Paula J. Caplan : "Listen to veterans"

The original post is being rewritten and will be reposted elsewhere. 

Link to a recommendation of this book in the MIT Press home page: 


https://mitpress.mit.edu/books/when-johnny-and-jane-come-marching-home

Quote: 

Traumatized veterans returning from our wars in Iraq and Afghanistan are often diagnosed as suffering from a psychological disorder and prescribed a regimen of psychotherapy and psychiatric drugs. But why, asks psychologist Paula J. Caplan in this impassioned book, is it a mental illness to be devastated by war? What is a mentally healthy response to death, destruction, and moral horror? In When Johnny and Jane Come Marching Home, Caplan argues that the standard treatment of therapy and drugs is often actually harmful. It adds to veterans’ burdens by making them believe wrongly that they should have “gotten over it”; it isolates them behind the closed doors of the therapist’s office; and it makes them rely on often harmful drugs. The numbers of traumatized veterans from past and present wars who continue to suffer demonstrate the ineffectiveness of this approach.

Sending anguished veterans off to talk to therapists, writes Caplan, conveys the message that the rest of us don’t want to listen—or that we don’t feel qualified to listen. As a result, the truth about war is kept under wraps. Most of us remain ignorant about what war is really like—and continue to allow our governments to go to war without much protest. Caplan proposes an alternative: that we welcome veterans back into our communities and listen to their stories, one-on-one. (She provides guidelines for conducting these conversations.) This would begin a long overdue national discussion about the realities of war, and it would start the healing process for our returning veterans.

Related:

When “Jane” Comes Marching Home Again

 | June 1, 2012

HOW DO YOU PRESERVE THE DIGNITY OF CHILDREN WHEN YOU SPANK THEM?

Next day: Good news further down: 
“Pope’s Spanking Comment Alarms His Sex Abuse Commission”

Read Latest Breaking News from Newsmax.com http://www.Newsmax.com/Newsfront/EU-REL-Vatican-Sex/2015/02/07/id/623388/#ixzz3RBRUKAWx
Urgent: Rate Obama on His Job Performance. Vote Here Now!

Pope Says It’s OK to Spank Children

By Melanie Batley

Pope Francis says that spanking is justified as long as it preserves the dignity of the child and is not done in the face, USA Today reported.

“One time, I heard a father say, ‘at times I have to hit my children a bit, but never in the face so as not to humiliate them,'” the Pope said during comments Wednesday at his general audience in St. Peter’s Square.

“That’s great,” Francis continued. “He had a sense of dignity. He should punish, do the right thing, and then move on.”



And a huge question is pushing itself out through tears:

Is it also OK to rape children if you are sure that you are not humiliating them?

Do children have the right have to say if their dignity is preserved, if humiliation occurs, if the right thing was done, if they can move on?

VATICAN CITY — Members of Pope Francis’ sex abuse commission have criticized his remarks that it’s OK for parents to spank their children, saying there is no place for physical discipline and that the panel would make recommendations to him about protecting kids from corporal punishment.

More links:

http://abcnews.go.com/Health/wireStory/popes-sex-abuse-commission-alarmed-spanking-comment-28797475 

http://www.csmonitor.com/World/Global-News/2015/0207/Spanking-OK-Why-Vatican-sex-abuse-commission-disagrees-with-Pope-video
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Lancet Psychiatry: "Do we need to talk?"

Yes, we need to talk. And the links I have collected here point to a theme I would like to talk about: 

PEOPLE ARE NOT LAB RATS
LAB RATS ARE NOT NATURAL RATS IN NATURAL ENVIRONMENTS
EVIDENCE-BASED PSYCH : HUMAN LIVES = RATRUNNING : ECOLOGY



There will be more comments later, for now I’m just quoting the conclusion:

Some people benefit from drugs; some from psychotherapy; some from simple lifestyle changes (including cat ownership); and some from all three. Mental health professionals must work together and learn from one another to give patients timely, appropriate, and honest advice regarding the best options for them. 

And inserting a relevant question: 
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pp: 75-157

http://journals.lww.com/jonmd/pages/currenttoc.aspx

Defining and Refining Self-Harm: A Historical Perspective on Nonsuicidal Self-Injury

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What Do Psychiatric Patients Believe Regarding Where Control Over Their Illness Lies?: Validation of the Multidimensional Health Locus of Control Scale in Psychiatric Outpatient…

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Emotion Recognition Impairment in Traumatic Brain Injury Compared With Schizophrenia Spectrum: Similar Deficits With Different Origins

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Attachment in Romantic Relationships and Somatization

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Nonverbal Communication of Patients With Borderline Personality Disorder During Clinical Interviews: A Double-Blind Placebo-Controlled Study Using Intranasal Oxytocin

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Processing of Facial and Nonsocial Information Is Differentially Associated With Severity of Symptoms in Patients With Multiepisode Schizophrenia

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Psychiatrists’ and Primary Care Physicians’ Beliefs About Overtreatment of Depression and Anxiety

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A Quantitative Review of Cognitive Functioning in Homeless Adults

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Extended Family and Friendship Support Networks Are Both Protective and Risk Factors for Major Depressive Disorder and Depressive Symptoms Among African-Americans and Black…

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Intensive Multidisciplinary Treatment of Severe Somatoform Disorder: A Prospective Evaluation

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Table of Contents Outline | Back to Top

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WHEN I HANG FROM AN OUTCROP

Wikimedia commons *
by bruised and bloody fingertips

there are certain actual needs I have.
Even when the cliff is not of stone.


I need eyes that see the abyss.
Eyes that see me, where I hang.
I need strong arms that hold a rope.
Even when the arms are not of flesh and bone.

I need a friendly presence
while deathfear cramps itself out.

I need safe silence when I have no words.
When words are there, I might need:

“What happened?”

I need a clear brain that reality tests with me:

Did I stumble?
Was I pushed?
What do others own?
What do I own?

I need someone who gives me time and space
to find what I can learn from my past.
When the time is right.

My time.

Someone who knows that it is my abyss.
These are my fingers.
This is my past.
Someone with guts to stay beside me
and does not try to show the way.

Can you give me what I need when I hang over an abyss?
If you can’t, more than anything else,
I need sentences that begin with “I”:

I won’t


I am afraid

I do not see you
I cannot help you
I don’t know what’s going on 
I do not understand what you are talking about
I am afraid of doing something wrong
I am fed up with talking about this
I cannot bear to go where you are now
I don’t want to know.
I can’t …
I won’t …
       I …
    I …
I …

When you say it like that
you own your reactions.
You don’t give them to me.

Rude, you say?
Subjective, you say?
Have a look at this:

Patients with your diagnosis …
You really need …
You are delusional
You are paranoid
You lack insight
There’s nothing you can do about it
Don’t worry about it
Your problem is …
You have to realize that you are ill
You can become whatever you want to be
You are overreacting
You …
You …
You are so aggressive and unpleasant
You have talked so much about this
Why did they do it?
Why did you do it?

You need to understand and forgive
You need to love
You need …
You need …
You need …



Don’t think about it

Don’t feel guilty
Don’t let problems stop you
Don’t be so negative
No limits to what you can do! 
Realize your limits!
Learn to live with your problems!

Put them behind you!

GET OVER IT!





Is this polite?
Objective?





Postscript: Have I been “psychotic”? I don’t know. 24 years ago there were months when I was hallucinating, hearing voices, suicidal and very confused, and I managed to hide these symptoms from my family and the health services.  


I had an inner image of  hanging on to a teetering “me” when people in my surroundings were trying to push me into a void. And this “me” was validated and strengthened by memories of people I had known and loved as a child, so I was actually hanging on to them, to what it felt like to be with them, what safety and trust and acceptance felt like. 


And I knew how my mother acted and what she did before she lost touch with reality, so I knew not to go into her world of polarization, of insisting that everyone else was crazy. 


And I finally managed to communicate with my inner critic, who knew that I was wrong, and that the world would be a better place when I was dead. That story is in “Psychiatry or liberation?“, but you need to scroll down a bit. That broke the spell. 

* “Preikestolenjuni2009” by Kjwathne – Own work. Licensed under CC BY 3.0 via Wikimedia Commons

BORDERLINE LINKS

I apologize. I posted a draft by mistake yesterday. So, to fill this space, I give you some links.


I decided a long time ago to flaunt my borderline diagnosis as a banner of autonomy. That liberated me from the shame and humiliation that is a harmful side-effect of borderlining. Rebecca J Lester describes this in Lessons from the borderline: Anthropology, psychiatry, and the risks of being human:

Clinicians generally detest working with borderline patients.1 These clients can present as unpredictable, needy, hostile, overly dramatic, and emotionally draining. As McGlashan (1993: 241) observes: ‘Officially, ‘borderline’ is a diagnostic label. Unofficially, in clinical parlance, it is synonymous with ‘anathema.’’ Gabbard (1997: 26) elaborates: ‘A significant number of professionals within the industry regard borderline patients with contempt.’ And as one psychiatrist told anthropologist Tanya Lurhmann (2000: 113), you look for the ‘meat grinder’ sensation: if you are talking to a patient and it feels like your internal organs are being turned into hamburger meat, she’s probably borderline.


Link to: People with a borderline personality disorder diagnosis describe discriminatory experiences

The experiences described by some participants regarding making complaints provide food for thought; the idea that making complaints is typical behaviour for someone with a BPD diagnosis seems to be a powerfully silencing one, positioning the client as someone whose complaints are trivial and/or pathological. The idea of BPD diagnosed clients as prone to making complaints probably also has ties to this client group being seen as difficult and angry, and being responsible for ‘splitting’ staff (Gallop 1985).

In my frame, the symptoms that get labelled Borderline Personality Disorder are symptoms of societal harm, loss, trauma and border violations. The meat grinder sensation is discomfort at getting a glimpse into an invisible war zone that the professional does not want to know about, and the diagnosis of “Borderline Personality Disorder” is generated by a professional Somebody Else’s Problem field and upheld by little homunculi that are jumping up and down in professionals’ heads.

In a strange double bind, psychiatry is clear about there being no need to be ashamed of having been sexually used, hit or gaslighted – and then treats the symptoms of having been used, hit or gaslighted as shameful and contemptible personality defects.


Borderline personality disorder: Abandon the label, find the Person
by Steven Coles

Linking to “Is Anakin Skywalker suffering from borderline personality disorder?” This might seem like a reasonable question to a psychiatrist:

Anakin Skywalker, one of the main characters in the “Star Wars” films, meets the criteria for borderline personality disorder (BPD). This finding is interesting for it may partly explain the commercial success of these movies among adolescents and be useful in educating the general public and medical students about BPD symptoms.

We are three generations of Star Wars fans in my family, and my children and grandchildren have often started discussions about this universe. Looking at how the character’s lives shape their actions and their options has led to useful explorations of free will, ethics, responsibility and values in the world we live in, far, far away from the mental illness frame of psychiatry.

A huge problem with the limited psychiatric illness model is that it gives up on people with “personality disorders”. I’ll be following this program with interest:

“Some psychopaths can be treated”
David Bernstein, Sacha Ruland




THE BORDERLINE PSYCHOTIC PATIENT: THE IMPORTANCE OF DIAGNOSIS IN MEDICAL AND SURGICAL PRACTICE*

MILTON H. MILLER, M.D.
Ann Intern Med. 1957;46(4):736-743. doi:10.7326/0003-4819-46-4-736


Psychoanalytic Dialogues: The International Journal of Relational Perspectives

Volume 7Issue 6, 1997

Translator disclaimer




http://www.psy-ed.com/wpblog/mental-disorders/borderline-personality-disorder/ 

http://www.practiceofmadness.com/2010/02/borderline-personality-disorder-and-the-control-of-subversive-women/
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