Читать книгу Resources for Extraordinary Healing: Schizophrenia, Bipolar and Other Serious Mental Illnesses - Emma PhD Bragdon PhD - Страница 4

Bi-Polar kills tens of thousand of people, mostly young people, every year. Statistically, one out of every five people diagnosed with the disease eventually commits suicide. But, I wasn’t convinced, to say the least, that gulping down a handful of pills every day would make me sane.

--Sascha A. Dubrui, in “The Bipolar World”

The following two stories involve families that are well-to-do. They have the means to go to the best clinics, hospitals and private practitioners available in the world. Most people do not have these privileges due to lack of financial means,; therefore, there is little is available to them for assistance except what is offered for free by governments’ welfare systems: psychiatric medication only.

1. Caught in the System: Low Functioning

(Names in this story are fictitious in order to protect the privacy of the people involved, but the story is an exact retelling of real circumstances.)

Sylvia is the youngest of 7 children, and although the family was not well to do in the early years of her life, Sylvia’s demands were always considered first. She generally got what she wanted as a child. When Sylvia was 18, she was diagnosed as schizophrenic and later as bipolar. She is now 56 years old. For thirty years, she has been taking a phenothiazine called fluphenazine”, or Prolixin. This is used to reduce psychotic symptoms in schizophrenia, as well as to reduce the acute manic phases of bipolar disorder.

Sylvia is under the care of her sister, Ann, a highly successful, wealthy businesswoman, aged 58, who worked closely with the mentally ill for two years before going into business. Ann chose to place Sylvia in a low-income apartment building close to Ann’s home, where Sylvia can walk to her psychiatrist and group therapy, as well as the bank and market. However, Sylvia is not able to follow the simple rules of the house, and her habits of being half-dressed in public places, and being abrasive and belligerent to others in the building may lead to her being evicted soon.

Sylvia says she stopped drinking alcohol 15 years ago, but Ann believes she continues to drink vodka regularly, and it’s her mixing alcohol with psychiatric medications that causes the hallucinations. “She knows how to take herself right to the edge, and she does it every day,” Anne told me, exasperated with how consistently Sylvia seems to take pleasure in disempowering herself, not taking any responsibility for herself, and manipulating others to care for her without regard to how that caring impacts their lives.

Thinking that it might be the drugs that kept Sylvia in this state, Anne asked the doctor, “What would happen if you weaned her off the drugs?” The doctor ushered her into a room to view a patient with severe tics and tremors to illustrate what Sylvia would be left with as the effects of taking the drug for 30 years and then stopping. Ann was horrified.

According to Ann, the conventional treatments of our mental health-care system only mask the symptoms of schizophrenia. Everyone with psychotic symptoms is given the same treatment, and the mental healthcare system seems incapable of treating each person as an individual, let alone addressing the spiritual nature of their situation.

In a way this supports patients not taking responsibility for themselves. They continue to be self-indulgent and self-absorbed, unable to relate to the needs of others or to the way their emotions or behaviors are impacting others.

My sister likes to be medicated. All she can do then is sit with an open mouth, drooling. She doesn’t have to face the world. She doesn’t have to function.

In group therapy Sylvia doesn’t tell the truth. She is constantly manipulating the system, manipulating others to get what she wants. It’s all about her and she’s very smart at using her intelligence to get what she wants.

The only way to get her to do something is when she understands the consequences that her actions or non-actions will have and understands that people will not always bail her out. But, our system continues to give her what she says she wants: medication to help her escape and remain self-indulgent.

Sylvia doesn’t appear to want to take care of herself, or help herself. She seems to want to ruin her own life. She also seems to have a crisis whenever I am about to celebrate something big: a wedding, a grandchild being born, etc. If she lived with me and my family, our life would be in chaos. But, it’s really hard for me to institutionalize her in a state hospital. Our family is used to taking care of each other…but, I wonder always how I may be enabling her illness by making things easy for her.

I know if Sylvia was alone, our system would institutionalize her in a locked ward, or leave her on the streets with minimal care. As it is, her life will likely be cut short by a drug overdose and/or her unhealthy habits, like smoking, eating poorly, and never exercising. It’s just a horrible situation.

Ideally, she would be treated as an individual and would be encouraged to be responsible for her actions and their consequences. Instead she is treated as a passive victim, and she continues to not take responsibility for herself or her actions, and to be insensitive to others and their needs.

I’ve come to believe that the common denominator in the seriously mentally ill is that there is nothing else in their worlds but themselves. They need to be put in a situation they can manage where they are sometimes attending to others: dogs, kids, someone else. They need to perceive that there is something greater than themselves, including what we call God or Spirit. Indulging them by helping them escape the world into themselves, into being passive, is not helping them to heal and it creates more dependency on the governmental welfare system, too.

I feel sure there is a better way than this. We have to get to the roots of what caused the self-destructive behavior in the first place. This means really treating each person as an individual. Next, we have to encourage self-responsibility and actions to assist others.”

2. Creating a Better System: High Functioning

Sascha Altman DuBrul (his real name) wrote his personal story of “The Bipolar World,” published in the San Francisco Bay Guardian in September 2002. It was published again in 2004 in Navigating the Space Between Brilliance and Madness: A Reader and Roadmap of Bipolar Worlds, edited by The Icarus Project. I met Sascha in 2008 and was impressed by how articulate he was, as well as his willingness to take a position of leadership in creating supportive community for those diagnosed with mental illness.

Sascha’s family considered him a highly sensitive youngster, maybe even too sensitive for his own good. Like Sylvia, he was first diagnosed with mental illness at age 18. He had not slept for months and had delusions and hallucinations. The symptoms of this manic state were first caused by an allergic reaction to penicillin that was supposed to be relieved by another prescription for prednisone, a steroid that he dutifully took on the advice of his physician.

Watching his struggle with the mania, his mother took Sascha to a hospital where, after observation, the attending psychiatrist diagnosed him with bipolar disorder. He was given another drug, Depakote, to stabilize his moods, and they were told Sascha would be managing this mental illness for the rest of his life.

Six years later, in 1999, he ended up returning to the same program, being diagnosed with schizoaffective disorder. This time he was given an antidepressant called Celexa (citalopram) and an antipsychotic called Zyprexa (olanzapine). Within a few weeks he began working at an organic farm, and eventually moved there—sowing seeds and taking care of plants. The drugs worked and afforded him some stability, but he didn’t like being dependent on them for his sense of wellbeing. He moved again after a few months.

In 2001, he was again put in a psychiatric unit as a result of destructive behavior in the streets of Los Angeles. He said, “I was convinced that the world had ended, and I was the center of the universe before they picked me up…[After I was apprehended] I spent the next month locked up in the LA County Jail.” This time he was again diagnosed with “bipolar disorder” and given medication. After being released, he spent a couple of weeks in a Kaiser psychiatric ward, followed by four months in a halfway house. Eventually he returned to live with friends in a collective house in North Oakland, California. By that time he was on lithium for mood-stabilization and the antidepressant Wellbutrin (bupropion).

Stabilized with the help of medications, at age 27 he began to study books about his condition. He studied psychopharmacology to understand the chemistry of the illness. He wrote, “I started coming to terms with the paradox that, however much contempt I feel toward the pharmaceutical industry for making a profit from manic-depressive people’s misery and however much I aspire to be living outside the system, the drugs help keep me alive, and in the end I’m so thankful for them.”

Sascha also studied books that helped patients and their families with creating lives that work. He was especially inspired to read about the connection between creative genius and bipolar disorder. Authors such as Virginia Woolf, T.S. Eliot, Hermann Hesse, and painters like Vincent van Gogh and Jackson Pollock all experienced serious mental imbalances and channeled their eccentricities into creative expressions that have offered profound sources of inspiration to many exposed to them.

Sascha wondered how to help teenagers find inspiration and support—especially those not exposed to the study and perspectives he had gained. He then went on to co-coordinate “The Icarus Project (www.TheIcarusProject.com),” a place for people like himself to connect, tell stories, and create a shared language that reflects both “the complexity and the brilliance that we hold inside.”

Although Sascha has found a way to positively contribute to society, he has to monitor himself and make sure he lives a life with a balanced diet and enough sleep, exercise, and time in nature, as well as the right balance of psychiatric medications. He has developed the self-discipline to monitor his lifestyle choices and make himself do what he needs to do for himself. He lives knowing that if he fails to provide for himself in these ways, he might again slip into an episode that is destructive to him and others.

How Much Mental Illness Do We Have and What are We Doing About It?

According to the National Institute of Mental Health’s “National Survey on Drug Use and Health” of 2008, serious mental illness (SMI) cripples almost 5% of the population. They defined SMI as “a mental, behavioral or emotional disorder resulting in serious functional impairment that substantially interferes with or limits one or more major life activities and was diagnosable within the last year.” Five percent of the population of 311,500,000 today (mid-2011), is more than 15.5 million people in the USA now experiencing serious mental health issues.

A 2004 study revealed the outcome of first-episode psychosis in USA, treated in the usual way primarily with drugs: Only 13.7% of subjects met full recovery criteria for two years or longer (Robinson et al., 2004).

Robert Whitaker, author of Anatomy of an Epidemic (2010), which made him the winner of a 2011 national award for investigative journalism, reported it this way: In 1955, when psychiatric medications were not yet used, there were 355,000 people [in the USA] with a psychiatric diagnosis primarily cared for in state and county mental hospitals. Four million American adults under 65 years of age are on Supplementary Security Income (SSI) today because they are disabled by mental illness. One in every fifteen young adults (18-26 years old) is “functionally impaired” by mental illness. Some 250 children and adolescents are added to the SSI rolls daily because of mental illness.

Psychiatric drugs are now being given more frequently to children. Dr. Mercola wrote a special report on Ritalin on June 30, 2011 (available through Mercola.com). He reported:

Consider the drug Ritalin (used for Attention Deficit Hyperactivity Disorder). U.S. pharmacists distribute five times more Ritalin than the rest of the world combined, according to Dr. Samuel Epstein's Cancer Prevention Coalition (CPC). In all, 60 to 90 percent of U.S. kids with attention deficit disorders are prescribed this powerful drug, which amounts to 3 percent to 5 percent of U.S. children and teens on Ritalin.

By definition, Ritalin stimulates your central nervous system, leading to side effects such as: increased blood pressure, increased heart rate, increased body temperature, increased alertness, and suppressed appetite. Research has also linked Ritalin with more severe health problems such as cancer as well as an increased probability of suicidal thoughts and behavior. Ritalin has the same pharmacological profile as cocaine, yet its effects are even more potent. Using brain imaging, scientists have found that, in pill form, Ritalin occupies more of the neural transporters responsible for the "high" experienced by addicts than smoked or injected cocaine.

Unfortunately, diagnosing ADHD really comes down to a matter of opinion, as there is no physical test, like a brain scan, that can pinpoint the condition. There's only subjective evaluation, so it's easy for kids to be misdiagnosed.

As for antidepressants, they have been shown to cause both suicidal and homicidal thoughts and behaviors. For example, seven of the last 12 school shootings in the USA were done by children who were either on antidepressants or going through withdrawal from using them.

Whitaker reports that the increase in the use of psychiatric medications has led to a rise in disability and clearly, a fattening of the bank accounts of pharmaceutical companies. Whitaker wrote, “In 1985, outpatient sales of antidepressants and antipsychotics in the US amounted to $503 million. Twenty-three years later, US sales of antidepressants and antipsychotics reached $24.2 billion, nearly a fiftyfold increase. Total sales of all psychotropic drugs in 2008 topped $40 billion” (p. 320).

The following is reprinted from a section of the introduction in Spiritism and Mental Health (Bragdon, 2012):

We are currently facing a sharp increase in the cost of health care, as well as an exponential increase in people on disability because of mental health issues. In the USA, our conventional medical establishments have the resources to administer excellent emergency medical care, but, according to the World Health Organization (2000) our overall health system performance ranks 37^th, and Americans rank 72^nd in overall level of health compared to 191 countries—even though we have the most expensive health care system in the world. We can extrapolate that our knowledge and practices regarding the healing of mental illness and chronic degenerative physical disease is not exemplary.

This obviously signals a need to look outside our borders for ideas about how to improve our health care systems, to prevent disease and maintain wellness. Possibly we can also learn more about the causes of illness.

Whitaker (2010)…reflects that our top medical authorities still do not know the real cause of mental illness. While many benefit from conventional psychotropic drugs the majority of individuals who use these powerful medications do not experience significant or sustained improvement or are unable to tolerate their long-term use because of associated toxicity and serious adverse effects including weight gain, loss of libido, gastro-intestinal distress, and in some cases, worsening of the mental health problem for which they are being treated. Whitaker suggests that conventional psychiatry relies too heavily on psychotropics and too little on viable non-pharmacologic alternatives:

The drugs may alleviate symptoms over the short term, and there are some people who may stabilize well over the long term on them, and so clearly there is a place for the drugs in psychiatry’s toolbox…However, (given the long-term outcome research) psychiatry would have to admit that the drugs, rather than fix chemical imbalances in the brain, perturb the normal functioning of neurotransmitter pathways…[Psychiatry has to figure out] how to use the medications judiciously and wisely, and everyone in our society would understand the need for alternative therapies that don’t rely on the medications or at least minimize their use. (Whitaker 2010, p. 333)

Recent systematic reviews of quality placebo-controlled trials bear out Whitaker’s observations and provide confirmation that available pharmacologic treatments do not adequately address common mental health problems including major depressive disorder (Kirsch 2008; Thase 2008; Fournier, DeRubeis, Hollon, Dimidjian, Amsterdam, Shelton, and Fawcett 2010) bipolar disorder (Fountoulakis 2008), schizophrenia and other psychotic disorders (Dixon, Dickerson, Bellack, Bennett, Dickinson, Goldberg, Lehman, Tenhula, Calmes, Pasillas, Peer, and Kreyenbuhl 2009; Tajima, Fernandez, Lopez-Ibor, Carrasco and Diaz-Marsa 2009), dementia (Birks 2006; Lam, Kennedy, Grigoriadis, McIntyre, Milev, Ramasubbu, Parikh, Patten, and Ravindran 2009), obsessive-compulsive disorder (Schoenfelt and Weston 2007), post-traumatic stress disorder (Berger, Mendlowicz, Marques-Portella, Kinrys, Fontenelle, Marmar and Figueira 2008), and generalized anxiety disorder (Katzman 2009). In spite of compelling evidence to the contrary, we continue to treat symptoms as if they are caused by a ‘broken brain’ in which deficiencies or “imbalances” of serotonin and other neurotransmitters are regarded by modern psychiatry as sufficient explanations of mental illness.

In 2009, one out of eight adults in the USA was taking psychiatric medication, most believing that medications are necessary for bolstering brain function in the way that insulin is essential for the diabetic. The results to society have not been positive. In 2007 the disability rate due to mental illness was 1 in every 76 Americans. That’s more than double the rate in 1987 [a year before Prozac was introduced], and six times the rate in 1955 [before psychotropics were being used] (Whitaker 2010, p. 10). The tremendous increase in the number of people claiming disability for mental illness is an indictment of contemporary biomedical psychiatry and points to serious unresolved problems of efficacy and safety with available psychotropic medications.

In other words, when psychiatric medications are used as the sole sources of healing and do not address the root cause of illness, they may be ineffective or result in worsening, to the point where patients turn to more potent synthetic medications sometimes resulting in debilitating adverse effects that interfere with their ability to function socially and at work. Research on the long-term effects of psychiatric medications reported by the Director of the National Institute of Mental Health in 1996 reveal that they compromise brain function rather than enhance it (Hyman 1996, pp.151-61).

We have hunted for big simple neuro-chemical explanations for psychiatric disorders and have not found them. (Lacasse 2005, pp.1211-1216 in Psychological Medicine, 2005)

Cultures and healing traditions outside our borders that offer effective therapies other than psychotropic drugs can add to our toolbox for improving mental health and promoting wellness. In order to transform mental health care into a more effective, more humane model it is incumbent on physicians to remain rigorously open minded about the range of alternative therapies and integrate those that work and are safe into the current model of biomedical psychiatry. Only in this way can the general population achieve a higher level of wellness.

Techniques for Releasing Trauma

Are there simpler and safer techniques to release the energy trapped in emotional imbalances and dysfunctional patterns related to trauma? If severe mental imbalances originate in trauma, wouldn’t it be more direct to simply resolve those traumas, rather than try to mask the results of trauma that have become the symptoms of mental imbalance?

In the not so distant past, long-term psychotherapy and psychoanalysis attempted to resolve deep-seated trauma through offering individuals a healing relationship with the therapist, entailing months or years of one-hour sessions, often more than once a week. Through the 1980s, some long-term therapy could be billed to insurance, which made it more affordable for the general public, but that has changed. The popular book I Never Promised You a Rose Garden chronicled the healing of a woman diagnosed with schizophrenia who came to be a successful and prolific author. She attributed her healing to her psychotherapist. The filmmaker Daniel Mackler interviewed the author, Joanne Greenberg, on camera, for his documentary Take These Broken Wings. She said her own story was reflected in the book and, “I never would have healed in today’s world if I had been given drugs and not had years of psychotherapy [to heal from the trauma she experienced as a child].”

Today, long-term therapy is categorized as “actualization” and cannot be billed to insurance as it does not relate to a disease category in the DSM. Instead, brief therapy of 2-3 sessions is billable and considered sufficient to deal with emotional illness.

There are excellent therapies for post-traumatic stress disorder (PTSD). These therapies include EMDR, EFT, and WHEE. They are especially effective for eliminating the effects of past traumas, as well as lingering negative emotional states, such as anxiety, depression, fear, frustration, sadness, and anger. They have been effective in treating panic disorder, chronic pain, and addictive cravings. Following is a brief description of these therapies. Please keep in mind we do not feel these replace long-term therapy and a healing relationship with a therapist; we do believe that these therapies can be a helpful component in treating a serious mental imbalance in some cases, and that they may be more ideally suited to those with less serious mental illnesses.

Eye Movement Desensitization and Reprocessing (EMDR) is currently recommended by the American Psychiatric Association as a treatment of choice for PTSD and is considered as effective as cognitive-behavioral therapy. EMDR has an extensive research base to confirm its efficacy in treating PTSD and requires therapists to facilitate it, as it is complex and may catalyze extreme catharsis. It is based on unlocking specific sites where emotional pain is buried. It does not appear to have a “spiritual” basis.

Emotional Freedom Technique (EFT): Psychologist Roger Callahan and Stanford engineer Gary Craig developed EFT. The technique is gentle and quick. In a session, the client is instructed to recollect thoughts, feelings, or images of a painful situation (emotional or physical) of which he or she wants to be free (e.g., an irrational fear) while the practitioner guides him or her to gently tap specific points of the face, neck or chest. The tapping on specific points on meridians of the body neutralizes disruptions in the body’s electrical system, which stops the chemical chain reaction causing the unwanted response pattern and thus frees the client from the associated emotional and physical discomforts. As the client gently taps on a point, the neural receptors under the skin convert the pressure to an electrical impulse that is transmitted to the brain--similar to using a remote control or tapping a key on a keyboard to send an electrical signal to the computer generating the output, balancing the right and left hemispheres of the brain.

WHEE is a wholistic hybrid of EMDR and emotional freedom technique (EFT) created by psychiatrist, Daniel Benor. WHEE can be easily done without a therapist. Benor writes,

It invites the body to participate in releasing anxieties and stresses. It is a way to reduce the intensity of negative feelings and to reprogram negativity in general…You simply alternate tapping on the right and left side of your body while reciting an affirmation, and the negativity melts away. You can then use the same process to install positive feelings, beliefs and awarenesses--to replace the negativity you have released. This is not about doing away with issues so that we can forget, ignore or run away from them, but transforming the energy that has been locked up in trauma” (see http://www.wholistichealingresearch.com).

To repeat, although techniques for releasing trauma are available and psychotherapy is sometimes used, mainstream medicine and managed care focus on the biochemical roots of illness. After all, managed care visits with health professionals have been reduced to 15-20 minutes—time to review medications but not much else.

Spiritual Practices

As we abbreviate the human, empathic dialogues and treatments that take more than 15-20 minutes, do we add to a spiritual imbalance? Is this rushed way of life aggravating the very mental illnesses more people are seeking help for? What can people do to assist in their healing?

Spiritual practices such as mindfulness meditation (an offshoot of Buddhist practices) and varieties of Christian contemplative practices have also been helpful for those motivated to learn how to cope with pervasive symptoms of serious mental imbalances that are not easily released. These can often be learned and then practiced in groups associated with spiritual organizations or churches, as well as in weekend or weeklong retreats. One can find teachers who will teach the techniques for free.

Shealy and Church (2008, p. 25)’s research review found that spiritual practice and spiritual and religious beliefs have a marked positive influence on longevity and health. They have been found to:

•Improve the survival rate of patients after operations

•Ameliorate pain

•Raise levels of pleasure-inducing hormones in the brain

•Improve mental acuity

•Reduce depression

•Boost immune system function

•Reduce the time it takes wounds to heal

•Reduce the frequency and length of hospital stays

•Increase marital happiness in men

•Reduce alcohol consumption and cigarette smoking

•Reduce the incidence of cancer and heart disease

•Improve the health of older adults

•Add years to the average life-span

Spirituality involves each person in the quest for ultimate meaning and purpose in life. It supports connection to and relationship with the sacred dimensions of life and, with each other. A life directed by one’s spiritual intention is more likely, then, to move a person towards wellness.

Perhaps we have invested our financial resources into researching and treating serious mental illnesses primarily with drugs or our culture-specific modes of psychotherapy because we have let go of spiritual belief systems that previously gave meaning and context to our suffering, or we do not respect the resources available from other cultures because we are so wrapped up in material science. Watters (2010, p. 255) wrote:

What is certain is that in other places in the world, cultural conceptions of the mind remain more intertwined with a variety of religious and cultural beliefs as well as the ecological and social worlds.