Tag: depression

Posted in Emotions, Supporting Friends/Family, Therapy

What Is Trauma?

Posted on by alidware

Today I’m switching up the format a bit. I’ve been doing lists and tips for the past few days because I feel the information has been important and also relevant to many of our lives (if this is an inaccurate perception, please let me know in the comments below). But today has a different vibe to it.

For the longest time, I believed trauma could only exist in the form of a sudden, violent, physical instance, like a car accident or molestation/rape or physical child abuse. It wasn’t until I was 21 did I learn consistently being told to shut up, to not speak, was a form of trauma. It wasn’t until I was 21 did I learn the three years I spent homeless during my childhood was a trauma. I also didn’t know that growing up with an alcoholic and an addict was a very specific type of trauma.

So what exactly IS trauma?

Trauma Is:

Any kind of repeated emotional, verbal, or physical abuse/manipulation that has caused lasting effects. This could range from something seemingly simple like your mother nudging you to lose weight and consistently commenting on what you eat, how much you eat, and what kind of clothes you wear, to your father threatening to kill you if you told the teacher he gave you a black eye.

The thing about trauma is that it doesn’t effect any two people the same way. Not every person who has experienced sexual abuse becomes a drug addict. Not every person who was verbally accosted spends a lifetime struggling with their self-worth. Not every person who was physically abused grows up to be physically abusive.

Many people develop their own ways to process (or not process) their trauma. Some people want to pretend it never happened, and there are times where that helps them move on. We hear a lot that everyone should process their feelings, but as a grief study in Europe showed, sometimes people move on easier and still in a healthy way by just getting back to life rather than diving deep into their feelings. (I will put proper citation for that study when I can find a full copy; I learned of it through my previous professor).

Some people relive the events everyday and it cripples them. It invades their relationships, their school, their work, their own sense of peace.

Some people, like me, don’t really recognize where the trauma has effected their life or how. I think I talked a little about the trauma around my learning to speak for myself in this post, On Mental Health and Freedom.

Some people are in the middle and can function well, but are haunted from time to time with flashbacks or residual effects of their trauma.

Where Is Trauma Located?

Maybe that sounds weird.

What I mean is, where do you feel the trauma?

Often with mental health, we’re told “it’s just in your head”, and with trauma that’s not always the case. As a hypothesis, trauma can also be felt in your body as physical memories. Now, I don’t have a research paper sitting in front of me to back me up with this, all I have is my personal experience of certain physical attributes presenting when preparing certain memories for EMDR therapy.

When I find a paper that has studied this with a proper research method, I will update everyone.

But, if you have experienced trauma, you may get what I’m talking about. You feel certain things in your body. You may feel yourself separating from your body as the result of a specific memory–we call this dissociation. There may be certain words or attitudes or body language from someone else that may activate a tightening in your stomach or nausea or hot flashes with seemingly no explanation.

For me, one of these things is the “inner child”. The last therapist who asked me to talk to my inner child pulled some kind of deep seeded darkness into the light and whenever someone says the words or I think about it, I break down crying. I’m not sad, it’s just my body’s response. I’ll get warm and my chest will tighten and I have no full explanation for it.

So, it’s not “all in your head”, from my personal experience.

We talked a bit about this at a Hearing Voices Network workshop a couple years ago. We talked about how trauma can cause our mind to separate from our body and how that relates to and can be a catalyst for psychosis.

What this means is that, in approaching trauma, we must consider the whole body experience. We must consider reconnecting the mind with the body and this is often done with grounding techniques, similar to those used for anxiety and panic attacks: reminding yourself you are safe, feeling your feet on the ground, pinpointing areas of your body and focusing on them, or pinpointing objects in the room and saying them out loud.

Is EMDR A Proven Therapy?

NO. You’d be surprised to find that mindfulness isn’t either.

For those who don’t know, EMDR (Eye Movement and Desensitization Reprocessing) is a type of specific trauma therapy in which a traumatized patient is guided by someone trained with specific skills in asking particular questions about a traumatic memory (some of which can feel like CBT therapy) while they move a wand back and forth or flash moving lights. The hypothesis here is that eye movement helps your brain process the memory as a whole.

What I will say, for EMDR, is that studies have shown it works for the majority of people. The problem with the majority of the studies is that they often don’t separate the actual therapeutic content (the therapist leading you, asking questions, guiding you to feel your feelings) from the little lights and wand and all that.

So, in order for a valid study to prove that this therapy works, it would need to be compared with CBT with no lights/wand, Lights/wand with no CBT, the full EMDR package of lights/wand, and guiding CBT questions, and of course a control group of no treatment. Haven’t yet read a study like that. (If you know of one, please send it to me or put it down below in the comments! Please link the FULL research article or at the very least the abstract, not a secondary source).

EMDR is very popular. But so is Debriefing Therapy done after a serious natural disaster/crisis and studies have shown that actually makes people worse.

So POPULAR does not equal PROVEN.

What I will say from my current EMDR experience, is that it’s brought up a lot of pain but it also helped me process an incident at work very quickly. And had I not done that, I think the incident would have stuck with me in a different way. A hindering way.

What is Dissociation Like?

Dissociation can become a way of life for those traumatized, and it can also be a savior. It can pull you through tough moments. I’ve been dissociating regularly, and heavily, since I was 14 and I can say the first few years it bothered me. It bothered me mostly because I wasn’t so aware of it happening until I was told I walked into four lanes of traffic and 3 miles home without responding to anyone.

A lot of the time it feels like you, your essence, is somewhere far away and your body is stuck down here in muddy waters. Other forms of dissociation make you feel like your body isn’t real or that none of the earthly objects around you are real. This can be terrifying for a lot of people, and upsetting.

I’ve been experimenting with turning my dissociation into a profit. Not a monetary profit, but a mental profit. Dissociating has helped me learn to share power with my voices and given me a space I can retreat safely when needed.

Am I Traumatized?

Are you? I don’t know. If you experience some of the aforementioned things, perhaps. I’m not going to tell you what you are and what you aren’t, though. If you feel that there are things in the past that hinder your daily activities today or effect your mood or how you interact with people, it may be worth finding someone to talk to about it.

It took me years to realize that the reason I struggled interacting with people wasn’t because I was strange, weird, or a freak, but because I’d been taught my words were invalid, my thoughts were useless, and I didn’t have any right to speak. That mentality has continued to follow me into my adulthood, and it’s only been in the past year I’ve been able to rationally confront it.

So, as terrifying as facing pain can be, if it’s something you feel you need to get off your chest, if it’s something that’s been keeping you from living the life you want to live, it may be worth working toward gaining a new perspective and reaching out for guidance.

I don’t think I’ll want to talk about all my trauma for all of my life. I’d get tired of being weary over it. But a couple sessions of half-ass studied EMDR won’t hurt.

Would you like to continue the conversation, see silly (and beautiful) photos, or nonsensical two-second videos? Great! Follow me:

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Posted in Peer Support, psychology, Supporting Friends/Family, Voices

How To Support A Loved One’s Mental Health Journey

Posted on by alidware

Chances are, if your loved one is struggling, you’re overwhelmed, they’re overwhelmed, and you all just want time to stop so you can breathe.

Unfortunately, we experience time in a linear fashion because of our physicality. Sorry.

What we can do is learn, adapt, and have a meaningful existence.

So, let’s start with something simple:

Tip #1: Offer an ear

The easiest thing to do, which can also become one of the hardest things to stay consistent with and have patience for, is be an ear for your loved one.

Understand you are not their therapist, you are not their treatment center and you are not their savior. What you are is a confidant, a safe person. You don’t have to solve any problems and if your loved one is asking you to, kindly remind them that solutions aren’t always the answer: sometimes you just need to ride the waves, feel the pain, and learn to adapt. They will know this instinctually, but sometimes the pain is so great that we just want relief. That’s why gentle reminders, patience, and compassionate words are the best a friend or parent or partner or sibling can do.

Depressive phrases like “I just want to die” can be startling and sometimes your first instinct is to ask “are you safe?”. Refrain from that. For the love of God, refrain from that.

A lot of the times in my suicidal ideation I needed to vent and get the heavy burden off my shoulders. I needed someone to hear me. I didn’t need someone to panic and make me doubt I had any control over myself.

If your loved one talks about suicide often, concern is valid. Fear is valid. But not everyone benefits from multiple 3 day hospitalizations just because they’re thinking about killing themselves.

Instead sit with them. If they have a mental health team, maybe connect with them. Ask what you can do to help. You’ll probably get a response of “nothing” or “I don’t know, I just don’t want to be here anymore”. And that’s okay. You can’t control their actions or their thoughts and sometimes space for the seriousness and the authenticity of the pain helps release the tension.

Remember yourself in this too. Your loved one is in pain and you don’t like that. You want to help. You want to pull them out. But you can’t do everything, and that’s killing you. Sometimes you get so angry you want to pull your hair out. Sometimes you just want to give up. And so do they. They don’t want to feel like a burden to everyone around them and a way to show them that they aren’t is to make sure you take care of your own mental wellbeing. Show them you will be okay.

Their feelings are not your responsibility. That doesn’t make you selfish or careless. It makes you an individual mind.

So, in short: offer an ear, really hear them, and restrain your panic. Keep firm boundaries—your friend can’t be calling every ten seconds for you to rescue them, they need to find their own footing and be less dependent. You can foster this with healthy support, a compassionate ear, and voicing your own struggle if their pain becomes too much to bear.

Tip #2: Stay Educated

This will be important particularly if your child is affected. There is tons of research coming out every day on all these labels we’ve created and a lot of the real research is in stark contradiction to what you find on your average health website or mental health forum. If this is all new to you, I’d suggest checking out my previous post, How to Read a Psychological Research Paper, so you know what to look for.

It’s nice to read personal stories of individuals who are also affected; that’s often why we tell our stories is so that people can understand where we’re coming from. If your son bursts in your room and says something like “why the fuck would you say that? Get away from me”, you might start to doubt your coping abilities, you might start feeing like you have to walk on eggshells, and you’ll eventually just blame his mental health.

The problem with just blaming the experience is that you lack the understanding necessary to actually be compassionate. You can learn to not take things personal, you can earn to ignore harsh words and phrases, but all that does is discount the experience. Let me explain.

In personal stories you may read that someone once thought his mother was part of the CIA and transmitting his thoughts back to headquarters, commenting on his movements and locations, and so he’d yell at his mom or break things or do strange things to disrupt her telepathy. In the story you might read about the fear he felt, the terror, how scared he was despite how angry he appeared.

And that’s the key. If you don’t understand that your loved one, in this state, is much more sacred and confused than angry, you’ll be more inclined to yell back or try and present evidence in an attempt to break a delusion.

Not everyone has the luxury of being able to discuss what’s going on with their loved one in this state. But if you do, if there are substantial moments of clarity, especially in altered states like this that aren’t a crisis, it can be transformative for both to explore some of the fear and terror and brainstorm some ways to help your loved one reality check when things get intense.

In order to do that, you’ll need to know some things about altered states. Read some personal stories, read some valid research, and involve your loved one in all of this. Introduce some stories to them, discuss some of the research if that’s possible at the time, and help them know they aren’t alone. Express to them your fears and your confusion. Maybe saying something like “when you do this, I get confused because . . .” And create a dialogue around confusion. For those of us with anxiety and psychosis and even depression it can be very helpful when we know where we stand with someone.

Tip #3: Be Involved

Maybe you can’t do all of this for just a friend all the time. But if you could join them at a support group or help them get to an appointment, that can really be a great tangible way of showing you care. And, again, boundaries are important; if you take your friend to her weekly appointment once, and she keeps asking for a ride every week, find a time to remind her face to face that you have responsibilities of your own. Offer to help her find a bus pass or teach her how to use Uber/Lyft. But ultimately she needs to find her own way for some of the time.

Ask what kind of involvement your loved one would like. I know when my parents came to my therapy appointments, even if it was just my mother sitting outside, I didn’t like it. It was supposed to be my own personal space, my own personal time to get my own personal thoughts out. Unless your loved one is incapable of speaking for themselves, you should give them as much space as they want so they can develop their sense of being again.

Do not take control. Reach compromises with your loved one. Discuss things. Don’t talk about things with your loved one’s doctor without your loved one present. We have a saying in the peer community: Nothing About Us, Without Us. When this isn’t honored, we feel cheated, betrayed, out of control and this can fuel paranoia for those of us dealing with psychosis; suddenly, you’re working for the CIA again and you have no idea why.

If the doctor insists talking about things without his/her actual patient involved, resist and stand up for your loved one, particularly if they aren’t in the room to do so themselves.

This is important because supporting us in empowering ourselves instead of supporting our dependence or helplessness is what becomes eventual motivation for us to find stability. In fact, it’s essential in finding stability.

You might feel that your loved one can’t do anything on their own, and maybe in a crisis that’s true. Helping has its time and place as all things. But you have to understand that a hospital doesn’t foster individualism. It fosters helplessness. And if that attitude is continued outside of the hospital, and after the crisis, there will be little motivation and little belief that things can ever change.

The belief is the key factor here.

My parents were never involved much in my health or my crises. That may have saved me, because they never treated me any different. They assumed me to be well, they assumed me to be able to feed myself and clothe myself and bathe. When I didn’t, when I went into crisis mode and was in a hospital that did all those things for me—reminders at least—and I came home to zero reminders, zero help, after a while I knew that I wasn’t going to get that kind of dependent support. I never suffered with the belief that I was incapable. Even when I wasn’t showering in a depressive episode. I didn’t believe I couldn’t, I didn’t believe it was “just too hard”, I just believed the pain was too great to pay attention to that kind of crap right then.

So, be involved, but don’t suffocate. Reach a compromise with your loved one. This may take some wrangling, and both of you may need some patience. It takes a while to figure this stuff out. A single conversation isn’t going to be enough.

Tip #4: Breathe

The best thing you can do for your loved one is be well.

There’s not much else to say about that.

And this isn’t to be well for them. This isn’t to be well so you can be their caretaker. This is for you to be well for you. This is to promote your own healthy state of mind and live your life with your loved one. It’s possible to have a peaceful existence. It’s just not possible to have it without some hiccups along the way. And there’s nothing wrong with that. It all depends on how you adapt.

A Final Thought:

These tips are built from things I wished people had done with me. Anxiety crippled me as a kid, and into adulthood; depression buried me my teenage years, and psychosis has given me insight to the universe, and not in a delusional sense. It would have been nice having close family or close friends along that entire journey with me.

And so, my parting word is this: walk with your loved one—not in front of them, not behind them, but beside them.

Would you like to continue the conversation, see silly (and beautiful) photos, or nonsensical two-second videos? Great! Follow me:

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If you liked this article, please share it, hit the like button, reblog, and follow ThePhilosophicalPsychotic. I appreciate every reader and commentator. You give me more reason to continue this joyous hobby.

Posted in Freedom, Peer Support, Therapy, Voices

A Different Way To Hear Voices: Tips and Tricks

Posted on by alidware

We ask doctors what we’re supposed to do about them, how we’re supposed to manage them, how we can make them go away and often the doctors don’t have a very good answer not because they aren’t book-smart (because they’ve certainly proven time and time again they are VERY book-smart) but because they have no idea what they’re dealing with. That’s the truth.

Medication works for some of us—makes them fainter, or less intrusive at the least. But rarely will you hear someone comment their voices have gone away completely.

Couple that with fleeting thoughts that seem to come from that one area of your mind you never open the doors to, and your ability to focus is reduced to the attention span of a goldfish, literally.

What are some other ways we can deal with this?

Get Involved!

I hear that Support Groups can be helpful. You meet people who you can form (perhaps) life-long friendships with, people who understand where you are and meet you there rather than try and pull you where they are. I’ve personally never got much from group therapy or support groups. I find it difficult to be truly open with people, even after a year of acquaintanceship, and so I stray from this option.

But if it sounds like something which may be good for you, I suggest looking into your local NAMI chapter (if you’re in the United States). I would also suggest searching for alternative groups and using other language besides “mental illness” or “disorder” in your search engine. By doing that, I found a list of wellness groups 45 minutes from me with names like “Support group for those with voices and visions”. These kind of groups offer the same type of peer support, but through a different lens.

It can be transformative to engage with people who have different perspectives. Through them, you learn more about your beliefs and form a more solid understand of yourself. I find this to be pertinent in getting grounded because we lose part of our identity when falling through a crisis. We have people telling us what to do, when to do it, how do it it, how to get healthy, why we are aren’t healthy, and kind of become the property of those around us and the terror in our head.

We want to reclaim some of who we are. Sometimes that means discovering ourselves for the first time. Sometimes that means reinventing who we once were. In either scenario, solidifying your beliefs, your passions, and remembering what it feels like to be respected and give respect are all things which help us build ourselves outside of others expectations.

Explore the Unknown!

This is probably a less sought-after option because it doesn’t involve immediate relief. If anything, you’ll be in more pain for a while.

What I mean by explore the unknown is actually listen to the voices. Don’t abide by them or agree with them (all the time) or allow yourself to be convinced of something you know for a fact isn’t true. That sounds a lot easier and more practical than it actually is. But it’s worked in many ways for me.

Stop yelling back. What does yelling usually do? Make them louder, right? Your voices aren’t some shy kids on the playground who you can bully. Most of the time, they won’t submit. And maybe they don’t need to submit. Maybe they’re there to teach patience and understanding and resiliency. Maybe they’re there to teach you life lessons your parents couldn’t. Or maybe they’re just there to be assholes. I think most people you know could fall into one or all of these categories. The point is, you’ll never really know the correct category (for both people and voices) if you don’t listen.

I explained in my previous post, How Philosophy Helped Me Process Psychosis, that I lived under the impression that my voices were demons from a hell I didn’t believe in, here to prevent me from serving my one true purpose. I didn’t just snap out of this one day from medication or extra sleep or hospitalization. It took a couple years of exploring and pain and horror for me to come to any coherent realization.

Seeing how others dealt with their voices was helpful, which is why I recommended support groups at the beginning of this post. In giving myself a chance to hear others, I also gave myself a chance to hear myself. I heard that I was wanted dead. I heard that I was doomed. I also heard I was the light of the earth and I was protected. I got a lot of mixed messages.

What does listening to these messages do, besides cause you more distress?

Well, what does listening to your friend do when they’re stressed out? Sometimes, if you’re attentive and listening closely, it escalates their pain and they scream or cry and they get it all out. Then they’re quiet, they’re thankful, and they might even ask how you’re doing. This leads me into my next tip:

Start a Dialogue!

Let’s be clear here: when I say listen to them, I don’t mean ignore them. Let them vent, yes. Let them vent the commands, the violence, the sadness, the happiness, the grandiosity, whatever their M.O is, and then ask a question or two. Make a reflection. If they are telling you to kill yourself, ask them why. If they respond with an answer that sounds reasonable to you in the moment, something like “no one loves you” or “they all hate you,” consider a compassionate response like “you’re in pain; I am too. Can we figure this out together? I don’t really want to die.”

Why?

What I kept hearing over and over again was the importance of showing yourself compassion. It’s no different than what people with depression or anxiety are told: be kind to yourself.

And if you don’t believe your voices are apart of you, if you believe they are outside of yourself as I believed, remember that we’re all an extension of the universe, and that’s not some mystical hippie stuff, that’s science. We’re all made of the same material, within the same cosmos. We are all each other. Be kind to the earth because earth is an extension of you. Be kind to your children because your children are an extension of you. Be kind to your voices because your voices are an extension of you.

No therapist or friend has (hopefully) ever supported you by screaming back at you and swearing to end you, even if you yelled first or insulted them, or threatened them. And so don’t support yourself that way. Support yourself with compassion and patience and kindness, and remember that you are sharing a space with these things, these voices. You’re all in this body together. This brings up the final tip:

Create A Space for Them!

This is better illustrated with a quick story.

Last night a wave of confusion hit me. My thoughts circled around my impending death and nothing I read made sense. I could barely respond to text messages. I knew something was upsetting my system, and a familiar voice told me to go for a drive. So I did, for two hours.

I headed to some cliffs. I realized I was fighting a lot, fighting the confusion, fighting the voices telling me this drive would be my last, fighting the belief that they’d trigger a heart attack if I parked by the cliffs, and fighting the fact that none of my fighting reaped any benefits. And so I checked out.

I gave them some space. I stopped arguing with the thoughts. I also stopped being fearful of them, and I stopped feeding them with attention. I dissociated and only remember a few snippets of my drive. I did reach the cliffs, but didn’t park partly because of fear and partly because I didn’t want to sit near other cars.

While weaving down some roads I didn’t know very well, I realized my body felt a little lighter I wasn’t as stressed, and some of the thoughts of death had gone away because I’d faced my fear. One of my more familiar voices told me, “See? We know what’s best for you.”

Did they know what was best for me? I didn’t think so. I disagreed and asked why, then, do you keep telling me I’m going to die? Why do you keep feeding my anxiety? His answer?

“Pain is necessary.”

We all know that pain is unavoidable in life, but this struck me so deeply because of all the duality I mentioned in my previous post, that they were here to both lift me up and pull me down and that’s what makes them no better than me, no better than any human. That’s what makes us able to relate. That very duality is what makes us able to share this body and live with each other.

This took a few years of confusion and talking and different types of therapy and 8 years on and (finally) off medication. This took a lot of anger and frustration and fear and maybe some risks. But it’s possible.

And in The End…

There is no textbook on how to deal with your voices. There is no doctor or therapist or friend or family member or self-help stranger or medication or amazingly insightful philosophical blog that can tell you what the right path is. The hardship and pain and joy is in finding that yourself.

You do have to live with yourself for the rest of your life. Might as well figure out a way to do so peacefully.

Would you like to continue the conversation, see silly (and beautiful) photos, or nonsensical two second videos? Great! Follow me:

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Posted in Freedom, Voices

The Advantages of Pain

Posted on by alidware

Let’s have a discussion about the power hidden within struggle.

After the loss of control that a crisis brings, it feels impossible sometimes to regain a sense of self and place in the world. You doubt yourself, you doubt your beliefs, your happiness, or any chance that this darker side of life has anything other than despair and mental anguish to offer.

I see a lot of #mentalhealthawareness tweets and posts on instagram that talk about how hard it is to have anxiety or how depression stops people from living life or how their mental torment holds them back in some way, and because of that the general public should stop using mental health terminology as adjectives, or the general public should “educate themselves” on what it means to have this devastating “mental illness”.

Then, there are other posts which are meant to encourage people stuck in these dark times to remember that they are strong for dealing with the pain that they deal with, and no one can tell them otherwise.

I’m never one to silence a voice, or voices in this case, but I do think we miss the mark a lot. It’s not really about how hard everything is, it’s about what we’re taught from that hardship. If you feel you haven’t learned anything, I encourage you to dig until you hit water.

It’s also not really about you being strong. Everyone struggles. Every single person in the world. And this isn’t to compare pains to one another. This is to say that if there’s one thing the human race shares across borders, it’s pain. We’re built, physically and mentally, to endure a lot of shit. The struggle worsens, though, when you lose faith and trust in your body and/or your mind. When you believe you’re inept to face a challenge, you’re basically telling your body “I don’t trust you to handle this”, and your mind “I don’t trust you to make it through this”.

The problem with that, in my completely hypothetical and unscientific proposition here, is that your body and mind start mistrusting you too. And when you’re out of sync with the two major systems keeping you conscious and alive, than you’re existing in a void.

I think the greatest lesson I have learned in experiencing psychosis is how important my body and mind are to me. I felt such a strong disconnect from my entire self. Nothing made sense. My body had aches and pains I didn’t understand and my mind told me things that didn’t make sense, things that came to me like an idea for a short story and ended up as a first, incoherent draft of a horror manuscript.

Making a decision to come off medication became a catalyst for reuniting myself with my body—the first step in my real recovery. But it wasn’t the physical act of getting off the medication that saved me. It was the fact that I made a decision based on what my body told me. I sat for some weeks and listened to my internal system until the cries were finally recognized. Hearing those cries and abiding by them restored a lot of trust between my body and myself.

My mind came next. I plunged into utter darkness. Voices said I should kill myself, and I tried. I was tackled into safety. No, I was not hospitalized that time.

But for the first time in this darkness, I let it sweep me away. I didn’t shoot arrows or fill my moat. I let evil overrun my castle and I shook its hand. It pulled me down a spiral of agony and I saw the deepest, rotted pits of my mind. I didn’t cry because I was fearful of that. I cried because darkness lead me around these pits and showed me the decaying feelings I’d neglected. The traumas I’d abused. I cried because I’d been hurting myself and I never knew it.

It’s been over a year since my descent, since I stopped taking the medication, since I got back into the gym and nurturing my body. I’ve made space in my physical self and mental self for aches and pains and darkness. I have a voice who reminds me when I’m not okay, or asks me if I’m okay when I feel a little rocky. In fact, with all of the thoughts and voices in my head, I’ve reached a compromise: we either live in this body together or none of us live at all.

I want to live. They want to live. And so we leave space for each other.

“Recovery”, or whatever you’d like to call it, for me isn’t about being strong or resilient or tweeting about how much my life has changed or instagramming paragraphs about why hope should never die. It’s about a willingness to be terrified. It’s about reconnecting myself with what I’d been too fearful to face. Granted, I didn’t do this all on my own. I had friends and therapists and some bad group therapy experiences, all of which lead me back to looking inside of myself.

This is why you will never catch me on social media telling people what they want to hear. What they want to hear is the same script that’s everywhere: you can live a normal life. Take control. Be your best you. It’s possible to live with “mental illness”.

That’s all fine if you just want to exist. But it’s deeper than that for me. Giving up control gave me more freedom than fighting for control. I don’t “live with mental illness” because I’ve been labeled schizoaffective. I just “live with myself” like every other damn human being.

We think we’re so different from others. For some of us, that makes us feel entitled, like we deserve special treatment because “we’re sick”. And then we turn around and demand we also be treated the same as everyone else. Classic identity crisis if you ask me.

For me, that mindset just never quite cut the cake.

So, there is deep beauty in suffering, and deep agony in happiness. Our minds and our bodies are built for adaptation. They’re built to endure. Trust in this.

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Posted in Emotions, Freedom

Tips for being in a relationship with someone and their mental health struggles.

Posted on by alidware

As someone labeled Schizoaffective (although I don’t consider myself disordered, disabled or “mentally ill”), and having read a few other articles online about relationships and mental health, I decided to weigh in on this with a little logic, rationality, and perhaps some harsh realities.

Paranoia, depression, and anxiety ruined a relationship with the person I am currently back together with. I won’t rehash everything. But my paranoia and anxiety wedged a wall between his family and me, and still does. It eventually wedged a wall between us as well. What I’ll share in this post is what we have learned.

Tip number 1: Your Partner is NOT Your Caregiver.

Unless the both of you have formally agreed to one person bearing the weight of taking care of appointments, reminding you to eat, reminding you to shower, reminding you to take your medication, moderating moods or behavior or trying to control behavior, and anything else a nurse or worker would do, this is NOT your job.

This is a harsh reality for many people because the first thing you’re told is your partner struggles with certain things (perhaps some of the things listed above) and may need gentle reminders or constant reminders. And there’s nothing wrong with a little help. The problem arises when this help reinforces the idea of helplessness, the concept of utter disability, both of which further the mindset which fuels depression. If your partner believes they can’t do something because their doctor says it, because you say it, or because all of the family says it, than your partner isn’t going to feel there’s a point to managing independence with their experiences.

This DOES NOT mean support isn’t vital. Support is vital in any relationship. But one person does not deserve to carry the weight of two people. Let’s explore this further.

Tip number 2: The health of both partners is more important than the health of one.

This sounds like “the majority outweighs the minority”, with some residual beliefs utilitarianism, which I’m not a huge fan of, but what I’m getting at here is that both partners must be healthy in order for the relationship to move forward as a whole. And it’s not enough to use that age old excuse of “my partner didn’t ask for this, it’s not fair.”

You’re right. Your partner didn’t ask for this. Who the hell asks for anything that causes struggle in this life? I suppose one could argue that by simple living you’re inviting and encouraging pain, but I have a feeling my readers aren’t wanting to go down that philosophical rabbit hole right now. Just because neither of you asked for this doesn’t mean milk the struggle. It doesn’t mean one persons health and well-being is more important than another’s. What it means is that balance is key. It means you, as the well partner, has a responsibility to care for yourself and your being, just as your partner struggling with their mental health has a responsibility to care for his/herself and his/her being.

In all of my crises I relied a lot on my partner. I was starved for understanding and wanted someone to pull me out of my head. I had psychiatrists, hospital visits, medication, and none of it seemed to make a difference. The weight I placed on his shoulders wasn’t fair. It’s important to communicate feelings. But not when you’re unloading those feelings like you’re a dump truck and he’s the landfill. That’s a classic case of me not having proper outlets or other areas of support. My health is my health, not his health.

Tip number 3: If your partner is the one struggling, be understanding but know when you need space

Know that you are not a savior. You are not there to pull us from our pain. No one expects you to. We have to feel our pain. We have to adapt in ways that work for us. Answers do not lie in you.

Now breathe. Doesn’t it feel good to not have the weight of someone else on your shoulders? Know that most of us are capable of taking care of ourselves the majority of the time, and also know that if we aren’t right now, most of us are capable of learning with a little firm encouragement from the entire mental health team (not just you) and with a little confidence in ourselves, which can take time to build when you’re constantly being told you’re sick and disabled. Remember: research shows thoughts have the power to transform the physical chemistry of the mind.

That being said, ask your partner what are some ways that you can support them in a crisis. Do not be offended if one the answers is “stay away from me”, or something of the sort. It’s not always someone dangerously isolating. Sometimes it’s a necessary space we need to really absorb our feelings, feel them, and help them pass on to the next life. If that causes you to feel ignored or unloved, discuss this with your partner.

Ask your partner when the proper time to get authorities involved is. Hospitalization is often another added trauma, as helpful as it may be. Handcuffs, cots, restraints, unwilling shots, all of it is trauma and can build a lot of mistrust in a lot of ways. If your partner is willing to go for hospitalization, make sure they are able to line up their treatment. Get a Mental Health Advance Directive if hospitalization is a common thing.

Empowerment is key to a confident, independent partner. They are in control, no one else. When they cannot be in control, brainstorm ways with them where their wishes can be honored (that’s an advance directive).

Tip number 4: If you are the partner who struggles, expand your support system.

This can be really hard. I’ve yet to get a steady support system around me that doesn’t involve friends from work or my therapist. And a support system doesn’t always have to be people. It can be things you use when you feel emotions taking over or a crisis budding. It could be a retreat if you have money. It could be a day at the animal shelter, petting animals. It could be local peer support groups, where you can foster connections with people who understand what you’re going through and are there specifically for mutual support.

When I feel I’m struggling, I alert my partner but I also take steps to process the pain. I’ll drive an hour or so away to some woods and a state beach and walk and contemplate and process and dissociate. It seems dangerous to some, and maybe for some people with certain struggles it would be. But for me it’s exactly what I need. To be away. It’s much less likely that I’ll be paranoid about a mountain. It’s much more likely I’ll be paranoid about that group of people across the street taking about my death. I often feel mountains intercept on people’s thoughts the way they interrupt cell phone service; their blockade stops people from hearing my thoughts or me hearing their thoughts.

If you don’t have transportation, which a lot of us do not, see if there are things within walking distance. If you’re comfortable taking public transportation, map out a route that could be helpful for you. Update your partner—remember, communication is key—but don’t send out distress signals unless it’s necessary. It’s important to reconnect with yourself, to learn your limits and push them just a bit, and to get comfortable juggling your pain without reaching for a life raft all the time. It’s the only way to learn how to swim.

Tip number 5: If you really love your partner, remember things will never be perfect and that healing takes time. A lot of it.

A partnership needs balance. It needs compassion and understanding and patience from both people. It needs trauma-informed processing from both people. It needs both parties to really see, hear, and feel each other’s perspective.

Struggling sucks. Trying to deal with other people’s struggles suck. Maybe you feel your partner will never be as independent as you hope. Maybe you feel your partner will never understand you. Maybe you feel your partner isn’t trying enough. Maybe you feel you’re trying your hardest and still not progressing; maybe that makes you feel guilty. Maybe neither of you know what to do.

And that’s okay. There’s a huge learning curve with this. And once every avenue has been exhausted, if either partner isn’t growing in a way that benefits the both of you, that’s okay to. You know why? You have the option to walk away.

No one, except your pain and fear and sorrow, is keeping you with someone who consistently hurts you.

Sometimes time apart is what fosters real growth. And sometimes it doesn’t. The point is you deserve to be happy. If you’re happy with someone who isn’t understanding or you’re happy with someone who is needing constant supervision, great! No one said that’s a bad thing. But the moment it becomes overwhelming, and growth has stopped, its time to reconsider what you’re putting yourself through.

I know

I’m aware this isn’t a typical perspective that’s written about. I’m also aware that everyone is different. There are different skill levels, different levels of lucidity and different levels of tolerance. Love is blind, I also know that.

I know that whatever satisfies your heart and your happiness is the choice for you. This article is not intended to shame or hurt or insult anyone. Its intent is to offer alternative perspective from someone who struggles with mental health issues and is learning to grow with a partner she never wants to lose because of some stupid unrealistic thoughts. It’s also coming from someone who refuses to let any mental health anything prevent her from living a full life.

Everyone is different. The point is to learn how to balance those differences so you can enjoy the best parts of sharing your life with someone.

Would you like to continue the mental health conversation, see silly photographs and nonsensical two second videos? Great! Follow me:

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Posted in Late Night Thoughts, psychology

Are People With Mental Health Issues More Creative?

Posted on by alidware

I feel this is a question constantly fueled by confirmation bias. That is, we believe that this is true, or want to believe so, and so if we are an artist or musician or whatever, we say that yes, a lot of our most creative works comes from our struggle.

My personal experience has been that there are moments where my creativity is boundless and other moments it is stagnant. It depends on my mood or my thoughts, and I think that’s how it goes for a lot of people.

I think why people get this impression is that those of us who have struggled with our mental health, in any form, are often forced to look at life and existence differently. We’re going to have some trippy insight or thought provoking ideas because we think a lot, too much most of the time, and we’ve investigated many different avenues for many different perceptions.

In the past, my depressive episodes consisted of no showers, too much food, sleep at peak sunlight hours and awake at peak sleep hours. I also wrote a lot of poetry.

I hate poetry.

Okay, that’s a strong word. I don’t hate poetry. But it’s never appealed to me as an art form. I could stomach reading really beautiful poetry, but if it wasn’t unique and full of meaning I didn’t like it. And so to belt out poems about sadness and the crushing weight of reality was very unlike me.

I wouldn’t say the depression enhanced my creativity. I would say it pushed me into another realm of expression. And really, poetry saved my life many times.

My psychosis introduced another art form I’d never considered: wood carving and burning. I designed, carved, burned, and painted the pieces for a good two months after getting out of the hospital. Something about following the lines and having that strict order, something to focus so heavily on, let my thoughts wander freely while keeping my body anchored and centered. When that form of expression was no longer needed, I just kind of abandoned it. I haven’t touched the equipment in over a year.

I did a lot of nonsense writing as well. I made dark drawings of creatures created in my mind and discovered when I focused, I could whip out some detailed designs. I don’t draw, either

And so what I think happens is our mind is so starved of understanding when we’re in these states because we fight it so hard. We fight the depression to stay happy, we fight the psychosis to say coherent, we fight the anxiety to stop shaking, we fight the mania so we don’t break the bank. But, in a way, these states are a type of expression. And when we stifle that expression, it finds another avenue. For many of us, we translate that struggle into music or art or writing or projects and hobbies. It makes us look like creative geniuses.

What could depression possibly be expressing? What could psychosis? It was only a few decades ago that psychiatric professionals believed delusions completely incoherent and meaningless. It’s only been recently that studies and observations have hypothesized that many delusions and ramblings are indeed coming from real pain and fear anchored in the patient’s past or present, or from something witnessed in the world.

For example, my “delusions” often revolve around possession. In the worst of it, I feel everyone is an imposter, that everyone is lying, and that if I let my guard slip I will be harmed. My soul will be stolen and trapped in the deepest depths of the most hellish hell.

None of that, so doctors say, is reality.

But, I grew up in a very unstable household with one parent heavy into mind altering substances–hard drugs and alcohol–and so one moment could be full of laughter and joy, the next full of tears and violence. And because I was quiet and sheltered, I never really interacted with other children to learn I could trust them. So instead, I learned to trust no one.

My lack of trust is the foundation of every delusion I’ve entertained. Now, when my thoughts turn in this direction, when everything is a message, when every death is a sign, when dead celebrities are lifting me up and pushing my career forward to trap me, I don’t try and reason myself out of it because I’ll only reason myself into it. Instead, I focus on trust. What, besides someone being possessed and meaning harm to me, is another reason I’m having trouble trusting and interacting with this person?

This steals a lot of power from the delusion sometimes, and also helps me notice that my brain is jumping to extreme conclusions as a way to express its distress. And that means I should pay attention.

Our brains are always finding weird ways to exist in this life. Humans are inherently creative, but we sometimes categorize said creativity and contain it. Instead, we should see it from all angles, even the dark ones.

Posted in science, Therapy

Exposure Therapy May Drown You

Posted on by alidware

My absence is attributed, this time, to preparation for a presentation that I did for my research course. We had great fun: saturated the Google Slides with relevent, cheesy memes, and presented our failed experiment data and had a great laugh about it all. I’m quite satisfied.

Finals week is next week, and all of this stress has had me tossing and turning in my sleep (partly because of my still injured back too) and has had me waking in the morning shaking, sweaty, and on edge. The other night I got minimal sleep because I went to bed angry, woke up a few hours later to a quite the slew of annoying voices, broadcasting really, and I could not sleep without some earbuds playing loud, chaotic rap music. I did not sleep soundly.

But it’s got me thinking about exposure therapy for some reason. I’ve been more talkative than usual, and although shaky the morning of my presentation and not quite as coherent as I wished to be, I was able to start out the presentation, get through my portion of the work, and relate my own experience with psychosis to our study on non-verbal cues and the effects it can have on interaction. The professor was surprised, I could see, and very rarely does anything from his students shock him, so that made me giggle internally.

If you remember me from the Mental Truths blog, you’ll have read tons of rants years old about my past battles with anxiety. So I’m not going to regurgitate everything here. Just know it’s been bad since I was about 5 years old. And every therapist I’ve been to has told me “Face your fears”. That’s the only way to rid the social anxiety–show yourself that you can do it. Prove your brain wrong.

It make sense.

Except that it doesn’t. And let me explain why.

Expose therapy, as a technique, has been proven not so much for specific phobias, but for PTSD. And when I say PTSD, I don’t mean emotional traumas. I mean physical traumas like a car crash you survived or a plane crash. It’s been speculated that it can work in other areas, but there’s no definite research with viable, proper experiments.

Remember, experiments can make claims to findings without being legitimate; it all depends on the method they used. An improper method can invalidate the entire study.

And so I’ve tried exposing myself to social situations in the past. Integrating into groups. Being nice to kids in class. And no matter what I did it seemed I always failed. I’d talk to someone or a group and still end up as the outcast. I concluded exposure therapy is a lie.

This time though, things are different. I’m doing the same things I did back then: taking risks, embracing the risks, following through with them, refusing to let the anxiety dictate whether I do something or not. So what’s the difference this time?

Readiness.

If you struggle with social anxiety and have been to a therapist who constantly tells you that the only way to conquer your anxiety is to face your fears, he/she is not entirely wrong. What he/she is wrong about it is pushing you into it.

If you attempt to face your fears with low self-esteem, showing yourself that you can engage successfully with people will look like a failure regardless. If anything, your therapist should be helping prepare your self-esteem. They should be encouraging you toward readiness, not tossing you in the pool without any floaters.

What helped made me get ready had a small fraction to do with the people around me. Some of it was support from friends. Some of it was a particular conversation with my therapist that, without intending to, made me realize I need to give myself permission to speak. So far, I’d been the only one holding myself back. I’d internalized this idea that I was only allowed to speak when spoken to, and that when I did speak it didn’t matter. People could tell me the opposite all they want; if I don’t believe it, them shoving it down my throat won’t make me believe it.

And so I told myself one day: you are allowed to speak.

And I continued to do so.

Over the course of a few months, reminding myself of this, engaging positively with classmates, roping them into my craziness with humor, leading my team toward good ideas, has shown me that I can communicate effectively. Speaking in front of others reminds me that I struggle with coherency sometimes–

Okay, I’ll finish that sentence in a second. I just saw these twin men who I saw the other day who had made direct eye contact with me and that was the night something was broadcasted to me and the fact that they’re walking into the library I’m in right now tripped me out for a second.

Squirrel!

Okay, back to the important stuff.

Speaking in front of others shows me that I still need to work on coherency, and being able to say what I want to say. I always thought Anxiety was the culprit. I always thought it made my mind blank, and it does, but not to the extent I believed it did. Once I stopped believing it was ruining my life, once I worked on my confidence and depression, the effect it’s had has been infinitesimally smaller than it used to be.

In the past, I took my incoherent speaking as a sign I would never improve. Because that was my mindset. Improvement was impossible.

Now that improvement has become possible, the coherency issue hasn’t disappeared but it’s become an obstacle instead of a brick barrier.

What is the point of this post? Well, I want us to do some critical thinking here.

It is true that some people learn to swim by being launched into the deep end of the pool.

It is also true that some people learn by not being launched into the deep end of the pool, but first by gaining confidence to step into the water.

Mindset effects our ability to take advantage of therapeutic techniques which have potential to assist us: that is my hypothesis. As a rough example, were I to test this, I’d do so with those controlled by severe social anxiety as I was. That would be screened with a questionnaire. Those chosen would report their levels of anxiety so we can get a baseline. One group would be given regular, well-defined exposure therapy depending on their greatest social fear. One group would focus on their mindset, specifically their confidence in all aspects of their life with CBT. The third group would be given no technique or put on a waiting list (I know, soooo cruel). This would have to be double blind obviously, considering my intense bias.

At the end of the study, which I would hope I’d have enough resources/money to run this for months, not a puny amount of weeks, I’d ask for a self-report of anxiety but also for them to return to that social situation that makes them the most anxious and rate their anxiety during that time as well.

Would the results be significant? Who knows. I can’t base a generalization to people on how this has helped me. Just as the European study which found people handle grief differently, and that for some “getting back to life” is actually more helpful for them than therapy and being forced into the “five stages of grief”, I would expect to find severe individual variation.

The study I read about non-verbal cues (related to the experiment we did for my course) and their relation to schizophrenia, how patients labeled with such are often influenced by their psychiatrists’ non-verbal cues, is something else I’d like to study. That is, if the psychiatrist is smiling, sitting straight, not monotonous in their tone, their “patients” tend to show a decrease in their symptoms and better satisfaction with their care. I had to find this study from a European research group because there is very little information like this from U.S researchers. That I am capable of finding.

There are so many more things to study in psychology in regards to mental health than pills and there is so much more to mental health awareness than vomiting stale definitions of disorders as “information”.

It’s technique here that makes a difference. That’s another hypothesis I’d like to study. Pit pills and well-researched techniques together and see which comes out on top.

They say that medication and therapy are most successful together. I haven’t read the research on all this yet, but I will. I think there are some things which technique could be better for than medication. This has been shown a few times I believe. But I think it can include certain cases of psychosis.

Post acute episode, of course.

Cognitive Behavior Therapy isn’t going to convince you mid-episode that your neighbor isn’t part of the F.B.I.

Or can it?

Let’s research.

Posted in Emotions

Self-Care During the Holidays

Posted on by alidware

Hey all. It’s been a couple days since I’ve written. The last post was the conclusion of our investigation into whether psychology is a science. We conceded, I think, on the view that it has scientific potential but isn’t quite there yet.

I had another post prepared for today, but in light of the coming Holidays, I’ve foregone my usually cynical direction and decided to engage in some positivity today.

I’m not sure how it is for you all, but for me Holidays are difficult. I didn’t know they were difficult until I realized my moods seemed to fluctuate more viciously during this time. I also realized I’ve been taken into the hospital in October/November three years in a row and last year stayed at the respite house which I work for.

And so, to celebrate the second year of not going into the hospital, I figured I’d share some ways to engage in self-care during these busy times.

Disengage When Necessary

I think what adds to the stress is this weird social pressure that comes along with being in relationships, friendships, or just apart of a family. There are parties, gatherings, The Spawn of Satan Activity a.k.a Secret Santa at work. You’re seen as weird if you don’t go, and if you’re awkward like me, weird when you do go.

Sometimes family is the exact opposite of who you need to be around. And if you have the ability to stay away, if that is what’s best for your health, than by all means stay away. If you must go, keep in mind it’s just for the holidays. Enjoy those who you are comfortable around and remember those who seem malicious toward you may have other things going on in their lives. The holidays are stressful for everyone, not just you. They might not want to be there either.

If you have a significant other who insists you pretend to want to be there, make sure that you take care of yourself while you are there. If there is too much conversation, politely excuse yourself; go for a walk maybe, or find an area with less people. Bring some music if that’s soothing to you and separate from the madness so you can gather yourself. Nothing is more important than your mental health, and if someone doesn’t understand that than you probably shouldn’t be going to parties with them.

Treat Yourself, But be Careful of Indulgence

Black Friday in particular can trigger me into spending way more money than I should. I’ve avoided spending thousands, but I think I spent a good couple hundred and it isn’t even Cyber Monday yet.

I also notice as the weather’s gotten colder (and as I’m still unsure of my back’s abilities) I haven’t been going to the gym and I haven’t been eating correctly, not with Thanksgiving and sweets and potatoes and other such delicious things being just an arm stretch away. In combination with the stress of the holidays, finals, and ridding my body of those pain meds, I can feel a shift in my mood. I’m fluctuating a lot between depression and euphoria and there’s some intense paranoia that intensifies and lessens.

And so as delicious as the food is, I need to remember to watch my sugar intake and carbohydrate intake. I need to get back into my gym routine, rain or shine, and keep away from anymore medications. My presentation this week is already torturing my anxiety enough, I don’t need any other weight.

And neither do you. If you feel yourself taking some cheat nibbles here and there, don’t spend hours hating yourself. If you spend or party or whatever, push against that guilt. It’s okay to enjoy the little things in life. When it starts affecting your body and your mental well-being, maybe then it’s time to take a look at how it could be affecting you and whether you need to adjust things.

Remind Yourself You’re Doing Enough

We often forget, in the bustle of the season, that we are doing all we can. And so we try and do more and that’s where the breakdowns come from. Maybe work picks up during this time and people go on vacation and you’re covering shifts you don’t normally do. It’s okay to make a little extra money, but be mindful of your mentality. Are you more angry than usual? More depressed? Anxious? Paranoia? Frustrated? If so, scaling away from work could do some good; your employer isn’t going to die without you. Their job is to keep their business running. Your job is to keep yourself running.

If you aren’t working right now, sometimes it can feel like you can’t contribute as much as everyone else because of income restraints or other inconveniences. Remember that whatever you can do, regardless of gossip, regardless of your own anxiety, is fantastic and someone in someway will appreciate it. Even if that someone is just you. You being appreciative of yourself is powerful.

If you’re a busy family and you’re running around throwing gatherings and planning trips or other ways to organize the kid’s winter break, remember to breathe. You can’t do everything all the time, and next year does exist. Time is something we may not always have, but we do happen to have a lot of it.

Take Some Time To Assess Why

What is it about the holidays that stress you out the most? Is it the anxiety in the air? The crazy drivers? Is there trauma around these days? The gift-giving insecurity? Work?

For me, holidays were always filled with arguments, violence, and drunken rages. When my dad still played music, he was gone every holiday at gigs so I missed him. But when he came home, there was always a lot of arguing and fights because he was drunk and/or high and got angry at little things that would have made no difference otherwise. When he stopped playing music, he was drinking at 9am and I usually woke up to things breaking and more arguing. So, no one would talk to each other for the duration of the holiday. It’s been a full three years since that has happened. So I’m just not getting used to this idea of “being together” on the holidays.

I notice that a lot of those experiences have shaped my perspective of the holidays. I turn away from parties and gatherings and family things because it’s not what I’m used to. I’m used to doing my own thing by myself.

So for me, it’s been trauma. The memories of the stress are still in my body. My body knows when November is here even if I don’t know it is. Because this is the beginning of it all. And so this year I’m remembering that my past hurt but that it’s not like that anymore. That I can embrace celebration and enjoy the time that I have with my dad sober, even though his health is in a decline and his short-term memory is deeply bruised. We can have a new tradition and that won’t be possible if we all resist it.

The point of identifying the source of your holiday stress is so that you may put your attention there, not to wallow in it but to nurture it and coddle it and respect its existence. Doing so lets you see the gap between what may have happened last year or as far back into your childhood, versus what this year could be. It reminds you to mold your perspective a bit. If it’s the crazy driving, try and identify times where drivers aren’t so crazy. If it’s parties, maybe choose a few not to go to. If it’s gift-giving, maybe investigate those you wish to give gifts more than you usually would, or opt to remember gift receipts; if this is a route you choose, and the person returns the item, resist the urge to blame yourself. If this is a regular pattern of there’s, maybe a gift card is best.

But most importantly everyone, identify what makes you happiest during these stressful times and embrace that. Take care of you. Tis the season of giving, so give yourself a little love.

Posted in psychology, science, Therapy, Voices

Is Psychology A Science? Part 1.

Posted on by alidware

That question won’t be answered in this post.

This will be a multi-part series I think. There is a lot to say here, a lot to absorb, and it’s not really a matter of opinion. That tends to turn people away, because they want their opinion heard and other’s heard. Your opinion can be heard, just know its validity lies in facts and not how much you (or anyone else for that matter) believes in it.

We hear a lot today that disorders are on the rise, specifically ADHD, Autism, and Bipolar (in children). We hear that there are all these new holistic approaches. We hear about EMDR, we hear about Mindfulness, we hear that long-term medication is the only reasonable approach for certain experiences. We hear supplements will one day replace these medications. We hear psychiatry kills. We hear psychiatry saves. We hear a mix of the two–not sure how you can both kill and save someone, but psychiatry seems to be pretty good at it.

So, how do we make decisions on what is accurate and what is not? Most of the time it’s a matter of opinion. You read something good on the internet, an article that cites specific sources and looks very professional and so you trust it. You do the same with your doctor. You hear things from friends and somehow generalize their great experience to all the population of mental health consumers and suddenly you’re an advocate for acupuncture exercising demons from the tips of your fingers and you’re not quite sure how you got there, but now you’re there and you really believe it.

The thing we don’t ask for is research. The things doctors don’t read is research.

There are about 40,000 psychological research papers published each year. The majority of clinical psychologists read 1 of those research papers a month. That’s about .03% of all psychological research papers.

So let’s talk about what’s going on. There are two main issues:

  1. Practitioners rely more heavily on their intuition than repeated, peer-reviewed research (which they haven’t read).
  2. The actual science of psychology is basically the quantum physics of social sciences.

We’ll start with number 1.

We talked in the last post about the differences between a Ph.D and Psy.D (both psychologists), MFT’s and LCSW’s. We talked about how the technique the clinician uses dictates the effect on the client more than the supposed higher or lower degree/education level of the clinician. What we didn’t talk much about is why a lot of repeatedly proven therapeutic techniques are being replaced with new fad-like “holistic” and “client-centered” approaches. There are a couple reasons and one of those reasons has to do with practitioner intuition.

They have gone through years of school. Residency for some. Internships. Hours upon hours of supervised practice (3000 for those who want licensing in my home state of California, 1000 most everywhere else). They’ve made sacrifices for this, thrown themselves into debt, worked shitty jobs, lived in cramped situations. They gave up a lot for their passion and now they can be called an expert. That means they’re, well, the expert.

It’s very difficult to read a paper that says your technique has been proven multiple times to present no significant effect on the wellness of most people (we’ll talk about this idea of “most people equating to the general population later, that’s related to my second point) and be forced to change your method of practice that you’ve grown comfortable with. It’s hard when you have to admit you may very well be wrong. It’s much easier to come up with reasons why the research may be wrong–you’ve seen the progress in your clients (confirmation bias; you want to see that, so you will see that), your colleagues are using the same techniques with great success (they may be biased in the same way, and may have not read the research), and you’ve read articles which said this technique is effective; in fact, you went to a specialized school for that technique. And so you ignore the shoddy research–there’s probably no control groups, a poor sample size/selection, not evidence of peer review, and a lot of pseudo-science talk telling you that this new discovery they’re providing you with is being “stifled” and “shunned” by the medical community.

It boils down to practitioners struggling to admit they may be wrong. Ironic considering the work they’re in.

The issue with this isn’t their pride. The issue is that by not considering the possibility that they don’t know everything, they don’t have the chance to learn something that could indeed improve their practice and the well-being of their clients.

Now, the effectiveness of clients (as much as I despise that word, it’s appropriate for what I’m talking about) is measured by behavior noted by neutral observers. To properly do this, behavior is measured before and after “treatment”.

From this scientific approach, we’ve learned that ECT has been “effective” (when effective is defined as a positive change in behavior, and “positive change” is defined as the patient’s depression lessening). But, the effects have been found to be temporary, we don’t know why it temporarily works, and it causes a myriad of health issues, most severely memory loss.

We’ve learned that CBT treats panic disorder better than no treatment, better than a placebo, and better than Alprazolam (A version of Xanax). 87% of participants reported they were free of symptoms 15 weeks into CBT. 50% reported freedom after 15 weeks of Xanax. 36% with the placebo, and 33% with no treatment–they were told they were put on a waiting list (Klosko, 1990). Now what this shows us is a couple things.

  1. CBT works pretty damn well for those struggling with panic disorder.
  2. With the simple passing of time, people get better. That’s very important to consider in this field with certain experiences.

The scary thing is a lot of people who struggle with panic don’t get CBT treatment. I didn’t, not for many years.

Now, I have two examples of practitioners believing more in their expertise than research. One is a wide-spread example, and the other is a personal experience from 10:30am this morning.

I’ll start tomorrow’s post with the wide-spread example, because there is a little background needed.

This personal experience of mine sent me in a tail spin. My thoughts today have been taken over with good and evil (not the separation of them, but the unification of it) and the spirits, the voices, have essentially been trying to thwart my success and I’m struggling with whether they’re doing it to save me or to torment me for both. They played a particular song to mock me in the store today, and there was a woman following me around, going where I went, picking products next to me just to let me know that they’re here with me again, the spirits. And so this is an example of why clinicians need to pay attention to how they speak with people.

I literally just did a panel presentation on this shit to some local mental health workers yesterday, and then this asshole comes along.

He wasn’t trying to be an asshole, I know this. He is a young psychiatrist, very kind, and struggled to find the right words to dominate me with. I made an appointment with him because the person who’d been recommended to me had appointments months out and I couldn’t wait; I’m looking for a PRN for my panic as my current techniques (CBT, and processing my emotions) haven’t been working as well lately. I want it for short-term use so I can get back on track. I am on no other medications right now.

Problem is, I was prescribed Percocet and Valium for my back two weeks ago. And he saw this.

He didn’t ask me much about myself. Which was strange; usually psychiatrists go very in-depth at the first appointment. He asked what my diagnoses had been. I told him one psychiatrist couldn’t decide between Psychosis NOS or Schizoaffective. I told him my current therapist believes Bipolar 1 with Psychotic Features (mainly because she believes schizoaffective means your psychosis is only in your depressive episodes; we’re discussing this).

In ten minutes, he says he thinks I’m Bipolar 2.

This is after I tell him about my voices. This is after I tell him I was hospitalized after the Vegas shooting as it perpetuated a delusion of mine. He didn’t ask me about the voices really, or the delusion.

The problem with his diagnosis is that psychosis doesn’t happen in Bipolar 2. That would automatically make it bipolar 1. I also haven’t been depressed in over a year, and Bipolar 2 is mainly depression and hypomania. He believes my manic episode in the beginning of college was not mania because I’d get at least two hours of sleep every day. I understand that reasoning. But it’s not a reason to conclude bipolar 2 in ten minutes.

So he didn’t believe the voices. Why? I’m not sure. He didn’t ask if they were external or internal. He asked me what they said and I gave him a couple examples. He asked me if I’d heard them within the last week. I said yes, and within the last month. I told him it’s not a constant roll of voices all the time, every day. When i’m doing well, it’s less frequent. When i’m not doing well, it’s constant.

He didn’t want to prescribe a PRN because of the Oxycodone prescribed to me. I told him I’m not using the Percocet for back pain; I have 16 out of the 20 pills left. I don’t need them. He seemed intent of giving me more Valium. I said I didn’t want Valium; it has a half life of three days and I don’t want a slight risk of physical dependence.

He suggested Gabapentin (the nerve pain and anti-convulsant that keeps being prescribed in psychiatry even though it shouldn’t be, like many other drugs)or Busbar. Both are taken daily. I said no. I told him three times SSRI medication did not work well for me, and he respected that. But he still tried to squeeze it in there, advertising it as a safer drug than Valium.

What this ended with is me with a 30 day supply of Klonopin (which I’ll use maybe once every two months??? I don’t need it all the damn time) and a lot of anger. A lot. I felt invalidated. Ignored. He was young, confused maybe, thinking I was lying, manipulative, and the voices told me that’s what he thought and I believe them. He thinks I was there for drugs and he didn’t believe my psychosis.

Who lies about psychosis?

This sprung a lot of thoughts. The store I stopped to shop in was malevolent. Class was difficult. My thoughts are not nice, they’re disorganized right now, and I’m disheveled.

But it’s an amazing example for today’s post: if you’re a clinician or a psychiatrist and you rely heavily on your intuition, you’re invalidating the tiny scientific standing psychiatry has in the medical community.

Take a day off and read some research.

To Be Continued . . .

Posted in Freedom

To Be A Mental Health Consumer

Posted on by alidware

Yesterday I said today’s post would be about whether or not psychology is a science and how certain types of philosophy play into the ideals psychologists and M.D’s are trained with, but right now I don’t have access to the notes I made in regard to that topic. So today will be kind of an introduction.

We’ll talk about the importance of education and its scary insignificance.

If you’ve ever taken an introductory psychology course, you have most likely heard the story of “Little Albert”. In using classical conditioning, John Watson and Rosalie Rayner conditioned Albert to have a fear of a white rat. They did this, according to my recollection, by making loud, sudden, scary noises when presenting the white rat.

Now, if you’ve taken a recent introductory psychology course which covered this case, and you are not in California, there is a slim chance you were not told what I was told. I’m betting you were, though.

I took General Psychology 5 years ago and was informed that the experimenters discovered this infamous baby known as Little Albert had also been conditioned to fear white things in general. Fluffy, white, harmless things like a puffy rabbit or a dust bunny. My class was then told this fear persisted throughout this child’s life, and that fears could be unconditioned as well. This example is used as evidence to prove that classical conditioning in humans perpetuates specific phobias.

The study was referenced in a few other courses as well, all with similar conclusions. The textbooks were no different.

So, imagine my surprise when my research course revealed Little Albert had been fearful for ten days. After that, his reactions subsided. When they attempted to recondition the fears, his responses were lessened than the first time and the fears did not stick. My research professor said he had never learned this until he actually read the paper Watson and Rayner published.

And so this brings up many serious issues, one of which I’ll talk about tomorrow.

But for today, we can just focus on one main issue: if we can’t trust our education, how can we trust our practical training? Are they following research or intuition? Are they creating programs and trainings that are based in research topics but finalized by idealism?

This doesn’t mean we flush our meds down the toilet and spit at our therapists. Maybe it means that for some people but for me it means self-research is probably one of the most important things I can do for myself as a mental health consumer. I don’t like to say “question everything” because that implies a lack of trust and in order for people to trust you, you also must sacrifice some vulnerability and offer trust. What I say instead is “research everything.”

Get a new diagnosis? Great! It matters to you, it explains what you feel and how you think and you really identify with it. Learn about it, if that’s something that matters to you. And that doesn’t mean googling “schizophrenia” and reading about how your negative symptoms will take over your life after medication quiets the positive symptoms and how medication is the recommended long-term treatment and how some people can still live meaningful lives (after the author spent six pages ripping your self-esteem to shreds).

Learn about negative symptoms if you want. Learn about positive symptoms. Learn about different medications, different therapies (usually CBT) used to help people cope with confused thoughts. Learn about why the dopamine hypothesis is only a hypothesis. Learn about how medications work and how they don’t work. Learn about support groups. Learn about alternative treatments. Learn about how they work and how they don’t work. Learn about hearing voices (if applicable) and learn about the Hearing Voices Network, and affiliated organizations/movements. And most importantly, be objective.

Don’t just swallow the information you’re provided and internalize it. Not even the information in this post: research it for yourself.

This is hard to do when you’re in a crisis. That’s when we’re at our most vulnerable. That’s when we put up defenses and refuse help that may be useful. Or that’s when we’re so outside of ourselves that we have no defenses and so we absorb any help, and sometimes that means forceful and hurtful help.

It took me years of mental growth supported (sometimes unknowingly) by the connections I’ve made at the Peer Respite house I work for, and my own inner revelations, my own retraction from society and sanity, to really learn things which I would have never known had I not had a few questions and some hours of research.

And so the second lesson here is patience. While you go through the horror and the terror and wallow in darkness, look around. Touch the walls you’re trapped in. Smell the air that’s tainted and stale. Feel the ache in your heart. Hear your own screams. Explore the desolation because there is nothing more all-encompassing. And when something is all-encompassing, there is no escaping. So don’t run. Melt into it.

Let me give an example.

I was part of a cultural competency training/story telling event for the company which helps run and fund the respite house. There were other providers from within the company who attended, nurses and clinicians from other mental health and housing programs. (For some background, the company runs 100+ other programs and the Respite is the only fully peer program).

I was one of three who was scheduled to tell my mental health story and how I interacted with providers during the worst of my crisis. This was to provide them a view from the other side.

However, public speaking isn’t usually my thing. I used to faint in elementary school when I had to stand up in front of people, and this fear continued through high school and college until about a year ago. It still makes me intensely nervous, but I’ve gotten just a smidgen better at controlling my body and my thoughts during my presentations.

And so my anxiety sky rocketed the moment I stepped into the building. What this usually means is I go sit somewhere quietly and ignore the room and put some music in my ears and try not to listen to my own self-criticism or voices.

What it meant this time was understanding my limits and using my crutch to further develop my own skills. I took some valium I’d been prescribed for my back. This doesn’t last very long in my body with my metabolism, but it lasted just enough to calm my body. I wear a Google Wear smartwatch that tracks my heart rate religiously and I use it as a biofeedback because biofeedback was what helped me see how my mind exaggerates my feelings.

When the medication kicked in, my heart rate went from 109 to 68. And in this period I felt it. I felt my body and my hands and how cold they were. I felt my eyes moving in their sockets and my tongue brushing across my lips. All the while my mind panicked.

And so I focused my awareness on that disconnect. I spoke with my brain and my body and I told my brain: do you see how the body feels right now? It’s okay. This situation is okay. Feel how grounded we are right now? Feel how I’m leaning on the counter top? See, you made that person laugh. You’re having conversations. Do you feel how loose the body is?

And so I didn’t run. I dove into the discomfort and identified the disconnect that perpetuated my fears. I will and do talk quite a lot of shit about medication. It’s understudied and should not be cleared for long-term use in any one human being or animal. It is studied for short-term usage, all of it (meaning 4 weeks to 3 months) and the only medication I am comfortable with my body enduring is as-needed medication for panic. And the only way I will take one is if I recognize I won’t learn anything from the panic if I can’t get out of my body and into my mind. I have to reconnect the two, and one needs to be isolated (calm) in order for me to show the other one everything is okay.

I quite enjoyed my talk. I’m sure there are many things I could have done better, things I could have said better maybe. But it was the first time I spoke to a room of people without pouring sweat, stumbling over words, or fainting. By the time the talk started, the Valium had left my system.

The key notes to take from this post?

  1. Be Objective.
  2. Have Patience
  3. Don’t Run