For those of you unfamiliar with the mental health system or are unsure about therapy or whether or not a psychiatrist is a good idea, this post is for you.
For the rest of us, it’s also a good post for you. It’s a good post for everyone.
Anyone (with a degree and some version of licensing of course) can be a therapist. That could be a LCSW (Licensed Clinical Social Worker), a MFT (Marriage & Family Therapist/Master’s of Family Therapy), a clinical psychologist (Ph.D) or Psy.D (Doctorate of Psychology). A psychiatrist (MD) could as well, but many of them have zero background in psychology other than your average level of undergraduate study.
An LCSW and MFT will indeed make less than a Clinical Psychologist or Psy.D. Those two will generally make less than any Psychiatrist depending on where you live and what clinics each individual works. If you feel that someone with a Ph.D will be much more knowledgeable and better trained than an LCSW, you would be terribly, terribly wrong. In fact, the main difference between them is the amount of money they make.
Studies (and the lecture in my research course) have shown that credentials have no effect on success rate; that is, just because you have a Ph.D doesn’t mean your “clients” do better than an LCSW’s clients. That includes the M.D’s.
This might seem obvious: it depends on the clinician, right?
It depends on the techniques. If a clinical psychologist with a Ph.D is certified as an International Board of Repression Therapist (a non-scientific therapy) and their colleague in the office next to them is an MFT certified in Cognitive Behavioral Therapy (a scientific therapy) and one client experiences IBRT and the other experiences CBT, chances are CBT will provide a hefty affect over the IBRT. Yes, there are other factors which play into this, some important ones being what the client is seeking support with and their drive level. Connection to the provider plays a role as well. However, speaking from a technical point, there is no solid (well-done) research supporting IBRT, and plenty of well-done research supporting CBT.
That doesn’t mean IBRT is useless. One day perhaps someone will come up with some verifiable, testable, and reliable data. But until then, I won’t be seeing anyone specializing in IBRT. The Inner Child exploration therapy is another “non-scientific therapy” and I’ll have a post on that later, as I have experienced it and have mixed reviews.
There are three basic differences between a Psy.D and a Ph.D.
Colleges which offer Psy.D programs are by far much easier to get into and much less regulated. They also cost thousands of dollars more (unless you’re trying to get Ivy league training in which case good luck paying out of pocket for your Ph.D from Yale. I suspect school type also doesn’t correlate with client success rate) compared to your average Ph.D training.
There is a school which I had planned on attending back when I was ready to transfer for a Psy.D until I realized their training isn’t really based in any science. And psychology is supposed to be a science of the mind, right? (More on THIS in tomorrow’s post). The success rate was large, in the 80 percent or so, the school was still working on its accreditation, and the classes they required were scant. In fact, they didn’t really require anything other than a couple of psychology classes. They claimed integrated, client-centered approaches, which is great. And I’m sure once we have more actual data on the effectiveness of their techniques, that school will be booming.
I believe they got accreditation some months after I learned they weren’t yet accredited.
I have seen MFT’s, LCSW’s, Psy.D’s, M.D’s, and now my first Ph.D therapist.
And so how do you pick?There’s all these choices, all this research you have no access to, all these articles online pulling you this way and that and are probably based more in opinion than actuality.
I used to choose my therapists by their profile picture and their degree level. If they looked friendly and had a high degree from a reputable school, I’d try them. And every time I left them.
This time I tried a different approach. I searched for therapists in town at all degree levels. If they didn’t have a website explaining their practice methods, mission, and specialties, I did not consider them. If their picture seemed unfriendly or strict, I also did not consider them (and that’s a totally unscientific, personal preference). If they did have a website but didn’t meet my specialty requirements, I crossed them off too. If their website wasn’t fully developed or seemed unprofessionally dull or full of metaphysical intuitive opinions about nature and life, I also crossed them off.
I love philosophy and enjoy metaphysics. But I’m also aware that people with that mindset are more inclined to tell me “if you believe it, you can achieve it” and I don’t need cliche sayings. Believing the demons will go away will not make them go away. I need to learn how to work with them, not shove them off a metaphorical cliff that I created in my mind and watch as they tumble helplessly into the locked drawer which I also created in my mind. Not my type of therapy.
Now, if someone had a decent, updated website that laid out their specialties which coincided with my needs, what insurance they accepted (if any), their location, phone number, and a blurb about their practice and themselves, I’d investigate further.
I eventually came down to three people: two women and one man.
I eventually crossed off the man because he had been in practice for many years, thirty or forty, and while that’s not a bad thing there is also no notable effect between years of experience and better rate of client success. I’ll explain why in tomorrow’s post as well. The reason the years influenced my decision is because many still maintain old views of specific “disorders” and treatment methods. I refuse to see a psychiatrist who graduated in 1979 and below.
The two women: one was a LSCW and the other a Ph.D. Both had well defined websites and structure to their treatment methods. I went for the LSCW because the Ph.D had listed their G.P.A and grades and I considered that rather conceited.
The LCSW was on vacation and when she got back she called me to let me know she wasn’t accepting new patients.
As disappointing as that was, my last choice was the Ph.D. I was nervous because of her degree and her listing of her G.P.As. I predicted she’d have an arrogance about her and see me as less than. I was indeed very wrong. This will be relevant in tomorrow’s post as well, how intuition can lead us far astray.
This particular therapist and I connected immediately. I have only connected in such a way with two other people in my life, one girl when I was in first grade and a guy when I was 14 in high school.
She is attentive and didn’t seem to mind that I hadn’t mentioned on our phone consultation that I hear voices and have experienced psychosis. She did believe that voices went away with medication (which isn’t the case for most of us, and I filled her in on my experience) and that schizoaffective can only be diagnosed under the condition that psychosis appears alongside depression (I didn’t correct that because I felt awkward doing so; it’s in the DSM-5, she can check it out if she wants. I have a DSM-5 PDF copy if she needs it) but overall she validates my feelings but also challenges me when something doesn’t seem quite right.
She will help me see alternatives and consider alternatives. She is full of humor, and gets my humor, and I’ve never laughed as much with a psychologist as I have this woman. I don’t feel judged usually, and have felt free talking about my voices with her. I have not talked in depth with anyone else about my voices, and I certainly haven’t told anyone else that I hear both internal and external.
Why did she work out? Because I didn’t follow my intuition, I followed a set of criteria I set for myself that weeded out those who were specializing in what I needed support with versus what I didn’t. And her listing her G.P.A has nothing to do with that.
And so what it comes down to is:
And most importantly? Remember you have a say in your treatment. Make the therapy and partnership and it could become one of the better relationships you’ll establish in your life.
I’ve been absent because the pain of sitting with this back injury was too great. I wish I would have injured my back before I started this blog; not writing for days isn’t the proper way to re-build a blog. I know at least that much.
In the midst of all this pain, I’ve been challenged philosophically once more. That seems to happen a lot. You think our minds gets off on presenting existential issues with every little aspect of life?
My drug record is as follows: Marijuana. Psychiatric cocktails.
Marijuana made me feel normal in high school. I stopped when I started college and psychiatric medication. Then 7 years on and off of those medications. Antipsychotics dull your mind, but I wouldn’t call it a high. Benzos knocked me out a couple times. But I’ve never experienced the bliss that is an opioid-based medication.
This medication (which only cost me two dollars compared to the 40 I used to pay for my psych meds each month–there’s your opiate crisis plain and simple) was prescribed strictly for that insurmountable pain I mentioned earlier. I couldn’t sit, I couldn’t lay down, I couldn’t walk. I also couldn’t give up going to class and work during recovery, and so the pain med and the valium came into play.
Valium is shit, in my opinion. I don’t like that the halflife is up to 72 hours, which can make your body very dependent very quickly if you’re taking it regularly. It was prescribed for muscle spams, which have been plaguing my entire body since the back injury.
The issue I’ve had isn’t with addiction. I’m not crushing the pain med and snorting it. I’m not injecting it, I’m not smoking it. I like the feeling, I enjoyed floating while in class, and in that high I realized how much I missed feeling THIS kind of disconnected. A happy disconnection. And then I wondered if it was really the disconnection I missed. That just didn’t feel right; I’m always disconnected in some way, and often that’s how I make it through my day.
It’s the sense of altering my mind state which I missed. That felt right, until it didn’t. This year has been the happiest year of my life; I’ve lost all the weight I gained from my depression, I’ve stayed off all psychiatric medication, including anti-psychotics, I’ve got friends, I’ve been more open with people. I’ve enjoyed work. I bought a 2019 car. I’m successfully completing the research course which I kept dropping because of psychosis and depression. I’m writing again, submitting fiction again, starting this blog, finished a manuscript draft. I feel mentally and physically back on track. So what is making me want to change this?
I don’t have an answer.
I can look at human behavior and make some guesses, though.
Some of us want to alter our state more than others. For me, it’s not about running from feeling anymore. Now it’s about boredom, it’s about routine, it’s about doing the same thing over and over again and being content, but wanting something more. And I think that’s something everyone can relate to: wanting something more.
People say if you’re satisfied where you are, content with yourself, you won’t want anything more because you have everything you need. Perhaps it’s the ideal case. It just doesn’t seem practical though.
Or, maybe I’m not as happy as I think I am. In that case, what aren’t I happy about? Maybe those who indulge in recreational drugs also aren’t as happy as they think they are. In that case, maybe no one is ever certain about how they’re actually feeling. Freaky.
Maybe the feeling of a new experience is exciting, maybe the devil hooked a Twinkie on his fishing line and we’re all chasing it into hell.
Maybe we convince ourselves of one thing to justify what we know isn’t true. For example, I enjoy the body high. I’m always so tense from anxiety, have been all my life. Marijuana could never take it away, and neither could psychiatric meds. But the pain meds can. And so maybe I’m saying I’m not trying to subdue my feelings or run away from something so I can justify continuing to use them even though I’ve finally made it past the most severe pain.
Seeing as that’s highly likely, although my mind is pushing hundreds of reasons why I shouldn’t admit to that truth, the question then becomes: is enjoying something like a high wrong?
Most people would say yes, if it interferes with your life. If it becomes an addiction and reduces your level of functioning (i.e, using the language we hear all the time in mental health). I would say that wouldn’t make it wrong. It would make it pointless. And pointless isn’t always wrong.
Other people may say yes, it’s wrong, because you’re avoiding life. You can’t cheat like that.
Then people go off on tangents of addiction, of blaming you for “putting your family through this”–similar to shaming you for considering suicide. Then they talk about death–you’ll kill yourself. You can see my analysis on THAT argument here.
I don’t quite know what the point of this post is anymore.
To indulge or not to indulge, that is the human question.
I did not post yesterday as I was in too much pain. Today is better, although I don’t really have a set topic for today’s post. Self-care would be a good one.
I’ve learned a lot about what that means in just the last six months. Some of it came from the guidance of others, and an equal amount came from me learning my body and my brain and what connects the two of them back together. In regards to psychosis and anxiety, although they tend to be categorized as separate, they have similar attributes. I’d say the biggest difference is anxiety you still recognize your physical and mental place in the world during your disconnect. With psychosis, nothing has a place and you are the center of that nothingness.
But they are similar in that you feel dissociated from the people around you, from life, from everything. Panic can make you believe you’re dying, psychosis can make you believe you’re already dead. Anxiety makes you think badly about yourself, psychosis is lazy and will just let the voices reprimand you. And the biggest part of all of this is that separation between the turmoil in your mind and the placement of your body. This is where the idea of grounding techniques come from; there’s this idea–quite an effective one–that if you can center yourself in your limbs, remind yourself who you are and that you exist in this moment, you become more aware of right now instead of tomorrow or yesterday or the future. That’s great for anxiety.
Grounding probably won’t stop you from believing your dead. But it may help ease the anxiety of the idea of being dead, and in that process you learn to accept death. In learning to accept death and the terror and trauma which may be circling death, you accept the idea of being dead. Once you’re there it becomes a little easier to put some weight to both sides: maybe I’m dead, maybe I’m not dead. Either way, I accept what is. That can take some power from the psychosis.
Professionals talk about wanting to break people from their delusions by presenting facts or evidence or saying “well, if that was true, why is this happening?” but that makes zero sense because in delusion everything has a place. And if it doesn’t have a place, we’ll make it have a place with “I don’t know how it works, but that’s how it works” and you won’t have any evidence (to us) against that solid argument.
And so breaking is an illogical step. Telling your loved one that this can’t happen because of that and then getting frustrated at them because they don’t believe you only adds more stress.
The power of unifying the mind and body, accepting uncomfortable thoughts and ideas, giving Anxiety a place to disperse is my greatest form of self-care. Giving my mind a chance to feel how my body is affected by certain thoughts, giving my body a chance to react to my fear and anxiety my mind tumbles through, gives me a chance to tether the two back together and gives me a sense of being a whole person. Because one thing about both anxiety and psychosis is that you feel shattered. You feel like a million pieces being pulled in a million and one directions and none of the directions make much sense. Or they make perfect sense and in that, make no sense because nothing can be perfect.
Self-care doesn’t always mean “doing what makes you feel good”. Sometimes it means doing what you need to in order to grow. And that can be quite uncomfortable.
Reconnecting your physical and mental selves doesn’t just have to be through mindfulness or meditation or mindful-meditation, I’ve learned. Although those ways are quite useful. For example, music reconnects my mind to my body, especially if I’m in my room and playing it on speakers where I can really feel the vibration of the sound and move with it. Japanese Karaoke, the Karaoke in the private rooms, is one of the best ways my mind and body sync up again, my mind riding waves of emotion and my body, my diaphragm and stomach and throat specifically, capturing those emotions into vocalization.
People wonder why medication doesn’t take their mental pain away and that’s because it can’t. We all know this, and if some of us don’t, well, get comfortable with the idea that there’s no such thing as a quick fix. Medication is a bandage. It will do nothing for your thoughts but numb you from them. It will do nothing for your trauma. For a lot of us, it will do nothing for voices besides make them fainter and easier to ignore (which isn’t a bad thing, it can be quite helpful). But, if all you do is throw some chemicals at your brain and roll some dice, you’re essentially allowing yourself to shatter. You’re blockading a chance to be whole again and maybe that’s because the idea of being whole is so foreign to you. Or maybe it’s too terrifying. Maybe it’s too real and too raw and it’s much easier to hide behind numbness than to face sharpness.
And that’s okay too. If that’s where you are your best, if that’s how you function best, if it’s not going to bite you in the ass ten years down the road, great. For me, I didn’t function being a shattered person. And so I listen to myself. I listen to every pain, every ache, every burst of happiness, every drop of sadness, every small voice, every screaming voice, every immovable belief, because all of it means something. It’s not random and useless. It’s annoying and tiring, but it’s a reflection of turmoil and an indication that I’m separating from myself again. That’s a warning sign.
What happens when we bury those warning signs? Or hide from them? Well, they just seem to multiply. And for me, I’d rather care for myself and nurture one warning than feel trampled by thirty.
Today’s post is a little late because I’ve just come back from Urgent Care to get my back checked out. I overextended in the gym and have torn some lower back muscles. The pain is pretty severe, the doctor is thinking it’s very deep tissue, and let me know what I need to do to continue recovery.
But the events leading up to Urgent Care inspired this post on how important it is to own your care, both physical and mental.
The thing is, you’re going into the office of a person who (usually) doesn’t know you very well other then the check ups or issues you come in for on a haphazard basis, and even if they do know you well they don’t know you so well that they are aware of your body more than you are. The same goes for psychiatrists.
An important thing I’ve learned to remember in both my physical and mental health care is that no one, regardless of Ivy League education or multiple specialties/degrees, knows my body better than me. No one.
For example, I’m considering getting a PRN (as needed) medication for my anxiety, as my panic has been off the Richter scale lately. It would be something I took maybe once a month, or even less, as I tend to work very hard on balancing my panic when it comes on. (I’m careful not to say I “control” my panic, because I’m not going to run around in circles and play Panic’s power-struggle game).
Since I’ve got to find a new psychiatrist for this, I filled out an intake form which asked me what my primary concerns were and if I had any other information about medication or suicidal tendencies. I wrote something along the lines of: “SSRI’s and SNRI’s do not work for anxiety for me; I do not want them. I don’t need anymore antipsychotics, they make me dead. I am coming in for a PRN for anxiety, and nothing more. I have been happily off medication for a year and three months.”
I stated that twice.
The reason being when the psychiatrist sees my history of psychosis and mood swings and depression and says “weeeeeeeell, how would you feel if we also try a little–”
I can then say “Weeeeeeeeell, why don’t we try reading my intake form where I state exactly what I’m here for?”
Because the fact of the matter is that yes, I still struggle, often daily. But I know myself. I know my limits. And I know that getting back on meds would wreck more havoc on my body. No psychiatrist can know that. All they know is what they read in a textbook.
Conversely, if you are content with taking poorly-researched medications, and you feel they improve your well-being, it doesn’t cause any side effects and hasn’t yet ruined your physical health and a doctor tries to tell you “this med isn’t very good, I’d like to try another,” your response should be something along the lines of “well this doctor isn’t very good, I’d like to try another.”
Not to be a smart ass. Not to insert your dominance. But to make sure you’re being heard and that you’re in control of your health. A lot of people like to say “doctor’s work for you”, but I don’t use that phrase because that initiates yet another power-dynamic with you on top. That’s not the goal here. The goal is fair collaboration.
Having an advocate accompany you to your psychiatrist appointments can be helpful as well, preferably someone who is very clear on what your concerns and wants are, and someone who has been through similar situations. Not only will you walk in the office with confidence, but if you’re someone like me who wasn’t always present or aware of what was going on and so assertiveness took a backseat, you have someone to fall back on who you know will do you justice. Doctor’s can be intimidating with their degrees and “factual” knowledge and they’ll blurt things at you that make you feel lesser, not always out of intention but just because that’s how they show you they “know what they’re talking about”.
This doesn’t mean be afraid of new things or ideas. If something isn’t working for you, speak about what’s not working specifically. Don’t say “I just don’t like it,” because that gives them more of a reason to convince you you’re just not giving it enough chance. If you feel coming off medication is something you’d like to try, find the doctor that will support your decisions. Don’t let anyone tell you that you can’t, because you’ll start believing it. Yes, you can come off medication, even with severe psychosis. If you’ve been on them for years, 10+ as many are, you’ll be needing to come down 50x slower. Even as small as .025mg at a time. Doctor’s words, not mine. Also, researcher’s words, not mine.
In the world of psychiatry, we must be wary of manipulative words. Whether they mean to be manipulative or not. When our brains are fragile we are at our most vulnerable.
And so take this post with you to your next psychiatrist appointment if you’d like, if you feel you haven’t been heard or respected and you’d like some strong words from an internet stranger to back you up. Hell, have your advocate read it and them snap their fingers in the “Z” formation afterward. Your doctor’s response will tell you all you need to know about that doctor.
Did you enjoy the totally unrelated photo I took of the Hollywood sign some years ago?
This August celebrated my third year anniversary at my job. I may have mentioned briefly in passing on one other post that I work in peer support, or maybe I didn’t. I think maybe I didn’t, because I talked so much about it on my old blog. I’ve only posted a few times there this year. Ultimately, it’s abandoned.
So I figured I’d talk a bit about it today. Not the job itself really, but the pros and cons I’ve come across with working with other people with lived experience at a respite house. There are ten times more pros than there are cons, but I think anyone would say that if they work a job they actually care about.
There are a lot more positives and probably some more negatives too, but I’m not trying to go on into infinity. Overall, this is the most comfortable and rewarding job I’ve had. They hired me a month before my 21st birthday and I’m still the youngest worker there by one year. I always joke they’re not allowed to hire anyone younger than me because I’ve always been the baby they’ve had to cradle; I feel like I was raised there and it’s only been three years. That should say something about growth. I think maybe I was mentally raised there.
There are a bunch of different types of peer services out there. Walk-in/Drop-in centers, Warmlines (which are phone lines manned by peers. Some are better than others. We offer a Warmline at the house.) NAMI is a version of family and peer services; some people find them useful and rewarding. There are more respite houses popping up across the U.S. There may be 40 or so now. There was 30-something when I first got hired. Sometimes there are peers working in the hospitals.
If you’re curious about a peer respite near you, check this directory This is the U.S list. There are peer services in other countries as well, it just takes a quick google search.
If you want to learn more about what a Peer Respite actually is, read this description here.
Do other bloggers/writers enjoy writer’s block as much as I do? I think it’s a time to explore what you want to say versus what you could say. Or maybe I’m one of those horrible people who see light in every darkness, and not in the cliche “there’s a positive in every negative” way.
Of course there’s a positive in every negative. It wouldn’t be negative if there wasn’t. Come on.
I was thinking about my previous post and about craziness in general, and about variation too, about how all of our experiences are different and yet they overlap. I wonder if they overlap because they are caused by similar “defects” (as the medical model persists) or if they overlap because we, again, enjoy organizing things into categories. Because it seems to me, in reading the research, that there are many different pathways that cause many different experiences, and no matter how much the media tells you serotonin is responsible for anxiety and dopamine is responsible for psychosis, no one actually knows.
Here’s a tip: if you hear a psychologist or researcher presenting information to the media, their work probably hasn’t been peer reviewed or replicated yet.
And so that makes me think about the spectrum of psychosis. I mean, there’s a wide range of experiences, and I touched on them last time just; this difference between internal versus external voices and how they were once regarded separate in their effect but now are regarded quite similar, the only difference being those with primarily internal voices have more awareness of their “origin”.
Some people have visual hallucinations, some people don’t. Some people have very few, like me. Some people believe people are coming to kill them. Some people believe spirits are coming to kill them. Some people think they’re God. Some people think you’re Lucifer. Some people sit silent, aloof, and stare at a wall (me). Others run down the street. A tiny fraction of people become violent out of nothing more than fear or confused anger.
So, what is it that varies all these experiences? It can’t all be chemicals. After all, delusions and hallucinations have a lot of fun playing off things/people/events happening around you.
There’s no point in arguing nature versus nurture, we’ll never be conclusive on that. People can have opinions, but the data will never be conclusive. What I think, then, is things like this should be considered with that ambiguity in mind.
It’s another fact that we’re human and humans hold bias. Researchers who want to be that one person to find conclusive evidence that a specific pathway with a specific chemical and electrical impulse in the brain is responsible for the cluster of experiences we call schizophrenia or bipolar or depression or anxiety will find that conclusive evidence. It might not be significant, it might not be real, and it will probably be correlational at best, but they’ll find it because they’re searching for it. They’ll find it because the companies they’re researching for toss out the evidence which doesn’t support the theory–that’s a big source of fraud in medical science these days.
It’s difficult to be objective in regular, everyday life. It’s ten times more difficult in research psychology, especially if you’re after fame or truly believe that your efforts will save millions of lives. Because if you don’t become famous and you don’t save everyone’s lives then you’ve just spend hundreds of thosuands of dollars on a degree in a job that may never pay off in the ways you imagined. And no one wants their fantasy squashed.
So I implore you in your daily lives, and especially those of you studying psychology or any science really, to remember nothing is certain. Remember a theory can never be proven; no matter how much “evidence” you think you find, we can never claim it as an absolute truth. Remember falsifying theories is more important; if we weed out the false ideas we can get closer to the truth, kind of how a limit never approaches zero but does that funny thing where it gets super close. Remember you’re the ass if you bend to the whim of money and fame and bribes.
Who wants to be so certain of everything, anyway? I enjoy waking up in the morning unsure of what the day will bring, and even more so now that I’ve stopped thinking “OH GOD OH GOD WHAT’S GOING TO HAPPEN TODAY” and started embracing “I wonder what could happen today? Well, I guess I’ll just find out.”
Certainty is so boring. That’s probably why the universe doesn’t care for it.
Jumping from the physical sciences (biology, physics, chemistry) and into psychological research methods is quite a leap. I am no expert in biology, physics and certainly not chemistry, and I never finished a degree in any of them, but I’ve taken enough to get a general understanding of proper research principals. Applying that mindset to people, however, is quite strange.
My professor quoted determinism as the most distinctive philosophical quality of all science. He also went on to (proudly) mention psychological research has 20% more accounts of replicated studies than physics and I resisted raising my hand and snapping back with a “well, no one in physics fraudulently fabricates a picture of a black hole the way psychological researchers fake prescription medication research for their own profit.”
But, that’s beside the point.
It’s not the first time I’ve heard this, and the further you go in science the more determinism becomes a question. It’s nestled deeply in psychology as well, which is probably the most terrifying place it can rest.
In a very basic sense, determinism is the thought that everything, every event/state of affairs/decision we make has been determined by events previous to that state. Some hard-lined determinists argue this is reason to scrap free will, while others insist free will exists within the parameters of determinism.
There’s thought that Quantum Mechanics has solid foundation for undermining determinism, and while it does present issues determinism cannot provide answers for, it’s been pointed out there are a few ways it could in fact support the idea of determinism.
I haven’t spent years studying Quantum theory, I can only know what I’ve learned from friends who went further than me in physics, and from research articles I’ve read in some journals. But, the Stanford Encylopedia of Philosophy has a great, short section on the multiple ways QM supports and doesn’t support determinism. (No, there isn’t a ton of incomprehensible math or professional jargon you can’t decipher). If you are also skeptical, I’d take a look at that link. There’s also discussion of naked singularities and probability.
That article concludes there can be no definitive conclusion–not in the way of empirical, mathematical support for determinism as a way of the universe. Instead, it postulates the universe be made up of both deterministic and indeterministic variables (i.e, proper randomness, proper chance).
This is one philosophical topic we can actually gather data for. But what does this have to do with psychology? Fucking everything, as it turns out. Let me reiterate some of B.F Skinner’s words and warnings from an excerpt of his (deterministic) book Beyond Freedom and Dignity:
“The appeal to reason has certain advantages over the authoritative command. A threat of punishment, no matter how subtle, generates emotional reactions and tendencies to escape or revolt. Perhaps the controllee merely ‘feels resentment’ at being made to act in a given way, but even that is to be avoided. When we ‘appeal to reason’, he ‘feels freer to do as he pleases’.”
In terms of the behavioral sciences, he’s referencing controlling unwanted/unruly behavior not with threats or anger or obvious statements (i.e, you’re going to hurt yourself jumping off that curb like that), but appealing to reason (look at how likely you are to get in an accident drunk driving! You could kill someone, or yourself!), disguising the control so that the person believes they have a sense of freedom. Skinner is not too fond of freedom. He insists “we must accept the fact that some kind of control of human behavior is inevitable . . . we are all controlled by the world in which we live, and part of the world has been and will be constructed by men”.
Appealing to reason is considered more compassionate than threats, but it can become unnecessarily coercive as it has within America’s mental health system. For example, if someone tells a professional “I can’t take it anymore, I want to end my life”. Often fear triggers a response of “how would your family feel? Would you want to do that to them? Think about how much you’d hurt them.”
And while on the surface that seems logical and effective, it’s shaming (how dare you consider doing this to your family). It’s refusing someone a decision and leading them into your preferred decision. And it’s also is a quick tactic to believe you have removed the crisis, to feel good for removing that crisis, to fulfill your quite well-intentioned need to save someone. It also often doesn’t allow us to explore the feelings behind the crisis in that deep, profound moment. But, it offers the question that is often debated of whether we have the right to tell someone “you have to live.”
This, of course, is rooted in the idea that if the benefit outweighs the risk, the benefit is worthy. The risk here would be removing someone’s freedom; the benefit, that someone continues to live. This, then, presents the question: is living chained (without knowing you’re chained) better than dying free?
It’s where the APA comes up with their experiment guidelines: if the scientific benefit is substantial, pain (human participants) or death (animal subjects) is warranted.
It makes us feel weird to think about all of this. It makes us feel bad too, for all the families who have lost someone to suicide, all the pain and horror that causes. As someone who was frequently suicidal, and attempted once, it makes me feel extra weird. We don’t want our friends or families or ourselves to feel that pain. But philosophically, that doesn’t remove the question of whether it’s our right to tell someone when they can live and when they can die.
And so, Skinner foreshadows many things really, with “The danger of the misuse of power is possibly greater than ever”.
The summary of his book, offered by one of my first philosophy texts, says he lectures on this idea that “behavioral scientists can and should be given the power to ‘engineer’ human behavior in accordance with an agreed-upon set of ideals (social harmony, individual happiness, and productivity)”.
Some form of control does seem inevitable. Is it because we like order and organization? Is it because we’re all power hungry? Is it because we can only see the world from our perspective and so absorb things personally/take them to heart? Or do we control out of fear of no control and therefore will never know if there is a version of constructive chaos?
I don’t have the answers. But, if we’ve created our mental healthcare system based on the idea that behaviorists should engineer human behavior into what they believe is the proper standard behavior, than I dare say we’ve actually lost some control.
As a species we really adore concrete things. We like to have hard lines; we like our tables to have edges, our doors to have frames, and a lot of the time that’s practical and necessary. I’ve noticed we also like our thoughts to have the same uniform structure.
Our brains are there to make sense of everything and when something doesn’t make sense we must make it make sense and to do that we find a perfect little box and if we can’t find a perfect little box, we create the broken box; if something doesn’t fit the standard box, that something must be broken. The broken box is where mental health issues lie.
We often call ourselves broken, ill, sick, all these negative connotations because that’s the box we’ve been given, and we feel broken, ill, and sick.
Within the broken box, there are three more little soggy boxes in the rain: mild, moderate, and severe. They’ve been around for a couple decades now, could use some time out in the sun and duct tape on the sides. In the mild box, you won’t find much help or understanding. Maybe you get anxiety every once in a while, or in specific situations. Maybe someone’s poured an ounce of depresso in your coffee and you have that annoying “blah” feeling, but you never miss work, you never want to die, and you function well.
The moderate box is a little less full. Your anxiety is constant. You get two ounces of depresso each morning and miss work once in a blue moon because you just can’t take it anymore. You think about finding a therapist, but draw the line at psychiatry until someone convinces you otherwise.
The severe box is the smallest, but that’s supposed to be good. Your anxiety won’t let you leave your house–not for the last three years. Your depression fills your cups of coffee, all four of them, every morning, and you don’t leave your bed, let alone your house. You can’t think straight, you’re spouting words which don’t exist on earth and God’s been talking to you, really talking to you this time, and you’re the chosen one. You can’t work, you can’t shop for yourself, and help is forced, not chosen.
So, for those of us who don’t fit in the soggy boxes, where do we go? We float in the ether.
Sometime I’ll talk about the most broken areas of the mental health system, and that will include the closet they keep all these boxes. But in this post I wanted to talk about variation.
I’ve never considered myself mentally ill, or to have a mental disorder. That’s not because I’m in “denial”. It’s because I don’t see myself as ill. I was in therapy at 6 for not talking. All of school was trauma because I still didn’t talk, I didn’t make friends, anxiety made me cry every five minutes, I was homeless for a few years and then also hormones. I think puberty should be considered a trauma. In high school I got depressed, was deep in self harm already, got on medication and into therapy. Neither helped.
In college, I solved Ebola and cured anxiety with frequencies. It’s a long story. Then I questioned things. People didn’t seem to hear the same things I did, or notice patterns I did. For some reason this didn’t frighten me. It startled me, but it never frightened me. I only got frightened when I was dragged into hell, trapped by demons, and then caused the Las Vegas mass shooting.
Obviously I didn’t cause the Las Vegas shooting, but I thought it was because of me.
And the things I heard: it was strange. It wasn’t just people outside talking to me, or talking about me, they were in my head too. Like, really lodged in there.
When you read this post silently to yourself, you have that mini-you voice. They were not that. They were similar as I didn’t hear them outside of my head, but they were differently pitched than my mini-me voice. They said random things (my favorite is “Put that burrito on reservation”), commented on things, and overwhelmed me when I sat in class. I dropped a lot of classes during this awakening period.
It never felt appropriate calling these voices because I knew it’d be dismissed and so when assessed I said I heard externally ones occasionally and they didn’t always say a lot, I didn’t know them well, and one just screamed.
Again, I didn’t fit in any box. I had periods of grandiosity, of depression, but also of consistent, unbreakable, delusions, regardless of my mood (sometimes). I’d seen things others didn’t. All I was missing to really put the dot on their fucking I’s were consistent, mind-numbing external voices.
So I read some papers. It was thought just a little over a decade ago that internal voices weren’t a thing, and then when they were, they were considered less severe than external ones.
And then I found this 2016 gem.
And felt oddly validated. Strangely validated. Horrifyingly validated.
Because now I fit in a box. And that feeling has plagued me ever since.
I don’t want to fit in one of those soggy, disgusting, abandoned closet boxes. But if I don’t, my struggles will be invalidated and dismissed.
So, I created my own box. Not a sick, diseased, ill box, but one which harbors a variety of human experiences and calls them just that. It’s not really a box at all, it’s just a flat piece of cardboard on the floor with no ceiling, no walls, and you can stretch your arms and breathe fresh air. There’s no duct tape or shipping labels or clumsy shoving of your limbs.
In the abstract of the above article, the researchers say they found those with internal voices to be more aware of where the voices come from. And that makes things easier, I think, because when I do hear things externally, I usually believe it’s someone in the building or outside of the building commenting on me or hating on me or whatever, and that’s a lot harder to work through.
Maybe it’s the awareness that dilutes the fear. It doesn’t dilute the stress.
And their internal nature doesn’t mean I believe they’re coming from me. So, do with that information what you will.
My point? We are human. Humans have experiences. Humans have varied experiences. And to call an experience, even a terrifying one, even a disrupting one, even a repetitive, life shattering one an illness like cancer is an illness, an illness like high blood pressure is an illness, is some kind of twisted medical logical fallacy.
You want mental health to be treated like physical health?
It already is.
I don’t know about the rest of you, but one thing I struggled with a lot in the worst of my mental health was feeling free. Not just from myself and my own judgments, but from other people’s judgments and the judgments of life; I talked a bit in the previous post about how it feels life has a standard of living we should be striving toward.
Growing up with anxiety meant every little thing made me cry. I felt kinds words reprimanded me, I felt harsh words reprimanded me, and silence or confusion around my actions or word made me feel “stupid”. That’s been a big hurdle for me: feeling stupid. Let me give you a recent example.
I decided to quit a second job I had acquired about six months before. One anxiety I still battle is approaching people, and a series of events lead up to me ghosting the job (as I have every job I’ve quit for the last 7 years). Their incessant calling my phone, my mother’s phone, and my primary job sparked paranoia; I heard the workers talking about me, their voices, their thoughts, and had the first panic attack I’ve had in 2.5 years. At the end of it all, friends seemed to reflect that I’d felt bad for ghosting my employer. But that wasn’t the case.
The things I heard were them discussing how stupid I’d been to do this. I feared looking stupid in the eyes of people I’d probably never see again.
There’s no guarantee had I quit “properly” I wouldn’t have experienced the same things. I always thought they considered me stupid, and that is in relation to how little I speak. That’s traced back into a childhood of selective mutism and gut wrenching anxiety and people actually thinking I was slow.
So, freedom felt hard to come by. Unobtainable. Non-existent.
My first realization came some months back: I needed to give myself permission to speak. I had never been given the chance or the encouragement as a child; at home, I was bullied into stifling my voice, especially around “grown folks”, and at school I was reprimanded for never talking. My child brain didn’t know how to reason through that contradiction. And so my first step as an adult was to remind myself I’m allowed to speak.
My second revelation came as I thought about the meaning of freedom. Could I do whatever I wanted? Murder without a conscience? Disregard consequence? Revel in havoc and embrace chaos? I dabbled in heavy partying for a brief period, mixed medications and alcohol hoping to feel alive and free in debauchery and carelessness. I didn’t feel trapped anymore, but I didn’t feel free either. So chaos wasn’t freedom, it was just a localized, appealing version of pain.
If recklessness wasn’t freedom, than what was? I thought back to the days I berated myself and physically hurt myself out of confusion and some underlying need to be noticed. I didn’t consider myself a bad person, but I didn’t think I was very good either, and then I learned.
I learned I judged myself (and assumed other people’s judgments) were based on whether or not I saw myself, or they saw me, as a bad person, a stupid person, an awkward person. I wanted to be good with the assumption that good meant genius, perfect, social. Being smart wasn’t enough for me–I needed to be smarter than everyone or my intelligence was worth nothing. I needed to not have acne or be so tall or wear unflattering clothes. I needed to not isolate. I needed to not need isolation. I needed to meet people and have friends and be normal. Normal was good. By those standards, I was very, very bad.
I spent time cycling around town, hiking in mountains, and thinking. I learned bad was pretty good.
I don’t mean this in the cliche sense of “in every bad person, there’s a good heart”, nor do I mean “not being normal is also good.” I mean, quite literally, we wouldn’t understand this concept of “bad” without good, and visa versa. Both are within each other, and created from each other, and therefore to label myself one or other, I labeled myself both. And I don’t mean that in the sense of “yes, everyone has a good side and a bad side”. Again, I mean this quite literally, and in a concrete sense, separate from the outcome of actions or thoughts. I.e, starting a riot in the middle of the street is called bad and therefore also called good. One concept can’t exist without the other in every form of life.
It didn’t mean that because snorting coke was both good and bad I should indulge. It meant I could acknowledge the duality and weigh my choices based on the outcome I wanted. I don’t not do drugs because it’s “bad”. I don’t do drugs because it would serve no purpose in the way of freedom.
That brought a lot of comfort because I no longer logically needed to live up to an invisible standard.
Being content with and understanding the connective duality of life gave me freedom from myself. It allowed me to allow space for those voices in my head, including my own negative thoughts; we were all now equal in our non-equality. Their darkness, and my own, was now also light. There was freedom in not fighting, and by not fighting, I fought. It’s similar to breaking an enemies resistance without fighting, which I believe is a central theme in Doaism teachings.
None of this stopped the pain. But all of this let me understand pain, and what I understand, I don’t fear.
It’s refreshing to understand yourself.
When I stopped seriously blogging about two years ago, it was abrupt and painful. Painful because I missed the writing community of almost five years which had enjoyed stories and laughs and tears and memories and traumas alongside me. They were there when I got my first car. They were there when I quit each job I got. They were there when I became employed at a Peer Respite house. They were there in my largest transformations of self.
Also painful because I was cracking up. Breaking down. In the hospital, confused and somewhat oddly satisfied in my terror of life. I felt alive again in a twisted way. I felt targeted and special and immortal and genius and connected to something greater than myself.
I posted every once in a while, but lost my follower’s attention. I created a slough of new sites, but WordPress changed so much of their format that I got frustrated trying to adapt. So, I went dark.
I told myself I’d be back only when I felt secure in myself. I’d be back only when I knew I had something important to say. I have something important to say.
This journey through depression and delusion and anxiety has given me new insights on darkness. Its introduced me to the true duality of nature so described in daoism. It’s roughly coddled me into accepting not only myself but all of life.
At the beginning of the pain, before I even worked at the respite house, a voice kept telling me “dead man walking”. Considering I’m a woman, it kind of cracked me up and also simultaneously terrified me; someone, something, was coming to kill me I thought. But I don’t think he predicted my future. I think he commented on my present. I was dead. I enjoyed nothing. I faked smiles. I practiced expert avoidance. I ignored myself and my inner processes because they scared me and because of that fear those inner processes found a way to express themselves for the first time in both of our lives. That way was voices, beliefs, depressions, a mania, panic attacks, and the underlying feeling of being broken.
I could talk about childhood stuff here. I could talk about medication and homelessness and the trauma of school. But I spent years reiterating that on my previous blog. I’ve spent time reiterating it to friends and therapists. And now, I can sum it all up in one word: fear.
I feared everything, for many reasons. I feared life. I feared being sad. I feared being happy because sadness came after. I feared anxiety, I feared death, I feared fear.
I think many of us go into therapy or other treatments confused on what “processing emotions” means. I think some therapists and psychiatrists who have never really gone through that heavy process are also confused on what it means. So they blurt it because they’re supposed to, it’s part of the script.
Processing emotions for me meant more than just talking about them and feeling them. It meant not telling myself “tomorrow will be better” or “this is temporary” or “I’ll be happy some day”. It meant not telling myself “you need to get up”. It meant greeting darkness with a handshake and respecting the space it needed within me. The darkness is lonely, too.
It meant sharing my body and my mind with panic and voices and fear and setting boundaries with them; if we all have to live in here together, we need to communicate and I can’t hold the power. But neither can you.
It meant getting comfortable with uncertainty. There is no standard “life”. My experiences don’t make life worse than what life should be, they don’t make life better than what life should be because life doesn’t have a designated “should”. It doesn’t have a designated “have to”. It’s just there.
It meant veering from my psychology degree and studying philosophy, a bit of physics, and leafing through neuroscience articles. It meant studying research. It meant, for me, getting off medication, and really feeling ALL of myself.
I’m sure most people have heard of the double-slit experiment in physics. I remember hearing about it for the first time as I sat high as a kite in High School chemistry. You learn the conclusion is that photons (and other particles) behave as both a wave and a particle, given the observed interference pattern. What high school teachers don’t talk much about is that the reason we come to that conclusion and label it as a reasonable consensus is because, as of right now, we’ll never know if we’re wrong.
We can’t see a single photon pass through anything with the naked eye. And so when we don’t observe it with a camera, when we can’t see what’s happening, the photon behaves as a single photon. The camera we use to observe this particle has a tiny light. That tiny light is a confounding variable–it could be affecting the particle’s behavior. Or maybe it isn’t. But, because we can never see for ourselves with a naked eye, we’ll never know. That’s the paradox, and part of the foundation of the Uncertainty Principal.
We’ll never know. We’re limited in this life we have, and when we’re not okay with that, we run ourselves exhausted trying to fix what isn’t broken.
I’m not scared of darkness anymore. What is there to be scared of?