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#4493 - Wednesday, January 25, 2012 - Editor: Jerry Katz

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  • Jerry Katz
    #4493 - Wednesday, January 25, 2012 - Editor: Jerry Katz The Nonduality Highlights - http://groups.yahoo.com/group/NDhighlights ... Salient points from the
    Message 1 of 1 , Jan 26, 2012
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      #4493 - Wednesday, January 25, 2012 - Editor: Jerry Katz
       
      The Nonduality Highlights - http://groups.yahoo.com/group/NDhighlights 
       
       
       
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      Salient points from the article
       
      The Social Construction of Mental Illness
      and its Implications for the Recovery Model
       
       
      Michael T. Walker, Ph.D.
       
       
      The vocabularies of the medical and psychological models, indeed the idea of “mental illness” itself, are social constructions – THEY’RE MADE UP. 
       
      Furthermore, they are vocabularies that describe disease and deficit.  They view a human being as something that can be “assessed”, “diagnosed”, and “treated” much like a machine – hence comes the obsession with “compliance.”  These models make distinctions between “normal” and “pathological.”  They position practitioner as expert and client as more or less passive recipient of “treatment.”  The focus of “treatment” is on the elimination of “symptoms.”  As will be discussed later, the recovery model is a state of partial transformation:  it is truly client-centered; however, it is contextually “weighed down” by the vestigial and anachronistic use of the medical and psychological vocabularies.  These vocabularies invisibly and insidiously support the old paternalistic roles.
       
      From a postmodern perspective these medical and psychological vocabularies are not representing reality, but, in fact, creating a “reality” or perspective.  The fact is that words simply “carve up” our undifferentiated sensory experience leading to many possible interpretations of the human condition.
       
      When we create words and concepts describing aspects of ourselves or of our environment (also know as making distinctions) they appear as “truths” and, consequently, they dictate our actions. 
       
      The word “schizophrenia”, and the next, “mental illness”, only exist through consensus and only persist by convention. Even if the correlations of defining symptoms was perfect (which it is far from), in light of the linguistic paradigm we have to ask ourselves whether using a pathologizing, deficit-based vocabulary is useful in helping people improve the quality of their lives.
       
      ~ ~ ~
       
      I am not trying to disqualify the use of chemicals (aka medications) to help people improve the quality of their lives.  I am saying that psychiatry will have to recognize that it is an art to be applied in a highly individualistic, non-pathologizing, collaborative way – perhaps something akin to how the East practices herbal medicine. 
       
      ~ ~ ~
       
      Mindfulness is one of the perspectives and practices that will eventually replace the old medicalization of experience
       
      ~ ~ ~
       
      In light of neuroplasticity, rigid abstractions such as “chemical imbalance”, “mental illness” and psychiatric diagnoses, such as “borderline personality disorder”, are linguistic “balls and chains” when it comes to helping people become self-determining.
       
      ~ ~ ~
       
      Mental health professionals may be creating much (being conservative) of that which they are trying to cure.
       
      When we speak as if someone has a diagnosis or has a “mental illness” we are unwittingly creating a reality – a reality in which human beings are transformed into the “mentally ill”.  When we use words such as “mental illness”, “schizophrenia”, “symptoms”, “tangential speech”, “clinical this or that”, “treatment plan”, “assessment” – we are unwittingly bringing forth the entire context, the hierarchical and paternalistic role relationship together with the sticky morass of pathological and deficit-based perspectives.  Jill Freedman and Gene Combs (1996) write:
       
      "Speaking isn’t neutral or passive.  Every time we speak, we bring forth a reality.  Each time we share words we give legitimacy to the distinctions that those words bring forth.”  (p. 29)
       
      ~ ~ ~
       
      We know not what we do.  By seeing the medical and psychological vocabularies as truths (as opposed to perspectives) we cannot see the profoundly destructive consequences of them.  These vocabularies comprise closed conceptual systems in which everything can be explained within them (not unlike a so-called “delusional” system).
       
      ~ ~ ~
       
      When you have a receptive audience, I suggest you present our message of hope: You don't have a disease, you are not powerless.  By staying focused on what is most important to you (which might be a higher power, but could be all sorts of things), you can gain full control of your behavior, and learn to lead a wonderful life!”  (p.3)
       
      ~ ~ ~
       
      This paper is calling for nothing less than a total transformation in education in the mental health profession.  The labeling has disconnected both professional and client from humanity. 
       
      ~ ~ ~
       
      If insurance reimbursement requires psychiatric diagnoses we simply remember that we’re changing focus (i.e. to that of “symptoms”) and using different abstractions (i.e. those of diagnoses) to make summary statements.  Insurance companies “believe in” (i.e. see them as essential “truths” or “entities”) these reified linguistic constructs only as a result of their having been sanctioned by the medical profession.  The profession can certainly establish the need for services or benefits based on behaviors, without resorting to making up “fictive diseases.”
       
      Remember from the old scientific-reductionist rigidly held perspective holding two contradictory points of view is impossible – because, as you will recall, the point is to reduce things to some unique essence.  From the linguistic paradigm we’re looking for words and perspectives that will help us solve a problem.  To receive insurance reimbursement and to establish disability benefits simply requires an occasional translation from one language to another.  Words are tools, not truths.
       
      ~ ~ ~
       
      The recovery model as it currently exists is an incomplete transformation of the mental health profession.  We are finally helping clients get what they want, taking them seriously, having high expectations of them, and eliminating barriers to employment, housing, financial stability, and relationship.  The basis of our helping interactions has to be freed from the vocabularies of medicine and psychology.
       
      ~ ~ ~
       
      The cultural pluralism in our country has led to an emphasis on “cultural competency” in the profession.  Gays won their freedom from the DSM in the 80’s; various non-dominant-culture-specific practices did so in the 90’s.  There doesn’t seem to be any pride in membership in the DSM.  I’m advocating freedom for all.
       
      Finally free from the chains of the medical and psychological vocabularies, many people would immediately fit into society with a little extra help.  Others would blend in immediately into artist studios, universities, and musician & literary communities.  19th century Paris was the mecca for such creative people.   Bohemian was the term for the artists and intellectuals that didn’t “fit in.”  Avant-garde referred to those who didn’t “fit in” and led the rest of us.  Something to think about.
       
      ~~~
       
      Read the entire paper at
       
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