Generativity and Recovery! Part Three: Dismantling Industry Constructs to Make Generativity Possible

When I think back to my twenty-two-year career working with other providers, my mid-career first-break, and the things that helped me recover, like my dog, I know for sure that the standard of care needs is a disservice to those who experience madness.

Many people who have breaks from reality get that permanent housing trajectory in their heads and rant and rail against it. They may still believe that there is such a thing as schizophrenia and be disinterested in the lives of their peers who are clearly schizophrenics. Those who have breaks, like me, are extremely diverse with distinctive cultural backgrounds, different access to resources and differing levels of buy into to the concept that they are permanently ill with something that will never go away. Those without a history of privilege become very susceptible for decline into permanent warehousing conditions that make healing very challenging.

Clearly, dismantling industry constructs for things like schizophrenia and poor prognosis is an important component of recovery. I have a hunch that to plan for generativity, schizophrenic constructs, other disorder constructs that block the formation of counterculture, and constructs from developmental psychology need to be challenged.

 

 

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Generativity and Recovery! Part Two: Generativity in My Own Recovery

My three-month psychiatric incarceration seemed to be aimed at discrediting me after I had leaked newspaper stories. On my way to Canada to seek asylum, I was stopped by police. I evaded them for three days through rural towns and surrendered one midnight, from a ditch on a mountain pass.

It was hard for me to accept the way I was treated. Confined to a ward for two weeks, I walked in circles. I barked on the payphone testing many of my supports. They all just said I was delusional.

I really did learn a lot from a mob boss’s daughter. There are a lot to the rules that govern those of us who get trafficked in this land of the free. Still, I did what I could to disrespect the mob especially because my counselor told me not to. And so, I endured a month of chronic warehousing conditions. I had to wear other peoples’ clothes to brave the ice-cold of the barely heated ward.

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Generativity and Recovery! Part One: The Need to Plan for Generativity from the First Break

 

In the United States, when a person has what is often referred to as a first break, the courses of action that get taken against them may end up being a crime against their humanity.

While there can be very diverse responses from family and friends, there is the unfortunate tendency to turn to the mental health industry for support and direction. Many providers in the industry only know the standard of care which is to refer the person to a hospital and psychiatric medications.

Few providers take an interest in understanding and exploring the important experiences that lead to the break. I call these experiences special messages. Finding a provider who is curious about these experiences, skilled at understanding them, and who knows better than to try to suppress them can be rare.

Many providers fail to acknowledge the trauma involved in the lives of the people who have first breaks and that the trauma that gets worsened as the standard of care—forced medication, social security, revolving hospital doors, and warehousing—get implemented. Many presume this is a necessary process.

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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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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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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.

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Retaliation Reactions

Jargonizing the Retaliation Reaction Construct:

This chapter’s construct consists of natural reactions that come up for message receivers as a result of acting as though their message experiences are the dominant reality.

Retaliation reactions can be as minor as a facial response: a glare, or a laugh; and in more dramatic occasions can involve actions that put the message receiver or the public at risk. In the course of this chapter I will provide some examples from my experience. While I certainly have observed the actions of others as most readers have too, I will limit the examples within, to my experience. Perhaps doing so will help make a case for group leaders to demonstrate their wellness by being able to take responsibility for their own complex behaviors.

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