Sunday, April 15, 2007

The Dialogue: Part 3

Topic: The Psychiatrized/Psychiatrist Relationship
By Patricia Lefave, Labelled D.D. (P) and Rob Wipond

Rob: Let me reiterate, I agree with almost everything you say about the fundamental mind-mess that exists inside the head of the average psychiatrist or psychologist when they are "diagnosing" people.

I feel like we're having a difficult time moving on from there in our dialogue, though.

You seem to be insisting that there is something fundamentally, radically different about a person who's been labelled and treated by psychiatrists.

Yet I'm trying to say, I don't really believe that difference is so radical or so fundamental as you suggest. In what way are the psychiatrized so completely different from many other severely oppressed people?

And I'm trying to say, let's look more closely at how these same dynamics of psychological power struggles and interpersonal oppression play out in regular life, outside hospitals, and maybe we can get better ideas about how to help PREVENT the psychiatric nightmares from unfolding.

Pat: I am not really insisting on there being something fundamentally different about the psychiatrized. I AM one and I am just like you. Of course, maybe this is a bad comparison?

There is something that is MADE to APPEAR to be fundamentally different, and with the ongoing insistence upon that, it often is a self fulfilling prophecy. We start basically the same but are then treated differently.

I am suggesting something else is at work in the use of language. It is like calling a pizza a pizza. We don't discuss what that means in detail as we both are sure we already know that so no lengthy explanation seems necessary right? But what if you had been taught that the word 'pizza' represents a bowl of oatmeal? It is about people’s ideas about what things mean and what is true. When a split takes place in reality between what is true and what is believed to be true, that is the beginning of our new ‘reality.’

We then fight against that, which makes us different to those who do not have to fight it, because even though they are the same, they have never been forced into a position in which they have HAD to fight to be seen and heard as the same as anyone else.

It has a whole lot to do with language and meaning. We all are using the same words and concepts but with “other'' meaning. That is why it is so hard for virtually ANYONE, from any perspective, to be sure we are all saying and MEANING the same things.

I don’t think you are hearing this in quite the way I am meaning it, Rob. We are NOT so different from other oppressed people but we are different from average Joe and Josephine who have not had this experience. Having the experience is what has made us different. Many of us are MORE aware than those who judge us; not LESS aware as most people seem to want to believe. I actually do look at how these power dynamics play out in every day life and in all other dysfunctional group as well. I do that all the time on two of my other blogs. One is my own personal very concrete experience and the other is a more abstract look at it.

I also agree it is possible to keep the psychiatric nightmares from unfolding but only if we all become able to see past the ‘that’s just the way life is' and the ‘we must overlook it’ kinds of responses that are used almost universally now to stop ‘the looking’ before it even begins.

What would you like to look at next? Give me a specific scenario if you want and we will jump into that for awhile.

Rob: Okay, now I think I see what you're trying to say. And I would agree with it generally. (And yes, I believe that makes me crazy -- in a good way!) In fact, it's interesting that you chose to discuss it with a language example, because as a person who has been passionate about communicating/working in words since I was very young, I have long been fascinated and concerned by the ways in which words mean different things to different people. The child's "is your blue my blue or is it my red?" question has hung with me until today. How do I get an audience to truly see and understand what I'm trying to say? That is an endless challenge for me. So I would emphasize that, I'm not even sure how many "ordinary Joes and Josephines" there really are who have absolutely never experienced this. I see human society, in many ways, as a gigantic struggle for people trying (and often failing) to come to understandings of each other. Is the ideological or conceptual gap between, say, George W. Bush and Osama Bin Laden, really smaller than the gap between the average psychiatrist and psychiatrized?

But of course you're right: If a person has never experienced severe oppression of any kind, of having their voice and language and concepts and worldview stripped of their legitimacy, then they are not as likely to have the level of insight into the mechanics of oppression as someone who has been on the bad end of it. Suffering has a way of making some people think. I don't think that's an absolute rule, though. Some oppressed persons have little understanding of oppression, and some who are not very oppressed at all (by conventional standards) can be very understanding, I think. How do we account for that fact?

That's one question. Now, a specific scenario... You have a friend who starts really unhinging from conventional reality and the dominant expected standards of behaviour. You don't mind it, maybe you even enjoy it, but part of it involves her not eating or sleeping and talking gibberish and yelling at strangers on the street and you can see that if she keeps going like this, that there's a good chance the psychiatrists who know her are going to reach out and get her dragged back into a hospital for her tenth time, and this time could be the worst, and it pains you that she might be submitted to more electroshock or tranquillizers. Do you warn her of this possible danger? And if you do, does it in any way help prevent the hospitalization from occurring? And if not, why not?

Pat: Well Rob agreeing with me (even if it is only ‘generally’) either makes you ‘mad’ like me or perhaps it makes both of us sane, depending upon your point of view I guess. Yes words are used differently depending upon the exact situation in which they are used and also depending upon the people using them. Meaning is elusive unless both people are trying to reach an understanding; and even then it is never exact. I think words are tools for understanding but less than perfect tools. I have also noticed throughout life that I was constantly misunderstood in what I said, or meant, and I was not always sure WHY. So for others to believe they know what everything means in situations in which they played no part is quite an unacceptable and rather na├»ve stretch to me. Yet psychiatry in general seems to believe this is possible for them, often without having any communication at ALL with the ‘patient.’

I think communication has to be very detailed and very plain between people until they reach the point of understanding each other, or at least get close to it. I am still working on this and thankfully, I get a fair amount of feedback from the psychiatrized, so I know when I am improving. I value that in all of them.
I also think it is very hard work, even when BOTH parties are really working at it. If one of the parties is not interested in communicating with understanding as the goal, it is impossible. Words then have about as much value as noise.
I also agree that many people try, and fail, to understand each other but, not ALL people are trying to understand each other. SOME people try to AVOID resolution and many of the psychiatrized have known such people personally. Some of the psychiatrized ARE such people too.

You also asked how you ‘get an audience to truly see and understand.’
Make it personal for the individual members of that audience. This dichotomy in understanding is created through the magical concept of ‘them’ and ‘us.’ We must SHOW ‘them’ (the psychiatrists and the ‘normal’ public), that ‘they’ ARE ‘us.’ Every one of us can be psychiatrized and the system seems to be working harder and harder on that all the time.

I am reading a book right now titled; A Social History of Madness” by Roy Porter, published twenty years ago in 1987. As I read it, I see my own conclusions drawn there in the experiences of the psychiatrized from CENTURIES ago. I see the same reality spoken about by those defined as ‘mad.’ He even talks about the mirroring effect and the similarity between the psychiatrists and the psychiatrized. So while I am ‘discovering’ this in my own case, I recognize years later that this is really not ‘news.’ It is just never HEARD because the system distances itself from the identified patient and sees itself (and it IS an ‘it’) from its ‘identified’ patients and supplies everything the patient is GOING to say with its own prefabricated meaning.
This book also points out the consistent power theme in this.

To me, the psychiatrist/psychiatrized relationship is the extreme of co-dependent relating, turned pro. The psychiatrist is free to project all of his own flaws onto the patient for no other reason than he has the concrete power to do so and the patient has none.

So, you get into a situation where the doctor wants absolute power and control over the patient while finding ‘madness’ in the patient’s reactions to someone (perhaps himself) who is trying to totally control her. The patient is PUSHED into a fight or flight response (or when trapped in the system, sometimes sees suicide as the only way out) and the psychiatrist then INCREASES his efforts to control her. They are traveling the road to hell together. While she is trying to get away from the mad doctor and his suffocating control, the mad doctor is sighing about how hard she is to control! Well, Duh.

The patient KNOWS they are on the road to mutual hell. The psychiatrist does not know. Why doesn’t he know?
His grandiosity (a trait he despises in the patient’s mirror-like psychosis or accusations) gets in the way of any real understanding.
Psychiatrists aren’t ‘objective.’ They are paralyzingly subjective but in denial about it.

Human beings do struggle for understanding of each other; at least, SOME humans do. However, if the premise of belief is that one human is inherently ‘superior’ to the other, understanding cannot occur as an outcome. Real understanding can only happen in the spirit of equality of being. If that is not there, as a STARTING point, then we can talk until hell freezes over and never get any closer. The reason we don’t is because everything we say and hear is built on opposing premises of reason.

Why do some understand more than others?
Some have lived with straightforward, honest communicators so they tend to hear and relate that way. Some have lived with dishonest manipulators who never really meant what they said so they listen for signs of that. Some people have suggested that many doctors have chosen to become psychiatrists as a way of working out their own relationship problems. I am sure that is sometimes true. I have noticed that personally.

Some work at communication. Others ignore everything. Some are introspective. Others externalize everything. But it is not all neatly divided up by family status or job titles as so many seem to want to think.
Who knows all the ‘whys’ really? All of this is a person, by person, individual exploration.
I think all humans have similarities in thought, deed and experience but we are also as individual as the sum of all of the parts of our lives, and all the people in them; whether good, bad or indifferent. I think the best thing that any of us can do to promote real understanding is to speak honestly and directly in the first place, about our OWN experience, and do it in the first person.

We have to make the experience of being psychiatrized personal for all of those who have not yet had it. I am not the ‘fascinating delusional disorder” nor a ‘case’, a ‘subject’ or a ‘disease’ process. Those are concepts used by controllers to reduce me to a manageable level; it is a process known as ‘levelling.’ It is ironic that though know this, yet cannot see themselves DOING it. I am a person. Just like my psychiatrists.

The psychiatrized will stop fighting against all control even that intended to ‘help’ when psychiatrists, and so many others, give up the attempt to control us, and learn instead how to support us emotionally, through a recovery process. It doesn’t happen now because ‘recovery’ isn’t part of psychiatry’s belief system.
Psychiatry, and, by extension, families and society, supports ‘intractable,’ biological, illness. In doing so, it destroys whatever is left of the identified patient’s hope and healing. More often than not, I think psychiatry ADDS to the burden the patient was already carrying when he or she arrived, hoping for relief and support from those who would surely have the empathy to offer it. That is rarely the case.

All right; now for your specific scenario:
You stated: “You have a friend who starts really unhinging from conventional reality and the dominant expected standards of behaviour.”

This is not specific enough. One of the biggest problems in this is abstraction. Abstract statements are left wide open to subjective projection from both parties and this is a huge part of the lack of communication. So let’s look more closely at this and the possibilities within it.

Define ‘unhinging’ in a concrete way. What is ‘conventional reality’ in this particular case? Define that in relation to your friend’s concrete experience. Precisely which ‘expected standards’ are we talking about here? (I know, you do add some of them here but we have to go into more detail.)
The not eating or sleeping is more of an effect than a cause. If someone goes off on an abstract tangent and can’t come out, that is when contact is lost with concrete reality so connecting someone to concrete detail will help with that. In other words, make sure that all abstractions are connected specifically to concrete detail and this will help to bring the person back ‘down’ to connect with concrete reality.
You must also treat the person like they are perfectly normal and like you expect them to be just that. What is ‘gibberish’ to you has some real legitimate meaning even if YOU can’t understand it.

One of the things you could use to understand the altered state of psychosis is that of dream interpretation, though I caution against trying to abstract that too. It is personally meaningful to the person experiencing it, and is directly connected to his or her REAL life, even if it is at times only symbolic rather than literal, so don’t ever judge this as meaninglessness because if you do, it may make the person disconnect even more rather than help them. What is said when altered is true on one level or another so accept that. It is often metaphorical.

This is not about everyday logic on this level. It is about meaning, and meaning that is directly connected to emotion. Validate the emotion. Be very direct and concrete. You can say, ‘not eating or sleeping is getting you caught in this cycle (since both can trigger psychosis in themselves) and I want you to eat and sleep so that you do not get picked up and have to go through all this system’s pressure again. Help me help you. What can I do to help you stay out of this system?’
Turn the control OVER the psychiatrized person BACK TO the psychiatrized because it is this lack of control, self control which has been taken away, which is a major part of the problem. Be an active listener. Be very concrete in your expressions and don’t go off on any abstract tangents of your own at a time like that.
You can also say, “Stop yelling at strangers on the street. Yelling on the streets will get you picked up because you are drawing attention to yourself and that is what will happen because of it. Stop doing that. ”

If the person is ‘hearing’, tell him or her they can talk to the voices, even yell at them if they like, (though that tends to make the voices worse) within their own minds. They do not need to use their vocal chords for that or even move their lips so tell him or her learn to speak ‘telepathically’ to the internal voices and things will go better. Even better is if they relate to the voices ‘as if’ they were real and find the boundaries necessary for all people to function as unique individuals as well as part of a group. They aren’t really opposites despite the illusions about that. (This is IF our imaginary psychiatrized person here is hearing of course. Not everyone experiences ‘hearing.’)

Basically, the focus needs to be on personal boundaries, which is the same thing we ALL need in concrete reality as well. So this principle works on “both” levels; both with abstract reasoning internally and concrete experience externally. These two levels of experience need to be connected or reconnected. This is what it is that is being disconnected in psychosis.
In any case, you need to understand your own boundaries very well as it is more effective to model boundaries, which others can choose to do too, IF he or she wants to do so. You have to know that you can’t really MAKE anyone do anything, nor should anyone be able to do that. One of the main issues in this is co-dependency. So, YOU can't prevent a hospitalization from occurring if things don't go well but, maybe you can do something towards really helping the psychiatrized person to prevent it for him/herself. The one who truly wants to help has to know that he or she can offer a concrete anchor to the person BUT must never hang it around the psychiatrized person's neck. That means you have to accept your own limitations if you are to help someone else get his or her own power back. It is powerlessness that makes people sick. If we all had power over JUST ourselves and not want it over others, we would all be well.

This includes those defined as sociopaths in my opinion. These ones are to me, the people who react to what was often a previous powerlessness by identifying with the aggressor. It is this polar opposite that makes them feel better for awhile, but that doesn’t really work either. I once told a psychiatrist that I believed that the 'schizophrenic' and the 'sociopath' were really the two extremes, the polarized opposites, of the SAME human relationship problem. They are the co-dependent extremes.

You want me to account for the resistance and the rebellion of the psychiatrized person? Ok, here it is.
We are fighting for our human right to determine our own identities in the most basic human way. We are fighting to have the same right as any (as yet) non psychiatrized person. We are rebelling against controlling, manipulating, demeaning, ridiculing, contemptuous ‘authorities’ who treat us like naughty children, or idiots, or whatever other denigrating view of us they choose to use to justify their total power and control over us.

We are resisting being controlled by them and having our thoughts, speech, feelings, the right to basic things like fresh air, courtesy, respect as human beings, etc being constantly ‘assessed’ and ‘evaluated’ for us.
We are resisting being manipulated, coerced, threatened, ridiculed, humoured, patronized and dictated to. The reason we are rebelling and resisting all of that is because we are human beings and ALL human beings have an urge to resist ‘other’ control, to self actualize, self define and self control. ALL of them. This is what is taken away from us in the name of ‘help’; our personal identities.
We fight for our very existence as the people we actually are because this is so fundamentally important to life itself. After being under constant pressure by so many, for so long, to deny our reality, we sometimes overreact to even a friend, motivated by a genuine desire to help.

What we all tend to HEAR when someone warns us of our ‘behaviour,’ especially that which shows any frustration or anger like ‘normal’ people are ‘allowed’ to have, is a repetition of the experience with psychiatry. It is always very abstract and non specific with them. We hear friends and family members singing the same old song, “You better watch your behaviour” even though we are not actually doing a damned thing wrong. What they mean of course is objecting to what OTHER people are often doing to US, to which we are not 'allowed' to object. We must watch out for those inappropriate affects of ours. (feelings which other people involving themselves in our business don’t want to see as a reaction) We are a ‘danger to self or others’ (since anger may precede someone, somewhere, sometime, getting a punch in the nose, so the fearful controllers cannot let any anger be shown by us.

What about anger shown by them? Sure, no problem. After all, they are only human, but no anger must be shown by us; not even in a raised voice.)
So this ‘warning’ from friends may have a very strong deja-vu feel to it.

Something IS trying to control us. It is the system itself. It is so thoroughly entrenched in it’s bio-psychiatric beliefs it has taken on a life of its own and it has closed virtually all escape routes while patting itself on the back about what a great idea it is to never have to bother to listen to a word anyone defined by it as ‘sick,’ ever says, ever again.
It has set itself up as an infallible dictatorship with a nice peasant smile on its face so no one can be angry about what it does, unless of course, it is defined as part of the angry one’s problem. After all, are they not smiling all the time? How can we be angry at all those grinning idiots?

If anyone wants to help the psychiatrized, here is what you can do. Get the focus OFF of the identified patient and onto psychiatry and all other dysfunctional group systems. This is a social sickness; not an individual one. So scrutinize every aspect of that and expose, expose, expose ALL the details and all the groupthink behaviours that go with it.
I’ll make a prediction for you. If enough people do this in pedantic detail, for long enough, the day will come when people will read what the identified patients were saying all along, heard all the way back through time, and ‘suddenly’ (after thousands of years) the group’s psychological deafness will clear up.
Get the focus ON the group of ‘normal’ people as a whole, as a societal system and problem, and the way they relate including all the mental acrobatics designed to keep dysfunction just as it is. Also focus hard on psychiatry’s support and enablement of this long standing dysfunctional status quo.
When the psychiatrized are relieved of society’s emotional burdens, by lifting it off of them, not by suppressing it with drugs, the relief, in itself, will allow most of them to resolve their own very REAL, and very human and perfectly NORMAL problems resulting from traumatic events and/or relationships. The invalidation, denial, contempt and disdain tied to our backs by families, society and psychiatry IS the biggest problem we all have.

This is an ongoing Dialogue on current mental health treatments, labeled people, and different points of view between Rob Wipond and I. This post concludes this topic. We may add a new topic later as both of us have the time to do so.

To bring up ALL sections of The Dialogue together, click on the label at the bottom of any of the sections. This will work unless part of it it is being read by someone else.

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