I grew up in the mental health system when Prozac was the new craze. Prozac was the second drug I took and within three years there was the new field of psychopharmacology. By that time, getting the right combo became quite the rave. What that meant there was little to no exploration of the role of trauma in my life. Instead of learning about elements of trauma that were related to the eating disorder that threatened my life, I was diagnosed with a personality disorder and told not to research it because it would only make it worse.

My therapist would repeat to me that the only way to deal with a personality disorder was in the context of a psychodynamic relationship. She didn’t let on that she didn’t think I was college material even though my GPA was a 3.9. She told my parents. They concealed this from me.

I stuck with this psychologist for seven years. It was true I didn’t want to look back at my life growing up with privilege. I also didn’t get the feeling that it was mature to blame my parents for the shameful eating disorder that left me dwelling in the inner-city and without a sense of support. My suffering was nurtured in psychotherapy by a rolling of the eyes and waiting for the impact of the next drug combination.

A History of Class Conflict:

I first started to notice not enjoying being around other people in fourth grade. It started by being bullied and teased by my peers for not wearing the latest fashions that my parents refused to buy. For some reason I dealt with this by fighting back and getting nerdier. My parents sought therapy for me. Perhaps, they were embarrassed by hearing about my social problems from their other friends on the private school faculty.

Back then, I could not understand why I stood out so much. My parents and shrink would tell me that my superego was too dominant. The shrink would get my Mom to let me buy more fashionable clothing.

Meanwhile, in the summers I found that I, in fact, did fit in with the welfare family who rented the downstairs of the Lodge, our vacation home in a rugged boon town in the Adirondacks. My family once owned a lumber company and my father inherited many old buildings which we used to vacation and rent out. With the welfare family living downstairs for three summers, I felt totally accepted. I was too innocent to realize that their lives depended on keeping me happy. We didn’t need to bathe and could be wild and have fun.

My welfare brothers would talk about hunting frogs with bb guns. The frogs wouldn’t die. Bbs would lodge themselves under the frog’s thick skin. They could shoot them all day. They loved to hunt frogs all day. One had so many bbs in it, it just floated in the water with a stunned look on its face.

One morning I woke up screaming from terrors. Pigs were being slaughtered in my dreams. My welfare brothers would laugh at me. They would tell me I was screaming, “Don’t you do that . . . Don’t you do that . . . Ah . . . AAAhhhh!” Then, we would go to work for my father who always told me that my welfare brothers were better workers than me.

I guess I lived and worked with that family enough to see the world from their perspective. And, boy, when I did that my family didn’t look too good. In many ways it only reinforced self-hatred.

Misfit:

Of course, even though I dressed better, things would still only get worse for me at the private Quaker school I attended in a Philadelphia suburb. I would break into my French-Canadian northern drawl to confront my peers about their teasing.

I think my social awkwardness really stood out during summer outings away from the Adirondacks. First, it was a two-week backpacking trip with middle-class Albany, NY kids at the adjacent YMCA camp. Next, it was not fitting in with rebellious rich kids who were getting straightened out at a North Carolina Outward Bound Course. And, finally, I attended a work camp in Belize where all the boarding school kids only wanted to drink and be ugly American Tourists. Meanwhile, I stuck to my stated goal, to live and work as though I lived in Belize. I was told it was the wrong reason for making the trip, but I didn’t care.

Starving:

The year before my parent’s divorced I didn’t sleep more than three hours a night for nine months. Then, when my parents got divorced things got tough as I had to keep up with sports, work, extra curriculars, travel between both houses, and the sharp increase in school work. My mom started staying out at all hours of the night and forgetting to check on me while I was up working through learning disabilities at two in the morning. My dad still expected me to do his house chores no matter how many papers I had to write or how hard I worked at my fast food job.

I was a hundred and three pounds when I got admitted to the hospital. My parents packed my bags to drop me off at the hospital and the therapist said, “Wow, these bags are really heavy!” Then, he ordered my family to attend daily family sessions with me.

When I graphically failed to gain weight in that setting, my family had to pay out of pocket for two months of inpatient treatment, so I could gain twenty pounds. My father cried signing over the check and I felt much shame. I presumed the expense depleted my college fund. Because my room was converted to a study and I moved in with a friend upon discharge, I chose the least expensive commuter school.

College:

Okay, my choice of College was not quite that simple. In the all-female inpatient unit where I’d be forced to revisit for an additional three months (this time insurance paid for it,) even a repressed fellow such as myself managed to learn to how to kiss. I started a sexual relationship with a twenty-five-year-old newspaper photographer who was schooling at the affordable commuter campus. After I graduated and worked at a summer camp, I moved in with her. Because she wouldn’t allow me to have friends, the relationship only lasted two years.

The latter two years, I hid the fact I was binging and purging by keeping to myself. I never learned to hang out and fit in. I didn’t make it to as much as a single college party. Instead, I worked with the neighbourhood kids at a local Korean gangster’s deli. Community relationships and the associated sociological learning was the thing that kept me going.

I’d do a little better with my socialization in grad school when I was medicated and under psychodynamic treatment. However, when I tried to breakaway and make a comeback on the west coast, it wouldn’t end well. I found myself compelled to uncover murder and mayhem in a local section 8 housing facility. I’d end up in a state hospital and believing I was under surveillance for two years.

One-to-One Hundred:

 It’s true with complex trauma, I am sensitive and overwhelmed by the regular issues that come up between people and in families. My emotions are based on a social justice narrative and I go from one to a hundred when I am getting teased, causing me to be further targeted. I may not get the joke right away, roll with it and have a good comeback. The insult may cut at my core when I think about it later.

During my twenty-something years, when people drank (or drugged,) I generally responded the same way I do when I get teased. I’d get a numb look on my face, withdraw, look at my watch and long to be somewhere else. Then, I notice when people talk to each other as if I’m not there and I don’t know what to do about it.

Disassociation:

Of course, despite all the years of treatment I received, nobody noticed or asked about my experiences with disassociation. It wasn’t until I wrote a memoir about surviving the schizophrenia diagnosis that I recaptured a memory of molestation the summer of my third-grade year. In fact, I don’t disassociate regularly, but it can happen in times of excessive stress.

Of course, my response to the molestation incident was so extreme, I wonder if that was my only experience. I have many traipsed memories that feel like dreams and mystery. Are they also disassociated memories? Are they Dreams? I have always had them, and I have always wondered. Additionally, having many hypervigilant memories means, I have lost trust for people without understanding why.

Post-Partum Depression:

I never really understood how devastating the experience of post-partum depression can be for a mother. Then I heard a severely-traumatized patient I work with say that her post-par-tum depression was the lowest point of her life. Think of a traumatized person. Think of years and years of homelessness, rape, physical abuse, family suicide, substance abuse. And think that all this does not compare to the pain endured during a post-par-tum depression when a woman just can’t connect with her child. This really made me think . . .

Up until recently, my mother made yearly visits to visit family in the area during which she would spend a day at my house. One year I drove out a couple of hours away to meet her at a park local to her other relatives to see her an extra day. Out walking in a flat, marshy California park amid Spring flocks of birds, my mother finally gave me a feel for what she went through after my birth. Her mother refused to support her in her most difficult hours. I knew she had been depressed when her mother died, but I hadn’t known this. I knew she only told me this because she wanted me to stop processing depressing stuff and I listened to her.

In my family two-generations back, lobotomies and institutionalization were the cure for family mental problems. There was no support available to my mother when it came to having depression. She had to buck it up. She still expects me to do the same.

Still the Pariah:

I find no comfortable around people. I avoid social engagements because I feel stigmatized, patronized or outclassed by the comments of others.

For example, while it’s true I do not know exactly what all my relatives really think about me, I think that in observing a slew of collective behaviour, most would conclude that something is going on that is not positive.

It is true I bear the stigma of having schizophrenia because I choose to live out of the closet. Additionally, my memoir was honest and not always flattering toward the family support I received going through the experience.

My grandmother with dementia could not remember who I was, but when she found out I was the author of the book, she declared, “It made the family look bad!”

My mother has said, “I could have written a book about all we did to try to help you and about how difficult you were!”

My uncle, a career professor at Princeton University, demurred in his response for a while and then said only, “the last chapter was positive.”

Even though it won awards in four contests, my aunt gave my book four stars on Amazon and wrote, “it is a difficult book, as the author, a trained mental health professional, dumps the reader into his own experience with precarious mental health . . .”

Many relatives refuse to look at me and only speak to my wife or each other when I am around.

When I had to miss a reunion because of a severe back injury that had me out of work for several months, I was told by my mother and cousin that my relatives said: “well, why couldn’t Barbara (my wife) have come!” It seems it was a joke that was tossed around so much at the reunion, some felt I should get to enjoy it as well. I still don’t know what to make of it. Do you?

It is true not all the responses of family members are necessarily negative. For example, the judicious comment of my uncle may not have been as negative as it had seemed. He later told me he liked my book when he saw I was upset. But it is much easier to withdraw and avoid my family. If my uncle really supported me, would he tolerate the jokes about me that are at my expense? I often wonder.

I perceive similar acts of hostility from other groups of people and choose to withdraw and write when I am not working.

Recovering from Psychiatric Treatment:

Being a psychiatric survivor means that I along with other marginalized groups in America like many veterans, homeless, felons, inner-city children and other abuse victims can relate to the symptoms of complex trauma. While it’s true there is the potential history of emotional neglect, the disassociation, the molestation, the hypervigilance, the psychic numbing, the emotional dysregulation, the avoidance of related things, the shame, the people-pleasing, there’s also a history of privilege.

It’s true, I didn’t have it that bad until I entered the twisted system of care that is based on a schizophrenia diagnosis.

While it’s true I continue to be dependent on medication, I do so because it helps me manage the oppression that surrounds me working in an inner-city outpatient psychiatric unit. I have learned with the help of the medications to have a public relationship with consensus reality that enables me to have meaning and purpose. I am liked and helpful to people on the unit where I work.

I suppose when I was coming up no one could get it right because a complex trauma disorder didn’t exist back then. Instead there was disorder after disorder after disorder. Nurses on the eating disorder unit suggested I was an adult child of an alcoholic. Now there’s another disorder or two to add of the epigenetic sort. What can I say, I am an easy person for whom to ring up a bill!

When I was in state hospital they couldn’t shut me up about how much trauma I was enduring locked up for being a whistle-blower. I circled the day room I was confined to for two weeks and got on the phone and yelled to my family and friends that the mafia was following me.

Meanwhile, I negotiated unwanted relationships with a red-state-Mexican-mafia-female and resisted the offers to run away with her. Then, I resisted the opportunity to join an outlaw gang for protection against her.

Also, there was a short, illiterate thief with severe scoliosis who said he was there to recruit me into the Navy Seals. He said I had what it took to be a great assassin.  He said I passed all his tests. However, for my last test, he said I had to say that Ronald Reagan was a great president. I failed that one! As a result, I was sentenced to stay in the hospital against my will for three months.

Six months later, after two moves, the only job I could find and maintain was a job at an upscale Italian Deli. So, all gaslighting, taunting and teasing aside, maybe I had a point!

Believe me, still taking medication for complex trauma is not the worst thing that can happen to those of us who are coming from an era of misinformation! But if I had been treated for trauma and experienced more compassion, I wonder if I would continue to need the medication?

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I contend that the negative power of a label is a significant part of a sufferer’s condition when they experience a “psychosis” or what I prefer to term a special message crisis. Indeed, many acknowledge that words like schizophrenia, schizoaffective, and bipolar lead people to being treated as though they have a hereditary brain disease with a poor prognosis that limits their ability to thrive.

It is arguable that the degree of stigma or what a sufferer’s surrounding social world starts to think about them varies a great deal. However, I contend that more often than not, it is based on an inaccurate understanding of what “psychosis” is and means. Many sufferers object to the social definition and deny that psychosis is what is going on with them. In treatment they are encouraged to suppress their experiences especially when they are in the hospital. If they disagree with the social definition, they may be labeled with poor insight and a poorer prognosis.

This article is about how the words associated with “psychosis” and the system of care work together in irrational ways that erode one’s sense of self, dignity, and identity. I believe that stigma deserves a place at the table when it comes to defining the experiences associated with “psychosis.”

Stigma in the Community and Clinic:

Before sufferers even arrive at the clinic, they have faced social stigma in their communities or the streets. Perhaps, they were confronted about being wrong, teased, talked about behind their backs. Then others caught wind that something was different, came to test it out and laughed or taunted. Maybe the message receiver has had this happen before, or maybe finding themselves alone and rejected is new. Perhaps, suddenly some people treat the sufferer like a charity case. Of course, people who care about them may give them orders that they sense are coming from a good place. The influx of stigma to perceive is alarming and it may become interwoven into the conspiracy that is for or against them.

In the emergency clinics and hospitals, many workers believe that this “psychosis” will cause progressive social decline and brain damage as time progresses. Thus, involuntary medication is ordered and administered. So many psychiatric survivors report hearing that they will have to be on medication the rest of their lives. The best they can hope for is to return to their functioning-level baseline. Often, supporters report getting told by professionals that they would be better off learning that their loved one has a diagnosis of cancer, rather than “schizophrenia.” So many treatment providers presume that therapy is a waste of time and behavioral control in a clinical setting is as good as it gets.

Not only is there is an absence of therapy specialists who have strategies that help reduce the suffering, often, supporters are encouraged to vie to reduce their loved one’s self-determination so that they can impose consensus reality on them and correct behavior. In worst case scenarios, the mentality is that if we all ban together and work together, the sufferer will be forced to listen to us and ignore those anomalous experiences.

Perhaps the sufferers’ valid extra-perceptual experiences sense that this is going on and it only adds to their distress.

Case Study—My Real Extra-Sensory Abilities and Confusion:

 For example, when I was on the streets and walking along the highways, I could sense via intuition and energy that some people wanted to support me, and others wanted to destroy me. While I may have been accurate in these perceptions, there was confusion that resulted from this ability. I did not know whether people were presuming I was ill or whether I was receiving these sensations because I was capable of exposing mass corruption. I believed in the latter to a greater degree.

Of course, believing I was a targeted individual as such, I tested people out to see whether they knew who I was or how quickly they would pick up on my purposely bizarre behavior. If people just thought I was ill, I was safe, if they thought I was a whistle blower, I was in danger. I couldn’t ask them these questions directly, I had to feel it out.

It’s true some targeted individual or voice hearers have the skills to evade treatment and live with their secret abilities. Many can survive in fringe communities or perhaps via using substances or through family support. Those able to conceal these experiences still face stigma. Others may think they just aren’t living up to their potential. Then, they may feel ignored and stigmatized as an underachiever, rather than as a “schizophrenic.”

I was one who was unable to evade treatment. What I found was that some people presumed I was ill, and others seemed to know about my ability to expose corruption, which was significant at the time. Even when this dilemma led to a three-month incarceration in a state hospital, there were different camps. Many were trying to figure out where I stood, and there were many opinions for me to perceive.

Was my dilemma real persecution or was I sensing different takes on the stigma of presumed illness because of my erratic behavior? It has taken twenty years, a return to my profession, and pioneering groups that specialize in treating psychosis to realize that I am not alone in experiencing these dilemmas.

Seeing and Accepting the Reality of Stigma:

The stigma of a label that is not accurate robs people of their identity and the roles that give them meaning and purpose. However, to minimize incarceration, message receivers must learn to lie and accept stigma.

The belief in inevitable decline is a lie. Even our imperfect research suggests to us that 25% of those with schizophrenia will recover on their own, 50% will take ten years to recover, and only 25% fit the stereotype of inevitable decline. Still many professionals presume message receivers are going to face inevitable decline. The idea that you can go into a hospital for a tune up and a board and care home to establish independence without facing inevitable decline stigma is naïve. Living like that is degrading and chaotic and in fact can be a lot to come back from. The goals of so many of our DSM financed institutions remain to impose upon the suffering the insight that they are ill and in need of medication, even in cases in which this is not accurate.

The pervading message is that sufferers are ill. As a result, many workers do not engage us with curiosity about our experiences with voices, visions, illusions, codes, synchronicities and extra-perceptual perceptions. These experiences may be streaming through sufferer’s lives but they must keep quiet and suppress them to earn back their freedom. Medications and drugs encourage us to suppress them and pretend they are not true. Even if we know they are true, we must pretend they don’t exist. Indeed, the realities we perceive are defined as symptoms whether they are accurate or only somewhat accurate.

Therefore, I contend that we are all facing stigma which is part of the “psychosis” process! Suffers like me need to know that this is the case. We need treatment that enable us to look at our experiences and strategize with each other.

Stigma is Irrational and Yet Pervasive in the Mental Health System:

I believe message receivers need to learn that stigma is not rational reality. This becomes hard to prove in mental health institutions where stigma is so pervasively embedded. However, message receivers who have been removed from such oppression can learn to use rationality as a tool to challenge stigma. Indeed, when we finally recognize the effects of stigma clearly, stigma becomes the spiritual trickster (see my previous article) that might come true if we believe in it. For many of our people, trust in stigma has left us to rot in poverty, inactivity and distress for so many years.

So many have determined that cognitive therapy for psychosis is the answer to this stagnation. However, teaching cognitive therapy may not help people in institutional settings like board and care homes. Most of the time message receivers may be forced to accept irrational stigma and submission in the institution. In the worst case scenario, the institution turns around and, in treatment, tells then that that irrational thoughts are part of their illness.

This is precisely why I believe that we sufferers must teach each other to acknowledge our skills and abilities yet conceal and not act on them. This serves to save us from being stigmatized. Pretending I was ill then, but now am well becomes a lifelong task for a person like me. I am a licensed therapist living life on the playing field of the oppressor—this has become my destiny. In reality I haven’t changed much other than gaining a sense of social power.

More on Using Rationality as a Tool:

It took me a long time, but I learned to conceal my anomalous experiences, and use emotional intelligence to wait and see what happens. Often, the truth becomes revealed to me at some point. Until then, I need to collect hard facts before I fully trust my message experiences even though often they prove to be correct a significant portion of the time.

In learning to survive amidst stigma, I have learned to respect people’s privacy and not expose corruption. That doesn’t mean I like and approve of corruption, but I am guarded with my suspicious version of truth until I know for sure. I have come to learn that there are many high powers that keep secrets and use them to manipulate. Secret societies are an epidemic in our nation and easy to confuse. Sometimes these powers may be good to me and sometimes, cruel.

I am only privileged with so much information. I do not know the whole truth unless I am watching Sons of Anarchy, Nine Seconds, the Wire, or Breaking Bad. Until facts are revealed to me, I will advocate for the truth to the best of my ability. That means info that I get from extrasensory I try not to act on, even when I believe it may be true. So often doing so comes back to haunt me.

At the same time, eradicating social, institutional, and self-stigma from my life means doing away with the hierarchy of corrupt and distorted facts. I do not trust information that others may believe. My goal is to help people live in their strengths and truth so that they can experience the meaning and purpose they deserve. To achieve this, I may use rationality and facts as a tool to empower people. Thus, instead of saying that the illness is caused by irrational thinking, I endorse cognitive therapy as a tool that is sometimes needed to eradicate the stigma. When presented in this manner, I argue, it becomes more palatable to the oppressed message receiver who already receives more blame for their lives than they deserve.

Acknowledging A Diversity of Stigma:

 I have learned a great deal being a Caucazoidal man working in a community that is predominantly African American. Indeed, there so often are multiple layers of stigma to face in a single institutionalization. In addition to mixing Caucasian and African American cultures there is a lot of other diversity in my workplace. In my opinion, mixing of cultures takes a little more care and effort but is an optimal place to reconstruct a culture of “psychosis” that can stand on its own two feet with stigma as part of its definition.

Participants in the program learn about oppression of many different types of cultures. Some of us may have a sense that their culture has turned on them when they send them to the institution. Others identify with the oppression of their culture’s history as a source of strength. Not only must they learn about deconstructing their own culture in a way to collaborate with others, doing so helps them understand themselves better and the trauma associated with special message crisis. Additionally, gaining cultural skills makes it easy to find common ground. I believe that “psychosis,” anomalous experiences, or what I prefer to call special messages experiences is its own culture that is dominated by stigma.

Learning to overcome multiple stigmas and greeting people where they are helps participants get a sense of their strengths. Eradicating stigma may well involve giving up privilege for me as a white male, but it is the right thing to do. It feels great and helps me accept myself for who I am and mutually grow with other people. As a therapist, I find myself constantly belittling my role to create mutuality.

I would love to say I am not guilty of racism, sexism, legalism, educationalist or stigma of any kind. But the fact is, to eradicate stigma from my life I must accept that it exists and be on the lookout for it in myself. That is part of my healing process. Judging things increases stigma.

Internalized Stigma, A Part of All “Psychosis” Related “Disorders:”

 Regardless of the stigmatized word, the public and the stigmatizing people in the institution have a way of getting into the message receiver’s head. Suddenly the message receiver starts thinking very irrationally about themselves. Distorted thoughts get expressed and must be countered with what I prefer to call anti-stigma cognitions.

When stigma gets internalized, the message receiver’s positive traits, inclinations, productivity, and the things that give them identity starts to decline. It doesn’t really matter what word gets used, what matters are willingly working with social skills and cognition to overcome stigma. Many message receivers can’t stop sensing that stigma is going on. They may effectively overcome it, but sensing it is a burden.

While currently the best practice for treating psychosis (CBT for Psychosis) involves eradicating irrational and stigmatizing thoughts, I must express my belief that it is also important to give message receivers the opportunity to map their voices or review their special message experiences with people who will not invalidate them. Telling their stories and collaborating with others who might help them change what the hearing voices networks calls “their frameworks” or what I have elsewhere termed “their causation theories” to make them more flexible in how they make meaning of these experiences.

Voices and messages may be an ongoing experience for many. Much like racism or sexism, suppressing or denying them may make them worse, while mindfully accepting them and letting them go may make them less burdensome. I believe that the more these experiences are stigmatized and suppressed, the harder it becomes to quit being impacted by them. The public, the institutions and the individual all need to learn to eradicate stigma to solve a person’s “schizophrenia.”

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It was once suggested to me in a sociology class that sometimes we should be skeptical of advances in society. “Sometimes for the truth,” the professor with a nose ring exclaimed, “it is wiser to go back in time. Sometimes the wisdom in ancient societies can teach us a lot.”

Nowhere, in my opinion, is there a field where this sentiment more applicable, than the fields of psychiatry and behavioral health. And within those fields, this is most true, in the treatment of “schizophrenia” and other psychotic disorders.

In the laboratory, “schizophrenia” is being better defined as more of a syndrome than a mental illness. Meanwhile, I find that when people are artfully prompted to share their stories of madness that details of their experience often correlate with mood, post-traumatic-stress, anxieties, neuro-developmental realities, substance abuse and dissociation experiences. In a sense, these experiences that are thought of as disorders seem to be like layers that go beneath any given madness.

Meanwhile locally in the bay area sprawling homeless encampments are adding cruel and unusual psycho-social stress and trauma that complicate recovery and exacerbate experiences associated with “schizophrenia.” In addition, many subjected to such hard circumstances develop mental health problems simply from suffering on the fringes.

It’s true, many argue, that substance abuse or sex work may provide income for many facing homelessness. There are many generalizations to be made about people on the streets. Meanwhile treatment exists in the revolving doors of the psychiatric ER and the county jail. Many sufferers end up tortured in solitary and suicide watch. Many others get forcibly medicated. Many of those who do have bad reactions to injected psychotropics find that this and restraints further traumatize them. Meanwhile, distressing experiences continue and worsen with coercion, abuse and being treated like traffic on the streets.

Now, attaining a bed in a shelter is a 24/7 job. Furthermore, it can take some years on waiting lists and displacement to find some form of housing. Locally, working a service job is not enough to solve the problem of housing. I hear many who stay in shelters and on the streets are working service jobs in addition to surviving on the streets. They may do this without having a sense of an end in sight.

Nineteen years ago, I experienced two years of psychosis that felt like it would never go away. While housing and service work were difficult to maintain, I am sure that the stress I experienced did not compare to the stress of homelessness that many are currently facing in the city where I work. Even so I can assure the reader that being surrounded by alternate realities and the way many people address the extreme-state lifestyle I led, made survival difficult.

Now, I have a recovery. I have worked providing treatment for “schizophrenia” for the past fifteen years. It is a costly endeavor, but treatment outside of homeless encampments and the hospital does exist.

Because of my own experience, I have stubbornly refused to believe the text books that say this problem does not go away. I have ranted and railed against the standard of care that forces people into the hospital for what is often referred to as a “tune up.” I have remained faithful to my lived experience, the Yale Harding Study, and the statistics that suggest that most people do experience recovery and healing over time despite the “treatment” that operates with a disregard for human rights.

Now thanks to epigenetic advances, two new “disorders” have been created in the DSMV that account for my mental health struggles: autistic spectrum disorder; and complex post-traumatic stress disorder. I think these new “advancements” help me understand my madness along with understanding of counter-cultural reality that many people I work with refer to as “the underworld.”

Now, I am going to argue that understanding elements behind a madness is like going retro, kind of like disco was in the clubs of San Francisco back at the turn of the century. I think that if these elements are understood as layers of personal realities beneath madness instead of epigenetic disorders, they bear the potential of moving the field of treating “psychosis” back in the direction that it used to be before the Prozac revolution and before industrial times when institutionalization and electric shock was the norm.

I know there are articles that exist that could support what I am saying. Still, I prefer to write without the mystique of a scientific platform. Perhaps the reason for this is that I have learned through cracking open thousands of stories over the years that causation for “psychosis,” or what I prefer to call a message crisis, varies a great deal. Generalizations do no justice to reality!

Indeed, I had a rough road receiving treatment during the era of Prozac and psychopharmacology. I had to learn to stop listening to the therapist who was constantly telling me to try new medication or to try to be a more normal person. Although she was very credentialed, she encouraged me not to research trauma treatment because she was an expert. As a man with an eating disorder, a personality disorder, ADD, and dyslexia, I would only be more difficult to deal with if I knew what I was talking about.

During my “psychosis,” I learned to pay a second therapist lip service while she took my financial support. This was done to satisfy my parents who seemed to feel that my continued suffering was more socially appropriate, rather than admit that my three-month hospitalization was inhumane. While the therapist was making 250$ a week off me, I biked twenty miles a day on top of working a forty-hour-week to stay housed. I struggled, but I worked through my “psychosis” at the only job I could find, an upscale Italian Deli. (I believed the mob was following me.)

Since this relationship, I have devoted my career to creating alternative treatment so that others do not have to go through the ridiculous invalidation and abuse I went through when I was struggling with psychosis. Instead of listening to these therapists, I got back on my feet and I have used my training and personal experience to infiltrate a psychiatric unit as a credentialed paid worker and created my own treatment and process of self-understanding.

In writing my way through this, I have developed my own little “schizophrenia” therapy platform. In developing this I have learned to use eclectic therapy concepts that are based on understanding that many of us who struggle with message crisis also have assorted mixes of trauma, social skill, mood, and substance abuse challenges. Learning how to take care of myself and others with these techniques has given me a stable life that I can tolerate.

Much as my sociology professor suggested back in the nineties, I think we need to look backwards to some of society’s older ways of managing mental health particularly when it comes to developing treatment for issues related to “psychosis.”

Indeed, as is commonly known in survivor circles, recovery rates from “schizophrenia” are higher in many traditional third world societies. Traditional societies are more prone to support shamanic endeavors and are less influenced by the bay area’s cost of living and shocking distinctions in disparities.

Consider what people like me must face in contrast to someone in a traditional society when they involuntarily descend into a “psychosis.” In our society, we face institutionalization, over-medication, and all the social issues related to decline in wages in postindustrial service economies (the construction of the drug war, and the prison industry to name a few.)

Even when western society was industrial and so brutal as to institutionalize people with psychosis, they used to define psychological problems as being related to trauma instead of chemical imbalances. Psychiatrists were trained to do therapy in addition to prescribing medication. Psychoanalysts performed extensive treatment for the wealthy and many avoided institutions.

It wasn’t until the postindustrial, x-generation when the economy shifted, that we began to see the rise of this notion of medication for mental health problems. With post-industrial society came the closing of mental institutions, homelessness, the prison industry, the explosion of free-base cocaine in the inner-city, and the Prozac revolution in the corridors of our institutions.

I am writing this account because I think respect for atypical, neuro-divergent brains, trauma sensitivity, understanding of black-market subcultures are required ingredients to helping people find the meaning and purpose needed to counter experiences associated with “psychosis.” I think that a better social definition is needed for “psychosis.” I think it is just as they are slowly proving in the laboratory, it is a syndrome.

The experiences that lead people to alternative realities need to be explored like different cultures so that they can be less judged. When those of us who have privilege in this society think of those homelessness images and realities, it is liable to increase our judgment of the experiences associated with special messages. This serves to make sufferers more impacted by psycho-social stress.

I happen to be a psychiatric survivor who continues to use psychiatric medication to improve my functioning. I am not against this when the situation requires it. I don’t think brain chemical fix disorders but rather aid in functioning. They have helped me accomplish things I wanted to accomplish. But I have also learned how to manage issues associated with “psychosis” by leading group therapy during which I disclose my own history.

In group I reflect on the content of “psychosis” in a structured way and on solutions that have enabled me to live in both worlds. I like the ideas of the hearing voices network movement; but because I work primarily with individuals of color, I wonder if it is more apt to call groups like the ones I run shamanic healing zones to honor Non-European Cultures. When it comes down to it, I believe that issues of trauma (which require safety, resilience, enhancing pain tolerance and justice to bring about healing) and neuro-developmental realities (that require acceptance, perseverance and accommodation,) and counter-cultural realities (which need to be better understood, less stigmatized, and less incarcerated by the public) must guide our treatment of the “schizophrenia” syndrome.

The post Looking Backwards for Psychiatric and Behavioral Health Solutions for “Schizophrenia” Syndromes: appeared first on Redefining "Psychosis".

The Hearing Voices Network training that I attended in the end of January turned out to be a time for self-reflection and personal growth. I experienced a mixture of validation and a profound sense of alienation. One of the trainers, Marty, sensed this in me and asked me to reach out after the training was over. In sharing my experiences and perspective with Marty in a lengthy email, I felt very heard. I know the truth about the way I have been treated locally and the importance of taking a best practice and adjusting it to local cultural contexts. Marty’s curiosity and ability to acknowledge and support my perspective means a lot to me.

Locally, I have tried to work with the hearing voices network in a collaborative manner. As a board member, I have faced a significant amount of objection to this from people with whom I have wanted to collaborate. Instead of feeling co-promoted, I have tended to face suspicion and have sensed a tendency to be marginalized and silenced. Some have objected to me expressing my work in trainings and two people even left the group with this as one of their complaints. Additionally, I have felt incredibly underestimated and slighted by some people with whom I yearn to collaborate.

As a neuro-divergent man I come with a mix of abilities and disabilities. The sense that people are judging my disabilities and using them to marginalize me goes back a long way for me. I had to repeat kindergarten and would not have been accepted, had my parents not been teachers at the private school I attended. When I brought home straight A’s my father said that I should not be able to get such high marks. I achieved a great deal in high school and graduated cum laude, but I lost my respect for school when I experienced stigma for having anorexia. I knew my writing was improving and yet my grades went down. My essay nearly got me kicked out of the school instead of receiving the praise it deserved. As a result, I chose not to go to the fancy schools I got into and continued to work hard living in the library when I wasn’t working.

During the training, I was validated that the jargon that was laid out matched much of the gooney-goo-goo jive/jargon that I co-created with people who attended special messages group over the years. I have been writing to sharpen this jargon for the past ten years. While my work is organized as a structural redefinition of psychosis (or special message crisis,) hearing voices network is structured around normalizing and accepting the experiences of hearing voices. They have “an other” section that includes many of the experiences I lived with for two years, and I have done some work to further define this.

While my groups cannot be acknowledged as part of the hearing voices network because they are professional, I feel I have done a good job replicating the values and ethics of the Hearing Voices Network movement quite naturally as I have become a professional who identifies as a person with lived experience. I hope that the fact that the same concepts have been learned in different locales might help validate the paradigm shift and legitimize the concepts. I am in favor of teaching professionals the lessons of the HVN so that we can get therapy specialists who better know how to work with experiences associated with hearing voices and special messages crisis.

At the same time, I had some important points reinforced during the training. For example, when I train people not to re-traumatize themselves, I may in fact alienate many participants. Doing this does not reinforce and equal and mutual relationship, it reinforces power dynamics that are toxic to many and prevents many from sharing their story. I had the opportunity to reflect on times I had done this in the community and lost participants as a result. This important point is something that I needed to have reinforced because I am often warned not to re-traumatize people as a clinician. This is something I can fix.

Another thing I learned from the training, is that I must do more to get off this uninhabited island I am stuck on. I need to reach out to people. I need to stop raging against things I have no control about and make friends like Marty. During the training, I had the opportunity to network with some people who had read my book or are willing to support me. Not everyone is working to exclude me. The more power I give to those feeling of exclusion the more real it becomes. When I get angry that the HVN excludes me, as I did during the training, I only give those critics who are looking to marginalize me the power and satisfaction that they can be successful.

I loved the HVN training and I think that the fact we have a handful of trained people is a massive opportunity to expand the formation of local groups. I met a grant writer in the training and perhaps I will be able to promote outreach groups to help those isolated in board and care homes. I know that to extend HVN groups to institutionalized peoples that we need to know the local culture and act accordingly. I think this can be done. I have done it for ten years and I hope to be able to do it for twenty more.

I have applied to present my six-hour training to CASRA Spring Conference. They have supported me in the past. I have also applied to present a small portion of my six-hour presentation and hope that at least one will be selected.

I have many posts I am trying to officially publish in a host of different venues.  This is a very frustrating process fraught with rejection. Still I have published the following posts on my blog you can see by clicking below:

The post Reflections on a Hearing Voices Network Training appeared first on Redefining "Psychosis".

It offered stillness

To a world

That was so active

Twirling tearfully

Like numb-chucking

Buzzards overwhelming

Peripheral horizons;

Its peace prevailed

In the dim after hours:

Dish rack in disciplined order, scant suds

Loitering around the drain, counter

Clear except for an occasional dish rag

Somehow charismatic in its grunge.

A few hours earlier

Rustle and business

Blinded us like a spotlight

From the evil

That lurks within,

My internal audience

Ablaze in idleness:

Pots on lit burners in domestic gloss,

Diced celery, grated cheese, the smell of

Taunt beans consuming simmering sauce—

Diverse was the color, taste, and shape of love.

You were the conductor

Of this orchestra,

Its inception

Beyond the realm

Of my awareness.

We worked together.

I was very good

At doing what I was told:

Steaming the broccoli,

Setting the table

Lighting the candles.

The table,

The conversation,

The delicate handling

Of utensils

Ushered in a dignity

I have never

Since known.

When dinner was done

The stillness

Returned carrying

The dominion of that shadow—

That atmospheric blur—

Fuzzy, hearkening in

Hypnotic fatigue.

At this point

The relationship

Would move

Up into

The bedroom,

Into its ceaseless storm.

I was a boy in big shoes

Unable to care for you

The way I wanted to.

Years later in the fondness

Of memory

I ponder

The phylum’s

Of footsteps

I’ve left behind

Always on the run.

I steal through the kitchen.

Counters cluttered with assorted open box.

Wrappers utensils and weeks-worth of mail

Vogue in grand collage to need for Luvox

On the old kitchen tables’ disorganized jail.

Kraft macaroni and cheese,

Rests in the wok

That need only

Be paper-towel-wiped

In accordance

With instructional

Dictates

Plates and cups

Remain in

The ajar cupboard

As I select one

From out of the sink

In contraceptive effort

To avoid unwanted dishes.

I have made many

Necessary changes

To function

Alone in this world.

It has been a

Wonderful challenge

With so much

To learn about

Forgetting

The customs

Of love

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Since I started writing my memoir ten years ago, I have not struggled with writer’s block. It’s true, I have produced drafts of my second book that were so bad, I scrapped them. But I was always able to use writing to help organize my thoughts without feeling defeated. Sure, I have taken a few vacations, but I always did that with a project or two on my mind.

Today, however, I cannot get a project started. For the past few days, I have been chewing things over in my mind and I feel totally frozen. I retreat in great frustration with my wife Barbara and my dog Jayla through the smoke-filled Bay Area. We drive out to the coast adjacent to Half Moon Bay. As the Camp Fire rages hundreds of miles to the north, I spend the drive trying to figure out what was happening to me to get me feeling so stuck.

It is true I recently heard from a high school English teacher who used to support me who read my memoir. She made a point of sending word through my mother that she was impressed with how I was able to get into my own head: had I ever considered writing fiction?

Enthralled by the compliment (and yet challenged,) I spent the week thinking about how I might add fiction writing to my platform to help tell some of the untold stories of the urban world I know. Curious characters I have known flashed through my head and I struggled to figure out how to create a fictional story out of them. When it finally came to be time to write, I could not start a story or even a personal essay on psychosis-like I usually do.

When we arrive at the Butano State Park, I find myself sorting through a couple of different identities as a writer. I know I felt comfortable and artistic as the memoirist. I likewise have felt purposeful using my experience in group therapy to reconstruct psychosis into solvable components. It hasn’t been until I have been recently been struggling to get published on blogsites or magazines to increase my following that I have become down on my writing.

As I watch my dog saunter up the fire trail, I remind myself that if I am going to publish a book that helps change the way clinicians work with psychosis, my voice and identity is going to have to be quite different. I am currently practicing changing my audience to providers and occasionally to family members. However, as I have done this, I don’t really feel I fit as a psychotherapist with an academic voice.

It may sound strange, but I have an objection to the practice of using journal articles and research to reinforce what I say. I have learned that I don’t really learn well that way. I don’t trust research to tell the stories that I hear on the inner-city backward.

I prefer to write what I know from experience. This is the writing platform I have set up on my blog. In the fifteen years I have worked on a backward, I have become skilled at cracking open the real story in ways I don’t trust research to be able to do. When I write honoring academic tradition and research, I feel phony and disconnected. I feel I am not taking advantage of real-life knowledge and my career. Plus, I find I like to maintain the use of language such as “dumb-ass!”

We continue to ascend on a fire road until we reach a viewpoint we have been to some thirteen years ago. On that occasion, we had hiked with my father. I feel impressed that my father made it all the way up this road to the look-out back when he was sixty-five. It had been a lite day of hiking for me thirteen years ago but now I realize, I didn’t realize what I was putting him though.

I reflect on how I get much more of my learning from listening to music than I do from journal articles. I think that why I like to write in a way that honors lived experience. I acknowledge that I fear to write a successful book that changes the way therapists approach work with psychosis, I need to use some degree of research to be accepted. Although I have created a therapy platform, I know that I don’t know how to write a readable book that promotes it. I know I need to read more theoretical books to get ideas for how to approach the writing. I just don’t want to do it.

We continue to hike up the hill until we’ve been out for two hours. Our dog suddenly bounds after a chipmunk and disappears down the gulley through the brush and we call after her to get her to come back. I feel that age is slowing me down. I used to be far more fit. It is time to turn around.

When I read writers, who do get published in psychotherapy magazines, I feel like a different breed. Firstly, I am uncomfortable with writing a case study about the real experiences of my clients. Even if I disguise the name, it feels like a massive breach of their confidence. Additionally, when I hang out with therapists who might one day benefit from reading my book, I feel like a flagrant victim.

I have taken a couple of courses in trauma from industry leaders and have learned that I disassociate around other therapists. Listening to industry leaders, I have felt alienated when they have made fun of “psychosis.” One talked angrily about people who are “reversed” or unable to benefit. “Why can’t they just accept help!” The presenter had continued, “you can see them when they come into the room, they are as clear as day.” Of course, I was feeling like the presenter was referencing me because the techniques weren’t working for me. In this way, the comments coming from the trauma gurus only further alienate me.

I think about how I have sent essay after essay out for publication and received only rejections. It’s true sending stuff out is painful. I don’t like to wait 2-8 weeks or even four months for some journals to hear back. Sure, I could be more persistent. Still, some of my best personal essays are starting to feel like rehashing the same story again. And, no matter what angle I put on them, they don’t seem to make it into print.

In many ways I treat writing as though it is an equalizer. It is my response to feeling bullied and invisible to mainstream people. I didn’t go to an Ivy League school, I went to a commuter campus. Being invisible happened to me in my family, during schooling, at work (for example, after fifteen years of work, I just got my first five-year chip,) and in my volunteer efforts. I write dreaming that one day people will hear me.

In fact, this is the same weekend I have sent in edits to a well-known publisher to whom I have sent upward of fifty articles. Finally, they think I have put something together that they feel is worth a response. However, in doing so I face a challenge. Did I write to tell my true story, or did I write to tell the editor what I think they want to hear?

This the dilemma was exactly what happened with my memoir. I had a deal with a publishing company, but the editors were not forthcoming with the fact that they didn’t like my views on racial inequality or male sexual abuse.  In a sense, I saw it coming; but was living on a prayer. Then, in the last edit, they entirely removed those important themes from my work and I chose to break the contract and reclaim my work.

Back at the car, my wife drives. We drive through the shadows of the redwood trees. Out on the highway, the late afternoon sun shimmers through the smoke. We head for a dog-friendly beach.

I come across a Facebook dialogue in a group in which a group member was contemplating writing a fictional story about a childhood friend who was Native American. She received quite a talking to by the group about it being exploitative to tell a story about a marginalized culture when she was not from that culture.

Perhaps some of the reason I have struggled throughout the day is that I was thinking I should be able to write fiction when it isn’t a good fit for me. As a white male, I work primarily with people of color and although I know their lives intimately, their experience is just not my story to tell. I know they have more social barriers to overcome than I. It is ironic, I think, that the one Facebook story I looked up happened to tell me what I needed to hear.

I think for a spell about the lessons of the day. I write because I believe there is value in it. I likely have the smallest writing platform there is on the internet. I think I create quality content, but don’t attract followers. I know it is important not to let the expectations of others negate what one does and so I persist. I write to keep things simple and real.

It occurs to me that this is my writing platform. In a few minutes, I will watch my dog spritz about in the sand. Now, I am using my writer’s block to sharpen it. I may have a long way to go but I have a lot of years to sharpen it until I get clicks and likes and the things I need to get published. Perhaps the stress of getting published is taking more of a toll than I like to admit. Perhaps, sometimes there is just too much going on to get a piece of writing completed.

The post Using Writer’s Block to Sharpen my Writing Platform appeared first on Redefining "Psychosis".

Twenty years ago, I experienced what might be termed a break from reality while I was working as a mental health worker. I worked in a last resort section 8 housing project that was rife with crime. It was called “The Hotel of Horrors” in an article in the local media.

For six months, I dedicated myself to acting as a safe resource to residents facing significant violence. I had the sense that my conduct which included alerting the press and working with local activists, was putting me and the project at risk. I kept doing what seemed to be the right thing and thinking, “I would be paranoid if I thought this action would be problematic!”

Still, my job was threatened by a supervisor who had a substance abuse problem. The pressure increased from the management company and a small segment of the residents. I decided to withdraw off the three medications I took for my hard-to-treat depression.

***

My own mental health struggles started with anorexia in high school and led to a rather impoverished and isolated collegiate experience. My best and only friend was an older recovering addict. I lived in a roach-infested apartment complex and made more friends with local people than I did with other students. However, when I graduated, I thrived as a social worker and was promoted once I put myself through graduate studies.

I was aware that I had a personality disorder that was often linked to schizophrenia. However, when I withdrew off my medication I found that I had enhanced intuition and that I experienced facts that were suggestive of corruption more intensely.

***

I called my old college friend and asked for advice and he threatened me. I bolted. I withdrew all my money from the bank, shaved my head and headed for the Canadian Border.

Sure enough, it was just as I feared! I was forced to stop to fill the tank at a gas station. Police had posted themselves at the station. “Did Mommy and Daddy say your brain chemicals are out of whack?” mocked an officer as they approached me.

I had my peaceful-ass taken in taken into custody with unnecessary pain tactics and bruised wrists. I was driven eighty miles from my car to the state capital where they turned me over to a psychiatrist to put me into a state hospital.

I first got confirmation that the mafia was in fact following me five days later after I finally surrendered to the police on a mountain pass late one night. My roommate identified himself as a Native American “hillbilly” with 130 IQ and told me the mafia was following me.

I had already met with my parents who had flown out to support the incarceration, so I told the “hillbilly” that I thought my family was the mafia.

***

I was only physically hurt once in the hospital. The beat down was by staff. My best guess was that I was outing an undercover FBI agent. I was confused. My parents were told I had become violent.

Indeed, I resisted invitations to run away with a Mexican mafia connected female who persisted in wooing me. I refused to join a white gang for protection against her. You see, I was hospitalized for three months in the State hospital. There would be icicles frozen on the inside of the window that was located above my bed.

***

When I got released, I packed the few belongings I had left that weren’t stolen, sold my car, and took a greyhound.

I tried to make it on my own. I got a job working in a daycare; but lost it when I ran out of medication. Then, I couldn’t find any work anywhere!

I had an aunt who found me a job at an upscale Italian deli in the bay area if I relocated. I moved to the outskirts boon town where housing was more affordable. I had a long bike and BART commute. I was able to use the service economy job with some help from my parents, to get back on my feet. It wasn’t easy because I had a bone to pick with the mafia and I was working at an Italian Deli with some substance-abusing rich kids, but I survived.

***

When I found myself incarcerated into a small day room for two weeks, I was traumatized. At least I knew not to accept the hospital social workers housing arrangements. Those kinds of resources are offered with the presumption of ongoing disability. Not only would I have had to deal with loss and ongoing psychosis, I would have had to languish behind the iron curtain of the mental health system. Many of my cohorts do so and end up on the streets. Many get put in jail or otherwise incarcerated and this dehumanizing treatment so often exacerbates the crisis.

For those readers who haven’t heard voices, try going through the traumatic treatment in our incarceration institutions, our public housing authority projects, or many of our board and care homes. See if you don’t come out hearing voices! I finally did hear voices after I escaped the Deli. I heard a demonic voice calling my name.

Now I am employed as a Marriage and Family Therapist and work with people in an inner-city mental health facility in Oakland CA. More and more as people are displaced in the city where I work, they end up in sprawling encampments, hard-to-get-into homeless shelters, board and care homes, bucket automobiles, and if they are lucky in a few years they may make it into an apartment in a housing project like the one I worked in. Many people who live in shelters work low wage service jobs like I did. Nowadays, it is easier for someone who has mental health struggles to fall and not be able to come back like I did.

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In creating a new definition for psychosis, I contend that we not only consider internal processes operating during psychosis or special message crisis, but also external ones. Though much of the eight-part definition for psychosis I propose is, in fact, internal, the last three components are not. This article is about the first two of these external components which involve studying the external behaviour of message receivers, or retaliation reactions, and the external behaviour of society, or social sanctions.

Ultimately, I will argue that by studying behavior openly in group in this manner, we can learn to reinforce the message receiver’s learned behavior of suppressing evidence of messages to the public. Crediting the message receiver for things they already do helps build trust and safety that can ultimately aid in developing strategic social skills that can help message receivers make relationships with tormenters. The development of these social skills I jargonize as nine social skills. To teach nine social skills a supporter needs to conspire with the message receiver and learn what those unique skills might be.

For recovery to happen, message receiver will need this nine-social-skill concept to promote social rehabilitation relationships with people who would otherwise torment them. I will argue that what is most needed for a behavioral recovery is supportive places where message receivers can strategize developing nine social skills. I will share the nine skills I have selected for myself.

It is my contention that if treatment providers and family members learn some of the lessons that come up in group, they would be able to better support healing in individual interactions with message receivers. Thus, I will contend that studying different types of behavior via reading this article is helpful not only for message receivers but also for supporters.

Retaliation Reactions:

I believe that having message receivers identify the actions they have committed that has gotten them punished in the mental health system is very important. However, in most cases the discussion of social sanctions is needed first. Consider that it is easier to complain about the ridiculous treatment that you received than it is to own what you did to bring it about. Message receivers are often used to having responsibility imposed on them. It is wise not to replicate this in creating a safe healing environment. Thus, retaliation reactions and social sanctions often need to be studied in unison.

The definition of retaliation reactions is important to review. Retaliation reactions means acting as if your special messages and especially your divergent view are true. Thus, in a fluid story, using the previously discussed solution of message mindfulness, the articulation of the special message experiences and divergent view thoughts might be necessary. From the story telling process, the leader might have to extract the retaliation reaction behaviors in a normalizing shame-busting manner. Thus, peers can relate telling their stories and consider the actions they did that started the process.

Ideally starting off the topic with a list of examples can help. Consider using the following list of retaliation reactions:

• Glaring with angry eyes
• Not sleeping
• Being overjoyed in a way other people don’t understand
• Looking behind you for the possibility of tails
• Making gestures of prayer
• Talking with voices in public
• Treating others as if they are CIA agents
• Sweating or laughing excessively about spiritual coincidences
• Raging or ranting about an injustice that others would question or call the “D” word (delusion)
• Talking in codes so that the people broadcasting your life on TV won’t be able to understand what you mean.
• Treating someone in a way you wouldn’t otherwise.
• Crossing against the traffic to make a statement.
• Barking at a passing bicycle because you are angry like a dog (which is god spelled backwards)

One can imagine how bringing up these behaviours provokes larger stories. At times, the action on the part of the message receiver can be very minute; but identifying and acknowledging involuntary actions that led up to being punished is healing and fosters responsibility and discernment that can reduce a sense of trauma. Having peers or supporters bare witness to the suffers perception of what they did and how it relates back to special messages and divergent views can be very eye-opening.

What was the message receiver experiencing and thinking at the time and how was their behaviour misunderstood? If they did have violent behaviour, did the punishment fit the crime? How did the fact that they were identified as mentally ill message receivers affect the society’s system of justice towards the deed? What were the positives and negatives of the process? Creating a warm environment where these kinds of questions are weighed, makes for a restorative justice experience. It might be very healing just to have the message receiver’s version of events considered.

I have witnessed that it can be very challenging for some supporters to let the story be told without saying something that will cause the message receiver to be punished again. Thus, I urge facilitators to maintain unconditional positive regard and to normalize reactions by being able to identify times they’ve acted in ways that are less than admirable. Indeed, participants will feel invited to share if the leader shares. Many participants may wait to see if they will be punished for sharing before they take the plunge.

Social Sanctions:

Though some may object to the idea that treatment is punishment, I have observed that most message receivers I work with see it this way. Even when voluntary participants are complicit with treatment and report good outcomes, there might still be an invisible process of institutionalization that influences them. Additionally, compliant clients have observed non-compliant clients and can stand to reflect on that. Even if this doesn’t tip the scale, most message receivers can relate to a sense of being punished that happens in interpersonal relationships in the community. As mentioned in the last section, the sense of punishment needs to be brought up to get the message receiver to identify what they did to bring on punishment.

Again, a personal story from a facilitator is a good way to get the ball rolling. The facilitator might start with something that happened to them and then admit the behaviours they did to bring forth the social sanction. Additionally, the facilitator might consider using a list of potential social sanctions to help the disclosures start to flow:

• involuntary hospitalization,
• seclusion,
• restraint,
• bruising handcuffs,
• physical abuse
• incarceration,
• loss of housing,
• loss of employment,
• loss of social role,
• social rejection,
• public ridicule,
• loss of family financial support,
• anger and resentment,
• loss of respect and validation

The group facilitator is wise to assess for the experience of traumatic recall as the stories are retold. The facilitator might consider strategies such as starting and ending with a grounding exercise, encouraging participants to be aware of the pain in their bodies, and warning participants to use discernment in deciding the full extent of the details to include.

However, I tend to verbally presume that message receivers are tough and can handle these talks. I not only consider this as a way of setting a brave tone for the group, but I have also witnessed that message receivers tend to experience relief and that normal observers or trainees are the ones who get traumatized.

As a result, I start the group, generous with details of my story to set the tone for sharing. I often talk about how I used to struggle with dealing with these details but have learned to share with practice and that I find the process to have significantly helped me. With the story, I bounce between retaliation reactions and social sanctions simultaneously as the details are often fluid in the play by play recount.

When message receivers get to the point where they can review and identify the punishments and the behaviour that led to them, a lot of healing can result. Reviewing the consequences of retaliation reactions seems to help many message receivers gain acceptance of traumatic content.

Starting the Behavioral Solution Process by Proving that the Social Sanction was Unjust!

Message receivers can often be observed experimenting with getting away with retaliation reactions to try to establish safety. When this is observed, know that it is a very important test! I believe if message receivers are provided with safety and support, particularly in a group or a supportive community, they will halt this retaliation reaction behaviour in the community and everyone will be happier. But before this happens, they may need to establish that the punishment of what they went through was unjust by establishing a relationship where their retaliation reaction is accepted, though, perhaps toned down.

Sometimes mirroring the retaliation reaction behaviour and accepting it, may lead message receivers towards a path of disclosure that might one day lead to a sense of safety. However, that is not to say that many message receivers may have a provocative tendency to stay quiet when they are invited to share and to share when it is inappropriate and not safe. In safe treatment this needs to be allowed. It needs to be acknowledged that this is a trust test. I like to celebrate retaliation reaction behaviour with mirroring and humour.

I qualify these comments on managing social sanctions with acknowledging that these stories may be hard for supporters to hear. It is true, in my opinion, that too often they go invisible and the stories of treatment providers or family members rule the day. That’s why I argue that it is a service to get these stories out in a group.

Studying Learned Behaviors to Reinforce them and Prove the Sanction was Unjust:

In preparing to review solution behaviours that involve nine social skills and forming relationships with tormenters, I am learning late in the game that it is valuable to study behaviour that message receivers arrive at to avoid trouble. This may be behaviour that scared participants exhibit at the beginning of a group process. Learned behaviours evade trouble but neglect the need for genuine relationships. In doing this message receivers will also need nine social skills to approach people who are punishing them, gain acceptance and correct the wrong being done.

It is true that message receivers are a diverse group of people and it is hard to generalize. People with positive message experiences or a strong counter-cultural affiliation may vary in their sense of utter alienation and need to connect with perceived punishers. But still, I believe that recovering message receivers must learn to pay lip service to consensus reality and therefore will hesitate to share their genuine selves in a group. They may be particularly challenged with the task of studying behaviour and on being mindful of special messages and divergent views.

Thus, listing learned behaviours that message receivers have can be key to unlocking stories of social sanctions and retaliation reactions. Indeed, listing learned behaviours also may convince participants to be more mindful of their message experience and divergent process in general. The point of highlighting learned behaviours says they are valuable and necessary for survival, but in another sense, it is a way of designating that it is safe here, that we can communicate in a way so that retaliation reactions won’t be dealt with the same way they were before.

In yet another sense, identifying learned behaviours is a way of sharing all the old tricks and highlighting the inherent stupidity of the way message receivers have been treated in the system that has worked to silence them. It is an invitation to share amid a culture of like-minded people and explore forming social relationships with people regardless of the fact the culture has been treated like untouchable outcasts. It is readying the message receiver to enter a slow steady movement of resistance that will enable them to penetrate normal enclaves and operate within them to create a social rehabilitation which can sustain the message receiver in society.

Ideally, the facilitator can start the process of studying learned behaviours by revealing a few tricks message receivers may relate to and encouraging group members to join in the process. To start the process, I will share a list I have started:

• we must lie about our experiences and thoughts to stay free
• we can’t talk about our divergent views without going to the hospital.
• we will be persecuted for our problems and as a result we will be more tempted to focus our attention on our special messages
• we don’t think we have experiences that cause our thoughts, we only have crazy thoughts
• we don’t have people who care about us if we speak up
• we learn to tell Psych ER that the voices or suicidal thoughts are loud when we need to be admitted
• we must learn to say the voices or suicidal thoughts are distant or vague when we want to get released
• we learn that we deserve to be neglected and are second-hand citizens
• we might as well not try, and just accept what we are given to avoid conflict
• we shouldn’t count on being able to depend on recovery and reality tasks to feel better
• we learn that we are better off withdrawing from social engagements
• we can’t trust other people who have message experiences, they are crazy and will burn us or ask for money and cigarettes.
• we must submit to normal people and play dumb, maybe with a little flair/humor
• we must be gamey to build trust with you

Nine Social Skills:

It is my contention that forming social relationships with chronically-normal people who might stigmatize us is necessary for social rehabilitation. Whether this is done through work, a consumer organization, a treatment team, or an activity focused meet-up social group, message receivers need to form relationships with people who can help them avoid the streets. To do this, they may have to practice social skills not only that are specific for message receivers but that are also particular for themselves. These social skills might not be the same as social skills that normals need to get ahead.

When I first started to work through identifying these skills, I tried to make them universal for all message receivers. However, I have been blessed with the opportunity to work in diverse circumstances and have come to see that my efforts are more personal and applying mostly to me and the self-directed life I have chosen. Thus, I suggest that message receivers create their own set of skills that work for them. Some of the nine skills I might utilize might work for some, but not for others. These are skills that can help someone climb up and out of the hole that mental health treatment, poverty, or internalized stigma has dug for them.

Appropriate Skill #1:   Learning lessons from being punished or unjustly victimized

I learned from a great many consequences for the retaliation reactions I committed.  While I had to suppress a lot, I needed to consider the consequences of committing retaliation reaction behaviour, so I didn’t lose the cultural capital gains I had made. This is made easier when it can be established that the punishment is unjust.

Appropriate Skill #2:   Maintaining a public- professional self

I was lucky to learn along the way how to be a professional counsellor. I had to learn to play that role on a regular basis despite a huge amount of ridicule and disrespect.

Appropriate Skill #3:   Killing stigma with kind social skills

I consider these bitter customer service skills that are ways of putting a tormentor on a pedestal no matter how ridiculously unjust the world is. It involves asking each rude customer if they would like a fork and knife (forkin knife) or a free piece of chocolate on you.

Appropriate Skill #4    Hanging in there with some troubled relationships:

I didn’t have any genuine relationships for two years and needed to tolerate a great deal of abuse. So, I extended relationship efforts with many people that I had no use for, just so I wouldn’t be alone.

Appropriate Skill #5:   Skillfully know when it’s time to hold or fold the trauma card to decrease stigma

Once I earned a sense of acceptance, there was always an effective time to come out of the closet with a humble reference to mental health and trauma. Containing emotion behind the disclosure is wise. I consider Patrick Corrigan’s research on stigma when I suggest this 😊

Appropriate Skill #6:   Make multi-cultural efforts to respect the Romans when in Rome.

When my parents divorced I eventually realized there was no way to win: I started to act like my mother in front of Dad; and my father in front of Mom. I learned to have fun with this in multiple contexts. When there is no hope for avoiding persecution, we may learn to do this. But we must learn to vigilantly check this behaviour when we are trying to build social support.

Appropriate Skill #7    Using humor:

Got to!

Appropriate Skill #8    Going towards many different relationships in many different contexts

Penetrate multiple cultural enclaves and participate even if you are persecuted for different reasons. Keep on moving and you will meet people in different contexts.

Appropriate Skill #9:   Presenting a strong front instead of acting as though I need a break

I try to do this because I know I wear my heart on my sleeve and it is a way of killing the normal with kindness.

I like to think supporters who work with specific message receivers and get to know them well enough to understand their learned behaviours to the point where they can help message receivers construct skills that will help them make genuine human relationships with the people who represent psychiatric and other forms oppression to them. Some may need to do this with oppressive voices. They are going to have to do it sometime. Of course, this really depends on the culture that surrounds the person and their experience of being punished and getting treatment.

Summary:

In many ways, the solution of using social skills in recovery from special message crisis requires understanding that retaliation reactions and social sanctions are both wrong ways to behave. Institutionalized message receivers know much better than most that they must submit to normal ideas and expectations. They may not know that recovery is even possible. It is skills that enable message receivers to suppress these experiences, keep them private and create relationships that one day might become of use to them that is necessary. Those skills need to be seen and acknowledged. Then, there needs to be a conspiracy started that can dupe the ignorant majority.

However, the message to supporters, providers and peer counsellors needs to be that social sanctions really damage the important skill of message mindfulness. Treatment needs to find new ways of managing retaliation reactions. Acceptance, mirroring, and perhaps toning it down is so needed. The same old punitive treatment is not going to help. It may control people, but it does not breed safe environments in which messages can be observed and reflected upon.

Treatment needs to conspire with message receivers to teach unique versions of nine social skills. And really, as it stands now, it is up to message receivers to train the supporters how not to punish them. However, it is my belief that message receivers can conspire with each other in support and therapy groups to develop the message mindfulness skills to study the ill behaviour of social sanctions that create institutionalization.

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In these happier days, I am extremely thankful to have my wife and my dog with me. This Thanksgiving we have escaped the urban psychiatric backward upon which I work for a few days in Lake Tahoe. Still complex trauma must be managed. I am bound to have unpleasant holiday as memories bubble up, no matter what I do.

I may remember the first year I got diagnosed with a personality disorder. I was twenty and just out of the hospital. It was the first year I honored cultural traditions on my own. I remember sitting all alone on Thanksgiving in the roach infested inner-city apartment in Camden New Jersey writing a villanelle praying for a phone call because there was no one to reach out to. Indeed, neither my parents, who were traveling, or the female I’d just asked out were going to call.

I may recall awakening depressed the very next black Friday morning to two six-hour seasonal shifts. I might remember the ceaseless Christmas music, the selfish stress of the customers, the vat of Barney Dolls sitting right in front of the cash register I was operating. I might remember the one customer threated to throw-up on me because I was so slow. Others were free to pick the Barney dolls up squeeze them. The “I Love You,” song would play from beginning to end. “I love you, you love me, we are a happy family . . .” All day long! Three or four different dolls singing at a time!

Or I may remember losing one of those jobs because I handed out three twenty-dollar bills to three random customers. One customer even brought one back to prove I had done it. Perplexed, I’d quit the job and blamed myself. I didn’t want to risk getting fired. I’d not noticed the signs that I was likely the victim of a holiday flim-flam scheme. Poor cashiers need to have Christmas too. Forty-dollars does make a difference. They were right to target me. My family did come from money.

Or my mind might flash to the Thanksgiving I was just out of the state hospital and homeless. I might remember how I took the day off looking for work to bike ride away from the city of Fresno CA until I caught a flat. I may remember returning to town in the dark and sinking so low as to ask a worker at the cheap motel I was staying at out on a date. No longer did I care if I got any calls. I believed my relatives were mafia and had used their private fortune to facilitate my three-month hospitalization. They did not have access to my whereabouts. Though I hadn’t run out of medication yet, for the subsequent year and a half I would feel followed and threatened daily! I would be alone at Christmas with my credit cards frozen. At least that Thanksgiving, the pretty motel worker was polite about her boundaries and the fact that I was a drifter. I still remember the bitter taste of the Oscar Meyer cold cuts in my lonely room.

Of course, there are hosts of other bad holiday memories that may come up: Christmas, the years I was working seven days a week and the unstable girlfriend was giving me the silent treatment; the “festive” phone call from a cousin in which I heard her in-laws insult me; the Easter holiday I worked alone at the delicatessen because everyone else conspired to take the day off.

Not only will parts of these holiday experiences flash in my mind, they will mix with current stressors. For example, this year we had a well-loved co-worker suddenly die of sepsis during a routine operation. I work on an urban outpatient psychiatric unit. Supporting the clients through this stunning news meant processing violent deaths in the city of East Oakland. Imagine intimate details about a dear sibling getting gunned down in the Felix Mitchell eighties. Then, others would bring up a twenty-two-year-old cousin or two who’d faced similar demise. Imagine living in a board and care home with nothing but these memories and stories to process over the holiday. Or being wrongly incarcerated in Juvenile Hall during that grief and dropping out of school as a result.

Indeed, in Tahoe I feel guilty for being able to escape these realities and the fact that I survived what I did. When it comes to celebrating Thanksgiving, my mind skips from bad memory to current vicarious trauma, to the people who have hurt me during work politics, and then back to bad memory again.

Simple Formulas for Dealing with Complex Trauma:

I have created some simple formulas that help me endure the weekends and holidays when my head gets flooded like this. I have always enjoyed nature and hiking through my pain. One summer I was facing a lot of pain and I took off hiking for forty-six days and successfully covered six hundred miles of the Appalachian Trail. I learned that surviving natures elements is a great distraction.

I have learned that when I am suffering, I need to get out into he woods on a hike. There, I let the troubling thoughts and experiences bubble up. When I process and honor them I can accept them and move forward. It beats internalizing the choir of negative thoughts I have heard about myself over the years. Moreover, my breathing from the exercise grounds me and seeds of resilience kick in.

Another thing that has helped me endure is to acknowledge that I have disassociated through some traumatic incidents leaving me constantly mistrusting and hypervigilant. As I have recaptured a few of these early memories it helps me remember that I am not entirely a genetic mishap who must be behaviorally controlled in a board and care home. For two years I fought against everyone else who insisted this was my reality. Now I know that this is not true about me or anyone else. Sure, I was the child who never smiled, but I wasn’t smiling for a reason.

Also, it helps me to trace my relationship with the community back through my development. Ever since my earliest memories, relations with people who don’t have complex trauma are at the heart of my suffering. What saves me is knowing that my brain is different and truly hated by the chronically normal folk. I’ve got two or three neurodevelopmental conditions to prove it! Therefore, all those years I was bullied and excluded from the circle, it was because elements of trauma showed in my interpersonal relationships. At the time, I never understood why the world was so cruel. Now, when I recognize why and accept it, I can accept the choices I make and appreciate the love that I have found. I can get the chronically normal negative thoughts out of my head. I have had cohorts call me evil for my social awkwardness! I don’t have to agree. I can just say, different!

And finally, it helps to have found love. My wife gives me the space to go through my trauma on our hikes. She has nurtured other family members with complex trauma. In fact, with a history of learning disabilities and OCD, she may smile, but she doesn’t feel much better a lot of the time. She resists the invitation to gang up on me with the rest of my family during family get-togethers. I am so grateful for such a loyal companera.

However, without the support of my wife, without my writing habit, without grounding myself in nature, the judgements and true gossip of the chronically normal folk come into my head like a plague and rule the day. Judged thoughts are so much harder to let float by like a cloud in the sky. I can really see myself being depressed and frozen in a board and care home without these areas of privilege and resilience.

When Politics Bubble Up . . .

I can see that others gossip about complex trauma and poor social skills. I know it happens because I sit in team meetings listening to colleagues discuss the behavior of our patients with complex trauma. They may experience behavior that bubbles up from those painful memories. Cohorts may not understand. They may judge the person based on their pain when they are not grounded. Then, they talk about behavior out of context.

It is easy, for example, for me to hear a person who frequently assassinates the characters of others, and then I see how everyone around me is full of negative perspectives about me and my work and connect-the-dots. When this happens, it makes sense to imagine that there is a real likeliness that my complex trauma is being exploited. Indeed, treatment teams, behavioral health administrators or other forms of secret societies exist and meet!

In families, secret emails get sent, venting gets whispered-down-the-lane, and suddenly the person with complex trauma is barraged by a world of people reacting to what they’ve heard. It is a lot like being treated on a hospital unit. Indeed, the process is replicated in mental health organizations and even in some peer organizations led by those who vie to direct and manage the unit.

Sometimes in team meeting staff members can learn something helpful about complex trauma in their lengthily venting sessions. Sometimes I take the opportunity to speak up and challenge chronically normal reactions. Sometimes other workers speak up too. There are ways to endure and help heal. But we all must pick and choose our battles, or we too will be targeted.

A Simpler Formula for the Surrounding Community:

I suppose this essay isn’t only about surviving another year for me. As a marriage and family therapist I like to think I can share my story to help the chronically-normal-folk understand how not to make things worse.

Let’s not forget that some chronically normal minds might want to be in relationship with us! They may connect with us in ways that don’t stab us and make things worse. Indeed, these chronically normal folk may be our mothers, fathers, brothers, sisters, co-workers, therapists, case workers, hospital workers. People who are forced to deal with the grief we endure at this time.

Just as I have laid out a simple formula for my survival. My suggestions to the chronically normal brains of the earth is not very complicated. It involves only two things that can be avoided that would make a sufferers’ life much easier.

First, when someone is going through it, don’t tell them they are just being selfish, inappropriate, or shameful. Instead be curious about the stories behind the behavior.

Second, don’t spread an out-of-context freeze-frame of the pain we share, and play whisper down the lane with the community that surrounds. Especially don’t use the struggles against the person to rise to power. Instead try to honor the trauma and suffering the person endured.

If you want a relationship with the person you can tolerate their suffering without personally attacking them. If you don’t, that’s okay, just don’t do the whisper-down-the-lane. There are other ways to be successful.

Initially, I was not brave enough to share the worst memories I have. They involve reflecting on the people who have succeeded by throwing me under the bus in this manner. They often hold high positions in the mental health or other type of social hierarchy. On the other hand, if I were to point them out I would be breaking my second rule.

Remembering the Intention of the Holiday:

In surviving the holidays, I have no need for revenge. I am grateful to be where I am at. The best revenge up here in Lake Tahoe is to celebrate what I do have and take care of myself so I can continue to reach and teach others who are likewise suffering. The point of the holiday is to remember to be thankful. Right before one of the world’s largest genocides, the perpetrators recognized and remembered to be thankful for the kindness of their victim. For god’s sake, let’s hold on to the intention.

Sometimes when I make a biannual escape to Tahoe, I do hate myself for being so lucky! On top of other things, I have survivor’s guilt. But many people I work with on the outpatient psychiatric unit find their own ways to celebrate the holidays despite their trauma. They have ways of being resilient and the least I can do is respect them. No one wants to be pitied. Instead, I can appreciate what they teach me, accept that we all have our ways of coping, and try to be stronger for it. I celebrate with them on the unit and do not feign from mentally bringing them with me on my vacation. And those who are lost and truly suffering as I have been, may they one day find their way to some form of recovery as well!

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