Bamboozled, hornswoggled and hoodwinked?

Whew! Just seeing this thread and I am excited about all the good reading that awaits me when I have more time Thanks!

About stress. Some is useful. Too much is not. But is it stress itself or our percetpion of it and our response to it that is important? This is something I struggle with now in my life and in therapy: do I need to learn to handle the stress, or is it healthier to move away from the stress? Or is that avoidance and missing opportunities to grow, which in turn can make the things that feel stressful not so much stressful...

I like this definition of support: help and kindness that you give to someone who is having a difficult time. "Support" has many senses. That administrators have to remind us about being supportive is indicative of the lack of a consensus about what support means.

Supporting for me is more an objective process than a subjective one. I attempt to subordinate my weltanschauung as a means to being less judgmental, critical or intolerant. Help and kindness suggest empathy and understanding. PsychCentral is meant to be a safe place to talk about troubling concerns. I say nothing if I am having trouble being supportive as I understand it.

Information: knowledge or facts about someone or something Again, the question becomes what knowledge or facts are appropriately shared? I have come back to this question frequently since becoming a member.

Providing phone numbers and links to state agencies or help organizations like NAMI and The Domestic Violence Hotline may help someone get assistance.

As a former lawyer, I have talked about legal matters in a general sense with the admonition to talk to a lawyer. There certainly is a problem if a member relies on anything stated here without first confirming with a licensed attorney the information given is current and correct.

Giving advice is the most problematical for me. Most of us are not trained professionals. I have had therapists tell me they cannot give me advice about what is best for me when decisions need to be made. One therapist explains:

Therapy is a process of exploration. It is unethical for a therapist to give you advice about what to do in your life. Therapy is about helping you come up with your own solutions. Practical suggestions about coping skills or referrals are provided in therapy. http://therapist4me.com/Boundaries%20of%20Therapy.htm

Others gave me advice and certainly tried to influence my decisions. The point is if professionals are reluctant to give advice, why would nonprofessionals venture too?

Also problematical is giving advice based solely upon our own life experiences. Each of us is not the final arbiter of what constitutes common sense or truth. Many of us will and have viewed the same facts differently. While I do and am talking about my own experience I understand and respect that others may disagree about my conclusions. Discussing options and alternatives might be more useful.

What do you think?

I think it's kind of sad when a health care professional blames their patient when their treatmeant doesnt work. In any other health-field this dynamic would seem odd.

Will a new vision help those burdened by mental illness?

In contrast to the Rehabilitation View of Recovery, people who have recovered from mental illness have an empowering view that full recovery is possible for everybody. According to this Empowerment Vision, people are labeled with mental illness through a combination of severe emotional distress and insufficient social supports/resources/coping skills to maintain the major social role expected of them during that phase in their life. The psychosocial nature of mental illness is highlighted by the common experience most consumer/survivors have gone through of having had a variety of diagnoses. In fact, the degree of interruption in a person's social role is more important in affixing the label mental illness to someone than their diagnosis. Recovery is possible through a combination of supports needed to (re)establish a major social role and the self-management skills needed to take control of the major decisions affecting one. This combination of social supports and self-management help the person regain membership in society and regain the sense of being a whole person. Self-help and peer support are fundamental elements in this journey of recovery because often the only people who can truly understand the feeling of exclusion are those who have also been labeled. http://www.power2u.org/articles/reco...ew_vision.html

As I've learned, both professionally and personally, social context is critical to recovery. In other words, there's invariably a social reason to get better. This is what has been largely overlooked by the "medical model" of treatment, which proposes that you must stabilize a person with treatment (typically drugs) before they can be put back in their social roles or environment.

Larry Davidson, a Yale researcher on recovery from severe mental illness, has examined the data and found that this model is flawed, at least in the field of mental health. "In the medical model, you take a person with a mental illness, you provide treatment in the hopes of reducing symptoms, and then they're supposed to approximate some notion of normality," he told me. "Our research shows the opposite. You take a person with a mental illness, you then reduce the discrimination and stigma against them, increase their social roles and participation, which provides them a reason to get better in the first place, and then you provide treatment and support. The issue is not so much making them normal but helping them get their lives back." http://www.mindlink.org/healing_a_troubled_mind.html

{{{{ Byz }}}} once again, your posts are so full of nutrition and sustanance~!



thank you,, thank you ~ did i say,, Thank YOU~!! ? Gus

((((((((((((( Byz ))))))))))))))

*****reading, considering, observing*****

-- Thanks Byz & Everybody!

Recover -- to what? What if you never were emotionally "healthy"? What if you never knew what that was like?

It is possible to get to a state of health that is much better than you ever suspected was possible. Is it "normality"? Depends on what you mean by "normal". You may discover a world that you never suspected was out there. On the other hand, you might not!

There to me is no such thing as normal. EVERYONE is disfunctional to varying degrees and off balance. Normal is unattainable in the first place. Functional with things that bring us joy in our lives is what we should be aiming for in recovery.

I do think treatment, and the expectations of recovery, has been oversold. There is not enough known about mental illness and the providers are limited in their abilities to make the promises for recovery that they are making confusing this with hope. Hope should not be abandoned but realistically as of now, each treatment option is a crap shoot and just like with one, we hope for a positive outcome but have no idea what's really going to happen.

Whenever people say things like that I think "Do you know EVERYONE"?

There may really be a lot of people out there who are not particularly dysfunctional!

We don't see them because they don't draw attention to themselves, and we respond to the dysfunctional ones because that is all we ever knew!

Of course, I don't know everyone. However, have you ever met anyone who did not have some kind of impairment or inability- mentally, emotionally or physically? It may not be readily apparent but if you really get to know someone the cracks begin to show. This is disfunction. Disfunction is inherent in the nature of being human; we ALL have some kind of impairment or inability because of genetics or how we grew up, and affects our learning patterns, our responses, how we deal with our emotions, and interact with one another. There is no way that two people are alike to set a normal standard and it is also partly because of our disfunction that is what makes us unique. There can be normal routines but normal humans, it is contradiction b/c of our disfunctions.

Yes, not everyone is FULLY disfunctional, But yes, everyone is disfunctional to varying degrees.

You have to know everyone to be certain of that.

And as I indicated, I think we may overestimate the numbers of significantly-dysfunctional ones because of our histories: those are the ones that surrounded us!

pachyderm, as I mentioned, there are many definitions of recovery out there. I appreciate this one:

Anthony (1993) identifies recovery as " a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness." http://www.mhrecovery.com/definition.htm

It addresses your concerns.

Byz, always liked Frankl. He was one of the few who when i read his work was ready to acknowldege that yes, even a trained psychoanalyst could have subjective experiences that actually have some value when it came to other people as well. Most of the others tried to disguise their subjective views as scientific "observation" or "professional expresience", although sadly enough, some of those couldl have been just as usefull in working with people, and more honsetly easy to trace and control without having to blame the patient when things went south.

I thought of that when you mentioned not giving advice: the idea comes fom the old view that the patient is to learn to be autotnomous. He or she is to find the answers to all things an his or her own, without the input of either the therapist or another. The ideals of western culture are, in my mind, nearly pathologically afraid of dependency on other humans, although our whole way of life is in fact based on dependency on structures and superstrctures we have little relation to (the government, legal system, roadsystems, health systems, tansport of food...).

Nowadays you might get different answers, but most therapists still live in that intellectual-historical framework. This in spite of the fact that many of my adolecent patients have already thought through many things that earlier would have taken YEARS of therapy for most kids to have come up with. We simply don't think about ourselves the same way as we did when the field of psychotherapy was starting, and when people ask for advice, it is usually not because they are seeking to avoid responsibility; they usually have actually hit the end of the rope in what they should do next, and they have no where else to go.

As in all professions, one must weigh the consequenses of advice givning and how it is framed. Does one imply following advice will solve everything? Mistake! Does one suggest it and leave the possibility that it might not work open? Better. Some cases you have no ethical choice. I have had to argue and say straight out to people who's partners were showing signs of becoming violent and/or overly controlling that the best thing to do is run, not walk, to the nearest exit. As a professional, if I see the signs and do not speak up, I share the responsibility of the consequenses.

Actually, therapists influence one al the time. Giving advice is in a way simply a more obvious and yes, agressive way of doing it, but also more honest. You can call a therapist on it. You can debate them about it, you can question them about it. You can't debate, question or call out on a tone, a nuance, a lift of an eyebrow, a certain choice of words one can't quite pin down... Ack, I DO go on. Huggggs.

As the burden of mental illness increases so does the controversy over the efficacy of treatment modalities. The influence of pharmaceuticals is part of the discussion:

Big Pharma, that is, the 50 or so biggest pharmaceutical companies, is an enormously powerful force in government and medicine, and I think people need to understand the depth of this. They have the power to control which “peer-reviewed” research gets published, this in turn has an influence on which drugs get prescribed, and in addition to this they have the power to wage billion-dollar advertising campaigns. They have a tremendous power to influence the very way we think about mental health. They have billions and billions of dollars. http://pasadenatherapist.wordpress.com/big-pharma/

Last July, Robert Whitaker, the Polk Award-winning journalist and author of the recent "Anatomy of an Epidemic," had an invitation to be keynote speaker at the annual "Alternatives" conference withdrawn. He explains:

"MFI: What is it that you write about in Anatomy of an Epidemic that is so threatening?"

"WHITAKER: The story told to the public by the NIMH and by academic psychiatry is that psychiatric medications have greatly improved the lives of those diagnosed with psychiatric illnesses. Yet, even as our society has embraced the use of psychiatric medications during the past two decades, the number of people receiving government disability due to mental illness has more than tripled, from 1.25 million people to more than 4 million people.

"So you can see, in that data, that something may be wrong with that story of progress. And then, if you look at how psychiatric medications affect the long-term course of psychiatric disorders, you find -- in the scientific literature -- consistent evidence that they increase the likelihood that a person will become chronically ill. I know this is startling, particularly since we do know that some people do well on the medications long term, but that evidence, in terms of how the medications affect long-term outcomes in the aggregate, shows up time and again in the scientific literature." http://www.furiousseasons.com/

A report describes the steps drug companies are taking to restrict what physicians who are part of their paid speakers' bureaus say during their talks:

According to the companies, these speakers ("shills" is the term that seems more to get to the heart of the matter) are now told not only that they must use exactly and nothing but the slides that the company provides, but that they must even show the slides in the same order as specified by the company. With the company pulling all the strings, one wonders why they even need the physicians to give the talk at all; any robot apparently could do it. http://brodyhooked.blogspot.com/ http://www.propublica.org/article/dr...-presentations

Combating the influence:

There is a growing need for physicians to limit their marketing relationships with pharmaceutical companies.

• According to the New England Journal of Medicine, 94% of physicians accept gifts, payments, reimbursements or other financial incentives from the pharmaceutical industry.
• Numerous studies have demonstrated that such gifts and payments directly influence medical decision-making.
• It has become difficult for physicians to find and distinguish legitimate, evidence-based sources of medical information from biased, industry-influenced sources.
• The very distinction between marketing and education has been blurred.

We must reclaim medical practice and training environments from undue marketing pressures. The National Physicians Alliance encourages all doctors to join our network of Unbranded Doctors — a national network of physicians committed to reducing the influence of pharmaceutical marketing on our profession.

The National Physicians Alliance’s Unbranded Doctor is unmasking the pharmaceutical industry’s bogus claim that its marketing efforts are just educational ventures for physicians. By signing up physicians to renounce gifts, lecture fees, and “education” from companies, the Alliance is championing objectivity, integrity, and professionalism.
—Jerome Kassirer, MD
former Editor-in-Chief, New England Journal of Medicine
http://npalliance.org/action/the-unbranded-doctor/

Are All Relationships between the Pharmaceutical Industry and Academia Bad?

In summary, we strongly believe that academicians should avoid any personal financial support from industry that is derived from marketing activities that are designed to enhance the sales of drugs. These activities include giving talks for companies and accepting gifts from companies. On the other hand, we believe that it is in the public interest to encourage basic and clinical scientific collaborations between academic medical centers and industry in order to enhance our knowledge about psychiatric disorders and to promote the development of new and more effective treatments. http://www.psychologytoday.com/blog/...ndustry-and-ac

My view is that codes of ethics have failed to deter relationships detrimental to clients and consumers. While I think it is wrong to make broad generalizations, I see pragmatism and expediency overtaking integrity.

Fresia: everyone is disfunctional to varying degrees.

pachyderm: You have to know everyone to be certain of that.

I'm confident that if anyone weren't, I'd soon be reading about them in the news.

I confess I haven't read very much of this thread yet so I'm throwing in my two cents' worth rather casually.

It sounds to me as if those therapists, whoever they were, had learned to follow some kind of cookbook strategy as in, "My mind is already made up. Don't confuse me with the facts." When their treatment recipes didn't work well for you, they couldn't afford to question their own understanding of whatever they were doing so it had to be your fault.

At least tangentially related to the experiences you describe with your therapists is this discussion from six months ago.

Do you suppose there was some kind of pattern to the kind of therapists and therapies you kept choosing, or were those the only ones available? It sounds as if something that was consistently missing for you there was the experience of being validated (a little more about that here -- no doubt lots more elsewhere that I haven't had time to find):

Additionally, I believe I observe a "progress bias," analogous to confirmation bias, among clinicians and therapists. That is, caregivers are often predisposed to see signs of progress, grant undue weight to those signs, and either ignore or downplay evidence to the contrary among their patients.

Psychologically weakened patients themselves may unconsciously abet progress bias by wanting to please the caregiving authority figure with reports that make the latter happy.

Fool Zero, I have had many therapists from social workers to psychiatrists and psychologists. Behavior therapy, cognitive behavioral therapy and eclecticism predominated. Going from one college to another, from one town to the next and finally to the VA accounts for the high number of therapists; that and having a personality "not conducive to therapy," whatever that means. I did not know enough to choose a therapist based on education or treatment approach. At the VA, I was assigned to a therapist who was available.

For the most part, I did not feel invalidated. At least two therapists passed me on to a colleague apparently because they found me difficult. Even so, my frustration arose from expectations and being told I did not understand. Despite asking what it is I did not understand, my question remains unanswered.

I want to make it clear that I learned a lot in therapy. Having to step up my efforts to better my functionality has been helpful. I have accepted my responsibility for not achieving a better result in therapy. Sometimes even the best efforts of all concerned is not enough.

http://www.mayoclinic.com/health/dep...atment/MY00751

For me, that would've been the very model of invalidation. Are you saying you didn't feel invalidated even then, or were those among the few times when you did?

I do not think I ever felt invalidated. I knew I had serious issues to overcome. No one told me otherwise. When I did not start to feel better, my anger and frustration surfaced. I often thought my therapists were as frustrated as I was.