Hospitals

Mental Illness by Caveat

by

James L. Secor

The dictionary defines “caveat” as: a warning enjoining one from certain acts or practices; or a modifying or cautionary detail to be considered when evaluating, interpreting or doing something.

The reason for this title will become clear not just from my tale but from the APA [American Psychological Association] directly. Shhh! Listen closely. You’ll hear the mice running around, playing. Nobody’s watching. They’re all asleep. The people are asleep to what’s happening to them. And the APA’s asleep to reality. Let’s not forget the APA sanctioned waterboarding and other forms of torture at Guantanamo Bay.

This is a direct quote from the APA: “The unreliability of psychological prediction of dangerousness is now an established fact. Even under the best of conditions, it is wrong at least two out of every three cases.”

A psychologist’s answer: “We could do better with a role of the dice.”

And. . .there are no tests for mental illness. How can there be when mental illnesses are no more than loose collections of vaguely-defined problems of thinking, feeling and behaving. The noted labels aren’t coherent entities of any sort, just x number of signs out of x total possibilities. It’s like taking a multiple choice test where there is no right answer. No physical illness is diagnosed based on a conglomeration of some bunch of symptoms from a list of all possible symptoms. Let us not forget Typhoid Mary who had the disease and showed no symptoms; she carried the typhus disease bacteria and passed it along, creating havoc, yet did not evince any of the known symptoms of the disease. None of all possible choices. By the diagnosing standards of mental illness, she would not be ill–as she maintained all her life. Mental illnesses are nothing more than labels of no explanatory significance–and they are not even good labels as they are so vague.

I guess it’s all mental craps. Because what the APA is implying is that the “normal” population is more dangerous and, thus, the group of people who should be watched carefully are those normals. The normals are the ones dangerous two out of three times–and there is a Murphy’s Law coming up for ratification. There is also a political move to have everyone in the country tested for mental illness, child, adolescent and adult. Once. There is going to be one test administered during the life time of each and every person. This is ludicrous. But, then, when politics gets itself involved in matters medical, especially in a medical area of non-definition, the result is always ludicrous. The possibility of error in such a situation is unquantifiable. And, even on the individual level, there is no test that can elicit a diagnosis of mental illness, albeit the MMPI [Minnesota Multiphasic Personality Inventory] can indicate if you may be in a depressed mood. Which, of course, does not indicate a diagnosis of mental illness.

Ergo, claiming the social mass shootings are due to the mentally ill is wrong; they are due to the normal in the population. What is known is that some of these shooters were taking anti-depressants because they were depressed–everybody gets depressed. That is, they were taking medicine known for making people more depressed, making people suicidal, making people aggressive and short on the fuse. Big PHRMA hushes up these news items because the open truth would hurt their multi-billion dollar business dealing in harmful and socially disruptive drugs. Better it is to create drugs that fuck people up and create social malfeasance than not. So that it is worth questioning why they would want to help and cure people? If people are asymptomatic, sales go down and that’s not good. No, no, no.

So, what’s the caveat here? Brain disease? There’s no such thing as brain disease. So, of course, there are no tests available to prove brain disease. Any kind of brain disease. When you are not ill, you are not ill; that is, when you are not ill, you are healthy; when you are healthy you are not showing symptoms; when the external stimuli are gone, so are your symptoms relieved.

Mental refers to what the brain does. What the brain does no one truly knows. Mental is your mind working. Mind? No one knows where mind “is,” if it is anywhere in particular. Thinking, too: what is thinking? Where are those thoughts? Point to ’em, won’t you? Feeling. Purpose, intention. Values, ideas, love, fears. Angst. Elation. These things, these mentals that we can’t see and can’t find and can’t define, these mentalities nevertheless run our lives. Terrance Deacon calls these characteristics “absentials” because they are “not there.” Because all mental functions are pointed toward some unseen end, they have purpose, which he calls “ententional”; that is, an ententional process–because the brain is all about processes–are expressions of finality, active processes going toward some end product that is not there as well. All of our living brings about some end or other. And if we’re all sick, suffering from a brain disease, what the hell’s going on? Shouldn’t we be able to define it? Specifically, not vaguely. How, though, can we define and delimit what isn’t “there”? Are we all delusional–including the testers and diagnosing people?

Because these mind-made things don’t have any physical presence, where in the brain do they arise? And where are they when they do manifest themselves? Where are they going? The people who have no feelings are the sociopaths, according to society. It sounds a lot like Big PHRMA doesn’t care what happens to people as long as they get their money, as there is no real reason for giving the medication sans disease. Once again, where’s the disease? (In your head.)

How can this be? The mind organizes and interprets and creates meaning out of other things, the chaos of the things of life, the life around us. Some of it we pay attention to and some of it we don’t. There is a floating choice; e.g., walking or driving we pay attention to the traffic, in the house we do not. That’s the brain’s job, to make sense of the world around us. That’s the mind working. But. . .where is “mind”? Even though it is intrinsic to the brain, it is, in fact, nowhere. As it is intrinsic to the brain it is mental; as it is intrinsic to the brain it is normal.

How can something that has no physical existence be classified as ill–or not? For illness relates to the physical: your body becomes ill, your heart becomes ill, your kidneys become ill. How can you have an illness of something that is not here, there and yet everywhere?

So, mental illness is the illness of the entire human world? Worldview? Apperception? A diagnosis of hallucination is given to people who experience things that are not “there.” Do we have a grand guignol of fundamentalist Buddhism?

R.D. Laing would say this kind or diagnosis is, itself, illusion but to be expected, for we live in a dysfunctional, abusive society. Thus the reasoning for diagnosing mental illness is part and parcel of the dysfunction and follows his three rules of an abusive society: “Rule A: Don’t. Rule A1: Rule A does not exist. Rule A2: Rule A1 does not exist.” Consequences? If you break a rule there is something wrong with you, you are insane, crazy, mentally ill. You are delusional because “everybody” knows it just ain’t so.

For instance, racism is abuse. Even with the obvious racism of certain people, the police, politicos, bureaucrats and the racial uprisings, all these social status quos maintain there is no racism. People who maintain there is racism are breaking rules A, A1 and A2. How fucking dare they! To the point that worthy news items are killed because they question the status quo, i.e., the abuse and dysfunction that is society.

So, then, who is insane? Who is mental? Who is mentally ill?

The caveat.

However, the consortium who made up out of whole cloth the DSM V have taken up the position that everything we do–the people, the lower sorts, everyman–is a diagnosable mental illness. Abnormal. Some of those deciders are doctors paid by Big PHRMA. Some of those deciders aren’t even doctors; they are health insurance representatives who are interested in a sick society because they won’t make any money otherwise. So, too, are the APA drug pushers. “Goddamn the pusher man!”

Ergo, all of the problems in society being due to the mentally ill, the elite status quo setters can continue to deny their culpability. Their abusive behavior. This kind of denial is a psychologically maladaptive behavior.

Brett Deacon, Ph.D. has succinctly set up a situation that is normal, everyday in psychological circles, showing how reactions to external stimuli become symptoms of a diseased mind. And the Psychiatrists and Behaviorists just happen to have the medical cure. . .

“Therapist: How are you?
 
Client: My house is on fire!
 
Therapist: I’m sorry to hear that. How are you feeling?
 
Client: I’m terrified! My dog is trapped inside! All my possessions are burning! What am I going to do?
 
Therapist: I understand that you’re upset. What’s going through your mind?
 
Client: I can’t believe this is happening! It doesn’t seem real. It’s like I’m dreaming or something.
 
Therapist: Do you also feel detached from yourself or your surroundings?
 
Client: Yeah, I feel like I’m in a daze. You hear about this happening to people but never think it can happen to you.
 
Therapist: I understand. These are common symptoms of Acute Stress Disorder. It’s a mental illness some people experience in response to a traumatic event.
 
Client: What do you mean mental illness? My house is on fire! My dog is trapped inside!
 
Therapist: I’m not saying you have a mental illness, only that you might have one. We’ll have to wait two more days and see if your symptoms continue before we know for certain.
 
Client: What symptoms?
 
Therapist: Symptoms like feeling unreal and being in a daze, and other symptoms like having upsetting memories and nightmares about the fire.
 
Client: Aren’t those to be expected?
 
Therapist: It’s normal to feel upset when something bad happens. But if you have a variety of symptoms that last for at least three days, and they bother you, then you may be suffering from a mental illness.
 
Client: Uh, okay. But what am I supposed to do? My house is on fire! My dog is trapped inside!
 
Therapist: Let me teach you some skills for coping with your negative thoughts and feelings. If you are feeling upset, breathe slowly and count to ten while thinking “relax.” You can also tense and relax your muscles. Negative thoughts can be replaced by positive thoughts, like memories of funny movies or times when you were happy. You can also imagine your negative thoughts floating past you like clouds in a sky. 

Client: Okay. But what am I supposed to DO?
 
Therapist: Practice your coping skills like we discussed. And come back and see me for another session as soon as possible. 

* * * * *

Two weeks later…

Therapist: How are you?
 
Client: I’m devastated. My house burned to the ground. My dog died. I lost everything.
 
Therapist: Have you been feeling depressed?
 
Client: Of course.
 
Therapist: Have you felt depressed most of the day, nearly every day for the past two weeks?
 
Client: Since the fire, yes.
 
Therapist: Have you lost interest in things you used to enjoy?

Client: I guess so. I used to enjoy hanging out with my dog, watching movies, and surfing the internet. But my dog died and all my stuff was destroyed in the fire.
 
Therapist: How have you been sleeping?
 
Client: Terrible. I’m staying at a friend’s house on the sofa and their baby cries all night long.
 
Therapist: Have you felt fatigued or had low energy?
 
Client: Yeah, I’m tired all the time.
 
Therapist: Have you been thinking about death a lot?
 
Client: I can’t stop thinking about my dog. It must have been horrible for him to die in the fire. I miss him so much and can’t believe he is gone. He was my best friend.
 
Therapist: Have these symptoms been bothering you a lot?
 
Client: What symptoms?

 
Therapist: Feeling depressed, losing interest in things you usually enjoy, not sleeping well, loss of energy, and recurrent thoughts of death.
 
Client: I guess. I’m just really upset and don’t know what to do. I lost my whole life in the fire.
 
Therapist: I think I understand the problem.
 
Client: What do you mean?
 
Therapist: You’re suffering from a mental illness called Major Depressive Disorder, also known as clinical depression. You reported having five symptoms that have persisted for two weeks, and the symptoms are producing significant distress.
 
Client: Wait a minute. I’m feeling depressed because of the fire. I’ve lost interest in doing things I used to enjoy because I can’t do them anymore because of the fire. I can’t sleep because the baby screams all night long. I feel fatigued because I’m not sleeping. I’m thinking about death a lot because I just lost my best friend.
 
Therapist: It’s normal to feel sad when something bad happens, like a fire or the death of a loved one. But when symptoms of depression persist and become distressing or interfere with your life, that’s when we know a mental illness is to blame. But don’t worry, you’re not alone. Depression is the most common mental illness. It afflicts millions of people every year. And it’s not your fault: it’s not a sign of weakness or poor character. Depression is a brain-based illness caused by a chemical imbalance. It’s a real medical condition, no different than diabetes or cancer.
 
Client: I’m confused. Isn’t it normal to feel depressed after what happened? Why are you saying I’m mentally ill?
 
Therapist: Because your symptoms meet diagnostic criteria for Major Depressive Disorder in the DSM-5, our diagnostic manual. Good mental health literacy involves recognizing the symptoms of mental illness. In your case, that means understanding that things like depressed mood, difficulty sleeping, and recurrent thoughts about death are symptoms of clinical depression.
 
Client: So, you’re saying that thinking I am depressed because of the fire instead of a chemical imbalance in my brain means I have low mental health literacy?
 
Therapist: That’s right. It’s important to understand that mental illness is real, serious, and treatable. Understanding the facts about mental illness reduces stigma.
 
Client: It reduces stigma to say I’m mentally ill with a chemical imbalance in my brain?
 
Therapist: Yes. The best way to combat stigma is by having good mental health literacy. Understanding that depression is a real, treatable illness caused by a broken brain reduces stigma.
 
Client: But it makes me feel worse about myself to think my brain is defective.
 
Therapist: Would you look down on someone for having cancer? Would you blame them for being sick?
 
Client: No, I guess not.
 
Therapist: When people understand that you’re sick with a real medical condition, and that it can be treated, they will have less stigma toward you.
 
Client: Wouldn’t it be less stigmatizing to say I feel depressed because my house burned down and my dog died?
 
Therapist: But that shows low mental health literacy. Remember, depression is a biologically-based mental illness. And the good news is that we have effective treatments for it.

Client: What kind of treatments?
 
Therapist: Both medication and therapy can help. Antidepressant medications help correct the chemical imbalance that causes depression. Therapy provides emotional support and helps you learn coping skills for managing depressive symptoms.
 
Client: How do you know I have a chemical imbalance in my brain? Don’t I need to take a test or something?
 
Therapist: No, that’s not necessary. We can tell your brain has a chemical imbalance because your symptoms meet DSM-5 diagnostic criteria for Major Depressive Disorder. Although antidepressant medications are effective, they are only part of the picture. Many people respond best to a combination of medication and therapy.
 
Client: What does therapy involve?

 
Therapist: Therapy provides a safe space for you to talk about what’s on your mind each week. I will listen with empathy and no judgment and provide emotional support. I can also teach you skills for coping with your depressive symptoms. These include skills for reducing negative feelings, like slow breathing and muscle relaxation. You can also learn skills for reducing negative thoughts, like replacing negative thoughts with positive thoughts and watching your thoughts pass through your mind like clouds in the sky. Having a good relationship with a trusted therapist is the key to success.
 
Client: What do you mean by success?
 
Therapist: Having fewer symptoms of depression.
 
Client: How am I supposed to have fewer negative thoughts and feelings? My house just burned down and my dog died!
 
Therapist: That’s where the coping skills come in.
 
Client: But I lost everything. I don’t know where to go from here. What am I supposed to DO?
 
Therapist: I will refer you to a psychiatrist for a medication consultation. Let’s meet again next week for another treatment session. You can book it with the receptionist when you pay for today’s session.”

(Cf. “House on Fire: A ‘Mental Health Literacy’ Parable,”Brett Deacon, PhD, for the full

article and his comments.) Ergo, we are sick at every turn. Mental health caveat.

I can say no more.