To Never Abandon the Pursuit of the Possible

This past week I was thinking about resilience.  What enables some to overcome and thrive while others fall into and remain trapped in the pitch black rabbit hole?  I thought about what I had written about resiliency in A Fight to Be and after re-reading it I copied it below.

“They are the ‘invincible kids,’ the survivors of horrendous abuse and neglect. They have defied their predicted fate. Unlike children whose troubled adult lives reflect the trauma of their childhoods, these children develop into “well-adjusted adults.” Their ability to thrive despite the adversity of their environment and upbringing was once thought by experts to be mainly the result of being born with certain innate abilities and temperaments. The longitudinal research of child psychologist Emmy Werner is helping us to understand that many children have the capacity to overcome even the most staggering odds. Her results suggested that the developmental outcome was more dependent on the quality of the environment in which the child was raised than the biological or psychosocial risk condition. Werner and Smith studied a cohort of 700 children born on the island of Kauai from 1955-1995. Due to multiple risk factors at birth, approximately one-third of these babies were considered high risk. Of these, seventy grew in healthy ways and developed no severe problems. They appeared to be invulnerable to their life-compromising risk factors. Moreover, Werner’s follow-up of children at age forty suggests that a person who has faced childhood adversity and overcome it may do even better in later life than someone who had relatively smooth childhood experiences. The resilient children reported stronger marriages, better health and little sign of emotional turmoil when compared with those who enjoyed less stressful origins.

I am struck by the parallels between the resilient kids and psychiatric survivors. What are the informed guesses about who will survive and who will thrive? The Kauai study shows that despite highly adverse conditions, the presence of later positive experiences with a caring adult, and circumstances like a safe place where trust can develop, can help the child to grow into a confident, caring, competent adult. I am particularly impressed by how similar buffers (protective factors) are important to both psychiatric survivors and the “invincible kids.

Defying the gloom-and-doom predictions of experts, the psychiatric survivor and the resilient child teach us valuable lessons. With evidence showing that children born into terrible circumstances are able to thrive, and research showing recovery from schizophrenia, we need to direct our efforts at constructing pathways to resiliency. The research indicates that the lessons learned from these nearly invincible kids can teach us how to help all kids to handle the inevitable risks and turning points of life. Instead of exclusively studying children who fail, we can focus on learning from the children who survive and thrive. The same might be said for studying the stories of psychiatric survivors.”

Every soul has to learn the whole lesson for itself. It must go over the whole ground. What it does not see, what it does not live, it will not know. (Ralph Waldo Emerson)

Exploring Identities of Psychiatric Survivor Therapists: Beyond Us and Them

Our new book has just been published by Macmillan Palgrave.  I copied our Acknowledgements here to express my appreciation for those who helped and encouraged us.

We acknowledge and offer our solidarity with the past and ongoing efforts of the psychiatric movement in their fight for seal-determination, human dignity and respect.  We thank our friends and family for their support through the process of writing this book.  Several colleagues took time out of their busy lives to read drafts for us, and we thank several people for their feedback on earlier versions of this book.  We are incredibly grateful to Dania Sheldon for reading and giving invaluable feedback on the book’s content.  We also thank Erica Lillelecht, Shannon Hughes, Darby Penney, and Claire Chang for reading and giving helpful feedback on sections of the book.

I am hopeful that our work promotes critical thinking in the halls of Academe and spills over into the community at large.

Hearing Voices, Visions and other Non-Ordinary Realities

“Man is the leopard who knows how to change his spots.”
Lewis Mumford, Sociologist and social critic

On Monday, October 2, I am scheduled to be interviewed on NPR’s Colorado Matters.  The topic of the interview is an introduction to the international Hearing Voices Movement, an important breakthrough in re-defining the meaning of voices and visions for people who experience them.  I have been co-facilitating a HV group for almost 2 years in Boulder, Colorado.  I deeply believe in the importance of both this and the myriad of emerging services that recognize the significant wisdom and contributions of people who have taken personal responsibility for re-constructing an identity that rejects diagnoses that come with a life-long illness label.  People may identify themselves as psychiatric survivors, consumers, ex-patients or as peers.  Their lived experience provides a diversity of expertise that demands change.  Respect, inclusion and an honoring of one’s basic rights are among the demands for services and supports that provide choices which recognize that an individual’s needs are not static but dynamic and changing.  What works for one, may not work for another.  Most who have experienced treatment for “madness” and have recovered know that a psychiatric system that relies exclusively on psychiatric drugs has been a colossal failure.

Extreme emotional states do not need to be permanently incapacitating.  In my decades of work, first as a patient diagnosed with schizophrenia in my 20s though my work as a psychologist, as an educator, activist and psychotherapist, I know that people are able to transform and overcome their deep and painful emotional struggles. They can and do live fulfilling and vibrant lives. Time and time again, people have demonstrated their remarkable capacity to overcome just about anything. 

When treatment choices are few and unwanted, and services are forced upon people, we are left with despair, hopelessness, and dependency.  Absent hope and discouraged from believing in possibilities, too many potential beacons of light have not been able to manifest their gifts. Those who have pushed the boundaries of compassion and understanding regardless of the cost continue to create the building blocks for those who follow to continue to move the work forward.

I do believe that an individual as well as a community – perhaps even a country can change.

 

 

Exploring Identities of Psychiatric Survivor Therapists: Beyond Us and Them

I am very excited about the new book I co-authored with 3 friends – it is scheduled to be available next month.  Below is an excerpt from the flyer that our publisher, Macmillan is  now distributing.  We are hoping that our work has an impact on the education of mental health professionals so that the expertise generated by lived experience is valued and incorporated into future academic curricula.  Most important to us is that aspiring professionals who have experienced and have worked through extreme emotional and cognitive states will not be disadvantaged and discriminated against but rather have their struggles regarded as potential assets.  If it becomes easier for people to be open about their past, progress can be made in understanding the pain, confusion and mystery of what it means to be fully human.

Here is the blurb from the Macmillan flyer.

Exploring Identities of Psychiatric Survivor Therapists: Beyond Us and Them
A product of Palgrave Macmillan UK

This book is about people that are uniquely situated between the realms of activism, within the Psychiatric Survivor Movement, and their careers as mental health professionals. It focuses on the co-authors’ navigation and juxtaposition of the roles of psychiatric survivor, mental health professional, and activist. Psychiatric Survivors is an international movement advocating for human rights in mental health systems and supporting humane and effective alternative options to mainstream practice for help seeking.

Drawing on past research as well as the co-authors’ own experiences, the volume explores identities of people who identify as both psychiatric survivors and mental health professionals, discussing the potential for further dialogue between psychiatric survivors and mental health professionals to create humane and person-centred communities of healing.  This book is specifically targeted for practicing psychotherapists and graduate students, to gain new insight into the Psychiatric Survivor Movement and to appreciate the value of lived experience and of psychiatric survivors’ efforts shaping the future of mental health care.

Alexandra L. Adame is an Associate Professor of Psychology at Seattle University,
USA. As a qualitative researcher, she has written about the Psychiatric Survivor
Movement and existential approaches to psychology.

Ronald Bassman was diagnosed with schizophrenia in his early 20s. He is now a licensed psychologist. He is the current chair of The Community Consortium, an organization that promotes civil and human rights of people with psychiatric disabilities.

Matthew Morsey is a psychotherapist in full time private practice. He has spent the last two decades promoting and providing alternatives to the medical model and organizing conferences, workshops, and protests within the Psychiatric Survivor Movement.

Kristina Yates is a retired Marriage and Family Therapist. After surviving forced electroshock treatment, she has been a mental health activist with MindFreedom International and has published in anthologies such as Beyond Bedlam: Contemporary Women Psychiatric Survivors Speak Out.

 

Crazywise

Last night I showed the documentary, Crazywise to about 35 people at the Meadows Branch of the Boulder Public Library.  Audience discussion followed the presentation.  I believe this film is very important for raising community consciousness, so I’ve taken on the task of presenting it in different parts of Colorado.   There will be another event in Boulder this Fall and I am in the process of planning events for  Denver, Fort Collins and Longmont.

Crazywise is being shown in various venues in the United States and internationally with no charge to those who attend.  Crazywise was produced to challenge the mainstream prospective on “mental illness”and the dearth of treatments and supports available to those who experience extreme altered states of emotions and consciousness.

What follows is a brief description from the filmmaker and a comment that is pretty typical of those who have seen Crazywise.

Crazy…or wise? The traditional wisdom of indigenous cultures often contradicts modern views about a mental health crisis. The documentary CRAZYWISE explores what can be learned from people around the world who have turned their psychological crisis into a positive transformative experience.

 “I can hardly describe the effect that this incredibly powerful and profound documentary had on me. I cried at the end. It touched my soul and moved me beyond words. I felt connected to the reality of the folks in it. I have always felt a spiritual dimension to having voices and seeing visions.” Joanne Newman

 When Crazywise comes to a community near you I strongly encourage you to find a way to attend.

 

 

The Healing Mystery of Placebo

“Facts do not cease to exist because they are ignored.”  Aldous Huxley

Pavlov’s “scientific” discovery of the conditioned reflex had a profound impact on psychological theory.  Motivated by their obsessional hyper attentiveness to food, dogs salivated in anticipation of food when Pavlov paired the ringing of a bell with a food treat.  Today, dog owners still use some version of this principle to train their dogs.  So I wonder, do all breeds of dogs with varying experience respond similarly?  Do abused dogs show the same propensity to salivate in anticipation of food?  Would fear and the lack of trust inhibit their responses?  Given a large amount of time and training could the dog whose personality had developed in a milieu of abuse learn to salivate like other dogs in response to the bell?  Would it follow then that the abused dogs would  become trusting and less fearful or would such dogs just learn to salivate to please their masters while remaining skittish and untrusting?

One of my favorite cryptic sayings:  If Pavlov had used cats instead of dogs, he would not have discovered the law that bears his name.  No amount of bell ringing would have made the cats salivate on cue.  Those of us who have lived with cats and dogs are very aware of the difference in these two species.   Whereas dogs thrive when dependent on humans, cats resist being controlled and seem to be driven to assert their indifference to following human directives.  Since human beings as a species are more diverse than cats, should not our complexity be addressed?  Unfortunately, our culture continues to incentivize the fruitless search and promotion of a one-size-fits-all solution for those who are struggling to find their way.

Even with the life-prolonging successes we see in dealing with diseases of the body (not an endorsement of dualism), we are still forced to pay tribute to unintended consequences – like the evolution of superbugs that challenge the benefits of antibiotics.  Magic, or what I might define as that which mystifies and stumps our usual ways of understanding, takes many forms.  When dealing with psychic suffering it can be argued that our standard approaches are often less successful than when we relied on magic.  A particular slice of magic that attracts me is the placebo effect.  Placebos, after many years of being dismissed as a confounding nuisance to be neutralized for research purposes, has risen to the status of independent variable worthy of study.  I wonder how hope, belief and expectation merges with and enhances the power of placebo.

Who among us is not familiar with pain, be it physical, emotional or spiritual.  We live with knowledge of our mortality and we choose a belief system (or use denial)  to make our inevitable death seem tolerable.   Perhaps for our ancestors, because it was necessary and reassuring to believe in magic, they were able to reap its benefits.   Absent modern pharmaceuticals, they treated physical and emotional pain with herbs, shamanic rituals and the support of the community

Life is mysterious and often less predictable then we are led to believe.  Francis Ashcraft, a scientist who is a professor of physiology at Oxford and author of the book, The Spark of Life has said, “All science is theory.  It is a continuing and evolving story narrative.”

After all of the  years of research dominated by a drug and illness approach to problems in living, we have not  benefited from the results to the extent that we have been promised.  Maybe it would be more fruitful to learn how to maximize Placebo Power.

 

The Healing Power of Being Truly Seen: Genuine Relationships

Doctors pour drugs of which they know little, to cure diseases of which they know less into human beings of whom they know nothing.”  Voltaire (1694-1778)

The practice of the medical professions in 2017 in the United States is costly, impersonal and discouraging.  Rife with inequity, perhaps it is merely a reflection of a culture that celebrates those who are successful and barely accords empathy and compassion for those who are regarded as undeserving Others.  Although scientific knowledge has charged forward, I question whether the quality of life for the majority has risen.  More technology, toys and diversions leave too much of life unexamined.

In the 19th century, Dostoevsky documented his experience as a prisoner in Siberia in his novel, The House of the Dead.  He wrote glowingly of the emergence of the new medical doctors who served in the prison hospital.  He described how the mistrust of those pioneering doctors was quickly overcome by the kindness and caring that the physicians brought to their relationships with the inmates.  Dostoevsky recognized what we are re-discovering – that it is the relationship between doctor and patient that is at the core of healing.

A few days ago I found an old book of mine, Dissent in Medicine: Nine Doctors Speak Out.  The book was published in 1985.  In it, prominent physicians were lamenting the demise of the doctor-patient relationship.  For many years I along with many others have been critical of how psychiatry is practiced.  Dissent in Medicine affirmed for me that dismissing or even ignoring the essential wholeness of patients was not a practice limited to psychiatry.

One of the nine authors, Dr. Robert Mendelsohn, declared, “I have long felt that medicine is a religion” and considered himself to be a medical heretic.

In the book’s introduction, he writes about learning in medical school the catechism of the Religion of Modern Medicine.  He describes it as follows;–“When asked a question by a patient, the proper response is ‘Just trust me,’ or to a female patient, ‘Just trust me Dear.’  When faced with a patient who offers information different from what you gave him, the proper response is – ‘What medical school did you go to?’ When faced with an older person – ‘What do you expect at your age?’  When trying to sell a hysterectomy—‘What do you need your uterus for? It’s just a sack for cancer.’ Or—‘We’re taking out the baby carriage but leaving in the playpen.’”  Dr. Mendelsohn’s explains: “Doctors have strange ways of thinking.  The impact of medical education is so powerful that we doctors develop different thinking patterns from the rest of the population.”

With the introduction of the internet and google, we now can find resources about our health and how to be proactive.  Yet it remains my hope that in our future, the value of relationships will be integral and primary in all of our healing endeavors.

I refuse to be discouraged.

 

 

 

“The color of truth is grey.” Andre Gide

Unhappiness with our lot in life is not an illness.  Learning ways for our communities to increase their members’ capacity for empathy and compassion is a more worthwhile pursuit than discovering new psychiatric drugs.

Understanding how people utilize their biology and developmental experiences to best access their potential and how some of us come to overcome emotional and physical pain eludes formulaic solutions.  We have learned only a few of the elemental factors that have the potential to nurture the transformations that we seek.  Yet I believe that we have within us an innate need to aspire to realize our unique potentials.  Unfortunately for many of us, the required freedom to pursue our goals is not equally distributed among us.

I am convinced that there are many paths that can help you realize your desire for personal growth and transformation.  I believe that if you are persuaded by some “expert” that you must limit your aspirations, you will be Limited. Because no two of us are alike, we must resist our culture’s reliance on some designated expert to find a uniform panacea for everyone to adopt.  Most of us are social creatures with a need for contact and relationships. Yet we must leave space for those of us who desire periods of self-imposed solitude.  Not fitting into the mainstream is not a disease unless one’s culture only leaves room for mindless conformity.  Exempt are those who have some outstanding talent that is revered by the community.  Then you will be considered eccentric rather than a deviant who is to be controlled. The freedom to be eccentric or different should not be an entitlement that is only given to those who have extraordinary gifts

If you are made to accept that you have only one primary option it is likely that you will continue to be stuck where you don’t want to be.

Endorsements of unique products (supplements, drugs) or methods (types of exercise, psychotherapy, prayer, meditation) are ubiquitous.  Who hasn’t heard the familiar refrain, “I tried everything but nothing worked for me until I tried _____.”  Although some of us are successful in finding what helps propel us forward in our quests, too often we become discouraged by our failure to find the right model to meet our needs.  I believe that if you persevere and remain open to possibilities, you will have the opportunity to find what works specifically for you.  My experience has taught me to be wary of guaranteed paths to success.

Below are some suggestions that I found to be helpful:

  1. Maintaining the steadfast unyielding belief that change is possible.
  2. To expect the desired changes to occur.
  3. The willingness and patience to apply self-directed discipline to the practice of the chosen endeavor.
  4. To be open to self-reflection in evaluating the benefits of what is being tried.
  5. To ask for and consider the feedback and support of those who are familiar with you.
  6. To move on if you have given sufficient time to what you have attempted and there are no hints of positive results to encourage you to continue with this method. Choose another path for bringing about the changes you desire.
  7. Finally, recognize that your attempts that have not worked are not failures. Each effort you make is a potential success that may become manifest at a later time.  In fact, you might re-try at a future date what has not worked in the past and find that it does work when the timing is different and when different needs, values and priorities have emerged.  Remember that we are dynamic and changing beings.

Of course, the above suggestions are not definitive, but merely offered to encourage a Never Give Up attitude in service of keeping hope and possibility alive.

A few pithy insights from French author and Nobel prize winner Andre Gide:

“Believe those who are seeking the truth. Doubt those who find it.”

“One doesn’t discover new lands without consenting to lose sight, for a very long time, of the shore.”

“Dare to Be yourself.”

 

In a Time of Fear and Scapegoating of the NOT US

Every soul has to learn the whole lesson for itself. It must go over the whole ground. What it does not see, what it does not live, it will not know. (Ralph Waldo Emerson)

Many of us see the end of the old year and the beginning of a New Year as a time of reflection.  My contemplation turned to thinking about what I had published ten years ago in A Fight to Be.  What follows is a short piece from that work that I believe remains relevant for today’s fearful and troubling times.

When I think of the wide array of people who have struggled, who have won or lost or who have remained stuck in their struggles to become, I do not see illness. Instead, I look at the dynamic interplay of courage, fear and safety, where individual and social structure clash. Childhood nightmares inform us of the intensity of fear that the mind can create. Fear restricts the roads and landscapes available in one’s journey through life, but it can also generate the motivation necessary to make powerful changes. Although some are blessed to be born with the temperament, abilities and tools that initially enable an early integration of fear-courage-safety, for many, this key triad is in an unstable flux that demands vigilance. Balancing and resolving the shifting requirements of this life-long developmental task has no immutable rules, laws or guarantees. A bolt of lightning or invading virus can cancel all prior resolutions.

I believe that the price of predictability and safety is too steep.

Can we evaluate our evolutionary progress as a species by calculating the percentage of human beings who experience more joy than pain during their lifetimes? While the volume of information we are exposed to has increased exponentially, our capacity to absorb and use that information lags far behind. While the human population continues to increase, the diversity of other complex life forms appears to be decreasing. While people are being told that there are greater numbers of emotional problems and behaviors that deviate from the norm, the norm itself is shrinking. While the need for tolerance and compassion is increasing, competition for shrinking resources feeds our intolerance for the not-us outsiders. Identifying those that are different from us as the source of our misery enables us to avoid the pain of our existential angst, but at too great a cost – alienation from self and others. It is essential to create and multiply the number of acceptable and productive roles available to all people. With our increase in numbers and technology, our humanness needs more encouragement.

Is it any wonder that the people who do recover from extreme and painfully troubling emotional states are the very ones who have challenged and rejected the mental health enforcers’ pronouncements and carved their own way into a new life? The people that I know who have transformed their experience are easily recognized by their passion, vitality and appreciation of life. They are winners by virtue of having engaged in the process of peering deep inside and not being destroyed by what they encountered. Victors in the fight to find meaning and identity, they are reminiscent of people who have survived near death experiences – their understanding and identity changes.

When you allow yourself to descend into the depths of an altered state, the need for safety moves from foreground to background. When you pass death’s threshold as described in near death experiences, safety’s demands are radically modified. I believe that we actively make a decision to let go when we enter a different realm of consciousness. In time-tested mystical traditions, one’s decision is reinforced by a commitment to rigorous preparation. Most of us do not have the determination, clarity of vision or access to that special guide who is right for us. Instead, we accommodate to our fears and life demands. But for those who must deal with too much fear, who cannot navigate the limited number of paths presented to them, who lack the skills, self-esteem, societally approved competencies, who have been hurt repeatedly, who feel the constant pain of extreme sensitivity, who have not learned how to trust or love, or have never been loved in a way that matched their needs, who see no future and abhor themselves and hate their life story . . . when critical mass is reached, there is a choice – to forgo safety and risk all. Our culture reflected in our mental health system is not a facilitator of growth and change if it cannot permit a person to risk one’s life in an attempt to create a future which is not a continuation of a predictable and horrific past.

The Wisdom of Personal Stories

The 18th century philosopher, Rousseau believed that we are different than all other animals because of what he called our perfectibility.  We are capable of developing and changing.  The gift of possibility is there for us throughout our lives.

Neuroscientists have now recognized that the brain keeps growing. Just like other muscles, we must use it or lose it.  It always has the potential to change and grow regardless of our age or condition. This concept – neuroplasticity has finally achieved some mainstream credibility. Humans are a work in progress.

From antiquity to the present day, madness has stubbornly resisted numerous and varied attempts to unlock its unwelcome grip on human beings. Historically, people who experience extreme mental and emotional states, struggle not only to find their way, but even more so from having to endure harmful treatments. Too often, desperate, ill-conceived attempts to control, prevent, and eliminate this frightening and confounding human condition (many times more disturbing to those around them} have resulted in severe and painful damage to the minds and bodies of people whose voices, rights, and feelings are scorned.

Until the latter half of the 20th century, knowledge of madness was the exclusive domain of the professional observers and treaters of madness. By virtue of being mad, a person was deemed to be without credibility and unable to contribute any meaningful knowledge to help understand madness – their own and others.  But the compelling need to give testimony to what one has experienced and witnessed has defied all attempts at suppression.  A vast store of once rarely read first-person stories bears witness to the need to reclaim their voices and find a way to speak of their own hard fought for wisdom.  I wonder why so much useful information that comes from their lived experience does not get used and valued.

How can mental health professionals understand complex life stories, when they are content to work with stereotypes – categories (diagnoses) that are used to explain what we do and who we are?   I see too much value given to simplistic formulaic responses that are revered as evidence based treatments. I think we can guard against going off course by looking at how people live their stories.  What do people do when unfolding events do not match the script that they and their families planned and envisioned?

A friend, who is a lawyer, well respected for her mental patients’ rights work, condensed her personal work philosophy into the four following statements:

1) No matter how messed up people are, force and violence and coercion usually make things worse.

2) No matter how messed up people are, almost always they will have a pretty good idea of what they need and what will work for them, and since most treatment is guesswork and the best treatment involves respectful attention, mental health treatment should aim its guesswork at respectfully attending to what the person says he or she needs and working with them on that.

3) Leaving people in the places where they live and where they have natural communities is almost always going to be better than locking them up in places like hospitals, where the primary goal is going to be the maintenance of order and control  (no crying, no sobbing, no raised voices, no being really upset in mental institutions).  I think institutions and the practices they breed, like seclusion and restraint are fundamentally inhumane, and they don’t help people get better.

4) The worst thing that can happen to anyone in severe emotional distress is to be labeled a mental patient.

People need safe affordable places to live, educational opportunities, friends, intimate relationships, to have families, raise their children, get jobs that give them the chance to advance and be able to see the future with hope and optimism.  We need communities that can tolerate, no better I should say appreciate and benefit from difference so that those who look act or perceive differently, can still find a community or social network of their choice where they can be fully integrated and valued.

Mental health services are most useful when there is a collaboration where growth and development permeates the relationship — where there is respect, dignity and equality.

No one is immune to the physical and emotional pain of living.  Such is life and perhaps especially so in these times that we live in.  Who would not want a quick fix…a pill…a strategy – one that works quickly with no ill side-effects …. one that would not interrupt the pursuit of our potential or corrupt our values?

Human growth and development thrives in an environment where there is support, encouragement — and a dynamic balance of risk and safety.  When there is no clear evidence of  harm to others, the quest for identity, authenticity, and the struggle to realize and act upon one’s potential should be a right for all.