Unconventional Wisdom: Beyond Medical - The Debate Continues (I hope) ...

Leaving PAVO and Ventures New

After 5 years of working within PAVO’s Mental Health Team and 10 years of working in the “mental health” field, in July 2014 I decided it was time to try and make my living in a different way, one that was outside of the mental health system and outside of the public sector.

I am opening a Micropub in Llandrindod Wells which is a whole other story (… one of craft real ales, conversation, bringing people together and other lovely things …). If you are interested you can find out more on twitter, look for @arvonales.

So why I am still writing a “mental health” blog?

Some of you may already be aware of my views on our mental health system and the ideas underpinning it from my previous posts. You can find some of these here. If so, you will know that they do not align with the conventional mainstream wisdom on this topic and although I am no longer working within mental health, my quest to find ways of highlighting the “beyond medical” debate to professionals, the public, people in contact with mental health services and those close to them continues.

I believe that basing our mental health system and public awareness campaigns on the illogical idea of “mental illness” is doing much more harm than good. This belief comes from personal and professional experience of mental health and my own 30 year quest for the truth about my brother’s “mental illness”.

“Here I stand. I can do no other.” Martin Luther

What’s the debate? The myth of mental illness and the harm that it is doing

I believe that the concept of “mental illness” is incorrect and illogical. That the thoughts, feelings and actions that we categorise as “symptoms” of “mental illness” are not that. That these thoughts, feelings and actions are instead a natural and normal response to the difficult things that happen to us.

I believe that basing our mental health services, policies, laws, treatments, responses and public health campaigns on this bad idea is leading to much more harm than good. That allowing this bad idea to underpin all of these things means that we start from the wrong place when trying to help ourselves and others.

That is a place that largely remains in the “let’s manage the symptoms” arena rather than one that asks “can we make sense of this”. A place that doesn’t always allow us to look first for any medical reasons for these symptoms (you can read my blogs on organic reasons for “depression” here and “psychosis” here).

“Language shapes the way we think, and determines what we can think about.”  
Benjamin Lee Whorf

What do I propose?

Well one thing is that I commit to continuing to write blog posts that highlight “What’s Hot?” in the beyond medical debate (…What’s Hot ?!?!?! - me trying to make the topic as interesting as I can).

I will also continue to use my personal twitter account @powysmh to present evidence that shows the invalidity of the idea of “mental illness” and that highlights the harm that this idea is having.

I know that I am not the only one in Wales wanting to see awareness of this debate raised and I would love to hear from you about what you are doing and any ideas you have about what else you think we could do.

So now it is up to you. Read or don’t read the blog. Follow me on twitter. Talk to me, contact me, challenge me, offer me words of support. I leave it to you.

Beyond Medical Debate. Where would I start from now?

As this is the first of these “round-ups” I want to start by highlighting just 2 links that are in my opinion a great place to start if you want to find out more about this debate. I hope you find them interesting and useful:

The Council for Evidence-based Psychiatry (CEP)   @cep_uk

• The purpose: To reduce psychiatric harm by communicating the latest evidence to policymakers and practitioners, by sharing the testimony of those who have been harmed, and by supporting research into areas where evidence is lacking.
• Where to start: Try the tabs at the top for a series of short videos on “Unrecognised Facts” and “Recovery Story”. Also find out more about the members of CEP here. One member, psychiatrist Sami Timimi, talked at a conference I organised earlier this year in Powys, you can find out more about this here.

Behaviorism and Mental Health    @BigPhilHickey 

An alternative perspective on mental disorders by Philip Hickey PhD.

• The purpose: To provide a forum where current practices and ideas in the mental health field can be critically examined and discussed.
• Where to start: Absolutely anywhere, this is a great site for exploring this debate. On the home page you will see a list of his posts and in my opinion they are all insightful, logical, thorough and interesting. There is a Tell Your Story page here and the Moderation Policy here is well worth a read.

Beyond Medical Debate. What’s Hot This Month? 

• Global Summit on Diagnostic Alternatives August 4th and 5th 2014 in Washington, D.C. http://www.psychologytoday.com/blog/rethinking-psychology/201408/12-keys-mental-health-revolution
• Antipsychiatry and the antidepressants debate by Sami Timimi, Philip Thomas, James Davies and Peter Kinderman their letter of response to David Nutt and colleagues in letter to The Lancet. http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(14)70297-4/fulltext
• The Psychiatric Epidemic - does long-term use of medication decrease the chance of recovery? Tweeted by @BeyondMeds · http://beyondmeds.com/2014/05/23/psychiatric-epidemic/ on Aug 13.
• Outcome Orientated Mental Health Foundation. Of specific interest to anyone working with children and younger people. http://oocamhs.com/index.php/resources/videos. Tweeted by @AnneCooke14 on Aug 13
• Trauma, Psychosis, and Dissociation by Noel Hunter Aug 6th http://www.madinamerica.com/2014/08/trauma-psychosis-dissociation/
• The Campaign to Repeal Mental Health Laws in US. Urging US Senate to ratify the UN Convention on the Rights of Persons with Disabilities (CRPD), without reservations, understandings or declarations (RUDs) to prevent people from being deprived of their liberty, restrained, and treated against their will in the name of “psychiatric help”. https://www.change.org/en-GB/petitions/us-senate-ratify-the-un-convention-on-the-rights-of-persons-with-disabilities-without-reservations-understandings-or-declarations-ruds
• Therapy Looking For Disease: A Special Tribute to Thomas Szasz. 1h 23mins. https://www.youtube.com/watch?v=sZgsxI3ZouU&index=67&list=PLA23EF81C730135CA …

Contact me (… fingers crossed …)? Laura Gallagher

To find out more you can follow me on twitter @powysmh.

You can comment below and I will respond.

You can email me at powysmentalhealth@gmail.com

Or find me on facebook here.

Fingers crossed that other people out there are also interested in finding out more about this this debate….

Exploring Mental Health and Trauma: Books To Get Us Thinking ....

Guest Blog by Jane Cooke.

There has been a focus on trauma-oriented work and ‘treatment’ in recent Powys conferences.  You can watch Jacqui Dillon at the Powys Stronger in Partnership conference last year here and you can watch Sami Timimi at the Finding Meaning in Psychosis conference in March 2014 here.

One of my roles in life (when I’m not working within PAVO’s mental health team) is as a counsellor/psychotherapist. I have a trauma-oriented approach which has been reinforced by listening to these speakers and by reading around the subject.

A trauma-oriented approach, as advocated by Sami Timimi, is a gentle way of beginning work that enables a person to feel safe and able to gradually build up a personal sense of control over their own boundaries and in time over responses to events or reminders that can lead to upsetting and overwhelming reactions. Even if a person doesn’t identify trauma as being relevant to them and why they come for therapy, this approach is empowering and helpful anyway. (It is not about forcefully inducing ‘catharsis’, re-living the situation, ‘facing up to it’ or any other similar techniques which can be re-traumatising or even abusive in themselves.)

Sami Timimi is a psychiatrist and a founding member of recently established Council for Evidence-Based Psychiatry.  He believes that working in a trauma-oriented way makes sense for most people who come into contact with mental health services. Much more sense than identifying ‘pathology’, symptoms and ascribing a diagnosis; all of which generally ignore the story, the experience of the person, how it is that they are who they are.

There are two writers who I have found very helpful and their work complements each other. Both Judith Herman and Peter Levine are concerned that people (clients, patients, service users, survivors) gain/regain their own sense of personal power and agency as they recover from their trauma/s.

Peter Levine has written a number of books about trauma. One of his books “Healing Trauma” is a slim self-help book with a CD covering a programme of exercises that anyone can follow to help overcome the neurological ‘holding’ of trauma. It is, he says “for restoring the wisdom of your body”.  He does caution that professional help may still be required. An empowering way of working could be therapist and client working together with the book and exercises, keeping the client in control of the work.

‘Trauma’ is a word we use in everyday speech,  but paradoxically in relation to emotional well-being there is a limited perception that trauma has to relate to major events that are, for example, combat situations, witnessing  extreme violence, being in danger of one’s life or experiencing sexual violence or abuse in childhood or adulthood. However, as Peter Levine says “People, especially children, can be overwhelmed by what we usually think of as common everyday events …The fact is that, over time, a series of seemingly minor mishaps can have a damaging effect on a person. Trauma does not have to stem from a major catastrophe” (his italics).

There is increasing evidence for this. So, for example, bullying, repeatedly not getting your needs for love and positive attention met, feeling fear regularly such as maybe a frightening  walk to school, regular contact with a frightening , threatening teacher or relative; being regularly shamed by powerful people when you are young.  Many things can build up to create a response in the nervous system which then needs to be ‘taught’ to respond to the here and now and to recognise/feel  current sources of support and comfort, including your own capacity  to support and nurture yourself.

Jacqui Dillon (a survivor of childhood sexual abuse) told us how much she had been influenced and empowered by Judith Herman’s book “Trauma and Recovery”. Herman looks at the way in which women’s (and children’s) experiences of violence, fear, captivity (and you can be captive in all senses without the doors being locked) and powerlessness in the domestic and community realm have been seen as variously: natural, bought on by the victim themselves, exaggerated  and overcome-able by normal acts of will. She looks at the way in which their experiences are minimised and belittled.  “Social judgement of chronically traumatized people tends to be extremely harsh” .She also looks at ways of working with people who have experienced trauma. Judith Herman has a framework for recovery from trauma. There has to be in her experience, in sequence (and returned to as often as necessary) Safety, Remembrance and Mourning and Reconnection. This works very well with Peter Levine’s work which in the early stages emphasises ways of achieving an inner sense of safety, and of course actual safety in daily life is essential.

Judith Herman is very clear that therapists need good training and good support, this is work that can be complex and challenging.

There are many books about trauma; I would recommend these two. They are compassionate and well-grounded in research and experience. They are as much for the person recovering from trauma as they are for therapists and other workers.  

Judith Herman’s “Trauma and Recovery provides a radical, community oriented approach to recognising trauma in the lives of women in particular as well as a way of working that can lead to recovery.

Peter Levine’s book is a gentle, practical self-help book (although he does not minimise the need for professional support as well).

Between them they are a very good ‘starter kit’ to this subject whether you are a health professional, or someone who has experienced, is experiencing, trauma – and you could very well, of course, be both.

Trauma and Recovery. Judith Herman.  Pandora  ISBN 978-086358-430-5

Healing Trauma. Peter Levine. Sounds True ISBN 978-1-59179-658-9

Written by Jane Cooke

Member of PAVO Mental Health Team:  jane.cooke@pavo.org.uk

And when not working for PAVO....

Gestalt therapist, ecotherapist  and interpersonal skills trainer.  Jane.cooke@heartfeltwork.co.uk

www.heartfeltwork.co.uk