major mental illness – Inspiring Change LLC

Biblical Literalism is the Disaster

September came hard as massive hurricanes slammed into our nation’s Gulf coast. Like many, I found myself completely distracted and immersed in the round-the-clock news coverage of the damage. When it comes to bearing witness to destruction, we seem unable to look away. While the information does soothe our need to know and connect with important people and places in our lives, too much information can damage our emotional balance. We must turn and turn again to the present of our own life, and help as we can with donated blood, money and specific resources to relief agencies. This is how communities recover; this is how we can help.

Yet we are meaning-making beings. We naturally tell stories of what happens in the world so we might order and understand what can feel like chaotic circumstances. Some of those stories involve theology, or talking about God. Preachers pounding out prayers, sermons, articles and social media comments, as they do. Believers repeating them. And some of these God stories make me sad and upset.

Despite centuries of passionate and careful study of the Biblical texts by both Jewish and Christian scholars, research that helps readers understand how this big library of old stories, poems, hymns, histories, letters and Jesus narratives is put together into a single volume, there are still those who read the Bible as if it were dictated word for word by Jesus himself to a single scribe somewhere. They pull verses and stories out of their original context, ignore the subtleties of language, form, history, and culture and proclaim the words as current truths about God.

This literalism has led one strain of popular theology to declare that hurricanes, earthquakes and destruction of land and people as evidence God’s wrath. This way of reading scripture has harmed untold numbers of people who have sought comfort, direction and help from God in times of disaster. This perspective takes as a starting point the way that the people of Israel, over 3,500 years ago, made sense of their own suffering.

The Jewish people are descendants of a tribe of people who believed they were God’s chosen nation. The only way those ancient people could reconcile that closeness to God and their suffering was to tell the story that both good and evil come from God. That included natural disasters, physical and mental disease, and war with neighboring tribes. Suffering? That must be God’s punishment. It made sense three millennia ago. It makes no sense now.

Jesus came fifteen centuries later and challenged that older way of thinking. If you read through the different versions of his story in the New Testament, you will read how he frequently challenged that theology. In several healing stories, people wanted Jesus to tell them who was to blame for someone’s suffering: a tower fell and killed several men; a child was born blind; a man was lame from birth. Part of his healing ritual was to tell the suffering that not only were their sins forgiven – the old way of thinking – but to “get up and walk.” There are dozens of these stories of Jesus’ compassion and healing, most of whom he heals without a judgmental word; just a command, and a touch.

Christians can disagree about much, but to continue to use meaning making from 3,500 years ago to talk about contemporary disasters and suffering is irresponsible and useless. Historic storms? They are a result of our complex dynamic atmosphere, now threatened by human environmental pollution and ocean warming. Earthquakes? Science has long ago discovered the massive pressures of our earth’s crust’s plates moving over time. These are scientific stories of meaning we can trust.

Is God our creator? Oh yes. But to assume that God’s action in the world is toward destruction is to fail to look at Jesus. Jesus’ life and death was a song of praise to a God of love and mercy, of healing and hope, of struggle for the sake of this difficult human family. If you’re hearing anything else from your church or religious media in these difficult days of natural disasters, wars and rumors of war, you’re not hearing the Good News.

(Published first in the Savage PACER 9.16.2017)

When Severe Mental Illness Strikes a Loved One

Book Review: “I Am Not Sick, I Don’t Need Help” by Xavier Amador, PhD. (Vida Press, 2012)

For the last 20 or so years, brain research has helped doctors and therapists understand that the serious mental illnesses of schizophrenia and bipolar disorder are diseases of brain function. During the century before the “Decade of the Brain (the 1990’s)”, these rare and frightening mental diseases were blamed on bad or inadequate mothering (the “schizophrenogenic mother”), thanks to the early theories of Freud and subsequent generations of psychology, puzzling over the cause and treatments of such life-altering and permanent mental illnesses.

In his wonderfully personal and helpful book “I Am Not Sick,” Dr. Amador explains that the primary feature of these severe mental illnesses is the core belief that the sufferer is “not sick.” In medical terms, this disbelief in their illness is called “anosognosia” (ã-nõ’sog-nõ’sê-ã). Sufferers may be homeless, talking to voices in their head, unable to sleep or put together a clear sentence, believing that aliens have made inroads to their cells, but to these ill brains, the beliefs and thoughts are as real as sunlight and gravity.

If you have ever been in a relationship with a loved one who has become mentally ill and whose illness has this feature of anosognosia, you know that trying to convince them to get to the hospital for treatment or to take their medication is a futile, frustrating, and relationship damaging exercise. But this is how almost everyone attempts to get their loved one’s the help they need to be safe and recover.

In his best-selling book, Amador explains the model of engagement that he has developed over 30 years of living with his older brother, who was a schizophrenic, and working as a professional forensic psychologist and therapist. He walks the reader through this counter-intuitive but effective model that listens, understands and collaborates with the sufferer, who, in the end, must participate in their care in order to get better.

He calls this program “LEAP,” which stands for Listen, Empathize, Agree and Partner. Utilizing the tools familiar to therapists of Client-Centered/Active Listening, Cognitive-Behavioral, and Motivational Interviewing models, Dr. Amador provides tools, examples, and scripts as examples of learning to use this strategy with loved ones who need help.

I read this book as a way to help one of my clients, whose loved one is beginning to demonstrate marked personality changes, delusions and strange behaviors. As we talked about how to be helpful short of calling 911, this book has become a welcome addition to my library and therapeutic models. If you have someone in your life you are seriously worried about and wonder how to help. I urge you to get this book or log onto his website, LeapInstitute.org.

Healing Traumatic Memory

If only life was one long, beautiful, inspirational journey. But it’s not. Some of us know that life can include experiences of such fear, helplessness and pain that we wonder how we survived. Over time, and with support, most of us get back to what we would call our normal. Yet others of us discover no matter what, we just can’t.

We call these experiences psychological trauma, the kind of experiences that steal our mental equilibrium. Many traumas have their origin in childhood; our bodies and minds are dependent, small, developing and vulnerable. The younger we are when they occur, the more impact they may have on the way we learn to relate, think, feel and trust the world around us.

Traumatic memories happen within the brain when we survive a life-threatening event and experience overwhelming shock, loss, fear, horror and helplessness. The words we have for what we experienced are just not enough to explain it to others. Motor vehicle accidents, physical, sexual and emotional abuse, parental neglect and addiction, domestic violence, plane crashes, witnessing homicide, military combat, escaping house fires: these are among the experiences that can overwhelm our emotions and capacity to bear what we have seen and known. The memory of the experience is stored in a kind of jumble in the brain, never blending into what we would call our normal sense of self, our everyday explicit memory.

Neurologists, psychologists and other researchers have made wonderful strides in the last 30 years in understanding how trauma effects the brain. And as the science of trauma becomes clearer, so has the clinical work of seeking effective treatments: treatments for the post-trauma effects that are expressed in our bodies in the form of chronic pain, sudden panic attacks, visual and auditory flashbacks, depression, anxiety, relationship and work problems, addictions and patterns of emotional dissociation.

First generation psychological care for traumatic memory was talk therapy; some relief was attained by patients helped to fully describe their experience in a private, compassionate therapeutic environment. Second generation care added strong prescription medications to calm the nervous system, limit emotional affectivity or target psychotic symptoms. What the most recent research has shown is that both methods are insufficient; talking uses the cognitive portions of the brain without adequately engaging the emotional and survival systems, systems that were in charge during a trauma, and dulling trauma memories or disengaging them temporarily with psychotropic drugs won’t heal the damaged and chronically misfiring memory patterns.

What does work is helping the sufferer to carefully, artfully, and in a controlled and focused way to re-experience the memories, feel the experience again in the body while expressing the energy, body movements, sounds, sights and postures that were suppressed at the moments of helplessness, dissociation and physical restriction. To think the thoughts that seem too terrible to think, and to help the mind link up the original memory to the fuller, day to day explicit or narrative memory that we live and work in every day.

This is what the work of Francine Shapiro’s EMDR (Eye Movement Desensitization and Reprocessing), Peter Levine’s Somatic Experiencing (SE), Albert Pesso’s Psychomotor Therapy and Pat Ogden’s Sensorimotor Approach all seek in their similar models: to have the sufferer become integrated with their physical bodies, those same bodies that have experienced the trauma, to feel, tolerate, express, observe and rewrite their story in the present sense of the self.

All this is to say: there has never been a time in human history where more can be done to help the trauma sufferer than now. If you are besieged by physical and mental echoes of a terrible event in your past, please seek out care from a psychotherapist trained in the newer trauma resolution techniques. Many of us have found peace where there was no peace, and wish the same health and healing for you.

Racism and Trauma

For decades, family therapists and other mental health professionals and researchers have believed that trauma in one generation can be expressed in the genetic code and passed as psychological suffering and vulnerability in following generations. This fact has been demonstrated in animal studies for years, but few human trials have followed.

A research team at Mt. Sinai Hospital in New York City, studying the DNA and mental health of survivors of World War II Nazi atrocities and their children, have newly demonstrated genetic changes in the children of these survivors. The Guardian article of August 21, 2015 describes the changes in a specific gene sequence associated with the regulation of stress hormones. What therapists have seen in their practices has begun to be proven in the laboratory: when emotional and mental trauma happens to us in our early life, it can change our genes, and those changes can be passed down to our children.

It helps to explain the increased mental health issues in children of Holocaust survivors, victims of political terror, accidental trauma, severe poverty, famine and the progeny of African slaves in the United States. This “epigenetic inheritance” can linger for generations and effect the culture, as it has done in the Jewish communities around the world after 1945.

The continuing hurt, vulnerability, anger and rage expressed in Native American tribes and African American communities in the United States against the majority white population can be understood as both cry for justice in the present, and a echo of generational trauma that was endured for nearly 300 years on our nation’s shores.

We have a responsibility as a nation to be struggling to heal the racial injustice and majority privilege that still stains our daily interactions. And therapists need to recognize the layers of trauma that their clients of color may bring to their offices, seeking healing for individual pain that may have been generations in the making.

UPDATE: Here is the link to the mouse study with traumatic epigenetic changes in following generations : Nature Neuroscience, Volume 17, Number 1, January 2014:
https://tinyurl.com/y7zblcwe

Violence and Mental Illness

Today I pray, along with so many others for the victims of the Arizona shooting yesterday: six dead, at least 12 others injured, including Congresswoman Rep. Gabrielle Giffords. The man in custody for this violence is now being held on multiple counts of murder, and his background searched for clues to his destructiveness. The county sheriff says the young man has mental issues. I say No Kidding.

Most of us who suffer from issues of behavior, emotion and thinking have what are called mental disorders. In other words, we as individuals have problems. Problems we know as something a part of ourselves but distinct from ourselves as a people. Those who suffer mental illness are people whose disorders have them. Major mental illness (MMI) like schizophrenia or psychosis so distorts the mind, mood, perception and behavior that we have commonly called these people “out of their mind.” They behave as if they don’t have two normal thoughts to rub together. Often, they don’t.

American courts have long recognized this distinction, with what most of us know as the insanity defense. Someone may be considered guilty of an action but not punishable, not sent to prison, because they were “out of their mind” when committing a crime. Instead, they are committed to a psychiatric hospital in a locked ward. Prison for the insane. Most never get out, because it’s pretty hard to get your mind back once you’re out of it.

Our current cultural political and religious speech, so out of control with hatred, divisiveness and extremism, is like gasoline to MMI’s fire. Words do have that kind of power, to inflame emotions and create sides where there needs to be common cause. Shame on those who, like former Alaskan governor Sarah Palin, have used their political power to incite violence with website images of a gun’s cross-hairs on an picture of a political opponent. Her ignorance of how her words can hurt people is mind boggling.

Internet technology gives hate speech a world-wide audience. When politicians stir up hate in the name of partisanship, it is no wonder those whose minds are disturbed and distorted by illness take their rhetoric for truth. And occasionally act on it.

Mental illness is the next great medical frontier. Just as MRIs, blood tests, CT scans and Xrays have given us astonishingly detailed windows into our bodies, I pray for increasingly clear windows of understanding into the most mysterious of all our organs, our brains. One day we may be more able to anticipate and treat MMI before individuals become violent to themselves or to others. It won’t save us from our stupidity and ignorance, though. So far, there’s no cure for that, save education, humility and self control. Something, at least right now, is in dangerously short supply amongst many in politics, media and self promotion.