The Issue of Medication for Psychosis

The issue of whether to take medication or not can be a difficult one. While medication may work well for some, it may do little for others. This syncs with the fact that experiences associated with psychosis are vast and varied. People who suffer are very diverse, and causation remains nebulous.

I believe that causation for each person is a constellation of a series of modalities. I have witnessed how comparing causation theories becomes the spice of life in a psychosis support group. I find support groups for people who experience what is labeled as psychosis to be full of cultural learning that can result in powerful growth and wisdom.

As someone whose been in recovery for fifteen years, I have also witnessed the issue of medication to be politically divisive amongst message receivers or people who experience psychosis. Personally, I am starting to see it more as an element of cultural diversity in which differences can make the support groups I run vibrant and spectacular.

I believe I have a moderate view on this topic, which means it can be hard not to feel under attack in differing circles. My hope in this article is to provide perspectives to help people make their own decision about medication and work together regardless of their views and life experience.

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Learning Disabilities and Psychosis

Never saw my hometown until I stayed away too long

I never heard the melody until I needed the song . . .

. . . I never I spoke “I love you” till I cursed you in vain

Never felt my heart strings until I nearly went insane

                                                           

–Tom Waites, San Diego Serenade

 

It is funny how sometimes one cannot really see themselves until they get a glimpse of a harsh paradoxical reality. Perhaps doing so gives one that alternate perspective that is so necessary to really see oneself and gain wisdom. I think that’s what Tom Waites is getting at in the excerpts of his song I posted above. That is why the ability to relate to others is such a powerful teacher and healer that is so needed in a therapeutic endeavor. Other people’s struggles help us stop and see ourselves better. Even if it is painful, growth is likely.

And, just as the song goes, I never really saw myself as a learning-disabled person until I just recently had the opportunity to sit with an individual while she was receiving a mid-life diagnosis. It was a diagnosis that I thought might be helpful. Little did I know that before this sitting, I rarely considered the full effect of how a learning disorder affects me as a writer, therapist and mental health consumer.

 

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Writing for Mental Health: Six Basic Considerations

I like to think that I could recommend writing to some other people who have been subjected to a diagnostic labeling process that diminishes their hopes and potential. Indeed as emotional tension pulses through my back and appendages, I have found few other outlets that are there for me like the mixing and mastering letters.

Sure, I have been sent to a shrink for being who I am. Sure, I have been buried in institutions at different points of my life. Indeed life on that trajectory has filled me with loss and lack. But when I’ve found myself incarcerated immobile, I’ve been blessed to find value in defining it. Initially as a teen, I found  appreciating expressive words through music got me started. The more I switched from song to verse to story, I found the problem-solving that takes place in the editing process satisfying. Indeed for me there are few other outlets that rival writing in terms of learning about life and wellness.

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A Vacation Day for a Schizophrenic:

Fifteen years ago, I remember hearing a psychiatrist who had just been away for two weeks say, “There is no such thing as a vacation when you are schizophrenic!” As an unlicensed professional vying to get a staff position on the unit, I had carefully avoided rolling my eyes. I had politely nodded my head as though it had been a thoughtful thing to say.

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This year’s weekend of April 1st, my wife supports me in insisting that we take a vacation day. She packs up her hybrid SUV with camping materials and when I finish my Friday commute, we hit the interstate headed north. We plan to camp and hike at the Kings Range on the Lost Coast in Humboldt County, but we know even before we sift through the remains of the Bay Area traffic, there’s no way we are going to make it the whole way.

We make it to the city of Ukiah and drive until we find a Safeway. I am about ready to drop as we load our shit into the front of the car and depart to hit the restroom. We pass the panhandlers and the no camping sign and I start to stress about the possibility that the security will force us to move on in the middle of the night.

“Don’t worry about it my boobie,” says my wife.

I look into the eyes of a particular panhandler and hate our privilege. There sure are a significant amount of late night shoppers who are finishing their long weeks. I ponder the meaning of it all over the urinal. After we regroup, we steal into the back of the SUV.

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When the Public Studies Mass Murder

January 7, 2017: I sit stunned in the wake of the tragedy of yesterday’s Fort Lauderdale shooting. As statements appear in the press that insinuate that these evil acts need to be avenged, I grieve for the senseless loss of life.  I grieve and I also wonder if anyone cares to understand the dilemmas that people like Esteban Santiago-Ruiz face. Having just endured another holiday season as a mad person, I am reminded of the importance of giving social scapegoats a space to celebrate their otherness. As a licensed psychotherapist, I create safe places where the untold story can be heard. I know that a state of victimhood can be transformed to a celebration. I see it happen every day. It helps me exponentially.

Having caught a fever, I spent Christmas day in bed in victim mode, reflecting on the way I feel scapegoated. Instead of working through the pain like usual, I lay incapacitated, overcome. I thought of my project design that could bring specialized groups into the county service system. Turns out eighteen months of pro bono work only further smeared my reputation. I not only am left unnoticed, I know there are rumors based on past politics and current ones that I can do nothing about. I reflected how, when I recently shared these ideas in a survivor work group, I only felt further marginalized. This hurt, as did the fact that my award winning memoir isn’t selling.

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Multi-Culturism in the Hacienda of Mental Health

Back when I was just a yuppie, I learned a few points of wisdom about working through stigma. I needed mentors to help teach me how wrong stigma is. Now,  I want to pay forward some of  what I learned outside the class room  to some mental health academics and administrators who may not have gotten the same lesson.

I was learning to chop cheese steaks at a Korean owned deli and instantly enamored with this mentor on the grill, Mister Ray Gee. The deli was located just across the river from downtown Philadelphia, in the North Camden ghetto.  This Mister Ray and I were just meeting. We were both the same skin-and-bones size, our last names went together in rhyme, and any middle aged man who didn’t have a gut was an inspiration to me.

Mister Ray took one look at me and exclaimed in one breath, “Wow you are an Asshole! But don’t worry, it’s not your fault!  You were just raised that way!”

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Recreating Myself within a Changing Economy

Seventy years ago my family closed a lumber company in upstate New York. A series of small towns had built up primarily around the business and had to be abandoned and redefined. As is often the case, times change the economy and people have to find new ways to survive.

Growing up, I never considered that the closure of the company had much of an effect on my family.  Perhaps as the first born in the second generation since the closing, I just didn’t notice that I carried an unspoken weight. For years I have seen my father at times thanklessly function as the steward of swaths of land and vacation homes up in a small town within the region. This was not a footprint that I in any way would end up following.

Usually one does not think of a child born with such immense privilege as ending up homeless and in a state mental hospital. At some points in my journey I have been defined by long lists of psychiatric diagnosis. I prefer to consider myself as having chosen to find a new way to survive based on a changing economy.

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Honoring traditions that helped me escape:

My revolt against my father’s and my family’s legacy was not well understood without lists of psychiatric labels. Now, as I am preparing to honor my father in a seventy-fifth birthday reunion in the belly of the beast from which I fled, I have a better sense of how I let the traditions of my family down.

The reunion is to happen in a small company town in upstate New York that was founded a century ago. The town provided timber for city-folk and funded a family structure that I have chosen to leave. Those profits are perhaps dwindling due to close of the family business in the fifties. As far as I know, the just property taxes that exist for swaths of vacation property that remain kill any kind of profit. My father has honorably and at times thanklessly managed the whole deal for us all.

The gifts that I was given: Continue reading “Honoring traditions that helped me escape:”

Viewing Myself through the Healing Voices Documentary

The Healing Voices documentary is a bold collaborative effort to recreate the public perception of people who hear voices or experience altered states. At a private viewing, amid a room of like-minded individuals there is cause for all of us to rejoice. We all sit engaged, excited, and proud as concepts and materials that we all work to share with others on a daily basis surround us booming through the theater. There is laughter, an occasion whoop or coyote cay-cay-cay. The past fifteen years of my recovery and efforts to share my developing health to others flash before my eyes.

The movie tracks three individuals: 1) a well-known leader in the movement and co-producer, Oryx; 2) a peer support leader from a small town setting who is a Mom, Jen; and 3) a youthful and creative outsider from a setting that never becomes clear to me, Dan. As this develops, I start to see three levels of exploration honored.

First, Oryx represents the movement leadership and has connection to all the expert philosophers who are interviewed to back up an alternate way to manage and treat these wide collection of experiences. Robert Whitaker, Bruce Levine, Will Hall, Marcus Romme are interviewed. A clear vision of the indubitable damage that the illness medical model has done, the senseless demand that society imposes that all signs of illness are suppressed and manner in which the western world has over emphasized psychiatric medications. Oryx details his journey with altered states at a safe distance and how it motivated him to found the Freedom Center with Will Hall. There are European cameos of people from the hearing voices movement who I recognize like Rufus May, Jacki Dillion and Rachael Waddington.  Continue reading “Viewing Myself through the Healing Voices Documentary”

Learning Life’s Lessons in the Least Likely of Places

I look out the window feeling like I am straight out of the mental institution as my wife’s SUV pulls off the freeway toward the Marriot Hotel. We are on our way to visit my wife’s dear friend and goddaughter at an Irish Dance competition. I know I will be feeling straight out of it: trying not to let my face go flat; exhibiting all the buoyant pleasantries. It is one of those rare occasions that I will be integrating with the “Normal” folk. I dread this. Often all I learn in these kinds of contexts is that I am less than.

Perhaps I feel this way because I work nine to five in a mental health ward that serves inner-city Boston in the Roxbury neighborhood. I have done this for thirteen years.  I work with an extremely deprived lot of people and it can be hard to leave it behind.  Before that I was underemployed for a significant amount of time having just moved into Boston from an out-of-state, State Hospital where I was an inmate for three months.

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