Diagnosis and the Real World

Under what diagnoses do you suffer? (Curious question isn’t it?)

Let’s Begin Here

Two definitions come to mind at once as we look at this post. Psychiatry is defined as: “the study and treatment of mental illness, emotional disturbance, and abnormal behavior.” Psychology has a variety of definition but I prefer: the study of human and animal behavior. The numerous other definitions suggest we aren’t actually sure what psychology is and I share that position. in fact, there is even a philosophical element which suits me just fine.

In Clinical Psychology

When we move on to the clinical area we quickly brush up against mental illness and as a student we quickly learn that diagnoses are generally expected. But how does mental illness fit with the broader definition of the study of human behavior. It seems like it must be a subcategory. What I found was that it is a restless subcategory and won’t keep its mouth shut.

Or at least it becomes a problem when we visit that devise place called the real world. And, of course, I believe in the cusp of reality which means I have questions. Are you hearing the pounding of philosophy at the door?

Then There Is Diagnosis

Freud defined a great deal of what is psychiatry and we entered a world of illness which required treatment and so there must be a diagnosis. The whole process was to be applauded because it moved emotionally disturbed people out of intervention for possession by demons  generally under the oversight of the church. They were in better, more compassionate, hands then. But not all of mental health people were devoted to Freud’s teachings. And that included Carl Jung who took us out into the world at large in a variety of ways. I won’t try to explore him. Take a look yourself.

What’s the Point?

It seems we are lost in a forest of exploration. There are those who believe in specific diagnoses for mental illness and in some case it yields helpful intervention. But there are others of us who believe it is far more complex than that. Sometimes diagnoses lead us down narrow corridors and sometimes it is more effective to shy away from an illness model and take the path to looking for functional factors and something I will call life management.

In This Age

Isn’t it interesting that as we rush forward into the future we are still mired in definitions and differing camps of adherents when it comes to what we call health care. At least we have latched onto prevention and a variety of preventive procedures. Those continue to need exploration and so do our responses to things happening to us that deserve attention.

That’s enough of the meshing of philosophical exploration with the real world. In future posts I’ll move deeper into the world of what we call mental illness and alternative forms of response which includes what I call self management.

What are your biggest concerns about health care?

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

Orlando! The Meaning and Impact of Mental Illness III

 In the Private Sphere

The story is long and detailed and over the years I saw so many dysfunctions related to how the mental health field was constructed. In private practice later I had to confront the insurance industry. In the end they were successful in virtually destroying much of the “mental health” field. They required ever more serious diagnoses if they were to grant payment. Often my decisions as a doctoral level psychologist were at the mercy of someone with a two year general college degree.

Stepfamilies at Risk

In work with stepfamilies we recognized that they weren’t pathological but were stressed family units in flux. Families in deep crisis were coming into our practice and we learned that it was essential to stabilize the stepcouple. Insurance would pay for therapy for the stepmother (to them it seemed women were usually the focus if not the origin of the problem), or they would pay for therapy for a child. We saw the need to stabilize the couple and when they were out of crisis the children realized this was their new family and went from crisis to return to their friends and schoolwork. Using a couple’s focused episodic model we were able to stabilize these families in an average of just seven sessions. They weren’t pathological. They were suffering stress from a major life change and needed management help.

The insurance companies were willing to waste money on individual therapy for women and children if we would declare them “sick” enough but weren’t interested in functional work. Their number one goal was obstruction in the interest of profit.

Corporate Dysfunction

People in the field have to face inappropriate “mental health” and diagnosis problems along with a health care industry which is not highly functional. 

And so we come back to the myriad of issues in something like the attack in Orlando. A political system failed to help protect the citizens and we cannot know what the course of the perpetrator was. He probably began with much less serious concerns or impulses and moved on to an ever deepening and more complex crisis. If we had detailed information all along the way we would seen a series of effects and crises that would not lend themselves to a firm diagnosis. And therein lies the problem. We need a wholesale revision of our thinking, description and approach not to mention the system for availability of help for our citizens and dealing with corporate obstruction in the interest of profit.

Coping Versus Disease

As I’ve said before, emotional and cognitive disturbances were moved over to medicine so that we could remove the influence of the church. We no longer believe in demonic possession although at times it is tempting to believe there are demons in human affairs such as in this election.

It was good to remove the demons from our thinking but defining our mental and emotional variations as illnesses was also a mistake. Over time I’ve seen the fads and the missteps. When I was in graduate school I saw not one child who was termed autistic. I had heard they existed but never saw one. Now we have an “epidemic”.  And now we learn it may be related to the use of chemicals which find they way into our food. That makes it an environmental issue and not a mental health issue at all. We have a lot of sorting out to do.

To be continued.

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

Feminism and the Roles of Characters

Changes For Female Characters

How do you feel about recent changes for women?

It has gotten more challenging to write female characters, especially now that the traditional role of women is being questioned. “The woman’s place is in the home” has receded into history and the permissible roles are changing. Yes, I chose the word “permissible” deliberately. There are still pressures regarding what a woman should and should not do and how she should act. This is an evolutionary process. And it affects how we develop fictional characters.

Greater Challenge

And so the author has to decide upon what a female character should be like or at least should attend to how they may be affected by contemporary views. Of course, if we are writing fiction a woman can do anything the author wants her to do. And then we will see how the reading public reacts. This raises the possibility for the author of challenging views and change. Of course, there is the matter of wanting people to buy your books.

Off Into a Changing world

And so I set off into the world of fiction and fantasy. The setting was contemporary which conditioned certain choices. And that can be challenging. There is a context for the present but if we are writing into the future there are many more contexts that become available.In the Gaia’s Majesty Trilogy these were women chosen for roles to lead us into the future and related to whether that future will be fulfilling or disastrous.

In history and in the present women certainly have had a variety of roles whether we approved of them or not. In this instance I began with a role where the Andromeda women were the consorts of rich, powerful and greedy men. I wanted them to be people readers could relate to and not simply courageous women who sought wealth and ease. They had to have values even if they were hidden. And implicit is that just because they are consorts they are in no way despoiled. They are their own person and have their mission. In fact they deserve recognition and praise.

What Will Women Think!

It would have been complicated to weave the history of the warrior women of ancient near Asia into the story for context purposes. It was inspiring to come to understand this part of history and the Andromeda women had to stand on their own. Of course they were not uniform and had their personal stories. I came to appreciate them more and more as I got deeper into the books. I’m pleased to say that so far I’m finding that women appreciate them. I think we all fundamentally understand that challenge in life is highly variable as is adaptability depending on need.

Coming to Comfort

The theme of an end to subjugation of women and their empowerment is woven deep into the story. I admired these “gutsy” women. They are smart and tenacious. Certainly they are not passive and retiring. They are who they are and they have joined a cause and that relates to what is happening for women and all of us now. Women have a growing opportunity to fulfill their talent and potential. And that in turn leads to value for all of us. It is truly a pleasure to see recent revelations about what women have suffered under predatory men and that those men are now suffering consequences. It is not all over, but increasingly we will now see women stepping foreword and they will receive broad support. It is more than about time for #MeToo.` 

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

Orlando! The Meaning and Impact of Mental Illness II

 

Have you had contact with mental health professions?

An Ongoing Dispute

When I wrote the initial copy for this post it was entitled The Myth of Mental Illness. That was also the title of the 1961 book by Thomas Szasz that I hold in high regard. He questioned the foundation of psychiatry as do I. His case gets stronger as time passes.

The fact is, I chose to become a psychologist for reasons I’m still uncovering. Probably the chief among them was my need to deal with my mother’s severe depressions. They seem to have been the result of personality problems but mostly reflected a genetically based vitamin D deficiency. I had set out to study particle physics but an unforgivably bad calculus professor turned me off on the mathematics which I viewed as fundamental. And so I found my way into a field I’m still disputing.

Decades later I have concluded that the term mental illness should be relegated to the dustbin of history. Recently I saw that someone had come up with a “diagnosis” for people who are concerned about healthy eating. Diagnosing them has the implication of viewing such a justifiable concern as an aberration or some kind of deviation of behavior.

The Beginning

In college I found the study of psychology interesting but that there were two parts. The clinical people were usually over in the medical settings and the academic setting was closer to experimental studies. They declared psychology was a science. Early on I was not impressed by the science part. I could see philosophy among other things. In the end I went to Duke University to study experimental psychology but within days asked to move to the clinical program which they granted. Steadily I was introduced to psychology, psychiatry and psychotherapy.

I was not prepared for the authoritarian nature of psychiatry. I attended Grand Rounds and saw patients paraded on stage while their history of “mental illness” was presented and discussed. (I should say this was decades ago and things have probably changed.) I also learned that psychiatric residents were not permitted to declare a diagnosis. A senior staff member would step forward and deliver the definitive word. 

There were times when graduate students such as myself went to clinical meetings and presented findings from our testing. Our findings were frequently used to harass and haze both medical students and residents. The effect was to build a wall between psychiatry and medicine in general.

Learning By Doing

I realized after the fact that I often was given very difficult cases. One of them was a very pretty, very dysfunctional and hysterical young woman. In her interest I managed to get her diagnosis changed from schizophrenia to a less damaging diagnosis which meant she might get more flexible and dedicated treatment in the years ahead. But one day I got a call from the emergency room. I found her seated on a gurney. A terrified intern was in attendance. In front of her he informed me (and her) that if she had sliced at her arm and throat in a different direction that she would have bled to death. It seemed he had not been prepared for this kind of management.

My supervisor asked that I be very careful with this young woman and said he assumed she had already driven three therapists into research partly because of her extreme behavior and seduction efforts. Her late night forays and partying led to a pregnancy and she wanted an abortion. The nature of the times was such that she had to seek out senior psychiatric staff on her own and plead for a diagnosis to permit an abortion. She was unsuccessful.

We struggled on and she managed to achieve more stable functioning. I assumed there would be a long road ahead. In all regards I found the system deeply flawed.

Moving On

After graduation I went to Baltimore to work in a community mental health program. Our group of dedicated twenty somethings formulated reality based approaches for the people of the community and were faced with obstruction by our seniors in that they had a much deeper self serving agenda.

To be continued:

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

Building an Unplanned Business

 

Do you have a life plan?

It Just Seemed Like a Good Idea

The house was finished and we had it furnished. But we weren’t going to move in full time. We had our clinical practice near Baltimore. This was a vacation home and we thought it would be a retirement home someday. We had okayed first to build a cottage but our builder, Wayne, had sold us on the idea that we might want to rent it so we went larger.

How Did That Happen?

We hadn’t actually thought a great deal about the rental process and so we didn’t think about it until the house was set up and furnished. At that point, when we inquired, we learned we were too late for wholesalers to handle it that season. With no other options we decided to simply advertise it for short term rentals in the Baltimore Sun. The winter was filled what felt like almost over night. That was easy!

What’s Next?

In fact we had more people who wanted a vacation in St. Lucia than we could accommodate. In effect people were standing there wanting to know where we could put them. Ooops! So, in desperation we called the real estate company that was managing the house for us when we were away. We found out it was not a problem.

Taking Another Tour

So we went on a tour of other houses that did short term rentals and booked in the people who were interested. The commission was respectable. So we looked around and found other places to advertise rentals. It proved not to be a problem. We had houses of all shapes, sizes, and costs we could offer.

Americans Like to Explore

We learned something else. Americans often don’t want to go to the same place year after year. The Europeans tended to go to the same island year after year and spent a month to six weeks. But Americans were asking “Where else can you send us?” So we crossed the strait and took a look at Martinique. We absolutely loved it. The French were very friendly and the island just as beautiful as St. Lucia. It even had its own active volcano and we stayed at the most romantic resort we had ever seen on the edge of the rain forest. But many Americans didn’t want a place where English wasn’t the first language. On to other islands.

One After The Other

It was so interesting. Each island we went to was different. Our advertising budget was expanding with our clientele. So, we added St. Martin/St.Maarten (French and Dutch), Barbados, and the Cayman Islands. We looked at Puerto Rico and the Turks & Caicos Islands but by then had enough inventory.

A Major Change

We were running the short term rental business on the side along with our clinical practice helping stepfamilies. But along came the insurance companies of managed care. They had found that they could effectively block mental health related practices and save money. Our model for stepfamilies was specific and they basically would not accept it. The mental health field was being torn apart by the insurance industry. So, regretfully we closed our practice and devoted full time to building our villa rental business. 

So Much For That Life Plan

It was an interesting experience. We assumed we would retire from our practice. But we fell in love with a Caribbean island, stumbled into building a house, rented it and, finally had a full time villa rental business. Both of us had always thought you built a life plan but in this instance good fortune, life insurance company depredations and an attractive opportunity sent us in another direction entirely.

Do you see a major redirection in your future? Would you like one?

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

Orlando! The Meaning and Impact of Mental Illness I

Another Terrible Warning

On what did you focus about this tragedy?

The massacre in Orlando, which was described as hate inspired terrorism, also raised the specter of mental illness along with a lot of other concerns which included effects coming from the political arena. Prejudice and failure to act in the national interest had a significant effect along with the manipulations by power hungry people who claim to be acting from a religious viewpoint. The true meaning of the attack has to be hunted out from the forest of offered opinions and the data which might give us clarity.

The perpetrator claimed allegiance to ISIS and had a checkered history. It is simplistic to reduce it to an act of terrorism. Other points may have more clarity. His history suggests a young man who was hunting for an identity and suffered deep conflict. Just now it has come out that he was visiting gay nightclubs. It may have been that in his personal crisis he was seeking intelligence for his attack. There is another possibility. The view of him suggests that he may have been a person who was facing uncertainty about his sexual orientation. In the end he may have struck out at what might have been his identity home. We probably will never know, but his life experience hints at a larger picture.

He appeared to have been insecure and identity issues are highlighted frequently. And it certainly may have been that the core was his sexual conflict. That conflict may have ramped up recently and who he thought he might be collided with other world themes. But, for us, perhaps the central issue is attending to a process. We can attach a diagnosis reflecting a view of mental illness and end our thinking there or we can look toward a process revealing how multifaceted is human life.

Reevaluation and Reframing Needed

We can hope that the horror of what happened in Orlando does not get lost in a haze of political backbiting. This is an opportunity to do a substantive reassessment of many things from our political stances, to the meaning of “mental illness”, to how we approach the needs of people who are under some form of internal and personal attack. Our services for people in crisis have been impaired and throwing money at it is not the answer. We need to thoroughly rethink out approach and how we offer services. There are many competing interests with which we need to contend.

In the Days Ahead

We have a lot to reconsider. Recent events have broadened the focus of this post as it was originally written. I will be going into matters of history which are illuminating. It is all too easy to accept “experts” but being an expert is often a reflection of the times. What served us at one time may have had purpose and utility just then. Later we may need to do a serious reframing. Now is such a time. And what is happening seems to go well beyond one recent event. We seem to be on the cusp of important change. Lets go exploring.

What have you concluded?

To be continued:

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

The Origins and Sources of the Majesty Trilogy – Pt. 4

The Human Potential

Emerging Themes

In writing the Gaia’s Majesty Trilogy I found, even though I had a chart of its arc, that components of it were emergent. Just as the characters emerged as well. To me it was not a story of whatever form. It had to have a future reflective of us and possibilities. 

In the scope of things it may be that we are merely a life form that emerged on this beautiful and unusual planet. And in time we may well vanish into the history of the universe leaving no trace whatsoever.

But what I saw was that there is the matter of potential that may lead to our transformation or even possibly some forms beyond who we are just now.

Exploring Us and Our history

In mythology we see themes in human existence as well as our development. In gods and goddesses we view ourselves but our future as well. It seems we take the hopes of our youth into thoughts about what might be to come. We are restless and often not willing to accept how it is right now for ourselves personally or collectively. In our recent past we see the acquisition of culture and language and now so many more things.  I say “recent past” because it is apparent that we have been developing for millions of years, but it is in the last thousands of years we see a sudden “maturation” and acquisitions of new skills. And now technology is thrusting us forward in a whole new way.

We regard history, but also regard our future. Parts of who we are seem little changed. But other parts are intriguing.

Carrying Forward and Progressing

When we look at human history we see some things which change little although on the surface there is difference. For much of our history we had ruling families and still do. We had kings and now we have people we are calling oligarchs. They simply direct and rule our lives in different ways. But developmentally there has been a change at the same time as we have struggled to acquire and maintain democracies where the mass of people actually have a say in government. It is a struggle to maintain it nonetheless. 

Without warning come new themes such as the liberation of women. I know I say this over and over but I’m intrigued about what this movement may mean. Suddenly we have women participating in a way which goes beyond what has gone before.

Our lives are woven together. There is chaos and cruel brutality even as there is caring for those amongst us. While some may care not at all about the welfare of others, there are some who set up beneficial foundations.

The Call of a Future

One purpose fiction can serve is to stir us to examine not just ourselves personally but as creatures on this earth. We see some marked changes over time and emergent themes born of dreams and hopes. But what is intriguing is the possibility not just for fundamental change but what may mean transformation. It may come upon us or we may grasp and trigger it. It is up to use individually and collectively. The two themes of Mysterium and Malestrom in this trilogy relate to interplay of fundamental force. We may give them names as we search and explore. It all grows out of asking “What if?” as a means to draw us forward to an intriguing future.

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt