September 2010 - Page 2 of 3

Shapes and angles

I was rummaging through my purse cleaning out debris from my recent vacation and I came across an article that I had torn from USA Today, Transitioning to college with a learning disability. According to the article the number of programs offered to students with learning disabilities at the nation’s colleges have skyrocketed since 2001 from 22 to more than 250. I get interested when I read these things in a “follow the money” curiousity. With programs come employment opportunities. Through grant money, the Department of Education encourages post-secondary institutions to establish transition programs for students with learning disabilities who want to go to college. According to the article, the number is “only going to increase”

Fair enough, I suppose for people with certain well documented learning disabilities like dyslexia, but then we come to a learning disability cited in the article that has to do with an “inability to recognize shapes and angles.” The girl cited in the article has been receiving help for this since grade 3. My thinking is that maybe she should not major in math or design. When my sons were at school, so many children had very specific learning disabilities that sounded similar to the shapes and angles one, or else they involved “auditory processing deficits” or not being able to find the right word to use. They received extra time on tests. Is this proliferation of really specific learning disabilities that most people will eventually manage to compensate for, really all that necessary? I guess so, since there’s a huge help industry out there that is “only going to increase.”

Mere alcohol doesn’t thrill me at all

Chris is quite perky these days. There are very few times in his life where I have seen him thrilled, but Sunday was one of them. His friend from high school who used to be in a band with him, phoned him out of the blue and asked if he would join his new classic rock band. No hesitation in saying “yes.”

The other times in his life where I would say he was thrilled are the following: Getting his first guitar, getting a laptop, our buying a la-z-boy recliner for our living room (all the men in the house were thrilled!) and being in a band.

He knows he has bigger things to think about, like a career direction, and he is working on these, slowly, while getting lots of support from others. For now, he is thrilled and it sure suits him.

Early separation trauma

The hardest thing for me about Dr. Clancy Mackenzie’s theory of early separation trauma for schizophrenia is in reviewing the way we lived our life when Chris was a baby. According to Dr. Mackenzie, he can tell from the way the person expresses pychosis, the age at which the separation trauma occurred. He links it invariably to separation from the mother, not the “mothering one.”

Here’s what Chris’s early life was like from a separation point of view. When Chris was four months of age, I went back to work and we employed a woman to come into our apartment and take care of him while Ian and I were at work. We felt this arrangement was preferable to day care for us. After less than a year, “Gloria” was no longer able to continue and we employed her mother. When Chris was two and half years old, Alex was born and we moved to a house in the suburbs. We felt that Gloria’s mother was too old to make the commute every day and we found a young live-in nanny. We employed a succession of live-in nannies until our youngest, Taylor, was in kindergarten.

Dr. Mackenzie would have a field day with the situation and the many caregivers. We honestly felt that keeping Chris at home and not taking him out to daycare was the least disruptive option.

Dr. Mackenzie claims that he can pinpoint from observing someone by their behaviour, reality and feelings the age at which the trauma occurred. He relates how a woman came into his office and said she had schizophrenia for the past twelve years, and he said “no you don’t. You have schizoaffective disorder.” He believes that schizophrenia has its origins in the first eighteen months of life and he told her that her trauma happened at 20 months. (Her younger brother was born when she was 20 months old.) This was obvious to him because he felt she had too much warmth and affect for a person traumatized before twenty months. (While Dr. Mackenzie’s schizoaffective/schizophrenia distinction is disturbing to people like me who don’t care for labelling, I think I get where he is coming from.)

Dr. Mackenzie’s trauma theory is compelling because he claims that the trauma is specifically within the first eighteen months and that it is separation anxiety. A quick reading of his website shows that he believes that the best expressed emotion is not low expressed emotion but zero expressed emotion, which means that the traumatized person has to break off all ties with the family while healing takes place. This sounds promising in that it has worked for other people, but how is this achieved in practice? We tried to encourage Chris to leave (for his own good!) two years ago and we got relapse in return. Where does someone go when they have no money or job skills?

Dr. Mackenzie may not have it all right, but he has made a good enough case to investigate further, which I will do when I am brave enough to follow up. Kris at Borderline Families is also getting the ball rolling on her blog post.

The child’s world is small

A recent comment from Anonymous sent me scurrying to Bruce E. Levine’s Huffington Post article Thinking Critically About Scientology, Psychiatry and their Feud.

Interesting article, but what really got me thinking was the author’s commonly enough held opinion that mental illness is a rational response to an insane world, which I am now re-examining. (The schizophrenia diagnosis has made me get around eventually to re-examining everything. It’s been a blessing.)

It was R.D. Laing, who made the original insane world observation and people like me have been making this argument ever since. Except that I am more of the opinion now that mental illness is the direct result of not the larger world (society) that most people have in mind, but the smaller world – the child’s world – the familiar environment, the family, not some abstract thing called “society.” People don’t go insane because there is air pollution or poverty in the world. Their suppressed sense of self has made them sensitive to these problems, yes, but people are more likely to go insane because the family environment is polluted with lies or has a poverty of emotional warmth or a tsumani of physical or verbal abuse. People do not go insane because someone else’s family tree is warped (who cares?), but they do inherit the emotional resonance that their own family tree passes down.

It is much less troubling, I suppose, for parents and patient alike to accept the idea of an insane world, rather than to accept the idea of insane family dynamics. The insane world view has much in common then with the diseased brain view of mental illness. Both deflect the situation in ways that don’t point the finger at any one individual, thus making the situation palatable and guilt-free.

I said to a friend one time when my children were very young and they were all at their most challenging/difficult/wimpy (take your pick), “I like my own children but other people’s children I can do without.” She heartily agreed that the same applied to her. The brewing period for mental illness is the period of childhood where the family is being formed, imperfectly. Families understand each other on some level, but do not understand the way other families relate with each other.

Society is insane, but “mental illness” begins and ends at home. The “mental illness” usually manifests when the older child leaves his small world and steps out into the threatening larger one. Rather than the individual directly confronting past hurts, psychosis feels like a “safe” way to express accusations, that if expressed honestly and directly, would trouble other family members.

Exceptional Mediocrity: Why Are Drug Reps Hot?

I was playing around with Facebook and spotted this.

Exceptional Mediocrity: Why Are Drug Reps Hot?: “

FDA finds new ways to increase Merck’s revenues

FDA approves wider market for schizophrenia drug Saphris.

The drug was first approved in August 2009 for treating acute schizophrenia episodes in adults and acute mania or manic-depressive behavior in adults with bipolar disorder.
Merck says the FDA now has approved Saphris for ongoing treatment of schizophrenia and for treating acute mania or manic-depressive behavior in adult bipolar patients along with lithium, a mood-stabilizing drug often used to treat mania, or the antiseizure drug valproate.

This raises the perennial, but naive question “Who exactly is the Food and Drug Aministration working for?”

This news item has been brought to your attention courtesy of:

“Evidence” that does stand up in court

Lately, I have noticed how often the DSM label is used in court in an attempt to either exonerate the person from assuming full responsibility for the crime of which they are accused or else to win sympathy from the court against the person with the label. In the past I have agreed with the general insanity defence, but am not at all convinced that parsing the insanity defence down to the specific “disorder” is a wise idea. In fact, the more I see this happening, the less I am convinced about the insanity defence. I see this being used more and more as an “out” for people who are not at all criminally insane or as a vehicle to convict the person you have a grievance against. Both sides are smart enough to know that the DSM carries the weight of “expert opinion.”

Since the more esoteric labels weren’t in existence much before the 1990s when pharma cemented the idea of the diseased brain in the public consciousness, it is axiomatic that their use in the courtroom has skyrocketed.

Last week-end’s Financial Times has an absolutely pathetic piece of journalism on Narcissistic Personality Disorder. Since the average reader of the Financial Times is supposedly a London investment banker, I feel this article was written more to titillate than to inform. The article begins with an anecdote about an enraged husband who threatens his wife with a gun when she decides to leave him. He backs off when she calls her father and later denied threatening her and the charges were dropped. At the divorce proceedings “a social services report diagnosed Rob with narcissistic personality disorder.” Why am I not surprised that the party seeking the divorce will try to pathologize the spouse’s behavior through “expert” testimony. The DSM is their friend in court.

The FT articles goes on at length about NFP as if it were a clinical disease (classified as a cluster B or “dramatic” disorder, as opposed to a cluster A “odd” disorder (paranoid and schizoid) and cluster C “anxious” disorders such as dependent disorders and OCD). It claims that NPD disorder is “diagnosed” when it it really apparent that there is no diagnosis, only “opinion.” The article demonstrates that even though “there is no laboratory test, no genetic predisposition, no specific types of people more susceptible than others,” a non-existent disease or disorder such as this will still stand up in a court of law. In my opinion, the social services report in the divorce case is tantamount to “hearsay.” Actually, much of the FT article struck me as hearsay evidence. We are supposed to believe the nasty things that someone else says about a husband, parent without our actually knowing them ourselves.

The author of the article writes while keeping a straight face “The disorder, formerly known as megalomania, affects 1 per cent of the population and up to 16 percent of the clinical population. It is not easily discernible to the untrained eye, partly because a degree of self-love is essentially healthy . . . . ” The article claims that this disorder is found frequently in the higher reaches of politics, finance and medicine, and, with no basis, claims that there is no cure!

Should this fuzzy labelling of a disorder that works well for many really have clout in a court of law? Should law abiding people who carry the label of schizophrenia and bipolar disorder object to their label being bandied about in a court of law to excuse someone else’s behavior? If these are phony diseases, as I firmly believe, then their presence should be struck from the court room, or certainly not carry the weight of “expert evidence.” Sensationalistic or lurid court cases where schizophrenia and other so-called disorders are invoked, condemn the vast majority of people with these labels who would no more kill someone, drive drunk or steal than the next person. They are stigmatized with the larger public courtesy of the DSM being allowed in the court of law.

“Expert evidence” in these cases claims to justify that there is no other motivation for the behavior beyond the “disorder.”

Political correctness just another form of social control

Kris Ulland’s recent post on Scientology involvement with Thomas Szasz’s Citizens Commission on Human Rights has been generating a lot of interest. I made a remark in one of my comments to her post that politics makes strange bedfellows. Organizations and politicians may disagree vehemently with another’s policy planks, but when their interests occasionally coincide they are more than happy to get into bed together to further a common goal.

Szasz’s reputation as an anti-psychiatrist is built on his disagreement with the idea that mental illness is a disease. I have come to the same conclusion myself, based on my observations of my son’s behavior. It walks like a duck, it quacks like a duck, but it is not a duck. It looks in many ways like a physical illness (slow and odd movements, incoherent speech, etc.) but it is not a physical illness. It didn’t really matter if Chris was on drugs or off drugs, the behavior was the same. I am glad to report that this is not the case now.

Wikipedia on Thomas Szasz:

While people behave and think in ways that are very disturbing, and that may resemble a disease process (pain, deterioration, response to various interventions), this does not mean they actually have a disease. To Szasz, disease can only mean something people “have,” while behavior is what people “do”. Diseases are “malfunctions of the human body, of the heart, the liver, the kidney, the brain” while “no behavior or misbehavior is a disease or can be a disease. That’s not what diseases are” Szasz cites drapetomania as an example behavior which many in society did not approve of, being labeled and widely cited as a ‘disease’ and likewise with women who did not bow to men’s will as having “hysteria”[9] Psychiatry actively obscures the difference between (mis)behavior and disease, in its quest to help or harm parties to conflicts. By calling certain people “diseased”, psychiatry attempts to deny them responsibility as moral agents, in order to better control them.

Szasz, in his later book, The Manufacture of Madness (1970) writes:

The best, indeed the only, hope for remedying the problem of “mental illness” lies in weakening – not in strengthening – the power of Institutional Psychiatry. Only when this peculiar institution is abolished will the moral powers of uncoerced psychotherapy be released. Only then will the potentialities of Contractual Psychiatry be able to unfold — as a creative human dialogue unfettered by institutional loyalties and social taboos, pledge to serving the individual in his perpetual struggle to rise, not only above the constraints of instinct, but also above those of truth.

I worked for many years in politics at both the national and state levels and directly for a couple of political parties. I have a certain sympathy for Scientology, not because I am a member, which I am not, but based on the experience of being the brunt of political correctness when the going gets down and dirty in politics. The party in perpetual power where I worked, would float all kinds of accusations against the party I worked for – racism, sexism and religious fundamentalism are the big three that generally make middle of the road people, tempted to shift allegiances, scurry right back to their comfortable center line. Do I want to be a Scientologist? No, but that doesn’t mean that I disagree with everything they have to say. Their stance on psychiatry (anti-drugging and anti-coercion) is one of the things they stand for that strikes me as appropriate.

Thomas Szasz suffers from the same political problem as any person or organization whose opinions are not held by the mainstream. He is politically incorrect by North American standards. I may be stepping on a lot of Hungarians’ toes here (hi, Tibor!), but Hungarian’s (like many of their European counterparts) are more often than not politically incorrect. Europeans have a long history of being at the mercy of the state and of those who enforce state control. Who are Szasz’s critics? Institutional Psychiatry, of course and those who are under its power.

I began to really appreciate Szasz when I was looking for something positive to believe in about my son’s prospects. Institutional Psychiatry was hinting that Chris was a lifer. It is odd that this psychiatrist, who mainstream psychiatry kept insisting was a heretic, was actually a psychiatrist who seemed to put the rights of the individual first. He seemed very much on the patient’s side. From my limited experience with institutional psychiatry at the time, I never got the feeling that it understood (had empathy for) the patient.

Szasz believes that the label of schizophrenia is like being persecuted for being a witch.

A direct line of progresion can be traced from the witch’s marks to the so-called stigmata of the hysteric, and, most recently, to the signs which schizophrenics are made to reveal through projective psychological testing. Each of these “diagnostic” findings is used to incriminate the subject — as witch, hysteric, or schizophrenic; each is then used to punish him — by means of theological, medical, or psychiatric sanctions.

He then goes on to say that “While some witches may have survived dunking, no “madman” survives psychological testing.” (Read Szasz for dark humor, too.)

The figure of the psychotic or schizophrenic person to psychiatric experts and authorities, according to Szasz, is analogous with the figure of the heretic or blasphemer to theological experts and authorities. According to Szasz, to understand the metaphorical nature of the term “disease” in psychiatry, one must first understand its literal meaning in the rest of medicine. To be a true disease, the entity must first, somehow be capable of being approached, measured, or tested in scientific fashion. Second, to be confirmed as a disease, a condition must demonstrate pathology at the cellular or molecular level.

A genuine disease must also be found on the autopsy table (not merely in the living person) and meet pathological definition instead of being voted into existence by members of the American Psychiatric Association.

The above quotes are from taken from Wikipedia and directly from Szasz’s The Manufacture of Madness, Random House, 1970.

___________________
Roughly speaking, institutional psychiatry is imposed on you, perhaps by force of law, while contractual psychiatry is when the individual seeks out a psychiatrist and retains complete control over his participation with the expert.

A question of accountability

Is there an organized effort (lobby?) that pressures the media to disclose the pharmaceutical ties of the people they are interviewing?

The media habit of publishing a story, such as this one, and failing to disclose that some, if not all of the “experts” quoted have ties to pharma, is just not good journalism.

So, who is forcing the media to be more accountable in this area?

I am doing my bit where I can and so are you, but I would like to know if there are organizations that are doing this more systematically.

Here’s what I object to in the NY Times article

I read the NY Times article Child’s Ordeal Shows Risks of Psychosis Drugs for Young. This is a bit of a rambling discourse because I am still feeling quite jet-lagged. I doubt if I’m making my points clearly.

I suppose I should be grateful if focusing on children to highlight the problem with psychiatric drugs will also benefit adults who feel they are being force medicated and overmedicated. Doctors don’t seem to be making the mental leap, judging by what I read in the article. Actually, the article made me extremely angry because it seems that the focus on children may be diverting attention from the greater flaws in the drug paradigm system. I am very cranky after reading this article.

If you read the comments section that accompanies this article, you will see that a great deal of the criticism is directed against the doctors who prescribed the drugs, but equally against the mother who allowed this to happen. Everybody has jumped all over this one and readers have offered up all kinds of parenting advice. Show us an innocent child and we all say, oh, it is obvious that the parent didn’t know what she was doing when she medicated this child. All the family needs is counselling, not drugs. True, true, but how does this change when the child is an adult? What seems ridiculously easy to spot in children somehow becomes “a true illness” as soon as they reach the age of psychosis, which is 15 to 25 in men and 25 to 35 in women.

I’ll start with the word “young” in the title of the article “Child’s Ordeal Shows Risks of Psychosis Drugs for Young.” The risks are the same for everybody – weight gain, diabetes, leaking breasts. Why isn’t this point made more forcefully? I guess the answer is found in the quote from Dr. Gleason, below. Apparently, there is mental illness for which antipsychotics can be justified.

Dr. Gleason says Kyle’s current status proves he probably never had bipolar disorder, autism or psychosis. His doctors now say Kyle’s tantrums arose from family turmoil and language delays, not any of the diagnoses used to justify antipsychotics.

So, the myth will continue to be peddled by people who benefit from enforcing these labels that there is something akin to true bipolar, autism or psychosis. Where’s the scientific validation, doctor, for mental illness? Show me! Dr. Gleason’s justifying antipsychotics is opinion based on wishful thinking. It is laughably easy to see that Kyle suffered from poverty, and a medically naive young unwed mother. It is not so easy, but shouldn’t be impossible, to figure out that adults with these labels are just children who have aged a few years.

Here’s the myth being promulgated in one of the comments to this article. Stephen Reidbord, MD, San Francisco writes: Antipsychotics are tremendously helpful for severe conditions such as schizophrenia, where the benefits usually outweigh the considerable risks. For lesser conditions, the risk/benefit ratio swings the other way.

The benefits to whom, exactly? Prove that they are “tremendously helpful.” Where’s the evidence? How patronizing.

…………………
“There are too many children getting on too many of these drugs too soon,” Dr. Mark Olfson, professor of clinical psychiatry and lead researcher in the government-financed study, said.

You mean that it is okay to get on these drugs later?
…………………

The article, which is not remarkable because there are so many of them today, has left me furious because it’s trying to separate obvious innocents from the older victims of this abuse. Since “Kyle” is a bright happy six year old today, he couldn’t possibly have had “real” psychosis. Anyone reading the article would agree. Now what about the over 18s?

How many of us are really excellent parents? Poor parenting? Yes and no. Parenting is difficult no matter who you are. Nobody, but nobody gets it consistently right. Some parents, such as single and divorced parents, are obvious candidates for criticism, particularly if they are poor, and they are forced to bear the brunt of the criticism because their situation is dysfunctional. The public at large gets this, as the comments to the article attest. What the public doesn’t often grasp when they get on the single parent bandwagon is that no matter who you are or how old you are when you first have children, having children doesn’t give us sudden wisdom. It increases the strain. Just getting married increases our anxieties. Having more children increases stress.

There is a good comment in the comments section from CJ, of Fort Wayne, Indiana. She gets it and is willing to admit that she was struggling, too.

Back in the day (1970) when my eldest son was about 5, I found him difficult to handle, easily distracted and inclined not to obey. Bright and articulate, he nonetheless made me crazy and unable to deal with him, much less his two younger brothers.Around that time, the term “hyperactive” first came into play, a condition with which even his pediatrician was unfamiliar. J. was hospitalized for 2-3 days for observation and then prescribed Ritalin. The results of the medication were that they calmed J. right into oblivion. In other words, it totally knocked him out for the afternoon or… it didn’t effect him at all. We never knew which to expect.

We kept him on it for most of the 30-day prescription, at which time it was either strengthen the dosage or take him off it. I opted to take him off it, without consulting the doctor, “asking” permission or anything else. It was breaking my heart to see what was happening to my bright-eyed firstborn.

Although he’s had his issues throughout the years, at least I know they weren’t caused by over-medication administered by his parents. And today he’s a happily married, soon-to-be-45-year-old –– hard-working, responsible and still employed, despite the economic downturn.

In retrospect, his father and I were 23 when we had him, both emotionally young, hyperactive adults prone to nervousness. What, then, could we expect in our little ones?
It appears today’s parents don’t want to take time to examine themselves, their lifestyles, their parenting skills (or lack thereof) to see what might be affecting their child/ren. In addition, they might look to the schools, who have in many instances effectively taken away all outlets for normal childhood rambunctiousness by eliminating recess and phys ed, and requiring these little ones stay at their desks most of the day.

As for parents and physicians “drugging” infants and preschoolers, well, as they say, you can’t cure dumb.

As a nation, we are doing our youngsters a great disservice, substituting drugs for parenting, and placing the blame on others. Parents, take control. Do this by first taking control of yourselves. Your children –– and their future –– is at risk.