We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
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Tuesday, November 2. 2021
From Michael Shellenberger, Madness for Decivilization
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I read once that a bar tender was a better source of life advice than is a professional. A lot of people need "attention". Give them attention and they "seem" to improve. Take it away and they may well be worse than before. Most people with mental health issues who are functional or somewhat functional can function much better with a love interest/partner. But that is a mixed bag because most people with mental health issues have/create conflict with their partners out of need of drama/attention/defensiveness.
It would be wonderful if a psychiatrist/psychoanalyst could fix a person with mental illness but in general they cannot. They can sometimes get a short term result because they are feeding the patients need for attention. They can often appear to be getting results with patients who are court mandated (or imprisoned) because the patient is smart enough to tell them what they need to hear. But in general the mental health issue cannot be fixed/cured and probably the best you can hope for is that the patient learns more coping skills and becomes functioning within society.
The old way of dealing with dysfunctional mental patients was to lock them up in asylums. This was the worst solution until the ACLU got them all released and now we know an even worse solution is to foist them on society. There is no good solution. Simple as that. If you "give" a mentally ill person what they need/want then they become dependent on this and become even less functional. If you don't give them what they need/want then their dysfunction will often cause them to commit crimes or at the least act in uncivil and unacceptable ways.
It is possible that it is in fact a mental illness to continue to try to help them after you finally figure out how fruitless and harmful it is to try.
Even in the bad old days of mental illness those that couldn't cope were institutionalized so that they remained under care and guidance. During the 60/70's the law profession pretty much loosened them onto the street. Now they show up in tent and cardboard box ghettos in every city and have become a crime and health threat. It is self evident that the lawyers responsible for that sure as hell won't find the solution. The mentally ill will die on the streets and take others with them...until they are once again institutionalized.
"can't get their acts together"?
More like: mental illness keeps you from earning a good living, more often than not. And Psychiatric treatment costs $$$.
One Guy: a Men's Shelter manager told me the main problem with his homeless men was the disconnect/isolation from family and society. Much the same as you mean by "attention". Yes there are mental handicaps, physical handicaps, addictions, mental illness, but connectedness helped them all. Only three times in eight years associated with homeless programs did I hear of homelessness as a choice of lifestyle.
As in the comments above, the average person simply does not understand what mental illness is, and so pretends it is something else that fits their worldview better, consequences be damned. People with schizophrenia, psychotic disorders, bipolar disorders, moderate to severe depression, and severe anxiety disorders, and personality disorders do not do better with bartenders. Would you send your cancer patients to a person who just gave good advice? Do you treat a broken leg with a sympathetic ear? These illnesses are biological and significantly heritable, though trauma and drugs can certainly make them worse. Psychologists and psychiatrists are not the same thing.
Acute psychiatric illnesses were my field for forty years. Medications treat most of these, some remarkably well, all with at least some improvement. Lack of insight is a frequent symptom, so that the sufferer does not think they have a problem, they think it is others, even if they live in squalor and keep getting arrested for "no reason."
It's a quick study for those who want to know what is up. I recommend Xavier Amador, a psychological researcher who had a brother who developed schizophrenia and eventually had to become his guardian to mke sure he got his long-acting medication and used his disability check to pay rent and get food. Amador has both books and youTube videos. He is a good speaker as well.
If I could wave a magic wand and fix these kinds of social problems I would. But the reality of homelessness is that 99% of homeless people are drug, alcoholics and/or mentally ill. A normal person or family who finds themselves homeless can easily avail themselves of the many programs to help them find housing and work. But drug and alcohol user's generally cannot use these programs for the simple reason that they screen for drug and alcohol problems (and/or activities that drug and alcohol users follow). Therefore in this instance these people DO in fact choose to be homeless. That is they will not give up drugs/alcohol and prefer to sleep on the street than to abide by the rules of facilities who would house and feed them.
This country doesn't have a homeless problem THAT is the symptom. Efforts and money thrown at treating that symptom are worse then useless because it reinforces the willingness of the addict to stay addicted.
What we need is a tough love program where anyone found drunk or high or sleeping on the streets is sentenced to 30 days in jail. No treatment, now kid gloves, just jail where they will dry out unwillingly. Release them after 30 days and require them to work and stay clean. If they are caught drunk or high again 30 more days in jail, ad infinitum. This won't "cure" them all but those who refuse to clean up will learn to stay away from cities and normal people simply so they don't go to jail.
It is extremely disheartening to see the shift away from the talking cure toward pharmacology.
Clayton Cramer, a former blogger and one of the researchers that debunked Michael Bellesiles book on colonial gun ownership, had a brother with schizophrenia and wrote about the experience of living with him.
My Brother Ron.
I'm a Thomas Szasz kind of guy. From his book The Myth of Mental Illness: Professor Thomas Szasz On Schizophrenia As A Disease
“If you talk to God, you are praying; If God talks to you, you have schizophrenia.”
“Schizophrenia is defined so vaguely that, in actuality, it is a term often applied to almost any kind of behavior of which the speaker disapproves.”
“If schizophrenia…turns out to have a biochemical cause and cure, schizophrenia would no longer be one of the diseases for which a person would be involuntarily committed. In fact, it would then be treated by neurologists, and psychiatrists then have no more to do with it than they do with Glioblastoma [malignant tumor], Parkinsonism, and other diseases of the brain.”
“‘Mental illness’ is an expression, a metaphor that describes an offending, disturbing, shocking, or vexing conduct, action, or pattern of behavior, such as schizophrenia, as an ‘illness’ or disease.”
Thanks for that - I'll check it out! What's the answer for public policy, in your opinion? Is it to re-open institutions and create a 'rules' system?
The talking cures emphatically did not work. Pharmacology emphatically does. It takes about a week of working with the seriously mentally ill to see that.
Szasz had about two good points decades ago. He was otherwise a crank. He did not even meet any schizophrenic patients. He was very good at telling people what they wanted to hear. That is true also of Freud, Jung, and Kinsey.
Families are told not to give up on their loved ones with mental illness, that there is hope, that drugs will work, that making the person self-aware will work, that the mentally ill are mostly not violent. After twenty years of distress and destruction in my family, I was forced to "disconnect" for my own mental health from my schizophrenic younger brother because he made credible threats to kill me and my children, and he had already served jail time for assault. He does not know where any of us are, and we don't know where he is or if he is even still alive. I mourn him, but I do not regret the disconnect.
The sad truth is most people who are mentally ill have no clue the harm they cause their families and friends. One the other side of that coin it can totally ruin your life to try to help them and most of what you try to do will be interpreted by them as harming them and they will turn against you. While it may be true that not everyone who is mentally ill is dangerous it is probable that everyone who is mentally ill is potentially dangerous AND unpredictable. Help them at your own risk but be aware that at best your efforts won't be appreciated, won't help in the long term AND will probably do more harm than good.
Dangerousness is strongly correlated with drug use, which is high in the group overrall. It's really gasoline on the fire for a lot of them.