An excerpt from a journal entry of mine on 15 Feb. 2009, to do with my nervousness at a new job:
...I feel entirely culpable (if there are any mistakes), it is not discursive, which I would like it to be - rather, it is a question of pure guilt.
There are two sources for this that I feel come into play. One being my (mentally ill) sister's opinion that I and I alone decided her ability to succeed. I.e., she blamed me entirely for her inability to finish school, retain employment, feel comfortable outside the house and any other failures that she felt she happened from day to day (including her inability to plan a garden to her own satisfaction).
The second reason is the fact that I do not trust people to comport themselves in reasonable ways due to my experience with my sister. I expect madness, negativity, disruption, and blame. I feel like a piece of elastic that has been stretched so many times that I have no sense of proportion anymore. I always am at the ultimate edges of my expectation of behavior: I expect and fear the worst always.
Because my experience with my sister was directly related to my isolation with her by my parents, and their active ignorance of her different mentality, both of these ideas lead into a discussion of the different modalities of how a severely mentally ill or schizophrenic person is treated within a family structure. As well, they speak about how ignorance and abuse can easily happen in a structure of 'right and wrong,' and about conceptions of deviance and correction in the family setting when dealing with drastic differences in reasoning abilities.
Much like early students of psychiatry, such as Pinel, my mother's treatment of my sister was basically corrective. She truly expected that if corrected, my sister would see errors in her interpersonal treatment of relatives, especially me. Usually my mother would reprimand her, tell her she was being "controlling" and try to explain to her why this was wrong, often with a 'do-unto-others' comparison, such as: "what if Gillia did this to you? How would that make you feel?" This offering of a mirror to the 'deviant' behavior was thought by my mother to be sufficient, and she trusted that in time Tavia would desist, after admitting to her own guilt, feeling the requisite feelings of remorse, and recovering.
Though not going so far as to make my sister see she was 'mad,' my mother did believe that if she corrected my sister enough times in the way she was treating me, my sister would eventually cease - even though my mother and my sister had long and bitter arguments regarding my sister's right to treat me as she pleased, conversations which seemed to clearly point to a drastic reasoning difference in my sister that may have indicated a need for therapy or help. However, my mother persisted in being certain that the 'deviant' behavior could be corrected (and trusted that it would be.)
The answer to the behavior was punishment, an apology, spanking, etc., but because my sister and I shared a bedroom, and were often alone together, I had become on the 'inside' of a group of people who 'understood,' made up of the two of us - my sister and me. My mother was on the 'outside.' My sister and I lived in a secret world where my mother's eyes and her logic could not enter due to the nature of our 'insider' group. If betrayed, my sister threatened various terrible things, such as never speaking or playing with me again, not allowing me into my bedroom or to get my things (since we shared the space), and trying to make my life miserable in every way she could.
For these reasons, I protected my sister, but I protected her for a deeper reason as well. I remember clearly feeling there were differences she was struggling with that I could not understand. I protected my sister because of her difference, whether or not the way she treated me was wrong, she simply could not understand why it was wrong. And she could not change it. So I became an accomplice to my own pain and hurt due to my childish understanding of her reality as different from my own, and the subjective nature of her struggles with 'reasonable' concepts of human interrelations.
Monday, February 23, 2009
Wednesday, February 11, 2009
global viewpoints on schizophrenia
I am posting the below link as a comment on globalized psychiatric techniques. The article discusses current mental health practices in India, and how they relate to Western understandings of mental illness, and its bounds, descriptors, and symptoms.
Most interesting for me was the focus on the experience of mental illness. As one doctor in the interview says, the symptoms may be similar world-wide but the actual lived and social understanding of the illness varies due to differing worldviews. This becomes especially clear when the social context has established practices that may include actions or experiences similar to those that are symptoms of mental illness - such as hearing voices or having hallucinations.
How does this reflect upon madness and a conception of, interactions with, and social experience of it? How does it affect the lived experience of those interacting with people who are "mentally ill"? And if context and lived experience do affect each other to this degree, how does one label "mental illness" at all?
For me, I would tentatively refer to my prior blog post - suffering in the person with whom one is interacting can be very clear, and from that I infer something is wrong. However; the concept, social constructs, and psychiatric assumptions surrounding this word "schizophrenia" require some deep analysis and serious socio-political contextualization in order to be truly understood.
Link: All in the Mind, Radio National, with Natasha Mitchell. 23 March 2003. http://www.abc.net.au/rn/science/mind/s811522.htm
Most interesting for me was the focus on the experience of mental illness. As one doctor in the interview says, the symptoms may be similar world-wide but the actual lived and social understanding of the illness varies due to differing worldviews. This becomes especially clear when the social context has established practices that may include actions or experiences similar to those that are symptoms of mental illness - such as hearing voices or having hallucinations.
How does this reflect upon madness and a conception of, interactions with, and social experience of it? How does it affect the lived experience of those interacting with people who are "mentally ill"? And if context and lived experience do affect each other to this degree, how does one label "mental illness" at all?
For me, I would tentatively refer to my prior blog post - suffering in the person with whom one is interacting can be very clear, and from that I infer something is wrong. However; the concept, social constructs, and psychiatric assumptions surrounding this word "schizophrenia" require some deep analysis and serious socio-political contextualization in order to be truly understood.
Link: All in the Mind, Radio National, with Natasha Mitchell. 23 March 2003. http://www.abc.net.au/rn/science/mind/s811522.htm
Monday, February 9, 2009
Schizophrenia through a Foucaultian Lens
"Madness was not what one believed, nor what it believed itself to be; it was infinitely less than itself: a combination of persuasion and mystification...And by a strange reversal, thought leaped back almost two centuries to the era when between madness, false madness, and the simulation of madness, the limit was indistinct - identical symptoms confused to the point where transgression replaced unity; further still, medical thought finally effected an identification over which all Western thought since Greek medicine had hesitated: the identification of madness with madness - that is, of the medical concept with the critical concept of madness" (p. 164, Rabinow, Paul, ed., The Foucault Reader,1984.)
In speaking about the evolutions of the view of madness in Western societies through the 17th to 19th centuries, Foucalt discusses here the idea of madness, delinquency, and the power relation between psychological treatment and the mentally ill; a manifestation of power relations elsewhere in society (family, government, social rules, etc.), as well as the needed confessions of madness on the part of the ill person.
I found this quote especially interesting because of its possible application to the experience of severe mental illness of a close relation(as a 'healthy' person). How does the process of forced realization as the perceived cure to 'madness' (p.165), conceptions of madness as social aberrance, "abnormal psychiatry," fear/shame/guilt relationships surrounding mental illness, shamanistic power plays with doctors and social stigma, as well as concepts of bourgeois factors in classification of dysfunction and madness (not human mental suffering, but 'dysfuntion' and inability to work, delinquency) relate to my own memories of being within daily and hourly contact with a person whose brain functioned differently from mine? And where do notions of responsibility/personal transgression of an ill person come appropriately into play - esp. when they are of legal majority?
In my own journeys into what seemed a dark house of illness, I think I did not know, and still do not know in many ways, how to fully comprehend this "other" who views the world with a mixture of different reasoning, lack of logical thought progression, and constant paradigmatic shifts. I become confused until all symptoms of difference become allotted to a false front of "madness" (not specific mental illness), which is an indelible stain that cannot lift, so the problem can never be excavated, explored, or understood. It becomes an almost magical, chimerical thing that only something equally "magical" can cure - in my parents' eyes, a miracle. In my own, a series of medications I do not fully understand (Foucault talks about the doctor as a pseudo-magical being, the doctor-patient power relationship on p. 165 of Rabinow, which is in part what I am using to help me view this experience).
What about the experience of the ill person? Is it simply subjective differences in viewing the world, and a lack of understanding on the part of the "well" majority, that renders the illness and illness at all? From my own experience, I would say that the encounters with what I did experience - an abnormality-illness-suffering that I will tentatively call schizophrenia for ease of use, were personally almost unbearable. And from what I could ascertain of what the other person was suffering, it seemed she was experience great pain, fear, and anxiety, thoughts of suicide.
Physically, what I believe to be at the heart of this suffering, which for her crosses bounds of mental pain and often enters the physical, is a problem of brain function. However, the suffering itself often seemed caused not by the "abnormal psychology," though this might seem to keep her in a constant state of changing viewpoint, from which it was impossible to grow forward toward mastery of her own life, but from the impossibility of association across two differing states of living. The mutual existence of the two incompatible ways of dealing with the world and others; hers constantly changing from one delusion to the next, versus mine, was too difficult for either of us to handle, but for her seemed especially painful. There could be no world that allowed for both states, one of us must be insane.
In some ways, I think I took on a magical quality for her because I had "abilities" she did not. (Like being able to understand unstated meanings in discussions, or having an understanding of basic social skills in places like the library.) At other times it was the opposite: she could physically withstand hours of insomnia and intense conversation in a way I could not. In her mind, I was almost always without fail the cause of her pain and persecution, either through my own malevolence or through my connection (spiritual/mental/magical/social) with others who were against her. I have come to think perhaps this was not due to an actual inhibition of her success on my part, nor a complete fantasy on hers, but rather the fact that I stood as a comparison, like Foucault's juridicial asylum systems, a mirror that I did not mean to be for her, and mentally I therefore had to become the Madness and she the Sanity, I the Transgression and she the Reason (pp. 152-155, "Recognition by Mirror" and "Perpetual Judgment").
thanks to Nara Hohensee for her insight in recommending this reading
In speaking about the evolutions of the view of madness in Western societies through the 17th to 19th centuries, Foucalt discusses here the idea of madness, delinquency, and the power relation between psychological treatment and the mentally ill; a manifestation of power relations elsewhere in society (family, government, social rules, etc.), as well as the needed confessions of madness on the part of the ill person.
I found this quote especially interesting because of its possible application to the experience of severe mental illness of a close relation(as a 'healthy' person). How does the process of forced realization as the perceived cure to 'madness' (p.165), conceptions of madness as social aberrance, "abnormal psychiatry," fear/shame/guilt relationships surrounding mental illness, shamanistic power plays with doctors and social stigma, as well as concepts of bourgeois factors in classification of dysfunction and madness (not human mental suffering, but 'dysfuntion' and inability to work, delinquency) relate to my own memories of being within daily and hourly contact with a person whose brain functioned differently from mine? And where do notions of responsibility/personal transgression of an ill person come appropriately into play - esp. when they are of legal majority?
In my own journeys into what seemed a dark house of illness, I think I did not know, and still do not know in many ways, how to fully comprehend this "other" who views the world with a mixture of different reasoning, lack of logical thought progression, and constant paradigmatic shifts. I become confused until all symptoms of difference become allotted to a false front of "madness" (not specific mental illness), which is an indelible stain that cannot lift, so the problem can never be excavated, explored, or understood. It becomes an almost magical, chimerical thing that only something equally "magical" can cure - in my parents' eyes, a miracle. In my own, a series of medications I do not fully understand (Foucault talks about the doctor as a pseudo-magical being, the doctor-patient power relationship on p. 165 of Rabinow, which is in part what I am using to help me view this experience).
What about the experience of the ill person? Is it simply subjective differences in viewing the world, and a lack of understanding on the part of the "well" majority, that renders the illness and illness at all? From my own experience, I would say that the encounters with what I did experience - an abnormality-illness-suffering that I will tentatively call schizophrenia for ease of use, were personally almost unbearable. And from what I could ascertain of what the other person was suffering, it seemed she was experience great pain, fear, and anxiety, thoughts of suicide.
Physically, what I believe to be at the heart of this suffering, which for her crosses bounds of mental pain and often enters the physical, is a problem of brain function. However, the suffering itself often seemed caused not by the "abnormal psychology," though this might seem to keep her in a constant state of changing viewpoint, from which it was impossible to grow forward toward mastery of her own life, but from the impossibility of association across two differing states of living. The mutual existence of the two incompatible ways of dealing with the world and others; hers constantly changing from one delusion to the next, versus mine, was too difficult for either of us to handle, but for her seemed especially painful. There could be no world that allowed for both states, one of us must be insane.
In some ways, I think I took on a magical quality for her because I had "abilities" she did not. (Like being able to understand unstated meanings in discussions, or having an understanding of basic social skills in places like the library.) At other times it was the opposite: she could physically withstand hours of insomnia and intense conversation in a way I could not. In her mind, I was almost always without fail the cause of her pain and persecution, either through my own malevolence or through my connection (spiritual/mental/magical/social) with others who were against her. I have come to think perhaps this was not due to an actual inhibition of her success on my part, nor a complete fantasy on hers, but rather the fact that I stood as a comparison, like Foucault's juridicial asylum systems, a mirror that I did not mean to be for her, and mentally I therefore had to become the Madness and she the Sanity, I the Transgression and she the Reason (pp. 152-155, "Recognition by Mirror" and "Perpetual Judgment").
thanks to Nara Hohensee for her insight in recommending this reading
Sunday, February 8, 2009
Online Research History
AAMFT (American Association for Marriage and Family Therapy)
http://www.therapistlocator.net/families/Consumer_Updates/Schizophrenia.asp
How does schizophrenia affect families?
"Schizophrenia has a devastating impact on all members of the family. For example, family members usually need to cope with:
. their caregiving responsibilities
. their own emotional distress
. the symptoms of schizophrenia
. increased stress and disruption
. the mental health system
. social stigma
As caregivers, families share three essential needs: for information about schizophrenia and the mental health system, for skills to cope with the disorder and its consequence for their family, and for support for themselves. Of course, each family has unique concerns and needs, which are likely to change through time. Even within a given family, the needs of individual members differ for parents, spouses, siblings, and offspring of people with schizophrenia. Communities differ as well. Some communities offer excellent services for clients and families, while others offer relatively few."
NAMI (National Alliance for the Mentally Ill:
http://www.nami.org/Template.cfm?Section=By_Illness&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=54&ContentID=23036&lstid=327
Discussion group for siblings of schizophrenic consumers:
http://www.nami.org/Template.cfm?Section=all_discussion_groups&template=/Forums/TopicDisplay.cfm&ForumID=34&ForumActiveFlag=Y&TopicActiveFlag=Y
http://www.therapistlocator.net/families/Consumer_Updates/Schizophrenia.asp
How does schizophrenia affect families?
"Schizophrenia has a devastating impact on all members of the family. For example, family members usually need to cope with:
. their caregiving responsibilities
. their own emotional distress
. the symptoms of schizophrenia
. increased stress and disruption
. the mental health system
. social stigma
As caregivers, families share three essential needs: for information about schizophrenia and the mental health system, for skills to cope with the disorder and its consequence for their family, and for support for themselves. Of course, each family has unique concerns and needs, which are likely to change through time. Even within a given family, the needs of individual members differ for parents, spouses, siblings, and offspring of people with schizophrenia. Communities differ as well. Some communities offer excellent services for clients and families, while others offer relatively few."
NAMI (National Alliance for the Mentally Ill:
http://www.nami.org/Template.cfm?Section=By_Illness&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=54&ContentID=23036&lstid=327
Discussion group for siblings of schizophrenic consumers:
http://www.nami.org/Template.cfm?Section=all_discussion_groups&template=/Forums/TopicDisplay.cfm&ForumID=34&ForumActiveFlag=Y&TopicActiveFlag=Y
Goal: To write an ethnography of families groups dealing with a schizophrenic member, in order to more deeply understand the physical, psychological, and social repercussions of schizophrenia and other serious mental illness in families.
Possible Themes:
1 Context, causality, genetics, and brain function (short overview).
2 The medical system, it’s interaction with families and senses of alienation – from a disability to a death sentence.
3 Family abuse and mental illness – the abuse of the mentally ill person (both to them and from them), the cycle of violence and abuse through mental illness (increased traits of prior abuse done to the mentally ill person).
4 Lack of information, interaction with stigma; shame, perceptions of weakness, and personal illness due to an ill family member
5 The intrinsic role of the family in diagnosis and care.
6 Family denial and a torn family structure
7 Issues of responsibility, anger, and personal healing in those dealing with the ill person
8 Long-term psychological fallout of having an ill family member, personal relationships and dysfunctions
9 How, when, and where to turn for help – the eternal question
10 Agency of the mentally ill person and lack of influence of families, questions of power and information privacy
11 Legal needs, long-term care
12 Loss and sorrow, a “death in the family” what this looks like and feels like as recovery occurs (or does not occur).
Possible Themes:
1 Context, causality, genetics, and brain function (short overview).
2 The medical system, it’s interaction with families and senses of alienation – from a disability to a death sentence.
3 Family abuse and mental illness – the abuse of the mentally ill person (both to them and from them), the cycle of violence and abuse through mental illness (increased traits of prior abuse done to the mentally ill person).
4 Lack of information, interaction with stigma; shame, perceptions of weakness, and personal illness due to an ill family member
5 The intrinsic role of the family in diagnosis and care.
6 Family denial and a torn family structure
7 Issues of responsibility, anger, and personal healing in those dealing with the ill person
8 Long-term psychological fallout of having an ill family member, personal relationships and dysfunctions
9 How, when, and where to turn for help – the eternal question
10 Agency of the mentally ill person and lack of influence of families, questions of power and information privacy
11 Legal needs, long-term care
12 Loss and sorrow, a “death in the family” what this looks like and feels like as recovery occurs (or does not occur).
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