Symptoms Part II

Symptom as Teacher, Friend, Gift

Symptoms of illness or distress can be viewed as messengers coming to tell you something important about your body or your mind. Killing the messenger, denying the message or raging against it is not an intelligent or responsible way of approaching healing. The real challenge when we experience symptoms is to listen to their messages and make the connection fully.

The ways we use language tell us a lot about the automatic way we personalize our symptoms and illnesses. For instance, we say “I have a headache” or “I have depression” when it would be much more accurate to say “”the body is headaching or “I am depressing.”

When we unconsciously link each symptom we experience to I and my, the mind is already creating a certain amount of trouble for us. We have to perceive this identification with the symptom as it occurs and intentionally release it in order to listen more deeply to its message, free from our exaggerated reactions.

Symptoms are often our best teachers, guides or friends. Instead of getting rid of them, perhaps we can be grateful for them and see them as gifts. Symptoms give people another chance, another opportunity to self-correct if they are openly received, accepted, acknowledged, honored and respected.

Thanks for reading “Is It Just Me Or…?”

Best,

Rae

Symptoms Part I

Respecting Symptoms

One of the major contributions modern psychiatry has afforded individuals, couples, families and groups in clinical settings is the reduction of symptoms through psychopharmaceutical drugs. One of the tenets of modern medicine is the relief of symptoms. In fact, this is a multibillion-dollar industry. The slightest ache or pain sends people scurrying to the medicine cabinet, doctor’s office, or pharmacy in search of something to make it go away.

There are over-the-counter medications, prescription drugs and illegal drugs that can be obtained to relieve pain, reduce anxiety and depression and even speed one up as in the stimulant medications.

People want instant gratification and they don’t want to do the hard work which would be working with the symptoms, working through the thoughts and emotions.

The trouble with the widespread use of many such drugs is that the underlying problems that are producing the symptoms may not be getting addressed just because the symptoms are temporarily relieved. Don't forget about the dire "side effects" these drugs often induce.

The practice, or as I would label it, the habit or compulsion, to reach for a drug to relieve a symptom reflects a widespread attitude that symptoms are inconvenient, useless threats to our ability to live life the way we want to live it and that they should be suppressed or eliminated whenever possible.

There are two major problems with this perspective:

1.   First is the common human error of causation which states that because my brain chemistry is out of balance, I am depressed. This has not been proven. Our mind-body-brain system is integrative and complex. It is much more likely that because we are experiencing symptoms of depression due to some sort of loss, denial, etc. the chemicals in the brain reflect that and adjust accordingly.

2.   The second problem with this attitude is that what we call symptoms are the body’s way of telling us something is out of balance. They are feedback about dis-regulation and dis-ease. Ignoring our body’s messages, or worse, suppressing them, may only lead to more severe symptoms and more serious problems later on. The person doing this is not learning how to listen to and trust his own body. Our bodies are wise and will always tell us what we need.

Thanks for reading “Is It Just Me Or…?”

Best,

Rae

Amy's Winehouse Part III - Playing Games

Amy’s Winehouse Part III - Playing Games

The Role of the Substance Abuser

If all behavior is goal-oriented and all behavior (including substance abuse) serves a purpose, we can view the individual who abuses substances as playing a particular role in a game. Eric Berne, founder of Transactional Analysis, believed that all games have an important and probably decisive influence on the destinies of the players under ordinary social conditions; but some offer more opportunities than others for lifelong careers and are more likely to involve relatively innocent bystanders. This group is called Life Games and includes the game of “Alcoholic.”

In game analysis, as in Choice Theory, there is no such thing as alcoholism or “an alcoholic” but there is a role called Alcoholic in a certain type of game. Because it has not been proven that biochemical or physiological abnormality is a prime mover in excessive behavior its study belongs in the field of internal medicine. No behavior is disease – including compulsions or addictions. Game analysis interested in something quite different – the kinds of social interactions that are related to such excesses, hence the game “Alcoholic.”

The treatment of a substance abuser lies in getting her to stop playing the game altogether, rather than simply change from one role to another. In some cases this is feasible, although it can be a difficult task to find something else as interesting to the substance abuser as continuing her game. Because she is classically afraid of intimacy, the substitute may have to be another game rather than a game-free relationship. The criterion of a true game cure is that former substance abuser should be able to drink socially without putting herself in jeopardy. The usual total abstinence cure will not satisfy the game analyst – or the Choice Theorist.

From a transactional point of view, after careful preliminary groundwork, the correct therapeutic procedure is to take the “Adult” contractual position and refuse to play any of the roles, assuming that the client will be able to tolerate a new game.  The therapist’s role in playing “Adult” is to break up the game rather than play “Rescuer” with the client.

In the “Adult” contractual position, the therapist can guide the client toward awareness, spontaneity and intimacy. Awareness requires living in the here and now and not in the elsewhere i.e., the past or future. Spontaneity means option, the freedom to choose and express one’s feelings from the assortment available. It means liberation from the compulsion to play games. Finally, intimacy means the spontaneous, game-free candidness of an aware person, the liberation of living in the present moment.

For a clever and witty introduction to Transactional Analysis, please read Berne’s Games People Play.

Thanks for reading “Is It Just Me Or…?”

Best,

Rae

Amy's Winehouse Part II - Psychology

Mental Illness as Metaphor

In my last post regarding Amy Winehouse’s demise I discussed philosophy; in particular, a philosophical perspective on happiness. Seeking happiness from an external entity, whether it comes in the form of  a person, relationship, work, money, alcohol, drugs, food, sex, gambling, shopping etc. may achieve a fleeting high, but  as soon as that high fades the individual will set on yet another quest.  

If the search for happiness is one of the chief sources of unhappiness, perhaps wise living consists less in acquiring good habits than in acquiring as few habits as possible.

People use mental illness as a language because they have not learned to use any other or because it is especially useful for them in their situation. How is mental illness learned? What does it mean to the person? Among a diversity of communicative forms each has its own reason and because of the particular circumstances of the communicants, each may be as valid as any other.

In discussing the clinical treatment of addiction (chemical or process addiction) the perennial frustration of therapists as well as the client’s partner, family, friends, coworkers, etc. comes down to the simple fact that they often try to teach new languages to people who have not the least interest in learning them, i.e., “resistant to treatment.” Recall Winehouse’s lyrics from one of her most popular songs…”They try to make me go to rehab I said no, no, no!”

For many people, playing psychological games is a perfectly reasonable and acceptable thing to do. There are moral choices inherent in psychiatric symptoms and syndromes. Game-playing habits should be seen more as habits clients actually want to keep rather than as happenings they want to lose.

The aim of psychotherapy is three-fold:

·         To illuminate behaviors and the thoughts and emotions which trigger them

·         To understand behaviors are goal-oriented and serve a purpose

·         To maximize the client’s choices in the conduct of her life         

The goal is not to indiscriminately enlarge the individual’s choices but to enlarge her choices by enhancing her knowledge of herself, others and the world around her and her skills in dealing with the important people in her life, her thoughts, emotions and behaviors.

The concept of “mental illness” undermines personal responsibility and precludes an inquiring attitude toward conflicts which her symptoms at once conceal and reveal.

Thanks for reading “Is It Just Me Or…?”
Best,
Rae

Amy's Winehouse Part I - A Philosophical Understanding

We mourn the death of Amy Winehouse.

Insodoing, it gives us the opportunity and ideal platform in which to discuss psychology and philosophy. Nowhere better do these fields converge on the concepts of fight or flight, avoidance, hedonism and Buddhism. Seemingly strange bed partners until you grasp the underlying concepts. Let's start with philosophy.

Hedonic happiness occurs when one is primarily seeking pleasant feelings and avoiding unpleasant ones, while eudemonic happiness is conceptualized more in terms of optimal functioning.  Eudemonia can be described as the striving for perfection that represents the realization of one's true potential. These two views of happiness illustrate two traditions whose philosophic roots are significantly divergent.

While in hedonistic philosophy the aim of life is to maximize pleasure (Aristippus, Bentham, DeSade, Hobbes) other philosophers and religious thinkers do not agree with this conception. Atistotle, for example, considers hedonic happiness as vulgar insofar as it condemns man to be a slave of his desires. According to the stoic Epictetus, happiness does not involve enjoying pleasures, but rather occurs when one is free from desires.

The Buddhists use the term sukha to qualify authentic happiness, and this term closely resembles eudemonic happiness. Sukha can be defined as a state of flourishing that arises from mental balance and insight into the nature of reality. Rather than a fleeting thought or emotion, aroused by internal or external triggers, sukha is an enduring trait that arises from a state of mental balance and entails a conceptually unstructured and unfiltered awareness of the true nature of reality.

In terms of Amy Winehouse's descent and self-inflicted demise, we can view her behavioral process through the lens of these two distinct psychological states. By trying to maximize pleasure and avoid displeasure, the hedonic approach induces a fluctuating happiness in which phases of pleasure and displeasure alternate repeatedly.

The experience of pleasure is by nature fleeting and dependent upon circumstances - but I would argue here more specifically, it is dependent upon one's perception of those circumstances. It is unstable and evokes a constant striving to attain pleasure and avoid pain.

Hedonism is based in stimulus-driven pleasures of all kinds and does not allow one to achieve authentic and durable happiness. Clinging to such stimuli as the actual source of one's happiness can easily give rise to at least intermittent, if not chronic anxiety as one faces the possibility, likelihood or certainty that stimuli will not last.

Authentic happiness on the other hand is not dependent upon circumstances, but rather gives a person the inner resources to deal with whatever comes his or her way in life. It is not linked to an activity but reflects a state of being, a profound emotional balance.

It is a state of durable plenitude based on a quality of consciousness that underlies and imbues each experience, thought, emotion and behavior and allows us to embrace all the joys and pain with which we are confronted in the full catastrophe we call Life.

Thank you for reading "Is It Just Me Or...?"

Best,
Rae

Response versus Reaction

More than 90% of human behavior is reactionary.

Human behavior generally falls into two categories: responding or reacting.
At first glance, these two may seem quite similar, but in fact, there is a great deal of difference.
The difference can make or break us.

To respond is to be in a state of mind which is 

• thoughtful
• conscious
• aware
• accepting.

It is creative, powerful and full of options.

To react is to be in a state of mind which is

• impulsive
• unthoughtful
• irresponsible
• unconscious
• in denial

It is uncreative, wreaks havoc and limits one's behavioral repertoires.

Our thoughts and emotions do not hurt us or others but our behavior can.

It is our perception or interpretation of an external event that triggers a thought, which triggers an emotion  and finally a behavior. Events can come in myriad forms such as a situation, relationship, person, job, task, finances and so forth. It is important to recognize that events are always neutral but the meanings we assign them dictate our relationship to the event.

The goal is to work toward responding versus reacting. And this is where mindfulness comes in. Being mindful helps us to create space and time between an event, thought, emotion and behavior. Mindfulness allows us the opportunity to respond rather than react.

The first step in breaking free from a lifetime of reactivity is to be mindful of what is actually happening while it is happening. At any moment, an individual may be encountering a combination of internal and external stressors that can trigger a cascade of thoughts, emotions and behaviors that can be called the stress reaction. People do not have to go the route of the fight-or-flight reaction nor helplessness every time they are stressed or anxious.

We can actually choose to cultivate moment-to-moment awareness that grants us the power to exert control and to influence the flow of events at those very moments when we are most likely to react automatically and plunge into hyperarousal and maladaptive attempts to cope.

Thank you for reading "Is It Just Me Or..."

Best,
Rae

Change

All human behavior is purposeful. Behaviors are not diseases. The diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, are more accurately read as a collection of descriptions of behaviors.

People choose, sometimes consciously and other times unwittingly, their behavior and their behavior always serves a purpose. It is much more interesting and helpful to inquire into one’s behavior and patterns to understand how it is goal-oriented. From this perspective, the change process becomes much more powerful and meaningful.

The therapist helps the client to cultivate a sense of curiosity, awareness, acceptance and growth. Behaviors that serve a person well can be maintained while those that are harmful to self or others can be discarded for new more adaptive ones.

This perspective of change has several important implications. First, an individual can only control or change himself.  External control psychology is not only ineffective but manipulative and irresponsible. True change and growth comes from an internally motivated psychology.

Second , this theory of human behavior brings dignity, respect, freedom, responsibility and choice to the individual. Simply put, no matter who you are, where you’ve been and what is happening, you are ultimately responsible for your life including your thoughts, emotions, choices and behaviors.  No more victimization, stigmatization or pathologization.

Thanks for reading this week's post to "Is It Just Me Or...?"

Best,

Rae

 

Monkey Mind

We are addicted to our minds.

In particular, our very own thoughts and emotions.

Let me explain.

In India, there is a particularly clever way of catching monkeys. Hunters cut a hole in a coconut that is just big enough for a monkey to put its hand through. Then they drill two smaller holes in the other end, pass a wire through and secure the coconut to the base of a tree. Then they put a banana inside the coconut and hide. The monkey puts its hand in and takes hold of the banana. The hole is crafted so that the open hand can go in but the fist cannot get out. All the monkey has to do to be free is to let go of the banana. But it seems most monkeys do not let go...

Our minds get us caught in very much the same way in spite of all our intelligence. 

Thoughts are just thoughts. Emotions come and go. Both are fleeting. We are not our thoughts or our emotions. Understanding this reality, we can consciously choose to relate or not to relate to thoughts in a variety of ways that were not available to us before we were aware of this one simple but essential fact.

I teach my clients to cultivate a sense of presence, acceptance and intentionality. Often, they are wasting time and energy - precious human resources - denying and resisting what IS already FACT...otherwise known as life, reality or the present moment.

Denying, resisting, forcing or struggling against the present moment, in any form it takes, leaves one with very little energy for healing and growth. The ego can be summed up quite succinctly:  

A negative relationship with the present moment.

Jon Kabat-Zinn writes about seven attitudes that lay the foundation of mindfulness practice and include:

1. Non-judging

2. Patience

3. Beginner's Mind

4. Trust

5. Non-striving

6. Acceptance

7. Letting Go

Most people who come to see me for anxiety or some form of addiction have not learned to recognize their negative relationship with the present moment nor can they tolerate being with their thoughts or emotions. Much of the anxiety and addiction is used as a way to avoid being overwhelmed by their thoughts and emotions. Part of the process of psychotherapy is teaching a client how to be containers for their thoughts and emotions, to hear the messages those thoughts and emotions bring and to decide whether to act on them in an adaptive way or to let them go.

In the beginning, I act as the container for their unwanted thoughts and emotions and insodoing, demonstrate that it is really not so scary afterall. Our thoughts and emotions do not kill us. Of course our behaviors can hurt us and others, but until we can be in touch with ourselves, our behaviors will only reflect and express this dis-ease and dis-connection.

Food for thought...

Please check out Jon Kabat-Zinn's 15th anniversary edition of Full Catastrophe Living (1990).  

Thanks for reading this week's "Is It Just Me Or...?" Please pass it along.

Best,

Rae

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Human Behavior as Disease?!!?

When did human behaviors become diseases?

The belief that "mental illness" is brain disease (biological/organic) was declared (not proven or discovered) by Carl Wernicke in the 19th century. This was a necessary step in the evolution of psychiatry; a way to legitimize the field. Unfortunately, people take this statement for granted. They believe this myth to be truth and fact (purportedly) based on pure, objective science. Bolstering their argument with the medical (disease) model, they've done a very good job of promoting this idea. Now that psychiatry is in bed with large profit pharmaceutical companies, the message is even louder, stronger and clearer.

Have you ever wondered about that? Who gets to decide which behaviors qualify as diseases? Let's take homosexuality as an example. Did you know that according to the American Psychiatric Association, being gay was a diagnosable mental disorder in the 1960's?  It has since been taken out of the Diagnostic and Statistical Manual of Mental Disorders but conversion therapy is still used as a technique to "straighten-up" homosexuals around the globe!

"Mental illness" defined as brain disease has several harmful implications:

• It allows for a simplistic, deterministic explanation of human behavior
• It minimizes the scope of explanations of a wide variety of human behavior
• It leaves no room for freedom, choice or responsibility 
• It pathologizes entire segments of the population (race, gender, sexual preference, etc.)
• It criminologizes entire segments of the population
• It victimizes entire segments of the population

According to Thomas Szasz, M.D., professor emeritus of psychiatry at the State University of New York in Syracuse and founder of the Citizens Commission on Human Rights, mental illnesses share a single significant characteristic with bodily/organic/biological/medical illnesses:

The sufferer or "sick person" is, or claims to be, more or less disabled from performing certain activities. These two differ in that mental illnesses can be understood only if  viewed as occurrences that don't merely happen to a person but rather are brought about by him (perhaps unconsciously or unwittingly) and hence are of some value (serve a purpose) to him/for him. This particular assumption is unnecessary and unsupportable in the typical (legitimate) case of body illness.

We can view the behavior of people said to be mentally ill as MEANINGFUL and GOAL-DIRECTED. We must be able to understand the individual's behavior from his particular point of view - a key element which underlies all forms of psychotherapy.

If you were intrigued by Szasz's perpsective, please read The Myth of Mental Illness: Foundations of a Theory of Personal Conduct 2010 edition.

Thank you for reading Is It Just Me Or...?
Spread the Word!

Best,
Rae






 

In Honor of Veterans on this Memorial Day Weekend

Mental health issues are social justice and human rights issues. Let's talk about veterans...did you know that

Mental health is one of the top three health issues for veterans?

Returning veterans are not receiving sufficient access, support and resources to quality and effective mental health and substance abuse treatment either through the VA system or elsewhere.
In fact, a large portion of veterans are not even eligible for TriCare for various reasons or they choose not to identify as veterans for the provision of services.

So, where do these veterans go for help? How can they access mental health and substance abuse treatment without stigmatization?

Here are some staggering and sobering statistics from the Department of Veterans Affairs (DVA):

• The number of Veterans receiving VA disability rose from 3.03 million in 2009 to 3.16 M in 2010. 
• The number of enrollees in the VA Health Care System rose from 7.84 million to 8.061 million.

• The number of Veterans rated 100% disabled in 2010 was 289,987.
• Those compensated for Post Traumatic Stress Disorder (PTSD) is 397,019.

• 1.5 million service members have served in Iraq and Afghanistan.
• 90% of wounded service members survive their injuries.
• Over 75% of service members report having been in situations where they could be seriously injured or killed.

• The Substance Abuse and Mental Health Services Administration's (SAMHSA) National Survey on Drug Use and Health found that in 2003, an estimated 56.6% of veterans used alcohol in the past month compared with 50.8% of comparable nonveterans.

• Heavy use of alcohol was also more prevalent among veterans, with an estimated 7.5% of veterans drinking heavily in the past month compared with 6.5% of their nonveteran counterparts.

• An estimated 13.2% of veterans reported driving while under the influence of alcohol or illicit drugs in the past year with 12.2% of comparable nonveterans.

• An estimated 18.8% of veterans reported that they smoked cigarettes daily in the past month comapred with 14.3% of comparable nonveterans.

It goes without saying that these figures do not truly reflect the sheer number of veterans (including their families) or the severity of issues because many veterans do not report issues, respond to surveys, access treatment and so forth. Imagine what the actual picture looks like!

We can do better. They deserve it.

Thank you and Happy Memorial Day Weekend!

Rae



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Hi All!

If you like this blog, please post a comment, share it with others and follow it!
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By the way, my goal is to post once per week - unless I'm feeling really frisky and I can't wait to shoot off an additional one when the urge strikes.

One last thing for today...anything that you think the rest of us needs to see, hear, read, know, experience, etc. please post it as a comment so we can all benefit. Thank you!

Best,
Rae

Is it just me or...is the mental health system mentally ill?

This blog is dedicated to anyone who is working in the allied helping professions: counselors, social workers, marriage and family therapists, psychiatric techs, psychiatrc nurses, case managers, psychologists, psychiatrists and any other professionals who work in the system but want to change the system from within.

This blog is dedicated to anyone who has received mental health services or has had a loved one receive mental health services and yearn for something better.

This blog is open to all critical thinking, engaged and curious citizens who are interested in learning more and becoming part of the movement.

This movement is revolutionary. It is provocative, controversial,  forward-thinking and progressive.
It calls for a paradigm shift. But we are not alone. Many compassionate, intelligent thinkers from inside and outside the field have paved the way for us. The concepts are not new, but they are not mainstream.  

The message or idea behind my blog is simple: Let's bring dignity, respect, integrity, freedom, responsibility and choice to mental health. I do not believe in the disease/medical model of "mental illness." The absurdities and atrocities that occur in the mental health system include but are not limited to the proliferation of mental disorders in the DSM, the fact that psychiatry is in bed with psychopharmaceutical drug companies as well as the ridiculous health insurance industry and their managed care, better known as "mangled care," not to mention the criminalization and pathologization of entire population segments.

Mental health issues are human rights and social justice issues. 
We must demand equal access to quality, effective, confidential, compassionate, culturally-sensitive mental health treatment for all who seek services.

Thank you for reading the first post to the "Is It Just Me Or..."blog.

Diverse views are always welcome. Open, tolerant minds engaged in dialogue is crucial.
This blog is written in the spirit of positive change/pro-mental health and not a negative/anti-movement. Please pass this along to anyone you think might be interested.
I look forward to hearing from you!

Best,
Raquel "Rae" Ornelas