Only those risking too far can possibly find out how far one can go. T.S.Eliot
I feel inspired to write a very personal plea to those working within Mental Health Care. I warmly encourage that this moment in History, Psychiatry has an opportunity to re-invent itself as the Study of Human Consciousness. Collaborate with other disciplines for the common good. It might be beneficial to include Physicists. Quantum Physics principles apply to Human Consciousness better than any other Science. All I can say is: Listen to me Now, Believe me Later. A phrase I heard regularly from my lighthearted Dad while growing up. I give a gentle nudge. It is all I can do as a person who Medical Science has invalidated. Anything I say or do can be viewed with the lens of the diagnostic label issued: Bipolar Disorder. What if I am right? Pretty uncomfortable for those who have wielded the no insight sword. For the record: I absolve you. I forgive you. I understand you. I prefer to live my life peacefully in my own version of reality… if it were not for that huge legally-backed power differential. Live and let live works well for me.
Let me introduce myself: I am a Family Doctor (now retired), a Person labeled as Bipolar Disorder (Three Out of the Ordinary or Psychotic Episodes over three years) and a Medium (able to communicate with benevolent, intelligent energies or Spirits). The Medium experience played a role in my Out of the Ordinary events. I am currently working with a Mentor to clarify my Mediumship. The philosophy that many Mediums work by is that every encounter is an experiment. Open-minded skepticism is embraced. You do not dismiss what you sense. You describe it as neutrally as possible, attempting not to interpret it at all. Transmit the raw data. No two people will interpret the same perception/data exactly the same way. This demonstrates a lovely way to work. One of these days I will complete the story “I Am a Medium”.
A long recognized Superpower, has at times felt like a fault, is that I cannot speak untruth. I can only say what I know to be true. That led to me stating “I Don’t Know” an alarming number of times as a Family Doctor. It always surprised me that the patients just gushed with respect and admiration. Most people have a reasonable spidey sense for Truth too, it seems. They sounded so unaccustomed to a Doctor admitting when she did not know. Loved the Therapeutic Alliances I formed during my brief run as a Doc. I left the Profession after tiring from Spitting into the Wind. A high proportion of patients took on the Biomedical Model of illness, not really expecting to ever be well. I felt uninterested in doing an illness dance, knowing at a deep level that there were other options. Checked out in 1997. Fully retired in 2003.
I want to highlight some areas within Psychiatry from my unique perspective.
There are many assumptions made in the Field of Psychiatry:
First Assumption is that Traditional Biomedical Model of Psychiatry is the highest order Truth. That our discernment of patients is optimal. The best Scientific discoveries come when we question our current understanding. If we never question, we are forever stunted.
At this present moment, there are well-founded, more efficacious models of care that are being overlooked. I speak specifically about Peer-Assisted Open Dialogue.
Historically it began as Open Dialogue in Finland under the reality of the worst results in care for Schizophrenia. Once implemented, Finland now has the lowest rate of Schizophrenia in the developed world. Compassionate care that is highly effective in treating Psychosis creating a new paradigm for discovery. Awareness is the first step. It exists. Now you know. It is Professional Integrity to know more about why this works so well.
I summarize the backbone of this too simple to be true model. It is Simple and it is True.
a. Multidisciplinary Mental Health Team.
b. Non-Hierarchical – circular , no team member above or below, equal.
c. Mindfulness Training for all Mental Health Staff – increase awareness of the Self.
d. Include a Peer – someone who has experienced Psychosis as a Patient.
All other assumptions fall under the first one – that the Biomedical Model is optimal in delivering care in Mental Health. I consider it a theory. When few patients under the care of a Discipline ever recover, it is worthwhile to question and keep an eye out for alternatives.
First sub-assumption:
Legal Powers are helpful in Treating Patients.
It saddens me to think I could be telling you something that you have never heard before but there are many Psychiatrists in the world who treat patients without ever using the force of the Law even when it is available to them.
If you are a true Scientist, you may want to experiment with this. A shift in paradigm is required. Where there is a will, there is a way. Empowering patients is a long term goal. The short term definitely presents challenges. When you know better, you do better. Educate yourselves. Examplars exist.
Second sub-assumption:
We know the Natural History of Psychotic Disorders.
I was fascinated to learn of the work of a former Patient, Sean Blackwell. He has documented supporting the non-medicated care of Acute Psychosis with a good resolution of symptoms over time. His results find people transformed and vital following the Journey through Psychosis. He has pulled out what may be a subgroup of patients who are actually experiencing something better termed a Spiritual Emergency. The term was coined by a Psychiatrist Stanislov Grof in 1989. It was the very term I chose to describe my own first episode shortly after discharge. I felt highly misunderstood. Pleasantly surprised to see that this term was already in use. I felt as if I had never heard it before. Connecting with an International Community of People who see the validity of this alternate term has been refreshing.
A dynamic duo of Kevin Tomlinson & Phil Borges have produced a film called, Crazywise. It is scheduled to premiere at an International Documentary Film Festival in Amesterdam November 2016. There may be a brief soundbite by myself. I met them in Brazil while we were touring to witness the use of Mediums in the treatment of Psychiatric Patients. The Hospital there was a loving, beautiful retreat. Turtles roaming free. Fundamental to the film were Phil Borges’ (former dentist) observations in his travels as a photographer. He noted that people we lock up as psychotic, other cultures nurture into Healers & Shamans.
Third sub-assumption:
Patients lack insight into their own illness. Just using the word illness might be misleading. In my world, a better term would be transformation. See how just with the switch out of one single word, the intention and meaning has been completely changed? It may be more accurate to say that the Patient’s insight does not match the Doctor’s. That is usually a true statement. It is very easy for me to take a slight twist to the old lacks insight. A concrete thinker is just taught this, believes it as gospel truth and then finds it very convenient to practice using this very powerful belief. Once a patient demonstrates to you that they do not share your view, simply check the box, lock the patient up and then throw away the key. The consistency is quite reassuring to the traditional clinician’s mind. Yes, patients acting how I expect them to. When one widens their view, as I have done by experience, it leads to the very real possibility that this consistency is there but not for the reason long believed. This is because the higher understanding and truth is consistent. The experts in Psychosis, the patients, are begging for a review of the concepts. Begging over and over and over. Science loves consistency. I understand why this has been difficult for Doctors to step back and take seriously. One cannot be blamed for ignorance. If one wishes to call themselves a Scientist, as I am still calling myself, one would want to consider if the patient’s view has some validity. This is a beautiful opportunity to look at this long held misunderstanding. In my 3 years as a labeled Patient, I have come across countless explanations to how this came to be.
I will attempt a brief explanation. For the love of humanity, I implore you to just roll this around in your mind a little, little bit.
Quantum Physics principles do apply in Human Consciousness. I will not elaborate on this but throw it out to aid you giving this a chance. I elaborate a little more in a story Quantum Theory of Psychiatry. Quantum Physics is Science. Just not the linear, logical form you are most accustomed to. Quantum Physics discoveries seventy years ago baffled scientists then just as much as now. Energy acting as both a wave and a particle. The energy of consciousness is coming into understanding in recent decades.
Consider the range of view of the traditional scientific beliefs human being. Views show what they show. You expect it. You see it. No problem. Very soothing to know that you have it all in your awareness. No surprises. You see what you expect to see. The human mind tends to work that way.
Psychotic Patient, better termed someone experiencing unshared reality, sees all you see plus a much wider view. Scares a person at first, especially if it comes all at once. The present model makes another sub-assumption that this version of reality is not valid. There is some confusion for the patient, but for most, meaning will be teased out of their experience over time. Symbolic vision is common. Deep truth can be revealed.
So now we have two people. One is the Patient. One is the Doctor.
Their worldviews do not match. The Doctor has power, even legally backed power to help the patient as they see fit. The Patient in some cases is left with a wider view. All the experience of the Doctor plus new additional views, visions and experience. Fear tends to be at the basis of many Doctors. In my experience, love without boundaries, scared doctors and staff a lot. I learned to find my balance after a day or two. Most comfortably achieved in a loving, nurturing environment – nearly exactly opposite to what I experienced during involuntary inpatient care. Invalidation, given a label of pathology with a bleak prognosis. Character building, yes. Nurturing, loving, no. My healthcare team did not even attempt to find anything valid within my experience. It could be better described as the most aggressive, obnoxious sales pitch you ever heard. Not what I would call healthcare. At this time of evolution for patients, we are extremely vulnerable. The Doctor does not view this transformation as valid or worthwhile, yet the patient sees the same situation differently. Is it an upgrade? At the very least, it is an alternate viable mindset.
Forth Sub-assumption: Listening to Patients is extremely important for the Therapeutic Alliance in all patients except Psychotic (unshared reality) ones.
This no insight issue is astronomical. In order for someone to firmly declare another’s insight to be subordinate, they take on one of the symptoms they generally paint their patients with: Omniscience, delusions of grandeur. One must be a God to deem another’s truth less valid. Caution. Here. Please.
It is urgent to step back and look at the lacking insight as more of an Hypothesis than a Creed. Alternative models exist and lead to a much higher prognosis for those who have experienced Psychosis. The entire argument is unnecessary when we just treat all human beings like human beings. Listen with a compassionate, open heart. Then support and treat accordingly. Judging each perception and experience is completely unnecessary. This would require evolution amongst the caregivers. It has been shown repeatedly that formally untrained caregivers in Mental Health can be more effective in treating Acute Psychosis in this proposed heart-open way because the ability to care is all that is truly required.
As scary as people in psychosis sometimes appear, they respond to caring in surprising ways. Keep in mind, scary is in the eyes of the beholder. As understanding goes up, fear will come down. We tend to see things through the lenses of our own beliefs. Peter Breggin describes this heartful care in How to Help Deeply Disturbed Persons. Some people come down within minutes just by being listened to, cared for and supported. Validated in their experience.
The biggest take home message I have is that it is a big, wide world we live in. If we remain complacent with an unending, self-perpetuating loop of sub-optimal understanding, are we truly embracing our humanity? I was a Doctor. I can very honestly proclaim that if I had any doubt about the care I was offering to my patients in full trust, I would work towards educating myself. First Do No Harm was the oath I took and stood behind. My dear, dear colleagues: You are doing harm. I am telling you that there is an upgraded form of care that will feel so much better to give, will be more effective and will have far fewer side effects. Your heart will thank you. Your Soul will thank you. Even your mind will thank you. In understanding effective treatment for Mental Health, you will naturally align with more harmony and well-being yourself. Based on my own direct experience as a Scientist, I am an expert in Psychosis. I am concerned that the Traditional Biomedical Model in Psychiatry is stunting our Scientific Understanding of Human Consciousness and Evolution. Talk to a trusted Physicist, they all get it already. If you do not know one, Thomas Campbell speaks to the Scientific Mind about Human Consciousness in a lecture series he titled, Reality 101. First of seven You Tube videos is linked. Metaphysics is in there.
Openminded skepticism is the only thing that can ever take you anyplace important. Thomas Campbell
I did not even get into my experiences as a Medium. Experience is the best teacher. You cannot tell me what I have and have not experienced. Which of my experiences are sanctioned by you and which are not?
The Truth has many gifts for health and healing. I would call it Beautiful … Beautiful Truth.
Listen to me Now. Believe me Later.
In a Nutshell: In Psychiatry, what is truly known? When consistent patterns are seen, get curious. Judgment is not scientific. Let us return to our scientific roots of neutral observation and curiosity. Let us return to our Human roots understanding loving energy is the most efficacious healing modality ever known. It is time to raise the Bar.
My prediction, shared by many, is that I am just the tip of the iceberg. Human Consciousness is rising on the planet. For many people, as their perceptions widen they will go through this highly energized, chaotic, confused state we now call Psychosis. Let us be ready. I see it as a pathway to a whole new upgraded way of being. Can we let go of the objective of trying to return the patient to their starting point? I warmly inform you that evolving to a new mindset is the objective. The system lags behind and is challenged to see reality differently. The patient’s sovereignty is sidestepped … and they become victim to the very mentality their soul attempted to escape in the first place.
What a terrible situation for those people who need compassionate care. Heartfelt compassion and empathy are rare commodities. … We live in a fear based society. Shut it up, shut it down. Eliminate the irritant….quick solution. Many suffer in silence, and if they are strong enough they wind up saving themselves. A fellow participant in the course, “How to Care for Someone in Spiritual Emergency”.
When we lack discernment about what is really going on for patients, which the system presently does, we are challenged to enact the solutions.
It is hard to find the solution when you are part of the problem. Contemplate this for a moment.
When you understand the problem optimally, you will easily develop optimal solutions. The challenge is how to define optimal. My suggestion: Multidisciplinary teams to define optimal. Ensure there is a Peer (pick me!) and a non-Healthcare person or two. Occupational Therapists are worth their weight in gold. A visionary is highly recommended. Revisit on a regular basis. Reality shifts as we do. Reality evolves as we do.
One important roadblock I see is the widespread Mindset gripped tightly by Health Professionals in the Traditional Biomedical Model.
I dream of the day, could be very soon, when optimal questions start being asked by the System. Starting with:
“Is our current model of care the optimal model for our patients, ourselves and society?”
“Have we made some assumptions that now need to be questioned?”
Demonstrating effective, humane, optimal care, easier said than done of course, would help the system to extrapolate the amazing financial savings when you can support someone through Mental Health difficulties instead of creating lifelong clients to the system.
Am I the only one who can see such a bright future when discernment is in place in a wider way?
I would like to play a role in bridging The Discernment Gap. A girl can dream…
I want to be truly helpful.
Mankind cannot bear very much reality. – T.S. Eliot …Yet. I add.
As I say regularly to my sons:
If you are not going to help me, at least do not hinder me.
Adapted version:
If a Psychiatrist cannot generate hope, at least do not prevent the patient from generating it themselves.
Eventually, all that one has learnt will have to be forgotten. Ramana Maharshi.
I would call that Evolution … on the path to Human Optimization.