Mad Spiritual musings on diversity and inclusivity

I can disagree with your opinion… but I can’t disagree with your experience. Once I have a sense of your experience, you and I are in relationship. – Krista Tippett

I’ve been working on a project with Chris Cole and Ian Scheffel. We want to create community and support for all of us who’ve experienced madness as having significant spiritual significance. Whether we’ve been psychiatrized or not and whether we’ve considered madness in terms of the psychiatric labeling or not. That would include anyone labeled with psychosis, schizophrenia, bipolar, schizoaffective, or psychotic NOS. That would also include anyone who has had experience with altered states that have not been pathologized by psychiatry, by self or others. Perhaps by naturally delving deep in meditation or with the aid of psychedelic drugs or practices like holotropic breathing. Basically anyone who has experienced altered states and resonates with what we are doing are welcome.

Did your altered states have spiritual significance or might you be interested in considering how that lens might be applied? Then you’re welcome.  sign up on our email list that we might commune together.

So – I’ve been thinking a lot about how we’re going to bring radically different perspectives and experiences from the mental health worlds and beyond together for our project Mad Spiritual.  Here are some of my musings.

Mad Spiritual Collective is a community organized around the intersection of mental health and awakening. The principles of mutual recovery and decentralized authority are central to our mission. Our primary focus is to offer online courses that support recovery, healing and becoming awake. We welcome your involvement!

We’re all just walking each other home.
— Ram Dass

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Past work that deals with inclusivity and diversity in mental health on this site:

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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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Beyond withdrawal…

This is a repost from 2015

This is a rework of some of my previous work for a small publication. It will be mostly familiar to long-time readers. I’m republishing here now since it’s somewhat different from previous pieces I’ve written. It’s also additionally edited for this posting.

After approximately two decades on psych meds I came off a six drug cocktail in about six years. This proved to be a gargantuan task and left me gravely disabled.

I see in retrospect that some core, vital part of me was always there during the drugged years, learning and remembering much that would help me in these years of coming off meds and now being med free. I no longer believe that I “lost” my life to drugs. This is, as Mary Oliver, puts it, my “one wild and precious life.”

Yes, this is it and so I celebrate it. I do think that it’s sad that I could not be more conscious during those years and that my body became toxic, polluted and chronically, painfully ill; and this is why I help others learn to avoid what happened to me. I’m highly motivated to help others avoid extreme suffering and so my experience is not lost; in fact it was stored in my body to be processed when I got free of drugs. This is what trauma does. The body keeps the score. It’s all there and really cannot be lost. This is one of the many ways that psych drugs act additionally as agents of trauma.  Part of the healing process, for me, and clearly many others who’ve been on psych meds and come off, is one of working through layers and layers of trauma — that which was incurred prior to psych drug use as well as that which is incurred as a result of psych drug use and exposure to the dehumanizing psychiatric system. I have done this mostly through self-enquiry, meditation, yoga and ecstatic dance. Trauma becomes embodied. Embodied practices have proven very important for me.

Nothing to do but feel, feel, feel…such is the peeling and healing of the trauma onion…

It is a job of sorts, to do this unpeeling, and we do it as much for ourselves as we do it for each other. This is a community effort of healing happening among everyone brave enough to face the pain of our lifetimes. This is the work of being human.

As many readers know, the process of drug withdrawal made me much sicker before I began to find wellness. I was one of thousands of people who develop serious protracted withdrawal issues that lead to grave disability. Still, I have not had 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 cry in contemplation. My clarity was stolen from me for almost half my life. I have it back and even while gravely impaired I was grateful for that.

 

My healing journey has entailed learning about our deeply holistic natures as human beings. EVERYTHING matters. The body you were born with. The body you have today. Your relationships with others and the planet, the food you eat, and the air you breath…. how often you move your body and the thoughts you nurture in your mind and soul.

That is what understanding ourselves as holistic beings entails. Understanding our relationship to EVERYTHING in our environment, and our bodies, what we’re born with and also social and political phenomena and then how it’s all connected.  We are all of it. Embodied.

So, by that slow and painstaking, but ultimately joyous process of coming to understand how everything matters, I’ve been healing and bringing back well-being to this body/mind/spirit.

We need each other in this process. Building non-coercive healing community is the most important thing to me these days. Community comes in many different guises and does not require giving up your autonomy and self-determination. Psychiatry and the mental illness establishment often steals both. I envision a world where people are empowered to make the choices that work for them in the context of their lives. Everyone’s path is going to be different. Respecting and celebrating that great diversity is key.

Below is a collection of links which contain many links to reconsider and reframe our experiences that otherwise get labeled mentally ill so that we might heal and transform and thrive.

See also

Understanding and Working With Psychosis (Part II of II)

by Joel Schwartz, PsyD

Note: Presented cases are composites of various individuals, with significant details changed to maintain confidentiality.

In Part I of this series, we looked at contributions to the understanding of psychosis from a humanistic and psychoanalytic perspective. In summary, psychosis was conceptualized as an extreme version of two normal processes that lead to human bonding and psychological growth:

1. Reification of complex and often horrific and chaotic feelings into comprehensible delusions and hallucinations, and

2. An Anti-Learning drive within the psyche responsible for making room for new learning; the breakdown of associative links can be seen in thought disorder of psychotic individuals, but also represents a severing of empathetic and relational links.

Within this conceptualization, we also brought up Carl Jung’s idea of Metanoia – that psychosis is a breakdown of the mind in order to re-emerge in a more functional manner, much like a Phoenix being reborn from flames.

The outcome of viewing psychosis from this perspective is that conditions like schizophrenia are not a process of disease, but a process of severing and re-growth. Indeed, cultures around the world that do not rely on modern conceptualizations and over-use of medications show much better quality of life and recovery – yes recovery! – of people with psychotic conditions.

So how does one treat psychosis from a humanistic perspective? What does the above theory suggest as a manner of concrete interventions?

First and foremost, if psychosis is indeed a process of growth and reorganization following an initial breakdown, then the primary task of the therapist is not to cure or prevent the psychosis in the person, but accompany them through their transition into something else. Accompanying means creating an environment of warmth and acceptance regardless of the anger, rage, and hatred often being expressed by the psychotic person. It can be important to temper one’s warmth somewhat, as too many emotions from the therapist can be experienced as overwhelming by the psychotic person. With more severe clients, this may take the form of parallel play. Drawing, singing, writing, praying along side them. This initial process can take months.

When psychotic individuals are met with skepticism or fear, or when well-meaning therapists insist on psychotic individuals returning to rational reality, or when family members express hostility at the psychotic individual’s strange perceptions and thoughts, it almost guarantees that the person will retreat farther into their psychosis, or worse, try to harm self or others.(most of the time to self – it is a stigmatizing myth the psychotic people are dangerous) Almost any therapist who has directly challenged a delusion has been met with rage, suicidality, withdrawal, or the client lying that they are no longer delusional.

So the first step in working with the psychotic individual is to get to know the person’s psychosis – begin to understand the person’s reifications. There is ALWAYS method to the madness. Often, reifications are emotionally similar to personally experienced traumas, the legacy of cultural or generational traumas, and/or intense emotionality felt on the non-verbal level. An example of the latter: A client who grew up with a father who intensely hated him. The father would try to do fatherly things and be there for the family, but was constantly pouring unacknowledged and unexpressed hatred into the family system. This emotional turmoil was felt by the sensitive child growing up. And as a young Jewish man, he began to hallucinate Nazis from which he had to protect other family members. Interestingly, he never had to protect his father from the Nazi hallucinations; they were a reification of the father’s hatred.

Instead of trying to convince this client that the Nazis were his imagination, we got to know the soldiers. I validated the horror of living Nazis. We put faces and names to the soldiers, did research into World War II, and expressed rage at racial hatred that exists in the world in myriad ways. Eventually, through this and family therapy, the hallucinations stopped and now the client dreams of being a civil rights attorney.

A key aspect in working with reifications is to pay attention to the emotional content of the hallucinations and delusions, instead of the actual content. It is very much like doing dream work. Sometimes clues can be found by developing an understanding of what stressors trigger a flight into psychosis. Is it abandonment? Assault? Racism? Next, it is important to validate the reality of the emotional experience, even in the psychotic person pushes back (remember, Anti-Learning often takes the form of breaking relational links too).

Another key to this is to not be frightened of the client’s subjective world. It is always easier to journey into the underworld and lead someone out than try to pull someone out from above. It takes the ability to hold two realities at once.

Once trust has been established, one can begin to build bridges between the psychotic reality and reality generally understood by non-psychotic individuals. This takes a lot of care and finesse, as the moment the therapist betrays skepticism is the moment the client withdraws. I had another client who was a victim of incest and would begin to see demons and conspiracies whenever a male would grandstand to her. I would say something to the effect of “There really are monsters everywhere in the world. It is so frightening. You’ve been fighting monsters since you were a child in that house.” In this way, I am linking the client’s trauma and intense emotions directly to the psychosis, hopefully creating a little wiggle room in the rigid reification.

Another example: A severely neglected client who developed the delusion that a famous actor was in love with them – “It must feel so good to be adored like that. Given what your parents put you through, you could use all the love you can get!”

More often than not, these bridges will be burned right away. Even the most empathetic statement will be met with denials of the empathy and flat out ignoring the link to non-psychotic reality. But a seed will have been planted, and scaffolding will have been built. Every time I’ve done this, the idea has re-emerged, sometimes months later as if it is an original thought of the client’s.

Another way to help with re-learning is through gentle interpretations that make complex emotions more manageable. An example frequently cited by a friend and mentor, Brent Potter, is “sometimes love and hate go together.” This gentle interpretation links a chaotic emotional experience into something shared and comprehensible.

Above all trust your clients. Recognize that they are going through something meaningful, shedding old selves that no longer work in order to make room for the new. Accompanying clients through psychosis is harrowing, but highly rewarding work.

More related: Healing psychosis: stories, information and resources

joel Joel Schwartz, PsyD treats people, not disorders. He aims to re-humanize the mental health profession. He says, “I treat people, not isolated symptom patterns or disorders. All symptoms occur in the unique context of a person’s history, temperament, experiences, and capabilities. I am a warm and compassionate therapist that goes the extra distance to sit with and humanize what others may be afraid of or view as not in the “norm.” I help people who desire to really know themselves, to understand their thoughts, feelings, and behaviors in order to make the life that is best for them. My orientation is primarily relational psychoanalytic psychotherapy, but I have a firm grounding in cognitive behavioral techniques and borrow from humanistic and existential traditions. I am a sex-positive, pro LGBT therapist in the South Bay of Southern CA.” see profile here

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:

And visit these pages too:

*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. 

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

Thirty Months Off – Renée is drug free and getting healthier everyday

By Renée Schuls-Jacobson

It’s been thirty months since I took my last bit of Klonopin, a dangerously addictive medication that a doctor prescribed for me when I was suffered from insomnia.

Thirty months since my world flipped upside down.

As you’ll recall, back in August 2013, I began to experience extreme withdrawal symptoms after a 1-year controlled taper, despite the fact that my wean was (mostly) supervised by a medical professional. At that time, I suffered from thousands of side effects, too numerous to list here. Unable feed myself, I couldn’t watch television, speak on the telephone, get on the computer, read a book or listen to the radio. I lived in solitary confinement, too sick to leave the house. I suffered irrational fears and believed people were trying to kill me. And I endured a depression so crushing that I considered killing myself multiple times. (You can read more about this horror, HERE.)

The few people who came to visit me can attest to the fact that I was truly a wreck. Unable to eat, I lost 30 pounds. I shook and rocked and paced and cried all day long. And it never got better. Not for one moment.

Until the symptoms slowly started to disappear.

So where am I now?

I’ve made major life changes so that I can focus on healing. Eliminating toxic people from my life has helped a lot. I get a weekly massage, which helps me heal in ways that I can’t even begin to describe. My body had been deprived on physical touch for so long, and my massage therapist’s hands always know just where to go and just what to do.

I’m working again, back at the local community college, in a part time capacity. I’m taking on more free-lance editing work. I’m selling my paintings. I’m exercising and meditating regularly, making sure to take time out to relax when I feel that I’ve been doing too much. I’m getting out socially and enjoying people again.

Amazingly, I no longer suffer from debilitating muscle spasms or brain zaps. In fact, most of my physical symptoms have disappeared. Symptoms that continue to linger include a constant burning sensation in my mouth where I feel like my mouth and tongue are on fire. Sometimes, this is coupled with the sensation that my teeth are loose in my mouth. I still struggle with insomnia. Benzodiazepines damage dopamine receptors, so I still have a lot of healing to do there, but I get about 6 hours of sleep each night, so I’m not complaining. After 2 years of psychosis as a result of chronic sleep deprivation, I’ll take 6 hours a night. I still get fatigued rather easily. I still have trouble with cognition; my long-term memory is much better than my short term memory, but even that is improving.

These days, I don’t take any prescribed medication.
None.
And I dumped my psychiatrist.
(I don’t believe in the efficacy of psychiatric drugs anymore, so why would I keep her on the payroll?)

And guess what?

I’m feeling fine, better than I have in years.

These days, I’m aware more than ever that we live in a country where making money is more important than anything else. Drug companies spend a fortune on “direct-to-consumer advertisements” which are shown on television, and studies show that when patients come in asking for a particular medication, they are more apt to leave with a script than not.

Physicians are susceptible to corporate influence because they are overworked, overwhelmed with information and paperwork, and feel unappreciated. Cheerful and charming drug reps, bearing food and gifts, provide respite and sympathy and seem to want to ease doctor’s burdens. But every courtesy, every gift, every piece of information is carefully crafted, not to assist doctors of patients, but to increase market share for targeted drugs.

And while I want to believe that most doctors want to help their patients, many are not educated about the real dangers of the psychiatric medications they are prescribing their patients and, as a result, they are harming people.

I’m profoundly aware of the connection between trauma and addiction.

Our culture demands that we hide our pain, that we move through our difficult times quickly, but dealing with trauma cannot be rushed. If someone is grieving the end of a relationship -a death or divorce – or going through a period of with intense stress, it takes time to be able to transition through these times of intense change. Sadly, our culture shames us if we slow down to take care of ourselves. We learn early on that we are supposed to be productive all the time. We stop listening to what our bodies are telling us (rest, slow down, cry, ask for help) and if we cannot “pick ourselves up by our bootstraps” there must be something wrong with us. We are given diagnoses and told to listen to “experts” who will provide us with medication to “help us.”

I believe part of the reason I had to go through this horror is because I’m supposed to use my  awareness regarding the dangers of all psychiatric medications, but particularly benzodiazepines.

Over the last 2.5 years, I’ve connected with hundreds of individuals who have shared their withdrawal stories with me. It’s a shame that there is so much stigma and secrecy surrounding mental health issues because, I’ll tell you, there are a lot of people out there who continue to suffer daily from the horrors of protracted benzodiazepine withdrawal as a result of doctors who were either uninformed about the risks of the medications that they are prescribing or prescribing these medications unethically.

They need to know they are not alone.

And they need to know that they will get better.

They will heal.

I’m almost there.

{Special thanks to Jenn Harran, the most awesome massage therapist in the land. And to my therapist, Dr. Bruce Gilberg, for helping me wade through my mess.}

***

For more transformation and recovery stories from all diagnosis  and drug combos see: Drug free healing from depression, anxiety, bipolar, schizophrenia, etc…

For information on benzodiazepines see: Benzodiazepine info, news, resources and recovery stories

img_5801A educator and artist, Renée Schuls-Jacobson began taking Klonopin for insomnia back in 2005. After a medically supervised 1-year wean, she became cognitively confused and accidentally went cold turkey before switching over to a water titration. After 30 months of intense suffering, she has been resurrected – a phoenix, come from the ashes, ready to battle doctors and big Pharma, while offering empathic support to those still suffering protracted withdrawal symptoms. You can read her at blog at http:// rasjacobson.com, follow her on Twitter @rasjacobson or on Facebook.

*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.  

Top 10 posts from Beyond Meds 2015 (and the top ten from all time too)

I generally find numbered lists annoying but this is one I do every year. I do find the end of year stats interesting and it seems fair enough to share some of them with the readers of this blog without whom there would be no stats.

I continue to be pleased to know this blog is being used as the resource I’d hoped it would become. Most of the highest trafficked posts are collections from the archives which allow people to peruse by subject matter. They’re listed beneath this years top posts. They’re also always readily available from the drop down menus at the very top of the blog along with a lot of other collections from the archives.

Thanks to all my many readers all over the world for your ongoing support and for your commitment to becoming who you are meant to be in a world that makes it very difficult for us to do that. We all need each other to do that. That we might heal not just ourselves but our families, communities and our planet.

Perhaps some of these posts will be new to you. Enjoy.

Happy Holidays.

  1. Psychiatry ignores trauma says Dr. Bessel van der Kolk

  2. How antidepressants (and benzos) ruined my life: Luke Montagu

  3. Mutiny of the Soul – by Charles Eisenstein

  4. The apex and decline of evidence-based psychotherapy and psychiatry – by Brent Potter

  5. The Brain’s Way of Healing: Discoveries from Frontiers of Neuroplasticity — Featuring the work of Norman Doidge

  6. Stimulate your vagus nerve and thus chill out: simple, natural, uninvasive methods

  7. It Gets Better: the series – about recovery from psychiatric drug withdrawal syndrome

  8. There is a drive to not only survive but to thrive: coming back from trauma

  9. Food sensitivities, histamine and mast cell activation syndrome

  10. To my friends and readers who take psych drugs (and to everyone on and off meds too)

The top 10 from all the over 5000 posts on the site are below. These are old posts that simply get traffic every single day now and in some cases have been getting daily traffic for several years. That’s pretty cool since most of them are carrying really important information that need to be more broadly understood. A lot of them beat out the new posts in traffic simply because they get traffic every day and in general most posts fizzle out traffic wise after a few days to a week…

The Lamictal post has been the number one post every year since it was posted in 2007. This year however a post from 2013 that feature the work of Gabor Mate got the number one place for the year. The post about Lamictal was number two.

  1. Mental illness, addiction & most chronic illness is linked to childhood loss & trauma  — featuring the work of Gabor Mate

  2. Lamictal (lamotrigine) withdrawal from hell

  3. Chemical imbalance myth takes a big public fall

  4. Psychiatric drug withdrawal and protracted withdrawal syndrome round-up

  5. Carl Jung’s Words of Advice for the Depressed – by Jason E. Smith

  6. Drug free healing from depression, anxiety, bipolar, schizophrenia, etc…

  7. Benzodiazepine info, news, resources and recovery stories

  8. Mental health and diet: nutrition and gut health

  9. Finnish Open Dialogue: High recovery rates leave many psychiatric beds empty – By Daniel Mackler

  10. About Beyond Meds

Recovering or adjusting to illness?

*editor’s note: the event Lewis Mehl-Madrona mentions below has passed. The time for the dialogue he’s encouraging is NOW.

By Lewis Mehl-Madrona M.D. (psychiatrist)

Paris Williams (2012) has marvelously summarized the existing research on recovery from psychosis in his book, Rethinking Madness: Towards a Paradigm Shift in Our Understanding and Treatment of Psychosis. Many of us were not surprised when the research failed to support the currently dominant biomedical model of psychiatry. A 2015 panel at the American Psychiatric Association’s annual meeting in Toronto confirmed that even more research is accumulating to question the benefits, if any, of the long-term use of anti-psychotic medication. Paris raises the question, why doesn’t research change anything?

In my day-to-day practice of psychiatry in a hospital setting, I continue to see the same story being enacted, the story that Paris questions (through the use of data). That story is considered absolute truth — that psychosis comes from diseased brains, must be treated with drugs that block dopamine receptors (among others), and requires life-long treatment lest the person relapse.

A recent Huffington Post article strongly supported that point of view, pointing to one research study showing that the longer the duration of untreated (with medication) psychosis, the worse the outcome. Studies must be read with caution — even those that support our position. The Huffington Post author, a NAMI member (National Alliance for the Mentally Ill) and the mother of a child diagnosed with psychosis, didn’t notice that the “untreated” patients were actually being exposed in an oscillating manner to high-dose antipsychotic medications, which they would take and then stop. This is the dominant pattern in the United States, and certainly not the case in the developing countries covered by the World Health Organizations’ studies of schizophrenia, in which people’s exposures to medications were either brief or non-existent. Other studies continue to accumulate to support these conclusions.

So why do we keep doing what doesn’t work? Recently my wife and I had a wonderful dinner with a long-time colleague of 30 years, Dr. John Dye, who is Chair of Mind-Body Medicine at the Naturopathic Medical School in Phoenix. He posed the same question to me. Why do we prescribe proton pump inhibitors for excess stomach acid when simple dietary changes usually suffice? The FDA has approved these drugs for short-term use (6 to 8 weeks), but people are kept on them for many years. They block the absorption of iron and other necessary minerals. Similarly, options exist for lowering cholesterol besides statins (drugs in the top 5 profit-makers in the world). We simply don’t think of these alternatives. Statins can erode exercise tolerance and permanently damage muscles. When a friend was prescribed them, she stopped all exercise, which was probably worse for her than having somewhat elevated cholesterol. She simply didn’t have the strength to continue to exercise. Do we take these options because they’re simpler? I suspect we should peruse the sociological literature for answers to these questions.

Dr. Williams makes the point that antipsychotic drugs have been, since 2009, the most profitable drugs on the planet. Their sales exceed $15 billion dollars per year in the United States. Not only that, but the marketing model is sublime — we force people to take them against their will. When that happens, we use the very expensive injectable versions. One month’s supply of one of the newer antipsychotics (risperidone) had a co-pay (not the total cost) of $800. That’s a powerful incentive for someone.

However, we doctors don’t see this money. I came onto the scene early enough to be given a nice doctor bag by Eli Lilly. I don’t think they ever gave me anything else besides pens. I used to attend on occasion reasonably lavish dinners at desirable restaurants sponsored by pharmaceutical companies to hear about their new drugs. I particularly enjoyed the food, but doubt I was ever swayed to prescribe anything based upon dinner. However, these contacts, including drug dinners, as we called them, have long gone the way of the dodo bird. The incentive is not direct. It consists in status and respectability. Drug company sponsorship of research can build careers in psychiatry. Doing drug research builds respectability and confers status. I have learned the hard way that psychotherapy research is tremendously less respectable than pharmaceutical research. Again, why is this so? Perhaps sociologists can tell us.

The trigger for this essay is the upcoming visit of Ron Coleman and Karen Taylor to Maine. They represent the Recovery Movement in Mental Health. As is often the case, Ron began as a patient, escaped the psychiatric system with the help of his friends, and started helping others to escape and recover in his native Scotland. Karen, a psychiatric nurse, joined him at some point, and together they have made a substantial impact upon people in such diverse places at the U.K., Italy, New Zealand, Australia, and the United States. The gist of their story is that people who get diagnosed as having psychosis can recover; they can get well. Of course, I agree with that. Throughout my life, I have worked with people who have had the psychosis label as they work to recover. Barbara Mainguy and I wrote a recent paper about over 50 of these people and how they fared (positively). The work is sometimes slow, sometimes exciting, requires patience and acceptance that people don’t always make the choices we want them to make, but that perseverance will further, as the I Ching often says, and recovery will happen.

I believe wholeheartedly in what Ron and Karen are doing. We want to participate in starting a recovery house and community in Maine, but I can’t see, in my wildest dreams, how this movement could ever enter mainstream psychiatry. For one, it’s peer led. Mainstream psychiatry is required to be physician led. When I say required, I mean by the government — Medicare and Medicaid. Aye, there’s the rub. When we bill the government for services, then the government gets to decide — rather, demands or requires, what shape those services will take. The government believes that if hospitals and clinics are to be reimbursed the maximal amount, a physician needs to be in charge of mental illness treatment. A physician must see every patient coming to treatment and must participate in writing the treatment plan. A physician must periodically review the treatment plan. In a hospital setting, when physicians and nurses are involved in the care of patients with psychosis diagnoses, medication is invariably part of that treatment plan. Indeed, nurses have scolded me on occasion when I do not prescribe drugs at every encounter, and one for each diagnosis. Psychotherapy can play a minor role, but the expert physician is in charge, and drugs are the primary treatment. This story is rampant across North America — that experts who are highly educated in their field, licensed, and closely regulated, have the answers. If peers could do the work equally well, that would completely challenge that story; overthrow it, even.

However, the literature, as reviewed by Dr. Williams, points to peers being at least as effective as professionals, and probably more so, if only because they keep their fellow peers away from long-term psychiatric medications.

However, here’s the rub. The patients I see in the hospital seem to be a different breed, for the most part, from the patients I see in my life outside the hospital. I haven’t found a way to bridge that gap, though I wonder. Here’s what I observe. People come to the hospital to be fixed, for the most part. Granted, in our society in Maine, there’s virtually nowhere else to go, which is probably true for most of North America. We don’t have non-medical environments where people can go to be surrounded by friends, family, and interested peers, where the crisis can abate, and where they can avoid being medicalized. What I observe is that mostly people are in crisis due to disturbances in their interpersonal relationships. Of course, the social determinants of health are also active. People can enter crisis states due to facing life and feeling shame, suddenly becoming homeless, jobless, without family (death or divorce), hungry, lonely, or tired. Shelters in North America, by and large, do what they can, but the environments are not conducive to healing except in some unusual circumstances. This has been described for Canadian aboriginal women who were homeless — the shelter was a strongly negative experience, but connecting with other women at the shelter was a strongly positive experience.

Unfortunately, when we are in crisis or lack the basic necessities of life, the only place we have to go in most areas of North America is the hospital. Due to our “chronic brain disease” story, most of my colleagues assume that people are worse due to a medication deficiency, rather than a striking social event. A colleague at West Virginia University recognized this and avoided changing any medications for the first week of hospitalization. He found that people improved and were discharged without any medication alteration on his part, for the most part. They just needed a break from their lives.

However, in defense of my colleagues, I should add that most have never had the opportunity to see psychosis in any other light than the glaring, harshly acute illumination of the emergency room. The dominant story is one of people stopping their medication and then decompensating, though when I have interviewed many of these people, I have found that they decompensated before stopping their medication. This stoppage, however, breeds its own kind of psychotic delirium, for one can’t actually just stop these drugs without dire consequences. The withdrawal produces all the symptoms the drugs purport to treat. It’s easy to say that the symptoms one encounters are from a lack of medications, when they may actually be from the withdrawal from medications. Couple that with the self-medication that many of our emergency department clients are adding (amphetamines, bath salts, marijuana in unknown potencies and doses, hallucinogens, Ecstasy, benzodiazepines, opiates, to name a few) and the confusion escalates exponentially.

I’ve had the opportunity to spend time in peer-led facilities such as Diabasis in San Francisco. During my training, I received supervision from John Weir Perry, the medical supervisor there, and a well-known Jungian analyst and psychotherapist of psychosis. Diabasis was so much more calm than the emergency department in our hospital, and no one was on medications. However, the demand characteristics of the two environments are so different.

In the hospital, we have a situation in which people are not responsible for themselves or their actions (in the relative extreme) and we doctors are. We are responsible for preventing them from killing themselves, hurting anyone else, or generally engaging in bad behavior after discharge. We feel the tremendous anxiety that this brings and want to sedate the patients lest they do something harmful. For example, during my training, I learned that it took 28 days for an antipsychotic medication to actually work in its antipsychotic manner. Before that, it was mostly functioning as a high-level sedative. In those days, we kept people for several months and let the drugs take effect before we discharged them. We can’t do that anymore. Insurance dictates that people should be well within 7 days. Insurance dictates were also the death of the peer-led facilities like Diabasis.

We feel the need to sedate people and control their behavior lest we be liable and culpable if they do something bad. Within this system, how could we grant them agency?

Once upon a time, I believed that we could transform the mental illness system in North America. I’m no longer sure. I have begun to wonder if we are not doomed to parallel systems–the underground railroad, as it were with slavery on the other hand. Recovery does not take place in a biomedical system. The goal is maintenance. Can it be any other way? Can people transform in the biomedical story about them? Or do they have to find their peers and withdraw from the system of mental illness? And who will pay the peers? Must they labor for love, forever? I certainly relate to that, for most of my work with people diagnosed with psychosis was uncompensated, for insurance would not pay. Psychotherapy and healing were outside the model.

Of the patients I see in the hospital, I estimate that it’s less than 3% who leave the system and find alternatives like the recovery movement. Is that enough? How do we make it more? Given the economic nature of recovery (largely uncompensated) perhaps that’s as many as can be handled. However, Ron and Karen, who are coming October 10th and 11th, to Coyote Institute in Orono, Maine, have ideas for how to make recovery economically viable. This is what I really want to hear, for I do not know how to accomplish this in the U.S. system, short of doing it as a funded research study (which rarely happens because the ideas lie so far outside the mainstream). Perhaps we need societies as in the 19th century in which we tithe time and money for the purpose of helping each other when need arises. Perhaps we should all become Quakers in the sense of the marvelous people who started lovely retreats for people who suffered emotionally throughout the 19th century, and who did so much good in helping people recover. This movement ended with the huge influx of World War I soldiers who were so traumatized that no mental health infrastructure pre-dating the War could handle them. Hence, the Quaker sanitariums were transformed to profitable warehouses for traumatized people, and the ideas that had worked disappeared.

We’re looking forward to this dialogue with our colleagues from the U.K. Stay tuned to our website at http://www.coyoteinstitute.us, where we plan to start an internet conversation with Ron and Karen in the near future. Part of this dialogue concerns the question of whether conventional services in the U.S. can interface with a recovery model, or will it always be a question of parallel processes? Can the two models interact, or must they always remain separate? The conversations will be forthcoming”.

469Lewis Mehl-Madrona graduated from Stanford University School of Medicine and completed residencies in family medicine and in psychiatry at the University of Vermont. He is the author of Coyote Medicine, Coyote Healing, Coyote Wisdom, and Narrative Medicine.

More on Beyond Meds:

More Psychosis Recovery Stories

Change, change, change

Sometimes I hear people say that nothing is changing. That psychiatry continues to harm and that for this reason despair rather than hope is warranted.

I don’t see it this way at all anymore.

I often take a moment for gratitude when I consider how many mental health professionals now read and share my work and other similar work all over social networks…it’s incredible how much has changed since I first started writing and editing Beyond Meds… I see things change everyday and am constantly motivated because the one thing I do see, everyday, is change…

The monolith which is the psychiatric/pharmaceutical system may take more time, but change is everywhere…in every one of us always…

If I didn’t think I could help folks heal and change etc, I wouldn’t get up in the morning. I’ve now seen 1000s of folks get better after being harmed. I need know nothing else to keep on inspiring others do the same. Healing, too, is by it’s nature, change…

We are the change.

Change, change, change.

It’s certainly changed a whole lot for me and so many I know. See: The It Gets Better Series (for those impacted by psychiatric drug withdrawal issues)

Other related links:

Let the tide continue turning. Turn Turn Turn.

May all those harmed by psychiatry find peace and wellbeing. May no one else be harmed. 

Look here to see how many other ways there are to heal and thrive:

*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 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!

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