Wednesday, April 19, 2017

Chapter 5-3: Putting the 'Experts' in their Place

The implications of the Survival Reactivity approach to mental well-being are revolutionary.  In this chapter we talk about why.

Here is what we have learned already in the previous chapters of this guide

  1. Much of what passes for 'mental illness' is actually High-Stakes reactivity
  2. High-Stakes reactivity often feels bad, but it is actually our friend. 
  3. The point of the High-Stakes system is to help us discover and address the real life needs and concerns that are bothering us. It wants us to feel safer and be more secure in the world. 
  4. The key to turning off the High-Stakes system is to find solutions that restore our sense that "All-Is-Well" in our relevant world. 
 (See Part IV, and Chapters 5-1 and 5-2),

What does this mean?

It means we now have a clear picture of what is creating 'mental illness'  It's not an illness at all! It's a normal reaction to high-stakes situations.

Better yet, we also have a clear understanding of what to do about it.  Our 'symptoms are not really symptoms at all.  They are warning signs, alerting us to potential dangers in our lives.  All they want is for us to be safe.  So, to get them to leave us alone is not that big a deal.   We just need to figure out:

  1. What are the real life concerns that are stressing us out or gearing us up? Part III of this guide can help with that.
  2. How to get back to feeling like 'All-Is-Well'?  This can be achieved, in both the short and long-run, either by fixing the problem or learning to cope with the discomfort. For ideas on this, see Chapter 5-2, and also the chapters that follow this one.

It's that simple.

Implication #1: The age of "expert interpretation" as the first response to human distress is over

For a long time, we thought mental health was really complicated, - far too complicated for the average person to grasp.  As a result, people had to go to 'experts' with the most important questions of their lives.

The Survival Reactivity theory changes that. It gives ordinary people a way to make sense of what is going on with them.  It puts the power to understand and interpret our own lives back in our own hands.

Very simply, we are the most important source of information about us.

  1. Our bodies are reliable reporters as to the fact of our distress and how big a deal it is to us.  
  2. Our minds are reliable reporters as to what it is that we actually are concerned about.

The take home message:

If we want to maximize mental health and well-being, we shouldn't start with all the complicated genetic, chemical or psychological theories.   Those things might be helpful or enriching at some point.  But to get started, first and foremost, we need to listen to ourselves.  We also need to listen to each other.  Equally important, we need to address the real life concerns that are bothering us as human beings.

Here is why:

High-stakes reactivity is driving the extremes that are scaring us or others. As the concerns that bother us are addressed or coped with, our High-Stakes reactivity ('symptoms') will ease and lessen. As we experience less and less High-Stakes reactivity - and become more able to understand and work with it - the fears that we and others have around it ('the mental illness') will lessen as well. This, in turn, will result in more and more resources being available - better sleep, nutrition, energy - for healing our bodies and brains.  As we heal and get stronger, we will have more and more resources available to address and remedy the high mental and physical price ('trauma') that we, our families and our communities have been paying for business as usual (social dynamics of power and privilege) in the modern world.

Implication #2:  We must put Medical Model in its proper place 

As part of listening to ourselves and each other, we need to seriously reconsider the role of common conventional treatments - like  drugs and electroshock.  Such approaches often add - rather than reduce - the stress on already burdened bodies and minds.  No less important, these strategies often have serious effects.  They can be toxic, even deadly, to some people.  Not surprisingly, this heightens, instead of lessens, High-Stakes reactivity in many people.

Additionally, both drugs and shock carry another risk.  Electro-shock - and many psychoactive drugs - reduce our capacity to stay clear-headed and figure out what is going on with us. They can wipe out the clues we need in order to understand ourselves.  They can obscure or even block awareness of the real sources of distress that are driving the High-Stakes system.  This is especially true when combined with pre-existing High-Stakes activation, which, as discussed before (Chapters 4-4 and 4-5), takes its own toll on mental functioning

A good analogy is like having your hand on a burning stove.  High-Stakes reactivity is designed to pick that up, figure out where the threat is coming from, and get you to move your hand.  In the case of burning flesh, it happens in an instant.

But High-Stakes reactivity resulting from a lifetime of social stressors - poverty, abuse, discrimination - can be much more subtle.  When we complain to our doctors about this kind of pain, only rarely does the medical system help us identify or escape these damaging - often deadly - social threats.  Rather, the standard response of our doctors is to give us pills.  These pills (often sedatives or tranquilizers) shut down the Survival Response.  As a result, many of us no longer care that we are in danger.  We can no longer feel the warnings our bodies are trying to give us.  Nor can we detect the damage that is continuing to be done to us.

In other words, the medical model approach is the equivalent of killing the signals that are telling us our flesh is burning.  Instead, they write of our real concerns as 'mental illness' and leave our hands burning on the stove!!

 Given that approach, it is hardly surprising that those of us with 'severe mental illness' end up dying  - on average - 15-25 years before the rest of the population.  Yes, you heard me right: that's 15-25 years on average.  In other words, it is not just that some of us with the big name mental labels will die 15-25 years before everyone else.  It's that every single one of us loses on average 15-25 years off our lifespan in our present day system dominated by medical model approaches. McLaren, N., Mainstream Western Psychiatry: Science or Non-science?,

Usually the medical model blames that on us. They claim we would do better if only we took all the pills they gave us. (Not true! The longevity studies suggest that we actually do worse. See, e.g., Whitaker, R., Norway Orders Drug-Free Treatment in Psychiatry,

Or, they say we aren't doing enough to take care of our health after they give us the pills.  (This overlooks the fact that the pills actually dope us up, disrupt digestion, and cause rapid weight gain - all of which interfere with our ability to take care of ourselves. See, e.g., McLaren, N., supra.

Far more close to the truth of the matter is this:  We are living in circumstances that, in actuality, are dangerous to human health and well being. We know this is true. The World Health Organization tells us how important the social determinants of health are to human health and well being.  The National Council on Behavioral Healthcare tells us that some 90 percent (90!) of behavioral health populations grow up with trauma, violence and neglect of basic needs. See Chapter 2-2: Social Determinants of Behavioral Health,

Yet, medical approaches do little - if anything -  to help us address these harsh realities of our lives. On the contrary, the main 'treatments' we are offered are designed to dull and disable the very biological warning systems that tell us something is wrong!  In other words, our bodies doing their best to wake us up to the fact that our lives are at risk.  At the same time, the medical model is doing everything in its power to shut them up.

When you understand this, the life-shortening effect of medical model treatment is no longer a mystery.  The treatment, quite literally, is killing us.

The Proper Place of the Medical Model

Please do not mistake what I am saying here.  I am not against psychoactive drugs.  Many people have been helped by them, and there clearly is a role for them.  Some people also report being helped by electro-shock and psychosurgery.  So, possibly there is even a role for those things too.

At the same time, we need to think very carefully about why, when and how these powerful, potentially deadly, interventions are used, if ever.  Do they help mitigate harmful effects of the survival response.  If so, why. Specifically, we need to think about:

  1. Do they help mitigate harmful effects of the Survival Response?  If so when, why, how and for whom? 
  2. Are such interventions the only tool -short or long term - that  a person can use to restore their sense of safety and turning off the High-Stakes system? If not, why aren't other options - e.g., massage, unconditional positive regard, childcare, a weekend stay at a spa - being offered.  Certainly these things are comparably priced, and far less aversive to the standard emergency room/ psych ward stay.  
  3. When, where and why (if ever) would someone find medical model interventions the most effective, best-suited short or long-term strategy for damping down their High-Stakes reactivity and returning their body to All-Is-Well?  Again, it comes down to choice, transparency and customer preference.  Rarely if ever are meaningful, cost-comparable choices being offered in this in the medical model monopoly of our modern times.
  4. If a person is deemed a danger to self or others, how likely is it that medical model approaches will actually reduce their Survival reactivity? What would be the response of the average person in a state of fear or heightened concern, if we removed them from their lives and force drugs, restraint or shock on them?  When if ever would we predict that such unilateral actions would increase a person's sense of well-being and safety and help them return them to All-Is-Well?  Given the high probability that people already in trauma will be further traumatized by such forcible domination when if ever is it worth the risk?  What is more, should such approaches ever be considered the first intervention of choice - as they all too often are in our current hospital system.  Equally important, if force is not the answer, then what is...? 

These are important questions that deserve an answer.  We will address them in detail in future chapters.

A Brief Word about Medications

Do your homework. Don't stop them abruptly.  These are powerful substances.  They really do alter our mental and physical functioning - some times irreversibly.  At a minimum, their effects can be long-lasting effects and extremely entrenched.  As life-diminishing as many of them are, it is wise to respect that.  

I say this because it has been my own journey.  Like some who may be reading this, I felt empowered when I first got information about alternatives to the medical model. I subsequently decided to taper off a medication I had been on for 10 years.  I went too fast.  It didn't go well.  

As a result, I still take a small dose of this medication.  Not because I think it has made my life better on the whole.  Not because I think it was 'the answer' to what I was going through at the time I started it.  But rather, because, after a decade (now 2 decades), the way my brain and body function are no longer the same.  In other words, taking this medication is 'harm reduction' for me.  It protects me from the damage that, I believe, the medication itself caused.  I'll say more about why I think that is in a later chapter.  

For now, my advice to you is to proceed slowly, gather information, evaluate results.  A great place to start is the Harm Reduction Guide to Coming Off Psychiatric Drugs,  
It will walk you through the considerations and help you learn the ins and outs.

Please also note that a lot of people think they have to find a willing provider to help them taper.  The research doesn't bear this out.  Don't get me wrong, a willing, knowledgeable provider is worth their weight in gold. Sadly, however, on average, they still aren't widely available.  As a result, the success rates historically have been about the same whether people taper with the blessing of a physician or taper on their own.  Harm Reduction Guide, supra, p. 28

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