Al Siebert’s double binds

Al Siebert, who passed away last year, has a website called “Successful Schizophrenia.” Here is an excerpt from Psychiatry’s Lack of Insight: Four Double-Binds That Place Patients in a Living Nightmare. The third double-bind below demonstrates the reason I have always had trouble with Dr. E. Fuller Torrey. I don’t think he sees people with a diagnosis of schizophrenia as fully human. He’s not alone, however. Family members often demonstrate the same lack of insight.

The third double-bind is to perceive someone as being “a schizophrenic” and then express humanitarian love and compassion for them.

The activity of allowing one’s mind to engage in “negative nouning” is similar to swearing. Perceiving someone as mentally ill is a stress reaction in the mind of the beholder. It constricts and reduces the person into something not fully human. When the viewer sees a person as a defective or sick it prevents the viewer from experiencing the diagnosed person as unique in a special way (the basis for love.)

The authors of DSM-III recognized diagnostic labeling as a problem and took the following position: “A common misconception is that the classification of mental disorders classifies individuals, when actually what are being classified are disorders that individuals have. For this reason, the text of DSM-III avoids the use of such phrases as “a schizophrenic” or “an alcoholic,” and instead uses the more accurate, but admittedly more wordy “an individual with Schizophrenia” or “an individual with Alcohol Dependence.”

Yet, even with the adoption of this position by the American Psychiatric Association in 1980, statements about “schizophrenics” abound in modern psychiatry. Psychiatrist E. Fuller Torrey, for example, tours the country telling audiences “there are over 100,000 active schizophrenics roaming the streets of our cities.”

An example of the “Love for Schizophrenics” double-bind can be found in Torrey’s recommendations on “How to Behave Toward a Schizophrenic.” He states, “In general, the people who get along best with schizophrenics are those who treat them most naturally as people.”

Silvano Arieti is a leading authority on schizophrenia. In concluding his award winning book Understanding and Helping the Schizophrenic: A Guidebook for Family and Friends, he states: “…where modern psychiatric science and our hearts meet, is the place in which help for the schizophrenic is to be found…”

The experience of people viewed as schizophrenic is something like being told by a smiling, powerful authority “I have only love and compassion for rotten assholes like you.”

Yoga and med

When “the crisis” unfolded several years ago, I went to my family doctor and asked him to give me something to help me get through this. I got Paxil. At first I was grateful for it making my mind less like a stuck record, endlessly obsessing about how awful life must be for Chris. I gained a lot of weight, but I also gained a certain distance from my own thoughts. I could maintain a stoicism that I didn’t feel I otherwise posessed. In the interim, I needed this crutch.

When I then tried to get off the Paxil, the haunting fears came rushing back. I thought I was going to be a “lifer” on an antidepressant because I obviously couldn’t handle life as it was. To make a long story short, I found a homeopath, took some natural products and weaned myself off the Paxil very slowly. (The weight loss was more stubborn.) I also took up yoga and meditation. That was three years ago. Yoga is the first “hobby” that Ian and I have done together in our close to thirty years of marriage. Ian and I are no spring chickens, we were both overweight and I couldn’t move one arm above my head for some mysterious reason.

The yoga was both wonderful and difficult. We knew it was the answer to our stress, so we perservered. Doing yoga is like letting the air out of our psychic balloon. Sometimes tears would roll down my face, not from the exercise, but from the spiritual release. The music in combination with the poses got to me in ways that organized religion up to that point had not been able to, regular church goer that I am. Ian and I also dabbled a bit in meditation, althogh not as consistently as the yoga. Today, I feel I can handle whatever it was that I couldn’t manage before. I understand spirituality better because I feel I have lived it. I am at peace.

Whatever it takes

Speak of the devil. The New York Times ran an article on Bill W. and the spiritual and chemical influences on the creation of Alcoholics Anonymous.

Were Bill Wilson’s spiritual awakening and influential sobriety the products of a belladonna hallucination shortly after his discussions with his friend Ebby Thacher? Could they have been incited by his alcohol withdrawal symptoms? Or did something else happen to him that science cannot explain? In the end, millions of people who have benefited from Alcoholics Anonymous and similar 12-step programs around the world would say that such pharmacological, physical or spiritual parsing hardly matters.

America’s medicated adults

I am a cynic when it comes to children’s charities. I have stopped even thinking of donating to a charity that uses children to pull at the purse strings of the donor. Just the other day at a famous coffee shop, right by the cash, was a box that said something to the effect, “children – donate”. Sure, there was some worthy cause connected to it, but not a lot of information about what you were donating to and why. It was felt that simply putting “child” on the label was enough to part you from your spare change.

So, when it comes to the overmedication of the children, permit me to be just a tiny bit cynical. Not for the reasons you are thinking. It is horribly wrong to stuff children full of unproven psychiatric drugs for dubious diagnoses. But, are we overlooking that is is just as wrong to stuff adults full of these same unproven drugs for dubious diagnoses? Why is a 17 year old a child and an 18 year old an adult when it comes to bad medication and lack of access to more effective non-drug interventions? Let’s not let the wholesale assault on adults go unlamented. If it’s wrong for children, it’s wrong for adults.

I will continue to ignore charities “for the kids”, because I know that child poverty is adult poverty – just a fancy way of diverting your attention from the totality of the problem.

Alcoholism and niacin

The relationship of Bill W., one of the founders of Alcoholics Anonymous, with niacin therapy is controversial. I first became aware of Bill W. and A.A. in Dr. Abram Hoffer’s book How to Live with Schizophrenia. ‘PASS IT ON’ the biography of Bill Wilson also discusses this chapter in A.A.’s development.

Dr. Abram Hoffer used megadoses of niacin to treat his schizophrenic and alcoholic patients because his research indicated that they were suffering from a vitamin B3 deficiency, similar to what is seen with pellagra. Pellagra is cured by introducing B3 into the diet just like scurvy is cured by ingesting vitamin C. One indication of a possible vitamin B3 deficiency is nicotine or alcohol addiction, another is severe acne.

I wish I had known about vitamin B3 when Chris developed severe acne as a teenager. Instead, I put him on medication. There may be no causal connection whatsoever, but within a few months of going off the medication, Chris was starting to develop psychosis. He may have already been developing early signs of psychosis due to the acne.

Vitamin B3 also lowers blood cholesterol. I can personally attest to this. I take 3 grams of niacinimide every day and six grams of vitamin C, along with a B complex vitamin. Every two years I see the company medical service for a check-up. The doctor remarks that while my good cholesterol is somewhat elevated, my “bad” cholesterol readings are the lowest she has ever seen.

I am a big fan on megavitamin therapy because I have personally experienced the results. So it is a bit troubling to read that Bill W., who also found niacin therapy very helpful in treating his addictions, parted ways with A.A. over niacin.

‘PASS IT ON’ describes the rift that developed over Bill W. endorsing a product or ethos that was outside of A.A.’s considered mandate. Now, apart from the fact that Bill W. may have been overzealous in trying to convert others in the organization to the benefits of niacin, I question why an organization dedicated to helping people with alcohol problems wouldn’t be more open-minded on the subject of vitamin therapy. Vitamins are not patented. You can buy whatever brand of niacin and vitamin C you choose, and they will all be more or less the same. Bill W. didn’t appear to be saying that A.A. should be aligning itself with a certain vitamin producing company or brand of vitamins. He was saying that A. A. could be aligning itself with the belief that alcoholics could also improve their health with niacin.

Having read both Dr. Hoffer’s and A.A.’s book, I now understand how the alcoholism came to be viewed as a disease. Prior to the vitamin research done in the 1940s, alcoholism was viewed as a moral weaknesses. The beginnings of A.A. grew out of the Oxford Group, which took a more Christian attitude to the problems of alcoholism. Indeed, it was Carl Jung who advised Roland H. to find a religious experience if he was ever going to beat this. Bill W. got quite far in his recovery from alcoholism by subscribing to the A.A. 12 steps, but he also became interested in the biochemical model of alcoholism when he met Doctors Hoffer and Osmond, who had initially introduced him to LSD. He felt that the LSD experience was beneficial, and he further benefited from the niacin work done by the same doctors.

To me, Bill W. was doing what responsible people should when it comes to their own health, which is to be open-minded to more than one intervention. A.A. embraced the alcoholism as disease concept, but fell short of presenting further information to its members about vitamins that they could choose to follow or not. There is a lesson here about organizations and your freedom to choose. Take the best of what they can offer, but keep in mind that your allegiance is to your own health. There will often be a conflict.

Cold turkey

Just back from a meeting with three psychiatrists. In the room were me, Chris, Ian, Chris’s psychotherapist, Chris’s medication doctor and her boss. I was looking forward to the meeting as a chance to move forward, to congratulate ourselves somewhat on things to date, until Chris let it out this morning before I left for work that he actually had stopped taking his medication a few days ago. A few days ago? How many days ago? This he wouldn’t say. Just dropped them cold turkey.

I saw this meeting going down the tube fast. “Chris,” I snarled, “get down to the pharmacy when it opens eight minutes from now and get that prescription filled.” Of course, he didn’t know where the prescription was, but luckily the pharmacist is okay with filling it first and bringing the prescription later.

What was Chris thinking? He is so close to shedding at least one of the drugs and possibly one psychiatrist if the meeting went well, why would he risk it all by showing up with a chance of looking and acting peculiar? As it turned out, Chris and Dr. Stern were there when I arrived at the clinic. I don’t know if she suspected anything. Chris looked kind of red around the gills but that was all.

The meeting was fine. At some point Chris offered up that he had not taken his medication, he claimed it was only for four days, but I have my doubts as I seem to be spending more time recently having these quiet “talks” with him. I got to say my piece about the meds. I decided in advance that I wasn’t going to debate the merits of Serdolect versus any other drug, I was simply going to “appeal” to their more noble selves by saying that Chris was spending too much time being a patient, and therefore not moving forward as much as he could and should. Having to schedule an ECG because of the Serdolect keeps him a patient, but so does seeing so many psychiatrists, no offense, of course! I told them that I personally don’t believe that two drugs are better than one, and that the reason Chris is on two is simply because the institution believes in two.

The chief psychiatrist picked up on Chris’s “forgetting” his meds and asked him if this was his way of saying he wanted off them. We chased that around a bit, and the upshot is that the chief said that cutting it down to one drug is in the realm of possibility. Dr. Stern had rather cleverly introduced the idea that Chris, in addition to gaining weight, was often tired. That may seal the fate of the Serdolect.

There is one thing that the chief psychiatrist said that rankled. He referred to Chris’s “disease”. However, here’s the good part. He said that Chris “had” a disease, using the past tense. This was sounding more like disease as metaphor to me. Ian picked up on this and his parting words to the psychiatrist was that he was glad to see that he used the past tense, because at least as far as Ian was concerned, Chris’s real problems were in the past.

Biology of relief

Here is how I read a book of non-fiction these days. I begin with the index and look for “schizophrenia” then flip back to the relevant pages. (I often feel I have read the book just by becoming intimately acquainted with what’s in the index.) My “schizo positive” meter is constantly scanning for the author’s “take” on this condition. Is the author “schizo positive” or “schizo negative?” So, it was a bit surprising to pick up The Biology of Belief, a book about how thoughts are much more controlling of health outcomes than one would imagine, and discover how the author classifies schizophrenia. Bruce Lipton refers to schizophrenia as a disease.

This may simply be an oversight on his part, because the book is not at all about schizophrenia, though it could be, given all its emphasis on quantum physics and energy psychology. These topics are schizophrenia’s home turf.

The book is about epigenetics, the study of inherited changes in gene appearance that do not change the underlying DNA sequence. These changes can come from the environment, can last for the life of the cell and express themselves over generations.

This book makes a good case that the environment before conception is vitally important to the general well-being of the unborn child. Epigenetics explains why genetically related siblings in the same family are born into a unique environment. We don’t treat all our children alike because the parents circumstances change before, during and after conception. Maybe we had financial worries, didn’t plan to become pregnant, or argued constantly in the process of marital adjustment. The list of hazards can be endless. All of this sounds kind of hopeless and Darwinian, were it not for the fact that people can change their cellular biology by changing their thought patterns, which can also come about by a change of environment. Moreover, cells replace themselves completely every seven to ten years, so you are not the person you thought you were. You can renew yourself.

Epigenetics shows that there can be a positive outcome to the negative diagnosis that mainstream medicine hands you, no matter whether it is a mental health diagnosis or something else. It also dovetails very nicely with the Family Constellation Therapy that our family undertook. Family Constellation Therapy acknowledges that people with schizophrenia are particularly prone to “atonement” of a generation’s past wrongs. Through identifying the family drama, “acting” it out, and through the act of forgiveness, healing is effected at the deepest levels.

Schizophrenia, too, as metaphor

We used to see drunks, now we see drinking problems. Are we ready for another new view? What would happen in homes, jails and hospitals if we started treating drug and alcohol abusers as highly evolved spiritual creatures. Like the disguised Princess in the story the Princess and Pea, perhaps these people are the sensitive ones whose “dis-ease” mirrors for all of us the pain we feel when we are emotionally separated from each other and spiritually separated from our Creator.

…We know that if we do battle against drugs and alcohol we are simply attacking the messenger without attending to the message it carries.

What is the message in the metaphor? The message is that alcoholism is a gift . . . to individuals, to society and to the planet. It is a way to get spiritual. The world is becoming aware that political and economic policies have not given us solutions to the ills of the world. The healing must take place in attitude. We must change our minds if we are to change the world. The next evolutionary leap is towards higher consciousness. If we are to survive as a species, we must begin to see our oneness.

The foregoing was written by Jaqueline Castine in 1989. Recovery from Rescuing is dedicated to her children, in one of the most unusual dedications on record:

“At great personal cost and inconvenience to themselves they lovingly, purposefully and persistently dedicated themselves to their roles of chemical dependency and irresponsbility until I learned the lessons they came into my life to teach me. . .”

The Inspiration came from her own mother: “I gave the best 20 years of my life to my family, and it has taken them 20 years to recover from it.”

Pharmacology and consciousness

Abstracts from the 9th Annual International Bioethics Forum that will take place April 22-23 2010 in Madison, Wisconsin.

Neurochemistry and Receptors as Mediators of Consciousness
David Nichols, Ph.D.
In the science of pharmacology, if one wishes to understand some physiological process, one can administer a substance that perturbs the process in some way, and then observe some effect that hopefully leads to understanding of the normal unperturbed process. Likewise, if one wishes to understand consciousness, the same principle should apply, and one could employ a substance that perturbs consciousness. As we know, psychedelics produce dramatic alterations in consciousness and would therefore seem to be perfect tools to help understand consciousness. Thus, this presentation will focus on some of the molecular aspects of psychedelics, including their brain targets, how they interact with those targets, the kinds of signals they generate, and some of the brain areas where these effects occur. There is now a general consensus that psychedelics activate the 5-HT2A type of serotonin receptor. These receptors are quite ancient, probably differentiating from the larger serotonin receptor family about 600-700 million years ago. Thus, these receptors have been around since the evolution of nervous systems began and, one might argue, have therefore been integrated into brain function at a very fundamental level. Reductionist neuroscience approaches to the study of this receptor in the brain will no doubt ultimately elucidate many of the components and processes involved in consciousness; the so-called “easy problems” of consciousness. It seems unlikely, however, that this knowledge will lead in any direct way to understanding consciousness. The explanatory gap between physical processes and consciousness is not one that will be easily bridged, but understanding how some of the component processes are affected by psychedelics may at least give some appreciation for the difficulty of the problem.

Psychological dimensions, neural networks and neurotransmitter dynamics associated with psychedelic-induced altered states of consciousness in humans
Franz X. Vollenweider, M.D. will first present new data on the phenomenology and structure of psychedelic-induced altered states of consciousness (ASC) based on a meta-analysis of a series of controlled studies conducted in healthy human subjects (n= 534) using state-of-the art psychometric and neuropsychological measures. Second, he will demonstrate that specific etiology-independent key dimensions of ASC, such as the experience of unity, ecstatic or anxious loss of ego-boundaries, religious exaltation or visionary states, are associated with circumscribed changes in brain activity in various extended neural networks. Third, he will also present novel data indicating that the serotonin 5-HT2A receptor together with the glutamate system plays a key role in the mechanism of action of classic hallucinogens such as psilocybin, and will discuss the implication of this recent finding for the understanding and putative treatment of some psychiatric disorders.
Geyer M. A. and Vollenweider F. X. (2008) Serotonin research: contributions to understanding psychoses. Trends Pharmacol. Sci. 29, 445-453.

The picket line

Schizophrenia should take a leaf from the Gay Pride movement. I have written several posts on the double standard that psychiatry exercises when it comes to a schizophrenia diagnosis. Scratch beneath the surface of most psychiatrists and you find the medical school training hardwired into their DNA. Medical school tells them that schizophrenia is a brain disorder, that it is most likely genetic, and that the “disease” is chronic. In other words, there is something really wrong with you by nature.

If you want help in overcoming a diagnosis of schizophrenia, it would be useful to interview your psychiatrist to ferret out the true feelings about your “illness” before you invest a lot of time and money thinking that this person is going to help you. Of course, in the end, nobody can help you but you, but some people can “encourage you” to be you, damn what others may say.

Psychiatry also believed that homosexuality was a mental illness, just like schizophrenia, just like depression, just like all the other labels that exist today that are still on the books in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Maybe homosexuality is a mental illness, just like schizophrenia, but who cares as long people who have “it” are otherwise happy and fulfilled?

The Gay Pride movement serves as a useful roadmap for what could happen to schizophrenia. In 1973 homosexuality was dropped from the DSM simply because homosexuals didn’t consider themselves mentally ill and objected to the stigma, and they began “outing” the psychiatric profession on their entrenched attitudes. To most psychiatrists, if someone with a diagnosis of schizophrenia actually “recovers”, then it is obvious to these thinkers that the diagnosis was wrong. Other mental disorders don’t suffer the same stigma, hence the double standard.

My suggestion is when psychiatrist shopping, to ask your shrink point blank where he or she stands on schizophrenia. Is he or she “schizo” positive? Chances are you will hear all the right words at first, enough to make you invest a bit of time and energy. Soon enough it should become apparent where the doctor’s convictions really lie.

Take a leaf from Gay Pride. Are you really “mentally ill” just because the DSM says so? Suffering the stigma of the medical profession and society in general does nothing to further you as a human being. Start picketing doctors who are not SZ positive. Man the barricades. You can change much about the way you are treated simply by being dropped from the DSM.