Orlando! The Meaning and Impact of Mental Illness IV

 

Dealing with Life

Each of us can be placed on dimensions of a set of behaviors and processes. When there is mental illness is a matter of dispute and fashion. When mental illness is defined, too often it is a function of funding and professional achievement. That sounds obscure, but think about it for a moment.

When community mental health blossomed, we learned, at least in inner city poverty, that poverty is stressful (seriously?) if not just plain overwhelming. The social workers were closest to the truth and saw our intervention as “case management”. People get depressed and anxious when they are overwhelmed and when we helped them manage their difficult lives they became less anxious and less depressed. In a poverty environment it is appropriate to be deeply concerned or even terrified regarding the future of your children.

The senior professionals above us wanted the grant money, the status and wanted to perpetuate the establishment. The young staff saw things very differently.

Guidance and Management

Through all my professional experiences I have come to see humans as functioning on a series of dimensions which instructs our personal development, defines, guides or disrupts our functioning. Stress exists and causes serious functional problems. Somewhere in there are biologically based issues and without a doubt most of us need guidance from time to time. And some people benefit from exploration of the self which they may find in some form of what is called insight therapy.

Sorting Out Reality 

Overall, I would like to see us dismiss the concept of mental illness entirely. We can focus on problems associated with biochemical processes when essential and detach severe reactions caused by trauma. It would take time to reformulate the field but we certainly could become more effective and husband our resources. Problem solving and management are basic parts of all human endeavors. What do you think would happen if we started to diagnose corporations or political candidates? I doubt there would be much approval by the objects of such activities.

What happened at Orlando was a terrible tragedy but also opened a door where we find the opportunity for reevaluation on a variety of fronts. I know I’m crying out in the wilderness because there is a huge investment of various kinds in maintaining the status quo. But I can dreams can’t I? There might be a world where we are honest with ourselves, where we can be more efficient and effective and accept our complexity and variety of potentials.

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

The Tragedy of Post Traumatic Stress Disorder

Not the Tragedy You Might Think

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Have you ever had a reaction to a painful or terrifying event?

Not all things in our inner life and parts of reality are what we would want. We have an image or images of how things are supposed to be. If we are fortunate these images are not seriously violated. But sometimes they are.

Sometimes life is devastating and devastation can come suddenly in many forms or slowly and insidiously. A terrible storm, a horrifying accident may visit long term consequences on us.

Up front I need to say that this post is not simply about trauma and stress. The term usually noted with the short form of PTSD most often makes us think of returning veterans. But, of course, it isn’t confined to veterans. It is my perception as a psychologist that we need a wholesale revision of the meaning and even the use of the term.

Diagnostic Labels

Long ago we removed many difficult personal issues from the care of the church and said particular kinds of suffering people were not being tortured or possessed by demons. Instead we took them to doctors and defined them as suffering from mental illness and give them a diagnosis. Well and good up to a point. A compassionate response and management was better than exorcism.

But now we use the medical model for ever so many things and it is time to redefine our intervention and perception of cause. In this blog the focus is on battlefield trauma. But trauma is not confined to the battlefield and there can be many contributing factors.

Origins of PTSD

In wartime we send our people into zones where people are trying to kill them on a daily basis and they are supposed to kill on a daily basis.Then we send them home and tell them to have a nice day. We are asking a huge adjustment overnight. And recently I heard an officer speak about the nature of the experience and that it includes close personal support from fellow military people. Suddenly, when they leave service they have to give up this essential daily support even while they are to leave the killing fields. We are asking a lot and we tell them they have a disorder—a mental illness. There is typically stigma attached to mental illness and it places a barrier to getting help for what is fundamentally an adjustment.

A Personal Experience

Decades ago I was in a terrible auto accident which sent me into years of pain and recovery. And then more recently I was sitting at a stoplight when a man came around the corner too fast, spilled his coffee on himself and he ran full speed into my car which was totaled. I escaped with only a bruise. But within 48 hours I was anxious, having terrible dreams and a variety of other reactions. As a psychologist I knew I was thrown into PTS because it called up my prior accident. I called a psychologist friends and in four sessions we detailed the reaction and separated it from my current life. The bottom line here is that I had a reaction, not a mental illness and I went to someone to help me through my reaction.

The Real Tragedy of PTSD

Too often the outcome of trauma continues but it can typically be attenuated if the person seeks support and understanding which can be on a personal basis or a group setting. But it is important that they don’t feel stigmatized by being called “mentally ill”. The military is working to use PTS rather than PTSD which is important. It can be dealt with but not if we don’t respond correctly.

Mental Illness in General

We have work to do. Our lives are filled with stress and simple change. Over time we have multiple adjustments sequentially or at once. Guidance and clarification often is crucial and disturbing definitions and often unnecessary psychotropic medications may not be helpful.

Wisdom is needed to handle our world as it is and wisdom should lead us to a complete rethinking of the mental health field. It is complex. Yes, we have anxiety and some people constitutionally have more anxiety than others. It is manageable. Yes, we have depression and in my case my bouts with it were a function of an inherited vitamin D deficiency. I won’t even attempt to detail all the ins and outs of what has been thrown on the heap of “mental illness”. Basically it is clearly time for a complete restudy and reevaluaiton.

What is your catalogue of stress factors and adjustments needed in your life?

Roger B. Burt’s Amazon home page

Orlando! The Meaning and Impact of Mental Illness IV

 

Sunset and fellow photographer at the beach
Sunset and fellow photographer at the beach

Dealing with Life

Each of us can be placed on dimensions of a set of behaviors and processes. When there is mental illness is a matter of dispute and fashion. When mental illness is defined, too often it is a function of funding and professional achievement. That sounds obscure, but think about it for a moment.

When community mental health blossomed, we learned, at least in inner city poverty, that poverty is stressful (seriously?) if not just plain overwhelming. The social workers were closest to the truth and saw our intervention as “case management”. People get depressed and anxious when they are overwhelmed and when we helped them manage their difficult lives they became less anxious and less depressed. In a poverty environment it is appropriate to be deeply concerned or even terrified regarding the future of your children.

The senior professionals above us wanted the grant money, the status and wanted to perpetuate the establishment. The young staff saw things very differently.

Guidance and Management

Through all my professional experiences I have come to see humans as functioning on a series of dimensions which instructs our personal development, defines, guides or disrupts our functioning. Stress exists and causes serious functional problems. Somewhere in there are biologically based issues and without a doubt most of us need guidance from time to time. And some people benefit from exploration of the self which they may find in some form of what is called insight therapy.

Sorting Out Reality

Overall, I would like to see us dismiss the concept of mental illness entirely. We can focus on problems associated with biochemical processes when essential and detach severe reactions caused by trauma. It would take time to reformulate the field but we certainly could become more effective and husband our resources. Problem solving and management are basic parts of all human endeavors. What do you think would happen if we started to diagnose corporations or political candidates? I doubt there would be much approval by the objects of such activities.

What happened at Orlando was a terrible tragedy but also opened a door where we find the opportunity for reevaluation on a variety of fronts. I know I’m crying out in the wilderness because there is a huge investment of various kinds in maintaining the status quo. But I can dreams can’t I? There might be a world where we are honest with ourselves, where we can be more efficient and effective and accept our complexity and variety of potentials.

Gaia’s Majesty: Discovery Amazon page

Roger B. Burt’s Amazon home page