Friday, January 9, 2009

Very extreme mental illness/addict case study

Violent mental illness and addiction is a complicated topic with much nuance and a myriad of complexities, and thus it is a difficult subject to productively talk about, say nothing about its actual treatment or legal adjudication. This is one reason why I keep repeating one universal formula, one tool that one must always keep in mind and that applies to all such situations.

When a person has a mental illness and you have a conversation with them, you are not speaking to that core person, but you are having a conversation with the mental illness. When a person is an addict and you have a conversation with them, you are not speaking to that core person, but you are having a conversation with the addictive substance. For example, if you are speaking to a crack addict, you are speaking "to the crack" not to the person "Mr or Ms Whoever."

This is true even for a long time after the addict has, hopefully, become clean and sober and kicked their addiction. This is because the substance has left its programming in the person's brain, nervous system and spirit, and it takes a long time and much acutely aware corrective reinforcement to revert away from the substance's remaining presence and toward the authentic person's core.

This is also true about mental illness, even mild forms of it. When you are speaking to your friend or loved one who has depression, for example, you are having a conversation with "depression." This is something that you, the sufferers of mental illness and strain, must become more aware of. When you have depression, in a way you have designated an ambassador to act on your behalf, and the name of that ambassador is "depression." When you are successfully treated for depression, you have taken back your own identity and no longer allow "depression" to be your ambassador in everyday speech and actions, but remember that the "ambassador" has left his rule book behind and it takes you a while to stop following the formulas.

One way to spot this is to be self aware of how often in a day you do the following: Are you assessing either consciously or unconsciously every event and conversation in your day as being something to give you an excuse to be depressed again, or something that helps you not to be depressed? I am not being unkind here, any more than if I helped someone to understand if when they are hungry if they need a snack or they need a full meal. This is non judgmental help in self diagnosis. So, if you are still looking at each event in your day in a help/hurt your depression viewpoint, you are still allowing depression to be your ambassador. If you get through the average day without having those thoughts of assessing your depression quotient, you are successfully banishing the depression ambassador from your "court."

I first explained this years ago to a friend with bipolar. As I got to know her I very quickly spotted what she did not see in herself, which is that her bipolar, even though successfully treated, was still her "ambassador." This is because she parsed every event and conversational sentence and facial expression, etc in her day according to what I explained to her is almost a "bank account" ledger mentality. She, or rather, the legacy of her active bipolar ambassador, was hyperattentive to every item of her day and slotted words, expressions, deeds and the moods of others as being "debits" and "credits" to that person's worth, to that experience's worth and to her own worth. Thus if you had a conversation with her and used a phrase she didn't like, her bipolar ambassador would issue an alert that you "might be an enemy."

I think that analogy had a great impression on her, and gave her a tool to be productively self examining and not unproductively hyperattentive. The road to sanity and joy does not travel through a country where you are obsessed with every brick in the road and the direction of every breeze.

So these are examples of how a mental disorder, even a relatively benign one, such as mild depression, has a serious and universal rule that one must remember, which is that the illness takes over control of much of one's interface with the world and one's own interior dialogue, much as if you have your authority seized by an ambassador who now operates on your behalf, both to your "liking" but also very much against what you would really want, in theory.

I wanted to remind people of this teaching of mine and introduce new readers to it before looking at our extreme case study. When one has a mental disorder, from mild to severe, one has ceded one's own authenticity over to that disorder who then proceeds to act as your ambassador. When one has an addiction one has not only ceded authority to the addictive ambassador, but the substance itself is now in control. I am only slightly exaggerating, for example, when I say that if you speak to a crack addict, you are actually having a conversation with the chemical compound "crack." That is MUCH worse than the ceding of your identity to your mental disorder ambassador. A mental disorder is still grounded in reality in the extent that it is an emotional situation (even if biologically caused) where one has normal desires even as they have been warped. An addiction is a substance that is a chemical, not a set of human emotions. Thus your addiction "ambassador" is not even human.

Suppose that you have depression. Well, whatever the cause of the depression, your ambassador is "Mr or Ms Depression." But suppose you are a crack addict. Your ambassador is "Mr or Ms Crack." Depression is a set of human qualities. Crack is a chemical.

Thus someone who speaks to your ambassador "depression" speaks to "sad, listless, tired, spiritually drained" etc. Someone who speaks to your ambassador crack speaks to "methylbenzoylecgonine."

Someone who speaks to your ambassador "schizophrenia" speaks to "hears voices, cannot see clearly, feels hunted, hurt, angry" etc. Someone who speaks to your ambassador heroin speaks to "diacetylmorphine hydrochloride."

Alright, now imagine the problem of treating someone with a severe mental illness, especially one that is violent, and also is addicted. At the very least imagine a crack addict schizophrenic. They have ceded their core selves to ambassador schizophrenia and ambassador crack. Imagine, worse, someone who suffers from childhood abuse, schizophrenia, multiple substance addictions, using both drugs and alcohol.

These ambassadors do not "work together." Rather, one has a multiple personality ambassador problem, and they war among themselves. Psychiatrists are only part way toward understanding this, according to my observation of them and their treatment methods. They do understand, profoundly, the problem of what they call "multiple diagnoses." However, psychiatry is far behind in understanding that they are not speaking with the person but speaking with the illness and/or the addictive substances. Thus they turn too quickly toward prescribing more 'benign' ambassadors, a psychiatric prescription drug without recognizing that this is what they are doing.

That is the heart of the problem of prescribing drugs to children with "behavioral" disorders. You have added a drug ambassador to a child who was struggling with only a behavioral ambassador, and now you have real trouble.

See, in a way the ancients who thought that all illness was "possession" by evil spirits were shrewd and accurate in one and only one aspect. They recognize that as we say nowadays "it was the liquor that was talking." The ancients recognized that those with mental illness no longer spoke for themselves. When Jesus cast out demons he was casting out the possession of the person by their illness. Not only was Jesus curing the mental disorder but he was also banishing the programming of the mental illness as ambassador on the human, thus cure was instantaneous and total.

But humans have to cure themselves now and Jesus can help in the spirit, but it is still a secular problem of how to avoid mental illness where possible (such as halting child abuse immediately and fully, the source of much mental illness) and to avoid addiction totally, as there is never "justifiable" addiction.

Now, when you have an extreme case such as in this incredibly sad news story, you have a hardening of heart on both sides (kill him or cure him) but both sides miss the point and everyone in between is baffled.

OK, now that you've read the story I'll bet you would tell me that if we were conversing that you read this story with a greater understanding of the problem. This does not mean that we necessarily have the ideal solution, but at least we all share an understanding.

This guy obviously, despite what the judge ruled, had at least one severe mental disorder. He then commits an incredibly heinous crime, and now has another layer of trauma and mental disorder (once someone commits their first violent act a "violence ambassador" is empowered). So he has mental disorders, an extreme violence and depravity action, and attempts suicide (recognizing his own depth of loss of humanity). He also, according to the lawyer, had both alcohol and drug addiction.

Many who read about crimes and pleas of insanity say, "How do we know who is really crazy?" Well, I've just given you a tool to better understand. The cynic who says he is crazy but coldly plans a crime and covers it up is hardly actually insane. But an eye plucking psycho with untreated mental illness and ruled by substance abuse is obviously insane. He has demonstrated a multiple year record of being controlled by his untreated illnesses and his legacy addictions AND the guilt of the violence ambassador (who is still active as he tried to attack fellow inmates).

This man is about the most extreme case we can find and this is why he is such a valuable case study. I'm not being cold; actually, I'm trying to help all of you see with compassion what is going on inside the wreckage of such a person and the crimes he commits.

So the case study helps you to see the layers of conflicting ambassadors that are within those who have more than one problem of mental disorder or substance. So you see how easy it is to recognize that a person with simple depression has a painful problem, but one that can be recognized as being a singular ambassador problem. The same is true of someone who in theory has no problems but drinks too much.

But as soon as you have two conditions, two addictions, two mental disorders, a mental disorder and an addiction, it is much more than twice as hard. It is like ten times as hard to treat. Then when you have someone with a handful or more of mental disorders and addictions, it is essential that everyone recognize that the core person is lost, overlaid by possessive ambassadors that speak for him or her, and some of those ambassadors have no human feelings but are chemicals making decisions and having "human" speech.

All I've explained will only assist each side of the "kill him" or "cure him" debate. The "cure him" side has better understanding of the layers of the problems and how throughout the cure they will rarely IF EVER actually speak to him... they will only speak to the illnesses and the addictions. This then helps the "kill him" side to understand that he is really lost under all the layers of his humanity destroying conditions. The "kill him" side can legitimately argue that no one can cure such a total wreckage of a person, one who would kill babies and cut their hearts out.

My point is not to assist either the "cure him" or "kill him" sides. My point is to educate how to navigate through understanding of mental disorder and addiction by this one simple rule, which is that the authentic person cedes part or all of their self to the disorder or substance "ambassador," and no cure works without understanding that at some level and helping the client to understand that in turn.

The first step in self empowerment is to tell the client or patient the facts, which is that substance or disorder "takes over" even when they are clean, sober or not feeling symptoms of their mental disorder. True self empowerment is diminished by victim mentality (or "chemical imbalance so it's not your fault" mentality) because you are having that mentality conversation with the disorder or the substance, not the person you are trying to help. You must first tell the person that the disorder or the substance has too much authority on their behalf, and teach them how to recognize those occurrences and take back their power from the disorder or substance ambassadors. When psychiatrists dispense drugs, even when helpful and necessary, they should explain it in those terms, that the drugs are a "best that we have" way to regain control of a more benevolent and authentic personal interface and that their constant objective should be to work toward an authentic and reality based being.

Keeping faith out of the psychiatric and other counseling arenas has been an incredibly bad mistake. I've blogged about this before. Here I will just join that observation to this blogging post by explaining that cultivating the patient's own faith is a way to wrest control away from the disorder or addiction ambassador and back to the person's core being. Far from 'believing in a myth' as loud mouth atheists charge, helping a person to strengthen their own cultural faith, whether Christian or not, is a means by which humane and authentic perspective is restored in the person who has been troubled by controlling ambassadors of disorders or substance.

I also hope that you really think twice about needless medication to children for simple behavioral problems. Behavior is behavior; it is not a mental disorder that has resulted in a disorder ambassador yet. Before imposing a benevolent (supposedly) prescription drug ambassador on your child, try to be more realistic about the sources of the behavioral issues in the first place and address them with traditional means.

Most important, those of you who suffer from depression, anxiety, bipolar, borderline, post traumatic stress disorder, attention deficit and other of the common conditions that are so frustrating and painful, remember that it is not your fault but it is a fact that the condition is only enhanced as their ambassadors retains control of your core being. Try to be aware when you let the condition "speak" or "think" for you and stop it by redirecting it. For example, if something minor happens but you find yourself thinking that this event "adds" to your condition, halt that thought in its tracks and examine it. Take control back from that ambassador thinking and think for yourself. Did the event really matter? Can you visualize that thousands of others have had the same thing happen to themselves today and they do not assume that it is reinforcement of their own burdens, but just a "stuff happens" moment?

For example, attention deficit people can be so tiresome in thinking that every racing thought that they have is "an ADD moment." Um, guess what? Normal creative people also have racing thought moments! Stop feeding your ADD ambassador by instantly labeling every racing thought or going off on a tangent moment as "an ADD moment." Sheesh. That's part of that bank account problem mentality that I explained to my bipolar friend. Your disorder ambassador is constantly racking up credits and debits to your account and that's erroneous and unhealthy. Understand that the things that you are hyperattentive of are, for the large part, part of normal human character. For example, I spend a lot of my time thinking rather dull and singular thoughts, plodding along in my world of constancy. However, I have spurts of ideas that can be very intense and multitasking and that's cool and creative, and sometimes I have to jot the ideas down on paper to keep track of them all, or pick just one and go with it. That's normal. But if that happens to an ADD person he or she immediately trumpets it in a mixed pride/self flagellating "ADD moment." It's not an ADD moment; it's being normal. But if you let your ADD ambassador rule your life your ADD ambassador will keep you in a constant state of disordered hyperattention.

I hope a lot of people with different perspectives and personal situations have found this case study and general discussion helpful.