What was emerging now was different than anything I had experienced prior.

I had just gotten support from relationships I had built over the past year at the Quaker meeting-for-worship.

Maybe my situation at work had been getting whispered about among my friends. Maybe my spirit was exuding a sense of desperation. Either way, I’d felt safer under the spell of the service, the last bit of community support I would experience for years.

When the service was over I’d checked in. A year-long friend gave me a deep hug with just a little more boob than I was comfortable with.

“I guess I am learning that it’s not safe to talk about what’s going on at the Morrison to anyone,” I told my slightly newer friend.

The Morrison was the notorious Section 8 housing project where I worked setting up social services for disabled residents. The deal was, homeless and disabled could get off the streets and into affordable housing, but they had to live in crime ridden contexts. Many good Seattle folk were concerned this just wasn’t good enough. As a result, there were frequent news articles written about the project.

“Well, I guess you know I will be holding you in the light,” said my newer friend who was so genuine I knew he was not an informer. He could be a life-long friend, I thought as I fingered the phone-number-paper-scrap in my pocket. I had obtained the number from a female just before the service.

But alas, I was ready to lay down my life to rectify injustice of what I’d seen at the Morrison. I was directly responsible for three recent news articles articulating the neglect. Maybe it was just a matter of time until they figured out it was me.

Now, here in this adjacent coffee house, it was as if I had just walked into a sting operation.

Having just gotten barked at by this addict with bulging veins when I had tried to use the bathroom he was occupying. I sat waiting with urgent need to pee, watching this father with his son.

The father was hefty and awkward, and his son was this with-it Seattle youth who looked adoring.

In fact, this father looked like a hometown acquaintance. I had just last night heard that this acquaintance had been found with a bullet in his head in his shed. Just last night, my oldest friend had told me the story when I contacted him. I had contacted him in hopes for his assessment of the level of danger I was experiencing.

“Just don’t let that happen to you!” my friend had said concerned.

Now it occurred to me that my oldest friend and I were basically saying this “suicide” sounded like a mob hit. Was it possible that the FBI sent a look-alike because they were tapping my phone?

Now this familiar looking man goes to the bathroom and pounds on the door. I see the addict emerge and fire an insult at him just as he had done to me. But the man, unlike me, was waiting for him. He barked right back. It was as if he were punching the addict in the gut. Still, no one was going to get in that bathroom! But the father walked away and was respected by his son.

Was this scene really staged by an arm of the government that trying to get me to change my Quaker values? I had a sense that I was meant to see this interaction! Was I being brainwashed into taking people out?

I did want justice; but violently taking people out and putting the wrong people in jail was more the work of the local law enforcement! It wasn’t what I was about.

My mind skipped. The night before I’d asked my mother if I had ever been sexually abused. I’d brought up some memories and had suspicions with a menacing tone.

I was believing that I was traumatized, not a mental case like my therapist had been telling me for the past seven years.

It was true, I once suffered from an eating disorder that almost killed me. It was also true I was extremely shy and had some disassociated memories. But still I had nothing direct to prove I was experiencing PTSD. Instead I carried the diagnosis of a schizotypal personality disorder. That meant when people picked on me I was paranoid.

When I finally left the coffee house, I drove north past my apartment, to the discount theater where I caught the afternoon showing of Me, Myself, and Irene. As the movie progressed, I remained astonished by the coincidences. Jim Carey had to suppress a secreted abuse. He had to raise his wife’s kids alone. Everyone around him mocked him. It was like that for me too. That was what my life had been like.

Now, as I watched the film for the second day in a row, I wondered about the role of the FBI following him. It was ironic that they were using his psychiatric profile to pin blame. Meanwhile to protect Rene Zellweger from the abusive ex-boyfriend who is controlling the FBI, Jim Carey has got to go through a caper to cure himself. I sensed that this is what I was getting ready to go through!

I knew there was alarming abuse going on at the Morrison. There were the secret files the management company held. There was a world of undercover informers and intelligence. These were the real muddy waters that infect those corridors of housing for the disabled, the backwards, the board and care homes, the jails, the prisons, and the inner-cities. I wasn’t accepting those: “now, that sounds like your paranoia!”— words my therapist frequently sang at me.

Since I stopped taking my medication a few weeks ago, I was starting to better see through the limited lies of the mental health establishment.

Back when this movie first came out, I choose not to see it because of the criticisms of the AMA! Now, I was meant to see this film when I did. I concentrated hard on the details guided by a higher power. More and more, the film seemed to be about me!

Earlier that week while at the Morrison, a resident had given me a great compliment about my work. “But I just want to say,” he added, “one time we had a worker like you who came and fought for the clients, but then he lost his job. He had to come down here and live as a resident himself. I just don’t want that to happen to you!”

As the movie finished, I felt at risk. I felt compelled to figure out the truth!

Later that night I made more phone calls in the bunker of my room just as I had done the night previous. Eventually, I called by best college friend who was fifteen years older than me and whose first career was that of a drug dealer. I called him believing that I was selected for this high-profile job by people who knew I would take it. People who knew me so well they knew what I’d do before I did it.

Indeed, it had been a strange shock to all involved that the power-brokers had selected the contract proposed by our agency. Now that I was getting wise, maybe I was becoming a threat.

My best friend always had delusions of grandeur that were associated with his bipolar disorder. He had this thing when he got manic. He sounded like he was connected to the mafia. He had shown me so many great mobster movies and was always seemed to use them to teach.

But now he replies in blunt tone “If you ever betray me, Tim, you need to know that I do have the power to harm you and I will use it if I have to.”

My mind sped through all the coincidences that had caused me to form this strong connection with my college friend. Was it true that it was all as it seemed? He often called himself a dry drunk. Maybe that meant he was still in the mafia.

Within twenty minutes I packed my car with the fundamentals and I took off. I would not live under this threat the rest of my life!

When I left Seattle that evening, I stayed in this state of emergency for two years. It wouldn’t be until many months after I returned to taking medication that the crisis dissipated.

On my way to Canada, I got stopped by police separated from my car. I was tracked for three days until I was remanded into a three-month psychiatric hospitalization in Montana State Hospital.

Once discharged, I got off the streets by getting a job but ran out of my discharge supply of medication. When I was told not to return to my job, I still had to pay rent! Despite intensive local efforts, the only job I could get was an arranged job at an Italian Delicatessen. To get the job, I had to move to the bay area.

To this day I still believe the job involved a mob connection. I know this sounds unlikely to many. It’s true that half of my evidence was faulty. But still a lot of it turns out to add up.

I also think I was correct about trauma and the mental health system during those tense days I was going through spiritual emergence almost eighteen years ago. I still work in the mental health system amidst great trauma and exploitation. I cannot maintain living in the murky waters of this modern-day fiasco we call the mental health system without using the medication I was started on twenty-five years ago.

I now pay mortgage on my own house, but still have no desire to do what it takes to be included in the false sense of community support I had back in Seattle. I wash my hands in the muddy waters of the mental health system.

It may be true I work hard; but I make money while my brothers and sisters remain warehoused and in dire circumstances. I sometimes think my ability to see all the angles and oppression is not really a disability. But I take my medication despite all the side effects to tolerate the abuse I see.

The post Spiritual Emergence in the Muddy Waters of the Mental Health System appeared first on Redefining "Psychosis".

When I was in psychosis, or what I prefer to call the message crisis, I was extremely angry when my family used leverage to force me into treatment. For starters, they contacted the police and supported a three-month hospitalization that kept me from seeking asylum in Canada. I concluded that they were a mafia family and the reason I was getting followed and harassed.

Perhaps this scenario sounds familiar to the reader? It lasted for two years after I was released from the hospital.

I continue to feel hurt by many of the things that transpired due to leverage. I may be able to act as I forgive, but I will never forget what it was like to experience such cruelty alone.

Thank god I was wrong about some of it!

Back in those days, I never imagined that I would someday write a blog about how to effectively leverage a message receiver into treatment. I would have sworn that I would never sell out so much to even suggest such an action.

Rethinking the Issue of Leverage:

Thanks to the word, “recovery,” I have been blessed with an opportunity to return to my career in mental health and work toward providing treatment for those who suffer from message crisis. It’s true, I have had to look the other way and swim against the tide a bit, but I have seen a few things work. I have witnessed how even things that I think would have been detrimental to me, can be helpful for some people.

Now, with hindsight as twenty-twenty, I ponder the issue of leverage for the conscientious family member, loved one, or helper who deals with the message receiver who is stuck. While a lot of my work emphasizes the fact that message receivers have a lot in common; there is also vast diversity in terms of strengths, preferences, support, and resources. I want to consider the message receiver who withdraws from their support and the world into the confines of their room or board and care with nothing but, perhaps cigarette smoke, and the wonderland of their messages to comfort or torment them. A recent Facebook post and unassociated conversation encouraged me to do this

 Establishing Treatment Instead of Confinement:

I think the first hurdle to clear is to assure that there is treatment available. This means that message receivers need to work with people who do not engage in senseless confinement and exploitation.

In my opinion, it is rare that using leverage to impose hospitalization and involuntary medication works out. Unless the person is on board due to their own large amount of suffering, imposing involuntary hospitalization or medication may sabotage future treatment. Let involuntary hospitalization happen as a natural consequence, not something to leverage. Anyone who is familiar with trauma research might tell you, it can take a long time for a person to work through being punished for an involuntary experience that is already traumatic.

Finding real treatment is a very tall order in a public system that primarily trains the message receiver to use medication via the revolving door of incarceration. Many therapists go against their licensure training to even attempt to treat a person in psychosis. I was taught to refer out or utilize the psychiatric emergency room.

I have found that developing treatment often involves a space to process how traumatic and confusing incarceration feels.

Additionally, I have come to believe that treatment involves workers and supporters who are curious and knowledgeable about psychosis with copious and flexible coping strategies, and the humility to engage in ongoing learning. I do not believe true treatment can happen when the content of psychosis is not welcome in the relationship. I think when the reality of psychosis is always suppressed, exploitive confinement might be as good as it gets.

The Natural Benefit of Community and Structure:

During the crisis, when the message receiver responds to their terrorizing or spiritual messages via social withdrawal, treatment may require community and structure of intriguing tasks and efforts that help draw the message receiver out. In the process of trying to create such an environment, teaching the message receiver to be interested in and respect their peers can really help.

While good treatment offers the safety of time to heal, it might also require an ongoing nudge toward challenging the message receiver to move on to their hopes and dreams when they are ready. If treatment doesn’t do this, it may easily get misunderstood as confinement. I do not believe productive trust can truly exist until the full extent of recovery hopes and dreams are supported.

I acknowledge that the function of having treatment communities available, which are costly and often scarce is a real service to the special message community. Still, I am not saying that they are for everyone. Treatment might also involve the freedom to say no, but the option of less restrictive alternative actions, such as individual treatment mixed with self-support activities away from the treatment team.

Yes, a treatment facility needs to sustain itself by making money, but it also needs to not treat the message receiver like they are a commodity. It may be okay to ask for some level of commitment to services, but it is not fair to push commitment if it does not lead to something that involves substantial sustainable community integration.

 Importance of Supporting Structured Activities Outside of Treatment Milieus:

Even if community and structured activity treatment exists, it is important not to overly leverage them. If they don’t exist or if they are unwanted, it may be important for the message receiver to receive support towards the social rehab endeavors that most matter to them and to have support in those endeavors.

Social rehabilitation support needs to capitalize on healthy, goal directed activities away from psychosis. Thus, any interest needs to be acknowledged and supported regardless of their ability to meet immediate career needs. If the message receiver is working against their psychosis, there is no need to impose leverage towards things they don’t want to do, like treatment.

A savvy supporter will try to help a message receiver do what they can to reflect positively on any activity away from message crisis. Likely these efforts are happening, but in my experience, they are not always talked about because they may seem to pale in comparison to the rat race we are all supposed to be in. Championing them may mean uncovering them and holding them up to the light instead of presuming that all is lost.

Processing and Reflecting on Messages:

I think it is fair to presume that the message receiver will need to take some time to process and reflect on their voices or other relevant experiences. As I suggested earlier, not inquiring about the magnificent learnings and focusing only on their inactivity with negative comments is rarely fruitful. Rather, encouraging a message receiver to schedule reflection/process time is important, as is encouraging them to join others this endeavor. The message receiver might be encouraged to do so with a therapist or mentors in a self-support group, or at least during exercise.

If a message receiver comes to therapy, it is important to be curious about the experiences they are going through and marvel and champion them, just as you marvel and champion activities away from psychosis. Support groups that bring out the silenced stories and give them time and perhaps some collective wisdom are important.

My Own Experience with Leverage and the Importance of Picking Your Poison:

My parents required me to take six hours in addition to my sixty-hour work week (two-125$-hours, plus travel time to and from the office) to meet with a therapist. A modest but life-sustaining amount of financial support was attached.

Had I been able to talk to this therapist about my messages without getting judged or treated disrespectfully, I may not have resented the large chunk she was taking away from my future nest egg. I may have been thankful. The exercise on the way to therapy plus the exercise I got on the way to my job was helpful.

Even though I did feel like a resentful slave or a piece of human traffic, what did help me get through this trying time was the fact that I had chosen it.

I wanted to work. I had happened to have worked in too many structured programs to feel they were worth my time. I felt that many programs I had worked in were too disempowering and provided little future.

I knew deep down that being a social worker was likely not feasible. Indeed, I had obtained a social work job and had an opportunity to risk homelessness for that job, or work at an Italian Deli when I believed my family was the mafia. That opportune choice was key to enduring a large amount of torment and suffering.

As a result, I did do my best to make the exercise time and therapy time work. It could have been easier for sure, but I avoided jail, homelessness and more psychiatric incarceration—things I was truly scared of.

Consequences of Using No Leverage:

While now one might argue that such drastic, do-or-die leveraging as I went through was harsh, I now reflect on how life might be with no leverage at all.

I work with some people who were once warehoused in State Hospitals and who live in board and care homes. When people are trained to withdraw into messages for years, stories become buried and goal-directed behavior get blunted. I am also aware that there are people who withdraw into messages who live at home. I am aware of the natural consequences of this: when their loved ones die, they are likely to become sequestered in board and care homes.

Thus, I think that there are times when working with leverage can make sense in lieu of negative consequences that may lie in wait. If treatment means getting to know people who are worse off, it can be an eye-opener that can help motivate. I think knowing local services and getting help with communication during the leveraging process can be helpful.

I have seen small, slow, humane amounts of leverage work without causing trauma. I think protecting a person from the harsh realities of the mental health system needs to be done with reason. Helping suffers know their choices and lead the lives they want to live even if it does not fit your own hopes and dreams for the person is certainly a brave thing to do.

 The Need for Ongoing Support and Encouragement When Leverage is Used:

I still reflect on times I wanted to give up. I can say that it was helpful and redeeming when my parents credited my efforts as mattering and being financially relevant. Being encouraged at these times was very important.

I feel compelled to add that if the leveraged message receiver tries and fails, all is not lost. It is important to remember that important learning can be capitalized upon from any failure. Good support does not use a failure to impose an agenda, but rather is there to support the learning that can happen. Advocate to apply the learning to the next opportunity of their choice! Good support maintains a positive perspective on the effort put forth regardless of the outcome.

Remember, this is supported by an evidence-based practice that is applied to vocational training (The IPS Model.) If you lose a job, get a new one. Keep going until you get one that sticks.

Conclusion:

I still wouldn’t advise using leverage very often. Remember that it is possible that unprocessed ill use of leverage might be part of the problem that is keeping the message receiver stuck. Still, I have come to believe that treatment does exist and can be helpful. Now I can say that apt leverage involves a mixture of timing, series of least restrictive choices and ongoing, attentive support. It involves holding hope for full recovery when the message receiver doesn’t have it.

The post Using Leverage in the Treatment of Madness appeared first on Redefining "Psychosis".

Having returned from an east coast trip to attend the memorial of my stepfather, I am a little late with my monthly update. The trip back east was hard as my mother is currently suffering from her loss. I tried to spend time with her to offer her support, but may need to stay busy and our vastly differing interests made the week challenging for both of us.

Those who may have visited my blog may notice that I have only published one post this month. I have been working extensively on one essay that I am trying to prepare to get published. It is frustrating because I feel unproductive, but I have a need to master the essay and prove that I can publish.

When I wrote my memoir, I wrote extensively and edited the work down to make it more likeable. It was a learning process which I used to heal, and I really liked it. Now I am trying to learn to do the same thing with the essay—pack it all in for the short attention span. Make sure I get the title right.

But I am finding myself challenged when it comes to the process of getting published.  I usually write to live, not write to publish. I have read some blogs about the need to research publications and write specifically for them.

This puts me in a bit of a dilemma. It makes me realize that finding a place to publish my brand and mental health niche is a crap shoot. And suddenly I am getting pulled away from the reason I write in the first place, to be myself use my experience to grow wiser and heal and redeem myself.

The essay which I am sharing a sneak peek of in my newsletter is something that I am fretting over. It started as a 5000-word essay and I have cut and learned extensively. I find myself extremely frustrated that I must wait so long to even learn if I will get accepted. But I know I need to get my name out there to draw attention to my work.

The post Waiting to Hear Back appeared first on Redefining "Psychosis".

Early in my career as a social worker, I couldn’t even see the phenomenon of mental health warehousing let alone know how address the issue in a relationship. My college texts had promoted the mainstream eugenic presumptions associated with mental illness. I didn’t know what was needed to recover from things like psychosis, personality disorders, or addictions and live a fulfilling life other than to tell the client to take their medication.

Now, in my twenty-three years of experience working in the system, I have seen many other workers not really learn about the effects of mental health warehousing. It’s as if those of us who work in the field slept during social psychology lessons of Stanley Milligram and the Stanford Prison Experiments. And many of us who do understand the dehumanization process associated with warehousing may abandon the work for private practice. It’d nice it they left a little space in their practice for warehoused individuals. Perhaps some do.

Believe me, I never imagined that mental health warehousing would happen to a conscientious person who excelled in the mental health professional like myself. I used to think I was empathetic towards clients because that’s what always impressed others about me. Now I think I was just sympathetic and encapsulated! Indeed, though it could happen to most us, we rarely think that way. When I did land in warehousing, it was a real education.

I went to work in a section eight housing project and alerted the press and challenged the police. A resident warned me to stop bucking the system, or the same thing could happen to me. He was right.

Now, seventeen years later, most of my clients live in warehoused conditions and need help adjusting to them. Many have lost family support and lived this way decades. Of course, I do what I can do to help them be free; but learning to do so has taken some time. For clinicians new to working with warehoused individuals, I have just five suggestions to make.

 One, don’t presume it is easy to leave these very real experiences behind:

Once subjected to warehouse conditions, people may have a need to honor their experience and have a hard time leaving the neglect behind. Many tolerate and honor things that don’t make sense to the observer. In fact, many observers might have a hard time believing that what warehoused individuals report is real.

How could it be, for example, that in the land of the free, that the only job that a privileged white man with a master’s degree and a beef with organized crime and the police could find was at an Italian Deli with a four-hour daily bike/train commute? It was not for lack of job applications or resumes, I assure you.

During a two-year period, I had to learn not to snitch. I had to accept that people were breaking into my apartment and stealing my things, just as they had done when I was warehoused three-months in the dilapidated Montana State Hospital. Maybe you can’t believe it possible until it’s happened to you!

For people like me, it can take years of revolving door hospitalizations to get to the place where they accept warehouse living to start with. Then, to move on can be a lot for the ego to manage. It is hard to say all the warped things they learned from their experiences in incarceration were unnecessary. It is hard to abandon the post because, often, warehoused people know first-hand that things could be worse.

Two, don’t presume that you could get out of the very real holes they are in:

In working with warehoused people, it is important to temper the amount of advice you give them about how to be empowered in their situation. Just because you have power, doesn’t mean that they do. Thinking that they don’t know how to assert themselves is a good way to diminish the amount of trust that develops.

I have seen clinicians burn out because their advice is never heeded. Maybe they leave behind their duties physically or emotionally because they don’t believe the oppression is real. Many clients have seen this happen repeatedly. Here comes another staff person they are responsible for training. Now, they start from scratch, just so they can get their weekly check.

No matter how seasoned you are, it is always wise to be thankful when your client teaches you something that deepens your understanding of the layers of oppression they face.

Many workers may not realize that they couldn’t manage themselves what they are presuming their clients ought to.

Many clients, like the section eight resident who tried to warn me, know better than to try to fight the system politically. They will see advice or action towards that end as simply being naïve and insulting. Really, they usually know what’s up! Respecting the power structure but talking about how oppressive it is may help.

Three, find ways to address the fact that you are financially exploiting them in the context of the relationship:

Many would say it is cynical to look at the mental health industry and say that there is a lot of money reinforcing the suppression of its subjects into mental house warehousing. Seeing the mental health industry from this vantage point makes it seem like it is a plantation industry with finely educated suits with six figure salaries making decisions about how to keep the peasants maintained.

Clearly, not all the people I work with see managing the trauma and strife in their lives from so cynical a perspective. Still, I believe a therapist who works with people who have been warehoused needs to be prepared to work through these realities and feelings as they get unpeeled in the relationship. At times, I have found that it is important to argue the cynical perspective to help people become sensitive to how being warehoused has impacted them. It may be necessary to help people see and remember the value that they really have. This may help reinforce social rehabilitation.

Many warehoused people will appreciate it when you acknowledge your buzzard role in nickel and diming them and picking through their bones. At least talking about it will help them know you will do what you can not to get caught up in that trajectory.

Although I was only warehoused for a short time, the therapy I got at 125$ an hour while I was making 9$ an hour at a Deli seemed ridiculous. Talk about financial exploitation—for years it was. My parents mandated it and paid for it from a nest egg, but would not give me money for a car.

 Four, know that therapy is still valuable and walk the line:

In retrospect, and knowing the business as I now do, I am just grateful that my therapist did not refer me back to the hospital so that I lost my job and my apartment. If I had seen an intern who wasn’t making top dollar, I likely would have overwhelmed them and their supervisor and been incarcerated back in the system where it would have taken me much longer to heal.

Having a therapist for warehoused individuals is important even if they don’t seem to like you. And good clinicians need to be tolerant, competent with what they are dealing with, and maintain unconditional positive regard.

Supporting your partners is ways that help them make well thought out slightly empowered improvements in their interpersonal situation is possible. In doing this, it is important not to act as if you know, but to collect a lot of information about the barriers in the situation with curiosity.

I think good therapy advances the mindset that it is possible to help warehoused individuals pursue healthy integrated activities that can mitigate the effects of warehousing. That is what I did maintaining a job. Many amazing people have taught me that a bed in a warehouse is just what it is. One can still do their hygiene up and go out and find healthy activities and connections. I now see and support people doing this every day.

Five, help!

And yet when I look at the workshops available to me as a licensed individual, there is little out there in my trade organization that encourages therapists to learn to work with these conditions and limitations.

I wish that more therapists would learn to specialize in helping warehoused individuals. For practitioners who care about social justice, there really is no better way to be of service in the community than to develop specialty practices that can reach out and include such individuals.

Currently we know this population growing exponentially in our local homeless encampments, our flooded shelters, our barrack-like board and care homes, our county jails and over-crowded prisons. Know people can recover and gain back their freedom! Help!

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