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26 Jan 2022

Category: identityCategory Archives:

Solid Ground and the Rescue Line

Peer specialists risk getting bit in the ass. If it is not the illness, it is the people we are supposed to be helping. How much do we disclose to them? What is the limit on honesty and openness?

I disclosed early on in my career. I just could not be bothered hiding the fact that I was just as “out there” as the people I helped. The difference was that I had gone through training and learned how to live with the “normals”. I knew how to talk with them. I competed with them on their academic turf. In short, I straddled both worlds. They were sometimes howling in the hospitals, other times having drinks and finger food with the boss.

My first time having my diagnosis shoved in my face was with a woman in one of my groups.

Everyone knows you have problems

EMB

Peer workers work in two dimensions. On the one hand, peers get paid to use their experience effectively with the clients. On the other hand, they go home to live somewhat marginalized and jeopardized by the illness. If not correctly put in its place, the insidious, dangerous condition threatens to wreak havoc with hard-won economic, social, and psychological gains.

I supervised peer interns from Howie the Harp. For the most part, they were terrific. I met my match, however, in a wild little devil that insisted on reporting me as unfit because I had told her to comb her hair and button her shirt. Luckily, the staff had my back.

I had had enough. The next intern insisted on going over my head to the director and workers she considered more competent because they weren’t peers like I was. So I went offline and waited for her internship out in the psych spa. I came back when she was gone and told my director I was through supervising peer interns. I knew my limits.

Peer workers are people who somehow pull themselves out of a hole. Now they stand on solid ground and throw a rescue line down into the abyss. Jealousy, resentment, and rage get in the way.

No matter. It is a crazy happy day in the neighborhood, and no one is going to mess with my high!

The Communication and Support That Allows Progress in Treatment

To make progress in life, maintaining a presence in mental health treatment is needed for many people. Personally, I know there are barriers to maintaining a presence in treatment. The goals of a practitioner and someone receiving treatment do not always coincide. It is interesting to determine at what point the purposes of the consumer and practitioner intersect. I know that treatment is beneficial in my life, but communication has become very difficult with service providers. For this reason, support needs to be established with common goals in a therapeutic alliance. 

Goal setting in treatment may be one way to establish a common ground and language. However, varying temperaments in a therapeutic relationship will slow the road to meaningful therapeutic gains. There are inevitable conflicts, with baggage on both sides hindering real productive communication and goal setting. Ironically, sometimes it is the practitioner that carries more weight and credence to drive treatment forward. Objectivity is difficult whenever people and perception are involved, as everyone has the best idea.

All too often, treatment gets disrupted, many times, without warning and naturally throughout care. When progress and accurate work in treatment unravel, establishing or resetting a goal and kickstarting the momentum of the work is almost impossible without a social worker communicating the clinical play by play when cases have robust moving parts. When personal ambitions interfere with goals, it also may be challenging to maintain the ethical reins to keep treatment smoothly and without incident.

In fact, specific measures such as more extended unnecessary hospital stays could be avoided in some cases with better communication from the treatment team. Certain attitudes by social workers may exacerbate symptoms rather than give relief when a clinician takes cues from the wrong parties or isn’t truly engaged in their work enough to be a real changemaker and cheerleader in their client care.

All too often, patients are triggered by treatment providers without empathy. These feelings can lead to an ‘episode’ or the unraveling of a patient’s progress to date. Sometimes, these clinical missteps are so critical and negligent they make further treatment and additional clinical services necessary. With proper caution executed, and good listening with precise language, treatment progress can be maintained and preserved during touch-and-go blips that arise during care provision. 

With a well-seasoned treatment team, enrollment and selection of programs and tandem services after discharge can be successful for many years. In the end, treatment at one level of care cannot go on or be maintained indefinitely. With time, everything changes, and someone may show the most signs of relapse when significant progress is being made. 

For this reason, identifying valuable resources for patient education is critical for long-term progress after discharge and incredible natural support for patients to draw from when other artificial supports are inaccessible. Some supports need to be titrated down for the well-being of the consumer. When someone craves independence, but their goals are being withheld, severe conflict may worsen psychotic symptoms.

In cases of serious conflict, the proper change may be medication, but there may be more going on in the environment, or socially that can ease the episode. Changes in both may be needed, but good communication and appropriate support can certainly help to calm an attack. 

In the end, the nature of life is dynamic, mental health treatment should be regarded as such. If life becomes stagnant due to failure to understand the needs of someone, symptoms can flare up. In worst-case scenarios, prison may be an outcome. However, communication and support are more attainable with grasping the history of someone. Responses will be more appropriate, and crises can be avoided with a reasonable, empathetic method of questioning. 

RELATIONSHIP ABUSE and DOMESTIC VIOLENCE 

“Hey, over there, that man is pulling that lady by her hair across the avenue.” 

“Watch out, pastor, those mean guys by the broken window are beating up those women with glass and blood flying everywhere. Someone, please call the police!”.

Abuse like this is becoming commonplace, and unfortunately, increasingly frequent in today’s society. There is never, ever an excuse for abuse. Anger, jealousy, alcohol, and drugs are not acceptable licenses to harm other people. In most instances, minor issues can escalate into more significant problems.

Since 1987, October has been Domestic Violence Awareness Month. A month to connect and unite individuals and organizations around this global problem.

Relationship abuse occurs across a broad spectrum of the population. Victims and abusers can be male or female or someone with gender identity, white or black or even yellow, be tall as seven feet or five feet or smaller. Harm occurs when someone uses behaviors to control and manipulate another person.

Perpetrators of emotional abuse are dominating and exert undue power over other individuals. In doing so, some resort to name-calling, humiliation, and threats. People can also be abused sexually in relationships. Husbands can sexually abuse a married woman. An example can be a wife who has consented to sex in the past, even when she does not want to have sexual intercourse and forces it upon her.

Victims of abusive relationships are subject to the dominance of their abuser, who want to be in total charge of their relationship. They tend to humiliate their partners to reduce their self-worth and exert power. Another way they use their passion is to isolate their victims from friends and family. 

Some people become more vulnerable if they don’t have any support systems around them. Also, abusers tend to scare their victims with threats and an array of intimidation tactics. When the wrongdoer blames the victims, the abused may feel that they are lower than low and worthless.  

Many of us wonder why victims of abuse don’t leave their current relationships. One reason may be that the victim is in severe danger if they go into the relationship. 

An offender could seriously hurt their partner or family member, including their children. Another reason that victims stay in their horrible situation is due to financial reasons or obligations to their partner. Victims may not be able to support themselves and their children without money from the abuser. 

If you know someone in an abusive relationship, listen to their reasons for staying in their predicament. Understanding these rationalities can make one a better resource for this person.

According to New Hope, Inc., located around the country, there are warning signs of Abusive Relationships.

One can call New Hope at 800 323 HOPE between 9 am and 4 pm Monday thru Friday, or visit their website for more information.

Signs of an Abusive Relationship:  

  • EXTREME JEALOUSY
  • CONTROLLING BEHAVIOR
  • QUICK INVOLVEMENT 
  • UNREALISTIC EXPECTATIONS 
  • ISOLATION
  • BLAMES OTHERS
  • HYPERSENSITIVITY 
  • CRUELTY TO CHILDREN AND OR ANIMALS
  • DR JEKYLL AND MR HYDE BEHAVIOR
  • PAST HISTORY OF AGGRESSION
  • “PLAYFUL” USE OF FORCE OF SEX
  • VERBAL ABUSE
  • USE OF VIOLENCE OR THREAT OF VIOLENCE
  • FEELINGS OF ISOLATION
  • EMBARRASSMENT
  • DEPRESSION
  • ANXIETY
  • FEELINGS
  • ADDICTIONS
  • INJURIES
  • FINANCIAL PROBLEMS

WebMD stated that people targeted by these controllers and have any connections with them could have dire consequences. They often live with many residual problems that can last for years or the rest of their lives. As a result, they can develop some of the following:

Talk to friends and family members about the signs of abuse. Reach out to someone who we believe might be abused by his partner. Assist domestic violence shelters or volunteer at a domestic violence shelter or hotline. If we’re being beaten and want to help others, there are several options to consider.

If you know about someone in an abusive relationship or dealing with domestic violence anywhere else, please provide them with education, hope, and this hotline.

1-800 799 SAFE (7233).

See you in the news blogs.

Working with a Mental Health diagnosis/disorder

During the early phases of my recovery from Schizophrenia, two things were important to me that I was unwilling to compromise because of a significant mental health disorder: working and further healing.

I was tired, not just from the impact of my symptoms or side effects from medication, but from laying in bed and feeling useless.

My parents, specifically my mother and father, were critical in dispelling the idea that my future was limited because of illness. They reminded me to take outstanding care of myself, and my career would follow. Well, they were right on the money. 

With the help of my therapist and a good psychiatrist, all reinforcing the concept of self-care, I went back to graduate school in social work. Within two years, I graduated from SUNY Binghamton with a master’s (Masters in Social Work). The same college I had my initial ‘break’ from first-episode psychosis (ultimately diagnosed as Schizophrenia). 

As a young licensed social worker, I taught my clients about self-care as well. Later on, I would teach self-care at the level of education. Specifically, I taught social work education to new social work students as an adjunct professor at Fordham University at their Manhattan campus. I had come just about full circle since my initial illness. 

When my illness was first blossoming, I was an English major at Binghamton University with dreams of becoming a professor. One decade later, I was teaching young therapists how to be future social workers. In some cases, these future social workers would be future therapists, reinforcing the importance of self-care to their patients, similar to how my therapist did ten years ago.

Today, I am confident, knowledgeable, and polished in my education and skills. But, this wasn’t always the case. Schizophrenia had struck me at the most inopportune time, right the peak of intellectual ability and personality development. Research indicates Schizophrenia often becomes diagnosable at this point in the development of young adults. This fact about Schizophrenia is sad and difficult for many people to manage (and understand), but it doesn’t have to be the terminal point in your career or education. 

There are few things to keep in mind as you pick up the reigns of your education again, or for the first time:

  • You are in charge of how far you take your education, with or without a mental health disorder.
  • The limits of your career and skills are where you set them.

So, when you go back into the classroom, remember that you choose the career you want. Please, don’t let your symptoms, as tricky as they may be to deal with while going to school or to work, dictate what you want to do in life.

Should work or education prove to be ‘too much’ or triggering, look inward, and ask yourself: are you taking the best possible care of yourself as possible? If you cannot identify the reason or roadblock that triggers or activates your symptoms and makes it difficult to work or study, consult with a therapist. Troubleshoot with a psychiatrist. 

Just don’t give up or throw in the towel because of a label. A Mental Health disorder is only as disabling as the power you give it to rule over your life. Sure, there will be days when you can’t make it to work because of your symptoms, but that is OK. 

Just like the flu, some signs make it too uncomfortable to go in and do our job correctly. Heck, going to work or school in such cases might even be a bad idea, should you be contagious from the flu or tired from depression to get your work done correctly. But these are blips and moments and should not influence your potential for lifetime achievement!

An Effort To Explain “Psychosis”

When confronted with a disturbed loved one, especially one who has been in the hospital with a psychiatric diagnosis, many people hear the word “psychotic” used to describe their behavior or thought patterns. What exactly does this term mean?

 

First of all, it is imperative to understand that those suffering from “psychosis” are often lost in their reality and thus are unaware they are “out of touch with reality” no matter how bizarre their behavior or ideas appear to other observers. 

 

“Psychotic” is a clinical judgment.

 

It is not a diagnosis but rather a symptom describing the status of a disturbance of a person’s mind. The difficulty with the word ‘psychotic’ is that there is no absolute state, or judge, of what constitutes “reality.” 

 

The word all too often is used to assess the condition of an apparently “sick” individual. Here is the issue– since all people live and operate in their perception– how can a court or clinician discern what a healthy reality is or is not unless their safety is a factor? 

 

A person with delusions of being God might well be perceived as psychotic (as was my case) and firmly believe their ideas. On the other hand, the constituents of a radical politician may applaud them for their “honesty” despite the negative emotions they might induce. After all, if people are not ‘harmed,’ what do feelings matter regarding health and perception.

 

Reality is always relative and never absolute, so that every diagnostic judgment is ultimately subjective to the clinician using it.

 

In society, “reality” is a cultural construct defined by the majority of that culture. In my case, I accept that it took me six years to return from my delusion enough to be able to have the mental and social focus to return to college after a schizophrenic “break” at my first university. It took a growing awareness and insight in a private “program” and nine hospitalizations before I was ready to re-integrate into an educational setting without regression to a state of illness.

 

But it was the transformation of my self-perceptions that finally freed me from the internal mental structures upon which my religious beliefs. All this work on myself and the steps to these changes has convinced me that my path forward hinges on bringing this awareness to the families of those diagnosed with schizophrenia. I want to help them navigate the challenges not only presented by their loved ones but more especially to themselves so they can believe “Recovery is Always an Option.”

My life as an Artist with Psychosis

The funny thing about my musical and artistic sides: these parts of me did not start to surface until around the same time as my diagnosis of bipolar disorder.

I was about 16 years old: an adolescent gripped by raging hormones.

At the beginning of my sophomore year of high school, my elder sister, by three years, brought home a classical guitar. With some sheet music and some instructions from my music major sister, I became engrossed in methods of playing the guitar.

I had dreams of playing on the stage with a rock band. I learned Led Zeppelin and the Grateful Dead and increased my classic rock CD collection. Led Zeppelin was my usual go-to for listening, as well as Jimi Hendrix and the Grateful Dead.

Although there were times out with drama club and occasional trips with friends who performed punk music, I felt less connected with peers.

As “Dust in the Wind” by Kanas plays in the background, I reflect on how sad it is that my dreams of being a rock and roll star never came to fruition. The reason this never materialized is a story that is at least as sad as this song.

The last two years of high school brought friends who got me further involved in playing rock music both in parties, and on stage.

Going to college brought an upheaval for me, newly diagnosed with bipolar illness with psychotic features. Conflicts between my party life, romantic life, and study life made it impossible to manifest a balanced lifestyle. However I burned extra energy by exploring my artistic side, and by producing professional level work for my drawing teacher.

Later on, in my early twenties, unfinished with undergrad, I moved into the city to live independently of my parents. For the first three years of life in Buffalo, I had the luxury of a car, which allowed me to make it out to music shows and get involved with local musicians.

Most of my music was solo, although there was some collaboration with friends I met on  alternative rock and folk music. My songs, performed solo on acoustic guitar, were praised by musician friends for their  expressive and theatrical dynamics.

My time playing was plagued by paranoia and hallucinations in the meantime.

My theatrics while performing guitar was replaced with shame and fear of public performances. I projected my self-destruction during that time.

I entered into a mixed manic and depressive episode in between performing live music followed by a year and a half of hospitalizations.

I still don’t have a car, as additional diagnoses make it more challenging to focus.

After ten years of group homes and supervised apartment living, I started the crawl towards further independence…

Exercising the Right to Speak Out 

In 23 years of being treated for mental illness, I have learned that it is common for some treatment providers to assume flawlessness. Although a practitioner may have training, practice, and experience on their side, It is questionable how much this experience should override someone’s right to think independently. Putting out a statement in treatment that questions the validity of a claim should be respected for its originality, not delegitimized.

The interrogation of my ‘Lived Experience’ has been commonplace with many psychiatrists, therapists, or peer specialists. Çommunication can become rocky when a person with a diagnosis expresses their rights in treatment. In treatment, it is the right of a patient to say their preference for the exercise and provision of care.

It has been my experience that practitioners can get hung up on how they do things, clinically speaking. Even more problematic, clinically speaking, everyone is quite different, and treatment should be person-centered. However, it seems as if theoretical example person ‘A’ may be getting too similar a treatment to person ‘B’ for very different disorders and presentation.

Clinicians must respect our rights; this should go without saying in mental health treatment. Expressing our needs may become a life or death situation for patients. When patients question the quality and provision of their care, it can create volatility.

When people feel that treatment is not going well and the therapist does not agree to change mental health treatment, this should be a red flag. It has been my experience that therapists can distort the severity of someone’s symptoms in their care when their motive is to retain their job as a therapist. I have seen this happen firsthand.

I think this is common due to the origins of mental health treatment. In psychoanalysis, the responsibility is given to the therapist to have an absolute understanding of the workings of a patient’s mind. In my opinion, this power differential helped give birth to the hegemony within the psychiatric profession. Finally, in the 1960s, mental health advocates began to question this hierarchy. Soon, the advent of patient rights came into being. I have learned that practitioners who call themselves peer specialists often betray their practice. They also often fall victim to a paradigm of teaching ‘learned’ helplessness.

Peer specialists especially should have respect for the position of a consumer. Taking on a superior attitude due to being a peer specialist runs contrary to standards of being a peer in the first place. Yet being with somebody, and thinking on their level, is essential in peer practice. However, before peer certification became the norm in New York State in 2015, empathic communication was more commonplace in peer agencies.

The hiring of peers may have to do with funding streams or simply because agencies get grants when they hire peers and get opportunities for other ‘reimbursable allowances’ having to do with money. Peers don’t require as much money as social workers when it comes to salary.

So I see the practice of hiring peers as being cheapened, and the real value is disappearing. Peers are overworked and don’t love their jobs anymore. While it is excellent that peers are more valued now than before, I see some themes remain the same between therapist practice and peer practice.

When it comes to peer practice in the future, it is essential to deeply examine the dynamics and the absolute authority present with therapists. Having volunteered at multiple peer agencies spanning my treatment, I feel this is critical as we move forward.

Effects Of “Broken Brain Syndrome”

One of the most significant obstacles to my recovery from schizophrenia is clinically-induced programming.

By ‘clinically induced programming’, I mean my self-perception was exposed to the influence of widely-accepted medical ideas. To recover, I had to filter it out.

First diagnosed in a psychiatric unit in New York City, my psychiatrist explained my illness by saying I had a “broken brain.” He compared my brain to a broken leg. This ‘brokenness’ was the reason I had been hospitalized in the first place. Although this seemed to make some sense, I did not realize at the time it was a faulty analogy. Most doctors do not believe the mind can undergo extreme disruption and mend like a shattered bone.

As I got deeper into my journey in the mental health system, I became aware of the general view that my job and “success” hinged upon avoiding permanent institutionalization. My success would be measured with taking my medication (which I still take at a much lower dosage).

I was led to believe I would be forever “sick” no matter how successful my recovery or how creative my writing production.

I believe this reality is one of the most significant issues raised by psychic affect (my term for “mental illness”), especially schizophrenia.

Even in a private psychiatric program, I was convinced by the doctor’s words and actions that I was constantly on the edge of a “psychotic episode”. Consequently, until I broke the cycle almost thirty years ago, I returned to the psych ward 15 times. During this period, I thought I was, in fact, insane.

When I was determined to be well enough by the doctor to be released from “The Program”, I got an apartment and, simultaneously, returned to college. I had a very successful academic and social life in college. Enjoying my reality as an undergrad, I came to the liberating insight I had to learn to trust myself while continuing to adhere to the advice of the psychiatric professionals.

So what is the solution to “Broken Brain Syndrome”?

There is an essential need for more research to get to the core of this mysterious condition.

Perhaps even more important is the need for more understanding and compassion in the face of the diagnosis and the clarity to know this illness is not necessarily permanent. Despite the intensity and long-lasting nature of symptoms, have hope!

There is a stigma with the language of ‘broken brain” which is accepted by professionals, caregivers, and loved ones as well as, most detrimentally, the diagnosed themselves. This stigma is perhaps the greatest challenge to my belief that “Recovery is Always an Option.”

 

INDEPENDENCE FOR ALL

 

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Hey everyone, this month, the United States of America is celebrating Independence Day on July 4. Three cheers for the red, white, and blue! Wave those flags proudly and find some patriotic songs to sing. As for me, I will not be singing out loud but only singing to myself. 

Fly those balloons and kites, just like Benjamin Franklin did in colonial times. Eating hamburgers and hot dogs, potato salad and coleslaw, and whatever float our boat. Sinking is not allowed or even encouraged by this writer. 

 

Enough digressing. We need to discuss Independence. 

 

Everyone can achieve some measure of Independence, but we have to learn how to get there. We probably know that there are many ways to either define or describe Independence.

Let’s start with just one of them: Independence is freedom from the control, influence, coercion, and oppression of other forces. Independence can be a group effort (like a country doing its own thing) or as an individual being a self-sufficient person. Each of us has to decide what is best for ourselves and try to attain it one thing at a time. Here positive reinforcement and support are critical. 

 

Yes, just like Peer Specialists do! 

 

For Independence is not only a word. It can be a feeling, also. Many experts and family, even friends, sometimes tell people with mental health issues independence is impossible. Freedom is impossible as a result of their “illness.” It took me a long time to get to the place where I felt strong and independent. Once I felt like I had finally found my feeling of Independence, I learned what other people say, think, or think about me didn’t matter. Sometimes, it still counts (and hurts), but for the most part, it doesn’t matter. 

For many years, I have struggled to figure out where my Independence is given my anxieties and obsessive thoughts. However, I’ve learned and practiced coping throughout my journey. 

  

Independence doesn’t mean we have to isolate or feel alone. Asking for help is OK. Know when and where to ask for it. Reach out and talk with someone special or anyone that can assist or ask for accommodations. 

 

Independence doesn’t mean not caring what people are saying to you and about you. It’s letting individuals know enough is enough and telling them when to stop.

Independence doesn’t mean taking on tons of work or responsibilities. Learning to say no. Remember, ‘no’ is a complete sentence. We are only one person, and we can handle so much.  

 

Independence doesn’t mean having lots of friends. It means figuring out what type of person we want to be surrounded by and then doing just that. 

 

Independence doesn’t mean doing whatever we want. It means prioritizing and making important decisions that will affect the rest of our life. No one individual can do whatever that he/she chooses to do.

 

Most importantly, Independence means being proud of what we have accomplished and all we’ve been through in life—not being ashamed of our past mistakes and the struggles of our life. 

 

Of course, I shared Independence and responsibilities for over twelve years with my significant other, Maureen. There were good times and bad times. Significantly, we became more independent because of one another. Also, my deceased parents tried to instill Independence in me. To everyone who attempted to accomplish this, dead or alive, thanks a lot. Of course to all, I miss you, I love you, and I still wish you were here. 

 

For all USA readers, HAPPY BIRTHDAY AMERICA! For everyone, be and have Independence from whomever we choose. See you in the NewsBlogs. 

Feed Your Head (says Grace Slick)

It was not until tonight that I realized “no one here gets out alive.”

Fleeing, escaping and running away are not good answers.  There is good and bad wherever you go.

The trick is managing your own head.

I played my playlist over and over during the past few weeks.  I had to endure a weekend in the country with husband and brother-in-law. It all seemed very middle class, and, if somewhat boring, at least within the confines of normal living.

In dealing with my head I believe change of environment is very important to perspective. For the mental Health consumer, switching off environments can be helpful in avoiding panic attacks, angst, and other symptoms.

There needs to be a balance of familiarity and novelty in environments.  Some people think this isn’t always possible. I found, for myself, when in desperate straits for a change in surroundings and perspective, that looking out different windows in the apartment,  or changing up the room plan, or just moving from room to room periodically can help boredom in a pinch.

Going away for the weekend, or hopping a plane to Somewheresville, USA is even better.

As you get older symptoms get harder to handle, especially if you’ve achieved the prize of living independently in the community with little professional intervention.

So, the weekend in the country? It was tough as a mother because of interactions.  Just as a balance between the familiar and the strange is important in gaining perspective, there has got to be a balance of solitude and interaction for the mental health consumer.

The playlist is important in feeding the head, as are visuals like TV and movies. Reading books, blogs and articles are good for the gray matter as well.  If there are tasks and work to do, so much the better.

If you write blogs, feeding the head is paramount.  If you are a consumer struggling with symptoms like catatonia and depression, a good diet for the head gets the mental wheels turning and keeps them well oiled.

I love my flights into fantasy, my magic carpet rides. I struggle with demons anyway.  Change of environment, a balance of interaction, music, visuals and the written word are all part of what the Red Queen said-

“Feed your head, feed your head...”

Mental Health Affairs 2022

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