Archives for posts with tag: mental illness

Heartbreaking.jpg~c200One of the most important examinations of oppressive double standards historically embedded in the medical model of psychiatry I’ve read all day  😉 :

“Implicit in a great deal of biological psychiatry is an asymmetry of explanatory principles. Normal (or healthy) forms of consciousness are assumed to be, to a great extent, under one’s intentional control and, in addition, to operate according to rational principles and to be oriented toward the objective world. While these normal mental processes are certainly assumed to be correlated with physical events occurring in the brain, seldom are they viewed as being mere causal by-products of such events, since the meaningfulness and directedness they exhibit seem intrinsic to the psyche, to the realm of meaning rather than of physical event. But abnormal modes of consciousness, at least those characterizing the insane, have often been seen very differently: as involving a ‘fall into determinism’, a lapse from dualism whereby the malfunctioning physical processes (in brain and nervous system) disrupt the mental or psychic stream, depriving it of its intrinsic rationality and meaningfulness.”
– Louis Sass

Above is the quote I have been contemplating for the last hour. To elaborate, I have been reading Madness and Modernism by Louis A. Sass. Here are some tangents which have emerged from an evening of reading and thinking:

Why is my experience of love or creativity or my choices in music seen to be mine – belonging under the blanket of individual personhood, when if I experience a projected image on the wall that others don’t see, or hear a voice others do not hear, or feel emotions more or less intense than the majority of people in the room – I am suddenly deemed to be at the mercy of my “broken brain?” Sass’s question written above is a compelling one. On the other hand, there are obvious pitfalls to thinking that my suffering or my difference is simply who I am, and that this variation in experience is in fact “me,” or at least these pitfalls are oft reported in many ineffective anti-stigma campaigns, wherein one is encouraged to separate oneself from the source of suffering or stigma, to say “I am not ‘my illness.’” But if one addresses this question with the level of careful analysis it deserves (or at least what is required to move forward and to come to any reasonable conclusions), one might find – as I am finding, that there are a lot of holes in the particular notion that we are in any way, a divided self.

For one, it features a great deal of western philosophic and pedagogical bias. The idea that this form of dualism is helpful likely stems from dominant historical assumptions in the western world, about the role of the rational mind to overcome emotional or irrational turmoil. We divide the person into two parts in this case – if we are “healthy”, we are assumed to be able to dominate the id with our ever-powerful egos.

So then, the divide between brain and self is not unlike this ongoing anxious battle to coax a part of our ‘irrational” selves into submission; only in this new, flashy, “anti-stigma” model, we attempt to say that we are somehow something more than our brains. More than our broken egos (or biological regulatory mechanisms – however you want to look at it). But what then, are we? Are we what we think only sometimes, when it looks good to us based on the opinions of others and doesn’t elicit oppressive or stigmatizing responses from the masses? Is this rational/brain piece exactly who WE are when it is convenient and when it provides congruency with society (at times, not necessarily a healthy society) and when it falls out of congruence, it is somehow NOT US? You can perhaps see why these anti-stigma campaigns aren’t so effective; they are based on some inherent flaws of simplistic dualistic thinking.

So what about alternatives? How about, I don’t know, acknowledging that we are holistic complex beings with minds and aliveness who interface with the world, and brains that reflect and respond to our environments and our minds and our aliveness and just about everything else we can imagine. How about acknowledging that these forms of duality are all western philosophic and religious inventions that in fact do not exist?

Yet, it is important to mention that many forms of dualism are part of how humans often come to experience the world. It is through my study and practice of Buddhist meditation that I have been empowered with some of the tools required to scrutinize the prevailing dominant views of good and evil, bad and good, sick and healthy. Inside this eastern context lies the realization that all human beings have delusions – that some are more in line with the masses, and some are not. One principle delusion that many societies suffer from is this delusion of separateness, or of dualism itself – that there is a self and an other, that we are not in fact interdependent and not constantly changing at such a rate at which we are at no point the same person than we are at any other point in our lives. No, this delusion is that we are discreet, finite beings with firm boundaries between us.

No wonder psychosis then, is so threatening to the dominant western establishment; when one’s boundaries with the outside world begin to dissolve, when one become acutely aware of oneness, or impermanence, of the absence of a self, when one is “inconsistent” and not following the social mores or cues of the pack, then the rules of western dualism are broken. And what better way to respond to people who challenge our fundamental beliefs (when we are in fact clinging to them to affirm our identities, because we have an inflated and delusional sense that a static self and identity are real things) than to cast them out, call them mad, crazy, deviant, dangerous, defective, essentially affirming our sense of dualism even further, because we are afraid that nothing we have thus deemed bad can be at all a part of “us.”

So our notion of good and bad, of dualism, IS the inherent problem – not who fits arbitrarily into the good and bad camps as being defined in one way or another as they go in and out of fashion. It is only in realizing that we are not fundamentally separate from anyone else on this planet (an admittedly difficult thing to do) will we then have enough empathy to save us from an endless cycles of mutual oppression and harm, or not much better – a hyperactive game of feminist standpoint bingo, wherein some people just don’t have the right education card to avoid being relegated to the loser/oppressor/evil capitalist sympathizer category, and thus creating more politically correct divisions between in groups and out groups.

As those who have experienced madness, and particularly those who live with experiences that threaten long held “boundaries” of reality like psychosis, we need to shake off this blanket of shame that surrounds some of our most central sources of revolutionary knowledge, and realize that there is in fact a place for us – not as those relegated to the sick and defective category, but as those who remind the rest of the world through the evidence our experience has rendered – that we are in fact not divided into ANY categories inherently, because WE are constantly changing and therefore do not exist. For some non-Buddhists, (and even among Buddhists themselves) this might be threatening, and of course we may be some distance away from transforming society with the empathy and compassion inherent in this notion. But the sooner we take the risk to work with our own minds, to ask hard questions, to pull apart the foundations upon which all of our stigma and assumptions rest, the sooner we will come to a place where someone with exceptional life experiences who therein reminds us of unity and impermanence – will manifest as the ironic beacons that they are. It starts with our own minds; by loosening the shackles of who we think we are, of who we think others are, we might make some room for these age-old wounds to breathe, and begin a process that can finally begin to resemble healing. Night folks ☺

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When I speak to conference rooms full of people on the topic of mental health, the most common themes to pass over my lips are: self-compassion, mindfulness, and the importance of cultivating courage, kindness, and an open mind.  The most prominent concept I speak to is change. What journalists seem to be driven to write after hearing me speak is another story, one wracked with sensationalism, voyeurism, and an incredibly narrow view.  I have yet to read an article about me that does not reference in the title the infamous buzz words attached to my name: my diagnoses. 

A number of years back, I was diagnosed with schizophrenia, the worst of all of my psychiatric name-tags I’ve acquired over the course of my 20s.  I work at a university, I hold a Masters degree, I am a therapist, an artist, I have won awards for mental health advocacy, and none of this is really a big deal – except if you remember that I apparently live with schizophrenia. 

I just preface my resume with the words “I have schizophrenia” and I dispel my reader’s hope that anything I say will be of relevance, or just as inaccurately – they may come to believe that I am some kind of hero.  Of course, neither of these extremes are true.  But people who survive a diagnosis of a major mental illness are often placed in the category of victim, or champion.  And in the mean time, all I am trying to do is to be a human being.

What would be more helpful is to accept people with all of their challenges and vulnerabilities, to not force them to put on some sort of mask in order to prove that they are over their bad days.  Bad days, bad months, bad years – so what?  What are we so afraid of?  I once had a relative say to me that I had reached my quota of bad days years ago.  It is precisely this kind of pressure to be perfect or to be “recovered” that leads people away from the self-compassionate, tolerant view that would allow them to be resilient, full human beings. I do have bad days, but they’re really not that as bad as they used to be.  In fact, everyone has bad days, but if you have a mental illness diagnosis, they are seen as somehow different – they are viewed through a pathological lens. And even though I do still have some bad days, I personally do not think too much about my diagnoses anymore on a regular basis.  However, I know that many people who meet me can’t seem to forget it.  I typically get one of two responses:

“Wow, isn’t she amazing; doing all that with schizophrenia!” or

“There’s no way that woman has schizophrenia.  She’s not representative.  What a fraud.”

As I am aware that both views are rooted in stigma, I try to ignore them.  But this same predicament affects my clients, and many of my friends.  It is certainly a reflection of a larger social injustice issue.  So I am speaking up. I try to be patient with people, but I am still waiting for the day when someone might meet me somewhere in between these extremes, somewhere in the middle, where I wouldn’t have to to play either a victim or a superhero.

A late night conversation has made me think a lot about my role in the psych survivor movement, and the importance of incorporating the truths of the people who are not privileged enough to even begin to heal, because they are under the foot of a system that continues to disempower under the guise of treatment – those who would never make it through the doors of a Laing House or a Youth Against Stigma coffee house because their shame is too deep. Although interactions with the mental health system can be likened to one with a benevolent caregiver at times, it can also be similar to an interaction with a mother who says you suddenly have to wear a sign signalling that you are now different and less than, but that the sign doesn’t really mean what it says to everyone, and she loves you … but expects nothing of you because you are were born with an inherently broken brain. These mixed messages should be acknowledged, particularly by people who are in my privileged position of living as someone that is often deemed recovered, as if my experience was a disease and not a profoundly life changing experience of loss and transformation. One does not recover from transformation. There is no need. However, I will work to include the voices of those deemed “mentally ill” who dare to show up at swanky mental health fundraisers that usually don’t even come close to representing their experience, and won’t try so hard to make everyone so comfortable. Healing is a goal, but healing can only happen when we meet everyone where they are and include them. And not everyone looks like a smiley face in a 1 in 5 ad.

It has always been far easier for most of us to look at the glamorous Margaret Trudeau, or Catherine Zeta-Jones and feel somehow that we are doing the world it’s greatest service by talking about them as inspiring examples of people who suffer psychologically.  But we are often far from ready to engage with people in the MIDST of acute suffering.  As a society, we are afraid of it.  Harkening back to Victorian times, we prize composure, attractiveness and intellectual prowess.  By failing to question these societal norms and hierarchies, we fall short of our goals of inclusiveness.  Must someone be well dressed, say all the right things, and have societal status to be deemed worthy of inclusion?

I had an interesting experience last year with a man who asked for change every day outside my door on St. Catherine Street in Montreal.  This man was complex, and sweet, and charming, and a complete hustler.  But I had come to respect him for the way he was motivated to survive – in and out of the justice system and psychiatric hospitals, he managed to pay for his injections of anti-psychotic medication by politely and consistently pursuing the kindness of the local passersby.  This man, like me, had a diagnosis of schizophrenia.  I could have been him.  Had I been born an immigrant, non-white, poor child of someone who also lived with their own mental distress, I might not be writing in the comfort of my heated apartment; I might be freezing my ass off, depending on strangers to eat, to survive.

I remember once, after having already given Robert money that day, he came up to me, ragged, disorganized, and on the border of psychosis. And I can spot that state like a soldier can smell war.  I had suddenly been pulled into Robert’s personal battle ground. I sat with him, heard his story, and gave him my last $60 for his injection, which was, as he said, a few weeks overdue.  But I struggled with the question of whether or not most of the money I gave Robert from day to day was actually feeding his hunger and his sanity, or if it was feeding a drug habit that may have been exacerbating the psychosis that he struggled daily to keep at bay.  Even though he appeared aggressive, manipulative, and sometimes downright annoying, I came to seriously respect this man’s ability to survive, as a true misfit.  I could walk down the same block and no one knew my psychiatric history by looking at me, but Robert wore his story like a potent cheap perfume.  It is people like him that we need to fight to include – because it is fear and disgust of the diversity and the complexity of the human condition, and the suffering it sometimes entails, which projects the same judgments onto the psych survivor movement as a whole.

It is as if suffering is unbearable, and we want to sit as far away from its unpredictable gaze.  We shun not only the Roberts of the world, but we secretly fear and avoid our own friends and families and colleagues who until a year ago were just like us, because we see suffering as a sign of weakness, or otherness, or inferiority.  I have to say, my experience is that it is anything but that.  Suffering is the gateway through which we open to a greater field of vision – one where we are forced to accept a more realistic, dynamic picture of the world, or else we will simply not survive.  As Brene Brown says, we live in a culture that flees from vulnerability, and psychiatric survivors and patients wear it like a badge that signifies all their battles fought with a world that fails to acknowledge their most basic sufferings as intrinsically human.  I refuse to pretend that I am invincible.  Like a compassionate professor of mine said once in my undergrad, when she saw me slumping down the hallway, about to burst into tears: “The world needs crying posts, where we can all lean against in the middle of our busy lives, and be human with dignity, and just cry.”

I can’t think of a better resolution than to embrace the dignity in vulnerability, because that is in essence the only thing the world can take from us, and the right to be whole is indeed one of the only things worth fighting for.

It was not an easy transition from the depths of mental despair into the present moment.  It was a long and arduous process.  For so long, I had lived my life as a professionally trained coward, and I don’t mean that as a judgment.  I mean that as a wake up call.  How many of us are walking around in fear of revealing our soft underbellies, of feeling sadness?  It is the constant self-reprimand for feeling sadness or anger or even shame – because shame can multiply exponentially when we try to push it away– that takes us to the edge of reason and destabilizes emotional equilibrium on both psychological and biological levels.  Our fear about simply being who we are – of feeling sad, or angry or joyful when others are sad, or even fear about our own shame – causes anxiety, depression, and despair.  Now, this may seem radical to some, and textbook knowledge to others.  And I have spent a few years telling people my painful recovery story, and fabricating a tale of transforming fear and shame into hope, but I have found empirically that essentially, fear and hope are but two sides of the same coin, and they are equally destructive. Bear with me.

The left wing creative media has done a pretty good job of warning us about us how a culture of fear pollutes our minds, our hearts, our ability to feel anything but fear itself.  It often hardens into an armor of judgment towards ourselves and others, and prevents us from touching in with our core vulnerability, our tender hearts.  But, so can hope.  This seems preposterous, some might say, and five years ago, I would have been with alongside these avid protesters, fighting for the preservation of this ever-elusive concept.  Yet, think about it for a moment.  Absence of hope does not mean nihilism, nor does it mean a dull passive acquiescing to whatever comes your way.  Absence of hope is a whole-hearted embrace of a situation with an open heart, without wishing that it be different.

In the service of hope, we strive to better ourselves, becoming preoccupied with the future, subtley telling ourselves that our present selves are not ok.  We are thus unable to engage with where we are in the present moment, which is the only place where real healing can happen.

Although hope is a common coping mechanism, like most coping mechanisms, it can outrun its course, and even get in the way.  Hope is often touted as the reason why people overcome mental illness.  But hope, or the desired fulfillment of an expectation, as it is literally defined, does not always precipitate wellness.   Because, to be honest, how often do our expectations manifest exactly as we had hoped?  And when you are depending on them to turn out in just the right way, you end up in dangerous psychological situations.  I did.  I for one always hoped things would get better, be better, that my environment and even I would get better.  I have found that self-improvement is one of the most aggressive acts towards ourselves we can commit.  When we do not allow ourselves to be ok with where we are, when we miss the only moment which we can really truly inhabit, because we spend all day comparing ourselves to others, or to a past or future self, we are doing the same as writing, in black block letters in the mirror: I am not ok. Right here, right now.  I did this for years. This self-improvement, this wish for something better, this harsh comparison to intangible possibilities,  this whittling away my body, this suppressing and shaming myself into numbness, dull depression, and even disassociation – all expressions of hope, almost killed me, literally, not once, but several times. I grew up constantly ashamed of who I was, how I was different, and because I was constantly compared to this nonexistent self I would not, could not be.

I have been given this opportunity to address this epidemic of expectation because I have been blessed with a sensitive enough constitution, and the right influences and terrible luck in my life to be placed in the position of either wake up from this toxic illusion, or die.  I have lived with depression myself , and though I think depression can have biological origins, it is clear that the environment is too a factor – and I’m not saying this to place blame – I am simply saying that our individual cultures, with all of their nuances and complexities, can inadvertently contribute to our the state of our minds in as accidental a process as a the countless complicated processes that cause cancer.

Some people can come to this realization gracefully. I however, did not.  I had to be pushed pretty far.  I’m incredibly stubborn.  I had survived depression, anorexia, anxiety, and losing major relationships in my life and I still managed to cling to the hope that I would some day be met by the approval of those whose opinions I deemed most important, and to the fear that I never would, and was destined to a life of mediocrity.  So, it took losing my mind – losing my emotion – my livelihood, my intellect, my sanity, my grasp on reality, even the expectations of others that I could even lead a mediocre life – for me to start the process of dismantling what I call endearingly – bullshit.

Yes, I was diagnosed with schizophrenia.  I may have been a frightening picture to those who witnessed this change: I slowly became was an overanxious, and otherwise zombified, nonsensical, monotone, almost averbal shell of my former self. But this severing of ties with the former honour student, actress, poet and all around normal person, precipitated the process of awakening from so many years of being a slave to hope that I would someday be enough, …and the fear and shame that I could never be.  I didn’t even fit into the same category of person anymore.  I was a used to be person.  So, I had to accept where I was.  That’s all there was to it.  But this change I speak of didn’t happen all at once.  On the contrary: I was brought to the edge of suicide, because I was brought to the edge of my own hope and fear.  I was so afraid of my own mind, of the inability to measure up to my former self, that I was prepared to die for it.  I was prepared to die for it.  As hard as it may be to hear, I know that I am not the only one.

And it took years of one day at a time, slowing letting go, again and again of my expectations and comparisons.  It is an active, ongoing process, there is no pill for it, there is no off switch that reroutes a brain that has spent years berating itself.  But it is possible.

I went from being unable to assist my parents find what they needed at the grocery store, which dashed my hopes of improvement and left me suicidal, to working towards a Masters degree in Drama Therapy, so I can help others creatively and actively heal from their own personal cultures of hope and fear.  How did I get here?  That’s really the link you probably most want to know about.  Well, I surrounded myself with people who didn’t have the expectation that I get better, or be any different than I was – people who validated my suffering, and didn’t try to make me push it away or change.  I reengaged with my creative process, and I tried with all my heart to stop comparing myself to my former skill levels, and stop hoping that I would return to some kind of prowess in any category of my life.  And suddenly, once you’ve been diagnosed with schizophrenia, it becomes easy to bypass other people’s expectations.  It’s refreshing in a way to be given a free pass to step outside the beaten path because few people continue to expect much of you, and then when you’re ready, just preface your words with “I have schizophrenia” and you’ll dispel your audience’s hope that anything you say will be of relevance, and so then they will be able to see you with clear eyes, because they won’t have any expectations.

Nonetheless, your hope in reading this blog, was probably that I provide you with some hope.  Sadly, I think I’ve failed. My story is not of one of hope; it is a story of realizing that life is workable, it is a testament to the brilliance of possibility in the present moment. What does happen when you let go of fear and hope, or at least hold them with some degree of scrutiny, is that you can work with yourself without being caught up in the shame of not meeting your expectations.  And this does not create laziness.  Absence of hope and fear is where we stop projecting ourselves into the past and future and can be in the thick of it, where real work, real healing, can happen.  I had a therapist tell me recently that only in letting go of hoping for something to be different and being with ourselves and our ugliness, our chaos, our true experience of the world, can people expect to improve from mental illness, because ironically, letting go of this desire for escaping our present into the future actually precipitates profound change.  Right here, right now.  Change can only happen in the present.  Some things, it’s best to plan for, but psychological change – I’m afraid that I’ve found it doesn’t work that way.   So, what does this change process look like, in my case?

Over time, I simply allowed and gently accepted who and where I was, and then in time, after letting go of the self-directed aggression of aspiration, my heart opened, and gradually, it became apparent that more important than my desire to be an artist of significance, was to help others.  When you start directly working with your sense of equanimity, of unconditional acceptance of yourself, then it just happens.  When you part the clouds, there you are, beautifully imperfect and you don’t even care about your own plight as much anymore because the focus has shifted, and it’s no longer all about you.  And the world, they’re not perfect either, but because you no longer judge yourself so harshly, you naturally have compassion for them, thus taking healing to a higher level and moving it into the greater world.  Suddenly, for me, after years of tumultuous emotions, and a few more of having none at all, I now feel something that is worth opening my heart for.  And the more you open your heart, the more you leap into the abyss of not knowing how others will react or if you are going to get hurt, but the more alive and human you will become.  I have not just described a cure for depression, or any other mental illness.  I still take medication for my symptoms of schizophrenia, and an antidepressant, so that I am well enough to help others.  I still struggle, and I still obsess about not being good enough.  But knowing that this is not the truth, creates gaps in the spirals of negative self-talk, and allows me to begin, again and again, to love myself.  I know that hope has its place, and it is not going to disappear for almost any of us.  But, there is the hope that I will be somehow better, smarter, more attractive, more talented, more significant.  That tomorrow will somehow bring some magic relief.  And for me, I now know it gets in the way of my mental health.  If I can provide a gentle assault to the obsequious veil of social propriety, and expectation, thus dismantling one person’s faith in its random and sometimes oppressive guise, I will say it with a smile: hope nearly ended my life.   Accepting and loving myself as is, was the beginning of my recovery.

One problem I have encountered in my journey through mental illness, is when people see mental illness as such an all-encompassing problem –  or when they see the illness as the whole picture before seeing the person behind it.  It is natural to do this.  The results of it can be disastrous, and sometimes when someone is ill, sickness can be the only thing that is visible.  But I entreat you to look deeper. In my experience, when someone acknowledges your suffering, but sees the whole person – that you are unconditionally well, behind a veil of illness, you can reach beneath it to the person who is always a lot more than their particular composite of symptoms.  We are not our diagnoses.  And This is not just a catch phrase.  We have to see a person’s value ourselves as clinicians, or how can we expect them to see it?  We have to envision something if we expect it to ever be possible.  The danger of seeing an illness first, is that you see the purpose of treatment as symptom reduction only.  But we are not symptoms to be reduced.  When we have confidence that a person can return to wellness, when we focus on the inherent wellness of the person instead of the symptoms, we can then circumvent this traumatic clinical battle against some slippery, almost undefinable disease, with the patient as the battleground.  Now, how does it feel to be the battleground? Some of you can tell me at the end, I’m sure.  From my experience, it sucks.  You end up fundamentally hating a part of yourself, or living in fear of it emerging.  Those parts you are often taught to push away– they ARE you.  Different parts of you.  And only when you can face them, accept them, and embrace them, can you hope to dissolve them and reabsorb them into the well from which they came – you.  And the you, is basically fine.  If the patient can be seen as basically good, filled with potential, that their case, their trajectory, is workable, and our coworkers and bosses and family members can all be seen in the same way, we resist the urge to project our ideas onto them and fix them, because we trust that they’re words are valuable, that they are simply people in need of assistance – people whom WE are serving, and that they are a part of this process too. And slowly, we learn to see not just our own role in the helping process, but also, simply the people front of us.

When we see a patient as a person, we can hear what people are saying to us, instead of looking for key words to help guide us into putting their concerns into little boxes of diagnositic criteria.  Suddenly, then you can communicate better, and you collaborate better.  Slowly, when the ego and the fear normally propagated by our training and by the existing medical model fade into the background, wisdom mind, and the true ability to heal and be healed, will begin to surface.  And when I’m having a particularly unenlightened day and I think this all sounds flaky, I ask myself if that’s my fear and my ego talking, or my intelligence.  And then I laugh at myself, swallow my pride, and my defenses relax a bit.

But seriously, We have to expand our notion of human potential if we are going to surpass cynicism and open to the possibility of real healing, and not just bandaid solutions, and revolving door treatment; but like pioneers and revolutionary thinkers in all cultures, one has to take a journey into unknown territory first,.  For one, psychiatry, although essential, does not replace the wisdom of having worked with one’s own mind on the level that peer support workers have had to. With their complimentary expertise, they could also be leaders in the health care world – they get it, and are examples of healing in the face of many voices which say it is possible, but don’t really expect it.

Regarding peer support: It is Interesting – med school goes beyond the experience of most patients and family members– most are not doctors, but so too does mental illness transcend and move outside the realm of direct experience of most psychiatrists – how then can they be the only  guide in healing someone when their knowledge is theoretical, and  does not really know the territory with first person experience, and have not known what it is like, and perhaps don’t know what it is they are healing?  When they don’t agree with the patient on what they are healing?  I’m not saying they aren’t knowledgeable and that they shouldn’t be commended for their essential and powerful healing role, but peer support is like the oldest type of healing on our earth –shamanism – where one who has transcended common perception of reality or suffered in some extraordinary way steps into their suffering, and beyond it, to help others  – peer support is, in a way, a resurfacing, of some very important and ancient aspects of healing.

Peer support also validates that a patient might have some wisdom – integrating peer support is part of establishing this unconditional wellness and wisdom view in the mental health system.  And, when dr.s and nurses see former patients working and benefitting their team, it can help to reduce the stigma that is actually present and natural in the mental health system.  It is important to recognize that we do carry stigmatizing views as mental health professionals.  Because we have a tendency to see worst case scenarios and acute cases in front of us, we sometimes forget that there is life after and outside of the hospital or the clinic.  No one is trying to provide false hopelessness, but as I (and Daniel Fisher) would argue, the inadvertent communication of false hopelessness is a much more harmful systemic danger than false hope. We need to leap.  We need to restructure our systems around how we can go forward, and envision more for our clients.  Daniel Fisher, who I just mentioned, a psychiatrist and former ED of the US National Empowerment Center, often talks about how we must dare to love our patients, to care deeply and to give them hope if we are to influence them in a positive direction in their most vulnerable of states.  Daniel Fisher might be considered radical in his proposed empowerment of people with mental illness, but he has not come up with these propositions out of nowhere.  Daniel Fisher is not only a psychiatrist.  He also lives with paranoid schizophrenia.  He has experienced the system, and has seen what makes a difference from both sides.  He talks about that one person he met who listened, who told him he could fulfill his dreams – in his case, going to Med school to change the system.  That person made all the difference.  We are more powerful as influences in each others’ lives than we may think.  Just as that nurse stayed up with me in the Bridgewater psych ward  7 years ago and validated my concerns, and offered me realistic hope, all of us can be that voice that changes a life.

And evidence is behind me in this regard.  But vision always precedes evidence.  Courtenay Harding had to have the faith that her radical psychosocial experiments with people with schizophrenia could produce results, or she would never have been able to convince others to get behind her in performing these large-scale, longitudinal studies.  She needed to trust her instincts, that these people weren’t irrevocably damaged.  And, as many of you know, she found that– people get better not with standard care, but with holistic, psychosocial, collaborative, community-centered care and a view that these subjects, these patients, these human beings, were not broken– still, this study published decades ago, and others, have not managed to infiltrate the predominant medical model to the degree that many of us have hoped.  It is true that multidimensional, psychosocial and early treatment programs are emerging, but as you know, we still have a long way to go.

We don’t necessarily need one more nurse, a different psychologist, a more cooperative, “compliant” patient; we need a bigger view; we need a systemic shift in purpose and a return to awareness about the reasons why we are helping these individuals who are struggling.  In helping them, we help our larger society.  If we propagate insight, and not neurosis, we create more wisdom and resiliency.  How we treat our sickest people is how we treat ourselves, and vice versa. – they, or we, do not need the paternalistic, categorical problem-solver of old – we need people who can see past our struggles and remind us of our own healing capacity and wisdom, our own unconditional value underneath all of our supposedly wrong views or behavior.  Remind us of our agency and dignity, and we will rise to your challenge.

 
I’ve been thinking about the recent discourse around treating mental illness in this country, and about the holistic approaches purposed by the Mental Health Commission of Canada. As much as psychosocial and alternative means to treatment are implicated in this document, I wonder how much attention will be given to establishing this essential part of the health care system. I worry a bit about the direction of research, and what we choose to make available based on our narrow scope of exploration. It comes down to an issue of funding, because without established evidence to attract funding, many avenues will never be explored. In psycho-pharamceuticals, for example, it is far too expensive and risky to fund anything but variations on the same drugs which have been used for decades now. Science is indeed under a bit of a stranglehold by it’s own scientific research hegemony, and by the economic systems and companies funding research. Even though one may utilize science to discover what is accurate about any chosen field of exploration, what is being chosen to explore is highly influenced by politics. What we have so far discovered to be useful in terms of treatments for mental disorder, for example, is a direct result of this influence. Although there is of course great merit in evidence-based treatments, it is always important to remember that they are only the best among the narrow scope of what we have so far chosen to study. If we always assume that all possible avenues of treatment have to be extensions of what has been studied and has gone before, we may miss out on real possibilities for innovation. If we hadn’t had the possibility of studying divergent areas in the past, where would we be now? That is why this current funding situation is of concern to me. I am a big fan of science – so much so, that I worry that the lack of support for alternative developments (including treatments outside the scope of big pharma) undermines not only science, but the future health of those who suffer from mental disorder. Any thoughts?

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CBC documentary – From the Heart

A documentary done by Dick Miller at the Canadian Broadcasting Corporation on mental illness, exercise and creativity.  Dr. Stan Kutcher and I are interviewed, and my poetry is featured.