The media needs to author their own DSM.
Sigh. More mental health quackery.
The media needs to author their own DSM.
Sigh. More mental health quackery.
Stigmatization is a cruddy reality for those contending with the symptoms of illnesses, mental and medical alike. There’s a group of terms affiliated with stigmas I really don’t like in the least, the most, and all points betwixt:
I’d like you to look at this photo of the NAMI Challenger. The front page article is one I composed during my time on the NAMI Albuquerque board. I ask you to look at this photo and remember it because when we travel full-circle back to “in the closet, “coming out,” and “outing myself,” the importance of this image will make sense.
So, I’ve got a buddy who is deaf (“Big D” as she calls it), and she is not the best at “reading lips.” That’s great for Hollywood scripts, she tells me, but not so great for actually carrying on a conversation. There are two things that bug her about people:
1.) When they raise their voices to talk to her, as if shouting will bring her hearing back.
2.) When people think she’s stupid, as in intellectually deficient, because her speaking voice is different than those of us whose ears collect noises and whose brains interpret the noises as sound.
These stigmas, when she was young and soon after she lost her ability to hear, had her hiding from the neighbor kids who were once her friends. After the accident that took her hearing, these “friends” became cruel, taunting, and vicious in the teasing and gossip they spread into the community that the accident made her stupid and deaf. She just wanted to hide, she just didn’t want to be with people anymore, she just wanted to die.
Now, she is a strong peer voice in the hearing impaired community (and I use the word “voice” purposely, and she likes it a lot), and she works with children with hearing impairment sharing her life stories and experiences to hopefully spare them the feeling of worthlessness and self-doubt that comes from being stigmatized.
In our chats, I shared with her that I, too, had feelings of worthlessness and self-doubt tied to my bipolar. I had a friend of two decades who stopped calling (after my wife… ex-wife now… told him I had a mental illness), I’d been fired from job after job, my marriage was a disaster and a failure, I’d been kicked out of New Mexico Tech… what I thought of myself was equivalent to what I thought of dog squeeze on the bottom of a nice pair of Nikes. I dreaded that point where someone caught whiff of me and tried to wipe me off on the lawn, the entire time cursing they ever met me… and the bottom of their shoe.
Stigmas abound beyond only medical and mental considerations. I gave a presentation to a group of kids at Polk Middle School earlier this year, and part of the presentation is asking the kids what stigmas they contend with in their lives. The typical teen-angstiness identified “We’re always on our phones,” “Everyone thinks we’re lazy,” and “All we think about is boys/girls.” I think they meant teen crushes, but I didn’t explore that one.
One young man shared a stigma that broke my heart. And, I could sense when he shared his stigma with the class that there was an implicit understanding with his peers:
The quality of this stigma, the impact it had upon the class, was tangible. It was real. It was beyond “always being on the phone” or “being boy/girl crazy.” A young lady followed up saying “That’s why I never tell anyone where I go to school.” Too many of her classmates nodded in agreement.
That sense of accepted worthlessness is something I realize and understand is part of any marginalized group’s mainstay. It’s a community bond built upon a foundation of presumptions, misconceptions, and lies. These kids believe that people think less of them because of where they live, and that this stigma they overwhelmingly feel is part of their identity is a preordained limitation on what they can accomplish. I’m not too proud to say I started tearing up when I heard the kids speak about this unfair assumption.
The word “unfair” is thrown out there so much and so often that it’s all but lost meaning. It’s unfair I have to wait until Sunday to see Force Awakens. It’s unfair she got to go to the company picnic while I had to stay at work and finish billing reports. It’s unfair he buys a brand new car every year and I’m stuck driving this clunker. Given these qualifications for “unfairness,” it’s easy to see why “unfair” is a nearly worthless word.
Yet when you hear from these Polk Middle School kids, the word “unfair” is afforded a clarity all but lost in the vernacular, that the magnitude and direction of vectored fairness is so real and succinct that stigmatization is unavoidable. These kids were all a part of a leadership class, and there is no mistaking why they were chosen for this class. Their leadership talents define them so much more than the geographic locality of their community.
That’s the crux of stigmatization. It is unfair and immediate, created by an unenlightened, self-appointed mob judiciary over generations. More than that, though, is stigmas become so pervasive and saturating that the people being marginalized come to accept the prejudice, and when this happens stigmatization mutates from prejudice to shame.
What is shameful about living in the South Valley? For me, it’s a gorgeous place to walk the old trails and follow the irrigation canals between neighborhoods. The history and culture are rich and so much more a part of New Mexico’s identity than my tract housing neighborhood. For some reason, though, kids living in the South Valley are ashamed to tell other kids where they live and where they go to school, and this is baffling to me. If anything, being part of such an important community is a trophy of pride and not shame.
Looking at different stigmas, and looking at my own life living with bipolar and how I’ve often devalued myself, there is a common link expressed almost universally by marginalized groups:
In fact, the shame is so powerful that people feel they have to hide themselves from public view and scrutiny. My Big D friend hid from kids who used to be her friends. The young lady from Polk Middle School won’t tell other kids where she goes to school. And me? I pretended that I was “normal” and dreaded that people would see the symptoms of bipolar that alter my behavior so detrimentally (read: I’m weird, I know it, and I hope nobody notices me because I just can’t handle another failed job, failed relationship, and failed self). I was ashamed of myself for having bipolar.
“In The Closet,” “Coming Out,” and “Outing Myself.” We touched on this at the beginning of this article, and as promised we’ve gotten to the reason I started the article talking about “in the closet,” “coming out,” and “outing myself.” This is a concept attributed initially to the LGBT community (I don’t know the full acronym any longer – please send me the entire list of letters if you know it and I’ll edit the text). Being “in the closet” was being homosexual and not sharing this with others. There are valid reasons for this, with the policy of the U.S. military being a fine example. “Don’t Ask, Don’t Tell” was actual policy and not just a catch phrase. Serving our country, protecting our freedom, rights, and liberty meant you couldn’t tell anyone you are gay. Where’s the logic in that? And yet there it was, and it was a policy that if you wanted to commit yourself to serving our country, it meant you couldn’t be homosexual, of if you were, you were required to hide it. It’s shameful to be gay while serving our country. It was official federal policy to keep people “in the closet.”
Now, stating proudly “I’m a guy who likes guys” or “I’m a girl who likes girls” is part of our American culture. Being “in the closet” has become more passe than “coming out of the closet.” Yet, the term remains. To share with those you love that you are gay still entails the idea of “I’m coming out of the closet,” shortened as “coming out,” and the choice and act of leaving “the closet” as “outing myself.”
I don’t like “in the closet,” “coming out,” and “outing myself” in word and concept, and this goes to the etymology of the phrase. The connotation retains the artifact consideration that “coming out” or “outing myself” meant I was hiding something that I felt was deeply shameful, and that I didn’t like who I was based upon others’ presumptions, misconceptions, and lies about what it is to be someone with bipolar.
I don’t like “in the closet,” “coming out,” and “outing myself” with such directed, purposeful zeal that it is part of my peer advocacy playbook. I don’t feel like I’ve “come out” to the public to share openly that I have bipolar. When I decided to start speaking in public about my challenges and triumphs living with bipolar, I wasn’t “outing myself.” I share openly that I have bipolar because I like who I am, and I’m hoping that my openness can inspire other peers to have the innate pride in themselves that every person on the planet has a right to.
Exactly like with “journey to recovery” versus “recovery journey” (I NEVER say “journey to recovery”), I NEVER say anywhere at anytime that me sharing my life experiences with others is the a process of being “in the closet,” “coming out,” and “outing myself.” You will NEVER hear me say “I’ve come out of the closet as someone with bipolar, and when I did I outed myself and you can, too.”
Why? Because while I felt inferior at the beginning of my recovery journey, and I felt I had to hide my shame away, the way I feel about the world and my place in it has evolved dramatically, and I’m exceptionally proud of who I am, and part of that is being a peer and a peer advocate. When I first began this peer advocacy phase of my recovery journey, I discovered in myself that I had no shame of having bipolar and I didn’t feel I had to hide my bipolar symptoms. There was no “coming out.” I didn’t “out myself.” There was only me sharing my life experiences with others in a celebration of life and all the quirky nuances that is the human condition.
So here is that photo again, zoomed in on a very specific sector of the article. “In the closet,” “coming out,” and in this article “outing myself” is not part of my vernacular, and I actively advocate removing “in the closet,” “coming out,” “outing myself” from the vocabulary of my peers.
That “outing myself” is presented in italics is a good indicator that my original article met with less-than-adept editing skills prior to publication. Sorry if anyone got the wrong impression, which many peers did at the time questioning, “Steve, ‘outing myself’ doesn’t sound like something you’d say.” Exactly. And please notice the “journey to recovery” kicking off the article as well. I covered this in an earlier “Letter to the NAMI Editor” article. “Journey to recovery” and “outing myself” in the same initial paragraph of my article are not my words or what I submitted for publication. Quality control and professional editing was not a priority for this issue of NAMI Challenger, so let this serve (vanity press) notice in lieu of a wordy editorial retraction in a future issue of NAMI Challenger.
If you’d like a copy of this NAMI Challenger issue, I’d highly recommend this specific issue. There is a very good article on WRAP, and a free WRAP class is taught at the NAMI Albuquerque office every Sunday.
Okay, so here’s the rub. I’ve learned a lot about myself as I understood more about stigmas. For you, I share a pocket-size version to take with you:
Reprinted with kind permission of Steve’s Thoughtcrimes.
There was a seven month window in 2015 where I dedicated a bunch of my volunteer peer advocacy hours to helping out on the NAMI Albuquerque board. It was best of times, and it was the best of times. See how chipper and chock full o’ golden sunbeams I am?
Jim Ogle, the then president of our crew, was a tireless champion for behavioral health legislation designed to help peers and their families and friends. He’s the dude who brought me on to the NAMI Albuquerque board. Jim rocks.
Our first project together was the Community Engagement Team, which I will talk about at another time. Always with the “another time” rhetoric. Look, I’ve got a few decades of bipolar experiences tucked away inside of my Bag o’ Wisdom and the anecdotes aren’t going nowhere. Patience, Grasshopper. My Kung Fu is stronger than yours.
Tireless. Jim was tireless. He still is tireless. He’s a committee chair for legislation at NAMI New Mexico nowadays. Tireless. Without tires. Like the cliche redneck tireless truck on cinder blocks on the weedy front lawn where the ratio of weed to lawn definitely favors the weeds. Tireless. I hate myself for starting this article with a pun. Puns suck.
Apparently, I love to write. Steve’s Thoughtcrimes has been live again for about 12 minutes now and I’ve pumped out a good half dozen articles already, each rivaling the collected works of Charles Dickens in length and content, only people will enjoy reading my blog. Dickens also sucks because he relies heavily upon puns. “There’s more of gravy than the grave about you…” Idiot. Lazy writer and an idiot. Puns. Sucky sucky puns.
Back on target: During my tenure on the NAMI Albuquerque board, I submitted three or four articles for the recently-in-limbo NAMI Challenger, our affiliate’s physical newsletter that is in transition to becoming a reality again from what I’m told. The articles I submitted are good articles, with topics like the Community Engagement Team (mentioned earlier), Minds Interrupted (mentioned now), and NAMI’s Peer To Peer (also mentioned now).
I am proud my articles were chosen for publication. I am thrilled with how many folks still approach me at behavioral health shindigs to talk about what I wrote. It’s cool beans, the coolest of beans. However, here comes the “however.”
However, the editorial quality control was somewhere between indifferent to ineffective. Shall I explain? Let me do so through the magic of “The Letter to the Editor” I never got around to sending.
To be fair (because I am always the epitome of tolerance and justice), the editorial staff was in great flux during my tenure, and Felicia (our treasurer) was the only one on the board doing anything to keep all the balls in the air and all the plates spinning on sticks without any of it crashing to the ground. Sigh. Tired metaphors. The point is Felicia was doing tons of work and that there was no oversight of our Challenger editor is not her doing.
Okay, let’s get to my Letter to the NAMI Albuquerque Challenger Editor.
NAMI Albuquerque Challenger editor:
As an editor, you are tasked with handling words. That’s the distilled job description. Editors handle words.
I’ve been an editor many times through the years. Looking back, my first editorial position was stealing like/love letters from my 3rd grade classmates, spicing them up a bit (as a 3rd grader, “spicing it up” was akin to “and I want to kiss you on the mouth with our eyes closed”), and then giving them to the intended recipients. Granted, this was more “being a jerk” than “being an editor”, but how appropriate the unintended parallel between “jerk” and “editor” I made in third grade to how “adult editors” behave?
Let me give you an example from my own days as an editor of our college newsletter.
We had a dude named Chris Becker who was getting ready to defend his PhD dissertation, and he asked me if I could include his abstract in our school newsletter so he had something in print with the college’s name on it to send to his mom and dad. Sure thing! Chris and I played volleyball together, and he was a fellow geology student, so you bet, Chris, I’m thrilled to post your abstract to the newsletter.
As many editors are keenly aware, there are a finite number of words you can cram into the pages of a physical publication. Sometimes, snipping even a few letters here and there (not even whole words) can free up real estate on one page so words will fit on the next page. Handling words. I was handling words.
Part of Chris’ abstract dealt with iron oxidation and iron reduction in sedimentary lithologies, with localized iron reduction spots in rocks being the result of carbonaceous biotic material like plants and dinosaur poop.
There are two types of iron:
Fe+2 – Oxidizing iron – Ferric
Fe+3 – Reduction iron – Ferrous
Now, “iron is iron”, right? How can the type of iron make a difference, and more importantly, how can using “ferric” and “ferrous” make a difference? I mean, other than ferric iron carries oxygen to the myriad of cells in your body on its way from the heart (it’s red, and it’s ferric) and on the way back to the heart the blood is without oxygen and won’t counterproductively strip oxygen away from the cells during this return journey (it’s blue, and it’s ferrous), and that our ability to live is predicated on nature providing us ferric and ferrous iron, about the only real, important difference is “ferrous” is one letter longer than “ferric”. And since Chris’ abstract inefficiently uses “ferrous” four times, heck, total bonus. I can free up four letters for use elsewhere making the edit from “ferrous” to “ferric.”
I’m a brilliant editor! Four letters! Enough for a four letter word in another article! “Pump.” “Cats.” “Full.” “of.” “Lead.” All four letter words. Sorry, I took liberty with “of” which is not a four letter word. No matter. I’m editor!
The newsletter came out. I proudly delivered a copy to Chris myself. He read the article. He turned red (a ferric emotional reaction, perhaps?). Chris had many four letter words for me. So many. So so so many.
For scientific accuracy, the difference between “ferric” and “ferrous” is like the difference between “man parts” and “woman parts” when choosing a romantic partner. It matters. It’s not just an edit of a few letters here and there. It’s completely changing the purpose and credibility of the author’s intent.
Chris is my friend, and I felt so horrible. I had to take him out and get him drunk that night on my nickel so he would slur his words and I could no longer decipher which four letter words he was using any more.
Where did I go wrong? Let’s see. I changed the words of the author without asking, although as editor it was my job to handle words efficiently and this fell under my purview. More crucially, though, I didn’t check with Chris after I changed these words.
This is the perfect example of editing without self-oversight, and I learned two very important lessons about being a responsible editor from this experience:
Had I followed these two rules of being a responsible editor, I wouldn’t have made such a huge blunder. And, I wouldn’t have had to use a good 500 characters in the next newsletter printing a retraction.
This ends the analogy and exposition segment of my letter. Let’s move to the issue I have with how you edited my article. Let’s move on to the point I’m making.
As a behavioral health peer advocate, I choose my words with great care and deliberate forethought. When I submit an article for publication, even though I’m exceptionally “wordy” and love things like nested prepositional phrases, I will all the same choose very specific words for very specific purposes to convey a very specific point to share a very specific message.
There is a huge difference between:
Since you seem unaware of how important of an advocacy talking point this is to me, and that I NEVER use “journey to recovery” in articles, public presentations, and behavioral health events, I’d like to educate you on this vital difference so you will not make the same error again with another peer’s article.
A “Journey to Recovery” implies that recovery is a destination, and if I work hard enough on myself I can reach recovery and be cured. To me, this is a ludicrous idea that does not speak to the reality of having a chronic condition like bipolar.
Conversely, my using “Recovery Journey” speaks to my managing the symptoms of bipolar. I do this through a proper medication regimen, exercise, diet, sleep schedule, playing my ukulele, tormenting my rabbits by shaving them and then petting them with steel wool (joke… I’m getting bored with writing but don’t want to take a breather), regular socialization, peer support groups, peer advocacy, and just keeping track of how my mood is doing.
Every day of my life for the rest of my life I am on this journey. Every day I’m in recovery. This is an important message I share with peers in my advocacy efforts. It is central to my advocacy.
It’s not an argument of semantics or “being touchy.” I am known and respected by our peer communities, and I am loud and obnoxious in my advocacy (some say “slash and burn” advocacy, although I prefer “If you people would stop and listen to me and my friends I wouldn’t have to drive my point home over and over and over” advocacy), and because of this I must be exceptionally responsible and aware of the message I present to my peers.
I am in a privileged position of being able to help guide my friends in their recovery journey through sharing my experiences in my own recovery journey. I speak regularly on exactly why I don’t use “journey to recovery” and insist on stating I am on my RECOVERY JOURNEY. Honestly. I’m a total, complete, and utter pain in the neck about this.
Do you know how I came to learn of your editorial error? A friend called me and said, “Steve, you didn’t write ‘journey to recovery’ in your Challenger article, did you? That doesn’t sound like you.”
This sentiment was echoed by quite a few more friends over the following week. Recovery journey, not journey to recovery. It is important to my message, it is important to my advocacy, and it is important to me as a peer with bipolar.
I have bipolar. I will always have bipolar. I will always have to manage the symptoms of bipolar. This is my recovery journey.
I need to be absolutely clear about this:
Had you sent me your incorrectly edited version of my article prior to publication, this error on your part would have never made it to print.
I’m a solutions kind of guy and will be presenting a proposal on how to professionally and responsibly manage our affiliate’s Challenger newsletter at our next board meeting. I welcome your input by inviting you to the NAMI Albuquerque board meeting.
Chair, NAMI Albuquerque Peer Action Team
President, DBSA Albuquerque
Ed. note: I know this letter was kind of saucy and bordering on condescending (and I can’t fib and say it wasn’t therapeutic to an extent… even though my calmer head prevailed and I didn’t send this letter), although I ask for you to consider that the editor made this “revision” by request of another NAMI Albuquerque board member who knew it’d bug me.
Ah, to be adults and in love/hate.
I’ve got bipolar. It’s a fairly straightforward, mundane flavor of bipolar with the ups and the downs. Way up and I’m driving to Nova Scotia in three days from Albuquerque, whilst my kidnapped roommate scribbles a “Being Held Against My Will. Call Police. Please Help.” on the back of a Howard Johnson’s napkin, plastering it against his passenger side window for passing motorists to glance at and ignore. Who wants to help a kidnap victim jetting along at 75 mph? By the time they called the police (these are the days before cell phones where really effort needed to be made to “call the police”), the poor kidnapped roommate would be 200 miles down the road where we could have turned off anywhere going to any place. Like Nova Scotia. In three days. From Albuquerque.
Way down and I’m not getting out of bed, barely feeding myself, and I’m debating the necessity of a bed pan as a convenience or merely an unfortunate middleman.
Something else happens when I get exceptionally depressed. I get psychotic. This is no mood disorder thing. I enter a reality no one else can see or hear or taste or understand. My brain has decided that depression is just not fun enough, like a girlfriend who decides a new apple red Miata would go great with the 20 carat diamond engagement ring you just got her by eating ramen and forgoing dental visits since your very first paper route, scrimping penny by penny just dreaming about the day you meet that ungrateful gold digger of your dreams.
This is the girl I married. Susan. Social climber, social debutante, social parasite. The majority of our relationship was spent with me being undiagnosed with bipolar. The symptoms were all there. It was the diagnosis and treatment that were missing. And the love. There wasn’t a lot of true love there. Not the type of love humans typically had for each other. My love for her was more like the love a neglected Chihuahua shows the person who occasionally throws wilted kale leaves into the garage, and lives most of his life in a mouse-chewed Adidas box in the back corner of the garage, and the single garage lightbulb burned out in 1992, and the Chihuahua was born in 1994 in that Adidas box with his seven puppy brothers and sisters, and the Chihuahua was the only one to survive birth, including his mother, and the corpses of pups and mum were never removed or noticed, and kale leaves were not on the menu for the first two months of his life and yet the Chihuahua wasn’t undernourished until his third month of life…
I grew to hate kale.
And the ex-wife, she had this to say to me during the divorce:
“I only loved you when you were successful.”
Our power couple name mash up was “SusanateluciferwholeandnowlordsoverhellSteve”. Not quite Bragelina or Bennifer in brevity or intent, but there it is.
So psychosis. I get supermega-depressed and I go psychotic. Full bore, engine in redline psychotic. Typically, this manifests as delusions and paranoia. During my divorce and the endless court dates to fight for custody of my very favorite son (my only son), my psychotic symptoms reached a new zenith, a trajectory even Icarus would envy.
The court battles sucked. The proto-ex-wife sucked worse. And she was kicking my ass in court. I couldn’t figure out how she knew so much of the strategy my excellent attorney engineered, but dude, it was like she was in my head, which I know is impossible because my skull was both lead and niobium-shielded. Yep, I was already well on the way to Disney’s Dimentialand. Every character there is named “Goofy.” Too easy. Sorry. Better joke writers for the next blog post.
So one early morning, around 2 AM-ish, I finally figured out how she was getting all the “insider information” she was using against me in court. If there was no way for her to penetrate my mind (because lead and niobium thwart pure, unfiltered evil very effectively), obviously my mind must be broadcasting my thoughts to her. Obviously. And it was the neighbor’s tree that was amplifying my thoughts and broadcasting them to the soon to be ex-wife. Obviously. Clearly. Variance denied.
I’m a solution guy. I’m all about creating my own solutions. The neighbor’s tree was broadcasting my thoughts. If my neighbor’s ham radio array was broadcasting video of me in the shower (I’m sure it was), what would I have done? I would take out that radio array. I’d topple it. I’d kill that broadcast suddenly and definitively.
A tree is very much like a ham radio array. Only it is alive and it’s made of wood. To kill the broadcast, the tree must die. The tree was like Jenny Picket in fifth grade who gossiped a lot. Jenny needed to die, too. But that’s hyperbole. You hope. I hope. Where was I?
Right! The tree had to die. And seeing as it was made of wood, I had the perfect instrument of “arborcide.” My camping axe. So at 3 AM-ish in the morning, I chopped down my neighbor’s tree. It had to be done immediately at 3 AM, before the soon to be ex-wife could wake up and start taking notes again. Guess what? I felled the tree… and the broadcast stopped!
Funny thing happened, though. When a tree thought-broadcasting array stops transmission, the Albuquerque Police Department picks up another form of transmission I understand is termed “The Neighbor Who Owned The Tree Called 911.”
That’s a tangential story. Enough for now.
As an active peer advocate in the New Mexico Behavioral Health Community over the last five years, I’ve learned there is one highly-sought commodity in our behavioral health community that is treasured over all others:
Any number of agencies, organizations, legislators, individuals, companies, etc. would love to get the “peer stamp of approval” for whatever product, project, or purpose they’re championing. Peer endorsement lends validity, credibility, and substance to behavioral health causes in a way no other type of endorsement can.
One way peer endorsement is achieved is through petitions. You’ve been handed a clipboard any number of times in any number of places. Heading in to vote. At the grocery store. At a sporting event. Someone knocking on your front door to ask you if “You’ve Heard the Good Word.”
The thing about petitions is the dude handing you the clipboard will give you a thirty second, rapid-fire spiel explaining what the petition is for and how you can help. It’s a thirty second sales pitch, and you’re asked to give your name in signature form at the end of that thirty seconds.
The pitch always sounds great. Sign this petition and you’ll be helping education. Sign this petition and you’ll be saying our community needs to be tough on crime. Sign this petition and you’ll be standing up to proclaim “NO WAY” to poachers who prey upon unborn gay whales.
But what can you learn in that thirty seconds that tells you exactly HOW your signature will be used? Who has access to your signature? Is the cause just or even real?
As a peer, your signature is worth its weight in gold-encrusted diamonds with a shiny platinum filling. Your signature says “I am a person living with mental health issues and I sign your petition because I believe what you say is just and true, and I want everyone to know you have my support.” Signing that petition is peer endorsement, and you’ve given it away for free with no consideration other than thirty seconds of explanatory sloganeering.
There are so many reasons for this. I’ve already detailed many of them. The most important reason for passing on petitions is just this:
Be sure of what you’re signing, and if you have only thirty seconds to decide, chances are the guy with the clipboard hasn’t earned your signature, your support, and your endorsement.
Sign here to add your name to those who agree with everything I ever say without question! (just joking)
Reprinted with kind permission of Steve’s Thoughtcrimes
My sis rocks. One of my fave Jimmy tunes recorded just for me. You rock, Sylvia Seren (Sarah).
By the way, this tech named Ben (I call him Ben the Tech) at Kamp Kaseman used to put Sylvia Plath “inspirational” quotes on the board every morning.
I told him, “Dude, this is a psych hospital. Sylvia Plath killed herself.”
And Techben (changed his name) said, “No she didn’t.”
So I said, “Google.”
And the next morning, no Sylvia Plath quote. Instead, Ben the Fool (changed his name) posted Kurt Cobain lyrics.
The point of all of this is being inpatient can be incredibly disempowering and outright scary. And sometimes, the staff is kinda dismissive of peers while we are feeling fragile. Ben and I were never going to be friends. And this time through Kamp Kaseman, I truly needed a point in the win column. Having a tech insisting he was “right” about Ms. Plath gave an easy avenue to self-empowerment. Score. Bonus score.
I used to see Ben when I’d visit Kamp Kaseman to present education programs. I’d say “hi” to Ben. He did not say “hi” to me. He did have to set up the DVD player for me. No documentaries on Robin Williams, thank the stars.
Reprinted with kind permission of Steve’s Thoughtcrimes.
The proto-missus and I watched Silver Linings Playbook a few nights back. It was her first viewing, my fifteen billionth. It is a favorite movie of mine for a very single reason:
A major studio motion picture where the central characters are not only folks with mental health diagnoses, they are also not violent and scary and dangerous… check the left armpit of my ex-wife for icicles and her heart for slippery black ice (ha!) because I think Hell just froze over.
“The opinions of the misanthropical rest upon this very partial basis, that they adopt the bad faith of a few as evidence of the worthlessness of all.”
– Christian Nestell Bovee
Reprinted with kind permission of Steve’s Thoughtcrimes.
Originally published October 27, 2017.
This week an article was posted to the Topeka Capital-Journal website concerning a program the Topeka Police Department has requesting citizens with behavioral health issues to voluntarily enroll in “Premise Alert.” The goal of Premise Alert is so responding officers will know ahead of time that there is an individual in potential mental health crisis, allowing officers to “make more informed decisions” because they know they are encountering a peer.
The goal is honorable. Safe, positive encounters between peers and police is what all of us want. However, I’m not pleased with programs like Premise Alert because I feel officers should be trained to deal with unique crisis situations and NOT an assumed predetermined threat. Education. I’ll say it again and again.
Following is my response to the article.
Topeka police encourage those with behavioral health issues to enroll in Premise Alert program
I am president of DBSA Albuquerque (Depression and Bipolar Support Alliance based in Chicago, Illinois) and sit on the Mental Health Response Advisory Committee, the DOJ mandated committee of community stakeholders who volunteer their time to help the Albuquerque Police Department develop better skills in engaging peers in crisis.
Our chapter collaborates closely with APD, including the 40 hour Crisis Intervention Training that was once a voluntary additional training and is now required of all APD officers. Peer involvement in creating those solutions that will protect both peers and police in crisis situations is key to successful, positive outcomes.
Many times, the topic of voluntary peer enrollment in a program such as this has been brought up at behavioral health meetings, and every time the concept meets with nearly instantaneous resistance to outright moral outage from peers. As one peer from our focus groups said last year, “Do they expect me to volunteer for a Tag & Release program?”
As an individual managing the symptoms of bipolar, anxiety, and PTSD, my reaction to this concept is also more than hesitant. The reason I share this is because often foreknowledge of a person’s behavioral health history can unduly affect a first responder’s attitude and readiness in a crisis situation. It may even have the exact opposite effect, something I can attest to personally. In one encounter with APD, officers focused entirely on asking if I was dangerous and not what help I needed.
Beyond the practical considerations of crisis response, there is a larger, more far-reaching concern among peers that has to do with the archiving and use of any database generated from an enrollment program. Let me share one example.
Say we have a peer who deals with alcohol misuse and schizophrenia (a condition the DSM V defines as co-occurring). Alcohol misuse exacerbates this individual’s schizoid symptoms to where police involvement is regularly required. However, when not misusing alcohol, this individual functions well and does not generate the type of crisis intervention needs.
Let’s say this individual voluntarily enrolls, under the auspices of “protecting all involved.” The idea doesn’t seem too horrible. Who doesn’t want to be safe?
Now, let’s consider this scenario:
A neighbor calls to report this individual’s yard is messy and the individual isn’t being cooperative in cleaning his yard. In fact, there was a heated argument over this to where the neighbor calls for the police.
The police arrive, already aware this individual has a prior co-occurring crisis history with police. There was an argument and police are dispatched “ready” for a situation where the individual.MIGHT be in crisis.
There are a few truths to consider:
1.) This individual is not symptomatic and in crisis.
2.) Neighbors get into yelling matches from time to time.
3.) They have been neighbors for 20 years.
4.) This individual experienced several crisis calls with police, and his neighbor witnessed this.
5.) The individual is 12 years sober.
6.) This happened to a friend of mine.
Granted, there was no enrollment program, and the foreknowledge provided police is from the neighbor of 20 years. But there was no crisis and responding officers treated my friend as if he was in the throes of co-occurring crisis. My friend is 12 years sober and only was a safety issue when drinking.
This illustrates striking concerns. How far does the enrollment record go back? How do you get yourself off the list once enrolled? What kind of information is collected and is this information guaranteed confidential? After all, the police are not medical providers and aren’t bound by mandates like HIPAA.
There are so many possible and real scenarios that all ultimately speak to one thing:
People with behavioral health issues are more than their symptoms and do enjoy significant recovery.
I’m not a sum total of my bipolar, anxiety, and PTSD symptoms. I don’t say “I’m bipolar.” If I’m trotting out self-proclaimed identities I’d go with I’m a father, I’m a son, I’m a geologist, I’m a boyfriend, I’m a peer advocate, and I’m a really great left defender on my soccer team. Enrollment in a program like this places symptoms I manage with exercise, medication, therapy, peer support groups, and personal responsibility above who I truly am. It’s too easy to mistake having foreknowledge as being forewarned.
The real, sustainable solution is education. Officer preparation doesn’t come from a list, it comes from training officers with the skills necessary to help peers help themselves to make good decisions. A single peer’s crises are not the same thing every time. Every potential crisis situation involves a unique individual under unique circumstances. Education is the key to being well-prepared. Crisis intervention training allows for officer safety, peer safety, and deescalation through a spirit of collaboration rather than predestined community peacekeeping.
Reprinted with kind permission from Steve’s Thoughtcrimes.
Originally published April 5, 2017.
I was intending on including this in the prior article. However, it’s a crucial concept that , as said, folks from agencies from DRNM to NAMI seem to neglect from their empathy toolbox and thusly their understanding of the Peer Experience.
Anything short of this is morally disingenuous and intellectually dishonest. What is the hazard? It’s simple.
To this end, Stand Up To Stigma has our first fully-trained Peer Focus Group that will be attending many public forums and advisory committees to ensure the proper information is shared and understood. Good information, good intentions, good policy.
What do you do with a dog with no legs?
You take him for a drag.
Gotta be me.
Reprinted with kind permission of Steve’s Thoughtcrimes.
This will be one of the shortest articles I offer on Thoughtcrimes, and it is special advice for the Muggles in the audience.
When it comes to AOT (Assisted Outpatient Treatment), rather than trying to convince peers AOT isn’t forced treatment try sharing what AOT can do to benefit peers instead.
Start the conversation with:
This will require some homework and analyzing AOT from a peer perspective. I feel we’re worth the effort.
Reprinted with kind permission from Steve’s Thoughtcrimes.