Saturday, November 7, 2015

Lone Wolf Speaks - And It's Madder Than You Think

[in progress, comments welcomed!]

Ok I'm going to go heretic right now. I know the right thing to say among Mental Health Activists is that there is NO connection between violence and madness.  I really would like to be able to tow that Iine.  The problem for me, however, is that I would be lying.

In my lived experience, there is a huge overlap. But not necessarily in the way you might think.

The first thing to get is a principle of Science 101:  Correlation is NOT causation. As Matthew Cooper pointed out in a great article in Newsweek earlier this week: ‘The sun doesn’t come up because the rooster crows, even if they happen at the same time.” Maybe Oregon Shooting and Others Aren’t About Mental Illness, http://www.newsweek.com/maybe-oregon-shooting-and-others-arent-about-mental-illness-378875.

How does this play out in fact?  Well, a lot of us who act violently toward others - whether verbally, morally, intellectually, emotionally, spiritually, materially or physically - either have a pre-existing mental health diagnosis, or someone eventually gives us one.  That does not mean that mental illness ‘causes’ violence, however.  In fact, making that assumption is bad science.  To be sure, fish that fly together often fry together.  But that does not mean that being fish made them fly - or that it made them fry.

On the other hand, both the flying and the frying may be connected with the same root cause.  To see that root cause, however, you have to look deeper than surface associations.  That’s what I think is going on here.

My best bet, from painful experience, is that the connection between mental health diagnosis and violence is 'marginalization.'  Let me say up front that I don’t think marginalization is necessarily the ONLY cause of either phenomenon  But I do think that marginalization is an important common denominator that can explain a lot.

Here is why:

1. Marginalization not only follows psychiatric labeling.  It routinely precedes it.  


It's now well known that 90% of the public mental health population are 'trauma survivors.'  Equally, important the same is true for other groups -  the substance use, corrections, homeless -  that society sees - both as 'problems.' and as groups with a propensity for violence.

The reality for those of us in these groups is that our marginalization preceded our 'problems.'  From childhood, we were already dealing with heavy duty stuff like abuse, neglect, domestic violence, sexual predation, discrimination, bullying, family conflict, poverty, homelessness, caregiver unemployment, etc. Moreover, when these things happened to us- not because of us or anything we did -  all too often the rest of society put its head in the sand.  Or worse, we were shunned for just for being in these situations.  A lot of time, people with power who were supposed to change things actually betrayed us.  They turned around and labeled us the cause of the social torture that was careening our way.

In other words, we live in a society that is marginalizing, literally, millions of people.  This happens in different places and by different means for many of us.  But, the fact remains that marginalization has been - and still is - a painful reality of far to many of lives.

Equally important, the consequences of marginalization - both personally and politically - are drastic and dire.  Literally millions of us are being marginalized and treated as if our needs (and lives) do not matter.  The message we get - and not just from 'perpetrators' but from upstanding community members and society at large - is that we have no worth, we do not deserve to belong, and there is no room for us in the world community of human peers.  This kind of marginalization is happening everywhere and every minute - in all kinds of relatinships and in every organ of society: - families, friendships, neighborhoods, schools, churches, workplaces, agencies, offices.  It is even happening - and perhaps most painfully happening - in the very organizations and institutions - that society has set up to 'help' 'problem' people like us.

2. Marginalization produces the kinds of biopsychosocial responses that get labeled 'mental illness.' 


This practical effect of mass marginalization that millions of human beings are growing up in a constant state of fear and threat.  This fear and threat occurs on 2 levesl.  It is not only about the pain and threat social exclusion - although - to be sure - and is vast and crippling in an of itself.  It also has to do with the effect of social exclusion.  In other words - what it is like to try to live and survive when no one you know gives a shit whether people like you live or die, have a place to live, enough to eat, clothes on your back, etc.

3. This is where the violence becomes predictable. 


Violence in these circumstances is a matter of statistics and odds.  It is no longer a matter of individual morality of self-discipline.  It is not about bad actors who need to learn how to calm down and 'act appropriately.'

It is about what happens when so-called civilized society has pushed people too far.  When threat, fear and pain reach the breaking point. In human beings who might otherwise think about consequences.  In citizens, friends and neighbors who might otherwise be inspired to care.

Enter the human survival response.  This is the place of live or die.  Where conscious thought stops - and sheer instinct takes over.  All that matters is self-preservation.  All choices that follow reflect this concern.

The world through this lens looks incredibly simple:  Friend or foe.  Predator or prey.  You are actively for me, or else against me.  If you want to live, make up your mind.  Declare your loyalties now.

To navigate this frightening space - where reasonable people can no longer think and compassionate people no longer care, nature, in her wisdom and kindness, gives us three basic tools:  fight/ flight/ freeze.

A lot of people flight or freeze.  There are many benefits to this.  Flight and freeze, on the whole, are a great thing for society as a society.  The nature of threat in the modern world is becoming less immediately physical and less life and death - at least in a immediate existential sense.  Maximizing responses that allow all concerned to see another day are, therefore, a very good thing.  Understandably, civil society prefers this as the social order.

On the other hand, flight and freeze have their limits -- even in modern society.  This is especially true, when - as now -  we have created a society where many people understandably feel it is not safe (emotionally, materially, economically, socially, politically) to take on the dominant structures of power and privilege.

When only flighters and freezers are allowed in this kind of world, nothing ever changes.  Flighters and freezers habitually ignore or avoid threat.  So, there is no effective counter-voice.  The powerful take more power.  The rich get richer.  The compliant become more compliant.

Thankfully, however, flight and freeze are not all we have.  Some of us will fight.  Even when threats are not immediate.  Even when they are not life and death.   This is not pathology, it is human diversity.  It is good and necessary.  It ensures not only the survival of the human species, but also protects the quality of our collective lives together.

While few people recognize this, the existence of social fighters keeps the rest of us safe and able to sleep at night.  We count on them and we need them.  The virtually assure the following:  When things get bad enough - or stay that way for long enough - some fighter, some where is going to break the tension.  They are not going to run or hide.  They are going to face the facts and take the problem on.   Hence, far from being an frustrating, inappropriate burden on the rest of humanity, the human 'fight' response - and those who wield it - serve and incredibly valueable social function.

4. Crisis meets opportunity.


Given the underlying social function, the sparks are bound to fly when the human 'fight' response collides with social dynamics like marginalization, exclusion and oppression.  The statistical incidence of both phenomena in the modern world (fight response on the one hand, marginalization on the other), guarantees this will happen.    A substantial percentage of the human population will default to fight under threat or stress.  A substantial percentage of the human population is living in daily fear/ threat/ despair due to marginalization and the other impacts it produces.  Routinely and regularly these states will collide.  

When they do, we can and should predict what will happen.  The fighters will target this source of their threat -  whatever that is in their eyes.  And they will try to take it down.

These are the 'lone wolves' of modern society.  They are doing what fighters do.  Consistently.  Across marginalized groups.  They are standing alone and taking on threat, because someone has to and fighters and freezers have ceded the field.

For this reason  - and this is really important for the rest of dominant culture to get - you can't stop violence by marginalizing people.  In fact, there's a really good case to be made that that will get you experiencing a lot more of it.

5. A personal appeal


To bring the point home I am going to say everything I just said again.  But instead of saying it generally, I will say it personally.  I frankly identify with the lone wolves and lone wolf violence.  It's hardly fun to be "Wreck It Ralph" - or the person that everyone loves to hate.  It's even more frightening to contemplate getting marginalized in this community and being considered the mad activist that other mad activists love to hate.

Be that what it may. I can't help myself.  Something in me says this issue is important.  Too important for us not to get.  So I'm going to try to share how I understand it, and what I understand to be going on, as frankly and relevantly as I can.  My hope is that some of those here will consider the points and engage in a meaningful dialogue around these issues that can take us further as a whole.

6.  Lived experienced of one lone wolf, speaking about myself and also from what I have heard from others who, like me, personally connect with that term.  


Those of us who society calls lone wolves frequently do not respond 'nicely' to oppression.  We do not think tactically, speak softly, or consider consequences.  We rarely live to see another day - at least in a metaphorical sense with regard to the issues of concern.  Frankly, that is not our top value or core function - either personally or from a socio-cultural standpoint.  It is also not the purpose of the energized responses that our bodies tend to favor, time and again, when exclusion, marginalization or indications thereof appear to us to lift their ugly heads.

The function we serve is simply this:     Lone wolves target and try to take down the relational and cultural dynamics that we see and experience - in our heart of hearts - as the source of our oppression.  In the heat of the  moment, when those associations are triggered, there is no arguing or being rational.  We are not leaving the room, running, hiding, or spacing out like everyone else.  Those are legitimate responses and lot of people do them in order to survive.

But that is not us.  We are the fighters.  We are protecting what we value.  We are the mother bears of what we see as the essential dignity of the human condition.  Whatever threatens this, beware.  We are taking it on and taking it down.  And the last person standing, turn on the rights.

Please also note: This response in us does not come from the fact that we are mentally ill, adcicts, uppity, black, poor, homeless, uneducable, unemployable, inconsiderate, inappropriate, anti-social, etc. - at least as we see it.  It comes from the marginalization - the socially constructed disabilities - that puts us in situations where we have to fight for human dignity - as we undertand that  - in the first place.

7.  Hoped for response


This is all pretty new territory to be articulating. At the same time, I'm betting there are a lot of lone wolves out there who, like me, have been secretly hoping for a different response from mental health advocates.  To date, mental health advocates have mostly been backing the dominant culture band wagon, which amounts to marginalizing and castigating people who get violent.

Ultimately, I think this is a disservice - both to the mental health cause, diagnosed people and society at large.  As a community, we have been making the same mistake with the lone wolves issue as the larger society has made with psychiatric labelling:  Both reactiions, while understandable and holding surface appeal, amount to some people (with power) marginalizing and writing off other people (without power) instead of making a thoughtful, considered effort to try to understand and make sense of what is going on from the perspective of lived experience.

The fact of the matter is that lone wolves attack for a reason.  In a very real way, this is violence that human beings of good conscience can make sense of -- and arguably must.  Lone wolf violence has both meaning and message.  You only need to scratch the surface to get a glimpse of the extensive, extended desperation and devastation that precedes (and builds into) the ultimate expressions that end up making the national news.

In almost every case, what you see is cultural outsiders, living in isolation, with no hope of ever belonging. As a group, we are people with few if any friends. We have virtually never experienced ourselves -  for any sustained or expended period - as welcome or wanted in the neighborhoods, communities, schools or offices where 'the people of value' work and live.  We have learned again and again that we do not fit in, that our best efforts are not enough and there is no reason to expect that they ever will be.

Year after year there is painful struggle.  There are new insults every day. Every time we walk down the street or enter a store, others walk or look away.  We are the fly in the ointment of human conversation.  We know - can see, feel, tell - the way others put up with us for as long as they have to and then change the subject, leavel the room, close the door. -- So that they can get on with the real busines of their life.  -- The real and really meaningful business.  -- The business that has nothing at all to do with us, or who we are -- and never will.

Suffice it to say, these things mount.  They reinforce, remind us, daily, of what we know to be true:  There is virtually no possibility of becoming regarded as community members of worth and value given how the social rules are currently being written - and by whom.

Far too many of us feel this way.  This is a source of boatloads of pain for boatloads of people who consider ourselves social refugees.  We are people without a country, always adrift, with no friendly shores.  To our knowledge, is no place in the known world that we can safely land and call our home.  We have no loyalties because we have no citizenship.  The politics of marginalization have stripped our birthright as human family.   Once that birthright was gone, the other things followed.  We lost, or lost faith in, our abiity gain digified work that would sustain our existence.  Without that, our access to participation soon followed -  the resources needed to create a community that speaks our language and that feels remotely relevant to what we care about and who we are.  The cycle was vicious.  The ending not good, no matter what route you chose to the bottom.

If these look and sound like mad peoples issues, they are.  If this looks and sounds like mad people's message, it is.  Mad people have been trying to this same message across to the dominant culture for years:

People react to real life concerns.  They aren't simply 'mad.'  They are 'mad' about something.   The biomedical response of locking and drugging serves nobody well - including society.   There are alot of things we can make sense of - but we have to look beneath the surface.  We have to stop labeling human beings and start trying to understand human doings.  We have to get to causes and conditions.

If we make a conscientious effort to do those things, everyone will be better off.  Not only will we begin to understand the seemingly inexplicable, we will learn a lot about human nature.  This in turn can help us transform our relationships with each other.  It can also help us create a more just, welcoming, mutually responsible world.

This message is our legacy as a movement.  It is the hugely important, critically necessary contribution that mad people have to make to human society as we know it.  But it is not just about the polite 'disorders' like anxiety or depression that everyone can understand.  And it's not just about relatively harmless eccentricities and quirks that, while troubling, create no real threat to anyones safety or property.  It's really about everything - even the hugely awful offensive stuff that is so vilified in modern society that no one dares speak its name (except to say it's bad, bad bad)

On the other hand, when we finally bite the bullet and begin to face this shit, it can -- and literally will -- transform the entire domain of human relations.  Not just personal and family relations, but entire communities and countries.

Moreover, given the dynamics of marginalization interacting with fight/flight/freeze, I'd also venture to guess that the route of trying to understand / make sense of experience is far the safest and most highly protective option.  At a minimum, there is a world of learning and transformative potential to be had - both for individuals, families and commuities as a whole.  Added to this, when practiced as intended, embracing a cultural ethic of curiosity, learning and understanding seems like exactly what we need to innoculate the the flighters and freezers from killing us softly by running away from problems.  Better yet, these same values build our community capacity to embrace lone wolf intensity and to clarify, appreciate and integrate it's core messages.  This means that instead of marginalizing lone wolves, we are using their gifts in the manner nature intended - and plus making an honored space in the pack for diverse people and insights that can benefit and enrich the quality of life for all.

This stands in stark contrast to the statistical probability, if we continue to marginalize and exclude, sooner or later, the lone wolf nature that is inherent in our species will boldly kill us all.
To me, that seems like a predictable outcome of the current course our culture is on.   Yanno, the one where we continue to marginalize and then ignore or suppress the voices that are trying to raise our consciousness.  It's just a matter of time.


Friday, November 6, 2015

Virtual Drop-In / Crisis Respite - Weekly Schedule / Special Events

Hi there!  Glad you found us!  Our group call format is in transition.  If you need peer support, want to offer it, or want to learn more about either or both, please contact us:


Our basic approach to people helping people ('peer support') is summarized below, as well as a flavor of what we've offered in the past.

PRIOR OFFERINGS

Tuesdays 



Fridays 




Join Us:




Need More Info? 

Contact:  Sarah Knutson

ABOUT US:


The Virtual Drop In/ Respite is a project of the Wellness & Recovery Human Rights Campaign, https://www.facebook.com/groups/WellnessRecoveryRights.

For more information about the Wellness & Recovery Human Rights Campaign and what we stand for, http://right2bu.blogspot.com/

Mission/ Vision:  Human community for all states of mind


  • To create an active, vibrant 24/7 community on-call that feels like human family and advances human rights.
  • To offer a rich array of drop-in spaces for people to connect around shared values, needs and interests.

Core Values: No pros, no cops, no 911

  • We are run by and for ourselves and each other.
  • We exist to serve our own needs and values, both individually and collectively.
  • First and foremost, we are accountable to our own consciences and to each other - not to the current mental health system or its values, practices, standards or laws.  
  • We respect the expertise and right to self-determination of our members. 
  • We check our degrees and credentials at the door.
  • We participate as human beings on a human journey.  
  • Professional opinion and experience carries no special weight here - it is just the opinion and experience of other fallible, mortal human beings like ourselves.
  • We support each other's capacity for reasoning and conscience rather that substituting or imposing our own viewpoints or values. 
  • We respect and learn from the diversity of our experiences, preferences and viewpoint.
  • We work to share space and negotiate differences.
  • We stay flexible to the emerging needs of the moment, rather than imposing hard fast rules about how every group should operate all of the time.
  • We are self-funded solely by those who participate in our community.  

One Firm Rule:   

No pros, no cops, no 911.

Helpful Links:

Monday, November 2, 2015

Federal Minimum Standards for a Community Mental Health Infrastructure

An Outline for Public Policy Reform and System Overhaul Legislation 

[Draft in progress - Suggestions, comments, recommendations welcome]

Principle 1:  Grow and Support Community Capacity.  

We must reverse the alarming trend toward permanent disability that results when people come into contact with our current system of mental health services.  This system "treats" mental health crisis by yanking people out of their lives, dislocating them from natural supports and making their issues the exclusive perogative of 'experts.'  When public or private health insurance runs out, this profit-dependent system of professional dumps these same people back into the real world with even fewer supports and resources than they had before their crisis began - and then blames them (or their families) when they fail to successfully reintegrate.  

To counter these harms and reverse this trend, we must build the capacity of ordinary people to support each other through difficult times.  Far from being the aberration, challenges and hardships are are a normal part of life as vulnerable beings in an uncertain, high-stakes, resource-scarce world.  We therefore should anticipate difficulties and breakdown, not pathologize them.  

To this end, every community and every citizen in United States should have access to: 

1. A safe place for respite



2. A peer support center



3. Hearing Voices groups and training



4. Intentional Peer Support groups and training



5. Emotional CPR crisis supports and training


6. Icarus Project groups and training



7. Wellness Recovery Actions Planning (WRAP) training and wellness supports/ groups that make available health- promoting, capacity-restoring activities like art, exercise, creativity, writing, social interaction, nutritious eating, meaningful vocation, relaxation, meditation, spiritual development, body work, massage, yoga, dance, etc.


8. Alternatives to Suicide training and groups


9. Peer and professional support for coming off psychiatric drugs 


10. A 24 hour support line staffed with people who care and want to listen 


11. A "When Johnny & Jane Come Marching Home" (citizens listening to veterans) Project to support, honor and begin to appreciate the experiences of our veterans.


12. Trauma informed local governments, agencies and policies. 


13. Open dialogue as a support for family communications during times of distress or crisis


14. Support for human rights
  • Center for the Human Rights of Users and Survivors of Psychiatry, http://chrusp.org/home/index
  • Campaign to Support Absolute Prohibition of Commitment and Forced Treatment, https://absoluteprohibition.wordpress.com/
  • Universal Declaration of Human Rights, http://www.un.org/en/documents/udhr/
  • Convention on the Rights of Persons with Disabilities, http://www.un.org/disabilities/default.asp?id=150
  • MindFreedom.org
  • Wellness and Recovery Human Rights Campaign, http://right2bu.blogspot.com

Principle 2: Fund Technical Assistance 


The above are cost effective promising and/ or evidence-based practices that have the potential to vastly improve the quality of community relationships for citizens at all levels, including individuals, families and neighbors.  To make these activities accessible and sustainable, Federal and State Governments must invest the resources necessary for communities to know what that these options exist and how to develop and sustain them.  The federal government should therefore expand, prioritize and/or redirect existing funding to a nationwide network of technical service centers that support States, communities, organizations and interested individuals to:
  
1. Develop and offer the TA support and training infrastructure needed to build the above capacities.  

  • Examples:


2. Ensure that new and existing practitioners are supported to grow and develop their skills


3. Design and implement a robust and integrated public health research approach for collecting broad scale system performance data.  
  • The data collected should include not only not only costs and outcomes but also service users' subjective ratings as to how their lives have improved (or deteriorated!) as a result of services received.  
  • It should affirmatively seek out service user recommendations for improvement;
  • It should follow service users over time and see if they continue to rate services the same over the long haul and also to capture the learning effects of hindsight and reflective insight into what, in the long run, was most helpful (and what wasn't!)
  • This publicly funded research initiative is necessary to counter the current abuses where the only research that gets done into what works is done by corporations with products to sell and profits to make, thereby creating huge incentives to distort and massage results. 
  • Resources for development: 

4. Develop independent oversight and regulatory infrastructures needed to ensure that communities and provider organizations meet these standards and support them in meaningful ways. 



Principle 3: Leverage Existing Federal Funding to Gain Local Buy-In


Without spending a penny more of federal tax dollars, existing federal healthcare funding has tremendous power to encourage local communities to change in the above directions. To this end, no State, community, organization, agency or hospital should be able to receive federal funding or any taxpayer healthcare dollars unless it: 

1. Offers individuals and families non medication alternatives on a par and as an equally respected alternative to invasive high-risk interventions like medications, ECT, TMS, psychosurgery or other procedures.  

  • This is necessary to counter the strong alliance between traditional services and the corporate interests that benefit financially from the medical/ high-tech model of services. This alliance has been resulted from the billing considerations - not participant service needs.  It stems from the reality that Medicare and insurance reimbursers have conflated concepts like 'health' and 'wellbeing' with the delivery of traditional medical services. Thus, in order to bill for services, mental health providers are required to offer services that fit the insurer's criteria of 'medical.'  This steers treatment recommendations in the direction of expensive high tech services (like Pharmaceuticals, ECT, TMS and psychosurgery) that benefit corporations and 'experts' - but which, in reality, few people in crisis really want or need.  
  • To the contrary, the vast majority of those who find themselves interacting with the mental health system would vastly prefer, if given a choice, to be offered basic human qualities like caring, listening and hands on assistance.  These services are no more expensive compared to the high tech options.  They are time and labor intensive, however,  and therefore would require service systems to shift resources away from expensive impersonal technologies and into adequately staffing mental health organizations.  It would also require organizations to shift hiring priorities from finding professionals who are good at technology, regulations and paperwork to people who can offer personal qualities like caring, interest, flexibility, creativity and a willingness to meet someone from their own frame of reference in a way that makes sense to them.  
  • Resources for making this shift include: 

2. Monitors, reports and makes publicly available data related to any and all symptoms and reactions from all high-risk high tech interventions like neuroleptics, ECT, TMS, psychosurgery, seclusions, restraint, hospitalization and the like. 

3. Monitors, records, reports and makes publically available data on any and every use of force by any service, program or law enforcement 

4. Conducts a post-incident debrief with regard to the above that invites the person of concern to share their experience and recommendations; 

5,  Implements an ongoing community-based research and system like that above to insure ongoing learning and quality improvement as a result of the federal dollars expended.  Such a system should, as a minimum assure that an outside, independent body collects customer satisfaction and recommendation data and that a sincere effort is made to collect such data from every person who uses its services; and

6.  Has a community review board staffed by at least 50 percent of current or former service users that reviews all services, programs and incident reports and customer satisfaction surveys and makes enforceable recommendations.

Friday, October 16, 2015

Recovering Humanity in Mental In Mental Health Policy.

With public violence happening somewhere nearly every day, it's natural to feel scared and concerned.  It's also great to give serious thought and consideration to the issues that scare us.  It would be hard to dispute that things are out of control at the public level.  There is more and more rage being expressed more often and more extremely.

The temptation in these circumstances react.  To go back to 'the basics'  - what we have learned to think of as 'tried and true.'  Stress is high, patience is low.  With this balance, we don't care that much how it is done.  Mostly we just want it to get done.  We say to ourselves, "Somebody really needs to get with it and fix this problem."

Usually this means telling people we trust to 'take control.'  It's pretty natural to want someone 'up there' to make it happen.  Not only is it the stuff religions are made of, it's the stuff of empires as well.  God knows, in the wake tragedies like Oregon et al., we could use a bit of that empirely feeling now.

Unfortunately, however, doing what we've always done is not likely to fix the problem.  And, doing more of the wrong thing is likely to make it worse.

When you get right down to it, the core questions are moral and existential.  They turn on what you believe is the real nature of human nature.  They also turn on what you believe turns people violent, including what you think makes people 'sick' enough to do horrible things.

In these trying times, the Human Rights Paradigm has much to offer us.  It offers a cohesive theory theory of violence.  It also suggests why many other pressing social issues, like 'mental illness', 'addiction', 'crime' and distress, substance use, homelessness, poverty, racism, have become as entrenched as they are.

Just as important, and perhaps even more, the Human Rights Paradigm offers a workable path to the other side.  The basic principles are elegant and unassuming.  In a few minutes, you can get a basic idea of where you are going.  This won't begin to scratch the surface.  But, it's enough to get oriented and make a start on a journey.

Not unlike the perspectives of Buddhism and Eastern Religion, the human rights paradigm posits that our problems, essentially, stem from ignorance. People aren't aware of rights - or don't grasp how important they are - to a civil, just society.

This results in judgment lapses. Not just in some of us, but practically everywhere. As individuals, families, schools, workplaces and communities, we have ignored the needs of some and favored those of others. We got scared, felt bad, wanted something - and a lot. The next thing you know we were intentionally using someone else - or our power - to get our own needs met. Not just a few of us, but pretty much all around.

The thing that made it even worse is we couldn't stop the cycle. If someone stepped on us, or shorted us, we didn't understand how to respond in a way that advanced the rights of all - and not just our own interests. Because of that, our reactions to injustice or inconsideration tended to make things worse instead of better all around.  That there would be both winners and losers - and a battle of wills/ resources that produced them - was pretty much guaranteed all around.

The human rights paradigms challenges this way of thinking.  It says we can free ourselves from this cycle. The key lies in:

  • knowing about rights;
  • understanding their value; and
  • developing still in using them to work for both (all) people.
Once we're aware of this is possible -- and that it matters human rights - and see how they matter - we start to treat each other differently. This helps us to avoid causing the kinds of distress that lead to breakdown, overwhelm and reactivity. It also creates more access all around to the resources that every one needs to live and feel well.

When issues do arise, we're more careful about our responses. We rely on human rights principles - instead of raw self-interest - to navigate delicate terrain. This helps us relate in ways that make things better instead of worse. With consistency and persistence, the vicious cycle of escalation almost always slows to a crawl.

Beginning to use this paradigm is a whole lot simpler than you think. The entire Universal Declaration of Human Rights provides a pretty good orientation - and it's only 4 pages long. Better yet, the important principles are summarized in the preamble - and a few key articles (Art. 1, . All, in all, less than a page of reading can get you up and running.

Human Rights Principles for Psycho-Social - and Socio-cultural - Well-Being


A lot of how we treat each other depends on how we see each other. And a lot of how we see each other depends on what we believe about human nature.

The human rights paradigm is far from neutral on this topic. It has very clear opinions about the nature of human nature. The good news is that the concepts are fairly universal. As a practical matter, human 'rights' don't become 'rights' until a lot of people from every country of the world see them as important. So there's a good deal of face validity to the conclusions that are reached.

The following are key:

1. Human family


Under the UDHR, this is our birthright. We are all members of a human family. No matter what we do, we can never lose this. No matter who we are, we must strive to live up to this. The quality of the lives we create with each other depends on this principle. We are members of a human family and should treat each other that way.

2. Inherent, equal dignity


Again this is something we are born with. We have the same dignity as anyone else. No one has the right to take ours away.

When you think about this long enough, it eventually becomes clear that the human rights paradigm sees human nature from a strengths based perspective.

Inherent dignity means that that everyone of us have worth. Worth means we don't come to the table empty handed. None of us, ever. There is always something to value if people our willing to look.

The fact that dignity is a right thus implies an obligation. If everyone is capable of offering something of value, then we have a duty to look. WE don't just get to write people off - not for a moment - and certainly not for life. Our obligation is to seek and find something of value in everyone we meet.

3. Rights


Rights in the modern world can get pretty tricky. In our dog eat dog world, they have become, largely, symbols of self-interest. "You can't [walk your dog here, say that word, play your radio, take my firearms, etc.], I KNOW MY RIGHTS.'

Rights in the human rights sense, however, go both ways. What's good for the gander is good for the goose. This has a lot to do with that the mental health system terms 'boundaries.'

In mental health and elsewhere, the function of boundaries/ rights is two-fold. They both (2) keep out and (2) keep in.

In keeping out, rights/ boundaries say to each of us: 'Your freedom to dominate ends where my personhood begins." (And vice versa.)

In keeping in, rights/ boundaries challenge everyone to ask: "How can we support each other’s access to the resources that all of us need to live, feel and be well?"

4. Reason


In the human rights paradigm, everyone is born with the capacity for reason. What does this mean?

Reason means that we can learn from the consequences of our actions. We have the ability to appreciate cause and effect and make sense of what we experience.

Reason also implies something very important. When people act in certain ways, we do this for a reason. It might seems strange on the surface, but there is a reason underneath.

This counsels us to judge less and question more. Even the most baffling or hurtful experiences might have a cause that could explain what happened and create understanding.

This brings us to conscience.

5. Conscience


Conscience overlaps a lot with what some people call motivation. On a basic level, conscience is about our capacity to care. Things (called values) matter to us. We care about some values (our priorities) more than others. We express our values through the choices we make. We evaluate our choices based on the results they get us. (Now we're back to reason)

Conscience is what makes us more than robots. It's about the values we live for, the results we want, and the subjective experiences we hope to achieve. Thus, how things affect us - and how we affect others - matters to us. In fact, it makes all the difference in the world.

6. Reason-conscience interaction.


If we put them together, the principles of reason and conscience have a lot to teach us about ourselves and each other. Reason asks us to look for why something makes sense. Conscience helps us see things in terms of meaningful (values-based) choices.

Viewed through this bifocal lens, every thought, feeling and action provides a clue for understanding human experience.

Per conscience: Some part of someone cared to produce it. Otherwise it wouldn't exist.

Per reason: The question is why?

Per both in tandem:


  • What kind of effect were we hoping for?
  • How did that particular outcome fit with our values?
  • Why was that value preferred over others?
  • What life experiences shaped those preferences?
  • What conclusions were drawn at that time and why?
  • Do those conclusions still hold true?
  • Are there impacts we didn't foresee then that matter now?
  • Are there new options now that could be considered?
  • With everything out on the table, does this still seem like our best choice?
  • If so, how will that impact the choices of others, including relationships we care about sustaining?


Get Ready for Blast Off


On the surface, these are simple concepts. But if you unpack them, they hold a world of potential. The implications are, truly, vast and revolutionary.

With these simple principles we can make sense of the entire realm of human experience. We can ge to the causes and conditions of our concerns. We can understand why we do what we do. We can right our relationships, heal old wounds, and stop new ones from forming.

Equally important, none of this stuff costs us a nickel. The most important stuff we can offer each other doesn't either.

Better yet:


  • No profession can license this.
  • No corporation can patent, bottle or sell this.
  • No Government can withdraw our funding.
  • There is no higher law.
  • There is no better law either.
  • We can't afford to ignore it.
  • We won't be happy until we live it.
  • It exists if we create it.
  • We can get there if we honestly try to.


Welcome to the human family.
There is no other.

Wednesday, October 7, 2015

Anatomy of "Othering": How Human Rights Neglect Creates Social "Others"

Missing human rights can cause a lot of distress. Think about what it’s like to be treated unfairly, go hungry, be thirsty, have nowhere safe to sleep at night or no meaningful way to make a living. Think about what it’s like to be disrespected, hurt, called names, beaten up, pushed around, held somewhere you don’t want to be, or forced to do something you think is bad for you.

These kinds of things are highly distressing for most of us. When human rights are violated or insecure, nobody does well. We don’t have what we need to live and feel well. Our survival is at risk in some important way – physically, emotionally, spiritually, socially… We may even be literally fighting for our lives.

Our normal response when our rights feel threatened is anxiety and concern. If nothing changes, this can grow into full-blown mental distress. A lot of time this is what people are talking about when they say “I have an anxiety disorder” or “I’m depressed.”

Intense, prolonged mental distress can lead to even more extreme states. We can end up totally disconnected from ourselves, others and the communities we live in. We can stop feeling like a part of things. We can stop feeling human. We can even stop feeling like living or being alive.

We may also stop caring how our actions affect others. We may look for anything we can that deadens the pain. We may become so physically or emotionally reactive that we lose our capacity to think or be aware.

Once these things get set in motion, they may stay that way for a very long time. We may get called “suicidal”, “borderline”, “addict”, “chronic”, “unmotivated”, “help-seeking”, “anti-social” - or even “psychotic”, “psychopathic”, “delusional” or “schizophrenic.”

Seeing Ourselves Differently


If that happens to us, it is important to look beyond the labels. We need to remember that the root cause is not our “mental illness.” It is not our “addict nature.” We are not 'inappropriate', 'impulsive' or 'manipulative.'

These surface appearances are merely effects. We can predict they will happen when human beings are overwhelmed by pain and have limited options for how they can cope.

To see the real root cause, then, we have to look deeper. Once we get beneath the surface there are things we start to see:

Something we needed was missing, disrespected, or threatened. There was no one to help us find our way. While some people may have tried, they didn't really understand. Their help wasn't all that helpful. Things got worse instead of better.

In the final analysis, we were on our own and continuing to fall. Eventually, we were in so deep that we didn’t know if we’d ever get out. True, every so often a passerby might come along and poke their nose in our hole. But, as soon as they saw how low we'd dropped, they’d turn up their nose and high-tail it on their way.

This kind of disconnection – both from the things we needed and from other people -- undermined our confidence in life itself. Neither the Universe nor those in it felt the least bit welcoming or worthy of trust.

This insult to our humanity was the real root cause.

Where to go from here?


If this has happened to you, you are not alone. It's happened to far too many of us.

But that's hardly the end of our story. Now that we can see where we've been, we can begin to see where we are going. We have a life to live, and we can decide to make it count.

One life, one vote. Each of us, no exceptions. Let's vote for a better world. Let's recover our humanity.

Our birthright is human family. It's time to stake our claim.

Human Rights ARE Mental Health

It's not just that human rights are important in mental health. They are mental health! People talk as if these are different concepts. But in practice, principle and ultimate impact, these concepts are one and the same.
Sarah Knutson, Organizer, Wellness & Recovery Human Rights Campaign. 

Most people have heard about the need for mental health recovery. Yet, very few have considered the need for ‘human rights recovery.’ In truth, you can't separate them.

All too often, wellness and recovery are seen as individual matters: A private problem develops. The 'person of concern' is expected to address it. It is their job to make progress and stop imposing their 'stuff' on unwilling others.

The human rights paradigm challenges this idea. It argues that mental health, fundamentally, is a shared responsibility. When respect for human rights is lacking, people don't have what they need to feel or live well. We treat each other poorly and relationships suffer. The resulting dynamics damage the quality of life for everyone. 

In these circumstances, the first person to break down is not weak. They are a warning to the rest of us. 'Pay attention! Something isn't working. Fix it before more people get hurt!'

The human rights paradigm was articulated in 1948 to steer us on a better course. It arose in the wake of Nazi Germany, with a global commitment to ‘never again.’ Everyone recognized that this was a tall order. If we wanted world peace, we would need to change how we were treating each other. We would have to learn how to relate in ways that led to well being, good will and collaboration - instead of exclusion, distress and retaliation. 

The human rights paradigm is not just for nations. - It's for all of us. People from around the world got together and agreed: There are just some things that human beings do not do well without!
What they wrote became the Universal Declaration of Human Rights, http://www.un.org/en/documents/udhr/  (UDHR).   Here is a summary of what they said: 
As human beings we have a lot of things in common. We all long for respect and dignity. We all want to belong and be seen as valued members of the human family. We all are capable of developing our reason and conscience. We all need safety and security - and not just on a material level: Our mental, moral, vocational, creative, social, and political needs also require protection. 
The UDHR is a recipe - not just for world peace - but for mental and behavioral health. Without these things, there is no wellness or well being. There also is no support for recovery - or any reason to work at it. 

In other words:
Human rights = mental health. 
No rights, no recovery. 
Well-being leads to well beings.

Monday, September 28, 2015

Reason # 2 to Grow Beyond the Medical Mindset of DSM Diagnosis (Essay Series on Mental Diversity vs. Mental Illness)

Trauma is Pervasive - and That Explains A Lot

In 2011, the National Council for Behavioral Health ‘broke the silence’ on the impact of trauma in behavioral healthcare. It devoted a special publication - nearly 100 pages in all - entirely to the issue of trauma in behavioral health. You can read it here:  Breaking the Silence: Trauma-Informed Behavioral Healthcare (National Council Magazine: 2011:2), http://www.thenationalcouncil.org/wp-content/uploads/2012/11/NC-Mag-Trauma-Web-Email.pdf

In this publication, National Council leadership called on behavioral health providers in mental health, substance use, criminal justice and public housing settings to recognize and respond to role of trauma in behavioral health. It called attention to the fact that ninety (90!) percent of clients across these public service domains are trauma survivors. Notably, A. Kathryn Power, then-Director of the Center for Mental Health Services (a division of SAMHSA) wrote: “Interpersonal violence … is widely accepted to be a near universal experience of individuals with mental and substance use disorders and those involved in the criminal justice system.” Many also have suffered serious neglect and deprivation related to basic human needs like food, shelter and protection from the elements.

The National Council is not a fringe organization. It is the premier representative of behavioral health organizations nationwide. It supports mainstream mental health providers nationwide and lobbies Congress for their interests. In calling attention to the importance of trauma, the National Council was taking an important leadership role. It was sending a message to providers nationwide: Do not ignore this issue. It is far too important to public health. We must get with the times and face these facts. We ignore them at our peril.

We Must Get With the Times


Sadly, providers overall have been slow to make the shift to a trauma-informed approach. That is not ok.

In the first place, the implications of this are vast. The emerging statistics on trauma raise a lot of questions about the the conventional 'medical illness' model of mental health. They suggest modern psychiatry could be entirely wrong. According to psychiatry, people have a pre-existing genetic or biochemical abnormality. But, in actuality, we could be seeing the after-effects of social and environmental trauma.

The treatment implications of these difference are urgent. If psychiatrist are correct - and people actually do have genetic or biochemical abnormalities - then medication and surgical treatments may make sense. In theory, such responses could actually correct something that is structurally wrong in the brain and make it better.

But, what if that is not the case? What if - as the trauma statistics suggest - many people (up to 90! percent) are actually just scared and overwhelmed? That requires a very different response.

When we are afraid and overwhelmed (not defective), we need responses that help us get out of fear. For most people, that does not mean high tech responses that involve complicated instruments or heavy duty chemicals. In the first place, we don't understand them. They act on our minds and bodies in unpredictable ways. They take us away from familiar environments and require us to navigate strange ones. They require us to put a high level of trust in people with white coats who seem very busy, and typically talk way over our heads. Such things tend to scare us more.

Secondly, a lot of current treatments may actually damage brain pathways, not help heal them. There is a lot of evidence that this is true of neuroleptics and electroshock, especially if we use them a lot over long periods of time. It may also be true of other treatments, like SSRIs, anxiolytics and psychostimulants. Whitaker, R. (2010), Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, Random House.

Finally, we should not overlook the demands that medical treatments place on our brains and bodies. Every new medication is asking our body to make an adjustment.  Sometimes this adjustment may help.  But for many people, it just adds a new stress on top of the ones that already exist.  This is bad news!  We were already having trouble coping.  Now it's even worse, because the 'treatment' made it even harder.  Romme M. Escher S. Dillon J. Corstens D. Morris M. (2009) Living with Voices: 50 Stories of Recovery, PCCS Books/Birmingham City University. 

Given the high prevalence of trauma, the safest course to start with is probably kind, caring human beings.   What if - before diagnosing people - and before prescribing medications - we simply offered someone to listen?  This person could try to understand, help us make sense of what we are experiencing and maybe offer a bit of support in getting our basic needs met. This is the approach of the peer respite movement and it's getting some good results. Evidence for Peer-Run Crisis Alternativeshttp://www.power2u.org/evidence-for-peer-run-crisis.html

At the very least, this way of starting out does no harm.  Practically no one says they were hurt because of kindness or caring.  To the contrary, many people report that this made a big difference in their healing.  Some people even say that this was main thing - or the only thing - that made a difference. 


Given the prevalence of trauma, it's a much better bet than the high tech medications and hospital-based treatments. There's no sense in our government is paying out public billions for 'treatments' that can't possibly work. It's hardly a surprise that conventional treatments have such low success rates. What person with real life problems would get better from someone telling them to take a pill, sit around and accept their illness? How can people overcome their challenges in a system that won't acknowledge them?

Trauma Survivor Bill of Rights


If you're a trauma survivor and no one is listening, we'd like to hear from you. Please complete our Trauma Report, which is available here: Human Rights/ Trauma Report, http://goo.gl/forms/08i6RsAEgY

We'd also like you to know that you have rights. You can read about those in other sections of this blog. In addition, your rights are recognized by the National Council for Behavioral Health and published on their website. You can get a copy here: http://www.thenationalcouncil.org/wp-content/uploads/2012/11/Survivor-Bill-of-Rights.pdf.

The Time for Change is NOW


There is no longer any excuse anything less than complete, competent trauma-informed responses to behavioral health needs. According to the National Council, universal trauma-informed care is a do-able, effective, cost-saving response. Providers can and should uniformly screen for trauma. They should also offer services that respect the rights of trauma survivors and address their needs.


Accordingly:

The premiere organization representing behavioral health providers nationwide has spoken. Trauma-informed care is the most effective standard of care. It is the 'best buy' both monetarily and in terms of human suffering. There is no reason not to offer it. Supporting trauma recovery benefits everyone!