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.

***

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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Presenting at CASRA Conference May 3: 10:30-noon

 

TITLE OF PRESENTATION:

Changing the Treatment Paradigm Locally for Those who Experience Psychosis

 

SYNOPSIS:

This workshop outlines how diverse persons with lived experience provided outreach, made presentations and ran groups in ways that honored their lived experience with “psychosis.” Imagine how a system populated with such specialists might improve treatment for those who might otherwise be wary of accepting services.

 

AUTHOR:

Tim Dreby, MFT Rehabilitation Counselor, Author, “Fighting for Freedom in America: Memoir of a “Schizophrenia” and Mainstream Cultural Delusions,”

 

LEARNING OBJECTIVES:

1.Participants will be able to articulate two reasons why psychosis can be treated as a as a cultural issue.

2. Participants will be able to identify three reasons why paying more mindful attention to elements of universal process of “psychosis” can help lead to social rehabilitation.

3. Participants will identify three things that can be done locally to increase engagement of individuals who experience “psychosis”.

Stigma

Jargonizing the Stigma Concept:

Stigma is a mysterious external process that becomes internal that all message receivers face. Though stigma works in many different ways, I think it is particularly astounding and deceptive that it is not considered part of the definition of all forms of schizophrenia disorders. In my mind including it in the definition is a way of acknowledging and respecting that part of the negative outcome for those who suffer is the way society and our culture defines and treats the phenomenon of special messages. Acknowledging the role of stigma suggests that the outcomes of people becoming resigned to isolate, to sit and smoke all day in a board and care setting, is not only the result of their internal choice or abilities but the systemic interplay of individuals and the community that surrounds them.

For example, having myself transitioned from being treated like a hard-working, conscientious social worker who inspired social change, to a mental patient who needed to be locked on a ward for my own safety, I know that the power of this concept first hand. The transformation was profound! Suddenly my strengths were no longer defined by me. As I walked in circles on the floor to maintain my need for exercise, the only strength my psychiatric nurse gave me was that my family, in spite of all the hurt that I had experienced over the past fifteen years, was good family support. Two years later stigma still dogged me as a deli worker who worked under the constant threat of being fired. Now, fifteen years later, in spite of the fact that that I have a house, a wife, and a job where I am appreciated, I still battle with a sense of being slandered and rejected while my work remains unacknowledged. While I have not let stigma ruin me, I work with people who are extremely undervalued who are fighting the same demon. I write notes that diminish their efforts so the organization I work for can get paid.

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Letting the Public Know I Suffer from Schizophrenia

When people seek mental health services from me, I routinely break what was once a cardinal sin to me early on in my recovery; I review my diagnostic history. I do this with love in my heart to help inspire recovery, however, in the process, the “s” word, “schizophrenia,” will bubble up.

I do this habitually in the outpatient program I work in. I have done this by redefining the medical model definition of the word so that it more accurately reflects the shared internal process that we with “schizophrenia,” or “schizoaffective,” or “bipolar,” or “depression,” or hosts of other diagnoses experience.

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The Male Heart

In the company of his own fellowship

A coldness impales the male persona

As he stands in a barren winter field

Where the rapidly shifting wind throws his

Chilled stiff body into nothingness.

He stands trying to conceal his shiver.

 

Above the infinite eye of the night

Glares down upon the stupid smallness

Of his existence, reminding him

That millions have died in war, all of whom

Have been embedded into the cold ice

Of this winter night. Masculinity

 

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Nine Social Skills Continued

Nine Social Skills I Developed for Myself:

Though in developing these social skills, I initially took a stab at writing from a universal perspective, I have had enough experience running them by people in groups to recognize that many of these are personal. Mad people are very diverse. As a result, the following are meant to be helpful in helping message receivers consider social skills that they need to penetrate the cultural enclave of their choosing. However, it is a wide world with very distinctive individuals and cultures so message receivers need to be constantly exploring their social skills even if they are neuro-divergent, like me, and struggle to do so.

I, for example, have learned to adapt to a ghetto culture and am somewhat comfortable in these contexts, however, have a difficult time switching so that I can be in mainstream culture without losing my social skills. When I feel excluded or sense gossip and slander, I withdraw and lose my ability to socialize. Thus, my ability and sometimes willingness to overcome deficits varies.

The following are set up to help me survive and overcome hostile environments. I’d argue that all message receivers need to consider adjusting social skills to overcome stigma and work together to help each other be successful. Perhaps some of what I have put together for myself may help message receivers and their helpers spot these issues in others and better reflect on the social skills they need to use to replace their retaliation reactions. The goal is to build relationships instead of break them.

 

Social Skill #1: Learning lessons from being punished or unjustly victimized
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Nine Social Skills

To avoid punishment, message receivers will need to build relationships with people who socially sanction the message experience. Social functioning will often require that the message receiver engage in relationships that are in the culture of the “normal” consensus reality. In fact, by the time many message receivers make it into a group many are taught through the mainstream system of care (and perhaps through internalized stigma) to deny their symptoms and play it normal. Indeed at the onset of group, it can take a long while for many group members to share message experiences not only because those experiences are traumatic, but also because they fear being persecuted for doing so. While there are message receivers who stick to their guns especially early in their message crisis, many experienced message receivers already know what it takes to survive in a world dominated by storm troopers. Often, it is anger and emotional desperation that makes them act out their symptoms when in crisis. The game becomes to contain these experiences so that there is no punishment. People may notice something is up with some of us, but social sanctions forces people to contain themselves when they can. Often times the way this is done is silently disdained. And still there are very different degrees of social skills as message receivers do this.

For me personally, learning to submit to this process was very challenging without medication. I do not consider myself to hold good social skills on the whole. In addition to struggling with messages, I like many message receivers have been diagnosed with dyslexia, ADD, and consider myself to be influenced by a mild level of autism. My whole life I have gravitated towards people who are different who might give me a chance. Thus, message receivers who are likewise neuro-divergent might also struggle with basic social skills like looking people in the eye etcetera. While I do my best to accept what I perceive to be the bullying nature of a great deal of social interaction, I do not like the fact that social groups exclude and differentiate themselves from other groups. For me, genuine cuddling is very difficult. As a result, I tend to come from the vantage point that social skills are very difficult when this may not be the case for all message receivers.

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