Pink Belette: La psiquiatrie en France/ Psychiatry in France

La psychiatrie en France, zone de non-droit (par Pink Belette)

Une patiente française sous contrainte fait son « audit » dans le cadre de la campagne pour soutenir l’Abolition totale des soins et de l’hospitalisation sans consentement en application de la CDPH de l’ONU

http://depsychiatriser.blogspot.no/2016/03/la-psychiatrie-en-france-zone-de-non.html

 

Pourquoi je suis contre les « soins sous contrainte » :

On pourrait croire que, au pays de la liberté, on a encore droit à son intégrité morale et physique.

Rien n’est plus faux. Par experience, impossible pour quiconque d’échapper à un soin sous contrainte (SPDT, « soin à la demande d’un tiers » ou « péril imminent »).

Il suffit que : une personne la demande (que ce soit la famille, un voisin…), qu’on soit « pas bien », déstabilisé, agité, « instable », en colère, dépressif, sur la défensive, « en opposition », « délirant », amaigri, boulimique, fumeur de shit, drogué…

Il suffit aussi qu’on refuse l’hospitalisation ou un traitement pour que les médecins se relaient pour demander un soin sous contrainte. Une fois hospitalisé, « on » vous fait comprendre que vous perdez vos droits à la personne, l’argument étant : « maintenant on est responsable de vous pour TOUT »… Par contre, vis-à-vis de vous, « on » n’est responsable de rien…

 

Depuis la loi Bachelot du 5 Juillet 2011, en particulier si on a le malheur de contester le diagnostic ou le traitement, c’est alors après la sortie d’hospitalisation qu’on ne peut plus se débarrasser de la contrainte, et c’est là que c’est le plus pervers : injections forcées, consultations obligatoires avec un praticien hospitalier non choisi (à la rigueur, on a le choix entre deux médecins).

Le pire : si on refuse de se rendre au centre médico-psychologique du secteur assigné, la police vient gentiment vous cueillir chez vous pour vous hospitaliser en soins obligatoires à un degré encore plus coercitif (SPDRE, « sur la demande de l’Etat ») et sur un temps plus long et sans contact autorisé avec l’extérieur (!) jusqu’à ce qu’il aient réussi à réduire votre volonté à néant. Ainsi, il arrive que les personnes concernées doivent abandonner leur logement pour « vivre » en psychiatrie (parfois pendant des dizaines d’années, voir le cas de Dimitri Fargette)…

 

Je suis témoin : en France, il y a réellement du souci à se faire…

  1. Il n’y a aucune alternative à la psychiatrie institutionnelle (lobbying des psychiatres ET de l’industrie pharmaceutique contre d’autres formes de thérapies) ;
  2. Aucune littérature ou culture antipsychiatrique (des « survivants », il n’y en a pas…)
  3. L’Ordre des Medecins Psychiatres qui suspend : tout psychiatre « en décalage » avec le système consensuel (d’après le Dr. O.G, psychiatre libéral et ex-chef de clinique) ;
  4. L’Ordre des Medecins Psychiatres qui suspend : un psychiatre responsable de la mort d’une patiente… seulement pour 2 semaines (voir l’affaire Florence Edaine)
  5. La « Mafia des tutelles » : tout patient faisant des séjours répétés est automatiquement placé sous curatelle ou tutelle (sans consentement, c’est renforcé)…
  6. Des mères se voient enlever leurs enfants immédiatement après la pose d’un diagnostic de maladie mentale ; jamais de scandale médiatique…
  7. On fait comprendre aux femmes en âge de procréer qu’il faut surtout adopter la contraception, en sous-entendant qu’on leur enlèverait leur enfant de toute façon. Ce qu’on ne leur dit pas, c’est que tous les neuroleptiques passent la barrière placentaire, c’est pourquoi j’ai entendu parler d’autant de cas d’avortements spontanés chez les femmes sous traitement. Dixit une infirmière, on donne de l’Haldol aux femmes enceintes, ce qui « prouverait » soi-disant « le peu de nocivité de l’Haldol » (!). Jamais d’étude là-dessus ni de scandale médiatique…
  8. Des services fermés qui regorgent de dépressifs qui ne sont pas en « péril imminent » et qui se sentent surtout mal de recevoir par exemple 4(!) antidépresseurs à la fois…
  9. Une cellule d’isolement toujours occupée (appelée « chambre de soins intensifs »!), ce qui participe du « folklore »…
  10. « Abonné une fois, abonné toujours » : les traitements qu’on ne peut plus JAMAIS arrêter ;
  11. Aucune étude à long-terme sur les effets des psychotropes…
  12. Aucun recours en cas d’abus psychiatriques (système interne de « médiation » caduc : mal vous en prend d’écrire une lettre au directeur de l’établissement…)

 

Pourquoi je suis contre ce nouveau système de « Juge des Libertés et Détentions » (relatif à la loi du 27 septembre 2013) :

On vous fait croire que c’est une voie de recours. Rien n’est plus faux, à part en cas de vice de forme (ce qui n’arrive quasiment jamais, puisque les psychiatres ont intérêt à ce que la procédure se passe en bonne et dûe forme). Au contraire, c’est un enfermement de plus…

  1. Le juge n’est pas psychiatre, il se garderait bien de remettre en question le jugement des médecins sur le fond. Par contre, on lui a expliqué que tout patient qui conteste le traitement est en « opposition », ce qui constitue déjà une preuve de « déni de maladie ».
  2. Les médecins y trouvent donc une voie bien pratique pour se décharger de leurs responsabilités, puisque « c’est le juge qui décide ». Et alors on voit défiler les patients dans le bureau du juge, accompagnés d’un soignant : « on vous amène Mme X »…
  3. On vous octroie un avocat commis d’office une semaine avant, mais qu’on ne peut pas contacter avant. Le jour de l’audience, c’est 15 minutes pour faire connaissance et se préparer, et ceci « dans les cases »…
  4. Ce qui est très alarmant, c’est qu’on ne trouve pas d’avocat en libéral, à part peut-être à Paris, et seulement pour un recours aux assises.
  5. Le juge prétexte qu’il ne peut lever le soin sous contrainte si c’est à la demande du directeur de l’établissement. Or, toutes les demandes de mise en soins sous contrainte passent par l’approbation du directeur. Tout le monde se donne bonne conscience, donc ;
  6. Une fois l’audience terminée (10 minutes), où l’on se voit déstabilisé, accusé et mis en doute, le juge « ordonne » le maintien en hospitalisation complète et de la mesure de contrainte, ce qui confère force de loi aux médecins (et donc une impunité totale) et SURTOUT donne encore plus de poids à la mesure.
  7. Inutile de préciser que si on était encore crédible avant, on ne l’est plus du tout et c’est définitif. Si on refuse de signer la feuille ou de comparaître, c’est pire, et on s’attire les foudres des médecins et du personnel soignant, qui vous mettent la pression, vous humilient et vous maltraitent. On ne peut pas non plus refuser que l’audience ait lieu.
  8. Le juge sait pertinemment qu’il s’agit d’une volonté potitique de faire taire les « récalcitrants » par voie chimique et coercitive. Il y adhère donc pleinement.

 

Pourquoi je suis contre les traitements forcés :

J’insiste sur le fait que les psychiatres hospitaliers ont les pleins pouvoirs sur le choix et le dosage des traitements, il ne s’agit JAMAIS d’un consentement éclairé. La « balance bénéfice-risque » est toujours de leur côté, même en cas de surdosage, même si la personne prend déjà 17 médicaments et pèse 200kg (ce qui est le cas d’une amie à qui on a donné Zyprexa ET Xeroquel suite à quoi elle a fait un accident vasculaire cérébral). Ils ne sont jamais responsables des effets secondaires non plus et vous orientent « gentiment » vers votre généraliste…

De plus, c’est toujours les médecins qui « décident » à votre place si vous allez bien ou non, et ce, même s’ils ne vous connaissent pas ou vous on vu seulement 5 minutes…

L’effet pervers de la chose, c’est que c’est tellement insupportable d’être enfermé et camisolé chimiquement qu’au bout d’un mois, on fait semblant d’aller mieux, on renie ses opinions et on arrête de se plaindre des effets secondaires pour pouvoir sortir, sous peine de se voir diagnostiquer en plus des « troubles du comportement » et un « déni de la maladie»…

 

J’AI ETE TORTUREE : au Zyprexa (surdosage), au Solian, au Tercian, au Risperdal (8 mg pour un poids de 50 kg), à l’Haldol (90 gouttes par jour) et « shootée » au Valium (40mg!)…

Le médecin et le personnel infirmier refusaient de prendre en compte : les troubles de l’élocution, tremblements, convulsions, dyskinésies, impatiences insupportables, angoisses mortelles, envie de mourir et tortures psychiques (« enfer » mental) qui ont apparu immédiatement et ont même empiré avec le temps. Je me suis battue en vain en plaidant que les neuroleptiques anesthésient la conscience, font perdre la mémoire, rendent docile et influençable, rendent dépressif et encore plus anxieux, affectent les capacités intellectuelles et détruisent l’âme.

J’ai également été mise plusieurs fois en isolement avec violences de la part du personnel ET des employés de la sécurité, alors que je n’ai JAMAIS été agressive. J’ai été mise sous contention, j’ai été déshabillée de force, j’ai été déshydratée, humiliée, bafouée, maltraitée…

Aujourd’hui, même si j’ai droit à un traitement moins inhumain, l’Abilify en injectable (après une 4ème tentative de suicide), je reste « accro » au Valium, traumatisée et toujours en alerte, dans l’angoisse de manquer à mes « obligations » ou de faire mauvaise impression, sans parler de l’absence totale de perspectives, de motivation et de joie dans ma vie, sans parler de ma vie affective qui est une misère (mort spirituelle, isolation, dépression, anxiété…).

Ma carrière artistique, qui avait débuté avec succès, a été définitivement brisée pendant mes meilleures années (la trentaine) et je suis aujourd’hui dans l’incapacité de créer alors qu’avant je foisonnais d’idées et me donnais les moyens pour les mettre en œuvre. Il est également trop tard et trop compliqué pour moi maintenant pour devenir mère.

Je vis dans la précarité à la charge de l’Etat.

 

Pourquoi j’ai toujours été opposée à leurs « diagnostics » pathologisants :

Je suis une personne ayant vécu les pires traumatismes dans la petite enfance (viols et abus, harcèlement), dont la plupart des souvenirs sont remontés plus de trente ans après, ce qui a grandement affecté mon équilibre psychique. J’ai malheureusement dû constater que, d’après les psychiatres (pour autant qu’ils m’aient crue…), il n’y aurait aucune relation de cause à effet entre ce que j’ai subi et mes troubles (!), ce qui est tellement énorme et risible qu’on aurait plutôt envie d’en pleurer…

J’ai pu constater, à l’instar de la Dre Muriel Salmona, seule psychiatre en France à ma connaissance qui aborde la souffrance psychique sous l’angle du trauma, qu’en France, aucune prise en charge spécifique n’est prévue ou proposée, et après 8 ans de psychiatrie, aucun médecin à ce jour ne m’a diagnostiqué un syndrôme de stress post-traumatique avec dissociation, ce qui pourtant devrait être le cas après des viols dans la grande majorité des cas selon la Dre muriel Salmona ( Association Mémoire Traumatique et Victimologie ). Je n’ai quasiment jamais pu faire de travail thérapeutique avec un psychiatre.

Quant à leur diagnostic de schizophrénie, il n’a jamais été étayé, expliqué ou argumenté, et mon dossier a été établi sur des « observations » des médecins et de simples « impressions » du personnel soignant… J’ai constaté également que parler de spiritualité conduisait immanquablement à un diagnostic de « délire mystique », donc, selon eux, de schizophrénie.

J’en conclus que l’enfermement et leurs mauvais soins n’ont fait qu’en rajouter à mes traumatismes, je ne crois pas un seul instant que leurs maladies imaginaires résultent d’un déséquilibre chimique dans mon cerveau ou d’une quelconque « maladie » biologique, je sais que les effets des neuroleptiques sont catastrophiques à long-terme et je suis totalement en accord avec de nombreux anti-psychiatres à l’international, dont le Dr. Peter Breggin, Joanna Moncrieff, David Healy, Robert Whitaker, Thomas Szazs, Peter Goetzsche et autres… (cf. le site madinamerica.com).

 

CONFORMEMENT À LA CONVENTION DES NATIONS UNIES SUR LES DROITS DES PERSONNES HANDICAPÉES, ARTICLES 12, 14 ET 15, TEL QU’INTERPRÉTÉ DANS L’OBSERVATION GÉNÉRALE NO. 1 ET LES LIGNES DIRECTRICES SUR L’ARTICLE 14, ET AUX PRINCIPES DE BASE ET LIGNES DIRECTRICES PUBLIEES PAR LE GROUPE DE TRAVAIL SUR LA DETENTION ARBITRAIRE DE L’ONU, PRINCIPE 20 ET LIGNE DIRECTRICE 20, JE PLAIDE POUR L’ABOLITION TOTALE DE LA PSYCHIATRIE COERCITIVE ET DES TRAITEMENTS FORCES.

JE REVENDIQUE TOUS MES DROITS A LA PERSONNE EN TANT QUE FEMME MAJEURE PROTEGEE, PERSONNE HANDICAPEE, EN PARTICULIER LE DROIT INALIENABLE DE DISPOSER PLEINEMENT DE MON CORPS ET DE MON ESPRIT SANS CHIMIE IATROGENE, DE MA LIBERTE INCONDITIONNELLE.

JE CONSIDERE LA PSYCHIATRIE INSTITUTIONNELLE ET SES PRATIQUES COERCITIVES COMME UN CRIME CONTRE L’HUMANITE, UNE ATTEINTE A LA DIGNITE ET A LA LIBERTE DE PENSEE 

Pink Belette, Mars 2016

 

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Psychiatry in France, NO-RIGHTS-ZONE (By Pink Belette)

A french patient under forced commitment makes her « audit assignment » as part of the campaign to support CRPD absolute prohibition of commitment and forced treatment

 

Why I am against commitment and forced treatment :

One could believe that, in the land of liberty, one is still entitled to his or her physical and moral integrity.

Experience proves it wrong. It is impossible for anyone to escape forced commitment (so-called « care on demand of a third party » or « imminent danger »).

It’s already a done deal if : one person asks for it (family, neighbour…), one is « not well », unsettled, agitated, « not stable », gets angry, is depressed, on the defensive, « in opposition », exuberant, emaciated, bulimic, shit smoker, drugged…

It is sufficient if one refuses hospitalization or a treatment for the doctors to relieve each other in order to enforce commitment. Once hospitalized, it is been made perfectly clear that one looses his or her personal rights, only argument is : « now we are responsible of you for EVERYTHING »… Thus, towards the « patient », nobody is responsible of anything…

 

Since the « Bachelot law » of July 5th 2011, particularly if one has something to object, be it diagnose or treatment, it is then after being out of hospital that one cannot get rid of commitment, which is most perverse : forced injections, mandatory appointments with an non-chosen clinical psychiatrist (or, best case, with a choice between two doctors).

And, worst of all : if one refuses to go to the assigned medical center of one’s district, the police comes to pick one up at home and rehospitalization is mandatory with an increased commitment that is even more coercive (« on demand of the State »), on a longer lapse of time and with no authorization to communicate with the outside (!) until they succeed to break one’s will and reduce one to nothingness… It so happens that people loose their home and « live » in psychiatry (sometimes for decades, see Dimitri Fargette’s case)…

 

I witness : in France, there is really matter to worry about… 

  1. There is no alternative to institutional psychiatry (lobbying of psychiatrists AND pharmaceutical industry against other forms of therapies) ;
  2. No antipsychiatric litterature nor culture (no « survivors »…)
  3. The « College of Psychiatrists » who suspends : every psychiatrist « not aligned » with this consensual system (according to Dr. O.G, liberal psychiatrist and former head of clinic);
  4. The « College of psychiatrists » suspending : a psychiatrist responsible for the death of a patient… only for two weeks (see the case of young patient Florence Edaine)
  5. The « Guardianship mafia » : every patient who is repeatedly hospitalized is automatically placed under guardianship under a certain degree (without consent, it is being reinforced…)
  6. Single mothers get their children robbed and placed immediately after a diagnosis of mental illness is established, never one scandal about this…
  7. Women in age to bear a child are being strongly recommended a contraception, with a wink that their child would be taken away from them anyway. What they are not being told is that all neuroleptics pass the placenta barrier, that’s why i have heard of so many miscarriages from women under treatment. A quote from a nurse : « pregnant women are given Haldol, which proves it’s little nocivity » (!). Never one study about that nor mediatic scandal.
  8. Closed wards full of depressive people who are not in « immediate danger » and are feeling bad mainly because they are being given for example 4 (!) antidepressants at a time…
  9. An always occupied isolation chamber (so-called « intensive care chamber »!), which participates to the « folklore »…
  10. « Once subscriber, always subscriber » : treatments one can NEVER withdraw from ;
  11. No long-term study on psychotropic medication… (All so-called studies are biased)
  12. No recourse in case of even flagrant psychiatric abuse (internal system of « mediation » obsolete : it’s a very bad idea to write a letter to the director of the institution…)

 

Why I am against this new system of « Judge of Liberties and Detentions » (related to the law of september 27th 2013) :

They are making believe it is a recourse. I was proved wrong, except for instance on a technicality (which almost never happens, because it’s in the psychiatrists’ interest that the procedure goes well and in due form). On the contrary, it’s in the sense of more legal coercion…

  1. The judge is no psychiatrist, he would never ever put into question the judgment of the physicians concerning the core. Thus, he has been briefed about the « fact » that any patient who opposes treatment is « in opposition », which establishes already a proof of « illness denial » (and as a proof of illness itself).
  2. Therein it has been found a very practical way for doctors to be discharged of their responsibilities, as « it’s the judge who decides ». And now, bunches of patients are being spotted filing up before the judges’ office, escorted by a nurse : « we bring you Ms. X »…
  3. Patients get a mandated advocate one week before the audience, but who cannot be contacted in advance. At audience day, it’s 15 minutes to meet and prepare, and, of course, in a « formated » way.
  4. Very alarming is the fact that no liberal advocate is to be found for psychiatric abuse pleas, except maybe in Paris, and mostly for a recourse before the Court of Assize.
  5. The judge pretends he cannot lift the forced commitment because it’s asked for by the hospital director. Yet, all demands for forced commitment have to be validated by the director. Hence everyone gives him- or herself a good conscience there ;
  6. Once the audience done (10 minutes), where one gets destabilized, accused and doubted of, the judge « orders » the maintaining of the person in complete hospitalization and of the measure, which confers force of law on the doctors (hence, total impunity).
  7. Not to mention the fact that if one still had credibility before, it’s no longer the case and irreversible. If one refuses to sign the convocation or to attend the audience, it’s worse, and one is being bullied by staff members and doctors alike, who put one under pressure, humiliates one… One also cannot refuse the audience being held despite of one’s absence.
  8. The judge knows pretty well that it’s a political will to make silent the « opponents » of the system, chemically and coercively. He therefore fully concurs with it.

 

Why I am against forced treatment :

I insist on the fact that hospital psychiatrists are almighty regarding the choice and dosage of treatments, it’s never about an « informed consent ». The « benefit- risk balance » is always on their side, even in case of overdosage, even if the person already takes 17 meds and weighs 400 pounds (which is the case of a friend to whom was administered Zyprexa AND Seroquel after which she had a cerebral attack with impairment). They are also never responsible for side effects and, in case of complaint, derefer to one’s generalist physician…

Thus, it is always them who « decide » on one’s behalf if one is well or not and this, even if they don’t know the person or have seen him or her only five minutes…

Perverse effect of the thing : it’s so unbearable being locked up and silenced chemically, that, after a month, one pretends to feel better, disavow his or her opinions and stops complaining about side effects in order to get out, knowing that otherwise one will be diagnosed behavioural troubles and « illness deny »…

 

I WAS TORTURED : with Zyprexa (overdosis), Amisulpride, Cyamemazine, Risperdal (8 mg for a weight of 100 pounds), Haldol (90 drops a day) and « shooted » with Valium (40mg!)…

The doctors and staff refused to take into account : speaking troubles, heavy trembling, convulsions, dyskinesia, unbearable akathisia, heavy existential fear, wish to be dead and psychical tortures (mental « hell ») which appeared immediately and even worsened as time went by. I fought in vain, pleading that neuroleptics anesthetize consciousness, occasion memory loss, make one docile and influentiable, make depressive and even more anxious, impair one cognitively and destroy the soul.

I was also put into solitary confinement several times with violences from the staff AND security agents, despite the fact I have NEVER been even agressive. I was put under contention, was violently undressed, dehydrated, humiliated, spoliated, mistreated…

Today, even if I get a « less inhumane » treatment – Abilify retard injection – (after a 4th suicide attempt), I remain addicted to Valium, traumatized and always on alert, fearing to miss my « obligations » or to make bad impression, without mentioning total absence of perspectives, motivation or joy in life, without mentioning my affective life that is a misery (spiritual death, isolation, depression, anxiety…).

My artistic career, which finally started with success has been definitively broken during my best years (in my 30′) and today I am totally unable to create despite the fact that before, I had thousands of ideas and was giving a great deal to put them into meaningful use. It is also too late and too complicated for me now to become a mother.

I live in precarity at the charge of the State.

 

Why I was always opposed to their pathologizing « diagnoses » :

I’m a person who endured the worst traumas in early childhood (rape and abuse, mobbing…), while most memories came up again more than 30 years afterwards, which greatly affected my emotional balance. I had unfortunately to experience that, according to psychiatrists (if they even believed me), there would be no cause-to-effect relationship between what I had to bear and my troubles (!), which I find so enormous and stupid that one would rather cry…

I had to notice, alike Dr. Muriel Salmona – only psychiatrist in France knowingly approaching psychical suffering under the perspective of trauma – that in France, no specific caretaking is being proposed nor planned, and after 8 years of psychiatry, not one physician has diagnosed me a post-traumatic stress disorder with dissociation which, according to Dr. Muriel Salmona (« Association Mémoire Traumatique et Victimologie ») is the case after rape and abuse.

I could almost never do a therapeutic work with a psychiatrist.

Regarding their diagnosis of schizophrenia, it has never been illustrated, explained or argumented, and my medical records have been established on mere « observations » from the doctors and sheer « impressions » from the staff…

I also came to the conclusion that to actually speak about spirituality would eventually always end in them diagnosing a « mystical delirium » and, as such, schizophrenia.

My conclusion is that their imprisoning and bad treatments have done none but to aggravate my traumas and personal issues, I don’t believe a second that their imaginary « diseases » result in a chemical imbalance in my brain or an unknown « biological » illness, I know that neuroleptics and affiliated meds are catastrophic in the long-term (causing brain damage) and I totally agree with numerous anti-psychiatrists internationally, such as the Drs. Peter Breggin, Joanna Moncrieff, David Healy, Robert Whitaker, Thomas Szazs, Peter Goetzsche and others… (see on madinamerica.com).

 

IN ACCORDANCE WITH THE UNITED NATIONS CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES, ARTICLES 12, 14 AND 15, AS INTERPRETED IN GENERAL COMMENT NO. 1 AND THE GUIDELINES ON ARTICLE 14, AND WITH THE BASIC PRINCIPLES AND GUIDELINES OF THE UN WORKING GROUP ON ARBITRARY DETENTION PUBLISHED IN 2015, PRINCIPLE 20 AND GUIDELINE 20, I SPEAK IN FAVOUR OF ABSOLUTE PROHIBITION OF COERCIVE PSYCHIATRY AND FORCED TREATMENT.

I RECLAIM ALL MY RIGHTS TO PERSONHOOD AS A DISABLED ADULT WOMAN UNDER PROTECTION, IN PARTICULAR THE INALIENABLE RIGHT TO DISPOSE ENTIRELY OF MY BODY, MIND AND SOUL WITHOUT IATROGENIC CHEMICALS AND MY UNCONDITIONAL LIBERTY.

I CONSIDER INSTITUTIONAL PSYCHIATRY AND ITS COERCIVE PRACTICES A CRIME AGAINST HUMANITY, A SEVERE HARM TO DIGNITY AND TO FREEDOM OF THINKING.

 

Pink Belette, March 2016

 

 

Eveline Zenith – Freedom From Religion

Freedom From Religion: Campaign to Support CRPD

http://muddledtranslation.blogspot.no

Freedom of Religion, Freedom from Religion: A Psychotherapy Survivor’s Account of Unravelling the Colossal Irony

By Eveline Zenith

Our freedom to believe and practice as we choose is correlated with the core values of liberty and autonomy. The Canadian Charter of Rights and Freedoms protects our rights by stating that everyone has freedom of conscience and religion; also, religious belief cannot be preferred to non-belief. In the United States, freedom of religion is constitutionally protected in the First Amendment, and is associated with the separation between church and state.

Freudian psychoanalysis is a religious ideology that has absolutely no relevance in my life. I can only say that now I have researched it in depth, and this has been no simple task. Finding information about this clandestine methodology required: hours of detective work; a small fortune of books; under-cover attendance at a psychoanalytic seminar; six months of email correspondence with a psychoanalyst; intensive abuse recovery; jumping through every possible hoop in the system… and it remains today irredeemable. I did all this in order to regain sanity after therapy; my mind became so scrambled I had to abruptly discharge myself from the transaction. I am staggeringly aware of how lucky I am.

I had a nervous breakdown and began constantly re-living the bizarre statements my analyst had said to me. They were all vague and stated in a slow hypnotic tone, by a man who had been presenting as a “blank slate”. I had absolutely no familiarity or understanding of him: his intentions, beliefs, or personality. With sheer terror I would wake at 3am… trembling, eyes watering, remembering his intense staring, cutting words, sadistic glee, and condescending manner. There were other times when I felt bonded with him, that he cared, that he was a spiritual guide. The cognitive dissonance alone was torture enough to drive me insane!

Once I went “no contact” all my illusions disintegrated; I became appallingly aware of the prospect that he had deliberately abused me. He has the power, the education, and the techniques at his disposal to really screw me just for kicks. The research I have done on emotional abuse is a succinct match to the so-called techniques; I was vulnerable and had no idea what I was consenting to. He would simply shift the goalposts whenever I grew wise; he’d divert to blaming my hyper-vigilance and trust issues.

I never imagined I would have to defend my human dignity to an institution that is supposed to protect me, or that they would dismiss my testimony and actually try to silence me. The greatest, deepest betrayal was that it was an endeavour to heal from childhood abuse. That therapist held the keys to my most defenseless wounds and senselessly battered them. There is still no accountability on behalf of the profession: either this is considered permissible, or this practitioner needs to be corrected.

I have learned that Freudian psychoanalysis – perhaps psychotherapy on the whole – holds the absolute belief that the pathological relationship will inevitably re-enact. What this means is that if you were abused before, you will re-experience it in therapy and be re-traumatized. I have not yet found anyone in the field who will explain in plain language how this works; it makes no rational sense. This is an accessibility issue. Not only is it illogical, it is downright heinous without mandatory informed consent. Currently, the authorities assume on good faith that the practitioner will inform the client. If you have any knowledge of the world of predators, abuse, and exploitation, you will know this is a loophole for corruption. Also, if you don’t understand this is the process, you will only experience your therapist as your abuser and hopefully get out of it like I did!

There is no therapeutic value in having your spiritual guide manifest as your worst nightmare unless there is a therapeutic alliance; this can only be forged through informed consent every step of the way. Sex, boxing, and psychotherapy are similar: if one person isn’t participating it’s a crime. Psychoanalysis believes practitioners can subject us to treatment because they feel we need it; they have a plan for us, but they don’t reveal it. There are plenty of ethics seminars where theories are discussed about what’s good or bad for clients, but no actual observance of human rights is mandated. The entire “treatment” goes on in complete privacy, with biased accounts of clients’ “transferences” scratched on notepads for billing purposes. I never consented to any transference; I assumed everything was in the here and now. All of this religious interpretation was done behind my back so there was no way I could refute it, question it, challenge it, or even benefit from it. I have searched far and wide in a vast wilderness of possibilities, finally concluding that my practitioner is delusional, sadistic-aggressive, lacks empathy, and has no substantive reasoning for any of it besides money and control. This conclusion is the reason I am alive and well today.

The imperative reason I advocate for the absolute prohibition of coercive treatments is because this harm is done to the previously harmed, vulnerable, and voiceless members of our society. These are people who have had cruel, devastating, and heinous things done to us; large parts of our bodies and souls have been murdered. Even with all the agency I possess, I can’t get through to anyone on the other side of the door. The lack of education and total absence of conversation about abuse in the mental health profession is criminal negligence, considering that is the number one reason people use these services. Although the Code of Ethics for Psychiatry explicitly states informed consent, I am told by the authorities I consented simply by being there.

In terms of CRPD principles, although many sections address aspects of this problem I focus on sections 14 through 16:

Article 14: Liberty and security of the person 

  1. States Parties shall ensure that persons with disabilities, on an equal basis with others:

(a) Enjoy the right to liberty and security of person;

(b) Are not deprived of their liberty unlawfully or arbitrarily, and that any deprivation of liberty is in conformity with the law, and that the existence of a disability shall in no case justify a deprivation of liberty.

  1. States Parties shall ensure that if persons with disabilities are deprived of their liberty through any process, they are, on an equal basis with others, entitled to guarantees in accordance with international human rights law and shall be treated in compliance with the objectives and principles of this Convention, including by provision of reasonable accommodation.

Article 15: Freedom from torture or cruel, inhuman or degrading treatment or punishment 

  1. No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. In particular, no one shall be subjected without his or her free consent to medical or scientific experimentation.
  2. States Parties shall take all effective legislative, administrative, judicial or other measures to prevent persons with disabilities, on an equal basis with others, from being subjected to torture or cruel, inhuman or degrading treatment or punishment.

Article 16: Freedom from exploitation, violence and abuse 

  1. States Parties shall take all appropriate legislative, administrative, social, educational and other measures to protect persons with disabilities, both within and outside the home, from all forms of exploitation, violence and abuse, including their gender-based aspects.
  2. States Parties shall also take all appropriate measures to prevent all forms of exploitation, violence and abuse by ensuring, inter alia, appropriate forms of gender- and age-sensitive assistance and support for persons with disabilities and their families and caregivers, including through the provision of information and education on how to avoid, recognize and report instances of exploitation, violence and abuse. States Parties shall ensure that protection services are age-, gender- and disability-sensitive.
  3. In order to prevent the occurrence of all forms of exploitation, violence and abuse, States Parties shall ensure that all facilities and programmes designed to serve persons with disabilities are effectively monitored by independent authorities.
  4. States Parties shall take all appropriate measures to promote the physical, cognitive and psychological recovery, rehabilitation and social reintegration of persons with disabilities who become victims of any form of exploitation, violence or abuse, including through the provision of protection services. Such recovery and reintegration shall take place in an environment that fosters the health, welfare, self-respect, dignity and autonomy of the person and takes into account gender- and age-specific needs. 
  5. States Parties shall put in place effective legislation and policies, including women- and child-focused legislation and policies, to ensure that instances of exploitation, violence and abuse against persons with disabilities are identified, investigated and, where appropriate, prosecuted. 

Unravel edit

Christian Discher – The forgotten and the “Hell in Ueckermünde”

The forgotten and the “Hell in Ueckermünde” [Die Hölle von Ueckermünde] Has anything changed in German Psychiatry’s since the wall came down?

http://inklusionspolitik.de/en/the-forgotten-and-the-hell-in-ueckermunde-die-holle-von-ueckermunde-has-anything-changed-in-german-psychiatrys-since-the-wall-came-down/

by Christian Discher

In Germany, politicians and social research institutes campaign under the claim that we live in a society, in which all people are to be included: older people and people in need of care; disabled people; women; homo- and transsexual people, as well as transgender people; children; the sick; men; and immigrants. Universities receive millions of euros in funding, so that they can begin and maintain research projects focused issues facing “inclusion“. However, due to the mighty cleave between theory and reality, results in research rarely become established practical behaviors or values. Still, a closer look at the concept of inclusion makes it clear: Germany has a long way to go before it can be considered an inclusive society. In the debate over discrimination and exclusion (Inklusion/Exklusion: Stichweh 1997), the public receives hardly any information about the fate of those who, due to a particular psychological disturbance, are forced to live in psychiatric wards. Mainstream media does occasionally report on particular offences, when an acutely ill person is institutionalized. Nonetheless, the difference between mentally ill criminals and mentally ill people is not highlighted. (legal foundation) Meanwhile, depression and eating disorders are widely recognized. Such is as well the case with schizophrenia only with the difference, that the schizophrenic, after being released from treatment, is rarely able to find a place in our society. The latter are those who make us anxious on the subway with their loud announcements the stalking methods of secret government services or CSI. Others beg and attempt to convert their audience. An honest question: who, when confronted with such people in the bus or on the street, doesn’t feel anxious?(Discher: 2015) That the diagnosis of schizophrenia or psychosis – now known to be rooted in a diseased metabolic system – leads to paranoid thoughts and socially inacceptable behaviors, […] Clarification is not provided by mainstream media. Yet, in the case of many diagnosed schizophrenics, this diagnosis is ungrounded. As C. was seventeen years old, he was treated in the intensive care unit at the psychiatric and psychotherapeutic clinic in Ueckermünde. Stettiner Haff (August 2014) Bild 1 In 1993, when the ARD compromisingly distributed the report, Die Hölle von Ueckermünde Hell in Ueckermünde [by Ernst Klee]  the media reacted aggressively. (Moussavian) The inhumane involuntary commitment in the psychiatric wards that took place in this period of the GDR called for worldwide shock and chagrin. What was more horrifying? The argumentation of interviewed personnel or the forcible commitment of human beings? Or was it the terrified men, who had not seen light for years and were showcased to the public without prior consent? Investigative journalism at whose cost? In 2014, on the 25th anniversary of the fall of the Berlin wall, people celebrated their newly won freedom. But what had become of those, who experienced Ueckermünde, and how is it with those, who are being treated their today? Ueckermünde, a small city at Stettiner Haff touts its “inclusivity” projects. On the website of a regional politician (Dahlemann: 2013), to following goal is heralded: “The beginning of an inclusive region [at the Stettiner Haff” “Many were already there in Bürgersaal. Whether Kulturspeicher or Kleeblattchule Anklam, politicians like Patrik Dahlemann, or regular people – they were all there in order to drive the project forward. Hopefully, it will then become concrete, so that many ideas like that of market for leisure activities, carpooling center, consulting center, among others, will be able to be better implemented and ‘inclusion on the backwater‘ will be brought to life.” The mission is expressed honestly, in words that include everyone. Nevertheless, the number people who retire early in Germany on account of psychological illness is increasing dramatically. In opposition to other German states, the number of mental illnesses in Mecklenburg-Vorpommern increased 102% between 1997 and 2011. The number of in-patients being treated grows at a steady rate. In plans for the further development of an integrative aid services for psychologically ill persons in Mecklenburg-Vorpommern, attempts are made to react to structural problems. There are even discussions about interdisciplinary collaborations. During this negative development, the role and responsibilities of those who are active in systematic psychiatric clinics is not questioned. But how do those people fare, who are placed in House 12, a clinic on the edge of Ueckermünde? On a sign at the Ravenstein St. exit, the way to the center for forensic psychiatry as well as to Kita Morgenstern is described.

Wegweiser zur Klinik für Forensische Psychiatrie und Psychotherapie

Further information leads the visitor to the AMEOS hospital complex. The clinic for psychiatry, psychotherapy, and psychosomatic treatment, which is located at 23 Ravensteinstraße, is not mentioned. Before the interested person can find a proper description of the way to the clinic, he or she must first conduct fairly extensive internet research. On its modern web page, the hospital appeals to its 130 year old tradition and gives a detailed presentation of its guiding principles. With 87 in-patient beds, 6 wards, an ambulance, as well as five different treatment options in the day-clinic, the hospital offers enough space for a large number of patients. Modern methods of diagnosis and responsible doctors rounds out the presentation. Since the end of the Second World War, the institution had been reformed. (Cf. Seiffert: 2010).

“Normal psychologically ill” patients as well as the mentally retarded were brought into either red brick buildings or an old socialist construction. Signs that are for orientation say “open and closed integration“ guide you to the buildings. What do the terms integration and inclusion have in common? Across from House 40 is a landing. It is a concrete construction from the socialist era –desperately in need of cleaning – that, in 1997 and for some years thereafter, was still being used in 1997 as an open ward. Today, it is used as dormitory space for disabled people; children play soccer, unconcerned and joyful. The kindergarten Morgenstern is walled in, surrounded by dilapidated shanties that are used as storage spaces. Barbed wire walls tower behind the kindergarten. A sports field, monitored by countless video cameras. Not too far away, at 15 Ravensteinstraße, is the hospital for forensic psychiatry and psychotherapy. With its impressive architecture and reedy ponds, it could easily be mistaken for a vacation spot, if one overlooks the security cameras. Is the latter really a proper place for the rest and recovery of children, patients, and disabled persons, a proper place for the new form of “inclusion” in Ueckermünde? Are the patients and residents given a modern place for sports activities? No. In 1997, at the age of 17 years, C. was checked into House 12, the ward for acute psychiatric illnesses in Ueckermünde. He was just about to complete his Abitur , a high-school examination in Germany, as he suddenly faced a personal identity crisis. Homosexuality, a young love affair, and exclusion in his social environment; problems with his parents. Inner changes and experiences, common among adolescents. In order to help himself come through these developments, he turned to god, began to pray regularly and trust his inner voice. Through conversations with helpful friends, C. searched for a way out of this life-crisis. It was to no avail. His way was impeded by too many of the difficulties and realities of growing-up. He then sought support from a female pastor. He sat across from her, crying, and listened to the advice he would eventually follow: he should check himself into the clinic in his home city. That time, he wasn’t offered alternatives. That he had lost a massive amount of weight in the weeks before he checked in to the clinic played no part in any of the conversations. As he came to the hospital, C. had no idea that he was in the psychiatry ward. It was a bad time. He wanted to display himself honestly, to stand by his homosexuality. He undressed and waited in the corridor of the ward. He realized quickly, however, that this was no way to solve his problem. He calmed himself down but still could not understand that the doors of the ward were locked. He was not used to being shut in, and he felt completely closed in. No one questioned him about his problems; no one noticed the life crisis. At the entrance to the lavatory, he suffered a hemorrhage, that would eventually lead to his downfall. The cleaning of the lavatory and his body cost time. As he made his way back to his room, nurses and doctors were waiting in the corridor. Insecure in front of the crowd, he pushed one to the side, excusing himself with the words, “You made me anxious.” No one knew about his problems and painful stomach illness. His behavior led to his institutionalization at the acute psychiatric ward in Ueckermünde. Discher (2015).

Extract of an Interview with C. “As soon as I got there, someone gave me medication, and I was fixed in 24 hours. The assistant to the doctor assured me, “Don´t worry, you won´t remember the time here”. “I wasn’t addressed to as “Mr.”, but as “Ms.” … After my first day in the acute ward I couldn’t speak anymore. Walking and moving around were as good as impossible. I would need two years until I could say a normal sentence again, and I would need more than five before I could return to my life. But that had nothing to do with the diagnosis I received: I had to recover from the treatment itself. I don’t think I need to tell you that this didn’t get any better after my release from Ueckermünde. I got to know a bunch of people. Many of them are dead; they killed themselves. I wanted to do it, too, yet somehow I knew, that I would make it. “Today I’m married. Despite all of the written attestations of my “below average intelligence”, “boundless hubris – particularly concerning life plans”, and my “immaturity and naïveté”, I  passed my Abitur and later I finished my studies at university. Now I have a job with responsibility and I have both feed on the ground. Out of all of my relations, only my closest friends know about my experience at Ueckermünde … and how I can’t help but remember my stay, every day, every word of it. Everything.” “I have yet to meet someone, who, after their stay in House 12, managed to get their life back together. Either they’ve got a pension, or they aren’t around anymore.”

How should the “normal person” understand the abnormal if no clear distinction is made between forensic psychiatry and the common clinic for psychiatry, psychotherapy, and psychosomatic? Who would have believed C. after his stay in House 12? Who would have even checked if the measures, which stripped him of his freedom, were justified?Judges aren’t doctors. When making decisions, they rely on the testament of medical experts. What goes on behind closed doors is typically controlled by the state and not subject to criticism. General standards make sure that there is consistency and verifiability. Tied up, untied, time to get up.

The lost identities and life goals are lost to the place, that was meant to heal them. I have spoken with countless individuals. Only after long and detailed searches in the internet can one become acquainted with the terrifying life histories which are inseparable from modern forms of psychiatric treatment. Bernd Seiffert from NRW. Thomas Juritz, Olaf L., Mario Hagemeister from Rostock. They are no longer among us. Ueckermünde and the fates of people with psychiatric illnesses are harldy mentioned in publically broadcast legal. After the therapeutically accompanying in Ueckermünde, one is thrown back into life, into the self-help and support groups, into assistant living, or—under the cloak of “inclusion”—into a sheltered workshop? Although people hear about the events in these hospitals, they never really learn about them. Only when they are affected can they afford a look into the inside workings of the red brick buildings. There is no way back. They have been permanently away from life.

These types of clinics create illnesses, psychosis, a metabolic illness of the brain, is not single-handedly responsible for the inability of patients to reenter their lives. If family members with psychosis feel themselves overwhelmed and rely on the advice of professionals, the story of C. will become commonplace. Today, everyone feels a personal connection to talk about depression. Depression has arrived in our society. Do people outside really know what it means to be taken over by deep sadness, avolition, or an urge to suicide? Or is “depressive” merely used as a popular word, because our society is too unreflective?  In this context, clinics are not discussed as much. Nowadays, who would be excited to go to a psychiatrist and get a prescription? These types of forcibly commitment and methods of treatment for younger and older people in Ueckermünde relegate the psychiatry’s to the shadows, that pay effort for a reorientation in medical and health care. Professions with leap of faith: the entire staff, composed of doctors, psychologists, social workers and consultants, that is, those whose level of trustworthiness is much greater than that of the psychologically ill. There is no chance of a collapse. Not only is that red brick building part of the complete system of our society, but the people that work there and go about their business as servants of the everyday, keep it alive. Outer facades and inner building structures are easily renovated. People and their way of thinking are not. Perhaps it is time for the 130 year old tradition of the psychological clinic to reveal its inner workings to the eye of the public.

We are searching for the way toward “inclusion”, that is, toward a society that is open and inclusive for everyone. Meanwhile, this word— “inclusion”—is a lovingly used in-word that sparks the interest of the public and propels politicians in their campaigns, but ultimately forgets the people who are left because no one is lobbying for them. “Inclusion” is a perfectly valid term in scholarship. It is wonderfully suited for raising millions of euros for research projects, the results of which are often not applicable in practice. Those who teach the concept of “inclusion” rarely think it out to its end or represent it practically. Those who actually campaign for “inclusion”, as they happily fulfill their contracts and are kept satisfied by their acting and remain in silence. (Discher 2015)

Bibliography

Thanks B. for your  support.

Adresse Kita Morgenstern: Christophorus Tagesstätte Kita Morgenstern, in: http://www.kita-portal mv.de/de/tageseinrichtungen/kitas_in_m_v/kitas_in_m_v_kita_profil&kitaid=66 (27.01.15).

AMEOS Klinikum: Klinik für Psychiatrie und Psychotherapie Ueckermünde: Ravensteinstraße 23, in: http://www.ameos.eu/1638.html (27.01.2015).

AMEOS Klinikum für Forensische Psychiatrie und Psychotherapie Ueckermünde. Ravensteinstraße 15a. Ueckermünde 17373. Deutschland. in: http://www.ameos.eu/forensik-uede.html(27.01.2015). Auszug aus dem Bericht Sicherheit und Gesundheit. Schwerpunkt psychische Erkrankungen, in: http://www.baua.de/de/Informationen-fuer-die-Praxis/Statistiken/Schwerpunkt/Psyche.html (10.01.2015)

Antwort der Bundesregierung auf die Kleine Anfrage der Abgeordneten Dr. Martina Bunge, Dr. Ilja Seifert, Diana Golze, weiterer Abgeordneter und der Fraktion DIE LINKE. – Drucksache 17/10576 – Zwangsbehandlungen in Deutschland, in: http://dipbt.bundestag.de/dip21/btd/17/107/1710712.pdf

Autor unbekannt: Tod in Rostock, in: http://www.todinrostock.de.(27.01.15).

Bundesanstalt für Arbeitsschutz und Arbeitsmedizin: Auszug aus dem Bericht Sicherheit und Gesundheit. Schwerpunkt psychische Erkrankungen, in: http://www.baua.de/de/Informationen-fuer-die-Praxis/Statistiken/Schwerpunkt/Psyche.html (10.01.2015)

Dahlemann, Patrick. 2013: Startschuss für eine inklusive Region am Haff: http://patrick-dahlemann.de/nk-startschuss-fur-eine-inklusive-region-am-haff/(10.01.2015). Die Hölle von Ueckermünde, in: https://www.youtube.com/watch?v=odtM4k9H4k4&spfreload=10.

Discher, Christian. 2015: Die Übriggebliebenen (in Vorbereitung).

Klee, Ernst, in: http://www.fischerverlage.de/autor/Ernst_Klee/2830 (27.01.15).

Mecklenburg Vorpommern. Ministerium für Arbeit, Gleichstellung und Soziales Plan zur Weiterentwicklung eines integrativen Hilfesystems für psychisch Kranke Menschen in Mecklenburg-Vorpommern, in , http://www.regierung-mv.de/cms2/Regierungsportal_prod/Regierungsportal/de/sm/_Service/Publikationen/index.jsp?publikid=4665

Moussavian, Sima: Die Hölle von Ueckermünde- Inhalt.in: http://www.helpster.de/die-hoelle-von-ueckermuende-inhalt_207544 (27.01.2015).

Netzwerk für Inklusion am Stettiner Haff, in: http://www.inkaha.de/index.php/component/content/category/33-website(10.01.2015).

Neurologen und Psychiater im Netz: Psychosen. Krankheitsbild. Herausgegeben von Berufsverbänden und Fachgesellschaften für Psychiatrie, Kinder- und Jugendpsychiatrie, Psychotherapie, Psychosomatik, Nervenheilkunde und Neurologie aus Deutschland, Österreich und der Schweiz, in: http://www.neurologen-und-psychiater-im-netz.org/psychiatrie-psychosomatik-psychotherapie/stoerungen-erkrankungen/psychosen/krankheitsbild/(27.01.15).

Seiffert, Bernd. Sein Trauerblog, in: http://psychiatriekritikerberndseiffert.blogspot.de. (27.01.15).

Seiffert, Bernd.2010: Das Verbrechen der Psychiatrie. Eine Zusammenfassung von Bernd Seiffert, in: http://www.meinungsverbrechen.de/wp-content/uploads/2011/03/Die-Verbrechen-der-Psychiatrie_02_2010.pdf (27.01.15).

Stichweh, Rudolf.1995). Inklusion/Exklusion, Differenzierung und Weltgesellschaft. Anmerkung des Autors: „Erweiterte Fassung eines Aufsatzes, der zunächst in Soziale Systeme 3, 1997, 123-136, erschienen ist. Der Abschnitt V ist neu hinzugefügt“, in: http://www.fiw.unibonn.de/demokratieforschung/personen/stichweh/pdfs/17_36stichweh_6.pdf (27.01.2015).

Workfare coercion in UK – Anne-Laure Donskoy

Workfare coercion in the UK: an assault on persons with disabilities and their human rights

Anne-Laure Donskoy_Survivor researcher, UK

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While there is a lot of focus on coercion organised and implemented in psychiatry, less attention is being paid to state engineered welfare measures based on libertarian paternalism1, which have coercive practices at their core. Among them are policies that strongly support behavioural change using positive psychology and cognitive behavioural therapy. Freidli and Stearn (2015)2 call this “psychocompulsion”. These policies and measures are increasingly used to ambush and coerce persons with disabilities and the long term sick into adopting new ways of being and living conditions under the constant threat of sanctions and which have driven many to attempt to their lives. This paper builds on the work of Friedli and Stearn3 as an attempt to highlight current coercive welfare policies, including forcing ‘therapy’ on individuals, as human rights violation of the CRPD.

 

Background: Psychocompulsion as state sponsored human rights violations

Psychocompulsion, the use of psychological strategies to “nudge” individuals to make “life changes” that fit a political ideology or programme, is not entirely new to the UK. Already in the 1970s, some long term job claimants would be sent for a medical examination, on the premise that if people were not physically ill then they should be able to find and take up work, any work. This had all the flavours of Victorian paternalism written all over it. The ‘mentally disordered’ and the ‘mentally handicapped’ experienced a particular brand of paternalism, hidden away from society and from consciousness in specialist homes and services, often suffering physical and mental abuse or used in rehabilitation work with little or no protection.

Today, psychocompulsion in the UK has been promoted by the Behavioural Insights Team (nicknamed the “Nudge Unit”), now in private hands as a social purpose company but still working closely with the Cabinet Office4, thereby guaranteeing prime influence on policy making. It is clear that psychocompulsion is being used to lock individuals, including the long term unemployed, the sick and persons with disabilities, into back-to-work schemes as a conditionality of welfare. In recent months and weeks, voices of dissent have arisen mostly from social movements, denouncing the use of coercion which put people’s lives at risk5.

As Friedli and Stearn’s paper show, this finger wagging attitude has taken on a far more sinister slant.

First, it turns on its head the idea that unemployment is the product of a failing economy by strongly suggesting that it is a state of mind, worse still a ‘mental illness’ that can be corrected by changing the psychology of claimants, thus placing the onus of responsibility for success, for betterment, for choice etc. on the individuals themselves. This totally ignores issues of social (in-)justice.

Second, it widens the scope by netting in the most vulnerable people in society, specifically the long term sick and those with disabilities, including psychosocial disabilities. This strategy narrowly avoids attracting full-on accusations of discrimination by putting these individuals on par with the long term unemployed and by stressing ad nauseam that the policy is about helping people which should be achieved through (any type of paid) employment. Paid employment becomes the embodiment and the “pinnacle of human experience”.6

Third, the underlying premise that ‘work is good for you’ ignores those dissenting voices which argue that without strong provisos (taking into account the complexity of individual circumstances, choice, timeliness, appropriateness as much as the quality of support and work on offer) the argument is both unhelpful and counterproductive7, and can have devastating consequences for those concerned.

Finally, the stance of the policy totally fits within the libertarian paternalism agenda which moves away from collective to total individual (libertarian) responsibility, slowly realising Ayn Rand’s vision for a permanently productive (and permanently disposable/replaceable) workforce serving an elite. In this scheme, all coercive strategies acquire a legitimacy that the psychiatric survivor movement rejects.

 

Being ill or disabled, and on welfare benefits: state coercion and the CRPD

The Welfare Reform Act 2012 introduced a wide range of reforms to the benefits and tax credits system. The stated aim was to reduce the financial burden of the cost of welfare. This is being achieved by introducing ever drastic and punitive policies under the guises of a responsibilisation agenda, underpinned with an intense authoritarian ideology not seen or experienced since Victorian times. The Tory manifesto of the 2015 general elections claimed it aimed to help people with mental health issues back in to work. The reality is very different and people with mental health issues clearly face discriminations which other groups do not.

 

Article 4: The rights and freedoms of persons with disabilities are violated under the social security scrutiny regime:

When people with mental health issues are on welfare benefits, they find themselves the object of intense, intrusive and inappropriate scrutiny by the system, notably through the Work Capability Assessment (WCA) which has consistently failed these claimants as it is totally unsuited to their singular predicaments and experiences. As a result, more and more people are placed on the Work Related Activity Group of the Employment and Support Allowance which comes with strict conditionalities. Also affected are those under the new Universal Credit (UC) system which is being rolled out for all benefits claimants which places yet another layer of scrutiny on individuals, possibly more so those in work.

 

Article 1-5: Discrimination

A judicial review in 2013 found that the WCA process actively discriminates against people with mental health issues. Since then very little has been done to change the process and the status quo remains.

The Centre for Welfare reform, in its recent report A Fair Society?, also shows that persons with disabilities are targeted the most despite the fact that they have the greatest and often most complex needs.

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Article 10: Right to life: “States Parties reaffirm that every human being has the inherent right to life and shall take all necessary measures to ensure its effective enjoyment by persons with disabilities on an equal basis with others”.

A poll of over 1,000 GPs commissioned by Rethink Mental Illness in 2015, found that over 20% have patients who have felt suicidal due to the WCA8.

In a report sent to the Department for Work and Pensions (DWP), the senior coroner for inner north London, Mary Hassell, said “the trigger” for the suicide was the man being found fit for work by the department”9.

[A Freedom of Information request has] revealed that the Department for Work and Pensions (DWP) has investigated decisions, via peer reviews, about the welfare payments of 60 claimants following their deaths. A peer review, according to the DWP guidance for employees, must be undertaken when suicide is associated with DWP activity to ensure that any DWP action or involvement with the person was appropriate and procedurally correct.10

 

Article 13: Access to justice: 13.1: “States Parties shall ensure effective access to justice for persons with disabilities on an equal basis with others, including through the provision of procedural and age-appropriate accommodations, in order to facilitate their effective role as direct and indirect participants, including as witnesses, in all legal proceedings, including at investigative and other preliminary stages.”

Benefit claimants who wish to appeal a decision need access to justice. This represents an expense they can ill afford (if at all) therefore need access to legal aid. However, the Ministry of Justice has removed welfare benefits matters from the scope of legal aid funding, thereby denying access to justice and discriminating against the most vulnerable and poorest, among whom people with mental health issues:

In order to challenge a decision of a First-tier Tribunal (FtT) the appellant needs to identify an error of law in the FtT’s decision and then request permission to appeal to the Upper Tribunal (UT). The process of appealing on a point of law to the UT has two stages, but, for the reasons set out below, the legal aid contract only covers the second stage … The absence of any legal aid at Stage One of an appeal to a UT on a point of law represents a major flaw in the current scheme as it is simply unrealistic to expect an appellant to draft an appeal on a point of law without any assistance.11

In the future, social security claimants who find themselves faced with an incorrect Upper Tribunal decision, or who win their case at the Upper Tribunal but find themselves on the receiving end of an appeal by the DWP12, HMRC13 or a local authority, could be facing the courts and the costs risks attached on their own or not at all.14

In practice, benefit claimants who wish to appeal decisions have to resort to charitable organisations to support them through the process. However these are seeing their funding cut, or they are not coping with increasing number of calls for help.15 There has also been some criticism from within the legal system with regard to persons with intellectual disabilities on matters of legal representation regarding privation of liberty; the same issues also apply to persons with psychosocial disabilities:

The Law Society, which represents solicitors throughout England and Wales, intervened [in a particular case]. Its president, Jonathan Smithers, said: “When a vulnerable person doesn’t have friends or family to represent them during a decision to restrict their liberty, it is vital that person is able to participate in the decision-making process . . . If this is not possible then they must have a legal representative to protect their rights as well as their health and general welfare. Those who are least able to defend themselves should not be sacrificed on the altar of austerity.” 16

 

Actively changing the narrative of workfare and welfare benefits

The narrative of welfare is changing drastically. As Friedi says, we are moving from a “what people have to do [to find work] to what they have to be [demonstrating the right attitude to be employable]17. This is exemplified through the new ‘Work and Health Programme’ planned to be rolled out in England and Wales.

This programme has many strands, including:

−   Embedding psychological services within Job Centres

−   Placing ‘job coaches’ within GP surgeries for people with certain conditions (specifically people with mental health issues): the ‘Working Better’ pilot scheme is funded by the Department for Work and Pensions and the coaches will be provided by welfare to work agency, Remploy (a welfare-to-work subsidiary of the Maximus).

12325145_10153490835113527_1349725544_n

 

This programme blurs the boundary between health and welfare, health and work domains, in a way that has not happened before. This is a coordinated move to effectively bring in the benefits system within NHS care: joblessness, being unemployed becomes an illness, specifically a mental illness which needs to and care be cured through psychological therapies.

It will not only extend benefit conditionality into the NHS but also compromise clinical independence and clinical ethics. In practice, people who display the wrong attitude to work, to work placements or who have been unemployed for a long time will be referred to psychologists and given forced Cognitive Behavioural Therapy, and be sent many motivational emails and text messages throughout the week; or they will be prescribed referrals to an in-house ‘job coach’. Failure to comply with these forced prescriptions will trigger an immediate sanction regime. This will inevitably threaten if not destroy that first quality that patients place in their doctor, trust. People may become reluctant to say anything whether it is about their situation or their health for fear of being forced into the schemes.

 

CRPD violations:

Articles 1-5: (equality, choice, autonomy, capacity)

Persons with disabilities are specifically targeted by the new measures

 

Article 25 (Right to health):

Currently both schemes are in the early stages of being rolled out (pilot stage) and the official line claims that they are voluntary. However, as the Tory manifesto stated “We will help you back into work if you have a long-term yet treatable condition”, this is set to become compulsory: “People who might benefit from treatment should get the medical help they need so they can return to work. If they refuse a recommended treatment, we will review whether their benefits should be reduced.”(p. 28). However, being forced to receive “therapy” for a “treatable condition” is not the same thing as being offered support, which would imply that the individual is free to choose to take it up or not. Most observers agree that what is currently taking place on a voluntary basis as part of the pilot projects will become compulsory, which would only follow the UK Government’s own stance of applying any means to get people “back to work”18.

This means that people with mental health problems will no longer be able to freely choose to consent, or withhold their consent, to ‘treatment’. There is also a high risk that people will feel intimidated into consenting to undergo these ‘therapies’. This is very similar to what happens in psychiatry whereby the right to health is invoked to forcibly treat people for their own good, “in their best interest” … but as their only option. To decline a recommended treatment or to fail to comply to the letter with the injunctions and expectations of the system will result in benefits sanctions.

Cognitive behavioural therapy (CBT), the approach chosen by the Government is highly controversial and does not suit everybody. Therefore a one-fits-all approach, whether it is applied forcibly or not, will be counterproductive as it may make some people feel worse (counter to their right to health) and shows the total lack of understanding of the often complex and singular situations of persons with disabilities.

 

Art 10: (Right to life)

Any Government that uses coercion and sanctions as a means to a political end must take full responsibility for the consequences of its actions. As with the Work Capability Assessment, people being coerced into receiving behavioural or any therapy they did not fully consent to, may experience adverse effects (making people even more unwell by making them even poorer and forcing them to live in a constant state of anxiety, making them suicidal).

It also denies the person as an autonomous individual able to make their own choices (Art 12, Equal recognition before the law; Art 16, Freedom from exploitation, violence and abuse and threatens their integrity (Art 17)).

It also contradicts the Government’s own claims that it is doing everything to make UK domestic law compliant with the CRPD:

The Convention is not legally binding in domestic law in the UK but is given effect through the comprehensive range of existing and developing legislation, policies and programmes that are collectively delivering the Government’s vision of equality.19

 

Article 17 (Protecting the integrity of the person): The issue of coercion goes beyond “designating work as a cure for unemployment and poverty”20 as Friedli puts it; this is also about changing people’s societal status and identity. In the new narrative, there are productive and unproductive individuals, therefore there is no such thing as a long-term sick or disabled person (all disabilities included). These notions pretty much disappear in the name of inclusiveness and fairness (in relation to so-called “hard working people”21 who are deserving of help and will do their utmost not to rely on the state for their individual needs).

Language is indeed important in this context, and language is shifting. As many have observed, ‘sick notes’ have become ‘fit notes’, the term ‘disability’ too is being erased as ‘Disability Living Allowance’ becomes ‘Personal Individual Payment’. This speaks to a simplistic but powerful narrative of ‘can-do-no-matter-what’ supported by having a compulsory ‘right attitude, which is where psychocompulsion comes in. Nudging then forcing people into having the ‘right attitude’.

 

Forcing people back to work by reducing their welfare benefits

Persons with disabilities are clearly targeted over and above other categories of individuals (Art 1-5 equality, discrimination, choice, autonomy). Indeed, another form of coercion has emerged through a recent drastic to the ESA in weekly support from £103 to £73, contained in the Welfare Reform and Work Bill. It will apply to new ESA claimants in the work-related activity group. This vote, pushed through Parliament on 7 March 201622, is meant to “incentivise disabled people to find work quicker”. This (purely ideological) decision will not only strip them of financial security but also reinforce the idea, by bringing the rate into line with Jobseeker’s Allowance, that disability no longer exists, that anyone can and should work, that there are only productive (deserving) and unproductive (undeserving) people.

 

An unethical social experiment

It has come to light that these new programmes are also the subject of ‘research’. The new Work and Health Programme is currently at a research and trialing stage23. As Kitty Jones writes,

Part of the experimental nudge element of this research entails enlisting GPs to “prescribe” job coaches, and to participate in constructing “a health and work passport to collate employment and health information.24

However, this ‘research’ (if one can call it so), has been heavily criticised because it is not sanctioned according to the usual robust ethical guidelines. Research that adheres to robust ethical guidelines would absolutely seek not to cause harm to its participants, and would seek their informed consent beforehand25. This is not the case here where claimants are the participants are the involuntary and ‘unconsented’ participants of an experiment they know nothing about.

There are a wide range of legal and Human Rights implications connected with experimentation and research trials conducted on social groups and human subjects.26

A spokesperson for Disabled People Against Cuts (DPAC), talked of the UN CRPD Committee’s visit to the UK and described the situation thus:

It means the UN will examine the vicious and punitive attacks on disabled people’s independent living as well as the cuts which have seen so many placed in inhuman circumstances and has led to unnecessary deaths.27

 

Articles 1-5: discrimination against persons with disabilities who are targeted through this programme.

Article 9: right to communication: The existence of this experiment and the format of its conduct has not been communicated with the claimants (the participants).

 

Article 10 (Right to Life): when coercion brings people to the brink of suicide or they succeed in killing themselves (one court case at least has pronounced on the clear link between benefits sanctions and reasons for suicide):

Research from the Black Triangle campaign group found more than 80 cases of suicide directly linked to billions of pounds in benefit cuts. John McArdle, co-founder of Black Triangle, said: “The Dept of Work and Pensions refuses to reveal the findings of their own peer reviews of suicides linked to the sanctions so we will never know the truth in those cases. . . He said the Work Capability Assessment regime applied to all sick and disabled people, without adequate risk assessment ‘built into the system’28

Mortality rates bring their own tales of woe:

[The government] published or, rather, was forced to after several Freedom of Information requests – that show more than 80 people a month are dying after being declared “fit for work”. These are complex figures but early analysis points to two notable facts. First that

2,380 people died between December 2011 and February 2014 shortly after being judged “fit for work” and rejected for the sickness and disability benefit, Employment and Support Allowance (ESA). We also now know that 7,200 claimants died after being awarded ESA and being placed in the work-related activity group – by definition, people whom the government had judged were able to “prepare” to get back to work.29

 

Articles 12, 17, 19: Coercive measures embedded in all aspects of the Work and Health Programme and its various tools and strategies run counter to the premise that the person is free and able to make choices for themselves, and considerably threatens their right to independent living when they are forced into poverty.

Nothing seems to shift the current UK Government’s assault on people with disabilities or long term sickness, and on their human rights. Not the many Freedom of Information requests which have revealed that the DWP did look into the death of 60 benefits claimants but sat on the findings; nor a Commons Select Committee inquiry into benefits sanctions in April 2015, nor the visit by the UN CRPD committee at the request of a disability group (DPAC) in the late autumn of 2015, nor a coroner’s report clearly linking a claimant’s suicide to the stress caused by the Work Capability Assessment. The UK is effectively engineering and encouraging coercive and punitive policies that specifically target people with disabilities and the long term sick, putting their lives and their future at high risk. Many have observed that ‘austerity’ was only ever an excuse to establish and implement ideological policies. This is not about saving money in hard times; this is about the willful annihilation of the disabled, either through language or deeds.

 

Anne-Laure Donskoy

March 2016

 

Notes:

1https://kittysjones.wordpress.com/2015/11/28/the-goverments-reductive-positivistic-approach-to-social-research- is-a-nudge-back-to-the-nineteenth-century/– The idea that it is both possible and legitimate for governments, public and private institutions to affect and change the behaviours of citizens whilst also [controversially] “respecting freedom of choice.”

2 Friedli L, et al. Med Humanit 2015;41:40–47. doi:10.1136/medhum-2014-010622

3 See also this short film: https://vimeo.com/157125824

4 http://www.behaviouralinsights.co.uk/

5 http://www.disabilitynewsservice.com/coroners-ground-breaking-verdict-suicide-was-triggered-by-fit-for-work-test/

6Cole M. Sociology contra government? The contest for the meaning of unemployment in UK policy debates. Work Employment Soc 2008;22(1):27–43.

7 Even the Department of Work and Pensions (DWP) who are driving these policies, acknowledged in a 2006 study have put forth provisos that “account must be taken of the nature and quality of work and its social context” and that, for sick and disabled people, “there is little direct reference or linkage to scientific evidence on the physical or mental health benefits of (early) (return to) work for sick or disabled people.” 8https://www.gov.uk/government/publications/is-work-good-for-your-health-and-well-being

https://www.rethink.org/media-centre/2012/09/new-gp-survey-shows-government-welfare-test-is-pushing- vulnerable-people-to-the-brink

9 See note 3

10 https://www.wsws.org/en/articles/2015/02/05/welf-f05.html

11 https://gclaw.wordpress.com/2014/05/30/what-legal-aid-is-still-available-for-work-undertaken-on-welfare-benefits-post-laspo/

12 Department of Works and Pensions

13 Her Majesty’s Revenue and Customs

14 http://www.cpag.org.uk/content/legal-aid-reform-or-termination

15 http://www.theguardian.com/society/2014/feb/25/benefit-cuts-welfare-linked-mental-health

16 http://www.theguardian.com/society/2016/mar/10/judge-challenges-government-over-legal-representation-for-

vulnerable-people?CMP=share_btn_tw

17 https://www.youtube.com/watch?v=Dt-V0e0-ipY

18 A side point has been made by Friedli and others about the questionable ethics of those clinical psychologists who accept to take part in such initiatives and about the rapid expansion of the back-to-work industry.

19 Office for Disability Issues, UK Initial Report On the UN Convention on the Rights of Persons with Disabilities, May 2011,

www.odi.gov.uk/un-report

20 https://www.youtube.com/watch?v=Dt-V0e0-ipY

21 An expression used as a constant leitmotiv by the UK government.

22 Ministers claimed “financial privilege” to assert the Commons’ right to have the final say on budgetary measures

23 http://php.york.ac.uk/inst/spru/research/summs/esa.php

24 https://kittysjones.wordpress.com/2015/12/14/the-department-for-work-and-pensions-dont-know-what-their-ethical-and- safeguarding-guidelines-are-but-still-claim-they-have-some/

25 https://en.wikipedia.org/wiki/Ethical_research_in_social_science

26 See note 15

27 http://www.disabilitynewsservice.com/confirmed-un-is-investigating-uks-grave-violations-of-disabled-peoples-rights/

28http://www.mirror.co.uk/news/uk-news/more-80-suicide-cases-directly-5634404

29 http://www.theguardian.com/commentisfree/2015/aug/27/death-britains-benefits-system-fit-for-work-safety-net

 

 

“Where Would I Be if I Didn’t Believe in Me?” – Corrine A. Taylor

Where Would I Be If I Didn’t Believe in Me

 

My name is Corrine A. Taylor, I just titled this piece, “Where would I be if I didn’t believe in me?” Every time I sit down to share an aspect of my story I do it from a place of my heart space wanting to share awareness in the world, knowing there was a period of my life where I knew nothing and only accepted what the psychiatrist and social workers told me. I was desperate to live a well life but didn’t know how. I have learned that I am not the only one and there are many more people just not knowing and accepting to be labeled and drugged. However, I have come to a place of awareness to know that this is just my story and everyone else’s story needs to be respected and validated as I choose to tell my own, knowing that each and everyone of us is worthy to live a well life. I am focusing on the aspect of my life of not being forced to take drugs and why I chose this title, “Where would I be if I didn’t believe in me?” for the Campaign to Support CRPD Absolute Prohibition of Commitment and Forced Treatment.

When I got to a place of awareness of what is happening with psychiatry and choosing to accept a mental illness diagnosis and label for so long, accepting drugs, dying slowly waiting for the cure to be better, to live the life I wanted, I decided, no more. I had been on a journey for peace in my mind body spirit since I was a child, but was interrupted by abandonment, physical, sexual and emotional abuse, along with poverty and poor education. When I said no more to the last psychiatrist I was seeing and she offered me more drugs, I had been involved with the recovery community and learned a lot of the history about mental health in our world. So I was informed and I had a choice. I choice to feel what I needed to feel, let go what I needed to let go, forgive others and myself, and to learn, relearn and learn each and every day. That meant I could no longer accept the mind numbing drugs that never allowed me to fully accept and let go the affects of trauma.

When I had that last session with the psychiatrist and she offered me more drugs, different drugs, I had to tell her no each time. I could still remember the look on her face. I could still remember the confidence in my being that I knew what I needed and what I was asking for and what I expected to get as my human rights. I could still remember the last session with the therapist I saw, giving me suggestions that I should still see her or come back to her soon, that I would need to come and dump on her all the things happening in my life instead of dealing with them. Talking to her and dumping them on her that meant, not facing the situations that I was dealing with outside of her office. That meant not connecting and disconnecting, not building relationships, and more than that, not trusting myself.

But I believed in myself that day. I believed in the journey that I have been living. I saw all the hard lessons things that I past through, learn and like sharing with others, the way that I learn from others. I had people who became friends who supported me and believed in me and helped to ease the burden of an oppressive existence of poverty and lacking. Gave me strength within the Bible stories I learned as a child of not giving up and persevering. I choose to share my story at www.theproject321.com it is the lessons I learned taking the time to take care of myself and learning the lessons from all of my experiences, especially the hard ones.

I am glad I believed in me. Working behind the scenes at a mental health clinic really helped, as I saw the psychiatrist and social workers have all there faults, insecurities, judgments, behavior issues, or really just being as human as I am. It made me strong to believe in myself. When they came at me with negative reports, I was able to stand up for myself. I saw them with all their human flaws, but deserving dignity and respect and I knew that I deserve the same and so does everyone else. If that last psychiatrist with the look on her face that she new what was best for me, had decided to call the cops and lock me up, forced the drugs on me that she was offering me, where would I be today. I have been working to live for the last five years, connecting with my children and supporting them emotionally. Made friends and allies in the community, and living my life included in society, not on the couch drugged, overdosed, dying slowly accepting a diagnosis, and label. I ask again, “Where would I be if I didn’t believe in me?” I know where I ended up when I didn’t believe in me, accepting one mental illness diagnosis one after the other, one drug after the other, and not living up to my full potential as a human being. That is all that I want. Feel I deserve and so does each and everyone of us.

M’hamed El Yagoubi, Campagne pour soutenir l’Abolition totale des soins et de l’hospitalisation sans consentement en application de la CDPH de l’ONU

http://cvjn.over-blog.com/2016/03/campagne-pour-soutenir-l-abolition-totale-des-soins-et-de-l-hospitalisation-sans-consentement-en-application-de-la-cdph-de-l-onu.htm

http://depsychiatriser.blogspot.no/2016/03/contribution-de-mhamed-el-yagoubi-la.html

aussi en traduction italien, http://www.ilcappellaiomatto.org/2016/03/campagne-pour-soutenir-labolition.html

13 Mars 2016

Photo de Nathalie prise le mois d'août 2012 Pont de l'Arc, Aix-en-Provence

Photo de Nathalie prise le mois d’août 2012 Pont de l’Arc, Aix-en-Provence

http://depsychiatriser.blogspot.fr/2016/03/contribution-de-mhamed-el-yagoubi-la.html

http://depsychiatriser.blogspot.fr/2016/03/contribution-de-mhamed-el-yagoubi-la.html

Campagne pour soutenir l’Abolition totale des soins et de l’hospitalisation sans consentement en application de la CDPH de l’ONU

Nathalie Dale. Née le 21 mai 1970 à Cagnes-sur-Mer. France.

Morte le 31 janvier 2014 à Aix-en-Provence. France.

Cause : Défaillance respiratoire au surcharge médicamenteux selon le certificat établi par le service de médecine légale le 03/02/2014.

1 – Détruite par un traitement psychiatrique non seulement inefficace mais dangereux et mortel dans son dosage à longue durée.

2– Traumatisée par l’enlèvement brutal de son enfant par le juge avec la complicité de la psychiatre de l’hôpital de Montperrin (Aix-en-Provence) et ses collaborateurs juste après l’accouchement le 30 mars 2010 à 10h00. Elle ne l’a jamais vu. Elle l’a reconnu dans sa déclaration administrative et lui a donné un nom.

– Dépossédée de ses allocations par les mandataires déléguées du « service juridique de la protection des majeurs».

4 – Hospitalisation sous contrainte à l’aide d’un arrêté préfectoral du 19 octobre 2010, non basé sur une enquête préalable mais sur une pétition d’une partie du voisinage aux comportements malveillants abusant de sa vulnérabilité. Elle aurait été sauvée si les services concernés avaient été animés d’un peu d’humanité et avaient pris en compte les nombreux rapports d’alerte que je leur avais adressés en tant qu’ex-mari et compagnon. Peut-être eux-mêmes sont-ils victimes d’un système incontrôlable et monstrueux. Un rapport écrit a été communiqué à la préfecture (Agence régionale de Santé) le 14 mars 2011 sur cet arrêté abusif violant totalement ses droits et sa dignité.

Le cas de Nathalie pointe les aspects les plus obscurs dans le non-respect des droits de l’homme et du patient en situation de handicap psychique : La maltraitance psychiatrique et l’abus tutélaire et curatelle.

Nathalie fut mise sous curatelle renforcée le 08 avril 2010 alors qu’elle était hospitalisée à l’hôpital de Montperrin. Elle n’avait pas été consultée pour avoir son avis. Un abus de sa faiblesse et les effets de sa grossesse ont été sans aucun doute une atteinte plausible à ses droits.

Elle fut éjectée de l’hôpital psychiatrique de Montperrin le 26 avril 2010 sans aucun centime, sans accompagnement social et sans suivi médical pendant de longs mois. Elle faillit mourir d’inanition dans un pays d’abondance, alors que l’hôpital et d’autres services prélevaient directement ses maigres allocations (AAH). Grâce à ma vigilance et mon soutien matériel et moral, elle a échappé à une catastrophe, mais pas pour longtemps.

Nathalie subit un internement psychiatrique du 19 octobre 2010 au 19 janvier 2011 suite à un arrêté préfectoral. Nathalie fut mise sous contrainte des « soins » obligatoires sous le contrôle de la même psychiatre au CMP (Centre médico-psychologique). Aucune écoute dans la dignité et le respect de ses droits mais des séances « expédiées » avec des menaces de retournement à l’hôpital psychiatrique et la prescription de « médicaments » aux effets dévastateurs et mortels : Lexomil, Imovane, Lepticur, Sulfarlem, Clopixol, etc. Elle passait les trois quarts de la journée dans son lit. Immobilisée, l’incapacité de se lever ou de faire quelques pas. Les traitements prescrits pendant les RDV qui ne duraient que quelques minutes n’ont pas été modifiés. Je dis quelques minutes parce que je l’ai accompagné plusieurs fois à ce centre (CMP) obsolèteLexomil, Imovane, injection (coplixol), lepticur, sulfarlem, etc. Aucune visite chez elle ni par les infirmières ni par cette la psychiatre. Tous les RDV se faisaient le matin à 09h00 dans ce centre. Nathalie ne manifestait aucun trouble et aucune inquiétude au début de la journée. Elle est matinale. Son fonctionnement global est normal. A partir de midi, les effets dévastateurs des traitements imposés commençaient à être visibles. Ils provoquaient un ralentissement de ses perceptions et de ses réactions. Sa langue se diluait, ses yeux se fixaient en haut, confusion et perte dans l’espace et le temps, la bouche ouverte avec sa langue qui descendait, toujours sèche, difficulté d’avaler, des mouvements et des réflexes de ses deux épaules perceptibles, tête baissée sur la table quand elle est sur son canapé, un ralentissement du fonctionnement de son corps, perte de sensations et de perception . Quand elle marche et quand elle parle, aucune coordination, elle tombait, elle éprouvait des difficultés cinétiques pour aller aux toilettes faire pipi. Parfois, elle le faisait dans son lit non par imprudence mais par l’incapacité de se mouvoir. Elle ne sentait plus ses jambes. Quand elle faisait un effort pour quitter son lit, elle tombait par terre sans pouvoir avoir la capacité de se redresser. Elle restait allongée avec sa langue qui sortait. Quand elle prenait son bain, ce qu’elle aimait faire tous les jours chez elle, elle aimait rester au contact de l’eau fraîche, pas trop, elle restait longtemps endormie. Elle ne prenait pas son traitement au-delà de ce qui est prescrit.

L’intervention des services de la préfecture en collaboration du personnel de la psychiatrie le 19 octobre 2010 entre 20h et 00h ont laissé des traces profondes dans le reste de sa vie. Terrorisée et mise dans un état psychologique dégradé de façon irréversible, alors que ces services savaient très bien qu’elle était fragile, dépossédée par leur pouvoir inhumain, poussée par leurs mécanismes destructeurs à l’irréparable et à l’impensable juste pour satisfaire une pétition d’un groupe de voisins violents et animés par un esprit communautariste défaillant.Elle ne pouvait pas sortir, quand ils étaient devant l’immeuble où elle habitait par peur. Quand je l’accompagnais tous les jours, dès qu’elle voyait un véhicule des services de la police ou de la gendarmerie, elle paniquait parce qu’elle a intériorisé le contenu de cet arrêté préfectoral qui fait froid dans le dos. Les pires dictatures n’auraient pas pu le faire. Et pourtant, cette décision mortifère est prise par la préfecture des Bouches-du-Rhône, haute représentation de l’ Etat de «droit». La France.

Ces éléments de connaissance sur les effets dévastateurs des traitements qu’elle prenaient ont été codifiés et mis en manuscrit pendant un longue période surtout depuis juin 2011 jusqu’à la fin de vie 31 janvier 2014. Il aurait été plus parlant si la victime était là pour témoigner. J’ai pris le risque de mettre en ligne ces quelques éléments dans une méthodologie crue pour ne pas trahir son vécu infernal que j’ai bien assumé son partage.

Ces pratiques « médico-psychiatriques », aggravées par l’enlèvement de son enfant et l’internement abusif et la privation de ses allocations par le service de curatelle ont été administrées jusqu’à l’étouffement fatal le 31 janvier 2014. Et pourtant, le dernier rapport communiqué aux services concernés sur la gravité de son état de santé et d’atteinte à ses droits a été fait le 07 octobre 2013. Un autre rapport a été communiqué le 28 décembre 2013 au Député chargé de la mission d’information parlementaire sur les dérives de la psychiatrie en France, M. Denys Robilard. Malheureusement, aucune suite.

Nathalie est victime des traitements « médicamenteux psychiatriques » abusifs suite à un internement illégitime et aggravé et une mise sous curatelle défectueuse et prédatrice.

Pour une provocation de plus, des acteurs institutionnels de la psychiatrie organisent à Marseille, Aix-en-Provence et Salon du 14 au 27 mars 2016, ce qu’ils appellent «Semaines sur la santé mentale». Il est plutôt réel de dire «Semaines sur l’institutionnalisation de la maltraitance psychiatrique mortifère».

Collectif Vérité et Justice pour Nathalie

www.cvjn.over-blog.com

M’hamed EL Yagoubi

compagnon de Nathalie

Fait à Marseille, le 13 mars 2016

-We are not violating the human rights. -Yes, you are! by Anne Grethe Teien

http://agteien.blogspot.no/2016/03/we-are-not-violating-human-rights-yes_74.html

Introduction

Psychiatric human rights violations are often  denied and trivialized, even distortedly re-defined as “human rights” and “right to necessary health help”. The UN convention for the rights of persons with disabilities, CRPD,  is changing that. CRPD demands an absolute prohibition of forced psychiatric treatment and involuntary commitment. These are important requirements in giving people with psychosocial disabilities equal human rights. In this text, I will look at different aspects of the CRPD related to that demand. I will illustrate with some references to Norway, the country where I live, showing ways in which the Norwegian Mental Health Act does not comply with the convention. I will also share some further reflections. Towards the end I have written a short version of my own experiences from forced psychiatry.  Mental health laws may vary between countries, but some elements are prevalent: the laws are typically directed specifically towards people with psychosocial disabilities and involve forced treatment and involuntary commitment . This text is written for the Campaign to Support CRPD Absolute Prohibition of Forced Treatment and Involuntary Commitment (17). Procrastinations must stop – CRPD-based law reforms must begin!

Norway and the CRPD 

Norway ratified the CRPD June 3rd 2013, but came up with some interpretative declarations of article 12, 14 and 25 that undermine central parts of the convention (1).  Norway uses these declarations to try to defend the Mental Health Act and forced psychiatric treatment. In February 2015, the president of the Norwegian Psychological Association, Tor Levin Hofgaard, wrote an article asking for a clarification from the government whether health personnel violate the human rights when they follow the coercion regulations in the Mental Health Act (2). He referred to a report sent to the authorities in December 2013 by the then Equality and Anti-Discrimination Ombud –  LDO, Sunniva Ørstavik (3). The report said that the Mental Health Act is discriminatory and does not comply with the CRPD. LDO also urged Norway to quickly withdraw its interpretative declarations. In public, the LDO report was met with a noisy silence by the authorities.  So, as time had went on, Hofgaard asked for the mentioned clarification.  Anne Grethe Erlandsen, State Secretary in the Ministry of Health and Care Services, answered on behalf of the Norwegian authorities: “Vi bryter ikke menneskerettighetene” / – We are not violating the human rights (4). That answer is absolutely not right.

Norway uses much coercion in psychiatry. In spite of reduction strategies, the use of coercion stays at stably high levels (3: p.6-8; 5: p.20-23). Also, reduction strategies instead of CRPD-based abolishment strategies do not go to the core of the issue. Norway is used to see itself as a human rights protective nation and often does not hesitate to criticize other countries for their human rights violations. So it is maybe hard for the authorities to take in that the state of Norway  is actually accepting torture and other severe human rights abuses in its own mental health system, via the Mental Health Act.  Point 42 of the CRPD General Comments No 1 says as follows:

As has been stated by the Committee in several concluding observations, forced treatment by psychiatric and other health and medical professionals is a violation of the right to equal recognition before the law and an infringement of the rights to personal integrity (art. 17); freedom from torture (art. 15); and freedom from violence, exploitation and abuse (art. 16). This practice denies the legal capacity of a person to choose medical treatment and is therefore a violation of article 12 of the Convention. States parties must, instead, respect the legal capacity of persons with disabilities to make decisions at all times, including in crisis situations; must ensure that accurate and accessible information is provided about service options and that non-medical approaches are made available; and must provide access to independent support. States parties have an obligation to provide access to support for decisions regarding psychiatric and other medical treatment. Forced treatment is a particular problem for persons with psychosocial, intellectual and other cognitive disabilities. States parties must abolish policies and legislative provisions that allow or perpetrate forced treatment, as it is an ongoing violation found in mental health laws across the globe, despite empirical evidence indicating its lack of effectiveness and the views of people using mental health systems who have experienced deep pain and trauma as a result of forced treatment. The Committee recommends that States parties ensure that decisions relating to a person’s physical or mental integrity can only be taken with the free and informed consent of the person concerned.“ (6: #42)

Neglected harms and traumas – and the need for reparations

Long-term studies have shown higher recovery rates for people who were not on neuroleptics and on very low doses (14, 15). The list of potential harmful effects from neuroleptic drugs is long, including tardive dyskinesia, brain damage, cognitive decline, neuroleptic-induced supersensitivity psychosis, Parkinsonism, sexual dysfunction, weight gain, diabetes, demotivation, anxiety, aggression, suicide, akathisia [ an extreme form of restlessness which in itself can lead to suicide], neuroleptic malignant syndrome — a potentially lethal complication of treatment etc (14, 18). In a research summary on possible harms from forced psychiatry done by nurse and researcher Reidun Norvoll, she listed the following main categories:  1) violation of autonomy and of psychological and physical integrity. Deprivation of freedom of movement (deprivation of freedom). 2) Physical harm and death. 3) Violence and abuse. 4) Trauma, retraumatisation and posttraumatic stress syndrome. 5) Offences/violations, loss of dignity and experiences of punishment. 6) Psychological agony in the forms of shame, anxiety, feeling unsafe, anger, powerlessness, depression and loss of self esteem. 7) Social problems  and loss of social identity. 8) Loss of access to own coping skills and of possibilities to self development. 9) Loss of access to voluntary treatment. 10) Harmed therapeutic relationships, resentment against- and distrust in mental health services. (7: p. 16; 8: #5.3).

It can be hard to process traumas that are not acknowledged and understood as such by society in general. When mental health services represents the abuser and as it is officially seen as the mental health helper, one can be left in a very lonely situation trying to handle psychiatry-induced traumas.  I think, as part of the implementation of CRPD, there should be provided access to help and support to those who struggle with traumas and other harms from forced psychiatry.  I imagine a reality where it is possible for everyone to ask for help when they feel they need it, knowing that they have the CRPD on their side; that the state can not expose them to torture and other terrible human rights violations for being in mental pain (!).

When the necessary abolishment of discriminatory mental health laws and the prohibition of forced psychiatric treatment and commitment has become reality, I think that representatives from politics and psychiatry should publicly perform statements about- and apologies for -the severe human rights abuses that have been going on for so long towards people with psychosocial disabilities. After all the societal acceptance, silence and denial of these kinds of abuses, I think such an acknowledgement and apology is of significant importance for starting reparation work. Compensations  is also a relevant part of this.  At the same time, there should be no pressure towards victims of forced psychiatry to forgive and get over.  I strongly recommend survivor and lawyer Hege Orefellen’s appeal on the urgent need for effective remedies, redress and guarantees of non-repetition regarding torture and other ill-treatment in psychiatry (9). Her appeal was held during a CRPD side-event about article 15 and its potential to end impunity for torture in psychiatry (10). Also, in Guidelines on article 14 of the CRPD, point 24 (a-f) one can read about “access to justice, reparation and redress to persons with disabilities deprived of their liberty in infringement of article 14 taken alone, and taken in conjunction with article 12 and/or article 15 of the Convention” (11).

Danger- and treatment criteria 

The Norwegian Mental Health Act has, in addition to its danger criteria, a criterion called the treatment criterion, which does not require danger to oneself or others. The treatment criterion allows for psychiatric coercion if the person is claimed to have a severe mental disorder,  and application of forced psychiatry is seen as necessary to prevent the person from having his/her prospects for recovery or significant improvement seriously reduced; alternatively that it’s seen as very possible that the person’s condition in the very near future will significantly deteriorate without coercion (12: Section 3 – 3. 3 a). A very wishy-washy criterion indeed, which is much in use. In 2014 the treatment criterion alone was used in 72% of the cases among people commited (16: p.37).

Both the treatment criterion and the criteria regarding danger to oneself or others discriminate against people with psychosocial disabilities in that disability, or ‘serious mental disorder’,  is a premise for psychiatric coercion to apply. In other words, this discrimination is a violation of CRPD article 14 which says that the existence of a disability shall in no case justify a deprivation of liberty (13). Secondly, as the Mental Health Act allows for forced psychiatric treatment, it violates the right to personal integrity (art. 17); freedom from torture (art. 15); and freedom from violence, exploitation and abuse (art. 16). (6:#42).

Points 13-15 in the Guidelines on article 14 are also relevant in this context:

VII. Deprivation of liberty on the basis of perceived dangerousness of persons with disabilities, alleged need for care or treatment, or any other reasons. 

  1. Throughout all the reviews of State party reports, the Committee has established that it is contrary to article 14 to allow for the detention of persons with disabilities based on the perceived danger of persons to themselves or to others. The involuntary detention of persons with disabilities based on risk or dangerousness, alleged need of care or treatment or other reasons tied to impairment or health diagnosis is contrary to the right to liberty, and amounts to arbitrary deprivation of liberty.
  1. Persons with intellectual or psychosocial impairments are frequently considered dangerous to themselves and others when they do not consent to and/or resist medical or therapeutic treatment. All persons, including those with disabilities, have a duty to do no harm. Legal systems based on the rule of law have criminal and other laws in place to deal with the breach of this obligation. Persons with disabilities are frequently denied equal protection under these laws by being diverted to a separate track of law, including through mental health laws. These laws and procedures commonly have a lower standard when it comes to human rights protection, particularly the right to due process and fair trial, and are incompatible with article 13 in conjunction with article 14 of the Convention. 
  1. The freedom to make one’s own choices established as a principle in article 3(a) of the Convention includes the freedom to take risks and make mistakes on an equal basis with others. In its General Comment No. 1, the Committee stated that decisions about medical and psychiatric treatment must be based on the free and informed consent of the person concerned and respect the person’s autonomy, will and preferences.  Deprivation of liberty on the basis of actual or perceived impairment or health conditions in mental health institutions which deprives persons with disabilities of their legal capacity also amounts to a violation of article 12 of the Convention.” (11: #13-15)

The laws that apply to people in the rest of society regarding acute situations and in the criminal justice system, must apply to people with disabilities too in non-discriminatory ways. The CRPD’s demand for absolute prohibition of forced treatment and involuntary commitment means that it applies both in criminal justice- and civil contexts. (11: #14, 16, 20-21, also 10-12). For people with psychosocial disabilities who come in contact with the criminal justice system, necessary support must be provided to ensure the right to legal capacity, equal recognition before the law and a fair trial. Forced psychiatric treatment and involuntary commitment can not be applied as sanctions for criminal acts and/or for the prevention of such.

Replacing substituted decision-making with supported decision-making

Substituted decision making must be replaced by supported decision making systems. Giving access to supported decision-making for some but still maintaining substitute decision-making regimes, is not sufficient to comply with article 12 of the CRPD (6: #28). From General Comment No 1:

A supported decision-making regime comprises various support options which give primacy to a person’s will and preferences and respect human rights norms. It should provide protection for all rights, including those related to autonomy (right to legal capacity, right to equal recognition before the law, right to choose where to live, etc.) and rights related to freedom from abuse and ill-treatment (…).” (6: #29)

Some who agree with the CRPD in that diagnostic criteria for coercion should be abolished, still seem fine with the idea that ‘mental incapacity’ can be used as criteria for psychiatric coercion. This is not in line with the CRPD, which neither accepts disability criteria for the deprivation of freedom nor psychiatric coercion. Here is a relevant point to note, from General Comments No1:  “The provision of support to exercise legal capacity should not hinge on mental capacity assessments; new, non-discriminatory indicators of support needs are required in the provision of support to exercise legal capacity.” (6:#29 i)

A summary of my own experiences from forced psychiatry 

I was not suicidal when psychiatry put me under the Mental Health Act and decided I should get forced neuroleptic “treatment”. I had never been suicidal. The former mentioned treatment criterion is the criterion that was used on me.  Forced psychiatry, with its locking me up, restraining me, drugging me, and keeping me on CTO when discharged from hospital, certainly did not make my life better  in any way– everything became indescribably much worse. I experienced forced psychiatry as one long punishment for having mental problems. After having been on neuroleptics for a while, my cognition, my intellectual abilities, were severely affected and reduced – and so was my language: from usually having a rich vocabulary I could just utter short, simple sentences. My body became rigid and lost its fine motor skills so I couldn’t dance anymore. A period I also had akathisia, a terrible restlessness which made me walk endlessly back and forth, back and forth. I’m trained a professional dancer and having my dance abilities medicated away was a big loss in itself. The medication took away my vitality, my sensitivity. My emotions were numbed. My personality faded away.  Then a severe depression set in – just a complete state of hopelessness – and for the first time in my life I became suicidal. Again and again I said to the staff, psychologists, doctors: – I can not be on meds. I tried to have them understand that the neuroleptics were destroying me and my life.  They communicated to me that they thought I was being fussy. They were a big wall that just would not listen to me. Respectlessly enough, some even told me –yes, told me -that I was doing better. The doctors said I would need to be on meds for the rest of my life. That was a message which just manifested the complete hopeless situation. From entering psychiatry, indeed having mental problems, but being a vital, thoughtful, and expressive person who was dancing several times a week, psychiatry  had coercively medicated me away from myself and iatrogenically made me severely depressed and suicidal . In effect a slow form of forced euthanasia . One day, while on CTO, shortly after a new forced injection in the buttocks with those horrible meds, I did a dramatic suicide attempt. I was put back into the hospital. I am very glad that I survived. Because unbelievably, a couple of months later, I was told that someone had made a bureaucratic mistake: the coercion documents had not been renewed in time, so there was nothing they could do to hold me back. Of course they would recommend me to stick to the treatment (Ha!) and not leave the hospital too fast (Ha!). I left the hospital the same day. It took me about half a year to become myself again, to be able to think and speak freely, to get my sensitivity, my emotions back, to dance, to feel human again, to feel life. I have never been in a mental hospital since then. I have never had another dose of neuroleptics. And I have never been suicidal again.  More than a decade later, I am still traumatized by my experiences from forced psychiatry.

Conclusion

I am very thankful to the CRPD committee for their important work. The CRPD represents a paradigm shift, and there is clearly a resistance out there to accept the full width and depth of the convention. That human rights and non-discrimination applies equally to people with disabilities should not be seen as a radical message in 2016, but sadly, it still is. Societies with their leaders need to realize that systematic, legalized discrimination and abuse of people with disabilities is based on tradition and habitual ways of thinking –not on human rights. That something has been brutally wrong for a long time does not make it more right. Forced psychiatric treatment and involuntary commitment need to be absolutely prohibited.

Thank you for your attention.

References:

1) MDAC:  Legal Opinion on Norway’s Declaration/Reservation to the UN Convention on the Rights of Persons with Disabilities http://mdac.org/sites/mdac.org/files/norway_declaration_-_legal_opinion.pdf

2)

Tor Levin Hofgaard:  Bryter vi menneskerettighetene?

http://www.dagensmedisin.no/blogger/tor-levin-hofgaard/2015/02/19/avklaring-etterlyses-bryter-vi-menneskerettighetene/

3)

In Norwegian: Equality and anti-discrimination ombud (LDO): CRPD report to Norwegian authorities 2013 – summary http://www.ldo.no/globalassets/brosjyrer-handboker-rapporter/rapporter_analyser/crpd–2013/crpd_report_sammendrag_pdf_ok.pdf

4)

Anne Grethe Erlandsen: Vi bryter ikke menneskerettighetene http://www.dagensmedisin.no/artikler/2015/02/27/vi-bryter-ikke-menneskerettighetene/

5)

In Norwegian: LDO’s report to the CRPD committee 2015 – a supplement to Norway’s 1st periodic report http://www.ldo.no/globalassets/03_nyheter-og-fag/publikasjoner/crpd2015rapport.pdf

6)

Link to download of CRPD General Comment No 1:  http://www.ohchr.org/EN/HRBodies/CRPD/Pages/GC.aspx

7)

In Norwegian: Equality and anti-discrimination ombud (LDO): CRPD report to Norwegian authorities 2013- full version  http://www.ldo.no/globalassets/brosjyrer-handboker-rapporter/rapporter_analyser/crpd–2013/rapportcrpd_psykiskhelsevern_pdf.pdf

8)

NOU 2011: 9. Økt selvbestemmelse og rettssikkerhet — Balansegangen mellom selvbestemmelsesrett og omsorgsansvar i psykisk helsevern. 5. Kunnskapsstatus med hensyn til skadevirkninger av tvang i det psykiske helsevernet. Utredning for Paulsrud-utvalget https://www.regjeringen.no/no/dokumenter/nou-2011-9/id647625/?q=&ch=12

9)

Hege Orefellen: Torture and other ill-treatment in psychiatry – urgent need for effective remedies, redress and guarantees of non-repetition https://absoluteprohibition.wordpress.com/2016/02/06/hege-orefellen-on-reparations/

10)

CRPD 13: WNUSP side event on Article 15: Its Potential to End Impunity for Torture in Psychiatry  http://www.treatybodywebcast.org/crpd-13-wnusp-side-event-on-article-15-english-audio/

11)

Link to guidelines on article 14 of the CRPD under “Recent Events and Developments” http://www.ohchr.org/EN/HRBodies/CRPD/Pages/CRPDIndex.aspx

12)

Norwegian Mental Health Act translated to English http://app.uio.no/ub/ujur/oversatte-lover/data/lov-19990702-062-eng.pdf

13)

CRPD Convention http://www.ohchr.org/EN/HRBodies/CRPD/Pages/ConventionRightsPersonsWithDisabilities.aspx#14

14)

Via Mad in America / ‘Anatomy of an Epidemic’ (Robert Whitaker):  List of long-term outcomes literature for antipsychotics http://www.madinamerica.com/mia-manual/antipsychoticsschizophrenia/

15)

Lex Wunderink et al: Recovery in Remitted First-Episode Psychosis at 7 Years of Follow-up of an Early Dose Reduction/Discontinuation or Maintenance Treatment Strategy. Long-term Follow-up of a 2-Year Randomized Clinical Trial http://archpsyc.jamanetwork.com/article.aspx?articleid=1707650

16)

Bruk av tvang i psykisk helsevern for voksne i 2014 (report on the use of coercion in psychiatry in Norway 2014) https://helsedirektoratet.no/Lists/Publikasjoner/Attachments/1161/Rapport%20om%20tvang%20IS-2452.pdf

17)

Campaign to Support CRPD Absolute Prohibition of Forced Treatment and Involuntary Commitment https://absoluteprohibition.wordpress.com/

18)

RxISK Guide: Antipsychotics for Prescribers: What are the risks? http://rxisk.org/antipsychotics-for-prescribers/#How_likely_are_the_listed_side_effects_of_antipsychotics_to_happen

Other:

Status of Ratification Interactive Dashboard – Convention on the Rights of Persons with Disabilities http://indicators.ohchr.org/

AFTERSHOCK, by Connie Neil

An offering in support of the CRPD campaign, an excerpt of my (as yet) unpublished non-fiction book about my ECT and forced drug experience and my work to recover a mental balance.

 

Connie Neil

Shock survivor and anti-psychiatry activist

 

AFTERSHOCK

 

They wheel me into the white, tiled room and shunt me onto a table. “Oops-a-daisy. Slide over now, there’s a good girl.”  Globs of cool slime smudge onto my temples, my chest, and the electrodes are lodged in those spots. The needle pierces my vein and fuzz creeps into my mind.

Wait! I can’t breathe.’  I can’t move or speak. My lungs are paralyzed. I try to tell them, try to scream for help, but a mask with a hose attached blocks my mouth and nose, and I know no more. Except I feel that I am dying.

How long after? Hours? Days? I have no idea how I got here. “Hush now, Connie, don’t make a fuss.” Am I making a fuss?

Perhaps my name brings me back to this world. I know nothing else. They show me how to hold a spoon and eat. That man – Bob — keeps fidgeting around saying, “Hush,” and that he is my husband. That shrieking noise is my baby, they say, held up to me by a leering old woman. I know nothing; care less.

Something bad has happened.  I no longer exist. A shell is left in my place.

* * *

That was my first shock treatment and it was in a general hospital with anaesthetic and so-called relaxing drugs, a kind of chemical curare that stops all automatic movement –like breathing, like heartbeats. This method today is called the improved gentle ECT form by Max Fink, teacher of ECT. (Fink, 1999)

      Like any sane person, given the disastrous reaction, I refused the next session. True to protocol, that is the signal I am clearly insane and cannot be trusted on the streets of Hamilton. I am institutionalized “on the mountain”, the crazy house the Ontario government runs with our tax dollars, for 20 more ordered against my will and without anaesthetic, so I can feel the full horror of destroying my mind.

If they knew the truth, I reasoned, of the permanent brain damage that was done by this seemingly barbaric operation, it would be outlawed, banned. There must be some major accident, something broken in the machine, which caused this horrendous aftershock for me.

But no:  they already knew. This burning my brain away, this slump in my ability to learn was exactly what was planned. No, mine was a typical case handled in the socially accepted manner.  Troublesome, opinionated, loudmouth rule-breaking new mother must be brought into line, or buried where nobody can hear her complaint. Shock will fix her.

And what did they wipe out? My acting/writing career, musical training, 8 to 15 years of memory, any trace of self-confidence, my IQ, EQ, every Q.  All depleted or burned away with every session.

Where can I go to learn to be whole? Shrinks? Hell, no. To whom can I appeal when my every comment is deemed crazy? Neat trick, these bio-psychiatrists and their ilk concocted. This treatise is not about me:  I am fine, perfectly fine, just fine, really fine; fine with my alternatives to achieve adequate balance but nowhere near what I was put into this lifetime to achieve. Yes, I am fine, but what of the millions over the past (2016 – 1939 which equals) 77 years who succumbed to this torture? Shock is ordered by an elitist group of mostly men upon women who make up two-thirds of the targeted victims fed electroshock purported to be a cure for depression, for sadness, for frustration, for reaction to reality that is unfair (Burstow, 2014, pg 195).

And what behaviour did I exhibit that was “a danger to myself and/or others”, the criteria for locking away recalcitrant members of society exhibiting egregious harm? I had a baby, got flu, and failed to wrest control of my baby’s care from my obsessed mother-in-law where I was parked while hubby wrote his final exams in another city. Shock was what I deserved, they judged. My adult history showed no crazy markers to convince authorities I was in need of their ‘help’. Before their infringement I had many successes.

 

What I Lost to Electroshock

We set out in two cars towing a trailer of our dismantled farm porch theatre set on a crisp winter day to drive 150 miles past Montreal to Lennoxville where Bishop University hosted the Inter Varsity Drama League Festival. Long trip. It was Ryerson’s first entry in five years. Fellow actor Robin Brewer and I sampled the whiskey bottle to keep warm until Donald Sutherland, our English teacher and chaperone, poured the remainder out onto the snow at our second stop. No more booze.

For our technical rehearsal, we re-constructed the set, designed and built by Bill Underwood, the only one not studying Radio and Television Arts. He later made his theatrical career at Stratford. The set was praised for simplicity and atmosphere by our adjudicator, Montreal producer Rupert Caplan. In the brief time allotted, we ran lights and cue-to-cue lines while director Ken MacKay roamed the gods checking that our projection was clear.

It would be surprising if we did not do well as Ryerson attracted talented young people. And we cleaned up with Tennessee Williams’ 27 Wagons Full of Cotton, his one-acter that the controversial Hollywood movie Baby Doll was based on. We took Best Production, Best Director, Best Actress and Honourable Mention for the lead actor.

At the awards dinner, when Rupert Caplan announced, “The winner is Connie Neil” he looked at me in surprise, did not recognize me off-stage, the mark of a talent for disguise. As I rose and walked forward, he added, “and accepting for Connie Neil is . . .” I had to tell him, “Connie Neil”. He fumbled, “Is it you?” I nodded.  For the part of simple-minded Baby Doll I was padded to a plump roundness so that my ripped costume after the rape only revealed blood and bruises, and not my usual sleek shape. He said, “Although this is not a great play, it is an example of how a good performance can make a play great because the audience believes in it. Connie achieved a great degree of believability. She is a promising young actress.” Two universities choose that play; only ours won awards.

At the Banff School of Fine Arts that summer I took both acting and playwriting to help decide where I best fit. At the auditions for their mountain dialect play, they moved me up to advanced acting, the Shakespearian studies, and gave me the lead of Barbara Allen in the 3-act play Dark of the Moon. In this challenging role I was wooed by a witch-boy, raped in church, gave birth on-stage, mob-killed and left dead and sprawled on a rock for the witch-boy to play with. Brought the house down. People hung around backstage to weep and tell me how strongly I affected them with my performance.

I also got high marks in playwriting.

For my final Ryerson year I took the lesbian role in Jean-Paul Sartre’s “No Exit”, the play of three disreputable characters in a waiting room for the afterlife that for them is hell. I received Honourable Mention for acting: No mean feat in competition with eleven universities.

Aside from these honours I performed in musical and comic revues, dance shows, piano recitals, singing, radio and TV acting and wrote a number of plays.

All this stopped with electroshock. In reviewing old papers I came upon letters of congratulations; there had been national newspaper coverage. One was signed “Sharon”, and from the content we had been close.  She named people I recognized, but she is lost in the area of my brain burnt out by thoughtless shock docs. What does it matter to them that a few lists or personnel are missing? It matters not at all.

Oh sure, my interests were still present, but all I was capable of was chorus work, minimally. Once I was helping choreograph Toronto City Hall Revue dance numbers. In the grand finale the lead dancer was to lift me, spin around and roll me out for the big finish. Because I had demonstrated both male and female roles, in performance I lifted him, spun him around and rolled him out for the final TA-DA. Did not even realize I had done it until we were in the wings and he asked, “What was that all about?” All I could do was laugh, and never tempt that brain shock mistake again on stage. Performing, even as an amateur, was over. That little brain glitch meant I was unreliable on-stage.

One reason I did well performing was my prodigious memory: All the script changes were imprinted on my mind. If an actor was in the wrong place or gave the wrong line, I could cover because I remembered every nuance of the rehearsal period. All gone now. No more connections. And what enrages me today is that psychiatry knew this destruction is the result of ECT, always the result, and in their arrogance, their greed, their lusting for the easy way around difficult personalities, they hide the truth they know; brain damage is always the result.

 

What Little They Disclose

Today there are legislated informed consent discussions as in the 2002 Andy Behrman memoir Electroboy. I notice the bio-psychiatrist and not the shock doc gives the information to him and his parents, outlining the different methods and expected results. It is now admitted the chief problem is memory loss, a condition even my nice psychiatrist suggested was brought on in me by my “mental illness”. They like to blame the victim:  it is how they are trained.  The classifications are: 1) neurotransmitter theory shows ECT is like antidepressant drugs and affects serotonin, dopamine and norepinephrine; 2) anticonvulsant theory claims ECT seizures condition the brain to become seizure-resistant; 3) neuroendocrine theory says these convulsions cause the hypothalamus to release mood stabilizers; and 4) brain damage theory admits that the damage created gives the illusion of mental stability.

Note that these are theories, not proven scientific facts that explain how ECT treats depression or mania. The fact that ECT results are unproven does not stop psychiatrists from charging ahead, delivering their shocks and, when they fail to ‘work’, adding more series of shocks until you no longer complain. You learn what torture comes from objecting.

 

 

THREE DECADES LATER

Close to the end of this retreat with meditation teacher Cecilie Kwiat at the Dharma Centre of Canada I was able to report that I could see what was hidden behind that all-encompassing blob of anger that dogged my steps for the past five years. Every word of those complaining 560 pages in my crumpled discarded memoir was filtered through the veil of my unrelieved anger; and I thought all along that anger, rage, fury was all that there was.

Since I had loosened up throughout this year, attending four retreats and finishing the story of what ECT had done to my very long life, I volunteered as copywriter to publicize teachers. Research for this chore interested me in attending Body, Speech & Mind with Albertan Cecilie Kwiat. She was a close student of Venerable Namgyal Rinpoche and had produced that text book from her (and other’s) notes of his teachings on a sea journey to Peru. And I had studied that text with both Buddhist nun Karma Chime Wongmo and the Rinpoche. I thought I knew the subject. I thought it would be easy.

But just as Cecilie taught, every moment brings a brand new “I” with a possible fresh outlook and opportunity for insight.

She arrived in time for the Namgyal Memorial weekend, a gathering that brought many old students to the centre to pay tribute to our lama who passed to the higher realms ten years past.

When I turned in my seat during the temple rituals I caught her brilliant smile, her hearty laugh, and I realized I had met her once before during a longer retreat that she attended with a few of her students. Seated side-by-side in the Tea House I had heard her answer a student’s questions with such clarity that I had to comment, “That was perfect,” and she smiled, “Thank you.”

This could be a stellar retreat. The morning after her first day of teaching as I lay between dreamland and waking I saw my brain, full of holes, covered in scabrous dead areas. This, I heard, was my leaky boat that would not carry me far on this river journey to enlightenment. Then, with tears wetting my face I heard my dead guru say, “You need mentoring!” Not even sure what that meant, I approached Cecilie after class and reported that little scene, expecting perhaps a name and phone number on a slip of paper. Instead, she made me cry. I tried to make my plea clear to her with dry eyes, but she poked me in the back, saying, “You’re frozen. Cry!”

She reached and captured my wrist and pulled me to her, seating me in her lap. Oh no! I must not sit in teacher’s lap! I would break her. Then what would the class do for a teacher? In my research I learned she had been run over by a gravel truck – twice – in a motorcycle accident in her youth, and was told she would never walk, never have a baby. But she fooled the doctors, and did both.

I was very awkward on her lap, trying to hold my weight off her while she questioned me about my history that I blubbered out to her, and she told me about her difficult childhood being called a Nazi because of her father. I blurted out, “Was he?” But that was not the point she was making. Some students were still in the temple. What a show we were putting on! They drifted away. Still on her lap like a toddler, she had me write in my notebook: “Here I am right now. As I am, may I be well and happy. May I be free from enmity.” It is the translation of White Tara’s mantra, my yidam, my guardian, and I had forgotten her Loving Kindness practice. That forgetting of crucial information was what was still, fifty years after shock, the plague accompanying ECT that thwarted my need for spiritual wholeness. I am ever unsure of what I know, what is missing.

I carried on with classes and exercises, but it took days to settle this stormy episode. I passed her a note for a private talk on vanishing emotions, a failing of mine because ECT was ordered for people who cause trouble, disturb others, have uncontrolled emotions; and so was my great fear. I over-react and, not only bury my emotions, I forget I have done so.

I explained to Cecilie that an unfeeling state makes everyday life easy, tempting, that nothing bothers me in that state, but because I do not notice the trigger, I cannot climb out. I am worried that outlawing my anger will kill all the emotions.

She talks about my heart, but I know my heart is closed. She tells me that is not true, that she does not work with people who have no heart: She can see my heart. Again she makes me write; “I aspire to be free from anger. I will un-armour my heart (and may armour it up again).

Her next class is on awareness of feelings and I take in what I can. There are fifty (some say 52) skulls worn by the deity as a necklace. These transformed mind states are now seen to be his adornment, his conquered wisdom. We must describe these mind states in our own language. We are often mistaken in what is our mind state, a result of conditioning. Change is all that is constant.

This has been a very cold and rainy retreat. The storm blew out our power for a day. Snow and mud makes walking a study in problem-solving – from one dry-ish clump leap to somewhere safe. We are to move from one form of meditation to another – sit, do body scans, review, walk slowly with one foot on solid ground, one foot over the abyss. Sheer boredom of looking at 25 of the negative, dismal mind states pushes me with my umbrella out of the temple to walk the centre, to sit under the shelter with the huge peace Buddha statue the Sayadaw, Rinpoche’s teacher, built here and all across the world. And here I caught a glimmering of another mind state.

I often wondered what I did in a past life to be born into this family. Cecilie phrased it differently: Whoever made me may have put me in this family, through attraction, to learn an important lesson. Could the lesson be Loving Kindness? To armour and de-armour my heart? Forgiveness? I already know anger.

I report that anger hides a great wall of refused and unresolved forgiveness. I see the wall, name it unforgiving, examine it and its many instances in my life.  I even refused under hypnosis – not just once – to forgive especially my father. No. I won’t. Even I know these denials expand to big trouble in river city. With that early decision, unforgiving moves to other beings until it is global: I am intransigent. I judge.  But now I think about who needs forgiveness (me, duh) and what qualities he (Dad) had and who this reminds me of (guess).

When Cecilie declares Congratulations! I stipulate I have not forgiven, only seen the awful wall of it. She repeats congratulations, that having seen it, the wall will dissolve bit-by-bit, one-by-one. She can see I can be kind and I agree I can be kind. I am kind. I wonder what is behind that dissolving wall.

To close the retreat we celebrate Cecilie’s 74th birthday on November 1st with two great cakes, balloons, gifts, and a healthy meal.

She took a compartment for her train trip back to Alberta, got in her car at the station drove off and hit black ice, a major accident. Many surgeries, many crises later, by Christmas, she was working her way into wheelchair rides and therapy to help her briefly stand. When my heart clutched at the photos in casts, amid hospital paraphernalia, what I take heart in is her still-brilliant smile.

If she can do that, so can I. Nothing can break Cecilie Kwiat. But just in case, I send her Loving Kindness.

In a noisy hostel in St Maarten, I cannot sleep for the rowdy drunken crowd outside my dark window, so I practice Metta. They leave and later I see in my dorm a white-robed figure approach my lower bunk. She offers something in her right hand. Is it a blessing? I see a square of light before my open eyes. On it I see a quick sequence of hieroglyphics. There’s a dark horse’s head, but other images change so quickly I can hardly register them. Then it is over and I ponder these screened messages.

On February 15, Cecilie Kwiat passed on into communion with the enlightened who have no need of their corporeal body. I miss her. And thank her for that parting visit.

 

An Understanding Forgiveness

Our school reunion lunch was set for the hottest July day, so I left my car in Oshawa and sailed into Toronto on the commuter GO train – early.

Walking up from Union Station I was so early that I found the one shaded park bench on King Street and parked myself at the end where a man of a certain age invited I might sit and join him. He wore tan slacks and a woven beige golf shirt with new trainers on his feet and a neat pewter-coloured close-clipped hairstyle. His teeth were perfect.

“Can you tell me where the . . . uh . . . the . . .” He scowled and concentrated on the elusive words, then triumphant, “the Eaton Centre is?”

I could and did. It was within walking distance, but he stayed seated. That was not what he wanted. We spent an hour piecing together what he needed to say.

He tried again, this time searching for the French word for psychiatrist. “I was . . . sis . . . sis”

And I supplied, “Psychiatrist?”

“Yes, but . . . neuro . . . sus . . . sus . . “

“Neuro-surgeon?”

“No, neuro . . . neuro sus . . .”

“Neuro-scientist?”

“Yes!”

Lordy, I was sharing a bench with the enemy. In my mind, this was the guy who made the pills, who screwed up my brain, who pushed me to ‘gentle’ shock treatment. Does the neuroscience model of brain-based consciousness really hold up? Here was the scientist behind psychiatry. And just look at what he had become: a wreck, my victim.

We painstakingly translated his story. Six years previous he had a stroke, could not speak. But his wife helped him and they were just fine together. Every time his wife came up in what I loosely describe as conversation, he cried. I understood the stroke had taken away his emotional controls. Here waited the enemy, at my mercy.

He also could not recall the word for “tomorrow”, not surprising as he was captured in the ever-constant now. What he needed to tell me was that his wife had died two years back, was buried in Barrie, where he was headed, just resting and walking in between trains. He had come from Belleville and, just like me, had walked up from Union Station to this shaded bench.

He stopped trying to control his tears and the quavering in his voice: He must tell me his tale. The tears were just scrubbed away by his hand. It was difficult to piece together what disturbed him.

Neither he nor his wife realized that her stomach pains were serious: He particularly grieved that he did not understand in time. When finally she was settled into hospital, the medical staff and his wife dismissed him, saying to come back “Tomorrow”. But when tomorrow came, she was gone. And he was alone. “Alone,” he cried, “alone.”

Two years were not enough time for him to accept her death and his damaged condition. So, what to do with the rest of his life? How to go forward?

Because he emigrated from France, I asked if his words were easier available in French. But no, it made no difference. Did he have friends, support, family there? But no, and he loved Canada and his life here – before his calamities.

I spoke as a Buddhist of the essence of a person going on eternally. And this sparked an interest and further distress. She spoke in his head as she was dying and declared there was no more suffering, that she was happy now, that she was fine. And then he went to the hospital, pleased with her stated recovery, and found her dead. What he cannot set aside is that she died alone, and now he was alone, struck asunder. The only comment that brought him some lightening of mood was when I observed that, “with your close connection, you will see her again. She will wait for you. You will be together, not alone.”

“Yes. I know it.”

And with that, he stood, offered his hand to shake, to stroll back the way he had come. Done. I joined my fellows at our reunion lunch. Good lunch; but a better chance meeting that corrected my biased view of all psycho-workers.

No matter what we achieve in this life through education, fame, important works, in the end we carry the exact same personal conditions that are the core of our life. Previously I could not see the purpose of this exalted class of doctors that had threatened my safety, harrowed my career, and damaged my brain. But this archetype of soul examiner invited me onto his bench to reveal his crying heart. Such hurt revealed; I could not do other than extend my hand and grasp his.

I see with softer eyes.

 

References:

Behrman, Andy  (2002). Electroboy; A Memoir of Mania.

New York: Random House, Inc.

 

Burstow, B. & LeFrancois, B.A. & Diamond, S. (Eds.) (2014) Psychiatry Disrupted: Theorizing Resistance and         Crafting the (R) Evolution    

Montreal:  McGill-Queen’s University Press

 

Fink, M.  (1999).  Electroshock: Restoring the Mind.

New York: Oxford  University Press

Post on psychiatric torture by Initially NO

Initially NO has brought together art, graphics, narrative, essay, and articles of the CRPD containing rights that were denied to her, in a beautiful and moving composition asserting a claim for justice.  Since the art and graphics are integral to her work and I cannot reproduce the layout here, I am sharing her introduction and a few samples of the art work and urge you to visit the original for the full effect.

of our human rights

Rights denied me, again and again over a 14 year period (1998-2012) brings back such feelings that make me not wish to attempt to talk about this again. It hurts so much, it was so painful, it upsets me to remember, but it upsets me even more knowing that over 5700 people are subjected to such horror, every year in the state of Victoria, Australia, people who actively say no I don’t want this, very clearly and are then put on Community Treatment Orders, and tortured with forced injections, electricity, and verbally abusive appointments, that must be met, or they’ll be put into arbitrary detention again. It hurts me that the people who say no they do not wish to take psychiatric prescriptions are then subjected to the system longer.

When you refuse to be injected they do this. One ambulance man said to me he was just a small cog in a big wheel. That’s the symbolism here and the bombs in the body profiteering, Otherwise, that many hands on a small young lady, as I was, as strip her and stick her.

This is what happens when you’re given threats of worse treatments such as electro-shock and detention if you do not turn up to a fornightly ‘depo’ injection. I had to pretend to be happy with this senario to a point. (I’ve cut out the true-feeling related swear words here to fit with #UN CRPD Absolute prohibition.)

Article 15 – Freedom from torture or cruel, inhuman or degrading treatment or punishment

1. No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. In particular, no one shall be subjected without his or her free consent to medical or scientific experimentation.

 

Sarah Knutson: Einstein, Social Justice and the New Relativity

Sarah Knutson’s second post for the Campaign.  Original is on Mad in America.

To create his theory of relativity, Einstein had to see things differently.  He had to view the universe not as an object of mammalian proportions, but from the perspective of a subatomic particle.  Essentially, he used imagination and empathy to come to know a new ‘reality’ of existence.

This essay is the second in a series.  We previously outlined a rationale for a 100% voluntary mental health system (read about it here). Now, we take a deeper look at the nature of human experiences that lead to public concern.  We delve deeply into the perspective of that experience and discover ourselves in a whole new realm.

Three ways of seeing experience

To understand where we are going, let’s first take a look at where we’ve been.  Here are some competing models for approaching socially troubling human experiences.

1. The DSM Model of ‘mental disorders’

The DSM Model is based on the Diagnostic and Statistical Manual of Mental Disorders published by American Psychiatric Association.  In no small part, the DSM has been the product of insider turf wars, political compromise, industry needs and billing concerns.(1) It is said to be atheoretical, but unquestionably the DSM views certain aspects of human experience as abnormal/ disorders.  Possibly, this is just a nod to the practicalities of healthcare reimbursement.  However, the process of distinguishing the truly abnormal (insurance pays) from the common effects of a stressful life (you pay) has left something to be desired.

Rote symptom checklists determine whether your anxiety, mood, grief, trauma, substance use, sexuality is ‘normal’ or ‘disordered.’  At a minimum, this is a lousy way to get to know another human being on the worst day of their life. Painful experiences, like getting fired, ending up homeless or being raped in shelter housing are routinely ignored or overlooked. It’s like the teacher pronouncing you ‘learning disordered’ without asking if you studied.

Reliability and validity have proved problematic as well. Individual diagnoses tend to vary, as do predictions of violence and suicide.  Given that single bad call can change the course of a lifetime, concerns like these led whistleblower Paula Caplan, Ph.D., to report to the Washington Post in 2012: “Psychiatry’s bible, the DSM, is doing more harm than good.”  A year later, the National Institute of Mental Health (think science, research, evidence-based) went on record as looking for a more valid approach (full statement here).

2. The Medical Model of ‘mental illness’

In contrast to the DSM, the Medical Model has a crystal clear vision.  ‘Mental illness’ is a real disease.  It is caused by pre-existing genetic, biochemical or physiologic abnormalities. Those affected are susceptible to disregarding personal welfare or that of others. Aggressive treatment (drugs, CBT) is required to correct or mitigate deficiencies.

For all its theoretical congruence, the medical model hasn’t fared much better than the DSM. Treating ‘mental illness’ takes a whopping 15-25 years (on average!) off of the average life span.  The promised ‘chemical imbalances’ and bio-markers still haven’t materialized in the research.  Disability rates have sky-rocketed. Long-term outcomes and relapse rates have worsened overall. (2)  Many suspect that prescribed drugs increase violence and suicide.

3. The Social Justice Model of fundamental human needs

This model comes in no small part from the learnings of World War II, the Holocaust, Hiroshima, and Nagasaki.  In the aftermath of atrocities, the nations of the world were interested in figuring a few things out.  They needed a way for those on all sides to move forward.  They wanted to set the stage for ‘never again.’  Their solution was the Universal Declaration of Human Rights of 1948 (UDHR).

The UDHR is premised on a simple idea.  For all our differences, human beings have much in common.  We all need certain things to live and be well:

  • nutritious food, habitable shelter
  • safety of person and property
  • dignity, respect and fair treatment
  • meaningful participation and voice
  • support for families to stay together and make a living
  • opportunities to develop ourselves across major life domains
  • freedom to make sense of experience in our way

Under the UDHR, advancing human rights is a universal, non-delegable obligation. Everyone everywhere is responsible for doing their part.  The peoples of the world understood that the basic requirements for human dignity must be accessible to all.   Without such access, neither individuals nor the human family as a whole will be well.

The theory of human conflict follows from this.  Under the UDHR, conflict arises when human needs are in competition.  It intensifies with time if only some of us have access to what all of us need.

Preventively locking someone up or drugging them against their will is a considerable human conflict. To meaningfully address such issues, the Social Justice Model counsels us to take a step back.  Those we are fearing (sick, disordered, untrustworthy) may be messengers, not madness.  Instead of privileging our perspective, what if we try to see the world through the other’s eyes:

  • Is it possible their experience might not be as senseless it seems?
  • Is it possible they may be expressing a history of social harms, rather than arbitrarily bent on inflicting new ones?

Before you immediately brush this off, consider the following:

If the nations of the world could adopt these attitudes in the aftermath of Hilter, concentration camps, kamikaze pilots and detonated atom bombs, then why not for modern public safety concerns?  

Support for the Social Justice Model

Nearly 70 years ago, the United Nations predicted the following (UDHR Preamble):

  1. ‘[R]ecognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world.’
  2. People everywhere long for a world in which ‘freedom of speech and belief and freedom from fear and want’ are the order of the day.
  3. ‘t is essential, if man is not to be compelled to have recourse, as a last resort, to rebellion against tyranny and oppression, that human rights should be protected by the rule of law.’
  4. ‘[D]isregard and contempt for human rights’ leads to ‘barbarous acts’ that ‘outrage[] the conscience of mankind.’

Now consider this:

1. Research on public and behavioral health impacts

An estimated ninety (90!) percent of those in the public mental health system are ‘trauma survivors.’  We have grown up without reliable access to same basic needs that the United Nations recognized as essential over six decades ago.

The same applies to the other so-called ‘problem’ groups in our society.  Yep, ninety (90!) percent or more of us in substance use, criminal justice, and homeless settings are ‘trauma survivors’ as well.

This is not just about individual needs, but also family needs and the needs of entire communities. These issues affect all of us across demographics.

Don’t believe it?  Check out the following:

  • National Association of State Mental Health Program Directors (NASMHPD), The Damaging Consequences of Violence and Trauma: Facts, Discussion Points, and Recommendations for the Behavioral Health System (2004). Full report here.
  • National Council for Behavioral Health (Breaking the Silence: Trauma-informed Behavioral Healthcare (2011). Full publication here.
  • Nadine Harris, MD, How Childhood Trauma Affects Health Across a Lifetime (TED Talk here.)
  • Substance Abuse and Mental Health Administration, SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach SAMHSA (2014). Full proposal here.
  • The School of Life, Sanity of Madness (1/18/2016). Full video here.

Yet, for all the fanfare about the need for more ‘trauma-informed care’, there has been little systemic response directed toward basic human needs.  Equally disturbing, behavioral health system involvement has become an independent, exacerbating source of harm for many.

The results speak for themselves.

2. Tremendous explanatory power

In addition to the public health data, the Social Justice Model has tremendous explanatory power.  It offers a straightforward way to make sense of experience (this essay), as well as principled ways to respond (future essay) that could easily be confirmed – or refuted – by research (future essay).

The basic paradigm is this:

  1. Resources are seemingly scarce
  2. People have basic needs
  3. They see a threat or opportunity
  4. This sets off a ‘high-stakes’ (aka ‘survival’) response
  5. Predictable physical, mental and social effects occur.

The above theory draws on work that has already been done.  In the trauma field, the human survival response (fight, flight, freeze) and its effects are widely known. See, e.g., ‘The Body Keeps Score‘ by Bessel van der Kolk.  As it turns out, you can tweak the same theory to make sense of a broad variety of human experiences that lead to public concern.

3. The ‘normal’ response when the stakes are high

For our purposes, there are two basic nervous systems:

(1) ‘All-is-well’ (parasympathetic) for everyday routines. This covers stuff like eating, sleeping, relaxing, hanging out, having sex, small talk, hobbies, tinkering around…

and

(2) ‘High-stakes’ (sympathetic/ ‘survival response’/ fight-flight-freeze) for responding when the stakes are high.  This is the ‘get your butt in gear’ reaction that takes over when something feels like a big deal.

High-stakes can get involved in all kinds of stuff.  This includes both threats and opportunities.  The critical factor is that (from the person’s point of view) the stakes are high.  For example, here are some things that can set off the high-stakes response for me:

  • Discovering new possibilities, new gossip, twenty dollars or my cat in the road
  • Taking tests, exams, the best donut or advantage of someone else
  • Scoring a point, contract, bargain, victory or high
  • Getting paid, laid, yelled at, ripped off, excluded, assaulted or stopped by police
  • Going on first dates, adventures, job interviews or a personal rampage
  • Performing on the job, in sports, in college, during public hearings or psychiatric exams
  • Resisting temptation, peer pressure, arrest, detention or a doctor’s opinion

Suffice it to say, the definition of ‘high stakes’ is a personal matter.  It depends on what you have lived or come to know.  Thus, one person’s ‘high stakes’ might not even register on another’s radar.

4. Explaining intense or extreme responses

To discover relativity, Einstein had to take the perspective of atoms.  To see the value of high-stakes responses, we have to experience what is happening from the high-stakes viewpoint.

When the stakes seem high, human beings are wired to respond in one of three ways:  fight, flight or freeze.

  • Fight’ goes after threats and opportunities.  It takes them on or brings them down.
  • ‘Flight’ avoids threats and opportunities.  It gets away (runs, hides) as fast as possible.
  • ‘Freeze’ hides in plain sight.  It shows no apparent reaction (de facto disappears), giving others nothing to notice or chase.

Despite their clear-sounding names, fight, flight and freeze are not fixed forms of expression.  They are directional tendencies that can occur across many life dimensions. This allows personal strengths, past experiences and familiar (‘tried and true’) behaviors to be optimized for survival value.  Here are some ways that I have expressed fight-flight-freeze when the stakes felt high to me:

 


Dimensions of Fight-Flight-Freeze

  • Physical
    • fight: striking out, yelling, swearing, telling someone to ‘get out! breaking stuff
    • flight: leaving the room, not showing up, running away, cutting, trying to kill myself
    • freeze: doing nothing, hiding in bed
  • Emotional
    • fight: raging, hating, envying, craving
    • flight: avoiding, cowering, dreading, numbing with food, drugs, sex, spending, computer, games
    • freeze: poker face, going numb
  • Social
    • fight: verbally attacking, ridiculing, blaming others, complaining, rescuing
    • flight: obeying, begging, flattering, apologizing, backtracking, blaming self, compensatory romantic interest
    • freeze: saying nothing, playing along, going with the flow, withdrawing
  • Intellectual
    • fight:  arguing, planning, plotting, obsessing, out-smarting
    • flight: distracting, fantasy
    • freeze: forgetting, going blank
  • Spiritual/ existential
    • mostly fight:  praying, seeking visions, looking for signs, exploring energy, becoming a deity
    • mostly flight: bargaining with God, trying to be a good person, wishing I were dead
    • freeze: losing time/ awareness/ consciousness

(Please note: Depending on context and underlying intent, the same response may fit in multiple categories.)


 

The wide variability of high stakes responses is a tremendous asset to our species.  It ensures that people will respond in numerous rich and creative ways.  When an entire community is facing a threat, this promotes resilience and survival overall. If we all responded the same way to danger or opportunity, a single threat (predator, disease, disaster) could wipe us out. We need the extremes that people tend to under stress to safeguard group survival.

On the other hand, when the stakes are seemingly individual, the virtue of diversity can get obscured. Since only one person is reacting, this can look rather odd to everyone else. Imagine Beatlemania, but only you can see the Beatles. Visuals here if you need them (with a little help from my friend, JH).

It’s also worth noting that there is a dose-response effect.  In other words, the higher the stakes and the longer I’ve been in that frame of mind,  the more intense or extreme my responses tend to get.  Over time, this has become a good way for me or others to gauge how important the needs involved are to me.  For example, if things seem relatively manageable, then my responses tend to be manageable – both by me and others.  On the other hand, if I can’t imagine living or being happy if the needs aren’t met, my responses tend to flair accordingly.

 

6. ‘Sarah, are you calling inappropriate the new normal?’

If you are nodding along with me at this point, thank you for getting it!  On the other hand, if you are feeling confused or disgusted, you are not alone.  Clearly, my experiences violate conventional norms. They routinely get seen as unacceptable, disordered or ill.

On the other hand, like the vast majority of the world, you may be seeing my life from an ‘all-is-well’ perspective.  And, for ‘all-is-well’ living, my responses sure aren’t the norm.

But that is precisely the point I am trying to make.   In behavioral health populations, all-is-well is not the norm.  The norm in behavioral health populations is violence, deprivation, poverty, injustice, and marginalization. In other words, the stakes are high all the time. Problems build on each other, then compound exponentially.  We rarely, if ever, get a break.  We feel like we constantly have to defend our right to be.  In dose-response terms, the dose is enormous.  So, predict a pretty big response.

From my experience, despite a lifetime of trying to learn how to do it differently, that is what keeps happening.  But don’t just take my word for it.  Here is 18-year-old Sabrina Benaim“Explaining My Depression to My Mother.”

And before you say, stop making excuses for yourself and take a little responsibility, consider the following (apart from the 20 years of therapy, thousands of dollars out of pocket, 20+ drugs tried, studying this stuff at the doctoral level, devoting my life to trying to understand it):

There is a really good reason that high-stakes responses are hard to turn off:  Any conscious, reality-based human being should be bothered by high-stakes conditions.  As a practical matter, the high-stakes response is a message. It is like your hand burning on a hot stove. The intense feeling (pain) tells you to move your hand. This prevents further damage. If you just rationalize or drug that sensation away, there is no telling how bad you’ll end up.  (We have the scars to prove it.)

Equally important, it is not an accident that high-stakes responses come across as ‘inappropriate’ and alarming. This is by nature’s design, and it serves a dual purpose:

  1. Predators/ competitors are unable to anticipate or plan for what we’ll do.
  2. Well-intended others will know that something is wrong.

Hence, while high-stakes responses no doubt alarm and baffle others, that is why it has actual survival value.

This highlights the futility of trying to classify so-called ‘mental disorders’ in a high-stakes population. The very purpose of our responses is to defy explanation. Outsiders are not supposed to know what is going on.  It’s a plus, not a minus when potential predators can’t agree.

The same survival function also explains why observers find these responses so distressing.  High-stakes responses are supposed to cause alarm. This scares outsiders off and alerts those close to us that all is not okay.  If society worked the way nature intended, the outcome would be great.  Opportunists are deterred.  Allies rush to your aid.  Real friends stick around and try to find a way to help.

That’s also a message for would-be helpers.  The assessment tool is built right into the high-stakes system.  The rules are fairly clear if you know what to look for:

 


High Stakes Rule #1: When something makes it worse, the stakes go up, and responses get increasingly extreme.

High Stakes Rule #2: When something makes it better, the stakes go down and all-is-well eases in over time.


 

In other words, the so-called ‘ravings of lunatics’ are actually  ‘rational’ from a high-stakes perspective. They scare off opportunists, attract available allies and weed out would-be helpers who don’t help. If no help is found, they keep us alive and free to keep looking.

From this vantage point, perhaps now you can appreciate the violence – the actual soul torture – of forcing survivors to present as if ‘all-is-well.’  Not only does that obliterate what we have experienced, it takes away what is often the only means we have to communicate our pain to the culture at large.

Suffice it to say, given the state of the world today, you should find us painful to be around.  You should find it difficult if asked to bear witness. That is what puts your hand on the stove burning with ours. That is what motivates you – everyone – to look for the source of the burning.  That is what makes it possible for human beings, in the spirit of Einstein — to get curious about the little guy, wonder what it is like to feel that small and discover a whole new reality outside of ordinary vision.

With the benefit of hindsight, what do you say we also look for a better energy source to power human relationships?  Instead of splitting dissenters off or leveling resistance, how about this time we stick with imagination and empathy and learn to create a  workable, honest fusion?

References:

(1) Caplan, PJ (1995) They Say You’re Crazy: How The World’s Most Powerful Psychiatrists Decide Who’s Normal  (Perseus Books: www.aw.com/gb).

(2) Whitaker, RH (2010). Anatomy of an Epidemic. New York: Random House.

This blog is a contribution to the Campaign to Support the CRPD Absolute Prohibition of Commitment and Forced Treatment. To see all of the Mad in America blogs for this campaign click here.

Sarah Knutson: Rethinking Public Safety – The Case for 100% Voluntary

(originally appeared on Mad in America website)

(now available in Italian translation on il cappellaio matto website)

Not long after posting this Principle from the 10th Annual Conference on Human Rights and Psychiatric Oppression, the following comments appeared on my Facebook page:

“It would have to be replaced with something else, we need to have strong supports we need to take care of each other.”

“Hey you radicals mental illness is a physical illness that requires the attention of a specially trained medical doctor if don’t like the treatment leave for a dessert[sic] island where you can suffer without disturbing others”

CRPDThese are understandably difficult issues.  Historically, there has been a lot of difference of opinion and genuine debate. In 2006, the United Nations weighed in.  They approved the Convention on the Rights of Persons with Disabilities (CRPD).  The CRPD prohibits involuntary detention and forced interventions based on psychosocial disability.  These are considered acts of discrimination that violate the right to equal protection under the law.  Under the CRPD, people with psychosocial disabilities have the same rights to liberty, autonomy, dignity, informed consent, self-determination and security of the individual and property as everyone else.

Shortly thereafter, forced ‘treatment’ was also held to violate the Convention Against Torture:

States should impose an absolute ban on all forced and non-consensual medical interventions against persons with disabilities, including the non-consensual administration of psychosurgery, electroshock and mind-altering drugs, for both long- and short- term application. The obligation to end forced psychiatric interventions based on grounds of disability is of immediate application and scarce financial resources cannot justify postponement of its implementation.

Forced treatment and commitment should be replaced by services in the community that meet needs expressed by persons with disabilities and respect the autonomy, choices, dignity and privacy of the person concerned. States must revise the legal provisions that allow detention on mental health grounds or in mental health facilities and any coercive interventions or treatments in the mental health setting without the free and informed consent of the person concerned.

Many of us hoped that would be the end of it: No forced treatment, clear and simple.  Nevertheless, the debate goes on.  It seemingly has sped up – rather than let up – over the past several years.  Clearly, many of us are sincerely struggling with these issues.  There are people of conscience on all sides.

 

The Case for 100% Voluntary

For the past ten years, the international community has been progressively moving away from involuntary interventions. This essay is the first in a multi-part series.  It highlights important reasons why the rest of us should follow suit. They are as follows:

1.     These issues are universal, not medical

Life, by nature, is difficult and risky.  Our primary certainties are death, loss, and vulnerability. Pain, suffering, sickness and need are pretty much a given.

The idea is to minimize risk as much as possible, but still keep the essential spontaneity of feeling alive.  This a highly personal undertaking. One is never certain what this means for someone else.

That being said, communities can and should offer support to all who want it. At certain times, any of us might want help to balance: (1) factors that concern others, (2) feasible (medical, natural and community) alternatives; (3) risks and benefits; and (4) personal values and lifestyle considerations. The onus, however, is on would-be supporters to earn and maintain our trust. This is the approach adopted by the United Nations in the CRPD. (Art. 12).

2.     Clinicians are lousy predictors

It’s hard to know in advance who is a ‘danger.’  Clinicians are notoriously poor in predicting suicide or violence.  In individual cases, they barely do better than the toss of a coin.

Equally disturbing, the people they will lock up have not been accused of a crime, much less convicted.  Yet, on flimsy odds, innocent people lose jobs, businesses, careers, homes, custody of kids, and much more.

And that’s not the half of it.  Typically, to lose freedom in society, twelve jurors who have been carefully screened for bias must unanimously agree that someone is guilty beyond a reasonable doubt. In the mental health system, a single clinician with little to lose and a lot to gain makes the call.  By far the safest course is erring on the side of lock up. Guessing wrong means serious harm, distraught families, internal reviews, bad press, lawsuits, potential job or income loss.  Sleepless nights and calls at home should not be overlooked.

3.     Drugs, at best, are problematic

Contrary to popular belief, the choice to refuse drugs is rational.  Even if you meet diagnostic criteria, there are many good reasons to ‘just say no.’ This not just for individuals and families, but for insurers and governments as well.

During the past several decades of increasing drug use, disability rates have sky-rocketed.  Long-term outcomes and relapse rates have worsened overall. Particularly disturbing is the fact that third world countries (where people are too poor to afford the drugs) get dramatically better results.

Even as a first-line of defense in emergency settings, there are serious concerns.  In simple fact, drugs are not harm neutral.  Known effects include death, psychosis, rage, despair, agitation, shaking, vomiting, impulsivity, tics, uncontrollable movements, memory loss, skin crawling, insatiable hunger, rapid weight gain, dulled awareness, impotence, insomnia, hypersomnia, fatigue, mood swings, and the list goes on. Many of us have experienced the drugs creating urges to violence or suicide we never had before.  Some of us have acted this out.

The long-term considerations are equally alarming.  Susceptibility to relapse, loss of brain matter, obesity, diabetes, congestive heart failure, and permanent disability increase as a function of exposure.  Due at least in part to drug effects, the ‘mentally ill’ lose 15-25 years (on average!) of our natural lifespan.

For many people, the health risks of drugs aren’t even the half of it. A lot of what you like depends upon your values. Preferences and comfort differ for, e.g.: relying on drugs vs. learning self-mastery, following rules vs. asking questions, respect for experts vs. internal wisdom, managing feelings vs. experiencing feelings, medical vs. natural approaches, and seeing the source of healing as science vs. human or spiritual connection.

When it comes to drugs, one nutter’s meds are anutter’s poison.

4.     Promising alternatives are not being considered

Many do better with non-medical approaches (or might if these were offered).  Fortunately, the options are legion. (See end notes.) Unfortunately, the alternatives are not well-known by clinicians, politicians or the general public.  They therefore not widely offered or available, and are not considered to be worthy of clinical trials.

This is not ‘the other guy’s problem.’  Vast numbers of us are potentially affected.  One in four crosses paths with the mental health system. (3) One in three currently takes a psychoactive drug. (4) And that hardly scratches the tip of the iceberg of all who are struggling.

What separates ‘the worried well’ from the ‘social menace’?  I’d like to think it was more than my natural affinity for the only approach the doctor on call was taught to offer.

5.     Natural diversity is not a pathology

Human experience cuts deep and scatters wide.  Statistically speaking, there are many shared traits, values, and approaches to life. But outliers are a fact as well.

Our variability is to be expected.  Diversity, not conformity, is the real ‘normal.’ It contributes to the robustness, resourcefulness, and creativity of our species.  While it may not get you dates or jobs in a self-promoting, efficiency-driven, corporate-run economy, it is not a disorder.

To the contrary, it is far more like a subculture than an ‘illness.’ In actuality, scores of us value our internal experience, being true to ourselves and treating others generously.  If we speak truth to power and get fired, this is not just impulsivity, mania or disorder.  It’s having the courage of our convictions. We want a world that’s more than just self-promotion, might is right, and going along to get along.  It’s a beautiful vision.  Many of us are dying (including by suicide) for the want of it.  Far from being a social menace, in the 1960’s, Dr. King argued that such ‘creative maladjustment’ is essential in our quest for a socially just, equitable world.

6.     This is about trauma, not disordered brains

Trauma’ is pervasive and potentially causal. Ninety (90!) percent of the public mental health system are ‘trauma’ survivors.  In effect, vast numbers of vulnerable citizens are growing up without a way to meet fundamental human needs. Things like:

  • reliable access to food and habitable shelter
  • safety of person and property
  • dignity, respect and fair treatment
  • meaningful participation and voice
  • the means to make a living and obtain basic life necessities
  • relational, educational, vocational and cultural opportunities for development
  • support to share and make sense of experience in our way

If the aim is to create a safer world, trauma is a much more pressing problem to fix than ‘chemical imbalances’.  There are numerous reasons for this.  We have not even begun to scratch the surface of the implications of a truly trauma-informed system of care.  As the next essay in this series will address.

7.     Do the math – it adds up to ‘voluntary.’

The primary mechanisms for a safer world are already in place.  We already have a criminal justice system with the capacity for detention, probation, in-home monitoring, geographic restriction, behavioral health treatment, drug testing, ‘no contact’ orders, restorative justice, etc.  We already have civil restraining orders, lawsuits, and mediation.  The essential task is to update these protections – and make them meaningfully available – to address modern needs.

The money we save by making things voluntary (police, hospitals, courts, lawyers, lawsuits, staff/ patient injuries, security, insurance, staffing needs, drugs) will go a long way to making this possible.  We could fund numerous thoughtful, responsive, social justice informed alternatives.

We could invest in a truly trauma-informed criminal justice system, rather than dumping that burden on hospitals and their employees. The change in morale itself is worth the price of admission.  Imagine no locked doors and everyone wants to be there. Violence happens, you call the police. Just like everywhere else.

8.     The continued prejudice against people with psychosocial disabilities is not worthy of a free society.

There’s a saying in twelve-step rooms: Every time you point a finger, there’s three pointing back at you.  Suffice it to say, majority fears and prejudice must stop ruling the day. That is discrimination – and it begets discrimination.

In actuality, people from all walks of life have presented a grave risk of injury to self or others at one time or another in their lives: Wall Street brokers, weapons manufacturers, new parents, drinkers, children, teens, Frat houses, Nyquil users, pot smokers, crack addicts, bungee jumpers, martial artists, car racers, dirt bikers, inline skaters, snake handlers, fire builders, gymnasts, boxers, weight lifters, ragers, ex-cons, insomniacs, equestrians, skiers, diabetics who eat sugar, cardiac patients who drive…  There is no end to the list. Some people (trapeze artists, law enforcement, fire departments, magicians, military, security guards, skydivers, operators of heavy machinery) even make a living from this.

There is no principled way of distinguishing the predisposition to such risks from any other kind of psychosocial diversity.  If you needed any better proof of this, the diagnostic criteria for so-called ‘mental disorders’ are so useless that CMS threw them out in 2013 and told the APA to start over.

In any place but a psychiatric exam room, those seen as a cause for alarm would have the following rights: due process, equal protection, liberty, privacy, security of person and property, free speech, freedom of association, freedom to travel, right to contract, written charges, trial by jury, Miranda, and compensation for unjust takings.  You need these protections more, not less when you’ve committed no crime and are simply having the worst day of your life.

In a society worthy of calling itself ‘free,’ public safety would mean all of us. It would go without saying that service recipients are ‘the public’ just as much as anyone else. We would look at fear and prejudice as the real social menace.  People who use mental health services would not need protection from people like you

So please.  Stop locking us up ‘for our own good’ and calling it a favor.  This only distracts from the real question:  If the crisis services are so great, then why isn’t everyone using them? 

Here’s a litmus test. Think about your last life crisis. Did you use these services? Did they feel like a useful, viable option for you?

Before you say, “No but I’m not [crazy, poor, uninsured…],” stop yourself. Try this instead, “No, but I’m not human.

It has a different ring to it, doesn’t it?

 

This blog is a contribution to the Campaign to Support the CRPD Absolute Prohibition of Commitment and Forced Treatment. To see all of the Mad in America blogs for this campaign click here.

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Sarah Knutson is an ex-lawyer, ex-therapist, survivor-activist.  She is an organizer at the Wellness & Recovery Human Rights Campaign. You can reach her at the Virtual Drop-In Respite, an all-volunteer, peer-run online community that aspires to feel like human family and advance human rights.