Liz,
I’m contacting J.'s case manager, hoping to speak with him personally about what I can do to help her. This would probably not fall under any infringement of doctor-patient confidentiality/privilege laws. I’ll let you know what his response is. Thanks for keeping this thread afloat. I think its personal nature doen’t sit well with many who believe that only objective takes are relevant. I’d also like to discuss further the 12 Step approach as therapy. It has plusses and minuses. PS patients need no minuses. Yet, 12 step programs are currently accepted as a legitimate form of therapy by many psychiatrists.
Ier, Have you read WWIII’s thread about what it feels like to experience psychosis? I suggest you do.
Was J. either a bag lady or an alcoholic? Would that be why she gives her money away?
Have you found a support group yet?–I’m going to hound you about that, you know.
Stay well, L.
I’ll read WWIII’s thread with the reservation that these conditions are illnesses not claims to being special.
And, yes. J has run the gamut of homelessness and despair.
J.‘s case manager read the note I gave asking how I could help and left it on her coffee table without response. I went to check on J. after the CM had left. She had her microwave on 36 minutes with nothing in it. Clearly he could use my help. I briefly met her daughter who was delivering grocreries. She simply thanked me for helping her mom and quickly left. I can understand the reticence on both counts.
About support, I have NAMI for discussing these issues and Recovery-World.org, which has the 6-step schizophrenics’ recovery program, a condensation and customization of AA’s 12-step program, and a forum.
J.s desires to do “normal” activities such as working are heartbreaking to hear. But I will not give up hope. My problems are minimal compared with what J. faces daily. I’m OK.
Hi, Ier, WWIII’s thread is one thing–you have to read his whole op–including the 12 1/2 pages of his journal. In no way does he come across as thinking of himself as ‘special’–except when he thought he had esp and was able to give everyone else esp–which meant, to him, everything should be ‘free’ to him, because mankind had benefited so much from his giving everyone esp powers. Or when he thought he could guarantee every woman heaven and every man hell simply because he could.
There is a thread, of sorts, that runs through his psychosis–a desire to
Don’t just read the thread, read WWIII’s 12 1/2 page journal that he seems to have written as a part of his therapy. One sort of thread seems to run through the journal, WWIII’s trying to ‘explain’ his thoughts rationally while admitting that he can’t because he wasn’t rational at the time. I’ve not read the book, A Million Little Pieces, so I really can’t compare the two. I can only opine that, while Frey was writing a book–either fictional or non-fictional,-- WWIII seems to have written a partial journal as part of his therapy. Read it and decide for yourself.
Can you honestly say what I’ve underlined above?–Really? Is running your microwave oven with nothing in it a sign of psychosis? Has your concern for J. not, possibly, become an obsession? Rather than go to the internet for support, why not get out of your apt. and meet real people with real voices who aren’t afraid to say what they’ve experienced, one-on-one?
Ierrellus, I’m not a person–I’m a bunch of words on your computer monitor. You need real people and real people contact. As a virtual person–a bunch of words on your computer screen–I can say I care for you. But what’s more satisfying to you–to be given a virtual, verbal hug, or to be given a real-live hug by a real, live person who shares, at least to some extent, your real, live feelings.
This is rather garbled because I thought I’d lost my original start of a response to you. I’m not going to fix it–it’s too late. You’re intelligent enough to unravel the garble, I’m sure.
Liz,
Your comments appreciated. I’m with J. about ten times more time than I’m on computer. Reading from WWIII’s journal, I find the same things J. says, just in different contexts. I cannot really say much that would help him in this virtual venue. I can say things about J. and ask advice on how to help her. She is, for me, anything but virtual. She’s here and now, alive and suffering. She is not my "cause"or obsession. I love her and would exit from her life on her word alone. Given my family history, I have about ten years left to live. What better way could I spend these years than supporting someone I love, someone whom life has dealt a bad hand, as mine has. I have no ulterior motives or desires that go beyond here and now acceptance of what is. I come to sites such as this for my rational “fix”, since her life and mine include so much that is irrational.
I’m glad that’s finally out–it took you long enough! 
I see no better way for you to spend your life than with someone you love and, as I said much earlier, I see no reason why it can’t be a ‘normal’ life as long as she stays with her meds and therapy. From what I understand of what WWIII wrote, part of his therapy was learning how he felt when he started slipping into a psychotic state and working himself out of it. Whether or not he learned that through group therapy, I don’t know–you might ask him in a PM. And I still think you both would benefit from an informal support group.
Have you met her family? I believe you should so they can see you for who you are and not as what they might think you are–the reverse is also true. I got the impression, early on, that you thought her family had abandoned her–and yet they’re supporting her. Perhaps she simply disappeared herself and her family finally found her and got her the help she needs. (I’d probably make a pretty good soap opera script writer–I have lots of plot lines running through my head.)
Whatever–
If J. returns your feelings, and I sincerely hope she does, I’ll pray that everything works out well–actually, I already do send my good thoughts into the oosphere, I’ll just send more of them.
PS I don’t think WWIII needs any help and I don’t think that’s why he published his journal on the board. I believe he wanted to answer questions and clear up mis-conceptions people here have concerning MI. We don’t read stories that often about bi-polar disorder unless it leads to homicide, which isn’t very often in the general scheme of things.
Again, thanks for your understanding.
Yesterday I met J.'s case worker. I engaged him only in trivial conversation. His duty seems to be to come to J.'s apartment on Fridays and bring her meds. This Friday he informed her that she would need to come in for a shot. That verified my suspected diagnosis. Shots such as those of Haldol are given to patients who are schizophrenic, whose meds are becoming ineffective or are not taken regularly.
After the case worker left J. told me the shot would turn her into a bug. Later when her meds kicked in she said that the shot would make a lie of everything she believed. For her, the hallucinations and delusions are a meaningful part of her existence, a real, alternative sense of reality. But many breakthroughs are happening. Good things among the bizarre.
For those who are turned off by these personal assessments, I’d still like to consider further the human sense of reality–what makes it happen. Schizophrenia has no known cause or cure. The best that can be done is to “soften” the symptoms. I think Jaynes was on the right track about an evolving sense of reality as is Wright (“The Evolution of God”–2009) in considering ideas of the last extant primitive societies. The brain chemistry of primitive peoples still alive can be assessed if they could submit to our imaging techniques. While they may not want to do this,their very words covey their brain activities. Also, the “psychotic” nature of dreams should give us some evidence of the sources of psychoses.
Yes, Haldol is given to schizophrenics–oftentimes because they don’t take their less strong medications regularly or when they’re first diagnosed and before they’re put on the less strong meds. So let’s talk a bit about the function of the limbic system, shall we? You can google it and find out where it is within the brain, the organs within the system, and its many functions. Basically, it’s about memory, spacial recognition, emotion, etc. all of which contribute to our sense of reality. Most people have the ability to ‘separate’ their inner, subconscious memories and/or percepts, from their conscious percepts. Other people don’t have that ability to a greater or lesser extent. The ‘separation’ is blurred. If the brain has a ‘clear separation,’ his/her conscious percepts are ‘closer’ to ‘reality’ than are those of a person whose ‘separation’ is less distinct. I think the brain ‘constructs’ reality in different ways–if the separation is clear-cut, it’ll treat a percept as the reality we see around us; if, on the other hand, the ‘separation’ is blurred, the brain will treat is as such. The schizophrenic, apparently, has the latter type of brain function, so the differentiation between what is ‘actual’ and what is hallucination becomes interchangeable and the hallucination seems more real than ‘reality.’ This could be a part of the neurological aspect of schizophrenia–the part that may be genetic.
Then there’s the emotional/environmental part, which could come from any number of stimuli. This is where psychotherapy can be useful. It’s hard to talk about this because of the plethora of pseudo-science so many people use, whether or not they understand what they’re saying. However, we all carry memories and we all react to those memories–whether they’re sub-conscious, unconscious, or even pre-conscious. We can deconstruct our thoughts–through introspection, meditation, and so on–by ourselves, or we can go through ‘guided’ deconstruction with the help of a skilled psychotherapist. Most people choose the latter method.
For a schizophrenic, however, the first thing that must be done is to control the symptoms. So far, that means drugs. If you get to a point of trust with J. and her care givers such that you can monitor her drugs, do so. Get her drug schedule and toddle on over to her apartment and watch her take the drugs she really does need.
Remember, until she’s stabilized, her illusions are her reality. You can’t ‘shatter’ that reality in one swell foop, nor can you go along with it. But you can take her for walks–or the zoo–or a museum–or an art gallery. If you get her stabilized with her meds and earn her trust, then I’ll plan your wedding.
In the meantime, don’t rely too much on philosophy–you’re not faced with a philosophy problem.
Ier, I’ve just re-read both this thread and WWIII’s. I hope I haven’t given you bad advice–although WWIII did advise against trying to introduce outside “reality” to a schizoid personality until the person recognizes the difference between the two realities and trusts your reality over hers. That’ll be one hell of a leap, and it’ll only happen with drug therapy.
It makes no difference what a schizoid personality ‘feels’ when they’re taking their meds–their perceptions aren’t ‘normal’ to begin with. Is rational thought possible for an irrationally thinking person?
Liz,
Reality eventually overcomes romanticism. J. seldom addresses me as me. About the limbic system–I’ve spent the past 25 years reading, among other concerns, the findings of neuroscience. I’ll talk of those findings here in a two part post on one-to-one diagnostic theories. 1. neurotransmitters 2. brain functions as localized in specific areas. --as these pertain to schizophrenia.
In the 1950s chlorpromazine, a dopamine inhibiter, was found to relieve symptoms of schizophrenia for many sufferers to the extent that they could live fairly “normal” lives. High levels of dopamine at the synapse were seen as causes of schizophrenia and bipolar disorder,while low levels signified Parkinsons. These findings ushered in an age of chemical intervention that focused primarily on what was happening at the synapse. Serotonin and norepinephine re-uptake meds were given to sufferers of depression. L-dopa, a dopamine precursor that could get past the brain blood barrier, was given to sufferers of Parkinsons.
Although some relief of symptoms occurred, what happens at the synapse revealed only part of what these illnesses are or do. In the 1950s only a few neurotransmitters were known. Nowadays about a hundred are known and about a thousand are suspected. They operate in concert, not singularly. And, nowadays, one-to-one diagnostic theories,such as the theory that malfunction of one or a few neurochemicals characterize a specific type of MI, are seen as outdated or inadequate.Torrey notes that in schizophrenia neurotransmitters otherthan dopamine are indicated as are neuropeptides.
Brain images, from CAT scans to MRIs, reveal enlarged posterior ventricals in schizophrenic brains. Autopsies have confirmed this and have found celluar damage in brain areas adjacent to the ventricles. Since the damage appears largely in the limbic system, it has become all too easy for researchers to localize the disease in the place where the most of its damage is evident. Even Torrey came to belive that the limbic system is a sort of grand central station wherein emotions and thought connect and wherein the sense of reality comes together.
One proof that ideas are organic is that they replicate and extend into areas of probabilty and possibility as organisms do. The soul is not located in the pineal gland as Descartes thought. One gene does not code for a single trait, disposition oris responsible for physical abnormality. One or a few malfunctioning neurotransmitters do not exhaustive characterize specific types of M.I .And-- one brain area, even the area revealing damage from the disease, does not reveal the sources of the disease.
In “The Brain That Changes Itself” Norman Doidge presents his case for neuroplasticity, the brains ability to tranfer function fom an area that is damaged to one that is not. His argument refutes those who theorize about some rigid or inflexible brain topology.
In the instance of schizophenia one needs to ask why some people recover while others do not. A comparision of recovering brains and non-recovering brains may show why some brains cannot regenerate cells or transfer function. And–stem cells may prove to be a useful tool for repairing brain damage.
Hi,
I’ve been reading this thread with a lot of interest, perhaps because I am involved with a lot of geronto-psychiatric illnesses and have experienced this also within my family. In my studies it has become very popular to talk about pre-morbid personality and life-events as factors which influence dementia and Parkinson’s disease, and there has been a lot of evidence found that this approach has been part of the common understanding, because examples of colloquial expression support the theory.
Since both diseases have a clear somatic effect which may be caused by psychological disorders, is it not possible that this pattern be true of other neurological/psychiatric diseases? If it is, then it may well be that an “insane society” produces people with an unsoundness of mind or even a severely disordered state of the mind in its population. It seems true to me that we can hardly differentiate between healthy or unsound minds because studies in Germany suggest that every third person has a diagnosable psychological disorder, and who hasn’t sometimes doubted his or her own soundness of mind?
It may be of topic for some, I don’t think so, but could it be the failing to connect with the soul (what ever that may be in the end) or losing contact with the soul, whether in organised religion or other areas of society, which produces morbid somatic outcomes? Pushing the question further in reaction to a statement made earlier in the discussion, could it be that those people who did have a sound connection to their soul have been marginalised or even diagnosed as having an unsound mind? The attitude towards shamanic practices, as an example for treatment which only treats the patients illnesses indirectly by stabilising the soul, comes to mind.
Excuse the interjection if it is off topic, but I find there is a lot to speak for such a theory.
Take Care
From what I understand of what you’re saying, Bob, I’m not sure that it’s off-topic, since the general topic is the treatment of mental illness in general; however, you bring up mental illness in geriatric patients–things such a dementia, Alzheimer’s, depression–which is a whole new ball of wax. I know Parkinson’s affects the body, but do the other three? And does the personality before the onset of disease or life events have that much to do with Alzherimer’s or Parkinson’s?
I’m not sure what you’re asking in your third paragraph. Are you asking whether or not mental illness has anything to do with religious belief? Are you asking if mental illness has to do with a lack of religious belief? As far as I know, there’s enough physical/scientific evidence to show that these diseases are physical rather than spiritual and really have nothing to do with faith or the lack thereof.
Some of the symptoms of some of the mental illnesses may present themselves as ‘religious’ experiences of some sort, however.
PS Peter Falk has dead of Alzheimer’s. He was a fine actor.
Hi Lizbeth,
Well, Parkinson’s disease is a degenerative disorder of the central nervous system, Alzheimer’s disease is characterised by loss of neurons and synapses in the cerebral cortex and certain subcortical regions. This loss results in gross atrophy of the affected regions, including degeneration in the temporal lobe and parietal lobe, and parts of the frontal cortex and cingulate gyrus (Wenk GL (2003). “Neuropathologic changes in Alzheimer’s disease”. J Clin Psychiatry 64 Suppl 9: 7–10. PMID 12934968.). So these two definitely have a somatic outcome, but also Lewy-Body Dementia and Vascular Dementia, as well as other types of dementia, have dramatic somatic effects.
Borrowing from Wikipedia for convenience, Depressive disorders have a large variety and when you experience these disorders, it becomes clear that they have a somatic effect on the patients (please see Wiki - en.wikipedia.org/wiki/Mood_disor … _disorders – for sources):
Years ago in training, our Professor indicated that these illnesses had criteria which associated them to pre-morbid behaviour patterns, but which hadn’t been clinically proven. In 1991, Dr. m. Eileen McNamara wrote on “Psychological Factors Affecting Neurological Conditions” including Depression, Stroke, MS, Parkinson’s and Epilepsy. Since then the development of Psychosomatic Medicine has progressed and here in Germany a study claimed that nearly all illnesses had a psychosomatic aspect about them, and a few MD’s were brave enough to say that they saw a diversion of soul-movement, or the attempt of the psyche to gain psychological well-being, as one (perhaps supplementary) cause of nearly all illnesses and even of accidents.
A book which a friend of mine (MD) has in his drawer, although he doesn’t display it openly, was “Krankheit als Weg” by T. Detlefsen and R. Dahlke, which spoke about this phenomenon is also from 1989 and has been backed up by numerous supplementary volumes since then. I personally am moved by Thomas Moore, a psychotherapist who became a full-time professional writer who lectures internationally about spirituality, ecology, psychotherapy and religion, because of his approach towards the instability of people he had given therapy to. His suggestion is that we are too heavy on curing and not good at caring for our body, soul and mind, and therefore create systematically an imbalance which we perpetuate by trying all the more to cure, instead of to care for ourselves. Our society drives us in this direction because we have put away the soul in favour of the more rational mind and even the psyche is regarded manipulable.
I think that really you may have inadvertently hit the nail on the head, although I meant that lack of faith and trust may be at the bottom of this. But religious belief in our times seems to be lacking faith and trust, but so does the opposition of religion. We seem to be on a wave of rationality which requires answers, facts and figures in all areas of human life, irregardless of the fact that much of life remains a mystery to us, whether we labour or study for our income.
After his study of active centenarians, Dr. Maoshing Ni wrote:
If you notice, there are lots of aspects from this small example of TCM-Habits which speak about caring for rather than curing the body, soul and mind. If you bring them all together, the future of treatment of mental illnesses seems to lie in prophylactic methods of caring, rather than in trying to cure after the damage has been done.
Take Care
Bob,
I’m very happy to get your input here. Briefly, I do recognize the mental/physical interactions in these illnesses and believe that the placebo effect is evidence of this. Also,I do not doubt that social and family situations contribute to diseases. I brought in Laing and Szasz to show the extemes of believing MI is a totally fabricated disease or can be totally cured by just the right combination of positive upbringing and social nurture. I don’t think we live in a sane society. So, I agree that distinctions between sanity and insanity are iffy. But, from first hand experience I’ve come to realize that the stop-gap interventions of medication and cognitive therapy are all we have at present to relieve symptoms for many sufferers of MIs. Freud wouldn’t touch on psychoses. It was beyond his basic form of talk therapy. Nearly a century later we have come to the pragmatic conclusion of doing whatever works for psychotics. This includes massage, laughter, hugs, music, pets–and, most of all–consistency of attitude toward the sufferer.
Also, I see the flip side of social or extra-mental influences in the fact that pain often comes across in dreams as negative narratives concerning guilt or shame over "sins"or failures. My friend J. dreams while awake. The negativity of her pain surfaces. I’d like to understand that.
In the US it has been estimated that 1 in 6 persons have been diagnosed as mentally ill. The fact that some of these are persons who have simply learned how to “play the system” continues to add to popular opinion that all or most MI sufferers are malingerers. The core group of MI sufferers deserve better treatment than our for-profit economy can allow. So, if society is insane, it is mad from a spiritual dearth of empathy and compassion.
For many deinstitutionalized MI sufferers living on the streets is a bizarre, confusing adaptational nightmare. They find that competition for survival and self-esteem is something like a one-legged man judged by how well he runs in a race with two-legged people. And the self-esteem issue, weighed down by false attempts or outright failure, harms the “soul”, which I believe amounts to our birthright of personal integrity.
On the streets such abstract concerns as pyschosomatics, cultural insanity or diagnostic fakery have little or no meaning. An erstwhile friend once told me: “A hamburger is worth more than your philosophy.” I need to be reminded of that often.
Hi Ier,
Yes, I’m sure that there are those people, who are driven by economic or other questionable interests, who want to lower costs by trifling MI as fabricated or negligible. The fact remains that the more we investigate, the more it becomes clear that our society is in fact making people mentally ill. Thomas Moore writes in “The Soul’s Religion” that a “secular society that desperately craves information and understanding operates from anxiety …” and neglects the mystery of life and the soul’s needs. Both of these aspects have to be addressed, but neither have been acknowledged by the powers that be.
Sanity is defined by those who want functioning cogs and wheels instead of human beings who have feelings, emotions, and are generally far more complex than these people want to admit. General Psychosis has been differentiated since Freud and there are a large number of psychotic disorders instead. Quoting from nlm.nih.gov/medlineplus/psyc … rders.html for convenience:
Going by this statement alone, how many people do you know who have lost touch with reality? Or how many have false beliefs, such as thinking that someone is plotting against them or that, for example, the TV is sending them secret messages? And how many have false perceptions, such as hearing, seeing or feeling something that is not there? It is uncannily worrying, but judging by the amount of espionage being done today, some of the people may even be right but can’t prove it. So you may have people with psychotic disorders which are not diagnosed and some people who pick up something going on around them and diagnosed as psychotic.
Reading Thomas Moore at present, his presentation of “The Soul’s Religion” picks up this and argues that we have more “antennae” than just our single senses. It is the combination of our senses which the brain translates into symbols and metaphors, analogies and myth, because there is no language to capture the mass of information we are taking in when we are astutely empathic or aware (not forgetting the signals from within, indicating that our soul requires attention). If this information has no receiver because the mind rationally rules it out, the soul/ psyche moves to enforce such listening through the body. Psychosomatic illnesses are alarms going off. Metal Illnesses are a sure sign that these alarms have been overheard for too long.
If enlightenment or being awake or coming to our senses is realising who we really are, the insane are those who have no antennae for such input and they are quite deranged, since they have false beliefs and false perceptions, and try to ignore what the combination of their senses is telling them. Secondly, if humility is the common denominator of spirituality in the world, based on the appreciation of the fact that knowledge will never suffice, and that the mystery of life must have its place in our lives, the all too present ignoring of this fact in policy making is a real threat to humanity.
This is just an example of a hierarchy of needs and, although understandable, is something which will be revised when the basic needs are satisfied.
I also experience this with my mother-in-law suffering from Lewy-Body-Dementia, and with her it is what has been a major influence on her life over decades. Of course, I can’t judge the situation with J. and I am sure there are vast differences. However, I think that you are quite correct in observing that dreams are surfacing. Dreams are one method of sorting the unfinished business of the day, but also the unfinished business of weeks, months or years. Often, even those things we rationally consider sorted have a soul-message which we have overlooked. The problem is that the mind sometimes has problems understanding the soul, especially if we have no bearing by which we can plot the course.
You may never understand, but you can go with her, as long as the pain doesn’t become your pain. It isn’t your pain and you will only add something to it if you try to make it yours. The best you can do is to remain inwardly distant whilst being physically close and just listen and be there.
Take Care
Bob,
As usual, your remarks are on the mark and much appreciated. I’d like to bring in here one of Torrey’s considerations as I think it pertains to spiritual considerations of this matter. And, thanks about J. Yes, it’s all I can do to help her–being there, caring and not becoming overwhelmed by the negativity the disease exhibits.
“A 2002 study comparing nonprofit and for-profit psychiatric inpatient units found that the nonprofit units were superior in almost all aspects of psychiatric care.”(Torrey). So,why don’t we opt for the best care available? Nonprofit units still require funding, which is available only through government subsidies or private charities. In both cases the fact that nonprofits give better care is a secondary consideration to questions about where the money is coming from and how it is being used.
Even in these tough economic times people in the US spend enough money on entertainment and junk food to support all nonprofits and to build and finance more of these. Charity is, of course, subject to personal priorites. The spiritual issue is how these two conflict or complement.
According to Torrey, MI sufferers contribute little or nothing to the societies that support them. IMHO, this lack of contribution is responsible for such questioning as to the validity of MI, questioning as to the efficacy and expense of long term therapies based on coping rather than cure and questioning as to the costs of necessary research. The questions are raised by those who believe they have “paid their own way.”
Continued–
In the 1980s I came to the conclusion that one dream duty was to empty mental garbage. What happens when the garbage can’t be removed? Dis-ease!
My friend J. is improving under med stabilization.
In my lifetime I’ve met three psychotics. Each exhibited their illness in different ways. One ran naked through the streets. Another publicly masturbated. J. doesn’t do these things. Her core personality seems dominant in that she is able to understand and abide by social standards of decency and propriety. The real J. beneath the protective masks is a sweet, conscientious, religious lady.
A study of extant primitives whose beliefs may seem psychotic to us may reveal why there seemed to be so few “insane” persons in these societies and why those who didn’t fit the mold were often seen as “spiritual” leaders. In our current societies, as you noted, Bob, no such reverence for the mystery that is the “manna” of the spirit exists. There is no allowance for what is considererd to be an anomaly or abhorration in the current societal demands for increased productivity and profit regardless of the human and humane expense.
Is Marx right in assuming that economics determine morality?
Economics play a big part of morality but I wouldn’t say determine. Is J a Catholic or a “harsh” believer in God via another religion who takes it gravely seriously?