by Ron Unger This sounds like a weird question – everyone knows that psychosis is often very disabling, and antipsychotic drugs are widely recognized for their effects in reducing psychosis in at least most people, and most often taking effect in just a few days. And when people become psychotic again, it’s often understood that it’s because they “weren’t taking their meds.” But what if it’s trickier than that? What if “antipsychotic” drugs make things better in the short term, but make long term problems worse? How would we even know? … [click on title to read and view more]
I was recently talking with a young man about his anxiety, which he experiences as extreme. When I asked him what the anxiety was about, he didn’t know. When I suggested that we become curious about it and explore what it might be about, he told me that it was so extreme, it must be “biochemical.” This meant to him that the anxiety could not be understood in a psychological way, but had to be dealt with as part of his “illness.” I acknowledged to him that anxiety certainly involves biochemistry, but suggested that there are also experiences and interpretations of experience that trigger the biochemistry into action. For example, if he experienced someone pointing a firearm in his direction, he would likely experience an intense biochemical process within his body, but the experience would not be “just biochemical.” If people are going to understand themselves and work through emotional problems, it is essential that they get curious about their experiences and reflect on what might be triggering them. Sometimes such curiosity or reflection results in getting valuable messages from those experiences, or at other times, it involves identifying a mistake that triggered the emotional experience, which then allows for resolution. To use the simple example of the threat perceived from the firearm, one might either take quick action to avoid being shot, or in another situation perhaps observe more carefully and notice a movie is being filmed and that the firearm being pointed is just a prop.
Rather than viewing voices (and visions) as the product of psychiatric illnesses, the authors, and the voice hearers and family members whose stories are told in the book, find ways of making sense of them in terms of what is going on in the child’s life. Factors such as conflict, bullying, grieving, abuse, and not being able to relate to particular emotions are all found to be possible triggers for voices, and learning how to deal with these issues successfully is found to be related to voices fading away or at least becoming innocuous.
It is not always clear what sort of experiences are best called “psychosis” and seen as bad, or what kinds of experiences are best called “spirituality” and seen as good. Instead it seems there is a realm of experience that is outside of our cultural norm, that we might call mystery, where people have experiences that are challenging, with a possibility of being seen as either bad or good, and of resulting in life outcomes that may be either bad or good in the conventional sense.
It has become apparent that huge numbers of people are receiving more medication, over longer periods of time, than what is optimal for their long term mental health.(Whitaker, 2010) What are the factors in the current mental health system that biases it toward greater use of medication than what is optimal? It is important that all of these areas be identified, since efforts to achieve medication optimization are likely to achieve only partial success at best if significant areas of bias remain unchallenged.
By Ron Unger I just did a rough draft of a handout which surveys the possible options when responding to voices and other intrusive experiences. I’m curious to hear what some of you might think about this. Notice that I am lumping unwanted and disturbing voices in with unwanted and disturbing thoughts, impulses, and emotions,... Continue Reading →
By Ron Unger: this article was first posted on his website. I recently read a very interesting and mostly helpful document by the UK charity Rethink, 100 ways to support recovery. However, I had some reactions to their approach to defining recovery, and I thought I would share them here. According to Rethink “Clinical recovery is... Continue Reading →
Talking to someone convinced it's all biological By Ron Unger Many people are still convinced that the “scientific” understanding is that if a person is diagnosed with a “mental illness” such as “schizophrenia” then this means they have a genetically determined brain dysfunction that has nothing to do with what happened to the person. Of... Continue Reading →
By Ron Unger At least here and there, mental health authorities are recognizing that it is a problem that people in the public mental health system are dying 25 years earlier than the average person, and they are starting to talk about it. (For more information on these death rates, see this power point presentation)... Continue Reading →