Bipolar: contemplation about the psych label

Contemplations on the label bipolar…

I listened to my friend Chris Cole,  speak to his embracing (reappropriating) the term bipolar in this podcast. I was deeply moved and spoke a response in the night, dictating it into an iPod. It has turned into an article.

This is what the podcast website (Mindful U at Naropa University) had to say about the interview:

There is more to bipolar than just pathology. People are familiar with bipolar as a disorder that used to be called manic-depressive disorder, or maniac depression. Bipolar Order is a declaration of that, and a necessary bridge for people meeting the criteria for bipolar disorder, and particularly bipolar disorder in remission, to be empowered. Chris Cole is trying to activate and inspire people to be empowered, be bold, and be bipolar strong. Listen to Cole’s podcast – Waking Up Bipolar – for more insight, and visit his website ColeCoaching for more information.  (listen here)

Chris is a close friend. We’re going to be launching a project together (along with Ian Scheffel, too)  by the end of June. (stay tuned). We are working out our differences together. Not in order to change them but to embrace one another even when we have different narratives. Our project will be inviting others to join us in this practice of loving each other…all of us who’ve been labeled or not labeled by psychiatry. In particular the project will be for those who have also experienced that which gets labeled psychotic (or altered states that were perhaps never labeled) It will be for those of us who understand our extreme states (perhaps among other things too) to have profound spiritual significance. We want to be inclusive and we’re starting with the three of us discussing our own experiences so that we can hold a container for others.

So, as I listened to Chris, loving so much of what he was saying, I also felt the below and allowed it to flow. I’ve shared it with him too and we’ve done lots more discussion with Ian too. This is an exciting time.

***

In response to Chris discussing reappropriating the word bipolar. I wrote spontaneously the following words:

I have a defiance…the defiance is where I am most soft…the defiance is where I am most vulnerable.

I have no interest in reappropriating a word that was used to poison my innocent body.

I have no interest in reappropriating a word that was used to almost kill me…more than once.

I have no interest in reappropriating this word and yet, I love this man, my brother, who chooses to reappropriate this word for himself.

There is no conflict here. Indeed, when we understand that those of us who’ve been labeled Bipolar, whether we buy into the psychiatric establishments interpretation or not, we’re subject to the very similar realities, then any language used to communicate with others ceases to matter so much. We start seeing our similarities and respecting our differences.

So while my friend’s stance raises this defiance when I’m facing the world, I am always soft  and vulnerable and safe when I speak to Chris.

Chris has a vision and a capacity, and an understanding of my vision. We share a vision and we have different ways of interpreting our own experience. Our different experiences and our different ways of interpreting our experience has led us to this same place at the same time. This is what our work is about. It is about inclusivity and loving one another even when we disagree. (read interpret our experiences differently…it’s not really disagreement at all and we see that clearly because we feel one another beyond the words.)

And here we are practicing our vision as we discuss how these issues are alive in our lives. We are creating the world we wish to live in by doing it in the relationships we’re fostering as we get our project off the ground.

So how can this be?

How can it be that this little soft wounded part within me — this heinously wounded part — can feel safe with someone who embraces the very word that has been used as an excuse to hurt my body–my integrity–so much.

It’s because as I became friends with Chris, I discovered that when we spoke that no one I had ever spent time with had ever held my entire experience with such delicate reverence. There is sacred space between us. We see one another and that goes beyond language.

So, to say that we disagree is not  accurate — the language we use — that feels most resonant with our internal experience that we project into the world by articulation differs…and it differs because the context of our lives differ…our kaleidescopic realities are endlessly different even while on the surface much appears the same.

Through our experiences we’ve been brought to serve and interact with different people up to this point. We’ve been in somewhat different fields of influence … energetic fields of influence and now we come together and we bring our fields together (at least in part…energetic fields are fluid and amorphous) and when we do that we can embrace a whole lot more people and for the time being as I feel into this delicate place that still will not, does not want, indeed cannot reappropriate the word bipolar, I simultaneously feel a larger capacity to embrace my human family, with all its complexity . There is no conflict  between Chris and me.

The conflict I feel is between me and my projected self into the world…which is pretty much an illusion anyway. It’s an important illusion, created and sustained so that I could heal from profound trauma. And to be clear, on the level I’m speaking all identity issues such as these are illusions. Bipolar/Not Bipolar etc. My projected self helped me find my grounding and I’m still in process with this healing a lifetime of traumatic insult.

I predict and sense that the defiance will continue to soften so that the vulnerability can just become raw strength. It doesn’t mean that I will fundamentally change my position. I don’t think that will be possible at this point.

I know what I know because of what happened to me and so many others and what happened is real. It’s why I can advocate so well for others who’ve been heinously wounded by psychiatry too — others who also do not want to subject themselves to the language of psychiatry for that and other reasons. As I soften I will less and less have to defend myself in the face of those who don’t share this particular woundedness. I will however, always, acknowledge and validate others who are still in process healing traumatic wounding by psychiatry. Society validates this wounding and compounds it with bigotry directed at all who have labels given to them by psychiatry. 

Chris and I do have somewhat different varieties of woundedness, however we’ve both been wounded profoundly enough, deeply enough, to understand the universal nature of human woundedness in all it’s guises and flavors and so we can hold one another in the ways that we sit differently with our interpretation of our woundedness in the face of psychiatry…we have much in common and yet we still interpret things differently. Our uniqueness in how we interpret is part of how we function in the world and how we serve others.  We bring those strengths to our own friendship.

the individual has always had to struggle to keep from being overwhelmed by the tribe. if you try it, you will be lonely often, and sometimes frightened. but no price is too high to pay for the privilege of owning yourself. — Friedrich Nietzsche

Epilogue: I am life. I am psychedelic. I am kaleidoscopic. I am conscious. I am aware. I am chaos. I am silence.  The term bipolar *disorder* attempts to diminish. Two poles? In a world of endless spectrums all interlacing into oneness? What nonsense. The term bipolar is attached to people like me because we frighten those “treating” us. We are sensitive, open, people in need of shamanic-like guidance. The current psychiatric regime doesn’t know how to support us in profound ways. We are finding out how to do that for ourselves and with each other.  I do not identify as bipolar nor do I identify as *not* bipolar. I’m just another little human being and so are you. Please don’t project your pathology onto me.

oh, and for the record I undiagnosed myself many years ago.  This site was brand new and I was still feeling my way around what I was discovering. 11 years ago now. Wow.

My vision of how to start supporting one another as articulated a year and a half ago:

***

For a multitude of ideas about how to create a life filled with safe alternatives to psychiatric drugs visit the drop-down menus at the top of this page or scroll down the homepage for more recent postings. 

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An inclusive approach to mental health: Not all in the brain

this article was submitted to Beyond Meds by Oxford University Press and was first published on their site

Editor’s note: Beyond Meds takes issue with the unequivocal comment in the below article that medications can take an important role in treatment. As it stands right now that may be the case given there is no infrastructure of care for meaningful alternatives. If there were such an infrastructure in place (something we must work towards) — it’s quite debatable whether medications would have any role at all beyond targeted and brief crisis intervention, perhaps). Until we have such an infrastructure of care that supports profoundly holistic care we cannot know what is possible. What I and many of the authors at Beyond Meds have discovered is that our bodies and minds and spirits seem to work quite well when all our holistically connected pieces are tended to with synergy and care. I and many others like me have found profound healing with such awareness. Medication used for prolonged periods of time simply does not support such deep healing. The rest of the modalities discussed in the article absolutely support growth, healing and transformation. Also in my experience I’ve found that this is true of all psychiatric diagnosis and is certainly not particular to only schizophrenia. 

By Michelle Maiese

For many years, the prevailing view among both cognitive scientists and philosophers has been that the brain is sufficient for cognition, and that once we discover its secrets, we will be able to unravel the mysteries of the mind. Recently however, a growing number of thinkers have begun to challenge this prevailing view that mentality is a purely neural phenomenon. They emphasize, instead, that we are conscious in and through our living bodies. Mentality is not something that happens passively within our brains, but something that we do through dynamic bodily engagement with our surroundings. This shift in perspective has incredibly important implications for the way we treat mental health – and schizophrenia in particular.

In much of the Western world, and particularly in the United States, drugs are a primary mode of treatment for psychological disorders. This reflects the common assumption that mental illness results from faulty brain chemistry. Although it would be difficult to deny that medication can play an important role in treatment, this drug-based approach faces three major limitations:

  1. It is doubtful whether disorders such as schizophrenia are caused by anything neurological (in the straightforward way that heart attacks are caused by arterial blockage). Indeed, many mental, emotional, and behavioural problems do not have clear-cut genetic or chemical causes, but instead result partly from difficult human experiences, stressful events, or other problems in their personal life. When minds “go wrong” it is not simply a matter of mechanical breakdown, and “fixing” neural wiring will not be sufficient to address the underlying causes of disorder.
  1. There is evidence that antipsychotic medications are not sufficiently effective in managing the debilitating symptoms of schizophrenia, such as delusions and hallucinations. Many patients on medication continue to experience psychotic symptoms throughout their lifetimes. In addition, there is a worry that anti-psychotic drugs may cause negative side effects, such as apathy, muscle stiffness, weight gain, and tremors.
  1. By focusing on just one organ of the body (i.e. the brain), drug-centred approaches overlook the role of bodily processes more broadly construed. Once we acknowledge that consciousness and cognition are fully embodied, this pushes us to move beyond narrowly defined, brain-based methods and to seek treatments that transform a subject’s overall neurobiological dynamics.

What can be done?

click pic for credit
click pic for credit

Interventions that target the subject’s whole body, and not just the brain, include yoga, dance-movement therapy, and music therapy – all of which have proven to help schizophrenic subjects re-inhabit their bodies and regain a coherent sense of self.

There is strong evidence that yoga therapy can reduce psychotic symptoms and improve the quality of life of adults with schizophrenia. Through the repeated execution of sequenced movements and postures, as well as enhanced sensory self-awareness, subjects are able to forge more of a felt connection with their bodies and also begin to feel more “at home” in their surroundings. Breathing exercises and meditation can help to make the make body feel more familiar, increase sensitivity to subtle bodily sensations, and minimize feelings of bodily alienation and hallucinations that are commonly found in schizophrenia.

Like yoga, dance/movement therapy centres on the use of movement to foster the integration of bodily sensations and emotions. Through exercises that aim to increase bodily self-awareness (such as sequential warm-ups, patting one’s own body, defining its outer limits, grounding, and reflecting on the movements of others), a sense of self is promoted. In addition, it provides opportunities for increased emotional expression and the controlled, cathartic release of emotions of joy, sorrow, rage, or frustration.

click pic for credit
click pic for credit

Last, but not least, music therapy may have great potential for treating schizophrenia. Subjects can be invited to play or sing, whether through improvisation or the reproduction of songs, or simply listen to recorded or live music. Like dance, music provides subjects with a nonverbal means of expression and can serve as a powerful therapeutic medium for those who are unable or too disturbed to rely on words. Improvising, playing, composing, and listening to music all are thoroughly embodied processes that address symptoms from the bottom-up, by engaging emotions and bodily feelings.

By tackling mental issues with this ‘bottom-up’ method, we are able to bring about changes in higher-level cognition and interpersonal functioning – by evoking emotion and tapping into bodily feelings. Such therapies have a fantastic potential to make subjects more attuned and sensitive to their surroundings, and to foster emotional resonance with others.

It is true that such treatments may take longer, and be more expensive than medication. However, such interventions may be our best hope for bringing about lasting improvements – focusing on the person as a whole, to treat a problem as a whole.

Michelle Maiese is Associate Professor of Philosophy at Emmanuel College in Boston, MA. Her research addresses issues in philosophy of mind, philosophy of psychiatry, and emotion theory. She is the author of several books, including Embodied Selves and Divided Minds – an examination of how research in embodied cognition and enactivism can contribute to our understanding of the nature of self-consciousness, awareness, and the metaphysics of personal identity in cases of psychopathology.It forms part of the International Perspectives in Philosophy and Psychiatry series. 

More on topic from Beyond Meds:

Diet too is a critically important:

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*it is potentially dangerous to come off medications without careful planning. Please be sure to be well educated before undertaking any sort of discontinuation of medications. If your MD agrees to help you do so, do not assume they know how to do it well even if they claim to have experience. They are generally not trained in discontinuation and may not know how to recognize withdrawal issues. A lot of withdrawal issues are misdiagnosed to be psychiatric problems. This is why it’s good to educate oneself and find a doctor who is willing to learn with you as your partner in care.  Really all doctors should always be willing to do this as we are all individuals and need to be treated as such. See: Psychiatric drug withdrawal and protracted withdrawal syndrome round-up

For a multitude of ideas about how to create a life filled with safe alternatives to psychiatric drugs visit the drop-down menus at the top of this page. 

That Awful Dread

By Georgi Y. Johnson

Dread is a fusion of anger and fear, in a cloud of threatening horror, that moves between and through people. In the social field, it is channeled through hidden agendas of entities that have lost connection with a deeper truth and purpose.

Firmly rooted in the belief of either-or, or kill or be killed, the agenda of dread is mostly occupied with possession: the possession of another human; the possession of things; the possession of truth; or the possession of status. Dread reduces form through forcing contraction (synchronizing it to a denser vibration) for the purposes of possession: an illusion which is closely knit with structures of control and power. In order to have power or control over another, they must be defined, objectified and available to be grasped and/or rejected.

In its subtlety, dread is the in-breath and out-breath of the twin movements of grasping and aversion, acting as one. Its toxicity can take the natural breath away.

Dreadopolis

When we can allow dread to be felt when and where it arises in our experience, allowing it to move through us, (just as we move through it), it has the flavor of pure suffering. Yet it’s origin is not in authentic physical hardship, but in a sense of endless lack found in structures of ego or false identity. As such, the energy of dread is often grandiose, inflated and vastly disproportionate to the perceived injustice.

Dread can be generated locally, but it is at the same time transpersonal: it broods through atmospheres in collective fields. It hangs around cities, families and places of historic horror. Mostly unconscious, it can be a torture to sensitive individuals that are formed with a low toleration of the grossness of its vibration.

When those individuals are led to believe that this is their own, private, emotion or feeling, they can begin to fear the dread to such an extent that they move into anxiety. Identification with dread as personal failing creates further contraction and isolation. These broad energy fields – such as anger and fear and their threatening blend in the form of dread – are like clouds of cause-less suffering on the surface of the planet. Mostly unanchored in the present moment, dread is the source energy of toxic illusion: it is composed of the unhealed horror of memory and the undefined threat of what could be.

In our weakness, we channel that energy towards each other. In our ignorance, we might even consciously direct it with angry, jealous and vengeful thoughts and stories. These stories are powered by a general feeling of ‘wishing bad’ towards the other, and inner satisfaction at their misfortune. Yet the dread itself is not inherent to who we are at source. It is an effect of the divisions that allow creation. Sooner or later, its mirage, whether individual or collective, will dissipate in the realization of the here and the now

Division Bells

Dread thrives off the belief in the separate self: that individuals are inherently separate units, sharing nothing other than what they choose to share through mind and body. Through the window of sentient awareness (the subconscious) it moves as a polluted form of conditional love, trying to grasp at objects rather than allow them as impermanent phenomena. In this, it gives the sense of solidity to appearances and binds consciousness to form.

Ensnared in the belief that ‘might is right’, dread moves mentally through a logic of either-or, you or me, kill or be killed. It energetically threatens others into contraction or retreat. The origin of this threat is fear: the fear of the separate self that tries to uphold the pleasurable side of the lie of its own invincible, surface individuality.

It is especially unfortunate that sensitive individuals that suffer more from this dread in the collective field, often get further isolated with the label of mental disorder and worse. Mental institutions are excellent schools to teach us what we are not.

A Dreadful Lock-down

The energy of dread encourages contraction, freezing and the distraction of consciousness. In this, it encourages disguise: the sentient, protective cover-up of form to shield from an unknown danger. It moves with a vibration of absolute authority as if it were truth itself, when in form, it is closer to a transient and temporal cloud of dense vibration. In this, it tends to shut down the sense of space and freedom within time. Resembling the tunnel vision of a traumatic state (which in a way, it is), it righteously believes itself to be a complete universe of absolute truth.

The undefined sense of immediacy within the blend of fear and threat generated from a dread field falls short of the eternal present, replacing it with a sense of existential threat (as if existence itself were temporal). In this, dread directly puts form in danger, as it drugs the immediacy of real danger with a sense of spooky abstraction. It stupifies the mind and confuses the nervous system and as such actually compromises our natural, living instincts towards safety and preservation of form.

Without a strong consolidation in the timeless and unbounded aspects of ourselves, the dread of abstract, ungrounded danger and threat can obscure the perception of actual physical challenges in real time. Dread even robs fear of its naturalness.

In addition, by clouding and closing the windows of perception, the vulgarity of dread confuses our natural psychic capacity which is possible through the refinement of our senses. It can make us feel and behave awkwardly, out of harmony with the environment. It inflates the visual and auditory imagination with fearful apparitions of ‘otherness’. These images are far removed from the here and now – such as the silence of a room; the miracle of the feet on the floor; and the gentle rhythm of the breath.

For some, it can only be with the deeper release of form (such as in the death process), that the impotence of a lifetime of dread becomes clear, as it dissipates in the living vastness of unrestricted space and time. For others, the realization of the impermanent nature of dread occurs through the realization of the thinking mind and belief systems as nothing other than an organ of consciousness.

Some pointers to help with dread:

  • Dread is a teacher (of what we are not).
  • The threat of dread is always a lie.
  • If we let dread be (surrender be allowing ourselves to become empty), it cannot take hold.
  • Dread fails in real time and space. Physical movement, coupled with attention in the here and now, neutralizes the amorphous dread energies.
  • The antidote to dread is compassion. Do something for someone else. Open the window of empathy.  The movement of service releases the unconscious ego structures where the threat could be attacking. It brings togetherness, and dread is all about division and conflict.
  • Breath in whatever nasty energies are around, breath back infinite peace. This grounds us in the body, which is more existentially present than any imagined threat or suffering.

georgiGeorgi Y. Johnson has an international practice in spiritual healing and inner growth with her partner Bart ten Berge. She is author of the book I AM HERE – Opening the Windows of Life & Beauty, which is a study of three layers of perception: consciousness, awareness and perception through emptiness. You can read more from Georgi & Bart here.

Easter: death and rebirth as archetype

We usually face a deeply felt experience of death before encountering the archetype of rebirth. Neither the death nor the rebirth or resurrection are things that happen quickly. There may be dreams, waking subjective experiences or a short period in ones life when death or rebirth are felt very strongly – but the process as a whole is a psychological one which may take years to unfold and stabilise. With many experiences of archetypal nature, such as entering puberty and meeting the process that unfolds manhood or womanhood, we are working out psychic growth which involves our entire nature. Puberty is an excellent example of how an archetypal human process works in us individually, yet is very unique for each of us. At the same time however, while puberty is a well worn path which virtually everyone travels, some aspects of human possibilities, like death and rebirth, are not universal. Only comparatively few people really manage these points of growth. — Tony Crisp

AND:

The smallest sprout shows there is really no death,
And if ever there was it led forward life,
and does not wait at the end to arrest it,
And ceas’d the moment life appear’d.
All goes onward and outward, nothing collapses,
And to die is different from what any one supposed, and luckier. —Walt Whitman, Leaves of Grass

AND

easter-lily-wallpaper-7What has always been basic to resurrection, or Easter, is crucifixion. If you want to resurrect, you must have crucifixion. Too many interpretations of the Crucifixion have failed to emphasize that. They emphasize the calamity of the event. And if you emphasize calamity, then you look for someone to blame. That is why people have blamed the Jews for it. But it is not a calamity if it leads to new life. Through the Crucifixion we were unshelled, we were able to be born to resurrection. That is not a calamity. We must look freshly at this so that it’s symbolism can be sensed. — Joseph Campbell

AND

It is very much the longing to be born anew the way nature is. All these elements fit together. Easter is calculated as the Sunday that follows the first full moon after the vernal equinox. It is evidence of a concern centuries before Christ to coordinate the lunar and solar calendars. What we have to recognize is that these celestial bodies represented to the ancients two different modes of eternal life, one engaged in the field of time, like throwing off death, as the moon it’s shadow, to be born again; the other, disengaged and eternal. The dating of Easter according to both lunar and solar calendars suggests that life, like the life that is reborn in the moon and eternal in the sun, finally is one.

Joseph Campbell, Thou Art That, p. 113

The aftermath: polypharmacology — protracted psychiatric drug withdrawal syndrome

This was first published on David Healy’s site, RxIsk: Making Medicine’s Safer for All of Us, about 4 years ago. I’ve never published it on this site and thought I’d do so now so that it will be part of the archives here as well. It’s a memoir of sorts up to that point 4 years ago.

The aftermath of polypsychopharmacology: protracted psychiatric drug withdrawal syndrome

I recently contacted the doctor who is responsible for my iatrogenesis — the doctor who grossly over-medicated me and made me ill. I’ve been corresponding with him for several years now, but this was the first telephone conversation I’ve had with him since telling him what his drug cocktail did to me. He rarely says much in response to my emails where I link to the articles I’ve written casting large shadows on the “treatment” he gave me. So I called him and left a voicemail that I might talk to him.

When he returned my call a few days later, we talked for perhaps a half hour. I always liked this man when I was his patient and now that I’ve worked through most of the rage of having been harmed by his treatment, I still like him. His intentions were good. I’m clear on that. I do not think this relieves him of responsibility, but it does relieve me from hating him which simply isn’t good for my soul. Still, I simultaneously appreciate Dr. David Healy’s insight about patients succumbing to Stolkholm Syndrome and have made the same observation about myself. I contain multitudes. There is nothing easy about emotionally processing what happened to me and what continues to happen to so many others.

So my conversation with the man who practiced wild, untested poly-pharma on me was actually quite civil and I felt it was productive too. He listened and shared his view too. He did not always agree, but he was clearly listening.

I want to share a bit of the conversation. He has a hard time believing that what happened to me is routine, that it happens to many patients. He grants me my experience, though, like a good shrink. He believes me when I tell him both that my mind is clear now and that I’ve been gravely harmed by the drugs. I’m not sure he thinks he’s responsible, but he doesn’t challenge my experience. The phrase cognitive dissonance comes to mind. How do they do this? I don’t claim to understand.

So he said something suggesting what happened to me isn’t the norm. That he sees medications working wonders all the time. I challenged him like this, “Dr. M, when you were treating me you thought I was one of your successes, right?” He said, “Yes.” And I responded with, “Well, you were wrong. My life was miserable. I lived in a drugged haze. I slept and worked because that is all I had time to do. I had no passion for what I did and I just lived by going through the motions, flat and empty. My life was hell. I liked you and you needed to believe that I was okay…I tried to please you like a “good patient.” Still if you’d paid attention you know that I was always asking to be put on disability. That’s because it was insane for me to work 8 hours a day when I required 12 hours of sleep because of the heavy sedation. It was also dangerous for me to drive on that pharmaceutical cocktail yet I needed to drive to keep my job. If you had really paid attention you would have known my life was miserable. And I promise you, you have other patients just like me.”

I’m sharing that vignette as an opening because I think most doctors hear stories like mine and think that they are not the ones perpetrating such injury. My doctor is a very well-reputed psychiatrist in the Bay Area, CA. He’s well-known and well-regarded. He is a typical psychiatrist and typical psychiatrists are causing grave harm every day all over this country and throughout a good part of the world. He still seems to believe that I’m an anomaly and that somehow I’m not his problem. Yes, cognitive dissonance.

So I was on a six drug combination including every class of psychiatric drug at high doses that required over six years of withdrawal. I was left severely ill, afflicted by a severe iatrogenic illness: “Withdrawal syndrome” for lack of a better name. The name makes it sound like something that might last days or weeks but it’s crippled my life for years. Those of us who become this sick (I’ve networked with thousands of folks in withdrawal now) are subject to dangerous care and outright denial of our experience by medical doctors and the medical establishment in general.

What possesses a doctor to prescribe such a cocktail? I don’t think I’ll ever know, but I can tell you how it happened.

The drugs never did “work” and in retrospect they made me much worse… in fact they caused the chronic illness I am now living with. It became clear to me when I was unable to continue working about fifteen years into the (heavy) drugging as my mind and body simply stopped cooperating under a fog of neurotoxic chemicals. I knew I had to try to free myself from them.

So, how did it all begin? After an illicit drug-induced mania I triggered in college, psychiatry got a hold of me. I was told that I was bipolar and would be sick for the rest of my life. One doctor, in fact, told me I would die if I did not take medication for the rest of my life. Having suffered repeated traumas in my life the additional trauma I was subjected to in the psychiatric ward took its toll. I gave in to what they told me, they scared me good including threats to send me to a state hospital for permanent residence. It’s clear to me now this was used only to terrorize me into submitting to drug treatment, it was not a threat that would have been carried out, but I did not know that then.

The truth, however, is that I had a history of trauma that needed tending to, not any sort of brain disease as mental illness is popularly understood. The years of heavy drugging, in the end, is the only thing that made me truly sick. That is, psychiatric and physical symptoms caused by the drugs I was being given for “treatment.” My original diagnosis, bipolar disorder, given as a life sentence never really had much credibility. The tragedy is that during all those years of being drugged during the prime of my life I felt purposeless, flat, barely alive and sexless. I went from being a fit and toned athlete to being 100 lbs over-weight and unable to exercise much at all due to the sedation and nausea.  I went through the motions of living while in a fog.

Now, drug-free, I’m quite often too ill to leave my home but my mind is crystal clear. I am motivated and productive, the author and editor of a popular mental health blog that offers alternatives to psychiatry. Having been both a professional in the mental health system and a victim of the same system, I have some interesting and uncomfortable insights into the standard of care. I’m passionate about my work. I have more of a life than I ever had on drugs even while able-bodied and even though now my life is painfully limited in ways it’s hard to convey to those who’ve never experienced such illness and isolation.

In retrospect I see now how one drug led to the next. The “mood-stabilizers” which left me depressed led to the antidepressants which left me with insomnia and agitation which led to the benzos for sleep. They still didn’t get rid of the agitation which led me to the antipsychotics (which made everything worse and in fact my doc kept adding Risperdal milligram by milligram until I was on 11 mg for my akathesia which I now know is CAUSED by the Risperdal—he was treating a symptom with the very drug that was causing the symptom!! My akathisia ceased when I finally got off the Risperdal. We always called it “anxiety”, but it was akathisia.

That big cocktail of drugs left me sedated and lethargic. No surprise. The next step was stimulants. Addiction and dependence to benzos also leads one to needing more and more drug to get the same “therapeutic effect.” And so my dose continued to increase. Unfortunately I’ve learned this happens to way too many people, some of whom never even realize it. Drugs leading to more drugs leading to more drugs. And once in the trap it’s almost impossible to see clearly. To realize what is going on is difficult and perhaps sometimes impossible.

I’ve been free of this massive cocktail of drugs for over two and half years now. The sad part is the greatest amount of suffering I’ve ever endured in my life has been a result of my body adjusting to no longer having neurotoxic drugs in my system. Medically-caused harm and a term that often sounds Orwellian to those of us who experience the protracted version: withdrawal syndrome. It totally fails to capture the grave disability some of us experience.

Still, I have not one moment of regret for having freed myself from these drugs because my mind is clear! I have a clarity of mind that is so beautiful I can cry if I spend time thinking about it. My clarity was stolen from me for almost half my life. I have it back and even impaired as I am, unable to leave the house most of the time, I am grateful.

I once made a list of the myriad insults my body and mind endured. It included over 50, mostly disabling symptoms. What is most astonishing is that I am exponentially better now and don’t experience the bulk of these symptoms anymore, but I’m still very very sick. This, again, is something very few people can conceive of. It’s mind-boggling to me as well and I’ve experienced it.

The fact is our bodies and minds are intrinsically driven to seek wellness and mine is no exception. I am on a path towards wholeness. I don’t imagine it will stop now. There is no going back.

Update: I’ve gotten much better since the writing of this post. My most recent anniversary video explains how I made it through the darkest times:

 

See also:

the “It Gets Better” Series if you’re sick and in the midst of psychiatric drug withdrawal it’s often helpful to know that others have made it through similar difficult times.

And The anniversary posts: the 5 years off psychiatric drugs documented

*it is potentially dangerous to come off medications without careful planning. Please be sure to be well educated before undertaking any sort of discontinuation of medications. If your MD agrees to help you do so, do not assume they know how to do it well even if they claim to have experience. They are generally not trained in discontinuation and may not know how to recognize withdrawal issues. A lot of withdrawal issues are misdiagnosed to be psychiatric problems. This is why it’s good to educate oneself and find a doctor who is willing to learn with you as your partner in care.  Really all doctors should always be willing to do this as we are all individuals and need to be treated as such. See: Psychiatric drug withdrawal and protracted withdrawal syndrome round-up

For a multitude of ideas about how to create a life filled with safe alternatives to psychiatric drugs visit the drop-down menus at the top of this page. 

Support Beyond Meds. Enter Amazon via a link from this blog and do the shopping you’d be doing anyway. No need to purchase the book the link takes you to or make a donation with PayPal. Thank you!

Bridging the Benzo Divide: Iatrogenic Dependence and/or Addiction?

By Richard Lewis

As the benzodiazepine crisis spreads throughout the United States and other parts of the world so does the debate within the benzo victim/survivor community about important definitions of key medical terms and about safe and successful paths to healing and recovery. Does “iatrogenic benzo dependence” and “addiction” represent completely separate medical and social phenomena? If they are to have distinctly different scientific definitions, can they also (at the same time) intersect in multiple ways in people’s actual real life experience? And what is the medical and social significance of exploring these concepts and seeking unity of understanding and purpose? Before delving into the content of this debate let’s briefly review the social context from which this “Benzo Divide” has emerged.

With almost 100 million benzodiazepine prescriptions written per year in the U.S., combined with the fact that there is a total absence of proper regulations and safety standards for this category of drug, high levels of suffering have been caused by a disabling form of iatrogenic dependence affecting an untold number of unsuspecting victims. Victims whose only “mistake” was trusting in the recommendations of Big Pharma, Psychiatry, and medical doctors who erroneously believe that tranquilizing pills are the quickest and best solution for patients seeking better ways to cope with life’s stressors. Most often neither the doctor nor the unsuspecting patient in these situations has the remotest idea what long term misery lies ahead for those following this all too common medical advice.

The number of benzo victims, which is likely in the millions, most certainly involves a large segment of people (perhaps, even the majority) who have no life experience or connection to anything involving substance abuse or addiction. When patients in this group are viewed as if they are common “drug addicts,” cultural prejudices combined with bad medicine adds “insult to injury” by often dictating more harmful forms of treatment.

At the same time we also know that there are a significant number of people damaged by the proliferation of benzo prescriptions whose behavior patterns have involved some prior (or current) misuse or abuse of various mind altering substances. We know that for this segment of the population iatrogenic benzo dependence will frequently compound and accelerate their addiction and, in some cases, even be a causative factor in the etiology of their addiction. Additionally, with newer studies indicating that at least 30% of all fatal opiate overdoses in this country involve benzos being present in the drug cocktail, this scary statistic only adds to our current knowledge of the amount of overall harm being done and the often deadly nature of the growing benzodiazepine crisis.

It is both mind-boggling and infuriating to contemplate the fact that most of these 100 million prescriptions for benzodiazepines are being handed out for long-term use, when knowledgeable medical experts have given major warnings for many years that benzos should only be prescribed for 2-4 weeks, including the time required for a safe taper. Irrespective of any one person’s prior history (involving addiction or not), prolonged use of this category of drug on a regular basis will lead to a state of iatrogenic (that is, medically-induced and harmful) dependence. This all too common form of medical malpractice can result in a myriad of negative physical and psychological effects that can be disabling for months, years, and even decades, especially if a person fails to receive a proper diagnosis and a safely designed protocol of medical care. This much needed type of medical care often requires special forms of micro-tapering regimens that few people in organized medicine understand or know how to implement for their patients. In addition to issues of dependency, addiction, and involvement in drug overdoses, benzos also have documented connections to Alzheimers’ disease, dementia, greater number of fractures and falls, and higher overall mortality rates. Outside of a hospital setting, this makes benzodiazepines one of the most dangerous categories of drugs on the planet.

In many ways “citizen scientists” using their own painful life experience as a guide (along with a powerful survival incentive) are writing of their experiences on many nonprofessional internet websites such as Benzo Buddies.org, Beyond Meds.com, Benzo Beware on Facebook,Benzo Support.org, and Benzo.org.UK. As a result they have provided important emotional support for people affected, as well as helped develop some of the more cutting edge approaches to finding more successful tapering and withdrawal protocols. It is here in the trenches of these internet forums where very important discussions and sometimes contentious debates take place regarding the road forward for all the victims of dangerous benzodiazepine prescribing patterns.

We cannot understand the true nature of todays’ benzodiazepine crisis without examining key events that go back several decades in the historical development of modern Psychiatry. Space and time limitations preclude my going deeply into this history. It is accurate to say that it was collusion at the highest levels between the leaders of the pharmaceutical industry and the American Psychiatric Association in 1980 that led to the development of the DSM lll (the diagnostic Bible of “psychiatric disorders”) and the classifications for a particular set of anxiety and sleep disorders. This ongoing collusion between these two powerful institutions culminated with an arguably fraudulent campaign that created favorable conditions for FDA approval of Xanax (and other benzos) as a so-called, “safe  treatment,” for panic attacks and insomnia. The rest is (today’s) history, as the expression goes.

Readers are urged to read Dr. Peter Breggin’s book, Toxic Psychiatry (1991) and Robert Whitaker and Lisa Cosgrove’s Psychiatry Under the Influence (2015) for a comprehensive history of these events. In addition, it is helpful to explore the more recent history of how the explosion of prescribed benzodiazepines has paralleled the development of a similar epidemic of opiate pain drug prescriptions, and how this has impacted the rising death rate of prescription drug and heroin overdoses. Readers are also urged to review a prior blog written by this author titled, “Benzodiazepines: Psychiatry’s Weakest Link,” that further explores in a deeper way the social and political implications of these developments.

Given the dangerous levels of benzodiazepine drugs circulating within our society and the fact that they affect such a large and diverse sector of our population, how has it come to be that definitions of the terms “iatrogenic dependence” and “addiction” can carry so much meaning and at the same time be so contentious? And why is unity of understanding and purpose on this issue so important to achieve as we attempt to build a movement trying to end the harm done by the benzo crisis?

Activism in Support of Recognizing the “Ashton Syndrome”

Over the past several years there has been a growing and increasingly more vocal segment of the benzo victim/survivor community who are leading the charge in educating and challenging their community as well as the entire medical establishment, about the fundamental difference between “iatrogenic benzo dependence” and “addiction.” They have made a strong case for why these definitions can be critically important, and why they could actually make the difference between failure and success for some patient’s recovery from benzo dependence. In fact, in November of 2015 a very scientific and scholarly presentation of these differences was authored by J. Doe and published online at the Mad in America blog in a two part series titled “Don’t Harm Them Twice.”  For anyone seriously interested in this topic, either due to their own personal experience with these drugs or because they are devoted caregivers and/or activists for people negatively affected by them, this new document is a must read.

J. Doe, along with others with similar ideas, are following in the path of benzo crusader Dr. Heather Ashton who worked for many years (1982-1994) in England in a clinic that championed the cause of hundreds of victims of benzodiazepine dependence. It was out of this work that she developed the highly respected Ashton Manual, which designed a new path breaking tapering protocol that provides one important option for people trying to safely withdraw from this category of drug. As someone who has been a longtime critic of the Disease-based medical model, and involved in addiction support work for over twenty years, J. Doe’s new document was both illuminating and challenging. This work is definitely a “game changer” and will forever change the way myself and others use the language related to issues of drug dependency and addiction.

Everyone owes a great debt to the important contributions that J. Doe and others have made in carrying forward the torch of pioneers like Dr. Heather Ashton. Today, J. Doe and others are calling for the recognition of a newly identified medical condition related to iatrogenic benzodiazepine dependence, called “The Ashton Syndrome.” Their long term goal is  “…to educate medical providers about the complexities of iatrogenic benzodiazepine dependence and how it differs from addiction, abuse, or substance abuse disorders (SUD) so that it is treated as a legitimate medical problem as opposed to a behavioral issue.” We all must learn from, respect, and support J. Doe and other’s efforts to change both the language and the harmful treatment “That Harms Them Twice,” as well as, support their advocacy for recognition of the Ashton Syndrome.

Exploring the Interconnection Between Iatrogenic Dependence and Addiction

While we must overall give high praise to the work done by J. Doe and others, there is an unfortunate secondary countercurrent to their arguments that weakens their scholarship and threatens to possibly widen an already existing divide within the benzo victim/survivor community. While there needs to be a black and white distinction made between the scientific definitions of “iatrogenic benzo dependence and “addiction,” there is a lot of grey area between these concepts when examining the real life experiences of all those people being harmed by benzodiazepine drugs. J. Doe’s theoretical shortcomings tend to downplay, or even deny, the reality that there are many people who have BOTH iatrogenic benzo dependence AND addiction issues present in their current or past life experience. In their advocacy for establishing distinctly different definitions for these two phenomena, they have chosen to promote both a theory and practice that encourages distancing themselves from anything addiction related. This includes distancing themselves from those people in the benzo victim/survivor community who also suffer from addiction related problems in their life. If J. Doe and others fail to reconsider this approach it could place unnecessary limits on the potential to build broad support among activists for their advocacy work, as well as interfere with future efforts to build unity among all those damaged by benzos.

Ironically, Dr. Heather Ashton (after whom J. Doe and others have patterned their advocacy work) clearly acknowledged in her writings the common intersection of “iatrogenic benzo dependence” and “addiction” in the lives of a number of her patients. In Dr. Ashton’s dedicated work she embraced the addiction community while questioning some aspects of the Disease-based 12-Step approach to recovery. Some related quotes by her on this topic are as follows: “A large portion (30-90 percent) of polydrug abusers world-wide also use benzodiazepines.”  (Ashton Manual, 2002) and “Initially prescribed benzodiazepines, if not carefully supervised, can lead to escalation of dosage and entry into illicit drug scene in vulnerable individuals.” (Drugs and Dependence, 2002).  And finally, what follows is a quote from some important questions and answers on the Ashton-inspired website Benzo.org.UK – FAQ File #38, that speaks directly to these very issues being discussed and debated today:

“It is important to note that a sizeable percentage of benzodiazepine dependents do exhibit patterns of abuse. The clearest signs are taking doses far in excess of what your doctor has prescribed, and/or having a history of abusing other drugs in the past or simultaneously with your benzodiazepine.”

In an effort to pursue these questions in a deeper way I am proposing one possible way to break down the different segments of people who are harmed by iatrogenic benzodiazepine dependence:

  1. People who have had no history or connection to substance abuse or addiction
  2. People who have had a prior history of substance abuse and are in a current state of abstinence
  3. People currently abusing or misusing other mind altering or addictive substances, including opiates
  4. People whose iatrogenic dependence on benzos was a contributing factor to them evolving into to abuse patterns with other substances such as alcohol, or a relapse back into addiction with a past “drug of choice,” and lastly
  5. People whose prescriptive use of benzos evolved into some type of abusive or addictive pattern with benzos, singularly, or with other categories of drugs.

As one can see from this breakdown, all those people included in groupings 2) thru 5) may have elements of both “iatrogenic benzo dependence” AND “addiction” in their life experience. This makes it obvious that there is NOT an impenetrable wall between these two concepts, nor could there be in a world where more and more people are polysubstance users and quite often, polysubstance abusers where the reality of “addiction” comes into play. Due to their powerful synergistic effects with other substances, benzos are an extremely popular option for many poly-drug users and many people acquire them through legal prescriptions. When looking at all opiate drug users (prescribed or not) at least 60% also use benzos, either daily or on a regular basis. Unfortunately it is very common for people receiving synthetic opiates, such as methadone and suboxone, to also have concurrent prescriptions for benzodiazepines.

While I have not attempted to actually define “addiction” in this context, let’s just say that leaving aside the common characteristics of physical dependence and tolerance, most people who identify as “addicts” will highlight all the “mind games” connected to the description of their addictive behaviors. They will often describe in great detail the duality of feeling like they are of “two minds”; one that wants to stop the use of a substance due to an excessive amount of negative consequences, and the other that wants to keep the substance in their life despite all the identified problems. Here we are talking about behaviors and thoughts that go well beyond simply following a doctor’s prescribing recommendations. Benzos are just one of several categories of drugs where people end up engaged in a serious form of cognitive dissonance about their choice to use certain mind altering substances given all the risks and benefits associated with their use.

This reality leads us to conclude that there are TWO main reasons why people include the use of addiction language to describe their relationship with benzodiazepine drugs. One reason would be the influence of certain cultural prejudices and the related long history of medical confusion and ignorance about terms such as “physical dependence” and “addiction.” J. Doe and others have correctly focused on this problem and brought greater clarity and understanding attempting to overcome these medical disparities and set forth a new scientific standard.

The OTHER important reason for people using addiction language to describe their connection to benzodiazepine drugs is the fact that these drugs CAN BE, AND ARE, in some people’s real world experience, ADDICTIVE. This is why people on internet benzo forums feel compelled to discuss issues of addiction and recovery connected to benzos, even when they might sometimes misuse certain word terminology out of the confusion referred to above. For those people who ONLY want to focus on the issue of iatrogenic benzo dependence, this truth about benzos’ connection to addiction may be uncomfortable and inconvenient. However, it is critically important to acknowledge this truth and accommodate and support this other sector of the community harmed by benzos and attempt to find ways to build unity of understanding and purpose while engaging in principled dialogue.

Yes, we know that it can be terribly invalidating to label and treat a person as a “drug addict” that is only physically dependent on benzos and taking these drugs exactly as prescribed by a doctor. And yes, this frequently leads doctors to force rapid tapering protocols on vulnerable patients with no addiction history. However, it can be equally as invalidating to deny that “iatrogenic benzo dependence” intersects in multiple ways within the lives of many people struggling with “addiction;” people who will ALSO SUFFER when yanked off of their benzos or forced into similar rapid tapers when a doctor becomes aware of their addiction history. Is there not aspects of adding “insult to injury” to promote a view that people with addiction problems should be subjected to “distancing” or somehow be separated off from other benzo victim/survivors because they may have made past unhealthy choices in their lives?

To further illustrate specific examples of some disappointing secondary arguments presented by J. Doe in “Don’t Harm Us Twice, Part 2, we need to critically examine the following quotes:

J. Doe stated: “People taking benzodiazepines as directed by their providers do not identify with being addicts.”

Counterpoint: This statement ignores the fact that some people who suffer from iatrogenic benzo dependence ALSO identify with being “addicts” because of current or past problems with addiction. These people may have taken their benzodiazepines exactly as prescribed by a doctor, but also have a history (or current pattern) of addiction with other substances. They may have, at times, also used benzos as a separate (or additional) drug in addictive or abusive ways.

J. Doe stated: “How do we stop using the word “addiction” in relation to cases of iatrogenic benzodiazepine dependence?

Counterpoint: We do not have to stop using the word “addiction” in every situation, nor should we.

Yes, we need to identify those people who only have iatrogenic benzo dependence and NOT call them (or treat them) as “addicts” for all the reasons J. Doe has posited. However, the word “addiction” DOES apply to many people who also suffer from iatrogenic benzo dependence and they must be understood and supported as well. In fact, their particular medical cases are often far more complicated because of their addiction history, and they are much more likely to suffer from too rapid tapering protocols (or a total cut off) once a doctor becomes aware that some type of addiction has been involved in their lives with either benzos or some other drug. For these patients this will also cause great harm by worsening withdrawal syndromes and creating conditions for possible dangerous patterns of addiction relapse. While there are many services offered in our society for people with addiction problems, due to the dominance of Disease-based theory and practice that guides most treatment in detoxes and rehab centers, these programs are sorely lacking in quality, and their success rate mirrors these shortcomings.

In order to stop any group of patients from being incorrectly labeled an “addict” due to physical dependency on benzos, we need to challenge the hegemony of the Disease-based theories of addiction and the related dominance of 12-Step Philosophy that controls (90%) of all addiction treatment in this country and pervades the outlook of the medical establishment. We need to sharply pose the following question to those people caught up in Disease-based thinking: Name another “disease” in which a “decision” can lead to the end of all the related “symptoms.” We cannot “decide” to end cancer or diabetes, but we can decide to end an addictive behavior, even if these decisions are, by nature, very difficult and complex.

We need to respect the fact that 12-Step Programs DO work for some people, though for nowhere near as many as touted (see discussion at The Fix, regarding Dr. Lance Dodes’ new book, The Sober Truth (2014)). However, at the same it may be necessary to criticize 12-Step Program zealots (or doctors) who repeat ad nauseam “a drug is a drug is a drug…” and promote the view that everyone, addiction history or not, may be “a single drink or drug away from an addiction or relapse,” or that physical dependence equals addiction.

People who participate in 12-Step Programs are not an impervious monolith. There are widely divergent views within these recovery groups, and this includes some people who openly criticize aspects of the Disease Concept of Addiction and the more rigid “single blueprint” approaches to recovery. For these more open minded AA/NA attendees, their lives more closely embody the philosophy in the oft repeated cliché that makes perfect sense in these situations, “take what you need and leave the rest.” The growth over the past few decades of important alternatives to 12-Step Programs such as Rational Recovery, Women for Sobriety, and Smart Recovery etc. reveals a very unsettling reality facing people with addiction problems in our society; that is, the current Medical Model has no viable or highly successful solutions for their life’s dilemma.

Yes, it is understandable that some people in the benzo community might want to subjectively distance themselves from 12-Step Program rigidity and dogmatism that often promotes ignorance and attempts to paint everyone into an addiction box. The worst of the commonly repeated clichés such as “shut up and get stupid” or “your best thinking got you here” or “Addiction is the disease and AA/NA is the medicine; if you don’t take your medicine you are destine to relapse” are indeed difficult to hear repeated over and over again. This is especially true if you have no addiction issues present in your life.

Not all people with addiction problems are hopelessly under the sway of these forms of rigid 12-Step thinking. We must somehow resist any tendency to deny reality or invalidate other people’s addiction experience with benzos in order to justify a subjective need for distance from that which makes us uncomfortable. To bring clarity and scholarship to all the scientific issues related to “iatrogenic dependence” and “addiction” we (out of necessity) must dissect and deconstruct the Medical Model and the Disease-based thinking that permeates the entire addiction and “mental health” industry. When we do this in a comprehensive and challenging way we can raise principled struggle with those people negatively influenced by the Medical Model while still EMBRACING ALL people harmed by iatrogenic benzo dependence, INCLUDING those with addiction problems. 

J. Doe stated: “My argument has always been that anyone speaking out about benzo dependence and withdrawal carries a responsibility to honor and appropriately represent the people affected.”

Counterpoint: Yes, yes, yes, I would hope that everyone would follow the “High Road” implied by this statement. This must include understanding and honoring the experiences of people who suffer from iatrogenic benzo dependence AND have additional issues of addictive type behaviors and/or thoughts interwoven within the fabric of their lives.

J. Doe stated: “Just as it is intolerable to turn rape victims into the accused, it is also wrong to treat iatrogenic benzo sufferers as if they deserve their suffering by using terminology that implies that they brought it on themselves.”

Counterpoint: While I believe J. Doe and the others advocating for their position have no intentions to demean or stigmatize the addiction community (and they have even stated this desire), this was a poor choice of analogy in multiple ways, and it unfortunately ends up contradicting their good intentions.

Nobody in the benzo victim/survivor community (including those with addiction issues) “deserves their suffering.” nor does the statement “brought it on themselves” accurately describe people’s common path to addiction. Nobody really chooses to become an “addict.” Addiction is usually a process that creeps up on a person slowly until one day they realize the drug (or behavior) “controls them more than they control it.” Now they may find themselves stuck in a pattern of self-destructive or self-defeating behaviors that “cause more harm than good.” Perhaps, formerly successful coping mechanisms have now evolve into a pattern of behavior that has become so habitual that it is very difficult to stop despite the awareness that the negative consequences outweigh the benefits. Once a person becomes more aware of this reality, “recovery” then becomes an optional “choice” in their life, and may soon evolve into an actual “event.”

“Bridging the Benzo Divide,” and the Road Forward

On one level, when considering all the cultural prejudices against people with addictions, it is understandable how some strictly benzo dependent people might arrive at some of their conclusions about the need for distance from all things addiction related. This is especially true when these prejudices influence the actions of doctors who often treat them with disdain or force all too rapid tapering protocols on them. However, given the powerful forces in society who benefit from using psychiatric labels and also from the sale of massive amounts of psychiatric drugs, it is highly unlikely that a more narrow strategy of “going it alone” will be listened to or achieve the desired goals for those duly harmed. This is aside from the fact that this path can have the unfortunate effect of marginalizing or, perhaps even, invalidating the life experiences of another sector of the benzo victim/survivor community who face additional addiction problems.

Seeking another path towards “Bridging the Benzo Divide” has the potential of uniting all sectors of the people and their families harmed by benzodiazepine drugs. We must face the reality that we live in a very powerful and entrenched profit based system that has given rise to the current Medical Model. This model includes Biological Psychiatry’s Disease-based dominance and control over an omnipotent “mental health” system and almost all forms of addiction “treatment.” It is in this context that the current benzo crisis has arisen and caused so much damage. When looking at class, race, or gender divisions within our society, this profit based system and the powerful institutions that control it, have a thousand and one ways of creating divisions among the oppressed and exploiting those differences. When looking at the benzo victim/survivor community we must find ways to avoid allowing ANY unnecessary divisions or separations to take place among the ranks of those harmed by these drugs.

Given that the benzodiazepine crisis emerged from within Big Pharma, Psychiatry, and organized medicine, it is important that many doctors step forward and acknowledge the enormity of this problem and become active in being part of the solution. There is a desperate need for doctors who have the compassion and courage to take the necessary risks involved with helping patients deal with protracted withdrawal and the tapering complexities connected with benzos. This includes being willing to work with those patients whose cases are more complicated by having additional addiction related issues in their life.

Taking on all aspects of the benzodiazepine crisis, from its broadest and most inclusive perspective, will have the greatest potential to advance the cause of this very important human rights struggle. An overall strategic approach that recognizes the commonalities of life experience and attempts to “unite all who can be united” has a far better chance of achieving our goals related to obtaining safer medical care and ultimately ending all the ways benzodiazepines harm people, in this country and around the world.

* * * * *

(more related articles below the references)

References:

American Academy of Pain Medicine press release March 6, 2014, Stanford University researchers (Ming-Chi Kao) warn: Prescriptions for Benzodiazepines Rising and Risky When Combined with Opioid

Ashton, Dr. Heather; Ashton Manual (Benzodiazepines: How They Work And How To Withdraw, 2002) and Drugs and Dependence (2002), available at Benzo.org.UK

Benzo.org.UK; Benzodiazepine Dependence and Withdrawal; Frequently Asked Questions (FAQ file #38)

Breggin, Dr. Peter; Toxic Psychiatry: Why therapy, empathy, and love must replace drugs, electroshock, and biochemical theories of the “new psychiatry”, 1991

Dodes, Dr. Lance; The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry, 2014

Doe, J; Don’t Harm Them Twice: When Language Surrounding Benzodiazepines Adds Insult to Injury, Part 1; and Don’t Harm Them Twice: What Can Be Done, Part 2, Mad in America blog, 2015

Fiore, Kristina; Killing Pain: Xanax Tops the Charts; MedPage Today; Feb. 25, 2014.

Hickey PhD, Philip; Benzodiazepines: Miracle Drugs; at Behaviorism and Mental Health.com

Jann, M; Kennedy, WK; Lopez, G; Benzodiazepines: a major component in unintentional prescription drug overdoses with opioid analgesics; J Pharm Pract.; Feb. 27, 2014.

Jones, Jermaine D.; Mogali, Shanthi; and Cormier; Sandra D.; Polydrug abuse: a review of opioid and benzodiazepine combination use; Drug Alcohol Depend.; 2012, Sept. 1; 125(1-2); 8-16.

Jones et al; Pharmaceutical Overdose Deaths, United States, 2010; Journal of the American Medical Association (JAMA)2013; 309:657-9.

Ornstein, Charles; Jones, Ryann Grochowski; One Nation Under Sedation: Medicare Paid for 40 Million Tranquilizer Prescriptions in 2013; Propublica.org; June 10, 2015

Skepticalscapel blogspot.com, Pain is Not the 5th Vital Sign; Aug 29, 2014

Whitaker, Robert; Cosgrove, Lisa; Psychiatry Under the Influence: Institutional Corruption, Social Injury, and Prescriptions for Reform; 2015

Addiction, Biological Psychiatry and the Disease Model: Richard D. Lewis, MEd, has worked with addictions for the past 19 years in New Bedford, MA. Richard discusses the relationship of addictions to severe psychological distress often labeled as a “disease” and/or a so-called “mental illness”.

More related from Beyond Meds (where the term addiction is often used as nomenclature for social commentary and not specifically about any drug user whether legal or illegal. The argument is that our culture is one of over-consumption and addiction in general, thereby affecting everyone regardless of whether one ingests any specific drugs at all. It’s a wider commentary that focuses on inclusion. That doesn’t mean that differences aren’t also a legitimate window some of the time it’s simply not what is being considered for the scope of this work):

Returning to Dialogue – The Core of Healing Madness

By Ron Unger

When people are “mad,” they are often insisting that certain things are so, and frequently seem unwilling or incapable of appreciating or learning from other perspectives.  Yet when the supposedly “sane” mental health system approaches those who are mad, it typically does the same thing – it insists that its own view of what’s going on is correct, and seems incapable of appreciating or learning from others, whether they be the patient, the family, former users of services, or anyone who understands madness in a different way.

So what’s going on with that?

One way of understanding it is to reflect on the very human tendency to narrow one’s perspective when feeling threatened.  When people feel threatened, they tend to narrow their focus down to what they believe may avert the threat, and to shut out other perspectives that seem “wrong,” or that could lead to doom.

That works fine when the threat is relatively straightforward, and a solution can be arrived at which reduces the sense of threat.

But what about when it can’t?

When individuals are facing situations where there seems to be a dire need to solve a problem, yet no solution nor path toward such a solution is apparent, the person naturally enters into a state of conflict.  On the one hand there is above mentioned drive to narrow attention in response to the threat, but on the other hand, there is a drive to expand awareness and experiment with unusual ways of looking at things, so as to possibly find a pathway to a solution that otherwise appears impossible.

It may be that it is the collision between the two tendencies, the narrowing of attention to focus on threat, contrasting and conflicting with the expansion of awareness while seeking to control what otherwise appears uncontrollable, that is responsible for the wild states we call psychosis, or madness.

So we see people who seem creative in some ways, often coming up with very imaginative interpretations of reality, yet who also seem very unimaginative and closed minded when it comes to seeing any down side in their point of view or being able to follow how and why others see things differently, or seeing how to negotiate in a world where others do see things so differently.

Those who are “mad” can then seem difficult to communicate with – their attention seems narrowed and entrenched in their point of view.  We might say they are stuck in “monological thinking” and have difficulty with dialogue, with really appreciating and reflecting on the views of others and learning from them.

Unfortunately, these difficulties can be so intense that those around the “mad” person typically enter into their own kind of threat response, and narrow their own attention, and become stuck in their own “monological thinking” in an attempt to cope.

In the monologue of the traditional mental health system, a “solution” for the problem of madness is outlined.  The mad person is simply experiencing an illness, one that has a name and a clear treatment plan, organized around attempts to suppress that “illness.”

The great thing about having this sense of a “clear path forward” is that it helps professionals and those around the mad person not feel mad themselves.  That is, rather than feel there is a problem that urgently needs solved yet for which there is no identified path forward (the bind that could lead to madness), it is now possible to feel there definitely is a path forward – just narrow down one’s thinking and doing to the medical style approach, and no doubt or further reflection or inner conflict is required!

But now we really have two clashing and very imperfect monologues – that of the “mad “person, and that of the mental health system and those persuaded by it.  And what happens when two fixed views confront each other?  Research shows the tendency is for people who feel confronted to dig in and get more entrenched in their views – and the possibility of dialogue, of reaching across the divide, and of healing, becomes more remote.

But fortunately, there are better approaches!  They are less simple, and involve deliberately accepting uncertainty, and taking some risks, while also attending to safety concerns.  These methods emphasize dialogue, and fight back against that tendency for narrow thinking in response to threat.  Instead they embody a wisdom that recognizes we all best face complex issues when we are willing to be wide and open enough to hear all the voices, and that “sanity” is most likely to emerge through this sort of dialogical process, when it takes place not just within the “mad” person but also within the social network and treatment team.

The Hearing Voices Network makes really important strides in this direction – emphasizing for example changing relationships with voices rather than defining them as illness or suppressing them.  There are now some forms of psychological therapy for “psychosis,” such as the style of CBT for psychosis that I teach (online as well as live) which emphasize relating in a dialogical way.  But it is Open Dialogue, and the dialogical practices it has inspired, which have uniquely framed mental health work as being fundamentally about encouraging dialogue, and which often achieve amazing results just by aiming to support dialogue on all levels.

I’m inspired to write about this now because I’m publicizing an “online meeting” or webinar with Mary Olson, titled “Introduction to Dialogic Practice.”  This could be a great opportunity for some of you to hear “live” from one of the experts in the field about how these practices work, and to get some of your questions answered.

This online meeting happens on Friday 3/25/16, noon EDT.  Here’s more details, and the registration link:

Dialogic Practice emphasizes listening and responding to the whole person in a context – rather than simply treating his or her symptoms. In psychiatric settings, this is accomplished primarily through a treatment meeting, or Open DialogueArising from the influence of the philosophical writings of Mikhail Bakhtin on systemic family therapy, Dialogic Practice can also be effectively applied to more ordinary couple, group, and family therapy, as well as community work in schools.

This conversation, or dialogue, is not “about” the person, but is instead a way of “being with” the person and living through the situation together. Referred to as “Withness Practices” by Tom Anderson, M.D., this process mitigates the sense of isolation and distance that a crisis can produce and gives the person at the center of the dialogue greater voice and agency. Ultimately, this allows them to participate more meaningfully in both the conversation and the resulting decisions about their own lives.

After eliciting the person’s point of view at the meeting outset, there is typically a back-and-forth exchange between this person and the therapists both to develop a more lucid way of expressing the situation and to create a shared language.  The voice of each participant is then woven into this conversation to create a new fabric of meaning and engagement to which everyone contributes.

In this online meeting, Mary Olson will help us understand more about what Dialogic Practice is and isn’t, what it requires, and what it looks like in action.  (Those interested in learning Dialogic Practice in some depth might consider attending the Introductory Intensive in Dialogic Practice which happens May 25-29 in NYC.)

Mary Olson, PhD is an internationally-recognized leader in the development of Dialogic Practice.  She is the founder of the Institute for Dialogic Practice in Haydenville, MA and is a faculty member of both UMass Medical School and the Smith College School for Social Work.  She has written numerous articles and book chapters on Dialogic Practice, including “The Key Elements of Dialogic Practice in Open Dialogue” (2014, with Jaakko Seikkula & Doug Ziedonis), and maintains a private practice in Western Massachusetts.

ISPS-US online meetings are free to ISPS members, with a donation of $5-$20 requested from others, though no one turned away for lack of funds. Please do register if you want to attend!

These meetings are recorded and shared on the ISPS website for later viewing.

Use this link to register:  I hope to see some of you there!

ronRon Unger is a therapist and educator specializing in cognitive therapy for psychosis, Ron Unger explores emerging understandings of psychosis and of efforts to change mental health treatment to support human rights and full recovery. Visit his blog here: Recovery From Schizophrenia and Other Psychotic Disorders

More about Open Dialogue, here on Beyond Meds.

More on MADNESS

Healing isn’t a choice for me — it’s an imperative; my body is in charge

sharing some thoughts on topic that have been shared on social media in the last week…these are various musings posted in different places that have been strung together for this post: 

Discovering Chinese and Ayurvedic medicine (the theory, not necessarily as practiced by folks who don’t get it DEEPLY) has allowed me to realize I was trying to reinvent the wheel. It’s all there already…it just all goes by different names and perspectives. I am beyond happy. These systems know what healing is truly about and that extends to just about all conditions. Anyway, I know this won’t mean anything to anyone unless one is resonant, like right now, because it sure as hell didn’t mean anything to me for far too long.

Healing is not always curing. People need to understand that. In the end these bodies die. So don’t misunderstand when I say they know how to heal everything. Healing is not the same as curing.  What is nice about profound healing, however, is that transformation of body/mind and spirit is possible in ways that most western modern human beings aren’t even aware of.

Books for further understanding:

This is the one I’m working with that’s helping with pragmatic, in the moment help, with healing. It’s like an encyclopedia and I look particulars up and then am inspired to integrate the information into my process: Healing With Whole Foods: Asian Traditions and Modern Nutrition. Two posts in which I talk about my experience are here and here.

To be clear:  I’ve been harmed by these sorts of practitioners too. Those who didn’t understand the nature of the psychiatric drug iatrogenic injury…or, more significantly, didn’t understand what Chinese and Ayurvedic medicine both are pointing too profoundly enough. Understanding the foundational aspects of being this human animal is what they achieve at their best…not everyone knows how to translate that to all particular individuals. So this isn’t a blanket suggestion to go out and see any Chinese or Ayurvedic practitioner. And I, in fact, am learning this theory to apply to my own life. It’s a process and doesn’t happen overnight. For me it’s involved a decade of carefully observing my healing process. Mindfulness is of utmost importance in this process. I simply consider it paying attention or the process of learning to observe that which is going on around us and in us.

***

From this perspective it doesn’t matter how our bodies are out of balance and thus became very ill, the general theories works in any case…both Chinese and Ayurveda are totally holistic and we (the iatrogenically drug injured) do fit into the whole picture. As much as it feels like we’re beyond the fringe (because in some ways we are). Anyway, that’s why I can work with the information that  both schools of thought supply…And Paul Pitchford the author of Healing With Whole Foods gets it because he can see that my body is simply grossly out of whack…from the drugs, yes…but that again, is secondary to it simply being grossly out of whack…and human bodies get out of whack on a foundational level in certain consistent ways (with lots of variables, of course, for the individual).

Balancing is balancing, healing is healing…you do what you can at any given moment during the healing process and move forward from there…

***

everything is on a continuum and spectrum so believe it or not, our radical experience is too.

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one moment at a time…a day is far too long

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butterfly on the butterfly bush by Monica CassaniThe stuff I’ve been reading in Healing with Whole Foods ties together almost a decade of what I’ve been observing in my body…it gives me a brand new vocabulary as well which is wonderful and it offers suggestions for continued and deeper healing that I can actually benefit from…because I’m already deep in a similar process of understanding and healing. No one has been able to give me effective or safe suggestions since the beginning of this. So that’s new and really wonderful.

What I’m learning is how to utilize these theories to heal myself…I still don’t expect anyone else to do the job at this point, though it’s always nice when we can find folks who can understand and help us in deeply meaningful ways and at this point that happens far more often than it used to because the more I understand the easier it is to discern who can truly be helpful and avoid those who would be harmful.

By the way, I’ve stopped thinking in terms of mast cell dysregulation and histamine intolerance. The foundational issues go deeper. I actually mention that in the previous post I wrote about this book … it’s been liberating and led me to bigger healing to do that. Certainly it’s not a necessary departure but I found that hanging out with a diagnosis for which people don’t expect recovery is not helpful to me. That said, at one time the histamine framework was a critically important part of my undertstanding and healing journey. 

***

When we are healing from long-term chronic serious illnesses, including protracted psychiatric drug withdrawal syndromes, some misery is to be expected. It has become clear to me that accepting this reality as much as possible rather than fighting it is the preferable way to move through what is undeniably and unavoidably a very difficult process much of the time. Hence practicing surrender also becomes very helpful.

Video: 6 yrs psych drug free: How I made it through the darkest times of protracted withdrawal syndrome

For a multitude of ideas about how to create a life filled with safe alternatives to psychiatric drugs visit the drop-down menus at the top of this page. 

Support Beyond Meds. Enter Amazon via a link from this blog and do the shopping you’d be doing anyway. No need to purchase the book the link takes you to or make a donation with PayPal. Thank you!

 

Food and diet for profound healing

All dogma is fear. One might even say all belief is fear. Belief and dogma are different shades of the same color. – travel lightly through the beliefs of others…all that written on this site too….feel free to discard whatever you pick up as soon as it is no longer helpful. 

Food and diet and the direction I’m headed in.

I didn’t choose it in any conscious manner…the path chose me by necessity. Healing this particular heinously injured body required this particular sort of consciousness…I love Paul Pitchford’s work…he articulates everything my body/mind has been learning over the years and supplies answers to numerous outstanding questions. This is a little excerpt from his brilliant, seminal, encyclopedic book.

This is where mindfulness with food leads to eventually…with consciousness and practice.

FOOD

From Healing With Whole Foods: Asian Traditions and Modern Nutrition

I love that implicit in what he says is that it’s ONE path…a path as good as any other to achieve wholeness and wellbeing. That means there is no reason to insist it’s everyone’s path. I’m clear that there are as many paths as there are people. This is my path. And many other “vehicles” also inform my path.

As my subtitle now states, everything matters. Food too. And it’s a window into the whole if we want it to be.  see: Nature vs nurture, biological vs. psychological: how about both/and rather than either/or

See more on this book from my post: Heal with whole foods: transform body/mind/spirit. Heal drug damage too

Eating wholesome whole real food is important for body/mind/spirit health and well-being. I’ve written a lot about my adventure with diet and healing here:  Nutrition and gut health, Mental health and diet

And you can find more Foodie posts and recipes here. 

More: Diet and nutrition here

For a multitude of ideas about how to create a life filled with safe alternatives to psychiatric drugs visit the drop-down menus at the top of this page. 

 

Support Everything Matters: Beyond Meds. Make a donation with PayPal or Enter Amazon via a link from this blog and do the shopping you’d be doing anyway. No need to purchase the book the link takes you to. Thank you!

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