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An Enabling Debility

I was watching mathematician John Forbes Nash Jr. on You Tube the other day, and he made a point that I don’t think a lot of people are catching. The mental health consumer represents a failure on the part of psychiatry to restore mental patients to health. Where we used to have a mental health movement, now we have what has been referred to as a mental health consumer movement.

Nash also noted that the basic difference between a person said to be mentally ill and a person said to be mentally well was that the latter earned a living and the former didn’t earn a living. This is what the whole idea of functionality is all about, the ability to make a good wage slave on the jobs market.

Of course, now we’ve got this idea of “high functioning mental illness” where the old rules don’t apply. Seeing that “high functioning” coupled with “mental illness” is basically a contradiction in terms, how do we explain this phenomenon? A few mental patients, aka mental health consumers, have managed through “compliance” to advance in professional, often academic, careers.

I would say you have about three things going on here at once. A bright and resourceful individual. A person who has a great deal of support–legal, emotional, and social–perhaps more than people who are not so “handicapped” by impugned disease. On top of which you also have someone who would tend to be less heavily drug dose disabled than many people in treatment due to the achievement (as opposed to troubling behavior) that the person had displayed.

It must be remembered here that the idea is not to produce a better quality consumer, the idea is produce a healthy individual, a non-patient. The “high functioning mentally ill” person also suggests a failure of the system to restore that person in particular to his or her right mind. One is also left with the question, are we making “illness” in cases like these a form of “success”?

There are other people who have been fully restored to “sanity”, but there is little glory in recovering one’s mental health as long “notoriety” comes of not recovering. Anonymity may be noble, but it doesn’t pay the bills. Acclaim, in one instance, must prove as much of a disincentive to recovery as federal benefits prove in another. How much of this is a matter of our cracked actor or actress making the most of his or her crack?

Acclaim seldom comes of recovery. More often than not what you have is a mental health worker who was a former patient, and as such represents the worst of two worlds. Your prisoner has become a warder, and your penitentiary system has grown exponentially. I suppose it represents job security on his or her part, but still this means the streets have gotten a little bit meaner, and the neighborhoods have gotten a little less secure.

8 Responses

  1. In regards to the question, are we making “illness” in cases like these a form of “success”?

    We have a certain breed of mental health consumer, known as the illness-success schizophrenic or bipolar person, who is a lawyer, an executive or talk show host, who has written a book that is supposed to leave the reader wondering, gasp, how did they do that?, even despite having been diagnosing with a mental illness? These individuals didn’t come from rags to riches, but you wouldn’t know it the way they talk about coming back from supa-scary states of mental being.

    I’d like to suggest that we see through people who write such books, who claim to have illness-success. Many of these individuals were never sick in a genuine way like Mr. Nash to begin with, and are just intolerable A-type human beings, made even more intolerable by their bland acceptance of a world issued to them by some authority figure, in this case in the medical field. The person with illness-success may know of symptoms, and is adept at discussing them, but might not have interfaced with them directly. He often accepts, with undue seriousness, the notion that mental health status is something akin to diabetes. This person has bought hook, line, and sinker, the prognosis thrust on them by the mental health provider, just gone and head and accepted it as the biggest event that will ever happen in their lives, it may become the main way that they identify themself. Whereas genuinely sick people know that the meds are toxic, the individual with illness-success is usually taking a low dose of the meds, and often swears by them, and his routine. “And as long as I stay busy, and have a pet who jumps on my lap, and always take my meds, like a good boy always should, then by golly I’ve got those symptoms under control and look how successful I can be, wheee! Look what I can do with my illy illness!” Unfortunately, the person with illness-success lends credence to the idea that people labelled with a mental illness can lead productive lives; this is often how they are viewed by most people. Unfortunately, the person with illness-sucess tricks psychiatrists and others into being hopeful in a false way that the drugs actually work.

    Then the book written by the person with illness-success is placed in the hands of someone who is suffering, and that person is told, you could be like this, if only you comply.

    • I don’t think we’re thinking on the same wave-length on this matter, Orion. I’m certainly not against, nor do I have any objection to, people with psychiatric treatment histories anchoring radio and television shows, authoring books, opening up law firms, running for political office, starting businesses, performing rock music, doing comedy routines, making art, or what have you. History is history, and one thing history is not is current. Most people are not going to get there through compliance as compliance means compliance with a drug taking regimen that can seriously impair a person’s ability to function on par with the average human being. I suggest that the one’s who do succeed through compliance are held at a lower dose than others due to the achievements they’ve shown that offset more serious concerns about their mental health. There are many, many others that have gotten beyond their troubles. You are not likely to hear about these others in the context of mental health, but they’re there. You are more likely to hear about those whose troubles are current, and whose station in life is precarious. Mental health literature is all about “mental illness” labels, and “mental illness” labels in general are anathema to success in the social realm. I’m talking serious “mental illness” labels here, not the more “minor” stuff. You do have a few exceptions that have managed this feat, but–it takes a lot of time and effort to be a mental patient–a few less bumps along the road of life, or less of an addiction to pharmaceuticals, and you’ve got another person who has abandoned the mental patient or, if you prefer, the mental health consumer role entirely.

  2. As long as pharmaceutical sales drive psychiatry, the system will not support recovery.

  3. People with schizophrenia smoke more cigarettes, use more drugs, and know more about how drugs affect their bodies than the average person. The person with schizophrenia is a shaman by another name. Pharmaceutical companies get a bad reputation but the problem is not that they want to medicate this population, but that they are not collaborating with persons with schizophrenia to devise the best drugs. Pharmaceutical companies and psychiatrists are having the destructive attitude that hallucinations, delusions and thought disorders need to be “corrected” or “erased”, rather than embracing it, and creative potential.

    • Medication should only be used when there is distress or danger, and in collaboration with the person experiencing these things. It should not be forced upon people who have the supposed potential for these things because they exist in everyone.

      People who experience different realities ought to be included in research (when willing!) and psychiatry students should be introduced to them at the beginning of their studies. Feedback on drug effects should be widespread and given heightened consideration.

      I do think, however, that pharmaceutical companies deserve a much worse reputation than they currently have and that they would willingly medicate everyone on the planet for a profit.

      • Neuroleptic drugs have harmful effects. These are direct effects and not side-effects. No law should, as in the case today, impose these drugs upon anybody against that person’s will and wishes.

        If these drugs are going to be given to people in institutional settings, if these drugs are going to be given to people who are essentially prisoners, these prisoners should have the right to another method of “treatment” (i.e. to decline psychiatric drugs.) The keyword here is “given”. Where something is “given” there is a choice. Where it is imposed, and a matter of coercion, there is no choice.

        It is my view that people should not be imprisoned in mental hospitals, but if you are going to imprison them, they should be given the choice to decline harmful “treatments” if they so choose. Imprisonment will not of itself harm the prisoner patient, drugs will harm the prisoner patient. Any imprisoned patient, if he or she is honest, will tell you that these “treatments” amount to torture, and torture is something that should not be used on law abiding citizens.

    • If we look at the original meaning of neuroleptic, a neuroleptic drug is a drug that seizes control of the nerves, or the brain.

      [French neuroleptique : neuro-, nerve (from Greek; see neuro-) + -leptique, affecting (from Greek lptikos, seizing, from lptos, seized, from lambanein, lp-, to seize, take).]


      This seizure isn’t going to make it any easier for the conquest of the drug to control his or her own addictions and appetites.

      On a more basic level, anti-psychotic is a misnomer. These drugs don’t counter psychosis, and in some cases they can actually be aggravate or increase “symptoms”. These are brain disabling drugs, and that is just what they do. Coming off other chemical agents, and reducing bad habits, requires a high degree of self-control, and it is to this same self-control that the drug would offer relief.

      • I see where you are coming from and I agree with regards to choice. If someone is imprisoned, it can be reasoned that they are not in a position to hurt themselves or others. Therefore the choice of whether or not to be treated with anything ought to be a given. I do think however that imprisonment itself has a harmful effect upon a person. It tells them that their freedom is not safe unless they act in a socially acceptable manner. There is a big difference between someone who acts differently and someone who acts dangerously. I believe that the differentiation between the two has been lost because the laws that give people the opportunity to incarcerate others on ‘potential’ behaviour delve into the arena of ‘pre-crime’.

        As far as neuroleptic drugs go, there are benefits that outweigh the negative effects in some cases. The problem is that everyone is different and although the drugs are supposed to have a uniform effect, this is not the case in practice. Self-control is not something that one can guarantee in each case; sometimes symptoms are out of the control of an individual. In these cases, neuroleptic agents can provide the dampening effects necessary for a person to gain that self-control.

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