Happy Holidays from me to you.
Great article at the Atlantic.
I took a job-related assessment recently. You may be interested in my results. Go here to view them.
Recently I wrote a memoir. You can buy it at Amazon.
I recently contacted the White House regarding the Dakota Access Pipeline. I asked Obama to oppose it, specifically. Today, I got a letter from him via email. He didn’t come out to oppose the pipeline exactly. Here’s what he had to say:
Thank you for writing, and for your thoughtful input. As President, my greatest responsibility is ensuring the safety of the American people, including when it comes to our Nation’s energy infrastructure. My Administration is setting the highest possible standards for oil and gas production and transportation, and each day we are working to make sure our pursuit of energy resources does not put our communities at risk. That work includes steps the Army has committed to taking in light of important issues raised about the Dakota Access pipeline.
I understand the risks associated with the development and transportation of fossil fuels, which is why my Administration has overhauled Federal oversight and raised the bar on safety across the board. As part of our efforts to improve Federal permitting and review processes, we are making safe pipeline infrastructure a priority in order to help ensure the health and security of our communities and the environment.
As new energy infrastructure is developed, the Federal Government will continue working with State, local, and tribal governments—which play a central role in the siting and permitting of pipelines—to address the concerns of local communities. One of my priorities as President is upholding an honest and respectful relationship with Native American tribes, and we have made a lot of progress in restoring ancestral lands, waters, and sacred sites over the past 8 years. My Administration also remains committed to consulting with tribes to ensure meaningful tribal input is factored into infrastructure-related decisions across the Federal Government. In the weeks ahead, Departments and Agencies will meet with tribal leaders across the country in a series of formal consultations on this issue.
Again, thank you for writing. I hear you, and I am optimistic that together, we can grow our economy and create new opportunities while securing a cleaner and safer future for all our people.
Recently, I wrote an article on Basic Income and what we can learn from Tribal Nations, some of which implement per cap payments. You can read my article here.
Interesting article at the Guardian.
I worked on the book Reading Barnard Williams (Routledge Press). I edited the work of Martha Nussbaum and Carol Rovane. The Editor of the whole project, Daniel Callcut, called me “a superb research assistant” in the acknowledgements section of the book. He also gave me a copy of the book, which he inscribed a comment to me on the first page of the book. I keep this page framed along with my prized possessions.
It says, “Jennie, One of my smartest students…ever. Good luck with everything and very fond best wises, Dan”
Recently, I was honored to be told by someone (several times) that I am creative.
I certainly do appreciate the arts and have won awards in poetry and prose.
Today is National Poetry Day and it’s hard for me to list my favorite poems or poets. I love Plath, Ginsberg, Nash, Whitman, and more.
All of these people have shaped my thinking and my creativity.
Today, take the time to read or listen to a poem.
Sometimes people ask me what I studied in graduate school. I focused primarily on Ethics and Political Philosophy. Here’s what I studied:
GRADUATE COURSES and READING GROUPS:
- Methods in Applied Ethics
- Philosophy of Language
- Contemporary Political Philosophy
- Practical Philosophy in Culture and Society
- Theory and Anti-Theory in Ethics
- Lies and Self-Deception (Action Theory/Moral Psychology)
- Mathematical Logic
- Philosophy of Language/Wittgenstein
- Readings for Master’s Thesis
- Virtue and Vice (Virtue Ethics/Moral Psychology)
Yesterday was my birthday. I had a wonderful, relaxing day. In the evening, my family took me out for dinner. We had Chinese.
Interesting article about the humanities here.
I mentioned earlier that I wanted to write down the skills I have gained as an activist and try to incorporate them into my resume. Here’s a short list of skills I have developed from my activism work:
- Campaign strategy and planning
- Building a movement and organizing in community
- Campaign communication: face to face mobilization
- Media skills and social media
- Lobbying skills
- Meeting facilitation and participatory decision-making
- Fundraising skills
- Action and event planning
UPDATE: Here‘s an article by Microsoft’s Lisa Brummel on the undervalued skill of social activism.
Good article here.
For the past month or so, I have been involved in the movement against the Dakota Access Pipeline. I have done many things with this movement, and wish to incorporate my activities into my professional experiences. As you will see in my previous post, I wrote a Letter to the Editor which was published in the Daytona Beach News Journal.
In addition to fighting against the Dakota Access Pipeline, I have also started doing editing work for a Basic Income website. I haven’t done as much work on this as I would have hoped because the Dakota Access Pipeline movement got in the way of that, but I have edited a couple of pieces on Basic Income.
I have been wondering about how to incorporate my volunteer and activism experiences into my resume. I will be doing that soon.
Recently, I wrote a letter to the editor of the Daytona Beach News Journal about the ongoing #NoDAPL movement, which I have been a part of. You can view my letter here. It’s the last letter on the page.
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.