Living with Learning Disabilities as a Psychotherapist, Writer, and Mental Health Consumer

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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A Need for Providers who Specialize in “Psychosis.”

This story is for the mental health providers or peer counselors who are invested in developing treatment for people who have experienced “psychosis” across diagnostic categories. I know firsthand that this can be achieved. I want to help other interested parties develop their own practice so that an important need gets addressed.

Maybe the reader can relate to me! I was hired straight out of college into work in the counseling field. I started to work with an adult mental health population at my second job at the age of twenty-three. Since that time I have been increasingly focused on how to make therapeutic engagement meaningful when working with people in “psychosis.” In the field there are many who will say or imply this is not possible. They may argue that the mental health system is the best we can do.

I believe uniquely talented specialists are needed primarily because the mental health system fails so many people. We need outreach specialists with lived experience who can meet sufferers wherever they are at to encourage them to seek out therapy specialists, competent in group and individual practice. The more people with lived experience the better! Even better we need a system of self-support to sustain people outside the system, like the hearing voices network.

 

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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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Living with Schizophrenia in Oakland: Esteban Santiago-Ruiz

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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Living with Schizophrenia in Oakland: Posted on bayart.org, December 10, 2016

Through a sea of tissues and a hacking cough, I scan Netflix pressing that stubborn button on my Roku remote multiple times. I read the summations of shows for several minutes until I come across a documentary called, the 13th. Finally, I settle in. Resting is not an easy thing to do with that constant sense of urgency I live with.

I don’t know what’s worse these days: dragging through a pre-holiday week on the outpatient psychiatric unit on Dayquil; or listening to the radio talk about impending loss as the new cabinet of Trump supporters get selected.

A cross town slog into East Oakland after work on the unit one night last week revealed once again that the streets are ever-burgeoning with homeless, some of whom I know intimately. In each car encampment, I saw a distinctive cultural story that needs to be heard.

Continue reading “Living with Schizophrenia in Oakland: Posted on bayart.org, December 10, 2016”

On a Writer’s Need for Acknowledgement

Ever since I finally, at the age of forty-three, published some of my writing, I’ve found that I am particularly prone to pain again. Ever since, each morning I have woken up driven to find ways to get people to read my book.

A year and a month later, I have primarily had to pay people to check out my work. There are those who accepted the free book without giving it a read, let alone write promised reviews. Sure the memoir itself has collected two awards and primarily five star reviews, but amid the boom of self-published authors I find myself more hurt by the silent echo, than grateful to the friends who have read, and not balked.

After a tough week,  I find  this pain expounding itself through every facet of my consciousness. I am out walking with my wife and I think about how psychiatrists have hustled me through explanation of my psychotherapy; about the numerous presentations I have provided that ended up empty; about leaders of the psychiatric survivors movement who promote those with less experience; about the presentation when I had people finally laughing and listening to me, and the smoke bomb that forced evacuation. There were past company owners who hired me, ignored statistics as I worked sixty hour weeks and demoted me . . .

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Homes for People with Mental Health Challenges

Perhaps, early in my career as a mental health counselor, I couldn’t consider the effect of mental health warehousing.  Landing my second professional job gave me the financial power to leave a ghetto apartment in the most murderous city on the East Coast. Since I was only just entering a Master’s Program, I felt extremely privileged. As a result, I aligned myself with my supervisor and other more experienced workers. Without credentials, I was focused on working with people who would get my back.

One day, I received a client and was ready to get to work on housing issues, when I found out that she came attached with a more experienced case manager. Though not very talkative, she did tell me very clearly that she did not want to go to a particular boarding home, the largest such facility in the county. When I talked to the case manager who would later be my supervisor when I got promoted, he was clear about the woman’s future. She had to go to the unwanted boarding home.

“Wow, that girl is really sick!” I heard the coworker who worked the graveyard shift at the crisis house say.

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The Mental Health Industry Needs to Overcome Stigma

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:”