Tuesday, October 10, 2017

"Why I Oppose World Mental Health Day" - Emily Sheera Cutler

According to physician and best-selling author Dr. Gabor Maté, every human being has two complementary needs: attachment, or connection with others, and authenticity, or the ability to fully be ourselves.

In my opinion, it is impossible to have the former need met without the latter. When we are unable to express who we truly are, how we are feeling, how we process and make sense of the world around us, and our deepest fears and dreams, we cannot fully connect with anyone else.

What does this have to do with World Mental Health Day?

We live in a world that constantly and relentlessly punishes us for expressing ourselves authentically. Our society often views emotion as a sign of weakness, alternative realities as indications of impaired judgment, difference as a form of illness that needs to be cured, and distress as a result of irrational thinking. We are taught to be afraid of this kind of authenticity in both ourselves and others – to be ashamed of who we are and how we feel, and to be embarrassed of others’ raw expressions of themselves.

To me, no system of thought reflects this cultural tendency better than the notion of 'mental health.' The ideology of mental health, or, as neurodiversity scholar Nick Walker likes to put it, the pathology paradigm, posits that there is only one correct, healthy way of being, and any sort of divergence from that way of being is illness or disorder. Any level of emotion that surpasses the DSM’s arbitrary cutoff for what constitutes a healthy amount of feeling, any belief or viewpoint that strays from the bounds of what doctors have decided is normal, any desire or wish that has been deemed unrealistic or irrational – these are all just a few examples of authentic expressions that are deemed by mental health professionals as in need of treatment.

The pathology paradigm is the foundation of a system in which people are punished violently for these kinds of expressions. Words cannot quite capture what it feels like to not own the rights to your own body; nothing fully describes the horrific realization that you do not have the right to say “no.”

Involuntary civil commitment and forced treatment mean so many things to me: the terror of being locked in a closet-sized room with glass windows, unsure of when I would be released; the panic I felt when I was ordered to take off my clothes for a strip search and knew what would happen if I disobeyed; the apprehension that I would slip up and falter from my “model patient” persona for even a second and be held longer; the restlessness and emptiness of waiting to be released, each minute feeling like an hour; the shame and regret I still feel over not attending my own college graduation due to being locked up instead.

To some of my friends, co-workers, and comrades, forced treatment has meant being electroshocked with and without anesthesia, being injected with powerful antipsychotics, and being subjected to behavior therapies and efforts to reprogram who they are through rewards and sometimes physical punishments.

And for all of this, we are told we should be grateful. One could argue that even the notion of “forced treatment” is the ultimate form of victim-blaming – survivors are constantly told that because the ways we were expressing ourselves were symptoms of an illness in need of “treatment,” the use of force was justified. “You should be glad someone cared enough to get you the help you needed,” I hear regularly.

It is not just the use of state-sanctioned force and violence that limits our ability to be ourselves. It is also social coercion – the social and environmental factors that make life very difficult for people seen as different. Every day, people face discrimination and prejudice for expressing thoughts and feelings that we have been trained to see as abnormal. Of course, the mental health industry exploits and perpetuates this prejudice.

In a world where these are the potential consequences of just expressing certain thoughts, feelings, and actions, how can we expect anyone to be themselves? And if no one can be themselves, how can anyone connect?

As humans, we are all so incredibly different from one another. We have vastly different ways of experiencing, processing, and responding to the world around us. And that is a beautiful thing – the world would be awfully boring if we were all the same! But sometimes, when one considers how different we all are, it is a mystery how we manage to connect and relate. It can feel very lonely and isolating to realize you are the only person in the world who possesses and fully understands your exact set of values, beliefs, thoughts, feelings, and personality.

But while we have differences, there are universal experiences we all share. Real connection comes from those shared experiences. To be human is to feel pain, sadness, loss, anger, fear, joy, happiness, and hopefulness. To be human is to have strongly held values and beliefs that are shaped by our lives. We can all relate and empathize with these human experiences. In being forced to suppress them, what is there left to connect over?

I believe there is nothing more powerful than the human connection that occurs when one person expresses a unique thought, feeling, or experience, and another person responds, “Me too.” It is in these moments that we begin to feel less alone.

The mental health paradigm so often robs us of our potential to connect with one another.

  • It is for this reason that today, instead of observing World Mental Health Day and validating a paradigm that views some people’s natural way of being and expressing themselves as ill or disordered, I plan to celebrate human connection. 
  • Instead of advocating for more mental health treatment, I plan to do my best to support people in distress by validating their emotions and sharing their pain. 
  • Instead of telling people to use coping skills to manage or curtail their emotions, I will view these emotions as a natural part of the range of the human experience. 
  • And instead of raising awareness for “mental illness,” I will help spread the message that distress and crisis are a universal component of being human. 
Only when we recognize this fact will our human needs be met.

Monday, October 2, 2017

Human Rights Competency #4: Sees the Violent, Vicious Cycle

Have you ever considered how dangerous the medical model is?

-- And not just to those of us with labels, but to everyone, everywhere who wants to live in a safer world?

In reality, the conventional treatment industry is creating the very public health nightmare it says that it is 'treating.'

A Recipe for Violence

If you wanted to bring out the worst in humankind, here's a pretty sure shot:

  1. Divide the world of human beings into two classes - those with personhood and those without it. 
  2. Create an entire class of people with nothing to live for
  3. Create an entire class of people with nothing left to lose
  4. Dismiss traumatic lived experiences as irrelevant
  5. Ignore real life precipitants to actual human suffering
  6. Use power, control and violence to resolve disagreements
  7. Consistently make someone's life worse instead of better
  8. Convince the entire known world that their truth is an 'illness'
  9. Accuse everyone who disagrees of 'enabling their pathology'
  10. Insist you are the answer and there is no hope apart from you

That's the medical model paradigm in a nutshell.

If you wanted a to create recipe for alienation, desperation and retaliatory violence, you could hardly write a better one.

A Literally Vicious Cycle

It gets even worse than that when you look at the big picture.  The simple fact is:

The more outsiders we create, the more unsafe we are.

Let me say that again:

The more outsiders we create, the more unsafe we are.

This is not about broken biology or aberrant genes. It is the Catch 22 of the human condition.

Here is the how and why of it:

  • None of us likes to feel scared or threatened.
  • Feeling at odds with others is scary and threatening.
  • Feeling unable to meet basic needs is scary and threatening — and it often goes hand in hand with being a social outsider.
  • Human beings who feel threatened tend to resort to one of three responses: fight, flight or freeze.
  • When the stakes are high, flighters and freezers usually are not a problem. They run or hide, which doesn’t scare others too much.
  • Fighters are a totally different matter. We don’t run, we don’t hide. We go toward the stuff that scares us. And then we take it on and try to bring it down. The more afraid we are, the harder we attack. We don’t stop until the threat is dead or we are.
  • It’s also no sense trying to talk reason either. As long as the stakes stay high and we stay scared, the sympathetic nervous system will continue to do its job. It will create tunnel vision and tunnel hearing to keep distractions out. It will make sure our attention stays riveted until the threat is gone or we are.

This isn’t going to change — not for a long time, probably not ever. The fight response has helped our species survive for thousands of years. There’s every reason to believe that it is genetically encoded. There’s every reason to believe that, for some of us, the fight response is a biological default. A species made up only of flighters and freezers wouldn’t last long. They would cede the turf with every new challenge. Humanity needs its fighters to ‘stick to their guns’ when the stakes are high.

Therein lies our problem as human beings.

Think about it:

  • A certain percentage of the human species defaults to fight when threatened.
  • Being treated as ‘other’ scares people.
  • The more we ‘other’ each other the more scared more people are.
  • The more scared people we have and the more scared they feel, the more violence we are going to see.

This is not because marginalized people are violent. We’re not any more violent as a group than anyone else.

But we are a whole lot more threatened. 

And the more of us who are threatened, and the worse we feel inside, the more fighters you will activate and the more violence you will see.

It’s a simple matter of statistics, percentages
 and computing the odds.

As a case in point, look at the public health data on four groups that society loves to hate: mental illness, addictions, corrections and homelessness. There’s a common denominator staring us in the face.

It’s not only ‘the mentally ill’ who have trauma. No, no, no. Widely-accepted government research suggests that roughly 90% of those who get caught in any of these systems are trauma survivors.

In other words, there are a lot of marginalized and very scared people out there.

Las Vegas just encountered another one today.

No doubt the ‘mental illness’ treatment industry will use this to argue for more conventional services and more money to fund them.

The outcome  of this approach is fairly certain:

We will alienate more people
Then we will see more violence.

The human rights framework gives us a far more viable option. Instead of creating social outsiders and killing hope, human rights connect us and repair our relationships.

Here is how:

  • Human rights focus us on the things we have in common
  • Human rights reinforce that all of us have worth
  • Human rights resource us to get the things we need
  • Human rights treat all of us withdignity
  • Human rights make the space to honor all our voices
  • Human rights require us to  hear each other out
  • Human rights respect those who disagree
  • Human rights seek out solutions that meet the needs of all of us

In a nutshell:

Human rights prevent violence before it ever starts.  

They ensure that all of us get treated 
the way every one of us would like to be

Human Rights Competency #3-3: Facilitates Restorative Access

The human rights paradigm is a roadmap for individual and social well being. 

The path to getting there is this:

  1. Identify the core needs that people world wide agree on
  2. Make sure everyone knows what they are
  3. Help everyone to access what all of us need.

This is the universal route to universal well being.

You'd be surprised at how many healthcare providers have never considered this. 

You'd be surprised how many of them claim to be experts on 'mental health.'

It's time for that to change.

This question helps you to help your healthcare worker to do that. 

Human Rights Competency #3-2: Assesses for Unmet Human Needs

Ok.  Here's the point:

'Mental Illness' portends to be about 'faulty thinking'

So how do you know if someone's thinking is faulty?

Well, first and foremost...

You have to know why they are doing what they are doing

Here's the long and short of it:

  1. Human needs are about human survival
  2. Human rights are about the survival needs  that human beings care about the most
  3. If you can't access what you care about, it feels bad
  4. If you have to chase what you care about, it takes a lot of energy
  5. If you feel bad enough or chase long enough, eventually it shows.

Here's the problem with the medical model:

It never asks the questions that people care about the most.

It just:

  • Looks at what someone is doing
  • Compares it with a check list
  • And ticks off boxes...

Poof!   -  You are 'ill'.

That is 'faulty thinking.' 

By it's own standards, the medical model is 'mentally ill'


Hopefully, the clinician you are seeing has higher standards.

This question helps you make your own assessment.

Human Rights Competency #3-1: Cares About My Basic Needs

Here's the down and dirty: 

No rights, no well being

Here's the deeper logic:

1. Healthcare is about well being
2. Being cared about:
  • a basic need
  •  essential to psychosocial well being

3. Meeting basic needs is:
  • essential to individual and social well being
  • the foundation of freedom, justice and world peace 


Providers who
  1. claim to offer 'healthcare' ...
  2. claim to care about 'public safety'...
... need to care about the basic human needs of those they serve and whether those needs are being met.