Social Sanctions (excerpted)

Jargonizing the Social Sanctions Construct:

Consider this construct a commentary on the ineffectiveness of punishing retaliation reactions with irrational and endless social sanctions. In jargonizing this construct, I have had a lot of success in uniting message receivers behind the idea that their history of treatment experiences basically feel like punishment. Sure some can evade it. Too often this takes privilege or gifted abilities. But those of us who have made it to social rehabilitation might need to acknowledge the advantages we had, advantages that we may have taken for granted during the process due to our intense suffering. And additionally it can help to know ways that you are gifted. Doing this helps one be helpful to others.

Whether primarily appearing to be paranoid, grandiose, somatic, spiritual, religious, catatonic, disassociated or other the tendency of the mainstream to disagree and reject divergent views hurts message receivers in a way that may even open old wounds. And the goal of getting the person into a hospital or a jail and medicated feels initially like suppressive cruel and unusual punishment.

In my experience many in the group will have an acceptance of these suppressive realities have learned that they improve with them. Often they may be homeless or institutionalized in circumstances that are worse, or find their message experience itself so unbearable they already feel a strong sense of deprivation or dehumanization. But still they can relate to feeling punished in some way. Usually, if a person says that a hospital or medication is not so bad they have a much deeper story of feeling punished to tell. All the helper has to do is inquire and learn.

The argument here is that if treatment were to be defined as ongoing efforts to social control and punish people who are different, it would be not only more transparent, but help people successfully adjust to without getting hurt and causing further brain damage. After all, punishment is a message that says: don’t do that or else . . . For message receivers already inundated with messages from varying origins, it is unreasonable to presume that they will take the punishment message the way it is intended.

Perhaps, the inherent flaw in the system of treatment is that special messages aren’t voluntary and that there is no way out but be punished when you are a message receiver.  The famous work of Gregory Bateson and the double bind, the idea that there is no direction the subject can go without feeling punished, emphasizes this point. I believe that it takes a markedly different culture to create no-way-out but win situations for a long time to counter the damage that the mainstream one does.

Special message groups are the effort to create such an environment. In being prepared to review this construct the group needs to have enough strength to hold and manage trauma. Stories of feeling punished and othered for having these experiences may go back a long way for group members.  Simply put, it takes a group that distinguishes itself from others to bring many people out of their shells. Historically I come equipped to distinguish every group I do by normalizing divergent views, asking questions that inquire about message experience, the sharing of my own lived experience, the ability to define associated constructs like sleuthing, theories, and tricksters, and by tolerating the confusion and tangents of those who act out retaliation reactions. Once these processes are reinforced people start to open up about things they’ve kept silent. When we discuss the reason many are so initially silent about their experiences social sanctions naturally social sanctions come up as an explanation.

I believe that in so many cases, being unjustly punished results in a decrease in trust for the establishment, in society and in our loved ones leading to a greater dependence on ourselves against everyone and a stronger faith in our special messages. In other words, message receivers become more committed to their message experiences. It becomes part of the experience of the altered state. As the diagram below depicts, once retaliation reactions get unjustly punished they are most likely to accelerate the message experience

picture1

 

 

Getting Punished Outside of Institutions:

Social sanctions may go back a lot farther in a message receiver’s consciousness than the first run in in the system and are vastly different for different individuals. I will trace an evolution of social sanctions as they follow a very general pattern involving: 1) early impressions; 2) observing social norms develop; and 3) relationship with first responders. I will start by openly using my own frame of reference, but I will also consider alternate cultural considerations as the experience and views of message receivers is in fact extremely diverse.

Early impressions are the foundation around which social sanctions take root. For me, it was the librarian in my third grade who first introduced me to the concept of Schizophrenia in a pamphlet. I have come to best see those early impressions as lies regarding incurable brain disorder that is very rare. At the time subsequent interfacing did a lot to diminish my sense of humanity for those who suffer with this. It was somehow okay to throw them away because there was nothing that could be done. Oh, for sure it was sad, kind of like when someone dies in an earthquake.

But having this early impression reinforced persistently through early experiences in hospitals for eating disorders, in Abnormal Psychology text books in college, and as a young professional in the mental health field did a lot to make me feel punished when I received the diagnosis. None of the trauma that I had been through mattered, only that early impression of what the “disease” was.

Early impressions of “psychosis” for those who have parents who struggle from it are going to be very different. Targeted abuse from symptoms or the outside world may result in innocent suffering and form a starkly different impression. Likewise, individuals who grow up in rural, urban, or differently zoned areas than I, where mentally ill people are housed or warehoused, are likely to develop very differing impressions of mental health in very different sets of circumstances. They may not be so book focused.  They may have more or less humanity in them. Nevertheless, I would argue that early impressions start a process of hurt and misunderstanding in many individuals’ experience.

The second part of social sanctions is the development of a social sense of what normal is. Though there are a great many ways people are different, children norm up and develop different perceptions on issues such as popularity, conformity, and authority. Bullying starts to happen and directs children in very different directions. But early impressions of what it feels like to be part of a group and what it feels like to be hurt by others along with senses of dominance and submission, have a lot to do in developing what it feels like to be socially sanctioned.

I myself quickly found myself not fitting in when I was not allowed to wear popular clothing. Perhaps my parents wanted me to go through this as they had and develop a sense of character. But I quickly found myself not fitting in and was easily hurt by the exclusion, not having the same skills to build my sense of character. I responded with hatred and isolation and lacked a place where I had a sense of belonging. This was the times when I first experienced issues such as abandonment, rejection, failure to be acknowledged, slander ridicule, intense criticism, issues that would become part of my experience with messages. While it is clear that not everyone with messages experiences this kind of early sense of bullying or feeling unaccepted, they may develop impressions about these kinds of issues that will affect them when they run into being different later on.

The third part of social sanctions are the quality of the support they receive from first-responder people who intervene when they are different. Do those people staunchly defend the norms as they guide the message receiver towards them? Do these people respect and honor the individual’s strengths when they show sign of having message experiences?

Not everyone is so lucky as to have a headshrinker help them along on this path. Early responders can be parents, outside family members, spiritual affiliates, teachers, coaches. I personally had a series of therapists who did not have a track record for accepting who I was and the gifts that I presented with. Yes, I did what they said and I became more normal, but as they noticed that I wasn’t willing or able to norm up and they recognized my message tendencies, the forecast became negative and the support was very poor.

I feel this is largely reflective of society’s vision of Schizophrenia and brain disorder. There was no one teaching me that there were mentors and people who I could relate to who had the same sense of things that I did.  Even though I maintained a career and got an advanced degree education, my headshrinker, unbeknownst to me, did not think I could do it repeatedly. I have been through training in psychotherapy and the standard of care that was taught to me was, to get the message receiver into the hospital and medicated, that therapy is not the place for them. Programs, institutions, and warehousing appear to be the only options to many first responders.

 

 

This Effort to Depict Punishment in Institutions

It is true institutions vary a great deal, state to state, county to county, private to public, and jail to prison. As a result, it is very hard to characterize what punishment is like across the board. Again, I will limit what I say throughout to my own frame of reference that spans different states, three decades, and experience both as staff and as patient. As I do this I will do my best to allude to and consider what other people from different backgrounds may go through.  Sure, what follows is limited and generalized. However, as a group leader, I argue that the leader needs to be prepared to explore social sanctions in distant epochs and across distinctive locales and institutions. Thus, as I have practiced in California, I have been called on to bear witness to stories about jail and prison and will make an effort to depict them as they do impact public mental health facilities in significant ways.

Author: Tim Dreby

I am an award-winning author and practicing psychotherapist

6 thoughts on “Social Sanctions (excerpted)”

  1. I agree that much of current treatment for schizophrenia is perceived as punishment by those subjected to it. It’s interesting because I think a lot of the excitement for the medical model of schizophrenia (and mental illness in general) came from the idea that it would support a less stigmatizing and less punishing view than the previous way of understanding mental illness. Many patients, advocates, and allies rallied behind the medical model (and often still do) as it helped validate the experience of suffering and helped defend against society’s responses of “just get over it” and “it’s all in your head.”

    I understand the desire to move away from the constant message from family, peers, and society that your suffering is because you aren’t trying hard enough, are too weak, or you’re exaggerating. But I don’t find the medical model less punishing or less invalidating— it just attacks from a different angle. Professionals tend to tell some version of the same story – due to your genes, your brain, or your brain chemicals, you had a biological propensity for mental illness and once diagnosed with this ‘disease’ you’re usually told it’s not curable (but manageable); you’ll probably need to be on medications and in treatment for the rest of your life, and may be limited in your functioning academically, occupationally, and socially. The medications they insist are necessary usually have side effects (ranging from uncomfortable to intolerable), but stopping them will result in relapse of symptoms and drop in functioning.

    So instead of feeling your character being attacked (as lazy, weak or overdramatic), we switched to a model that can make you feel inherently flawed biologically. While the message may seem better because it appears on the surface to be less judgmental (ie. you can’t help it, it’s a brain disease), it carries with it a message that you couldn’t change it even if you wanted. It leaves people feeling helpless and hopeless, not wanting to try to recover because the professionals told them there’s no cure.

    It’s not usually that the psychiatrists and other mental health professionals intend to convey hopelessness or think of what they do as inflicting punishment. It’s often well intended, with the desire to help. But our field is one with a bad track record of mistreating people while thinking that they are helping (forced institutionalization, solitary confinement, physical and chemical restraint, lobotomies, fever therapy, insulin/come therapy, electro shock therapy, etc). Most of the people implementing treatments that were later seen as barbaric thought they were helping. This does not inherently mean that current methods will follow the same pattern of later being viewed as barbaric, but it does suggest that your motivation being pure doesn’t protect you from causing more harm than good.

    Your post is a good reminder that the perception of treatment from each side of the therapy couch can be extremely different. To lose sight of our impact (intentional or not) is to lose sight of the people we would like to help.

    Liked by 1 person

    1. Thank you for your thoughtful reply. It is good to be reminded that the medical model views were meant to be less stigmatizing.

      What you’ve said help me reflect on the reality I encounter, that people become very unmotivated to be in relationship with others. It is easy to blame the medical model for that when really it is the fact that society doesn’t respect encourage or teach people to accept and be in relationship with people who are experiencing these things.

      I feel the experiences have value and can help people contribute in unique ways, but too often people end up being so shamed they cannot share their experiences and thoughts with anyone. I tend to believe that the medical model makes people less communicative and makes people give up any hope for connection. It can justify poverty and warehousing. I tend to rebel against that.

      My work is an attempt to create a more accurate picture that can promote inclusion, but ultimately I don’t know that it will get anywhere and if it does that it will not create new problems for people who are different.

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  2. Absolutely. I join you in the rebellion against the medical model and its various forms of dehumanizing people. And I also see it is one of many tools that people (scientists, doctors, mental health professionals, and loved ones included) use to try ease their own discomfort with someone else’s unfamiliar experiences. Labels, categories and research with the intent to ‘understand’ sounds good, but too often this desire to understand is really motivated by the fear of experiences that are different than their own. What I’ve noticed in this field, is as soon as the focus shifts to easing the therapist’s discomfort with the client’s suffering, walls are created blocking the ability to actually connect and understand. So I agree with you completely that the medical model is only one of the more recent forms of inability or unwillingness to relate and connect to people.

    I guess it’s always possible our efforts at connecting, respecting, and valuing people will ultimately go nowhere, but I have hope that as these ideas grow in pockets around the world, that they may eventually make a dent. Maybe it’s me being overly idealistic and naive? But I believe that in the short term, you and I (and the many other rebels) can have positive and meaningful connections with people even as they are stigmatized and dehumanized by others. And that those moments in which someone feels no judgment or urging to be different than they are and instead consist of humans being vulnerable and genuine, with all their flaws and their gifts, trying to understand each other — those are worth it regardless of whether the system at large is still crappy.

    I noticed when working with you a few years back that your clients could tell you wanted to actually connect to them and that you valued their experiences and their perspective of the world. Seeing you convey a genuine belief in their value and the unique abilities they bring to the table that early in my career gave me hope that there were positive ways to connect to people even within a system that does’t encourage it.

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    1. Wow, Stacy, I am so honored by what you wrote. I am grateful for your rebellion and work as well. It is good to know others are out there working hard for improvements to care. You’re writing is very eloquent and you communicate the key to effective work so amazingly here. I think I needed to read this sooner than I did. It really is extremely supportive and helps me enormously. Thanks

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  3. Thanks for the kind words. Your blog has been helpful in sparking my thoughts about treatment, therapy, madness, etc and it’s always nice to remind each other we’re not alone in the fight!

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