Tag: critical psychiatry

I updated “I’m Autistic. Here’s what I’d like you to know.” with a selection from “Psychiatric Retraumatization: A Conversation About Trauma and Madness in Mental Health Services – Mad In America” to expand the bullet point on stress and stress cases and bring in a critical psychiatry voice. A longer quote from this piece is included in “Design is Tested at the Edges: Intersectionality, The Social Model of Disability, and Design for Real Life”.

People who enter services are frequently society’s most vulnerable–people who have experienced extensive trauma, adversity, abuse, and oppression throughout their lives. At the same time, I struggle with the word “trauma” because it signifies some huge, overt event that needs to pass some arbitrary line of “bad enough” to count. I prefer the terms “stress” and “adversity.” … Our brains and bodies don’t know the difference between “trauma” and “adversity”–a stressed fight/flight state is the same regardless of what words you use to describe the external environment. I’m tired of people saying “nothing bad ever happened to me” because they did not experience “trauma.” People suffer, and when they do, it’s for a reason.

Source: Psychiatric Retraumatization: A Conversation About Trauma and Madness in Mental Health Services – Mad In America

This doesn’t fit the flow of the bullet point as well as I’d like. Connective editing TBD.

I might work this quote/theme into Autistic Burnout: The Cost of Masking and Passing.

I updated “Wanted: psychologists, psychiatrists, neuropsychiatrists, and neurologists who…” with selections from ‘“Don’t Be Stupid, Be a Smarty”: Why Anti-Authoritarian Doctors Are So Rare’.

Anti-authoritarian patients should be especially concerned with psychiatrists and psychologists—even more so than with other doctors. While an authoritarian cardiothoracic surgeon may be an abusive jerk for a nursing staff, that surgeon can still effectively perform a necessary artery bypass for an anti-authoritarian patient. However, authoritarian psychiatrists and psychologists will always do damage to their anti-authoritarian patients.

Psychiatrists and psychologists are often unaware of the magnitude of their obedience, and so the anti-authoritarianism of their patients can create enormous anxiety and even shame for them with regard to their own excessive compliance. This anxiety and shame can fuel their psychopathologizing of any noncompliance that creates significant tension. Such tension includes an anti-authoritarian patient’s incensed reaction to illegitimate authority.

Anti-authoritarian helpers—far more commonly found in peer support—understand angry reactions to illegitimate authority, empathize with the pain fueling those reactions, and genuinely care about that pain. Having one’s behavior understood and pain cared about opens one up to dialogue as to how best to deal with one’s pain. Because anti-authoritarian mental health professionals are rare, angry anti-authoritarian patients will likely be “treated” by an authority who creates even more pain, which results in more self-destructiveness and violence.

It is certainly no accident that anti-authoritarian psychiatrists and psychologists are rare. Mainstream psychiatry and psychology meet the needs of the ruling power structure by pathologizing anger and depoliticizing malaise so as to maintain the status quo. In contrast, anti-authoritarians model and validate resisting illegitimate authority, and so anti-authoritarian professionals—be they teachers, clergy, psychiatrists, or psychologists—are not viewed kindly by the ruling power structure.

Source: “Don’t Be Stupid, Be a Smarty”: Why Anti-Authoritarian Doctors Are So Rare

I updated “Design is Tested at the Edges: Intersectionality, The Social Model of Disability, and Design for Real Life” and “Compassion is not coddling. Design for real life.” with a selection on stress and trauma from “Psychiatric Retraumatization: A Conversation About Trauma and Madness in Mental Health Services – Mad In America”.

People who enter services are frequently society’s most vulnerable-people who have experienced extensive trauma, adversity, abuse, and oppression throughout their lives. At the same time, I struggle with the word “trauma” because it signifies some huge, overt event that needs to pass some arbitrary line of “bad enough” to count. I prefer the terms “stress” and “adversity.” In the book, I speak to the problem of language and how this insinuates differences that are not there, judgments, and assumptions that are untrue. Our brains and bodies don’t know the difference between “trauma” and “adversity”-a stressed fight/flight state is the same regardless of what words you use to describe the external environment. I’m tired of people saying “nothing bad ever happened to me” because they did not experience “trauma.” People suffer, and when they do, it’s for a reason.

Source: Psychiatric Retraumatization: A Conversation About Trauma and Madness in Mental Health Services – Mad In America

Rather, the entirety of the mental health field and the paradigm under which it operates is a modern-day religion rife with all the familiar problems and benefits that exist in any religion. Most importantly, however, there is hope if people are willing to move beyond what society tells us we “must” do. People have been healing from great pain for 200,000 years—the mental health professions have existed for less than 200. While there are some things we have learned, we need to stop trying to re-invent the wheel. People need love, support, community, to be heard, to be valued, to be validated, to have purpose, to have health and housing, to have nutrition both physically and emotionally—it is not rocket science and doesn’t become such just because we keep saying that it is.

People who enter services are frequently society’s most vulnerable-people who have experienced extensive trauma, adversity, abuse, and oppression throughout their lives. At the same time, I struggle with the word “trauma” because it signifies some huge, overt event that needs to pass some arbitrary line of “bad enough” to count. I prefer the terms “stress” and “adversity.” In the book, I speak to the problem of language and how this insinuates differences that are not there, judgments, and assumptions that are untrue. Our brains and bodies don’t know the difference between “trauma” and “adversity”-a stressed fight/flight state is the same regardless of what words you use to describe the external environment. I’m tired of people saying “nothing bad ever happened to me” because they did not experience “trauma.” People suffer, and when they do, it’s for a reason.

If patients willingly adopt the role of defectiveness, then how is the doctor doing anything harmful or wrong? People who grew up as the scapegoat, who believe they are dirty or defective or bad, who are ashamed of their existence or believe they should be someone they are not, who have led their entire lives being marginalized and discriminated against in society-these are the people who most frequently enter mental health services. They are also those most readily vulnerable to accepting these messages under the guise of treatment and care. It is not until people are willing to start to consider that, in fact, they are not defective in the least, rather, that they are just flawed and unique human beings adapting to incredible pain that they can start to actually believe in themselves enough to heal.

Of course, there is simply the existential issue of mental health professionals that may be unbearable for them to face: If I am not fixing a distinct and identifiable problem, what, then, is my purpose? If the real healing power I have is something that any human being could ostensibly provide, if willing, why did I spend all those years in school and possibly hundreds of thousands of dollars? If these are not specific diseases related to specific biochemical or genetic flaws, why have I specialized-and who doesn’t like feeling special? And, worse, if I am not addressing people with genetic illnesses and biochemical problems, what, really, am I doing when all I have to offer are drugs and technological interventions?

This problem is not unique to mental health professionals. Medical doctors are caught in a similar dilemma when it comes to obesity, heart disease, diabetes, chronic inflammation, and many autoimmune diseases, even cancer. What do these doctors do when they realize that these problems are almost entirely due to an industrialized diet largely based on corporate interests-the sugar industry, soy bean manufacturers, Monsanto-and that if people just ate the way humans are designed to eat, these problems mostly would not exist? And, of course, these issues are entirely intertwined with mental health problems! If these are not specific diseases related to specific biochemical or genetic flaws, why have I specialized? If these problems are not really genetic illnesses and biochemically-based problems, what, really, am I doing when all I have to offer are drugs and technological interventions?

A black man spends his life being marginalized and aggressed, dismissed because of his fear and pain-should he enter the system, he is no longer “less-than” because of his blackness, now he’s marginalized and dismissed as “schizophrenic.” A sexually-abused young woman who was told she “wanted it,” was blamed, and was never given the opportunity to be angry enters the system-she now is “borderline” and once again blamed for being too sexualized, for causing staff to behave in shameful ways, and condemned for her anger, even when it is taken out on herself.

Perhaps more than any other, the most common enactment is that associated with the individual who grew up with a narcissistic parent in constant need of adulation, intolerant of discomfort or self-reflection, and who was a master in the art of gaslighting.

We live in a society that values stoicism, complete control over one’s behaviors, lack of emotional expression, “politeness” at the expense of authenticity-I love New York!-and an eerie Stepford Wife-like ideal of conformity. Mental health professionals often are selected for their ability to represent these values. Those troublemakers who tell the truth, are spontaneous(otherwise called “impulsive”), who laugh or find humor in the darkness(or “inappropriate affect”), who refuse to conform(or my favorite, “oppositional”) are ostracized and pathologized for the threat they pose to propriety. They generally don’t make it through the training process. I know I almost didn’t. It is the Anglo-Saxon way. It also is what makes most of us completely miserable.

Source: Psychiatric Retraumatization: A Conversation About Trauma and Madness in Mental Health Services – Mad In America