Tag: medicine

Posted in psychology, science

Is Psychology A Science? Part 2

Posted on by alidware

Welcome back. Yesterday we touched on clinical arrogance a bit, and discovered that the real problem with it isn’t the arrogance of the provider, but the blockade it provides against learning new techniques and staying updated with proper research. I mentioned I had two examples, one was personal, and one was a more wide-scale issue. You can read about clinical arrogance and my psychiatrist visit here.

I want to start this section of the series off with the second example. We are still under my first bullet point from yesterday: practitioners most often rely on intuition rather than verified and reliable research.

One thing psychologists attempt to do is predict a client’s behavior. This already sounds wishy-washy. No one can predict behavior 100% as we are limited in our understanding of ourselves (more on this once we get to my second bullet point), but there are two main methods which are used: The Actuarial Method and The Clinical Method.

The Actuarial Method

With this method, data is gathered within the range of the target population. That data is then plugged into a formula or some charts or graphs, anything that quantifies the data in some way, and what this yields is a general percentage. That general percentage represents how likely someone is to behave a certain way given the observations of their behavior (or scores on an MMPI, or this or that). So, theoretically, and very simply put, if Johnny is experiencing a psychosis we can use this method to get a general idea of how he may behave and what the best treatment may be given the outcome of others who have experienced similar things.

In trying to predict the rate of degeneration in patients who had been diagnosed with neuro-degenerative diseases, this method was correct 83% of the time.

Why is this important? Well, one thing practitioners may need to predict, especially in the current mental health system and current mental health wards is this concept of “dangerousness”. You hear all the time that people particularly labeled with schizophrenia are dangerous, unpredictable, violent. You also have probably heard that the truth is people with mental health adversaries are more likely to be a victim of a crime than to commit one. So let me tell you why this stereotype continues to persist.

In 1999, a researcher, Liener (I tried to find the full paper, I couldn’t; when I do, I’ll link it) asked clinicians to rate clients’ based on their intake interviews. These clients were hallucinating. The providers were supposed to give an answer for which clients were more likely to become violent. He gave the same case studies to untrained, random high school students and requested the same service. Conclusion?

There was no difference in the predictions. That is, the high school students predicted the same level of danger as the clinicians did, and those who were seen as withdrawn were all rated as most likely to be violent. Research shows the opposite. In fact, when mass amounts of individuals locked in criminally insane wards were let out, 97.3% never got into trouble again. 2.7% wound up back in a hospital or prison.

It’s not the public’s lack of awareness, so you can chill on your lovey-dovey, let’s all unite instagram Mental Health Awareness campaigns. We don’t need as much awareness of experiences as you think–we need research. I’ve been saying this before I even started my college journey. Talked about it every May on my previous blog Mental Truths, in fact. Want to bring awareness to something? Bring awareness to the fact that none of the research is being paid attention to. That’s what needs awareness.

The Clinical Method

In this method, we gather data about the individual and use that information to attempt to predict what the individual will do. There is no real, clear-cut formula for this as far as I’m aware, it’s kind of a guess and check system. Kind of like taking psychiatric meds.

In the neuro-degenerative disease study, it was found that this method was correct 58% of the time. Diagnosis was generally accurate, but judgments and human error lead to incorrect predictions. I mean, 58% isn’t bad, that’s ore than half, but it’s no where near 83%.

And so we see the Actuarial method is quite effective when it comes to doing something human brains on their own can’t always do very well: predict things. We see in some Meta Analysis that there was either no difference in correctness between the two study methods or the actuarial worked better. Never once could the clinical method beat it’s cousin.

You can read more about both methods here.

And still, Practitioners insist that their expertise provides a better prediction. Again, this is what I like to call Clinical Arrogance. And maybe it’s not purposeful–as I said yesterday, they worked hard for their degrees and spent long hours accumulating all that knowledge in their head. Let’s not bash these individuals, a lot of them are very bright and are in the field to support people who really need it. They just can’t read. Kind of like the HumanCentIPad from South Park.

“Why won’t it read!” (22 second clip. Totally worth it.)

I think the most hilarious thing out of all of this is that a lot of pracitioners say they never use the actuarial method, and the majority of them say one reason is because they were never trained in it.

Jesus Christ.

Jesus Christ.

And remember now, we’re trying to figure out how much of a science psychology really is. This is a tough question, because so far we see that there are methods which meet the standards for the label of scientific. But they’re not being used, and when they are and the research is done properly, free from bribes by pharmaceutical companies and researchers looking for fame, the results aren’t given any attention. Can something be called a science if it neglects the only aspect of it which is a science?

I want to stop here and let this kind of sink in, because tomorrow we’re going to shoot to the top. We’re going to investigate how this trickles down and make some speculation to why.

It seems like everything is negative, but it’s not. We hear a lot of the positive in most psychology classes, at least the ones I’ve completed, and that’s great. But some of that is misinformation and that’s problematic. This isn’t about focusing on what’s wrong with the industry, this is about awareness. I think it’s great that people feel making a social media page dedicated to a “Safe Space” or whatever can help others–and for people who are super isolated, it probably is nice to see other people experience their pain. But that’s not the kind of awareness that’s going to shift the system. More people knowing the word “Schizophrenia” could indeed perpetuate stigma if you have no research to back it up.

In fact, why not raise awareness about the fact that the dopamine hypothesis is actually kind of a shoddy hypothesis? Why not find some of the studies that point toward the many holes in the chemical imbalance hypothesis? The ones that discount genes as the biggest player in mental health heritability? Where is the awareness of this?

Oh wait. No one reads.

And if someone does read, and they have articles contradicting me, please, please send them. I’m always looking for something challenging! I only ask that the articles either cite actual research so I can find the papers, or are the papers themselves.

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 Emotions, Freedom

Caring For The Shattered Self

Posted on by alidware

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.

Posted in Peer Support, psychology

Own Your Care

Posted on by alidware

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.

Posted in psychology

Objectively being Objective

Posted on by alidware

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.

Posted in Voices

Soggy Boxes and The Variation of Us

Posted on by alidware

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.