Classic blog: ‘Talking About Psychosis, Part 1: Why Do It?’ by Marc Ragins MD

mraginsThe stuff on Mad in America just keeps getting better and better. Here’s a thought-provoking blog from another of my favourite bloggers.

‘I was taught in medical school and psychiatric residency not to talk to people about their voices and their delusions:  “It will only feed into them and make them worse.”  Nor was I supposed to argue with people with paranoia because they’ll just get agitated and won’t change their mind anyway.

We were taught that the psychoanalysts had wasted a lot of time trying to connect people with psychosis by trying to find meaning in their psychosis.  I was taught that there is no meaning.  All we needed to know about their psychosis was enough to prescribe medications and assess if the meds worked.

The venerable Chestnut Lodge where Frieda Fromm-Reichmann had treated the woman in “I Never Promised You a Rose Garden” with psychoanalysis was successfully sued for not providing research-proven meds instead of talking with patients with psychosis.

Beyond that, I was told not to try to relate to the patients in the State hospital because they couldn’t handle relationships and when I left they’d feel abandoned and decompensate.  Most of my medical school class mates were more than happy to follow that advice and left the ward as fast as possible. They already knew that “people with psychosis are creepy and frightening and frustrating anyhow” without having met any of them.

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Understanding Psychosis and Schizophrenia

understanding“An individual having unusual difficulties in coping with his environment struggles and kicks up the dust, as it were. I have used the figure of a fish caught on a hook: his gyrations must look peculiar to other fish that don’t understand the circumstances; but his splashes are not his affliction, they are his effort to get rid of his affliction and as every fisherman knows these efforts may succeed.” Karl Menninger

What would happen if a team of highly qualified psychologists joined up with a team of people who knew psychosis from the inside, from their own journey into madness and then recovery – and if they collaborated in writing a guide to understanding the difficult states that get names like “psychosis” and schizophrenia”?

Well, you don’t have to wonder anymore, because the result was published a couple of days ago in the form of a report (180 pages) that is free to download. This report is well worth reading. Here’s a summary:

‘Executive Summary
This report describes a psychological approach to experiences that are commonly thought of as psychosis, or sometimes schizophrenia. It complements parallel reports on the experiences commonly thought of as bipolar disorder and depression.

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‘CRAZYWISE – Extended Trailer’ from Phil Borges

A 20-year fascination with shamanism leads filmmaker Phil Borges to question Western culture’s definition and treatment of severe mental disorders.

CRAZYWISE, a feature length documentary, centers around a young man struggling with his sanity, world renowned mental health professionals and a survivor-led movement… all challenging a mental health system in crisis.

‘It Gets Better!’ by Bertel Rüdinger

brudinger‘A little more than 10 years ago, when I was 29 and 2 weeks away from turning 30, I was a patient in the psychiatric system here in Copenhagen. I am a pharmacist and I specialized in neurochemistry and psychotropics throughout my studies.

While I was working in the labs at The Royal Danish School of Pharmacy I was intent on getting a job as a medicinal chemist at Lundbeck – the Danish pharmaceutical company behind Celexa and Lexapro and in their own words the only company specializing solely in developing drugs for the treatment of neurological and psychiatric disorders.

At the university we were taught that psychiatric disorders were diseases just like diabetes and hypotension. We were told all the ‘truths’ that the psychiatrists now admit were myths about the so-called chemical imbalances in the brain and the clear genetic component of schizophrenia and other psychiatric disorders.

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‘Talking About Psychosis, Part 1: Why Do It?’ by Marc Ragins MD

mraginsThe stuff on Mad in America just keeps getting better and better. Here’s a thought-provoking blog from another of my favourite bloggers.

‘I was taught in medical school and psychiatric residency not to talk to people about their voices and their delusions:  “It will only feed into them and make them worse.”  Nor was I supposed to argue with people with paranoia because they’ll just get agitated and won’t change their mind anyway.

We were taught that the psychoanalysts had wasted a lot of time trying to connect people with psychosis by trying to find meaning in their psychosis.  I was taught that there is no meaning.  All we needed to know about their psychosis was enough to prescribe medications and assess if the meds worked.

The venerable Chestnut Lodge where Frieda Fromm-Reichmann had treated the woman in “I Never Promised You a Rose Garden” with psychoanalysis was successfully sued for not providing research-proven meds instead of talking with patients with psychosis.

Read More ➔

CRAZYWISE: Rethinking Madness – A Documentary Film

There’s a great film coming to our screens next year. CRAZYWISE, directed by Phil Borges and Kevin Tomlinson, is a feature documentary exploring alternative treatments for mental illness.

You can learn more about the film and support its production – PLEASE do – by going to the film’s Kickstarter page. I’m really excited by the film. Here’s what is written by Phil and Kevin:

‘About the Film:
CRAZYWISE centers around Adam, 29, a former wakeboard champion who struggles with his sanity following a psychotic break. Desperate and feeling shame from being labeled with a potential lifelong disease, Adam embraces meditation.

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‘Jaakko Seikkula Speaks on Finnish Open Dialogue, Social Networks, and Recovery from Psychosis’ by Daniel Mackler

Daniel Mackler interviews Jaakko Seikkula, PhD, a professor of psychotherapy at the University of Jyväskylä in Finland who is best known for his work with Finnish Open Dialogue.

He speaks about the value of engaging social networks in crisis situations, the development of the Finnish Open Dialogue approach, the idea that there is meaning behind psychosis, and some unexpected benefits in Western Lapland of including family members in therapy with people experiencing psychosis.

You  an read more abut this approach here.

“Healing Voices” Promo

I don’t know where this film is in terms of production but it looks as if it will be very good.

‘HEALING VOICES is a feature length documentary currently in Production, examining mainstream mental healthcare in the US, and the experience commonly labeled as “psychosis”.’

‘Traditional Healing and Psychosis vs. the Promises of Modern Science’ by Jonathan Keyes

PdxJonMad in America just keeps getting better and better. I strongly recommend keeping an eye on this excellent website. Here’s a fascinating and important blog from Jonathan Keys.

‘As noted by Robert Whitaker in his book Anatomy of an Epidemic, the World Health Organization reported that the prognosis for someone experiencing psychosis is far better in developing countries than in industrialized countries

Mr. Whitaker and others posit that this is  due to the treatment models used in the developing world, as well as to debility and chronicity caused by psychiatric drugs themselves.  I think this is undoubtedly true.

A number of other reasons for the disparity in outcome have been suggested.  Some have put forward the idea that there has been a rush by consumers to apply for this disability money, leading to an increase in apparent chronicity.  While this is quite possible, I doubt that this alone explains the large gap in outcomes.

Other researchers have suggested that family and community support networks are often stronger in developing countries and that there is perhaps more tolerance and acceptance of people with psychotic tendencies.

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