Neuroskeptic has a video here about how 99% of claims people make based on what they think are findings in neuroscience are rubbish.
There’s a lot of talk about parity in medicine, especially now during Mental Health Month. Brain disorders are treated differently than other illnesses, so there’s differences in policy, funding, and so forth. But when we talk about parity, we also need to keep in mind that, for carers, nurses, doctors, and other non-disordered people, we need parity in motives.
I’ve come across many people who seem to just want an ordered world–a world free of psychotic people. These people are not acting from the motive of caring and concern for someone who may be suffering. They are acting from other motives. When we think about treating brain disorders, or when we think about possibly curing or ridding the world of them, we need to search our motives, and make sure they are the same for any ill person.
Sometimes I think psychosis simply bothers some people, and they feel the need to rid the world of it. This is not the motive one wishes to move from.
There’s a good article here about the biases we all hold. I mean bias in the psychological sense.
I learned a lot about bias as an undergraduate, and tried to root out as many as I could over the years. I can’t say that I’m perfect (who is?), but I think I’ve gotten better.
I thought this related interestingly to my work on schizophrenia because I want to take seriously people’s narratives about what they think caused their psychosis, and what happened when they went psychotic. But I also want to take into account that we are imperfect when it comes to these things. We tend to overestimate bad things that happen to us, for example. Still, I think it’s important to take the agent seriously.
In practicing the biopsychosocial model, interviews with the client are paramount. However, other data is collected, such as interviews with other people, school records, and so forth. This, I think, is good. It takes into account the individual, and also refers to other data so we can glean a picture of what possibly caused the illness in this particular case, and what treatments we should apply for health. This is a strength for the biopsychosocial model.
After reading about bias, you should be skeptical about yourself. If you aren’t you didn’t take the data seriously. But there are ways to reduce bias, and it’s good to apply them. This could make a better place for all of us. This means you don’t have to remain skeptical of yourself. But it does mean you need to constantly work on yourself.
If you live in a constant state of skepticism about yourself, that’s probably not healthy. But a light dose of skepticism is good.
I was thinking about how people strive for things.
Aside from basic survival, and other basics of life, most of out strivings are within a context and a culture. For example, I wanted to be a philosopher, and, currently, most philosophers are associated with a university. So I learned the game of the university. I learned how to teach, how to conduct research, who are the important people in the field, and what the major university departments are. My goal, like anyone’s was to do well in philosophy.
But even as I thought about things that weren’t necessarily tied to my culture, these embedded rational decisions were within the context of a culture and, importantly, with the context of an institution. Institution, here, I use broadly, in the sense of being institutionalized.
Most of out strivings are embedded in this way. These are socially constructed realities within which our reason applies itself.
For example, I was just reading a bit about the prestige bias within philosophy. People from prestigious departments are more likely to get hired at prestigious departments. Many people strive to work for a prestigious department, but few do, and it seems that the bias is towards people who are already prestige-affiliated.
But for me, as an now an outsider, it seems to me that these longings and strivings are embedded within a large university-industrial-complex, which I am not a part of. I’m not saying it’s bad to strive in this way, or that that system is a bad thing. I’m just saying the things related–such as where one applies for a job, that one applies for a job, what one wears to interviews, that one goes to the APA, and so forth–are embedded within a constructed system.
I think most of our strivings are embedded in this way. Our reason is often “applied” within a context and culture. This doesn’t make it any less rational, but it does seem that we may be fooling ourselves if we think, normally, that we are applying reason to the thing-in-itself.
One may think that feral children can teach us a lot about, especially, psychology. In fact, I turned to feral children today in order to think about what happens to a person devoid of the social. I was thinking about this in order to think about the -psycho- in the biopsychosocial.
Here’s what I thought. It’s hard to glean a whole lot from studying feral children. For one, these children aren’t randomly feral. That is, they aren’t randomly assigned to being feral. We can’t do that. It’s unethical.
Which brings me to my point: It would be a major form of abuse to create a feral child. Why would it be an abuse? Not just because they need to be “socialized” and taught “social skills.” It would be an abuse because it fundamentally alters a child for life in a way that pretty much seems unjustifiable.
Being a feral child is, automatically, being traumatized and neglected. So what we can glean from studies of feral children can’t be pulled apart from studying trauma, abuse, and neglect.
This means they don’t provide the perfect case study for looking at the human-being-minus-the-social. The social is already interacting with the child by neglecting it.
There may be some things we can learn, anyway. Scholars think that many feral children fail to learn to speak because they miss a key point for language development.
If these children lack language, they may lack concepts that make them able to strive for things in life. They may have a basic need for survival, so they eat, but they may lack ‘thick concepts’. That is, they may not be able to strive toward being a doctor because they lack language; they lack the concepts involved in being a person who wants to grow up, go to college, and be a doctor.
Now, I know that, from studying what people say about schizophrenia, that I should be careful about what I say about people who have experiences I know nothing about. But, still, I think this may actually help me develop a theory.
On the view I developed while at the store today thinking about the psychosocial, language hooks one into the social. It brings one in to the social community as a full member. In this way, concepts can lead one, make one strive for things. But, also, when reflecting one these things, we can question, develop, make new concepts, and so forth.
I kinda like it. Plus, it talks about the biopsychosocial model.
Most people give credence to biomedical research over biopsychosocial research, thinking, I suppose that biomedical research shows us about reality. I don’t want to argue that it doesn’t. What I do want to do is argue for the social sciences as giving us information about the nature of reality.
For example, we know that Holocaust survivors are at-risk for developing schizophrenia. This gives us reason to think that exposure to trauma, psychological hardship, and so forth, can trigger psychotic symptoms. What we can’t do is replicate those conditions, and randomly assign people to Holocaust-like conditions.
What we can do is look at other instances where trauma may have caused a break from reality. For example, we can look to the Ghost Dance.
I invite you to watch this video, and consider whether the restrictions of liberty, trauma, and hardship, etc., caused the break from reality which was the Ghost Dance.
Everyone’s favorite neuroscientist, Neuroskeptic, comments on an interesting study which involves adoption and schizophrenia.
I’ve mentioned that schizophrenia is currently considered a bio-based illness. And I am doing research on the biopsychosocial model, which states that schizophrenia can have multiple causes. But, of course, the biopsychosocial model is not in fashion right now. The research dollars go to what’s trendy, and Engel is not trendy right now. (No matter how much social science evidence we may have.)
This study looks at children who had ill biological parents, and were adopted. It found a decreased risk in developing schizophrenia.
Do take a look at Neuroskeptics’ blog post, and consider reading his blog more often! (I have been a reader since grad school.)
It may seem like being a social causal realist, the way I’m shaping up to be, would be a weird thing to be. But I just found an interesting lecture on causal explanation in the social sciences, and it includes a discussion of causal realism. I don’t have a fully formed theory I want to advance, but I want us to think a minute about social shame.
Shame is something that many people with schizophrenia can relate to because schizophrenia is a stigmatized illness. But let’s look at something other than schizophrenia. Let’s take a look at The Scarlet Letter by Nathaniel Hawthorne. In this work, the main character, Hester Prynne, has to wear a scarlet ‘A’ (for adultery), and is publicly shamed by the community.
There’s a reason we don’t shame people in this way anymore. For one thing, ethically, it’s wrong. For another, and perhaps the reason it’s wrong, is because it can cause psychological damage to a person, especially a vulnerable person; a lone person with no social supports.
In this day and age, when adultery is common, it may seem like no big deal; that one could take the public shaming. But I invite you to read the work, and see whether, if you were living in the 1600’s, if you could withstand being made to be a social outcast, and publicly marked for a private affair.
I was doing some reading about psychological causes of schizophrenia, and came upon the Schizophrenia Proneness Instrument-Adult Version. This is an instrument to test whether a person is at-risk for developing schizophrenia. I am not trained to administer it—it seems one needs a great deal of training. But it looks interesting, and I will read more about it.
I’ve spoken a lot about the biopsychosocial model, but I haven’t posted about George Engel, who posited it. Here‘s the seminal paper.
I want to argue, using the biopsychosocial model that, for any case of psychosis, we cannot, currently, say for sure what the ultimate cause of it is.
The biopsychosocial model can be thought of as both a theory of causes, and a theory of treatment. When thought of as a theory of causes, one looks at biological, psychological, and social factors involved in the development of psychosis.
We may find that, for example, there’s excessive pruning of neurons in the brains of most people with schizophrenia. But we may not know why that happens. It could be they are born prone to developing psychosis. It could be they are neurotypical, and have experienced a lot of hardship. It could be that, psychologically, they are vulnerable to stressors.
These can all be causes, and they can all contribute to one developing psychosis. For any individual person, they may not know what caused their own psychosis.
Think of global warming. We know that the Earth is warming at alarming rates. But, at any given place, it may be warmer or cooler. Just because one area experiences warmth or cooling doesn’t mean we can assign this to global warming. Global warming is an effect that is broad, and covers the entire Earth.
In the same way, psychosis may affect individuals, but each individual has had a different upbringing, social environment, experiences, and each individual reacts to their environment in different ways.
For some people, the biomedical explanation may be sufficient. For others, however, we may need to look at social and psychological factors. Teasing apart causes in any particular case would be difficult, and that’s more the job of clinicians and case managers, who are “on the ground” and working with the client.
As for me, when I look at data, I am looking at groups of people, and making connections. I may be focusing on social causes at the moment, but that doesn’t mean I don’t think other causes may be involved in particular cases.
Recently, I started writing mind with an asterisk behind it, like this mind*. That’s because sometimes I want to use the word mind, but I think people equivocate on it. I’m not going to lay out every meaning I’ve found of mind, but I will lay out two:
- Mind: A set of cognitive faculties that enables consciousness, perception, thinking, judgement, memory, etc.
- Mind: The soul; an immaterial, and mystical thing we cannot only vaguely know about.
Yes, I do think people use “mind” in that latter way. When I use “mind”, I mean the former. So I will continue to use an * after “mind” in order to make sure I’m not equivocating, and to be clear about what I mean.
If you can think of another term for mind* that I should be using, please let me know.
Read it here.
Read about it here.
The biopsychosocial model was never developed fully theoretically. Yet, I, and many researchers, think it shows promise. In this essay, I want to think about how a brain condition can have multiple causes. In doing this, I will make analogies with broken bones and physics, and posit social causes.
The cause of a broken bone may be many things. It could be one is vulnerable to breaking bones; there is something about one’s bones that make them prone to breaking. If this is the case, a minor bump, simply standing up, or fall could cause a broken bone.
One could get a broken bone by accident, in playing a sport.
One can get a broken bone by being assaulted by another person.
We have no problem thinking about different causes of broken bones.
Yet, many people have trouble understanding how there could be different causes for brain disorders. This seems to me not an especially difficult problem when we look at non-brain pathologies.
Causes, especially social or psychological causes, may seem strange because we cannot directly perceive them. We cannot see stress or trauma. Yet we seem to have no problem talking about these things, and, in the literature, we see a body of data that strongly suggests causation between stress, trauma, and brain disorders.
Let’s look at stress, for a moment. There’s a whole body of research on how stress can cause a variety of physical problems. Most people, and most professionals, do not have a problem assigning stress as a cause to things like acne, sleep problems, weight loss, overeating, and so forth.
Yet, many people, especially those who hold firm to the biomedical model, would have a problem assigning invisible causes to physical illness, such as brain illness.
This need not be that case.
To see why, let’s turn to introductory physics.
Although the aim in physics as a science is probably to find testable hypotheses, much of physics is theoretical, and deals with both visible and non-visible things. We cannot see gravity, for example. Yet, the average person understands the basics of how gravity works in everyday life, and physicists have a good understanding of how gravity works in the universe. We posit a name for such a thing—calling it gravity—because we can, or rather Newton could, see that things must be pulled to the Earth.
In the same way, I want to posit social causes. A social cause is not a force acting directly upon one’s body, that we know of. It may very well be, I would need more data in order to posit a social force in that way. What we can probably say is that, whatever we make of the psychological, be it material or immaterial, the social can act upon the mind*, and affect it in both positive and negative ways.
This is easy to see, when we look at the literature, but it’s difficult to find a theory and proper understanding of it.
I do not want to imagine the mental or psychological as something mystical and beyond comprehension. I do not think many things in the universe are mystical or beyond comprehension. I may not currently understand such things, but that does not mean human beings cannot understand them.
I also do not want to posit too many things; I want my theory to be as simple as I can make it. This is just keeping with Occam.
Likewise, in keeping in the tradition of many empiricists and philosophers, I take it that the universe makes sense. It is not disordered. It may be surprising, or counterintuitive, at times, but it is not disordered. For me, what’s disordered is my mind*, when I am psychotic. But even then, there’s some sense to it. I do not magically know how to speak Arabic—which I don’t know when I’m sane—when I’m psychotic. My mind* can only scramble, order, disorder and reassemble things I know, and it can create just so long as I am, at any rate, creative, when I am psychotic.
So I want to posit social causes, which are causes just like any direct, physical cause. This is what I mean by cause.
Much has been made of making psychology, sociology, and other social science into hard sciences. Many think this is not possible.
I think, when we are dealing with the social sciences, we are dealing, in a way, with the same kinds of things as theoretical physicists are dealing with. What I mean by that is that we are dealing with many things interacting, we are dealing with complex causes, and we are dealing with forces acting upon things which are not, necessarily, directly touching. I do not have the understanding of physics that I’d like to have in order to make this comparison even more compelling, but I’m not trying to make the social sciences into hard sciences in order to make them more credible in whatever way. I’m making this analogy because I think it’s true, and, after looking at data, think there’s some merit to it. We do not have a problem, normally, thinking that the Sun affects the Earth, even thought these two objects do not touch. In a similar way, I want us to think about social causes as one social event affecting a person, even though they may not be touching.
In this way, I believe in the armchair, but I also believe in experimenting. Because there’s only so much we can directly observe. Our personal observations may lead us astray, which is why I refer to the data, which I am keen to look at.
So, social causes, I want to think are just as real and forceful as physical causes.
I have mentioned this study in previous posts, so I wanted to link to it here.
In this essay, I want to argue that we should refer to psychotic disorders as brain disorders, but that doing this doesn’t mean giving primacy to the biomedical view versus the biopsychosocial view.
In keeping with some of my previous thoughts, let’s assume you get a broken leg. Furthermore, let’s assume that your broken leg is due to a social ill—someone assaulted you.
You go to the doctor. You get a cast, but, in addition, as you heal, you may need physical therapy in order to heal better in your leg.
Seeing a broken leg as a medical issue doesn’t mean you won’t need treatments other than having a cast, and using crutches until you heal.
In fact, this may be yet one more trauma in your life that you don’t need.
Now imagine that, years down the road, you become psychotic. Imagine further that this is because you have experienced hardship, childhood abuse, and trauma, including being assaulted by someone who broke your leg, years back.
You are taken to the hospital. The psychiatrists there see you as a brain patient. They try to treat your brain by giving you antipsychotics.
But, in addition, you are assigned a treatment team that includes social workers, case managers and counselors.
Seeing psychosis as a brain issue doesn’t mean you won’t need other treatments, like counseling. And, further, your society may need some treatments of its own, if it produces people who traumatize and torments people, and produces social injustice.
Calling psychosis a brain illness doesn’t negate other biopsychosocial causes or cures, just as thinking of a broken leg as a medical issue doesn’t negate the fact that you have been assaulted, and may need counseling, or physical therapy. In other words, calling schizophrenia a brain disorder doesn’t commit us to the biomedical model over the biopsychosocial model.
Imagine that you get assaulted. You are kicked in the leg and it is broken. You go to the hospital. Your leg is x-rayed, and casted. You are given crutches, and asked if you want to press charges.
That’s the way it normally goes, I assume, when you are assaulted and get a broken leg.
No one says you aren’t really hurt, even though your broken leg was caused by a social ill—a bad person assaulting you.
Now imagine you have a psychotic break. Your symptoms cause your family to call the police so you can be taken to a hospital. At the hospital, your blood is taken, you are given a CAT scan, and are, after a while, diagnosed with schizophrenia.
The tests in involved—taking blood, and CAT scan—don’t reveal anything. They are done in order to rule out other things. You are given an antipsychotic, and released from the hospital after seven days, when the doctors see that your medication seems to be working.
At home, you peruse the literature, and find that some people think your illness is not real the way a broken leg is real—because your illness, they think, has psychosocial causes. Perhaps you experienced a lot of adversity, or trauma as a child. These are things correlated with experiencing psychosis.
Not everyone who gets kicked in the leg will get a broken leg. That depends on a lot of things—where you were kicked, how hard you were kicked, if you were kicked repeatedly, and if your bones were prone to breaking.
Not everyone who experiences adversity or trauma will experience psychosis, either.
Both of these things can be caused by social illness, and social ills in combination with your makeup. If you have especially brittle bones, and some bad guy kicks you, you are probably more likely to get a broken leg. Likewise, if you “are prone to” (we don’t know what that means, but let’s not assume it means you are less “hardy”) psychosis and experience trauma, you are more likely to develop schizophrenia.
But no one says you aren’t *really* hurt when you get a broken leg this way.
Unfortunately, they do say this when you become psychotic.
There is no test, they say, for schizophrenia.
True, the biomedical markers for schizophrenia are not testable in most hospitals. They can’t, for every patient, check for chemical imbalances. Instead, they rule things out, try a medication, and see if that medication (in my case, regulating dopamine) works to restore health.
Not long ago, before the x-ray, they couldn’t *see* a broken bone, either. They had to do similar things in order to diagnose and treat a broken bone. The patient would, I assume, report symptoms and people could observe symptoms. That doesn’t mean broken legs weren’t real problems before the x-ray, just like it doesn’t mean psychosis isn’t real just because not everyone has access to MRIs.
Just because something may have a psychosocial cause, or can’t currently be directly apprehended in the hospital doesn’t make it less real.
The tendency has always been strong to believe that whatever has a name must be an entity or being, having an independent existence of its own. And if no entity answering to the name could be found, men did not for that reason suppose that none existed, but imagined that it was something peculiarly abstruse and mysterious. –JS Mill
I just read a psychosocial report on psychosis. While I agree with looking at psychosocial causes of psychosis, the report states that psychosis is not real the way a broken bone is real. That there are no medical tests, like an x-ray, that can help us diagnose psychosis.
I think, when thinking about the ‘mental’ or ‘psychological’, people get mystified by it. That’s one reason why I decided to refer to schizophrenia as a brain disorder. The fact is, in many people who experience psychosis, there *are* biological differences. There is, according to many studies, excessive pruning of neurons in the brain. There is, moreover, often chemical differences, which is why regulating dopamine in my brain is helpful to me.
However, that doesn’t mean psychosocial causes aren’t important. I’m a believer that they can be causes just like, if someone kicks you in the leg, you may get a broken leg. Not everyone who gets kicked in the leg will experience a broken leg, but some will. There are a lot of factors at play, such as how hard they kicked you, if you were kicked more than once, and how vulnerable your leg is to being broken. And when we look at data, we will find that people who got kicked in the leg will show up more to the hospital with a broken leg, just like we find that people who, eg, experience childhood trauma will more often later show up with psychosis.
So we think of a broken leg as a medical problem with the leg, and I (at least) think of psychosis as a disorder of the brain. This, even though abuse may be the cause of both of them.
It seems like a cruel joke. People who are already in disadvantaged positions are, on top of that, vulnerable to brain disorders. Then, the society that produced the disadvantage (poverty, racism, sexism, etc.) stigmatizes the person for having an illness.
I want to be transparent here. I am diagnosed with schizophrenia. I live openly with my illness. I am also trained as a philosopher. I had my first psychotic break in graduate school, where I was studying ethics and political philosophy. My doctors told me to apply for disability, but I wanted to work. After a series of various jobs and hospitalizations, I finally applied for—and was granted—SSI. The day I was granted SSI, I cried. It had been an extremely rough ride.
One of the jobs I applied for, and kept until I was hospitalized, was as a case manager. As a case manager, I was trained to treat people in a holistic way. I was to look at each client from a variety of perspectives. But, also, I was trained to advocate for justice for my clients. That’s what I want to focus on here.
Theory and Practice
I want to set aside the theories of justice we learn about in school for a minute, however important and interesting they are. Although my academic training is mostly in philosophy, I have also done an assortment of different work. I have had time to think about—and live out—the issues I am discussing. So I’m not going to apply any certain theory of justice to the problems I am discussing. Besides, Bernard Williams would think applying a theory to a problem the way that is often done would be really uninteresting. And, of course, I want to be interesting.
I am also not going to get into a debate about psychiatry versus psychology. Brain versus mind. I think training as a case manager was good experience for me in diffusing that dichotomy. I am trained to deal with both medicine and psychotherapy, as a case manager. And I am trained to think about the soul and the brain, as a philosopher.
However, I am going to refer to schizophrenia as a brain disorder in this paper. Because that’s what it is, whatever, ultimately, causes it. There is something going on differently in my brain when I am psychotic. I’ll set aside issues of dualism, materialism, and so forth, and let other philosophers better trained in that area deal with those issues.
I am also going to set aside cultural differences. Although there has been interesting anthropological work on the differences in the expression of psychosis, there is also consensus that psychosis occurs in every culture. What I will focus on, however, is treating psychotic disorders in the United States. That’s where I live and am best trained.
“What happened to you?”: Social Causes of Schizophrenia
We know that social factors can be a cause in brain disorders. For example, Holocaust survivors are at an increased risk of developing schizophrenia. There is, we may say, only so much a mind can take.
This does not discount other factors involved in developing brain disorders. However, I want to discuss various abuses and forms of disadvantage at play in developing psychotic disorders.
Prior to taking up research specifically on psychotic disorders, I did a great amount of research in Native Studies. Native Studies is an interdisciplinary field, and I had to learn and read in many different fields—anthropology, psychology, sociology, history, law, criminal justice, philosophy, to name a few. In the social and psychological work I read, it was clear that the effects of colonialism had an impact on the minds of indigenous people. They are at an increased risk for many illnesses, including brain illnesses.
This informed my early notions of brain illness: that it’s mostly social. So, when I became ill, I didn’t know what caused it. (It could be, however, that I have, in fact, experienced a lot of hardship, and was prone to developing a psychotic disorder.)
I eschewed psychotropic medications, and psychiatry in general. I was held, for periods of time, in hospitals and told to be “compliant” (to take medications). I sought out therapy, however, and had a few wonderful counselors. Counselors, I knew, treated things differently. They are not medical doctors shoving, as it were, pills that caused me horrible side effects down my throat.
Eventually, however, I was given an antipsychotic that both managed my symptoms and didn’t cause side effects. I am now a firm believer in taking the appropriate medication at the appropriate dosage, along with therapy, case management, and so forth.
One of my good friends, who, for reasons to protect them, will remain anonymous and vague, works for the military. This is not a delusion. They really do work for the military, and they are not the kind of person you would imagine an ethicist would associate with. The fact is, it’s their job to kill people efficiently and effectively. They are not a soldier. They make the plans that others carry out.
Let’s just say that this person knows how to inflict all kinds of torment on people. (This does not carry out into civilian life.) This person once asked me the most important question anyone ever asked me about my illness: “What happened to you?”
They wanted to know what kind of torment, abuse or disadvantage I experienced that made me have schizophrenia.
I wanted to tell them that I was a teen parent, who had to fight for her education, and was treated very badly by, especially, conservatives as a teen parent. I was told I was going to Hell, and funding for my high school, which was my joy and hope in the world, was always threatened.
I wanted to tell them that I had experienced sexism in the field of philosophy that made me very uncomfortable.
I wanted to tell them that I experienced a lot of sexual harassment when I was working as a teaching assistant.
I wanted to tell them that academia is not made for parents, especially teen parents.
I told my counselor instead.
There are at least three kinds of stigma: (1) Self-Stigma, (2) Other Stigma, and (3) Stigma by Association. The literature discusses each of these.
Self-stigma is when a person internalizes the stereotypes and “othering” the society holds about them. They may think they are, in fact, a bad person for having schizophrenia. They may think they are at risk for committing violence. They may think they should be punished, or closely watched. This can cause a person to have low self-esteem, live “in the closet,” and not seek treatment.
Other stigma is when people who do not experience psychosis have negative views and discriminate against people with psychotic disorders. This can include not wanting to date a person with schizophrenia, not wanting to have conversations or be friends with people with schizophrenia, and not wanting to work with people with schizophrenia.
Stigma by association is when people who are associated with a person with a psychotic illness feel shame about having that person in their family, school or workplace. They may lack education about people with brain disorders, and there is evidence that proper education about these issues can lessen stigma by association.
Stigma can lead to discrimination by making people treat one differently. As someone who has dealt with gross amounts of stigma, I can say that people have treated me as a potential threat, a wild-eyed disarray, and needing to be “compliant” and tamed. This, even when my symptoms, which have never been threatening, were at bay. Stigma leads one to “see” you differently. It leads to bias in how your actions are interpreted.
I have learned to deal with stigma by living openly and “calling it out.” I risk all kinds of things doing this, but it’s the only thing I know to do.
Justice at Both Ends
We may live in a world where luck is involved, but there’s luck and there’s luck. We have the ability to change our world, to make things better for other people and ourselves. We have the ability to reduce the amount of negative luck people experience. For example, if we alleviated poverty, there would be fewer brain disorders, just as if we reduce child abuse, there would be fewer cases of child PTSD. If we want to reduce the amount of brain illness in the world, we need to be committed to justice.
At the same time, there are people who do and will continue to suffer. For those people, we need justice at the tail end—we need justice for people with brain disorders. This means making people feel OK with accepting government benefits, increasing government benefits so that people with brain disorders are not living in poverty, and, of course, reducing stigma.
I hope I have made a case for justice before and after psychosis.
My undergraduate thesis in philosophy, entitled The More Freely He Breathes: Colonialism in the United States, explored indigenous colonization drawing upon work in Native Studies. All of my prior education prepared me for taking up the research role, during which time I consulted experts across campus, students, experts from other universities, American Indian philosophy, and American Indian Law. In addition, I took a road trip recounting the Trail of Tears from the Choctaw perspective, visiting the reservation of The Mississippi Band of Choctaw Indians, where I was priviledged to experience Choctaw Indian Fair and a speech by Chief Martin. I visited The Choctaw Nation of Oklahoma, seeing historic, administrative and governmental sites and visited tribal-owned businesses.
I’ve been a little busy; too busy to blog to much. But I have been enjoying this great weather!
Yes, I am still eating healthy.
But, I came across this article today about new research on weight loss and obesity. It’s very interesting, and points to future medical treatments for weight loss. Give it a look!
Here’s a good article about self-care on a budget. I have done (and do) all of these things.
There’s an article here about how experts have decided that we need a large-scale, federally funded effort to end stigma of mental illness. It’s a good article. Check it out.
Here’s a good article about how creativity–and the arts–can help people with mental illness (and other disabilities).
As I mentioned previously, I live on a protected environment. I have also worked with an environmental organization. I did business development for a local environmental nonprofit. I had to quit when I fell ill. But perhaps my biggest environmental accomplishment is helping get the lake and wetlands I live on protected.
I received a great environmental education at Stetson University. I learned about Florida springs, wetlands, and more. When I moved to the place I currently live, I was told the lake was over 80 feet deep, and was naturally spring fed. Some years later, they were beginning to put a development up on the other side of the lake, cutting down acres’ worth of forests. People in my community got together to have the lake and wetlands protected, which they now are.
Since the wetlands are protected, we let everything grow as it wants to. This is what it looks like now:
And this is what I looked like working for the environmental organization:
I was doing some reading about how to know when you are ready to work when you have a mental illness. I came across this helpful article written by a person with mental illness who now counsels people who are looking to go back to work. Have a look.
There’s an article in the Atlantic about how cheat days can boost your self-control. Since today was my cheat day, I was glad to see this. From the article:
[A] recent study suggests that it’s best to plan certain days on which you’ll cast off the shackles of your diet—or budget, or workout plan, or whatever ascetic goal you’ve set for yourself—and really just let loose. Temporarily, that is.
These so-called planned hedonic deviations, or “cheat days,” can boost your drive in the long run.
I had my cheat meal today instead of Friday because my daughter and I are both a little busy on Friday. So I had a delicious burrito.
Last year or so, I posted about living on a protected environment. My neighborhood had the lake and wetlands I live on protected. So, we have been letting things grow as they wish. Turns out, things have grown quite a bit! Take a look:
There’s an article in the Atlantic about job hunting while having schizophrenia. According to the article, 85% of people with schizophrenia are unemployed, while 70% of them would like to work. This gets back to my previous post about how I am an asset. I explained that discrimination still occurs. Check out the article.
It’s been a while since I’ve been in high school, but I still use things I learned in high school every day. I went to a school for teen parents, and we had regular core classes along with parenting classes. I also took nutrition. In fact, I took four whole years of nutrition. That’s how I know I got my day’s worth of fruits today at lunch. This is three servings of fruit.
Although it’s illegal to discriminate against people with mental illness during hiring, it is well known that discrimination still occurs. People with disabilities are disproportionately living in poverty (partly because SSDI and SSI, if they are on that, provide you with just that—poverty) and cannot find work.
Previously, I hid my mental illness from people, especially people I worked with. These days, I live openly.
Let me tell you a few reasons why I am an asset due to my mental illness. Maybe this will change the way people view people with mental illness during the hiring process.
Firstly, having a mental illness, and wanting to be well, makes me, de facto, responsible. I have to go to the doctor once a month for a shot of Abilify. I cannot miss this appointment. It is important that I get my shot on time. The consequences of me not doing this are that I may suffer a psychotic break—considered one of the most disabling forms of disability. So, I am used to both being responsible, and having a huge risk involved in this responsibility.
Secondly, I have been hospitalized eight times. Eight times. How, you may wonder, does that make me an asset? I’ll tell you: Mental illness strikes every income bracket, education level, race, ethnicity, gender, sex, religion, sexuality. Each time I have been in the hospital, I have made it a point to associate with the other patients. I have met people with PhDs from Harvard, teachers, train engineers, gangsters, Christians, atheists. I have bonded with people of every different color and creed.
Thirdly, I have to associate with many types of professionals. My condition has put me dead center in the middle of medicine. I have to have fruitful relationships with (1) my Nurse Practitioner, (2) my General Practitioner, (3) my therapist, and other medical professionals, including nurses and psychiatrists. If these relationships are not fruitful, I don’t get better and they can’t do their job well.
Fourthly, I have had to navigate government bureaucracy. I have been on SSI for a couple of years now. Getting on disability requires that you, even though you may be very ill, navigate a huge system that may seem impersonal and mechanistic. There’s the paperwork, the doctors’ notes, the phone calls. This continues even after you get on SSI. I am required, for example, to give an accounting every six months about how I have spent my money.
Fiftly, I know what it’s like to struggle and to succeed. I have had to learn how to become “scrappy.” A scrapper. It’s not below me to do entry-level work, even though I have a great education and experience beyond entry-level duties. Mental illness knocks you on your butt, quite often, and people like me have had to re-learn how to perform basic acts, like self-care (hygiene, eating, brushing teeth). It is very humbling to be on top of things and then, suddenly, have to remember that you need to wear shoes when you go outside. My success has not been handed to me on a platter. I have earned it.
Sixthly, I know how to manage stress. In fact, I went to counseling for six months one time just focusing on how to manage stress. This is because stress, for me, can cause flare ups in my schizophrenia. I’m not the only one prone to stress-related illness, though. There’s a whole body of research on how every day stress affects most people. Most people. Not just me. However, I have had expert education and training in managing stress.
Seventhly, I am creative. It’s not just me who is creative. Anyone who has had to deal with a serious, chronic illness has had to get creative sometimes. I have had to try different treatments, different doctors, different therapists. And I have had to be open to different and new treatments, therapies, solutions. Sometimes, I have proposed my own solutions to these challenges. I have discussed treatments with scholars who work in the area of psychiatry.
Eightly, I have a unique perspective. This is because, when you are ill, you come to a point where you are free to think differently than most people who are going about their daily lives. Not often do we have time to pause and reflect on the important things in life. But I have. Not just as a philosopher, but as an ill philosopher. Illness forces you to pause and take stock of things. As an ill philosopher, I have been forced, on top of my choice, to take a perspective of reflection and mulling over what’s important in life. This has given way to creative and unique thinking.
These are but a few reasons why I may be an asset to an organization. I’m sure that other people with mental illness have similar ways in which they are assets. Think about that next time you are hiring.
I’ve mentioned previously that I’m participating in NAMIWalks. The walk in Orlando is on April 30th. It’s an awareness raising and fundraising event. Please consider donating to NAMI through my NAMI walker website. It is safe and secure.
My page is here.
Contrary to what many people think, the government doesn’t actually want people to be on disability. They make it hard to get on and easy to get off.
I see my doctor soon, and will discuss again whether or not she thinks I should work.
They have incentives to get off disability, or see if you can work.
I write a lot about having schizophrenia, but I don’t often write about what it is and how it differs from other mental illnesses. Here’s a short article over at PsychCentral that discusses the difference between schizophrenia and bipolar disorder.
Schizophrenia is less common than bipolar disorder and is usually first diagnosed in a person’s late teens or early to late 20’s. More men than women receive a diagnosis of schizophrenia, which is characterized by having both hallucinations and delusions. Hallucinations are seeing or hearing things that aren’t there. Delusions are the belief in something that isn’t true. People who have delusions will continue with their delusions even when shown evidence that contradicts the delusion. That’s because, like hallucinations, delusions are “irrational” — the opposite of logic and reason. Since reason doesn’t apply to someone who has a schizophrenic delusion, arguing with it logically gets a person nowhere.
Schizophrenia is also challenging to treat mainly because people with this disorder don’t function as well in society and have difficulty maintaining the treatment regimen. Such treatment usually involves medications and psychotherapy, but can also involve a day program for people who have more severe or treatment-resistant forms of the disorder.
Because of the nature of the symptoms of schizophrenia, people with this disorder often find it difficult to interact with others, and conduct normal life activities, such as holding down a job. Many people with schizophrenia go off of treatment (sometimes, for instance, because a hallucination may tell them to do so), and end up homeless.
I came across this article with facts about disability, and I thought I’d share it here. It contains information about how hard it is to get disability, what kinds of disabilities you have to have in order to get disability, how many people are rejected, and so forth.
There’s a large amount of evidence that exercise does not make you lose weight. I have lost over 10 pounds with really no changes in my exercise. All of my changes have been with my food, which is the most sound way to lose weight.
Yet, I plan on joining the gym at the beginning of the May. Why do you think that is?
It’s because, if you want to be fit and healthy, you should exercise. Just because exercise alone doesn’t make you lose weight doesn’t mean you should give up on exercise. Losing weight is not the only goal in life, especially if your aim is to be healthy.
So, exercise away. Just make sure you understand it won’t help you lose weight very much.
Right now, my doctor doesn’t want me working. I’m simply not ready, and I have to come to terms with the fact that I may never be ready.
I have a very good friend who has bipolar disorder. He is also on disability, and we recently discussed working. He was feeling like he should work, but was unsure about whether he could handle it.
He’s been stable for a few years, and here’s the conclusion we came to: He remains stable by (1) taking meds, (2) going to counseling, and (3) maintaining a therapeutic lifestyle 24/7.
We concluded that, without any one of these, he would probably go back to the hospital.
It’s the same for me.
I continually do things that are therapeutic—whether it’s participating in poetry, painting, writing, reading, photography, walking, and so forth. I maintain a therapeutic environment for myself 24/7, under the advisement of my doctor.
It’s only been a year since I have been in the hospital, and just under a year that I’ve been on my current medication. That’s far too early to tell whether my medications will prevent me from having a psychotic break if I should try working. I have, in the past, had a psychotic break every six months to a year. I still vividly remember my last break, and I don’t want it to happen again.
Keep in mind that I was given a poor prognosis. The very first psychiatrist I saw told me I should expect to lose a lot of cognitive functioning. I’m lucky to have not lost as much as they thought. I chalk it up to having good care, and fighting like hell.
But I still struggle with not working. The feeling of not working for a living.
If you browse around my website, you will see that, from an early age, I have been involved in many things, and have been very career oriented. For a person like me, not working is devastating.
This is true even though I have doctors’ orders.
I know I have a legitimate disability. There’s no doubt about it. I have had serious psychotic breaks. I am trying, each day, to maintain my health, above all else. I don’t like becoming psychotic, and it’s not like my medicine is so magical that it will, with 100% efficacy, prevent a psychotic break.
They know that, for example, stress can exacerbate psychiatric symptoms. So, I try to limit my stress, and engage in stress-reducing activities, like practicing mindfulness.
Currently, I have to come to terms with the fact that I cannot work—my doctors says so, even—and that I may never be able to work again.
For me, coming to terms with this myself is one thing; a big thing. Realizing this is but one step in coming to terms with my condition and lot in life.
But the even bigger thing is having regular people understand this. When people meet me—when I am out in public—they may not know I have a mental illness. (Unless I am symptomatic. In that case, I may be in my pajamas in public, or looking a huge mess.) I have an “invisible disability.” Not to mention, many people still have stigmas about mental illness, making them think a mental illness is not a real illness just because you can’t really see it.
So making other people understand that I may not be able to work—and that I may be on SSI (and poor)—for the rest of my life is difficult. But it’s something that’s important.
I hope that, if you are reading this, you will not judge people who have to be on disability and who cannot work due to disability. There’s a segment of society that makes people feel like it’s not a legitimate option. This often stems from conservatives who tout the notion that people exploit the safety net system. For so-called Christians (as most of them allege they are), they are highly skeptical and not especially loving when it comes to caring for the wretched of the Earth. (WWJD?)
In my experience, it’s very difficult to get disability. It wouldn’t be easy to fake it. I had to be hospitalized eight times and given a poor prognosis from several doctors before I was given SSI. I was suffering, and denied SSI (and, thus, healthcare) for several years. The whole process is insult to injury. And then you end up living in poverty, anyway.
But my whole point is that each of us can make a difference. We can change things so that people like me, who have to be on disability, do not have to constantly feel like we have to justify this to people who have no business prodding for our medical information.
The fact is, I have tried working several times. Everyone who knows me knows I didn’t want to go on SSI. I wanted to work. Take a look around my website—I like professional accomplishments. But I had to go on SSI because I simply could not work.
Let’s try to make things easier for people who are already suffering enough.
Several months ago, I decided to stop wearing makeup. I just stopped cold turkey and haven’t looked back. I’ve had to get used to a new aesthetic. A natural aesthetic. I was used to a faux healthy look, using makeup. (This is how this post ties into my current posts on health; most women, whether they consciously know it or not, use makeup to fake a health look.)
It was rather easy for me to get used to seeing myself without makeup, and even thinking I may be somewhat pretty without makeup. This is because I have a broad sense of beauty. I am well-acquainted with art.
I have had problems with makeup in the past. It has damaged my sensitive skin.
I have been using both of these daily for about three weeks now.
This is all part of my Grand Plan to beef up my self-care.
It may seem that eating is straightforward. You get legitimately hungry, so you eat. But research has shown that the majority of eating is actually psychological. I like psychology, so I have found this research interesting.
If you have ever tried to lose weight, you know how difficult it is. Luckily, I have some tips to share with you here. These are psychology tricks to use as you lose weight. They have helped me and, if you are at all interested in psychology, they may also independently interest you.
What do you think of when you think of a person with schizophrenia?
If you are like most people, you probably don’t think of technology savvy people, using said technology to better themselves.
But according to this new survey, that’s exactly what the picture of schizophrenia is in America, currently. That puts me in line with other people with schizophrenia. I use a lot of technology–computer, smartphone, tablet–and I use all of this to connect with other people, including other people with mental illness, and gain information and other things to help me.
When I started eating better, I cut my calories and decided upon more realistic portion sizes. We humans are really bad at estimating the portions we are supposed to have. I include myself in this. However, I also decided I would have one cheat meal per week.
This is my third week of having a cheat meal. I decided that every Friday I would go out to eat with my daughter. It’s easy to have a cheat meal when you are eating out because portions at restaurants are out of control. But this way, I get to go out and have some fun with my daughter and we both get a good meal. She is in college, so she really appreciates going out to eat one day a week with me.
Oftentimes, when people think of cheat meals, they think of eating all kinds of sweets, chips, and so on. Not me. I just go out and have a meal. It’s typically a pretty healthy meal, too. For example, last week, we went to Olive Garden and I got soup, salad and breadsticks. I chose the minestrone soup. All in all, it was fairly healthy for eating out.
Today, however, we decided to go to a Chinese buffet. It’s hard to count calories for that. I know I had a lot of food. But the best thing was the fortune cookie at the end of the meal, which told me something I needed to hear. Duly noted.
As readers know, I recently had my yearly physical. The only thing that was off was that my lung capacity wasn’t as good as it could be. That’s because I was smoking. I have since quit smoking. If you are having trouble quitting smoking, drop me a comment here. I tried several different ways before I could finally quit. And several people I know have recently quit or are quitting.
I may look healthy, but looks can be deceiving. That’s why it’s so important to get a physical and get all of those tests done. That way you know for sure if you have high cholesterol, high blood sugar, or something else. Several people I know have been diagnosed with different things, so I thought it was important to take my physical seriously, and then take precautions for my health.
I’m lucky. I naturally like healthy food. When I say I’m losing weight, it’s not just a matter of counting calories. A calorie is not a calorie, as it were. It matters where your calories come from. That’s why it’s important to get your fruits, vegetables, and so on. These things can make a difference. So, too, does avoiding the wrong things.
When someone who looks overweight asks me about how they look, I simply tell them I care about their health. You can look overweight and be internally healthy. Likewise, you can look skinny and be an internal mess. Don’t believe me? Have a look at this article. It is but one that I have read on the subject.
I was recently telling someone about how in shape I was in my twenties. Well, here’s a picture of me from that time. I believe I can get close to that again. (Mentally and physically.)
I’ve mentioned previously that BMI is something to take with a grain of salt. I use it as but one measure of health. It does track some things I’m looking for, and is a quick, easy measure for me to look at, taking into account other things.
I am losing weight–and becoming more healthy–under the advisement of my doctor, as I suggest anyone do. I’m not really close to being at risk for anything, but I’d like to stay that way. Besides, being on antipsychotics messes with your metabolism, among other things, and as soon as someone is diagnosed with schizophrenia, their risk for things such as diabetes, heart disease, and more, goes up. There’s evidence that some of the things I’m doing can stave off those things, and that’s what I’m hoping for. It’s bad enough for me to deal with one chronic illness (schizophrenia) without dealing with others.
In light of all that, I thought I’d share this article about BMI. It goes into detail as to why BMI alone is not a good measure of health. It also discusses other options to look into that do track health. Have a look.