Comments: Answering Questions
Well, I focus on issues of adherence to treatment so I admit to a bias, but cognitive dissonance precludes me labeling someone who pointedly attests to 98% compliance with his prescribed psychiatric medication as being vehemently anti-psychiatric. For what it's worth, that notion and Furious Seasons are the topics of my own post today: My deal is that I have almost perfectly med compliant for 17 years–98.6 percent of the time
Posted by Allan Showalter, MD at May 15, 2007 04:33 AM
I would like to address recovery, and medications.
Philip has brought the attention to recovery/remission in his post Just How Bipolar Is America, And Treatment Notes.
I also felt a need to explain my opinions regarding medications on my blog, after being outspoken [and on medications]about psych med use in kids.
Who is a mental health advocate?
Then, doing a little more reading from the popular Torrey/TAC blog as well as NAMI-Seattle--I came across a running theme. Medications are key to recovery,and the only "acceptable" way to be recovered.
Stop the madness: A call to arms,TAC Blog
"If recovery means we are headed to a mental health system without medication … we’re all in trouble.
We need to save the mental health system. Don’t let the self-righteous recovery zealots intimidate you."
TAC-[Fuller Torrey] has an opinion stating that recovery can't happen without medication. NAMI supports a house in Seattle, Hoffman House one for men, and recently opened one for women. I took a look at the website, and there is an application for the women's house. "What is your idea of recovery, and what are you ideas about medication and recovery?" the application clearly needs a person to respond with a positive outlook, and a promise to take their medications.
I recently took my daughter to her mental health agency case manager appointment, and the focus was on medication compliance--and a "firm" lecture was given by the case manager to take meds "I don't want to put you in the hospital." What happened to the in between? like talking? spending time with the client and encouraging them in their lives? I've been in the hospital loop for so long, I can safely tell everyone here, that "clear danger to self or others" only gets a bed in a psych ward in this state. What happened to alternative places? step down's from hospitals? MORE than daycare clubhouses from 9-3pm Monday through Friday? What if a person is dx SZ or BP and is doing well off of medications, and needs a mental health case manager to help them with job searches, or housing?
Are we now classified as "self-righteous recovery zealots"?
Posted by Stephany at May 15, 2007 08:16 AM
After an initial period of about 4 years when I was not "compliant." (I find that word offensive, as if there is something wrong with someone who doesn't want to be drugged silly) In any case I've now been completely compliant for 15 or 16 years. Even now in my journey off of drugs I am being "compliant" as I have psychiatric approval.
So I'm med compliant and I work with psychiatrists. (I have two...one that lives nearby and prescribes and another I drive a distance to see for orthomolecular and holistic treatment to heal me so that my withdrawals will be successful.)
I lean toward's "anti-psychiatry,"--I share many ideas of those in the so-called camp--but what does that really mean. First I am measured in my beliefs--I'm not as dogmatic as some in "that" camp. And I work with two psychiatrists I like, who respect me and trust my experience. So I say banish the word "anti"--we need radically transformed psychiatry. One not informed primarily by the pharmaceutical companies.
There is nothing wrong with being in a helping profession for those suffering mental anguish. What is wrong is how those professions are acting at this point in time.
Posted by Gianna at May 15, 2007 12:10 PM
About forced treatment, religion, and (by implication) psychiatry:
http://www.thespoof.com/news/spoof.cfm?headline=s2i18704
Posted by Kent at May 15, 2007 02:38 PM
I probably wouldn't have much quality of life now if I hadn't been "non-compliant" and got the hell away from shrinks and my parents when I was a kid. I imagine I could have made quite a nice little career for myself as a "professional patient", ricocheting in and out of hospital, making a mountain out of every emotional molehill, allowing post-traumatic stress to degenerate into outright psychosis, taking drugs, drugs and more drugs and never having to engage with the demands of the outside world.
Having such an experience is obviously not conducive to developing a positive attitude to psychiatry. However, I'd hesitate to call myself "anti-psychiatry", which is a term loaded to the dots on its i's with specific historical and philosophical baggage, which means some caution is called for when using it. It can no more be reduced to the bare sum of its phonemes than "consumer" can be said to mean "someone who shops" and nothing more.
"Critical psychiatry", on the other hand, implies a much broader church, encompassing people who choose to see psychiatrists and/or take medications and people who don't; people whose primary concern is in the tactics of the drug companies; or the scientific or philosophical underpinnings of the discipline; or the abuses of power that occur both in hospitals and in outpatient therapy. Some are just wounded, raw and angry, feeling betrayed by a system that purported to help but only made their problems worse. Some are psychiatrists, psychologists and related professionals themselves.
People who have been hurt by psychiatry have already had to deal with having their wishes constantly overriden, their perceptions denied, and their opinions mocked and invalidated. To then have some "self-righteous recovery zealot" come and hector them about coming off their Zoloft would merely perpetuate that dynamic. So indeed, "don’t let the self-righteous recovery zealots intimidate you". But who/where exactly are these zealots? Sure, there are one or two couch-jumping high-profilers who don't know when to shut up, and a few not-so-famous people who are just so fucking pissed off that their passion overrides their politesse. But the majority of psychiatric critics I've encountered would not say "Throw away your medication," but "If you're considering taking such-and-such, make sure it's an informed decision. If you want to stop taking such-and-such, whatever you do, don't do it suddenly." (Advice I would have done well to heed.)
Posted by Ruth at May 15, 2007 08:27 PM
Excellent comment Ruth! I absolutely agree.
Posted by Gianna at May 16, 2007 07:39 AM
as an ex psychiatric nurse married to an ex schizophrenic one of the things that I have noticed is that coming off medication is strongly linked in a good recovery journey with the person reframing their experience from one of illness & powerlessness to another of overcoming adversity ,in pride & in overcoming shame & guilt.
we know that 75% of voice hearers can relate their lived experience to their voices, (romme, & Escher, smith , & Vanessa Beaven)
we know that upto 95 % of women diagnosed with borderline personality disorder have been sexually abused. But what do we do, label these people with a a so called biological condition to which they feel powerless to get over , in some cases we even put their memories of trauma down to hallucinations & dellusions & further abuse them.
it is only when people are allowed to expore the metaphor of their voices & unusual experiences that they begin to see what they need to do to heal themselves & recover. My best understanding is for most people suffering mental distress you can bet that shame & guilt will be manifest. This is what professionals should be enaged in dealing with , with their patients not compliance to some medical regime which leaves the person little hope of journeying through the depths of emotional pain they feel & emerging the otherside a free person again
Posted by karen Taylor at May 30, 2007 04:29 PM