Psychiatric survivors, labels and me

If any organism fails to fulfill its potentialities, it becomes sick. William James

Ω

The deleterious effect of evil, pernicious, stigmatizing labels is at the core of psychiatric survivor discourse™, so of course it makes me wonder why I don’t care about mine so much, like — what am I missing here, am I insufficiently outraged about a civil rights injustice?!
Borderline, Bi-polar, Schizophrenia, these official stamps of psychiatry will lead to life of ruin, they say, while saying not so much about the label that actually got them committed. Puzzling, but later for all that. The thread on BPD at the only blog that matters has me head in a spin.

I identify with borderlines, my life’s been filled with them, I have it in me, it’s a hellish disorder. I’ve only seen doctors in offices. In the room, every diagnosis came at a snail’s pace by reluctant treaters who always provided the caveat that what they do are “diagnostic IMPRESSIONS” — their best opinion, that others might not agree with, including me. Fair enough. Over many years 3 different diagnosticians gave me a Cluster B (Dramatic) Personality Disorder Not Otherwise Specified, all of them working independently without reading each others notes, and all of them placing an AXIS I diagnoses as the primary concern, whether major depression, bi-polar, PTSD, hysteria (conversion disorder) or some kind of schizophrenia. The docs I saw regularly who presumably knew me best were adamant that I do not have BPD, and I wanted that diagnosis, to feel closer to the people I love, and the musicians I relate to, all the luminous, sullen and delicate cutters.

I just last week sat down for the first time to read the opinion of the psychiatrist who evaluated me for the Social Security Administration. It’s been sitting here seven years and I’m aware that I have feelings about it before even reading it, the language is very sobering. I saw this SSA psychiatrist for 90 minutes and turns out he settled on “a long-standing and well-documented history of borderline personality disorder” with the following attached:

Dr. Aitcheson’s testimony is well-supported by the objective medical evidence, which establishes a deeply ingrained and maladaptive pattern of behavior associated with oddities of thought, perception, speech and behavior, … extreme difficulty getting along with others…panic attacks, psychotic features, vegetative states, hypersomnia… emotional lability as well as intense and unstable interpersonal relationships and impulsive and damaging behavior. This symptomatology has resulted in marked difficulties in maintaining social functioning, marked difficulties in maintaining concentration, persistence, pace, and repeated episodes of decompensation, each of extended duration.

I’m supposed to be offended by that? It’s the truth. I guess I could be offended, but appears I have a rather full plate to be upset by something so removed. I mean, it seems removed; I have my life and I have these labels. Now I finally have one that makes me chestpuff, I’m in with the out crowd.

I don’t care. That’s the problem, I am perceived as falling short in the victim identity. But listen, schizoaffective disorder was real tough on me, due to all the research it requires, but okay fuckit, overall I have no personal issues with labeling, I’m not outraged by the iffy nosology in psychiatry because the iffiness has been established for me by psychiatrists throughout my treatment course. Now I’m getting shit at Furious Seasons because what happened to me just don’t sound right. It’s a competition, this shit right here.

I feel protective and territorial about my newfound BPD label and don’t like how things are going over there. I am nobody’s victim and am sorry to say have always felt supported by my treaters, but do hang on to anger for the lobotomy and expect I always will. My gramma was the only one in that house who loved me, I saw what it did to her. Saw what psychiatrists did to my whole family, who, hang on a sec, unlike me were all involuntary patients. I guess today they’d be psychiatric survivors, since they were forced into asylums and treated against their will.

The difference between voluntary and involuntary patients is something. Seriously, cartoon king Szasz got one thing right.

Still, I am against the BPD dx for all the right reasons. People are negatively effected by that specific label in all kinds of specific ways and they don’t like it, and that should be reason enough to say it’s got to go. Period. But none of these DSM labels, invoked like mantras are what I look for when psychiatric survivors say they are sharing their feelings about what society thinks about them. The label they avoid is the one I’m most interested in hearing about  and what they do with it.

Yeah. What’s it like to be considered dangerous by the powers that be, and is it too late for me to get some of that juju?

The sole justification for involuntary commitment. You must be found to be a danger to self and or others. You might think that would make some impact on a person, an activist, a truthteller, but damned if I’m onto that discourse, in fact I’m seeing more like a taboo around meaningful discussion in the psychiatric survivors, but hey I’m borderline now, I get to stir shit up.

I realized something the other day, how the same thing happens when visiting a General Practitioner for the first time. The Physicians Assistant does the standard intake on medical history; surgeries, cancers, allergies, heart disease, mental health issues? “Yes,” I reply breezily, I’ve been treated for psychiatric conditions. “Any hospitalizations?” Why do they always look up and ask that? They do it every time, ask and look up, make eye contact and hold it.

Any hospitalizations for mental illness?

They are trying to gauge how much they need to be on guard in my presence. I guess we’re all doing that to some extent, but this makes it rather stark. I’ll remember next time to say “Nope, you’re safe!”

As am I, so far at least. I imagine that things could be different for me.

I try to praise the mutilated world

I often wonder what it will look like to reach the point of not just surviving my misfortunes but being simply and profoundly grateful for every single thing that has ever happened to me. And why people who want things like that are so perplexing to those who don’t. Those who wonder, in their golden ways what’s so funny about gallows humor, the sole comfort of those who’ve escaped the hangman and an affront to those who have no knowledge of his existence.

Welp, there it is, in black & white, no less.

Thanks

by W.S. Merwin

Listen
with the night falling we are saying thank you
we are stopping on the bridges to bow from the railings
we are running out of the glass rooms
with our mouths full of food to look at the sky
and say thank you
we are standing by the water thanking it
smiling by the windows looking out
in our directions

back from a series of hospitals back from a mugging
after funerals we are saying thank you
after the news of the dead
whether or not we knew them we are saying thank you

over telephones we are saying thank you
in doorways and in the backs of cars and in elevators
remembering wars and the police at the door
and the beatings on stairs we are saying thank you
in the banks we are saying thank you
in the faces of the officials and the rich
and of all who will never change
we go on saying thank you thank you

with the animals dying around us
our lost feelings we are saying thank you
with the forests falling faster than the minutes
of our lives we are saying thank you
with the words going out like cells of a brain
with the cities growing over us
we are saying thank you faster and faster
with nobody listening we are saying thank you
we are saying thank you and waving
dark though it is

Discovered Wordle

This summer it’s been living on the Outskirts of the Intranets since I found my library card, but have to mention a new toy making the scene; it’s a time-sink but beautiful, and about time. Just follow this link, cut, paste, Java does the work, you reap the warm inordinate glow of artistic accomplishment. You can tweak your clouds with different fonts, layouts, and color schemes, he says, though judging by the spellbinders my learning curve has hills to climb. But for now some thoughts inside my head are free. Sobering, yes I know.

they work best when you click them

The snakepit is doing its job

Our officials do nothing while a flood of ink spills about the known atrocities taking place in Texas MHMR residential facilities. From my initial link three weeks ago on 800 disciplinary actions taken against Texas state schools, to the latest coverage of “choke holds, headlocks, torture, rape and death” in psych hospitals, perhaps our governor would like to revise his blithe summation that “the state is doing its job.” Meanwhile, accounts from the reality-based community beg to differ:

United Press International: Abuse Common in Texas Mental Hospitals.

Psych Central: Texas Mental Hospitals: A Haven for Abuse.

Furious Seasons: Article Exposes Injuries, Death at Texas Psych Hospital.

New York Times: Firings at Mental Hospitals Over Abuse.

Reason: One Flew Over the Lone Star State.

Rad Geek (must read): Texas Psychoprisons.

The Trouble With Spikol: Happy happy joy joy…uh…maybe not.

Houston Press: Mental Anguish at Texas West Oaks Hospital.

Reeves Law Blog: TX Psychiatric Patients Suffer Abuse, Neglect.

Hymes: Acceptance and Expectation of Abuse and Neglect in State Hospitals Are a Large Part of the Problem.

Texas Observer: Systemic Neglect.

Dallas News: Reports Show Systemic Abuse at Texas’ Psychiatric Hospitals.

Systemic is the operative word, systemic tells us the apple is rotten to the core, overall, built in, affecting an entire system, making it untenable in its totality. Documented systemic abuse, requiring swift and decisive action and impossible to ignore. You would think so. Who among us could ignore these published findings but the paid parasites who earn their professional cred by providing oversight of the system in question? The entities that are charged with getting hysterical over these facts will of course ignore them, and because that’s not surprising makes it no less unbearable. If you have any doubt that’s just what they’re doing, scour a few websites, and wait for the blackout:

Department of Aging and Disability Services.

Texas Department of State Health Services.

Governor’s Task Force on Mental Health Transformation. (pdf of May 6th agenda).

Texas Health and Human Services: May 12th “Stakeholder” hearing agenda.

Every front-page News brief at all 40 Community Psychiatric Centers, example: Austin-Travis County Mental Health Mental Retardation Center.

Blackout, zip, zero, nada, not a word of acknowledgment from the mental health overlords charged with public accountability. Pretend it’s not happening, maybe the public won’t notice. 135 news articles. What’s that if not delusional? A complete break with consensual reality, there is a place to put people like that.

Link love

I think I’ll start doing more of this sort of round up, beginning with a new blog, Eliminate the Stigma, “an open project for those passionate about mental health.” My first comment (in moderation) is a response to this wrong-headed post, which maintains that explanations of mental illness contribute to social stigma, so helpful folks will stop talking about causes. What they don’t seem to recognize is that we are countering explanations, and that we need to, like it or not.

AHRP has a blistering piece on Big Pharma’s green light to take over the lives of another captive population:

Massachusetts has embarked on a mandatory mental health screening policy targeting disadvantaged, poor children whose medical care is paid by Medicaid. …People on Medicaid have no resources for making informed choices or for obtaining second opinions–these children are trapped into a system whereby Bad Medicine is shielded from accountability.

Philip at Furious Seasons is thankfully posting diaries at DKOS, he is of course opposed to the mandate:

One of the symptom checklists on the paper’s website contains a stunning array of non-symptom symptoms: teases others, refuses to share, is fidgety, acts younger than others, daydreams too much, is afraid of new situations. And so on.

The scientology strawman begins with comment number five. Good times, this work.

The Buffalo Beast posted their annual list of the 50 Most Loathsome People In America. Number 4 is Seung-Hui Cho, delivered with proper snark:

Charges: A useless fucking nerd who shot a bunch of better people because he couldn’t get laid. Take note, all you pent-up losers out there: If you think you’re about to go on a murderous rampage, either take up a drug habit, find a hooker, or just kill yourself. Your inability to cope with a comfortable life in a developed nation is nobody else’s fault, except maybe your parents. Nothing says “I have a tiny penis” like a douchebag taking pictures of himself with a gun.

Exhibit A: Cho’s infamous “disturbing” stories are only disturbing in how completely terrible they are, but now every kid with an imagination is going to be hauled off to the nuthouse if he expresses himself.

Sentence: Used as kindling at bonfire kegger for rich, popular kids.

And our very approachable Candid Psychiatrist has an enervating post up this week, psychiatrist as cop, I so totally hope others will join that conversation. Or, if you have an opinion and elect not to share it, will tell me what stops you, and how you can live with that. If nothing else I might learn how to keep my mouth shut.

One of these psychiatrists is not like the other

These two posts caught my eye today, different starting points but seem related somehow:

Philip at Furious Seasons responds to a reader who asks if bipolar is a dangerous gift, and the breadth and scope of his response deserves a standing ovation. Not only does he describe the Icarus Project clearly and with enviable economy, he explores the possibility that what we sometimes call mental illness has more to do with personality and character issues, the medicalization of which enriches no one but the medical establishment. No, don’t expect recovery (especially since we’re avoiding the real issues), or as his pshrink tells Philip after successfully going off meds and being subclinical for years, Once diagnosed, Never undiagnosed, i.e. you’ll never make it without me.

If anyone but a psychiatrist said that it would be considered abuse. It’s abusive to nourish dependency and hopelessness, and no less so when a professional does it from a place of fear and prejudice, from their *training* in the scientific method. As if. All abusers create dependency to feed the ego-gratification of their own indispensability, the difference when a psychiatrist does it is in the additional perks of social superiority in relation to a defective human, the expectation of gratitude, and of course the most relevant and un-ending paycheck.
Ever get the feeling you’ve been cheated?
Yes, and on the other hand baby, here’s a treat at Daily Kos from our punk rock Candid Psychiatrist; Stop calling EVIL a mental illness. Predictably, his rendition of conscious evil to describe ah, conscious evil, comes under fire as imprecise and inflammatory from the usual science-addled liberal quarter, to which the CP replies

I’m not concerned about being inflammatory–I’m already inflamed!!!

Let me know if I’m reaching in seeing these two posts as somehow related. The underlying question seems to be, “who is in the driver’s seat, your disease or your volition?” So much is at stake in the answer to that. Who profits and who loses? Power, money, control, the mantle of science, the comfort of certainty, intellectual escapism, all in all, including the comments, much thought provoking, this here radical psych-O-sphere.

Spectacle: this word is an eyesore

You can’t see anything from a car; you’ve got to get out of the goddamn contraption and walk, better yet crawl, on hands and knees, over the sandstone and through the thornbrush and cactus. When traces of blood begin to mark your trail, you’ll see something, maybe. ~ Edward Abbey

I found myself wandering in traffic yesterday, cars whizzin at 40 mph, swerving, horns blaring, and OH SNAP I’m standing in the middle of a street, lost in reverie.

I closed my eyes, took a deep breath and burst out laughing. It’s funny, imagining what it must be like for people who never end up in life threatening situations, for whom life threatening situations just never happen, while for others it’s all that ever happens. And it does just happen, nothing you set out to do, more something you’ve been conditioned to do, and over the years take steps to unlearn, until that fateful and inadvertent gap in vigilance, mixed with the sense that you’re probably indestructible by now anyway.

Home again, happy and safe with my stereo, cats, coffee and cigarettes, I could reflect on events and figure it all out, but that would be going against the received wisdom of what to make of people labeled like me. We’re just not deep enough, lacking of insight and given to exaggeration, unreliable personal historians, whose experiences are meaningless symptoms of severe and persistent mental illness, and as such completely divorced from reality, which is why I keep chasing the documented evidence, there’s no denying the records were kept. One day we will free the bound periodicals.

I heard from my living brother Marky this week, first time in ten years. I learned most of my family’s alive, if sad, incoherent, in treatment, in foster care, stumbling, blind, and that’s for real, stone blind, he said, the one I used to call Bestdad, mom’s second husband, Gordy, he just up and went blind some years back. A karmic cliche, perhaps, but nothing I would wish on the man, who really did do his best by me, within certain characterological limitations. He stopped himself when he was about to molest me, that’s the truth, and all the facts matter, not just the bad. I woke up with him pressed against me and moving, then he shifted his motion and made it safe and fatherly. He could have gotten away with it, there was nothing stopping him, I was ten, didn’t say boo, never understood anything about what was going on. He’s moving against me one minute, then out of nowhere stopped in his tracks, broke down in sobbing shock and apology and grief so sorry I cried too. Probably one of the best things that ever happened to me growing up, seeing one weak man compare so favorably to the ones who came before and the others still to come. He left for good the next day. Some parents do that, make unintelligible, drastic changes without explanation, as if kids don’t think, don’t provide their own context, don’t invent, for the same reason adults do, but unlike adults have no one to blame but themselves. Thanks for waiting til I’m old enough to know better, go blind in both eyes some more, I can say that’s a mystery, don’t look at me.

This wasn’t on my mind yesterday when I found myself walking in traffic. I was thinking about that Hawkins boy who killed 8 people at a shopping mall. My brother Ricky’s birthday is coming up, even though he’s been dead a long time his birthday is a dependable stressor, it is for everyone in my family and we all act weird when he moves into our fields. That was one of his lifelong goals, to take out a shopping mall, and one reason our mom had him forcibly committed, it seemed like he really could do it. Objectively speaking, yes. That did not happen, no thanks to him being forcibly committed, which was just a pause in his trajectory, if anything, the humiliation of being declared insane, a very public ceremony, only made him more determined to have his angry public revenge. These are my impressions, I am shaping experience, an exercise in meaning-making that the powerful negate because power prefers the void. Not for themselves, though.

I was remembering the first time he shot someone I was seven, he was twelve, a neighbor boy named Terry played golf in his yard the same time everyday after school. Rick took Bestdad’s hunting rifle and scoped Terry out for a couple days, just stood at the window with the boy in his sight, then on the third day he shot him in the face. I was in the ravine that day, my underground haven, dozing on a bed of crushed leaves, inhaling burnished wood and looking at the sun filter through the golden trees in certainty that no one had any idea where I was when my brother Mark woke me up and said you have to come home, Ricky shot Terry, he didn’t mean to, it wasn’t on purpose. I got up and followed behind Mark who never looked like that before, stricken, gray, muttering to himself all the way home; he didn’t mean to, it wasn’t on purpose, it had to be an accident, had to.

A few weeks later Mark was caught laying out with arms akimbo in the middle of Thompson Avenue, while a group of schoolkids stared in amazement as horrified drivers slammed on their brakes to avoid running him over. There were long tracks where the cars made rubber, and punishing adults asking what in gods name possessed you to do that? Mark explained it by saying he was just playing chicken, and from that day on boys will be boys became the official story, no one ever asking why he wanted to die.

I couldn’t understand why the police were wearing brown, that’s all I could think when we entered the house. Two policemen wearing brown taking Ricky away, because he shot a very sweet neighbor who plays golf everyday. You look for clues to explain what’s happening, something to tell you it’s all a big mistake, something askew sticks out and that was it, police dressed wrong isn’t right, policemen wear blue uniforms, these police are dressed in brown, this must be a dream.

While walking yesterday I was thinking about what boys can do instead of shooting people, and what will happen when the redemptive properties of imagination are misapprehended as symptomatic of an underlying psychiatric disorder requiring outpatient commitment. The way ignorance that doesn’t recognize itself as ignorance looks at something it doesn’t understand, and says this must be stopped.

I don’t know where I’m going with this, but just turned on the Saturday afternoon movie, and see they’re showing Taxi Driver today. I guess someone up there is watching over us.

A different vantage point

The Miami Hurricane on the University of Miami Counseling Center:

After it became public that Virginia Tech student Seung-Hui Cho had been diagnosed with severe anxiety disorder before going on a shooting rampage, several universities looked into training faculty and administrators to monitor student behavior.

Although UM faculty members do not go through any formal training, Counseling Center Director Pamela Deroian, a licensed psychologist with a doctorate, said she encourages faculty members to notify her of “irregular student behavior.”

“Faculty have a different vantage point of what goes on with students,” said Deroian, who has been with the counseling center for 17 years and became director in June. “We’ve focused a lot on the English Department, specifically creative writing, and I’ve gotten calls from professors about several things to look into.”

Yes let’s do, let’s look into several things, beginning with Deroian, who, as a psychologist, holds the defacto privileged point of view, against which no mere English teacher can begin to compare, it being “different” from hers and therefore easily dismissed. The implicit question she’s avoiding is this — who better to teach us what makes people tick, the author of literature or experimental research?

Exhibit A:

Carson McCullers, American writer of novels and stories that depict the inner lives of lonely people.

Exhibit: n:

BF Skinner, highly influential American psychologist, abandoned English literature to raise his daughter in a pineboard box.

About which she says, in her father’s defense:

My early childhood, it’s true, was certainly unusual – but I was far from unloved. I was a much cuddled baby. Call it what you will, the “aircrib” ,”baby box”, “heir conditioner” (not my father’s term) was a wonderful alternative to the cage-like cot. [!!!] My father’s intentions were simple, and based on removing what he and my mother saw as the worst aspects of a baby’s typical sleeping arrangements: clothes, sheets and blankets. These not only have to be washed, but they restrict arm and leg movement and are a highly imperfect method of keeping a baby comfortable. My mother was happy. She had to give me fewer baths and of course had fewer clothes and blankets to wash, so allowing her more time to enjoy her baby.

Back to the University of Miami, where Counseling Center Director Pamela Deroian, a licensed psychologist with a doctorate is busy

in the process of writing policy guidelines for the Counseling Center because there currently are none. Some other universities, such as Tulane and Emory, use the Diagnostic and Statistical Manual of Mental Disorders as guidelines.

Although involuntary hospitalization never happens outside the psychiatric system (except in case of unconsciousness or the inability to communicate), all states, including Florida, have “mental hygiene” statutes authorizing involuntary holds for psychiatric examinations. Florida’s law is known as the Baker Act. Under it, 25 UM students were hauled off to the psych unit last year on the word of a mental health professional:

One student, a junior who lives off-campus, said he was committed to Mercy Hospital for one night his freshman year in spring 2006. The student said he was no risk to himself and recalls saying he loved life while at the counseling center, but he thinks his disheveled appearance was the reason he was sent to the hospital.

“He sought help by professionals, but they didn’t help,” said his mother, who went to the hospital that night to see her son. “Instead it cost us thousands of dollars, aggravation and maybe even humiliation for [student’s name]. I wish I hadn’t been reminded of this horrible incident. There was a huge lack of human warmth.”

Patricia A. Whitely, vice president for Student Affairs, said the university errs on the side of caution when using the Baker Act, especially after Virginia Tech.

“If my staff determines a student needs to be Baker Acted then that’s the decision they will make.”

“I know that sometimes we look like the bad guys, but everything we do is in the best interest of the student.”

So there you have it. The design:

And the Vantage Point.