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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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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