness", is very well possible, and that drugs aren't always necessarily required in order to deal with extreme states of mind. He manages to get out the essential truth that there are more than one ways to look at and deal with "mental illness" in under two minutes. Great job, Steven!

There also is a comment section to the article, where Steven in his uniquely serene way deals with one of the attacks, people like him (and me) unfortunately all too often have to deal with (comment # 73, respectively Steven's reply, comment # 75). I wish, I had Steven's serenity.

Thursday 17 July 2008

The other side of mental health science

And here it is, now also on this blog: the article "The other side of mental health science" by Steven Morgan, that I mentioned in a previous post, and that puts a number of common misunderstandings about "mental illness" right. For everyone who, for whatever reason, hasn't been to Gianna's blog yet to read it there.


The other side of mental health science

BY STEVEN MORGAN stevenmorganjr(at)gmail(dot)com

Scientific studies about mental health are widely considered to be the ultimate source for objective information about psychiatric disorders. However, most people do not or cannot access these studies themselves. They instead rely on information from doctors, organizations, peers, the media, and so on. Unfortunately, this second-hand information is often oversimplified (i.e. “Mental illness is a chemical imbalance in the brain”), spoken with too much certainty (i.e. “Schizophrenia is a chronic brain disease that is lifelong and incurable”), or skewed and manipulated to justify an opinion (i.e. “People with Bipolar Disorder must take medication to live well”). As a result, popular myths now overshadow much of the data available from science.

The following list is a collection of facts from peer-reviewed scientific journals and several research-based books. Each source is hyperlinked in References, meaning the reader can literally click on the name of the study to access it from the Internet. Given the heated atmosphere of opinions about psychiatric disorders, the hyperlinks were included to make this document user-friendly so that readers can research the facts themselves.

FACTS ABOUT PSYCHIATRIC DISORDERS

I. A chemical imbalance for mental illness has never been found in anyone’s brain.1 There is no way to measure the level of neurotransmitters in synapses between brain cells, so there is no measurement of a healthy chemical balance that would allow for comparisons of “too many chemicals” or “too few chemicals” to be made.2,3 That is why our brains are not scanned for chemical imbalances when we are diagnosed. Even if chemical imbalances are one day found, it does not mean that they cause psychiatric disorders. Indeed, since the brain changes in response to both internal stimuli (thoughts, imagination, feelings, etc.) and external stimuli (sunlight, trauma, playing the piano, etc.),4,5 a chemical imbalance could just as likely be a biological reflection of environmental, emotional, psychological, and spiritual stress as a primary cause of it. Finally, the idea that specific genes cause mental illness is inaccurate, leading one prominent genetic researcher to state in the American Journal of Psychiatry: “The impact of individual genes on risk for psychiatric illness is small, often nonspecific, and embedded in complex causal pathways… Although we may wish it to be true, we do not have and are not likely to ever discover `genes for’ psychiatric illness.”6

II. Long-term studies from around the world demonstrate that the majority of people diagnosed with major mental illness – including schizophrenia – significantly improve or completely recover over time.7,8,9,10,11,12

III. Adverse childhood events can lead to mental health problems in adulthood – including psychosis, bipolar affective symptoms, depression, borderline traits, and so on – and the vast majority of people diagnosed with major psychiatric disorders have histories of trauma, neglect, or abuse.13,14,15,16,17,18,19,20,21,22,23 Thus, in many cases, the cause of psychiatric symptoms is childhood trauma. In this context, saying “mental illness is just like diabetes” or “mental illness is a physical brain disease that is no one’s fault” is inaccurate. Consider this parallel: if I am stabbed by a knife, is my bleeding caused by weak skin, or is it caused by the knife, the stabber, and the surrounding circumstances? Linking the cause of psychiatric symptoms to the appropriate source – i.e. a traumatizing environment instead of one’s brain or genes – is crucial in determining an effective treatment path to recovery and in actually changing larger social, cultural, and familial problems that contribute to mental breakdown.24

IV. A large subset of people diagnosed with schizophrenia fare better with little or no medication usage.25,26,27 Several alternative treatment models that use little or no medications for people experiencing psychosis have outcomes equal to or better than treatment-as-usual.28,29 Also, antipsychotics are far less curative than generally acknowledged: in the most recent and largest ever study of antipsychotic efficacy for people diagnosed with schizophrenia, 74% of participants (1061 of 1432 people) quit taking their initially-assigned antipsychotic within 18 months, mainly due to ineffectiveness or intolerable side effects.30 Of these unsatisfied participants, about half (509 people) dropped out of the study altogether, while the other half entered a second phase in which they tried a different antipsychotic. During the second phase, 44% of participants assigned to clozapine (20 of 45 people) and 75% of participants assigned to another antipsychotic (282 of 378 people) again discontinued it within 18 months.31,32

V. The brain can heal, and the biological abnormalities linked to psychiatric symptoms are often reversible or can be compensated for by other areas of the brain.33,34,35,36,37,38,39,40 In other words, psychiatric recovery can happen on a biological level, both with and without medication usage.

VI. According to repeated studies by the World Health Organization, people diagnosed with schizophrenia living in developing countries have significantly better outcomes than those living in developed countries.41 The WHO suggests the better outcome “…was unrelated to drug treatment since many in the developing world did not receive continuous treatment. Psychosocial factors, such as better family support, community tolerance, extended networks and more favorable job opportunities, have been postulated as the reasons for this observation.”42

VII. Antidepressant medications are no more effective than a sugar pill for people with mild to moderate depression, and only slightly more effective than a sugar pill for people with severe depression.43

VIII. Efforts to increase a person’s awareness of their diagnosed mental illness – known as “illness insight” – may lead to self-stigmatization that decreases self-esteem and hope.44,45,46,47 Research shows that the “mental illness is like any other physical disorder” message behind many anti-stigma campaigns actually increases the public’s fear, prejudice, and desire for distance from people who are diagnosed.48

IX. Psychiatric diagnoses are not based on medical testing, but instead on self-report and professional interpretation according to culturally-defined notions of disease. They are therefore arbitrary and often unreliable, especially over time, being prone to racism, sexism, classism, and Eurocentric bias. Many people receive different diagnoses from different doctors, which muddles treatment options and can lead to unnecessary or mismatched medication usage.49

REFERENCES

For links that direct you to these sources see Steven’s hyperlinked version of this paper for further study:
1 Lacasse JR, Leo J. The Media and the Chemical Imbalance Theory of Depression. Society 45(1):35-45, Feb 2008.

2 Lacasse JR, Leo J. Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature. PLoS Medicine 2(12), e392 doi:10.1371/journal.pmed.0020392, Nov 2005.

3 Breggin PR, Cohen D. Your Drug May Be Your Problem: How and Why to Stop Taking Psychiatric Drugs. Philadelphia, PA: Da Capo Lifelong Books, 2007.

4 Doidge, N. The Brain that Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science. New York, NY: Viking Adult, 2007.

5 Begley, S. Train Your Mind, Change Your Brain: How a New Science Reveals Our Extraordinary Potential to Transform Ourselves. Ballantine Books, 2007.

6 Kendler KS. “A gene for…”: The nature of gene action in psychiatric disorders. Am J Psychiatry 162:1243-1252, 2005.

7 Davidson L, Harding C, Spaniol L, (Eds.). Recovery from severe mental illness: Research evidence and implications for practice. Boston, MA: Center for Psychiatric Rehabilitation͵ Boston University, 2005.

8 Harding CM, Brooks GW, Ashikaga T, et al. The Vermont longitudinal study of persons with severe mental illness I: methodology study, sample and overall status 32 years later. Am J Psychiatry 144:718-726, 1987b.

9 DeSisto MJ, Harding CM, Ashikaga T, et al. The Maine and Vermont three-decade studies of serious mental illness, I: matched comparison of cross-sectional outcome. Br J Psychiatry 167:331-338, 1995a.

10 Huber G, Gross G, Schuttler R. A long-term follow-up study of schizophrenia: psychiatric course of illness and prognosis. Acta Psychiatr Scand 52:49-57, 1975.

11 Ogawa K, Miya M, Watarai A, et al. A long-term follow-up study of schizophrenia in Japan–with special reference to the course of social adjustment. Br J Psychiatry 151:758-765, 1987.

12 Ciompi, L. Psyche and Schizophrenia. Cambridge, MA: Harvard U. Press, 1988.

13 Read J, van Os J, Morrison AP, Ross CA. Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatr Scand 112(5):330-50, Nov 2005.

14 Rosenberg SD, Lu W, Mueser KT, Jankowski MK, Cournos F. Correlates of adverse childhood events among adults with schizophrenia spectrum disorders. Psychiatric Services 58(2):245-53, Feb 2007.

15 Hammersley P, Dias A, Todd G, Bowen-Jones K, Reilly B, Bentall RP. Childhood trauma and hallucinations in bipolar affective disorder: preliminary investigation. Br J Psychiatry 182:543-7, Jun 2003.

16 Garno JL, Goldberg JF, Ramirez PM, Ritzler BA. Impact of childhood abuse on the clinical course of bipolar disorder. Br J Psychiatry 186:121-5, Feb 2005.

17 Morgan C, Fisher H. Environment and schizophrenia: environmental factors in schizophrenia: childhood trauma–a critical review. Schizophrenia Bulletin 33(1):3-10, Jan 2007. Epub Nov 14 2006.

18 Janssen I, Krabbendam L, Bak M, Hanssen M, Vollebergh W, de Graaf R, van Os J. Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatr Scand 109(1):38-45, Jan 2004.

19 Chapman DP, Whitfield CL, Felitti VJ, Dube SR, Edwards VJ, Anda RF. Adverse childhood experiences and the risk of depressive disorders in adulthood. J Affect Disord 82(2):217-25, Oct 2004.

20 Herman JL, Perry JC, van der Kolk BA. Childhood trauma in borderline personality disorder. Am J Psychiatry 146(4):490-5, Apr 1989.

21 Harkness KL, Monroe SM. Childhood adversity and the endogenous versus nonendogenous distinction in women with major depression. Am J Psychiatry 159(3):387-93, Mar 2002.

22 Vythilingam M, Heim C, Newport J, Miller AH, Anderson E, Bronen R, Brummer M, Staib L, Vermetten E, Charney DS, Nemeroff CB, Bremner JD. Childhood trauma associated with smaller hippocampal volume in women with major depression. Am J Psychiatry 159(12):2072-80, Dec 2002.

23 Edwards VJ, Holden GW, Felitti VJ, Anda RF. Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: results from the adverse childhood experiences study. Am J Psychiatry 160(8):1453-60, Aug 2003.

24 Read J, Ross CA. Psychological trauma and psychosis: another reason why people diagnosed schizophrenic must be offered psychological therapies. J Am Acad Psychoanal Dyn Psychiatry 31(1):247-68, Spring 2003.

25 Harrow M, Jobe T. Factors involved in outcome and recovery in schizophrenia patients not on antipsychotic medications: a 15-year multifollow-up study. Journal of Nervous and Mental Disease 195(5):406-414, 2007.

26 Whitaker R. The case against antipsychotic drugs: a 50-year record of doing more harm than good. Med Hypotheses 62(1):5-13, 2004.

27 Bola JR, Mosher LR. At issue: predicting drug-free treatment response in acute psychosis from the Soteria project. Schizophr Bulletin 28(4):559-75, 2002.

28 Calton T, Ferriter M, Huband N, Spandler H. A systematic review of the Soteria paradigm for the treatment of people diagnosed with schizophrenia. Schizophr Bulletin 34(1):181-92, Jan 2008. Epub Jun 14 2007.

29 Mosher LR, Hendrix V, Fort DC. Soteria: Through Madness to Deliverance. Xlibris Corporation, 2004.

30 Lieberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO, Keefe RS, Davis SM, Davis CE, Lebowitz BD, Severe J, Hsiao JK; CATIE Investigators. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 353(12):1209-23, Sep 2005. Epub Sep 19 2005.

31 McEvoy JP, Lieberman JA, Stroup TS, Davis SM, Meltzer HY, Rosenheck RA, Swartz MS, Perkins DO, Keefe RS, Davis CE, Severe J, Hsiao JK; CATIE Investigators. Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment. Am J Psychiatry 163(4):600-10, Apr 2006.

32 Stroup TS, Lieberman JA, McEvoy JP, Swartz MS, Davis SM, Rosenheck RA, Perkins DO, Keefe RS, Davis CE, Severe J, Hsiao JK; CATIE Investigators. Effectiveness of olanzapine, quetiapine, risperidone, and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic. Am J Psychiatry 163(4):611-22, Apr 2006.

33 Morgan, S. Rethinking the Potential of the Brain in Major Psychiatric Disorders. Retrieved July 6, 2008, from http://www.mindfreedom.org/kb/diagnostics/rethinking-the-brain

34 Bernier PJ, Bedard A, Vinet J, Levesque M, Parent A. Newly generated neurons in the amygdala and adjoining cortex of adult primates. Proc Natl Acad Sci USA 99(17):11464-9, Epub 2002 Aug

35 Draganski B, Gaser C, Busch V, Schuierer G, Bogdahn U, May A. Neuroplasticity: changes in grey matter induced by training. Nature 427(6972):311-312, Jan 2004.

36 Merzenich, M. Brain plasticity-based “cognitive training” elevates BDNF. Message posted to http://merzenich.positscience.com/?p=35, Apr 2007.

37 Bremner JD, Elzinga B, Schmahl C, Vermetten E. Structural and functional plasticity of the human brain in posttraumatic stress disorder. Prog Brain Res 167:171-86, 2008.

38 Gould E, Graziano MSA, Gross C, Reeves AJ. Neurogenesis in the Neocortex of Adult Primates. Science 286:548–552, 1999.

39 Bieling P, Goldapple K, Garson C, Kennedy S, Lau M, Mayberg H, Segal Z. Modulation of Cortical-Limbic Pathways in Major Depression: Treatment-Specific Effects of Cognitive Behavior Therapy. Arch Gen Psychiatry 61:34-41, Jan 2004.

40 Schwartz, JM, Begley, S. The Mind and the Brain: Neuroplasticity and the Power of Mental Force. New York, NY: Harper Perennial, 2003.

41 Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper JE, Day R, and Bertelsen A. Schizophrenia: Manifestations, Incidence and Course in Different Cultures. A World Health Organization Ten-Country Study. Psychological Medicine Monograph Supplement 20. Cambridge: Cambridge University Press, 1992.

42 World Health Organization. Schizophrenia: Youth’s Greatest Disabler. Retrieved July 6, 2008, from http://searo.who.int/en/Section1174/Section1199/Section1567/Section1827_8055.htm

43 Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT. Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Medicine 5(2):e45, Feb 2008.

44 Lysaker PH, Roe D, Yanos PT. Toward understanding the insight paradox: internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders. Schizophr Bulletin 33(1):192-9, Jan 2007. Epub Aug 7 2006.

45 Watson AC, Corrigan P, Larson JE, Sells M. Self-stigma in people with mental illness. Schizophr Bulletin 33(6):1312-8, Nov 2007. Epub Jan 25 2007.

46 Link BG, Cullen FT, Struening E, Shrout PE, Dohrenwend BP. A Modified Labeling Theory Approach to Mental Disorders: An Empirical Assessment. American Sociological Review 54(3): 400-423, Jun 1989.

47 Link BG, Struening EL, Neese-Todd S, Asmussen S, Phelan JC. Stigma as a barrier to recovery: The consequences of stigma for the self-esteem of people with mental illnesses. Psychiatric Services 52(12):1621-6, Dec 2001.

48 Read J, Haslam N, Sayce L, Davies E. Prejudice and schizophrenia: a review of the ‘mental illness is an illness like any other’ approach. Acta Psychiatr Scand 114(5):303-18, Nov 2006.

49 For a research-based and in-depth overview of the problems with subjective diagnosing, see Chapters 3 & 4 of:
Bentall, RP. Madness Explained: Psychosis and Human Nature. London, England: Allen Lane, 2003.

Wednesday 16 July 2008

What time is it?

Some time ago, I said, I wouldn't do any commercial reviews on this blog. However, I recently received an e-mail, bringing something to my notice, that I found both true and entertaining at the same time, so I decided to mention it here: the Now Watch. Check it out, and imagine: "What time is it?" - "Let's see, oh, it is now."

BTW: I wasn't asked to do a review.

Sunday 13 July 2008

Slow scripts and Safari

As mentioned in a previous post, I've had trouble with an extremely slowed down Safari for a while. Especially e-mailing, but actually the whole business of surfing the net, commenting on blogs, and posting entries on my own, turned increasingly into a trial, and more and more often a message popped up "A slow script at (URL of the site I was at) is making Safari unresponsive. Do you want to stop running the script?" No matter what I chose, nothing happened. Yesterday, I thought, I'd solved the problem, since Safari speeded a bit up after I'd deleted some recent downloads. But no, no such luck. Safari slowed down again.

Eventually (after days and days of suffering...), I had the bright idea to google "slow script Safari" (which took what seemed like hours...), and found the, in hindsight, quite obvious advice to check for software updates for Safari. Bingo! So, Safari got updated, and is now faster than ever.

Just in case you face the same problem at some point, happen to be just as it-naive as I am, and can't figure out what to do about it (both the it-naivety and the problem itself...).

Since I see, that this post gets quite a number of hits from "slow script safari"-searches, here's an update to the post: Recently (January '09), I again ran into trouble with Safari running a slow script. There was no software update for Safari this time, but there were a couple of other software updates, waiting to get downloaded and installed - iTunes and another one which I don't remember. I downloaded and installed, and it solved the problem with Safari. Don't ask me how, why, or whatever. I've got no clue.

Saturday 12 July 2008

Choose your battles carefully

Of course, I stirred up a hornets nest with my criticism of the latest issue of Outsideren, especially of the article about psychosis.

The first reaction (by the chief sub-editor) was to take my criticism as a FORMAL such, and thus to refer to the "rules of journalism", "how to write an article", something. I replied:

To leave everything, that is said in this issue (and not only in the specific article) unchallenged alone, not only as ONE but as THE truth (and still the question is, whether some of it is as much as ONE truth at all...) is, yah, simply a bias. No matter however perfect style and layout may be.

If it really is the case, that things preferably are to be spelled out, some few and vague remarks on one of the last pages won't do (while the vagueness is of an extent, that lets EVERYBODY read whatever they want into these remarks). Doubtful truths maybe should get investigated further (research), and commented in their direct context, in order to not be misleading? Now, that everything is supposed to be so easy to get.

On the other hand, also this issue quite correctly reflects the Danish information level. So, yes, we do have a lot of DANISH truths here. Hardly anybody will realize. So, let's continue to ignore possible doubts: our belief system says the earth is flat, in consequence, it can and must not be other than flat...

And, yes, I fully understand: You DO risk to get burned at the stake (to lose subscribers and funding) [Outsideren is awarded both governmental funding and has recently been awarded a fund by Lundbeck, producer of the SSRI Cipralex and the neuroleptic Serdolect. Outsideren says, this doesn't have any influence on the contents of the zine, and I do believe, that they really do believe that...]. Rather be good! [Outsideren wants to be "Denmarks most well-behaved magazine", also giving the "experts" a chance to speak - and, geez!, yes, they get that chance!]
_______________

As a response to this, the chief sub-editor asked for people to comment on the article and/or tell about their own views of psychosis. He also asked for me to write an article on my view of psychosis, in detail. Praiseworthy.

Nevertheless, once bitten twice shy, I replied as follows:

Articles, or whatever you like to call it, from my computer, will in future only be published at places, that also have space for the deviant, the odd, the maladjusted.

No hard feelings: as said, I fully understand. And, as I also say at my blog, I have no ambitions to go on a mission, in the sense that I'd want to force anything on anybody.

But in order to be accepted around here, I'd need to identify as "mentally ill", and I'd need to subscribe to an overall view of psychiatry as blameless and indispensable in regard to contents (there maybe aren't enough beds at psych wards, places at half way houses, whatever, available, there maybe should be some more focus on overmedication, we'd maybe need more "therapists" like Torben Schjødt, i.e. on a purely FORMAL level there maybe are some things that would need improvement, but otherwise everything is just as it has to be).

I don't identify as "mentally ill", and, although I can accept that there are a lot of people, the majority, actually, who regard psychiatry as blameless and indispensable as far as contents is concerned, mine isn't such a view, I can't subscribe to this myself. So, what am I actually still doing around here?? "Let go of whatever you can't change."

As mentioned: no hard feelings! It's been exhausting and frustrating at times, but it truly also has been very pleasant on a personal level, and it certainly has contributed to me gaining some more insight in who/what I am (not), too.

Friday 11 July 2008

Change, transformation and growth

I found a link to the below video at one of Patricia Lefave's new sites, CounterPsych. In the video John Breeding talks about "Helping People w/ Psychology Issues & Mental Health Problems", about Loren Mosher and Soteria, about how "everything eventually changes and transforms" ("This, too, shall pass.") if only it is allowed time and a safe space "to be and express itself", about how important it is "to stay in present time, in space, to not let our fears and reactivity run us", about how important it is "to bring yourself into this space of calm and relaxed confidence", especially for those, who want to help people in crisis.

He also talks about the devastating effect of concepts like "permanent conditions", "permanent mental illnesses and stuff, as a condition, a state that you have and will have", that "makes it impossible to change, and transform, and grow, because it is a negation of reality, and it puts a fear..., and it puts a false premise, a big lie, in there, that there's this brain disease, when there's not."

Now some people may wonder: "Well, isn't there? I've always been told it were a brain disease." The concepts of biological, genetically predisposed, and permanent brain diseases are altogether believe-it-or-not concepts. No scientific evidence has yet been found to prove any of these concepts right, as this article by Steven Morgan, that Gianna posted on her blog yesterday, once again makes clear. On the contrary, as Steven's article states, every circumstantial evidence points towards (childhood) trauma to be the cause of existential crises.

The video in many ways can stand as a response to Sean's video on crises, supporting his views, just as it at the same time clearly contrasts with Torben Schjødt's views, indeed, exposes these as the big lies, the negation of reality, that, come into existence out of fear and reactivity, make change, transformation and growth impossible ("Many of the patients Torben Schjødt has met have never overcome their illness completely.").



Thanks to Mike (PsycheTruth), John Breeding, Steven, Sean, Patricia, Gianna... to everyone out there in the blogosphere, at YouTube, in cyberspace, making an amazing contribution to bring about change, transformation and growth, and for all the positive energy that keeps coming from you!

Thursday 10 July 2008

Criticism Anxiety, part III - or: Maybe next time?...

So the latest issue of Outsideren, the users magazine I no longer write articles for, though still do some research for, was in the mail box today. 'Will reading this issue maybe be a better experience than reading the previous couple of issues was (that were rather disappointing reading)?' I wonder, and start to read, about "medicine": "It is very rarely the ambition to get the patient completely out of the medical treatment", a psychiatrist (Jan Nielsen) is quoted. "He is convinced that the medications, that are being used today basically do have a positive effect", the article tells. And, another quote: "In addition, medication has shown to have a protecting effect on areas of the brain, among others on parts of memory (...) I think, the medication we administer today, contributes to preserve the personality." He really said that. No typo.

I read about coming off of psych drugs, another article, another interview, another psychiatrist (Anders Fink-Jensen), basically the same message: "No one should start reducing their medication without consulting their doctor." (Fact is, studies have shown that just as many people succeed reducing or coming off completely, with as without consulting their doctor first. But be careful! Quitting cold turkey is never a good idea! Get all the information you can about coming off, before you even think of starting. - I'll add relevant links to my sidebar here on the blog, as soon as I've found out, what makes Safari running this absolutely maddening slow, and have fixed the problem, that is.)

The pattern continues throughout the magazine. "Expert" after "expert" is given huge amounts of space to, at length, spread their "knowledge". By and large unchallenged. I soon realize: No, it will not be a better experience this time. It isn't a better experience. It is a worse one. Much worse. I'm rudely roused from my just recently regained, and thus still somewhat frail, Buddhist inner peace.

And it gets even worse. I had my suspicions. In context with an e-mail correspondence with the chief sub-editor, who also is the author of an article about - psychosis.

On Outsideren's blog I wrote:

Now I could take apart article by article. However, I will settle for one of them. The one about something I imagine to know quite a deal about, via first hand information, additionally to the second hand information, I otherwise mostly have to resort to. When it comes to drugs, for instance (even though I've tried also this, once - and never again!). I will settle for the one about something, I imagine myself to be an expert on, via my own experience.

"Psychoses are a defence", the headline goes. 'Hm, all right', I think. I don't agree completely, since I'd chosen the term "healing attempt" instead of "defence", 'but what', I think, 'maybe this anyway will...'

It won't. "I don't agree to this purgatory-understanding that goes, if only it gets sufficiently bad, it'll arguably get all right afterwards, Torben Schjødt says. [Torben Schjødt is the leading psychologist at Psykiatrisk Center Bispebjerg]. It just isn't true in regard to psychotic individuals, that there would be unconscious conflicts, that only would have to be made conscious."

'Where does he know that from?' I ask myself. 'Has he ever been there himself? Has he ever talked to someone who has been there, without getting immediately psychiatrized and drugged?? Someone who has received the support necessary to get through and out of purgatory without the interference of psychiatry?' Obviously not. The quotation reflects the article's essence, but also that of "Ude i galaxen" on page 7 [An account by someone who went in and out of psychosis - in each time she stopped taking her drugs - until staying on these very same drugs "saved" her: hurray for the drugs! - and for psychosis to be a meaningless brain disease that needs drugs for proper treatment!]

The essence is, that some people are more sensitive to the world - certainly because of their genes! - than others, and because of that sensitivity experience psychoses. [Actually, I find it very interesting, that Torben Schjødt says, these people experience a meaninglessness with life because of their sensitivity, the sensitively experienced meaninglessness triggering psychosis. This implies, that he regards life as being completely meaningless himself, although neither he nor most other people have the - genetically predetermined - sensitivity to react psychotic to the meaninglessness. Uhm... and this guy is supposed to be a psychologist?!]

The Stress Vulnerability Model, yah. That, by and large, is nothing else than pure biological psychiatry, spiced - and disguised - with a little "psychology", in order to make it acceptable even for those, who maybe are a bit sceptical towards pure biological psychiatry.

In addition, it also is a very appreciated model for "psychologists" like Torben Schjødt, i.e. for the majority of psychologists. Because it reduces their responsibility to only having to practice "the slightly more sophisticated" version of psycho-education. Instead of having to guide an individual through and out of "the dark night of the soul", purgatory. This being an incomparably more demanding task than the first. In human terms.

"Many of the patients Torben Schjødt has met have never overcome their illness completely." No, I have no doubt about that! It needs something quite different from what Torben Schjødt wants/is able to offer, in order to be able to give useful support to an individual in crisis. Apropos of "Psychotherapy - is there a meaning with it at all?" [A post on Outsideren's blog, that questions the effectiveness of therapy, all therapy.] There's no greater meaning with "organizing the psychotic experiences a little bit", nor with "developing coping strategies". These measures are nothing but a bit sugar-coating on top of bitter pills. And thus only suited for one thing: to keep the individual in crisis even more stuck in the crisis, than "medicine" is able to keep them.

"It is almost impossible to discuss the imaginations that emerge during psychosis,... ", the article ends. Strange. How then was it possible for Jung? Or for John Weir Perry? How is it possible for Sean? Or for Dorothea Buck? How is it possible for me???

This article isn't "the dark night of the soul". It's the dark night of psychosis-understanding. Sleep tight!

"Toxic and violent", Jane the other day wrote in a comment on my blog, the English one, about psychiatric institutions, with Torben Schjødt being the leading psychologist at one such institution. Which explains a whole lot... 'Toxic and violent... Yes, you bet!' I think, "putting down" Outsideren no.64, to go and meditate for a while - 'I'm angry. It's ok to be angry.' Yes, I certainly hope so! 'I say yes to my anger.' Hereby, this has been done! - for then to return to Sean's A quiet mind, to some much healthier reading thus, and to, hopefully soon, regain my Buddhist inner peace.

But, all in all, I guess, I'm just a little more "sensitive" than most people. Certainly because of some defective genes, yes!

P.S.: I want to point out that I'm not that much angry with Torben Schjødt. Unconsciousness and fear can hardly lead to any greater insight than the one he shows. Which I am angry with, though, is biased journalism, that only listens to the mainstream, keeping everything else at arm's length. Unless it can be ridiculed [this article not only was another brilliant example of biased journalism, but also portrayed me as some kind of complete weirdo, freak who has no clue what she's talking about] or more or less hidden away in a book review. What is Outsideren afraid of ??? ('The next issue, maybe...' , I nevertheless also think. 'It may be...')
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'What is this,' I actually thought while reading the magazine, 'The American Journal of Psychiatry in a Danish translation??' But no, each time I checked the front page, it still said Outsideren - "Denmarks largest independent users-magazine on psychiatry".

Now, I've no intention to go on a mission. If people want to believe in their "mental illness", their drugs, their shrinks (and their ego)... be my guest! I really don't want to take this from anyone. I just wonder whether I would have to expose myself to this continuously ongoing disrespect for anyone, who doesn't share their beliefs, and thereby expose myself to feeling threatened, time and again. Since, even though I deep down know, that no one (neither Jan Nielsen nor Torben Schjødt, nor Outsideren, for that sake) can get at me, unless I let them get at me, I still have more or less trouble putting up with regular confrontations with such an amount of, well, toxicity and violence. And I also wonder in how far I make myself an accomplice to the toxicity and violence (the lying and deceiving and the suppression of anything that doesn't altogether fit Outsideren's/psychiatry's belief system) by still doing research for this magazine. "Turn away from whatever you can't change"...

Tuesday 8 July 2008

How to create your own suffering

I made it, once again: I succeeded in creating some nice suffering for myself. But, well, it's been a while, so I guess, it was about time. If I wasn't to end up megalomanic.

How to do? Well, just take a minor misunderstanding about some weekends off, for instance, that presents you with an additional weekend on duty, instead of the weekend off, you have due, and then - of course without trying to do anything to clear up the misunderstanding! - rush to take on the role of the victim: "What did I say, you're not worth being shown consideration for!" the little voice in the head says. And since you got going this well, why not going all out, why settle for half-baked solutions: "You might as well vanish altogether. After all, there's no one who sees you, and thus would miss you." You just have to take on the role of the victim, whole-heartedly. The role, you maybe once found yourself in, in the dim and distant past, when you actually, and more or less consequently, were overlooked, but that you here and now only need to find yourself in to the extent you choose to ignore the present moment, and instead choose to identify with the dim and distant past. Just choose to identify with your own past, your story - as a victim. There you go.

The part of the ego, which Eckhart Tolle calls the "Pain Body", loooves this. If no one sees me, if I am that invisible, insignificant, that no one notices me, shows me consideration, if I, in the eyes of others, am nobody/nothing, I may as well resort to suffering as a last straw, and become (make myself) "the victim", right? An entire Saturday evening spent in wonderful ego-identification ("I am my story - as a victim, yep!"), and thus in tremendous suffering, and half the Sunday, too. Yeehahhh! I did great. "Voices", momentary "thought disorders", flashes of "delusions", and occasionally full stops. (While all this, and especially that which I call "full stop", prevented me from clearing up the misunderstanding, thus effectively providing the peace and calm necessary for me to be able to continue to suffer.) A little of everything. I wasn't out diving. I was about to drown. Myself in my self-created suffering.

I didn't drown, anyway, because I, deep inside, knew very well that I had hang the millstone, this great big NO! to the present moment, that dragged me deep into the suffering, around my neck myself. So, I could as well just take it off again. Since I'm sooo finished with drowning - myself in my self-created suffering. And that was what I did. At last, and not without also having tried to put an even greater NO! on top of the original one, first. Something that is suitable for applying a furthermore intensifying dimension to the suffering.

I tell this, because I often meet people who say, that all which the mental health system terms "symptoms" of an "illness", "just happens" to them, because of a quality without them, an "illness". That it is totally out of their control whether it happens, or to what extent. And, and this is the decisive factor, that control can't be achieved. Not within themselves, at least. Only and solely through means and measures without themselves, like chemistry or, in case, electricity.

Emotional suffering ("mental illness"), although most often caused by the world, is always created within and by oneself, or: within and by one's reactive (to the world reacting) ego. The end of this suffering thus only can come from within. With the insight: "Your past has no power over the present moment."
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Jane at Bipolar Recovery has an excellent post about meditation on her blog, that also somehow explains, why I nearly drowned this weekend, recently having started to practise meditation on a more regular basis as I have.

I don't expect it to get much worse though, since I've been there, facing my demons, most of them, going through fire and water, and drowning, time and again. Since I've had my "dark night of the soul". And since I've gained some swimming and diving skills in therapy ("meditation light"), too.

Friday 4 July 2008

Changing the system from within

Gianna at Beyond Meds posted a great piece, including two videos, on Patricia Deegan earlier today, where she, among other things, mentions that she'd "wish she (Pat Deegan) would talk more about the importance of freeing oneself of meds".

About two years ago, I read the Norwegian psychologist Arnhild Lauveng's account I morgen var jeg alltid en løve (Tomorrow I always was a lion) about her experiences in the Norwegian mental health system as a "schizophrenic", her recovery, and her becoming a psychologist.

I recall being slightly disappointed about Lauveng's "somewhat laissez faire approach to suggesting others are often extremely over-medicated", as Gianna has it in her post in regard to Pat Deegan.

Lauveng's account was one of the first I came across by someone who'd recovered and had become a professional, working in the mental health system, and back then I thought, it was rather exceptional for a survivor/ex-user to enter the system as a professional. Which I later on found out it isn't. Dan Fisher and Rufus May are just a couple of others who chose to become professionals, determined to change the system from within.

The problems with this are the same as they often are with political activists who choose to try and change the system from within: before they've reached a position in the system, that really would let them change it, they've often become more or less spellbound by this very same system, while another, and maybe even more important, aspect is that if you take on the role of and identify as the fighting "guerilla", fighting an enemy who you feel, fights you, you'll inevitably keep on fighting, even though there might be a shift in power, even though you one day may be the one who holds the power: the revolution devours its own children. Black people in South Africa successfully fought Apartheid, the white oppressors. Now they fight each other.

So, in order to break the vicious circle of aggression, you'd have to stop fighting, stop creating enemies, stop objectifying others and thus turning them into your enemies.

Now, I don't suggest, that either Pat Deegan or Arnhild Lauveng are any more aggressive than most people. They certainly are not, they're rather less aggressive. Still, participating actively in a system, that is as characterized by aggression (with fear being the source of all aggression) as the mental health system is, requires that one is willing to compromize with a certain amount of aggression.

In the second video, which Gianna posted at her blog, and which I'll post below, too, Pat Deegan talks about her torments while witnessing others being subjected to the same dehumanizing "treatment", like being put in restraints, that she herself had been subjected to, while being an intern at a psychiatric hospital. If she didn't want to get into serious trouble with the system, putting her position, her future as a psychologist, at risk, she had to, at least, tolerate, tacitly accept, these human rights violations to take place, with very little, if any, possibility to stop them right here and now. This, to me, is a kind of "passive aggression". It is complicity. And it is selling your soul.

In his latest radio blog show, Larry Simon talks about why he left the ICSPP, and why he stopped his professional partnership with Dominick Riccio. Although the ICSPP as well as Dominick Riccio "in private" agree with a view of "mental illness" identical to Larry Simon's, i.e. that "mental illness" is not a biologically caused brain disease, not an illness, but rather a quite healthy reaction to traumatizing experiences, and as such shouldn't be diagnozed, they still, officially, label people with diagnoses of "mental illness" (because of insurance, i.e. payment, issues), thus tacitly agreeing to the mainstream mental health system's practise of discriminating people. For the sake of cash.

Some people will maybe say, that in leaving the ICSPP and terminating the professional partnership with Dominick Riccio, Larry Simon misses out on a possibility to bring change into the system. I think, in doing so, in resisting in a passive way rather than actively fighting, he actually makes use of a very wise tactic, that maybe won't bring about change tomorrow, but certainly over time. While at the same time it allows him to keep his integrity intact to a somewhat greater extent than any further attempt to change the system from within would have allowed him to do.

Whenever someone needs to compromize, to tacitly accept, to condone, doing so makes them accomplices. Which is more or less murderous to their soul. Making people witness others being tortured, without leaving them any possibility to step in and stop the torture, is a well-known means to train these people to become torturers themselves.

Of course, entering the system with the intention of changing it, also has its positive aspects. At least there are a few people inside the system who, how carefully ever they need to tread, advocate a less aggressive way of treating people in crisis. On the other hand, the fact that they accept the system, even if certain reservations are made, reassures the system of being acceptable on an overall scale, and that only minor and rather insignificant changes would have to be made.

There are several ways how to do non-violent activism: change whatever you can change, turn away from whatever you can't change (in order not to become an accomplice), and accept whatever you can't change and can't turn away from (because if you fight it in the only way possible in this situation, i.e. by repressing it, you sell your soul). To be applied in this order.

To me it seems rather impossible to change the mental health system from within. While, on the other hand, no one forces you to stay in it and become an accomplice. Turning away from it, and maybe engaging in the establishment of alternatives outside this system, like Loren Mosher or John Weir Perry did, is possible and, with all respect to Pat Deegan and everyone else who chooses to try and change this system from within, seems to me the best solution.

Make sure to read Gianna's post. It also has links to both Pat Deegan's website and a very interesting Madness Radio interview with her.

Gaderummet - determined to continue

For quite a while I've intended to write an update on Gaderummet. I had to delay it, time and again. After weeks of waiting, the painters eventually, and rather unexpectedly..., showed up to paint my flat. Great! Finally my dim den - undressed pinewood everywhere: walls, ceiling, floor, and I'm still a quite heavy smoker... - would get lightened up somewhat. And, indeed, it got! But, of course, that meant a two-week stay at one of the guest rooms, that luckily are available here at the farm, right next to my flat. It meant the challenge of having to stay a three-steps walk away from the surroundings I'm used to stay in. I'm not good at that. Especially if I have to sleep in surroundings, I'm not used to sleep in.

Well, and then, actually during my stay at the guest room exile, I had this absolutely breathtaking experience - how to put it? - not just a step in the right direction, more like a leap, a breakthrough, something, that seized all my attention - and still seizes a great deal of it.

Nevertheless, here a quick update on Gaderummet's situation:

Gaderummet's right to use the localities Rådmandsgade 60 at Copenhagen came on last month, and June, 20th the court's ruling was announced: Gaderummet will have to leave the localities, that are transferred to two community mental health organizations, working closely together with several psychiatric institutions. Sad, but not unsuspected: no one has ever won a case against the local authorities at Copenhagen in the latter's entire history. This would have been the first time.

"Is it really possible, that an important part of all initiatives for homeless people at Copenhagen is thrown away in such a way? That from the mainstream and from what there is plenty available of diverting initiatives aren't wanted? That there is no room for initiatives that choose a different approach?" asks Preben Brandt, psychiatrist and spokesman of Gaderummet's board, in an article in the Danish socialist newspaper Arbejderen.

That this is very possible, the example of Soteria has shown, way back in the 70ies. That was the U.S., yes, and Gaderummet is Denmark. But psychiatry, and the politics of discrimination it serves, are international evils.

Gaderummet hasn't yet decided whether to appeal the decision, or not. Meanwhile they're looking for other localities to continue at least their counselling activities at, but hopefully also to be able to offer a place to stay for the homeless among the users at.

Update, July 4th, 10 am: Gaderummet decided to appeal the removal order.