Story of Pat Risser
TREK THROUGH THE YEARS
In the early 1980's I was one of the students in the first Consumer Case Manager Aide (CCMA) training program in Colorado. (This was the first training in the nation to train consumers/survivors to work for the mental health system as professional mental health providers.) I didn't remain a CCMA but went on to work as a professional Intensive Case Manager and as a therapist on a locked acute inpatient unit. However, because I had gone through that initial training, I was given the opportunity to travel with those who created and presented the training at conferences.
I traveled the conference circuit for several years. As a result, I got to make friends and know people from all over the country. Many people were impressed by the CCMA program and using information gathered at conferences (and sometimes purchased from RATC) they would try to replicate the program in their own community. By returning to the same conferences year after year, I got to hear how things had worked out as others set up their own training programs.
In Arizona, they set up a two-year program with the Community College and in Alaska, they went so far as to set up both a two-year and a four-year program. Unfortunately, these programs did not succeed. One of the research results was that "fast-track" education is successful because by the time people who have had mental health issues are ready to consider education, training and possible paid or volunteer opportunities, they have often waited a long time and are anxious to get started. Many people (particularly after their lives have been on hold for a long time) lack the patience to take the usual longer route through 2 - 4 or more years of schooling. The original CCMA program also proved, by its success, that people with mental health issues are able to absorb and learn information presented in a "fast-track" format, something that was previously thought to be unlikely.
I paid attention to what worked and what didn't as others tried to create similar programs. A few years later when I was hired in California, I was able to put what I had learned into action.
Much was happening in Colorado back in the mid 1980's. Colorado received a couple of federal grants that were important to the growth of the consumer movement. First, Colorado received a "networking" grant. I traveled the state and helped start over forty self-help, peer support groups. I also helped start several drop-in centers and seventeen new, local AMI (Alliance for the Mentally Ill) groups. For my efforts, I was recognized by my peers by being voted the first President of the new statewide consumer organization. I was also recognized by NAMI for my organizational efforts on their behalf. I also received an award from the Colorado Mental Health Association for producing an outstanding quality newsletter for the fledgling consumer organization.
Another federal grant Colorado received was a Community Support Systems Change Grant to start consumer operated businesses. I traveled the state again and trained consumers in how to write business plans and obtain 501(c)3 non-profit status (where applicable). One of the more successful of those businesses is described later in this paper.
In 1990, I was recruited by and hired to be Director of Mental Health Consumer Concerns, Inc., (MHCC), the second oldest continuously operating consumer/survivor organization in the country. In California, Patients' Rights Advocates provide legal representation to people in civil commitment hearings and in forced medication competency hearings. MHCC was the contract agency providing this service in Contra Costa County. In addition, MHCC did monitoring (seclusion and restraints, medications, etc.) on inpatient psychiatric units and in Board and Care homes. During my tenure with MHCC I helped to grow the agency budget from $150,000 to over $1 Million per year. However, the largest reason for hiring me was that MHCC wanted to replicate the success of the Denver CCMA program.
I worked with Jay Mahler and others in Contra Costa County California to try and get a state "systems improvement" grant. Unfortunately, we didn't get that grant but our efforts weren't in vain. In the process of creating the grant application, Jay and I did a lot of outreach and created successful coalitions with consumers/survivors, family members and providers. Following the unsuccessful bid for the state grant, these coalitions felt that the idea of consumers as providers still had merit and decided to pursue other means of supporting the project. Using the "clout" they had as a coalition of various interested parties, they managed to get the county mental health department to agree to fund the first training. In addition, there were some small amounts from Kaiser, Vocational Rehabilitation, United Way and other sources to help support the project.
I worked with others to update and revise the curriculum to reflect the knowledge I had gained over the years. In addition, the curriculum had to be updated to reflect current knowledge and trends in mental health including information about dual diagnosis, trauma issues and recovery. I also knew I'd be unable to withstand the rigor of trying to teach the class by myself. I'd had three heart attacks by this time. In order to relieve some of the teaching burden and to assure that the students would be exposed to more diverse perspectives, I chose two others to help him facilitate the classroom training.
It was important that the training be "consumer/survivor" operated. I therefore chose Mary Carley to help carry that load. She is a wonderful "earth-mother" type who was very supportive of the students and who helped them as issues would arise in the classroom. I also chose Candace Fox. Candace is a mental health professional who spent most of her time working for the county in "crisis" services. She also had experience as a trainer and was the primary facilitator of various family member trainings in the county. Candace was also one of the more progressive minded providers in the county and she would "balance" the information I presented without being offended or "pushing" the medical model onto the students.
From mid-March to the end of April in 1994, the first "consumer/survivor operated" training was conducted. The six-week training was so successful that the county immediately wanted more trainings to follow. I worked though the summer with various groups in the coalition to create a ten-week training that would be even more thorough.
The second O.F.F.I.C.E. (Office For Family Involvement and Consumer Empowerment) training commenced in October. Two weeks into the training, on October 13, 1994, I had my fourth heart attack. Fortunately for the class, Mary Carley and Candace Fox had already done one training with me and they were able to pick up the slack and keep the training on schedule. I returned to the class but in order to ease my burden, I began cutting back on the various other activities such as outreach to the community. The rest of the folks at MHCC also carried an increased load to help things along. Karen D'Antonio who had been the original state grant coordinator carried much of the burden for keeping the coalitions together and focused. Barbara Lyon (MHCC's co-coordinator) worked extra to assure that the funding would continue. Jay Mahler worked on job placement and job development to assure that the students would have opportunities when the class graduated. The trainings were truly a team effort.
Jay cultivated relationships in Solano County and eventually, OFFICE training was done there also. It was at one of those classes where the program that eventually became known as "WRAP" was created. (The original WRAP was done as a brainstorming session in the classroom. The results were written down and then placed on my web site. Over two years later, Mary Ellen Copeland published "WRAP" based upon that and other works.) The program grew and its success lead directly to a major conference in the San Francisco Bay area called "Jobs Now." All of the local mental health directors wanted to jump on the bandwagon. This was quite a testament to the success of the program. Further trainings were done in Contra Costa County but the curriculum pretty much remained the same. It was settled that eight-weeks, not six or ten, was the ideal length of the full training. Contra Costa tinkered with the program a bit after I left and tried to create a program that only met two or three times a week for a longer period of time but that program was never quite as successful in terms of being able to help people find satisfaction in the paid or volunteer position of their choice (or go back to school for more education).
FORWARD TO OREGON
I moved to Oregon in the Spring of 1996 to be with my new sweetheart, Trish. I felt I'd had a pretty good run and decided to retire. This was probably a good idea since I had my fifth heart attack at the end of January 1997. As I slowly recovered, I also slowly built connections and started to get involved in mental health in Oregon. While I claimed to be "semi-retired" I couldn't keep out of the field he loved and to which I'd dedicated my life.
I got involved at the state level and based on my reputation from Colorado and California, I got even more involved at a national level. For about five years, I worked hard at state and national mental health issues. However, it was at one of the national meetings in Washington, D.C. that I realized that I may have lost touch with the "grassroots." Therefore, when I returned home, I got involved in local activities for consumers/survivors. I visited the drop-in center and got to know some of the people. I investigated and found out ways to get involved in the local county mental health council in Clackamas County.
Eventually, I became the chair of the Clackamas County Mental Health Council. During one of my many conversations with the county mental health director, I reminisced about the trainings I had done in California. Intrigued, the mental health director, Melinda Mowrey, wanted to learn more. It suddenly dawned on me that I could and should provide similar training in Oregon. A meeting or two with Melinda, a meeting or two with Jessica Leitner (Adult program boss) and funding was secured and the basics of the training were in place.
In talking with Jessica and describing the program, she felt that two county staff would be able to carry the role that had been played by Candace Fox in California. Those two were Erin Staley and Jan Miller. To provide the support that had been provided in California by Mary Carley, I elected to work with Empowerment Initiatives, Inc. The Executive Director of EI, was Adrienne Young and I knew that she understood the principles of self- empowerment better than most and would be great at fulfilling the support role. Adrienne secured a contract with Clackamas County and hired Angel Moore to be the co-facilitator of the training with me.
In addition to updating the training to include contemporary subjects such as trauma and abuse and spirituality and sexuality, the training took on a new name. O.F.F.I.C.E. (Office For Family Involvement and Consumer/survivor Empowerment) became S.P.I.R.I.T. (Service Provider Individualized Recovery Intensive Training). The name was developed in Contra Costa County after I had left but I felt it was a better name and more reflective of the purpose than the original OFFICE name.
I had other conflicting interests happening in his life. My grandmother had died in Ohio and I was interested in purchasing her home and moving back to the small town in which I had been born and raised. The schedule for the move to Ohio meant that the training in Oregon had to move very quickly. There wasn't time to do the outreach and coalition building that had been a part of the foundation of the program in Contra Costa County in California. I also wanted to get in some research to validate the success of the program but there just wasn't time. There was also not enough time to do the job development that had been done in the past. However, I knew that the most important part of the training was to help people regain their personal self-esteem, self-confidence and the self-assurance to pursue whatever their dream may be, beyond the end of the formal training.
So, the training proceeded despite all of the pieces not being in place. I took the lead in training the class and trained the others (Jan, Erin and Angel) to be the trainers of the future. Everyone pitched in and did a lions share of the work of matching speakers to the dates in the curriculum and even teaching some classes themselves. Even before the class began, everyone was working hard to create the flyer, the application, conducting interviews of potential students and arranging the classes.
By half way through the training, the students were chomping at the bit to start working with the system and making positive changes and helping other consumers/survivors. With some guidance from Angel, the students decided to articulate their progress by writing letters of thanks to Melinda for the opportunity to participate in the training. These letters provided a powerful testimony to how much the class promotes recovery. (See http://home.att.net/~PatRisser/StudentLetters/index.htm)
At present, Angel is leading the way to create more classes in Oregon. MHCC continues to provide some scaled down version of the training without as much success as that seen in the fuller versions of the training. Colorado and RATC folded the trainings they did, a few years ago. I am in Ohio and will hopefully find an audience there.
FLASHBACK (HOW I GOT HERE FROM THERE)
My difficulties with the world started prenatally if you believe that's possible. "Mommie Dearest" lost her job trying to abort me by jumping off of tables at work. She was heavily into physical abuse but, I'll spare you the sordid details for now. (If you want details, some are at: http://home.att.net/~parisser/book/book.html) My dad died in a car accident when I was almost 2-years old. The court records reveal that he would have been the first male parent awarded custody of minor children in the state of Ohio had he lived two more weeks. "Mommie dearest" remarried when I was seven hence marking the beginning of the sexual abuse I was to suffer until I was 17 years old and finally managed to emancipate from the family.
My first encounter with psychiatry happened in the early 1970's when I was about 22 years old. By then, I was married and had one child. Also by then, I had managed to repress most of the memories of any of my past. One day I got angry and after some yelling, I threw a plate at the bedroom door. I became so afraid of my anger that I sat on the couch, put my elbows on my knees and my clenched fists to my head and dissociated. I physically locked up and mentally went away. My wife called 911 and the medics straightened out my rigidly curled body and got me on a stretcher and to the hospital where they managed to stop the hyperventilation. She was scared and so was I when I came to, so we gladly accepted the referral to the psychiatrist.
I went to the psychiatrist with the faith of a child. I followed orders faithfully and took the Stelazine and Navane (two powerful anti-psychotics), Imipramine and Sinequan (two anti-depressants) as well as three different "side-effect" medications (Cogentin, Valium, Benedryl) he gave me quite religiously. I never missed a therapy session nor did I question the diagnosis of Schizophrenia, catatonic, atypical. Heck, I didn't even know what that was.
Over the years, I managed to have two more children and hold several jobs in a nice career progression. All the time, I continued to take the drugs and trust the shrinks. I managed to find a way to go to college and became student body president and quite an overachiever. It was in college that I made my first serious suicide attempt because of depression. Of course, by then, I was becoming a bit skeptical. It seemed weird that my diagnosis and the drugs would change every time I saw a different shrink. My label changed from schizophrenia to schizophreniform, to schizotypal, to schizoid personality, to schizoaffective. Then I went through all the various affective disorders. I was labeled bipolar I and bipolar II. I was labeled with major depression with various features.
Between college and law school, my family and I spent time homeless on the streets of Denver. My wife and I took turns sleeping in the front seat while our three children and two dogs slept in the back seat of our car. We kept a vigilant watch because we were so afraid that the police would catch us, take us to social services and they'd break apart our family. Eventually, I managed to scrape together some student loans and get a small place to live.
I managed to struggle through to second year of law school before things finally got to be too much. I made several serious suicide attempts and became a well-known figure within the Community Mental Health Center. As I became more and more sucked into the system and their attempts to "treat" me, I got worse and worse. I did some time in the state hospital and I had my share of run-in's with the Vocational Rehab system and other so-called supports such as welfare.
I put my time in as an inpatient and an outpatient on a voluntary and an involuntary basis. I did time in individual therapy and group therapy and I served my time in "Day Treatment" as well as all the other sorts of treatment modalities. I've had every diagnosis in the book from schizophrenia to manic-depression to major depression to multiple personality to 8 of the 12 different personality disorders to various dissociative disorders to all sorts of other labels. I've taken just about all of the drugs and I've suffered the pain of a serious dystonic reaction as well as the embarrassment of having that reaction in front of others who didn't know what was happening.
When my memories started to come back, I only knew that I wanted the emotional pain to stop and I wanted to die. Death quite simply meant, no more pain. (To this day, I have no fear of death and view it more as a relief from life than as any sort of ending. It will be a return to the eternal sleep from which I temporarily emerged when I was born.) As I started having flashbacks of the repressed traumatic memories I couldn't understand the pain and how something so many years previous could still hurt me now. I would cut myself. I would sit under a freeway overpass and rock back and forth and bang the back of my head against the concrete until the back of my head was a bloody mess. I would walk down the middle of the street (no walls at 3 a.m. unlike state hospital where there was not much room to pace) and holler at the voices (usually some remembrance of mom) to get the hell out of my head. I would cut myself and watch the arteries throb until I could finally no longer be consumed by the emotional pain.
The single biggest question I faced as I was flooded with memories of pain and terror was, "Why?" None of the mental health professionals ever had an answer to this question. Why me? Why didn't I die? Why didn't family, friends or neighbors help when I was a child? They must have heard the screams. Why did mom and dad do it? Why does any adult hurt a child? I finally realized that my "why" was mine and the only one who could find an answer to the question was me. Mental Health and all of it's practitioners held no answers to *MY* question. That was when I broke from therapy and drugs and started to work on my own healing.
Eventually, I found some support. I became part of the first male/female mixed group in the country for people who had survived incest and child abuse. We also did a special "Outward Bound" for our group to rebuild trust. I found peer support with one of the oldest peer support groups in the country - Esso Leete's Denver Social Support Group. I found the consumer/survivor movement in the early 80's and started to heal and recover.
I had a chance to leave day-treatment and I jumped at it. I became part of an experimental group of psych patients who were trained to work as "Consumer Case-Manager Aides." I went through the training and just as we were graduating, I applied for a job as a Case Manager (as opposed to a Consumer Case-Manager). I went to work in Denver. Our job was to seek out those most in need of assistance and try to aid them in order to cut down on the flow of folks through the revolving door of the Denver Mental Health system.
I later went on to work on the acute locked inpatient unit. I never really fit in because I didn't follow the rules; I did things like let folks out to go for walks. I was the only mental health worker on the unit to never get assaulted. I had stopped taking my drugs and I'd stopped therapy and I was learning more and more about the system and how it worked. I joined the local AMI group and I even served on the state AMI Board of Directors for a three-year term. As my reputation as a psych survivor grew, I became more involved in different parts of the system. I served on the Board of Directors of the Denver Mental Health system (appointed by Federico Pena who went on to be Secretary of Transportation for President Clinton). I was appointed by the Governor to the State Regulations and Standards Commission. I was at the State Department of Mental Health for meetings several times a week.
In the early 1980's I worked with the state of Colorado to obtain federal grants to build a statewide consumer network. I helped to build and start over 40 self-help groups around the state and mold them into a network. I was unanimously elected the first President of that network. I helped write the grant for Colorado that got us federal funding to help mental health consumers own and operate their own businesses and I trained folks in how to do that. I built a coalition that successfully opposed a legislative bill supporting shock treatment. I helped to build drop-in centers and I fought (successfully) for housing for the homeless.
Being an advocate was easy for me. I'd started as a kid in elementary school. Back then, I ran an underground newspaper from a friends garage attacking the school for being segregated. I went on to fight against the dress code. I fought for women's rights, veterans rights, students rights, farmers rights, the rights of the homeless and the rights of folks with physical disabilities. I was with the folks in Denver when, from their wheelchairs, they took sledge hammers and made their own curbcuts. I knew how to be an advocate. Heck, I didn't know much else. My friend Mary Carley once introduced me to an audience. She said, "This is my friend Pat. He and I fight all the time but that's okay because that's how he communicates." It's true. I am a strong advocate and I often do communicate with passion.
Through it all, I was working on my own healing. Along with the memories I'd repressed, I also manage to suppress most of my emotions although they churned inside like a seething cauldron. Eventually, it all caught up with me and I suffered a heart attack. The first was in 1988 and I was 35 years old. I had two more heart attacks in 1988 but, I didn't slow down. I'd get out of the hospital and go right back to work. I'd been through too much and I'd seen too many of my friends die due in whole or in part to the "system" and I was going try and fix it.
I moved on to California where I was a Director of a Patients Rights Advocacy Program and a Self-Help network (MHCC). I worked there and I fought valiantly to protect the rights of mental patients. I joined and was appointed to numerous committees and did all the systems advocacy of a good advocate.
I've been there/done that on many things. Throughout my advocacy, I've reached many conclusions. I've figured out that each person is an individual and that only that individual has the answers for them. No amount of professional intervention or treatment of what-have-you will change that fact.
Psychiatric drugs are dangerous. Most people who take these drugs don't know this. They can read of the dangers in the PDR (Physicians Desk Reference) and yet they will continue to take the drugs. They are looking for a quick fix to complicated human problems. Some claim relief of symptoms. I claim that life isn't a symptom; it's something you have to learn to deal with. If you hear voices, learn to deal with them. If you get depressed, learn to deal with it. This isn't the same as saying to, "pick yourself up by your bootstraps." I'm not that naive. However, the fact is that depression or voices can be dealt with if you are willing to learn how to do so. If not, you'll probably go into denial and take dangerous drugs and refer to certain aspects of your life as "symptoms."
I have helped lots of folks do figure out how to deal with life. If you want to know how, you can figure it out yourself. I started with Judi Chamberlin's book, "On Our Own" and I continued through various twelve-step programs and tried just about everything at one time or another. One of the best things I discovered is that we have a difficult time holding too many things happening at once within ourselves. In other words, you'll find it hard to be laughing and depressed at the same time. You'll also find it hard to feel depressed and sorry for yourself if you are busy giving of yourself to others. One of the best ways I discovered about how to help myself is to help others.
I've learned that we learn our helplessness. We may not like it but, we are taught to trust and have faith in doctors and professionals and the less we have faith in ourselves, the more likely we will be to surrender ourselves to others. The problem is that mental health professionals don't have the answers. Psychiatrists spend many years in school learning to view us as diseased pieces of flesh and in the process, they forget that we are people. They forget the power of intangible aspects of people such as the human spirit.
In the process of learning to treat problems instead of people, psychiatrists develop an ego problem. They feel a great internal pressure to have the answers for others. When they fail, they turn to the prescription pad to mask the problems that life presents us. Most psychiatrists don't ever follow up on the learning they gained in college. Instead, they rely upon the information provided them by the folks who market and sell the drugs. I have a real problem with this. I don't buy a car or anything based solely upon print and other commercial data but most docs (particularly shrinks) seem to feel they are immune to market forces. This is their ego problem and not science.
I was disgusted with what I witnessed in day treatment. I saw folks who'd been there for many years and the system called them a "success" because they had learned to comply with taking the drugs and hadn't been in the hospital. What I saw were folks who did nothing but smoke cigarettes and drink coffee all day. I figured I could do better so I built drop-in centers. Folks came to the drop-in centers and guess what...they did nothing but smoke cigarettes and drink coffee. The problem was that they had been brainwashed into a dependent state of helplessness. (Granted, it wasn't everyone so don't flame me because of this.) I knew that the problems ran deeper than just getting folks away from the professionals.
I designed a curriculum and began training folks. I helped to break the brainwashing and to rekindle the hopes and dreams that existed in each of my students. I helped people to again believe in themselves instead of the system or the drugs. I helped folks to gain the tools and knowledge to cope with life. I know what's possible because I've been there/done that and I helped folks to seek and find their own answers.
Armed with experience and expertise, I went to the system and trained classes of 20 people at a time. They are all better off now and no longer are dependent upon the system or drugs. (Several may still use psychiatric drugs but now it's only by choice and fully armed with information on the potential risks and benefits.) I guess I've trained hundreds of folks now and by any measure the system cares to use, I've been more successful than the system was in reaching many of these folks who had been labeled as "difficult". My students have not returned to the hospital. My students use fewer psych drugs. My students are more self-sufficient and most are working. They are no longer a drain on the systems resources and in fact, are now productive taxpayers for the most part.
I know of many alternatives that are taboo in the mental health field. I know of the healing power of touch which is acknowledged by most of medicine but which is particularly frowned upon in mental health. I know of the power of knowledge which is acknowledged almost universally but in mental health, many clients have never even looked up their diagnosis or questioned it as it appears in the DSM (Diagnostic and Statistical Manual).
I find it interesting that the DSM is used only by American psychiatry. If it is not a fund raising tool for the APA (American Psychiatric Association) which publishes it, why isn't the ICD (International Classification of Diseases) which is used by all the rest of the field of medicine as well as psychiatrists everywhere else in the world, good enough?
I find it interesting that when they claim to find a genetic marker for depression or manic-depression (which they can't define in medical terms) that it appears on the front pages of journals but, when the results of that research can't be duplicated and the research is later discredited that those results are buried in the back of the trade publications. However, shrinks with no time to review the research themselves still believe in the initial claims even after they are discredited. The shrinks pass this on to their patients who then use those arguments to defend the fact that they take the harmful psychiatric drugs.
I smoked cigarettes for over 35 years and I never defended my smoking as not being harmful. I acknowledged the harm and did it anyway. I wish if folks were going to take harmful psychiatric drugs they'd at least be honest enough to do the same. I have harmed myself in many ways over the course of my life and I can certainly think of many better ways of self-harm than psychiatric drugs but, to each his/her own. I even sometimes wonder why mental patients don't just go down to the corner bar and have a couple of beers on Friday night and let off steam that way like everyone else. It'd likely be far safer than taking psychiatric drugs that contribute to shortening our lives by over 25 years.
Enough of the rant against the drugs. I want to let you in on a secret. I'll tell you how I helped people to live, thrive and survive without the system. I helped them to discover their passion. I got to know them and I asked them what they loved, what they dreamed about, now and in the past and I helped them to see that it is possible and I helped them to reawaken those dreams. If someone felt strongly about saving the whales then, I helped them to get re-involved in doing that. I discovered that if a person is pursuing their passion, they have a will to live that grants them a strength they might otherwise not have.
I helped a person whose passion was herbs. He was an expert but had been consumed by the mental health system and had languished in day treatment and hospitals for years. I got him to talk about his passion. I could see the way he lit up. His energy was unbelievable. I helped him to write a business plan and I helped him to get start up capital to start an herb farm in southwestern Colorado. A few years later (drug and system free) he sold his little farm for millions of dollars to a new enterprise called Celestial Seasonings Tea. Not only this but, anything is possible. We are limited only by ourselves and we must not let the system delude us into thinking otherwise.
This is who I am...a believer in the power of the individual and the strength of the human spirit...a person who's been clinically dead and has chosen life instead...an advocate who appreciates the forum of madness where folks can share themselves. I'm enjoying life and all it has to offer.
IN THE BEGINNING THERE WAS MARK: CONSUMER/SURVIVOR ACTIVISM - WHY?
I've dedicated the greater part of my life for over twenty years as an activist in the mental health field. I've occasionally been asked, "why?"
About twenty years ago, I'd been hospitalized several times for suicide attempts. My initial diagnosis was schizophrenia but, that changed each time I saw a different doc or therapist. The diagnosis also changed depending upon what the insurance companies were likely to pay for at any given time. I'd taken and tried most of the psychiatric drugs available at the time. I'd been in and out of day treatment several times.
The day treatment I was in at the time was changing. They were going to create two new levels. One level would be for the "high functioning" and the other would be a longer term, more elementary program for the more hopeless cases who were designated "low functioning." I fell into the latter group.
Of course, in every hospital and in every treatment program in which I'd participated, there was the same old worn out standard fare. They would have groups which included stress management, assertiveness, recreational therapy (RT) also known as play time and of course, occupational therapy (OT) which is another name for ceramics and other useless arts and crafts sorts of activities.
One day, I'd grown bored with hearing the same thing repeated in eight week cycles and so, as assertiveness group was beginning, I challenged the therapist. I claimed that I could run the group as well or better than they could. Naturally, this upset the poor fellow and in his flabbergasted state, he accepted my challenge. He haughtily assumed that I'd fail miserably and thereby be set in my proper place.
I approached the front of the room with confidence and calmly proceeded to articulate a method of understand assertiveness which was far in advance of that which he was going to teach. Flustered, he got up in a huff and left the room to the cheers of the dozen or so of my fellow compatriots who were present.
From that day forth, I was known as "treatment resistant" and "low functioning" among the treatment staff but, I was elevated to a sort of informal "senior client" status amongst my friends.
Unbeknown to the staff, we clients talk a lot. We talked before groups, we talked after groups, we talked before day treatment, we talked after day treatment, we talked during lunch. Of course the staff were not aware of this because they were busy in their offices doing staff stuff. We especially loved to talk at lunch, when the staff would disappear like cockroaches when you turn a light on in the kitchen. While staff would climb into their nice cars, we'd sit around and eat our meager bag lunches and talk together.
We talked about everything. We talked about our families. We talked about the staff. We compared which drugs we were on. We compared docs and hospitals. We talked about who we had been before we were mental patients and some of us even dared to still dream and hope for a future.
One friend named Mark Smollen had a drinking problem. He was also on some very heavy-duty neuroleptic drugs. Using all the influence I could muster I warned Mark of the dangers of doing both the drugs and alcohol. With the added influence of the others in the program, Mark stopped drinking.
Staff had their own impression of Mark. Mark was bored with day treatment. He'd sit in the back of the room with his arms folded across his chest and never say a word. He was labeled "low functioning" also.
Mark was very alive and animated among us mental patients. He'd come in every day and boast that he had gone another day without a beer. Mark was especially eager to let us know on Monday's that he'd managed to go a whole weekend without a drink. We were very proud of Mark. We saw his great sense of humor and his enthusiasm for life. Staff on the other hand saw none of this. All they saw was the same old Mark, sitting in the back of the room with his arms folded across his chest.
At my weekly appointment with my therapist, I was told of a brand new program to train consumers to work as case manager aides. She asked if I was interested. I could barely contain my exuberance. Of course I was interested. I'd be interested in anything to get me out of the drudgery of day treatment. The next day, I applied and was accepted to this revolutionary program. It was the first of it's kind in the country.
I leapt into the program with all the enthusiasm I could muster. I never looked back at the day treatment program. HARUMPH! Call me "low functioning" would they? I'd show them!
Toward the end of the eight-week training program, I got a call from a friend in the day treatment program. They informed me that Mark was dead. I asked what happened.
It seemed that Mark got despondent about being placed in the "low functioning" group and started to drink again. He grew more and more desperate. He went to the staff and asked for help. He begged them to intervene. They just sort of chuckled at him. They hadn't seen him get better without the booze and they hadn't seen his deterioration when he returned to drinking. All they saw and knew of Mark was that he sat in the groups, in the back of the room, with his arms folded across his chest, in silence.
Mark had tried desperately to reach me in his final week of life. He felt that because I'd once stood up to the staff, I could make them listen to his pleas for help. Finally, in one last act of desperation, he went home, downed a twelve pack and pulled the trigger, blowing his brains out.
I was devastated. I felt consumed with anger at the staff. I wanted to grab them all by the throat and shake some sense into them. But, with time, my anger changed. I also grew angry with the other clients. Why hadn't they spoken up for Mark? For that matter, why couldn't Mark speak up loudly enough for himself? Mark's parents just wanted more drugs for Mark. They didn't understand either.
Finally, it became clearer to me. I knew that I must work to help clients have their own voice. Not just some weak squeaky whimper but a strong and loud and clear voice. This became my calling as an advocate. From the day I learned of Mark's death to this day, my motto has been, "NO MORE MARK'S!"
I fight as an advocate and an activist to shake the mental patients out of their complacency and to strongly speak out with their own voice. I fight as an advocate and an activist to shake the mental health professionals out of their complacency and to know that we have a right to and MUST speak and be heard. I fight as an advocate and an activist to shake parents out of their complacency and to let them know that whatever their interest in us or the public mental health system, our interest is even stronger because for us, it's our very lives which are at stake.
I have met, spoken with, worked with, helped and interacted with literally thousands of mental patients and former mental patients over the years. The thing that keeps me going, despite five heart attacks is, that I'd rather someone pick up a phone and give a call than pick up a gun and pull a trigger.
Forcing more drugs down our throats isn't going to cut it. It will not make the system more responsive to us. Collaborating with AMI isn't going to cut it. They may be concerned family but, it's not their damned lives that are at stake. We have to reach out to each other and help those who are still trapped by the system and who are desperate for real human contact and real ways of coping with life. Let's try and reach them before they get so desperate that they...
NO MORE MARK'S!!!
Mental Illness and Recovery
Recovery from Mental Illness by Pat Risser
What is Mental Illness? According to medical practitioners and others in the mental health realm, mental illness is a diagnosis as defined by the DSM-IV (Diagnostic and Statistical Manual, Fourth Edition). This manual is held in such regard that a diagnosis from the DSM-IV is the standard by which insurance companies define mental illness. The DSM is published by the American Psychiatric Association and it is from the ranks of psychiatric practitioners that the various diagnoses are defined.
The DSM is not without controversy. As the primary fundraising book published by the APA, many contend that there is a conflict of interest in using this tool. Many other psychiatric practitioners contend that the book lacks in scientific development. Even greater criticism comes from within the psychiatric survivor community (people who have "survived" psychiatric treatment or mistreatment). Survivors claim that there is no proof of mental illness. By proof, they mean, that to be able to scientifically "demonstrate a reliable association between a clearly specified pattern of observables and other reliably measurable event(s) which operate as antecedents." This fits TB, cancer, diabetes, etc., but doesn't fit any DSM "disorder." This does not mean that the phenomena of "mental illness" does not exist. There certainly are human conditions that deviate from the norms. However, that does not mean that we should call those conditions a disease, illness or disorder. There are studies that have examined the harm (stigma and discrimination and worse) caused by such labeling.
Part of the problem with the DSM is that what is being diagnosed are our thoughts, moods, feelings and emotions. What is necessary is to instead look to our behaviors. Someone may "feel" suicidal but that is just a feeling. If the person never acts upon that feeling in a way that is self-harming then we should not label them as having a mental illness. Our thoughts, moods, feelings and emotions may not be able to be controlled but we can learn to control our actions or behaviors and the way we respond to our thoughts, moods, feelings and emotions.
So, just what is mental illness? I contend that it is a state of mind where a person loses their sense of self and suffers a loss of hope.
Like most who come to the mental health system, I was taught from infancy that if I had a problem then I should go and see a doctor, trust doctor, that doctor would fix it and make everything better. So when I went to a psychiatrist for help for emotional distresses, I offered myself submissively for assistance and the psychiatrist accepted my submission and dominantly (and perhaps arrogantly) offered his ability to heal and treat.
There is an old saying that says, "Give a man a fish and he eats today. Teach a man to fish and he eats forever." I was given lots of treatment and I accepted it all without challenge. I expected to get well from the treatment and when that didn't happen, I didn't blame the doctor. Instead, I blamed myself. I believed that doctor couldn't be wrong so the fault must be mine. I must not be doing the right things or not trying hard enough or not accurately conveying my symptoms or something. The longer things didn't get better, the more I blamed myself. This sort of self-blame is common among abuse and trauma survivors and perhaps among others.
Self-blame may be a dysfunction that primarily affects those who have suffered from abuse and the effects of trauma. It may affect others to some extent but given the high percentages of people who get labeled with mental illness who have survived abuse or trauma, it may approach universality.
As I sank into a quagmire of self-blame, I started to lose my self. We each have many roles in life. I was husband, father, student, worker, friend, brother, son, neighbor, etc. However, my primary role evolved into and became "mental patient." What that means is that if my wife or children needed something and I had a therapy appointment, I would choose to attend therapy. My life revolved around being a mental patient. It became almost all consuming. The more I blamed my self for not getting better, the more I lost hope and the more I became primarily a mental patient as that role became the dominant feature which defined my life.
In addition, that which receives the attention is that which grows, whether it be plants or emotions. Studies have shown that if you pay attention to plants, talk to them, water and fertilize them, they will grow more than plants that receive no attention. Similarly, those of our emotions that receive attention will grow. If we are repeatedly told that we have a "mental illness" and that we have a problem, that notion will grow within us until we come to believe that we not only have but that we are a problem. We will lose hope as the psychiatric system amplifies our fears into terrors, our angers into rage, our anxieties into panic and our grief into homicidal and suicidal despair. Our sadness becomes depression and we sink into a miasma of despair because we are lead to believe that is the way of things for us as mental patients.
I contend that the more I sank into the role of "mental patient," the more I lost my self. I lost my self-esteem, self-admiration, self-confidence, self-glorification, self-love, self-regard, self-respect, self-satisfaction, self-sufficiency, self-trust, self-worth, self-determination, self-exaltation, self-importance, self-assurance, self-important, self-interested, self-possessed, and self-pride. I lost hope as my identity became more and more just that of "mental patient" and my loss of self-pride resulted in a loss of self.
At the time, had someone pointed this loss out to me, I would probably have been confused because I had always associated pride with that negative sort of excess that has been labeled self-absorption, self-worship, selfish and self-pity. My life revolved around my "mental illness" to the exclusion of everything and everyone else. I became one of those helpless, hopeless and overly dependent patients who lived from Big Gulp to Big Gulp and for whom time was measured from one cigarette to the next.
Slowly it came to me that I had lost my sense of self. I had lost pride in myself and in my life. Pride is essential to our concept of self. A smart person could probably get away with stealing all of their life and yet most do not. Why not? Because of pride! "To thine own self be true, and then it follows as the night from the day, thou canst not then be false to any man." A proud self-image is the strongest incentive you can have towards correct behavior. Too proud to steal, too proud to cheat, too proud to take candy from babies or to push little ducks into water is what separates us from the animals. A moral code for a community must be based on survival for that community, but for the individual correct behavior in the tightest pinch is based on pride, not on personal survival. This is why a captain goes down with his ship; this is why "The Guard dies but does not surrender." A person who has nothing to die for has nothing to live for.
One definition of the opposite of pride is shame. As I lost my self, my self-pride, I had grown ashamed. I was ashamed of my life. I was ashamed because I was weak and couldn't work, I couldn't support my family, I couldn't support myself, I couldn't do anything. Certainly, I couldn't do whatever was necessary to "heal" myself. No matter how hard I worked at it, I was still suffering from "mental illness" or a disease or disorder. I had grown paralyzed emotionally because I lost my self. An enormous amount of shame comes with a history of abuse and trauma but, the system played upon that vulnerability and amplified my sense of shame by treating me as a mere mental patient, a chart number, a diagnosis.
Each human being must free himself; freedom cannot be thrust or forced upon people if they are to be truly free. Force cannot be abolished by use of force. Freedom must be obtained by voluntary means, accomplished by reason and persuasion. Freedom is not free! Unless we mean "freedom" as defined by Orwell and Kafka; "freedom" as granted by Stalin and Hitler; "freedom" to pace back and forth in your cage.
I had to liberate myself. I had to recapture some sense of pride. I had to "recover" my self.
I began to question and to challenge. It was terrifying when I first stood up to staff and asserted my self. I felt that I could potentially lose their approval but worse, I could also be kicked from the program and perhaps lose my primary "self" identity as mental patient. My "mental patient" identity was so strong that to risk losing it was very frightening. I wasn't sure what "self" I might have left if I were to lose my primary identity of "mental patient." Who and what might be left? However, when I did question and challenge, I felt some small sense of pride. It felt good to stand up for my self somehow.
With each episode of standing up and questioning and challenging, I felt better and stronger. I felt better as I became more self-determining. I slowly began to regain my sense of self. I grew stronger in my self-esteem, self-admiration, self-confidence, self-glorification, self-love, self-regard, self-respect, self-satisfaction, self-sufficiency, self-trust, self-worth, self-determination, self-exaltation, self-importance, self-assurance, self-important, self-interested, self-possessed, and self-pride. I acquired a renewed balance in my roles in life. Instead of my life being dominated by my mental patient role, I became more of a husband and father. I got into the workforce and developed a strong sense of pride in my work and even in my ability to work; something that had been missing for many years. That sense of self-pride grew to impact more and more areas of my life and the sense of accomplishment was tremendous.
So, just as I had lost my "self" I worked hard to recover that lost "self" and pride was the key. In losing my "self" I lost my pride in who and what I am and I became "mental patient." In recovering my "self" I rediscovered a sense of pride as I redeveloped into a self-determining adult.
Most people, instead of climbing the ladder of success, keep looking for an escalator. I had climbed quite far and quite successfully a long way up my life's ladder. When I fell into "mental illness" I crashed hard. When I tried to "recover" initially, I tried to resume my life's path at the point where I'd left off. Imagine trying to levitate back up a long ladder to the point at which you fell. For years, I frustrated myself trying to "wish" myself back to that point. Eventually, I found that I could reach that point again but only by taking it one step at a time and reclimbing a ladder. I wouldn't have to retrace every step. I wouldn't have to graduate from college or high school again but to get to where I left off, I would have to touch certain rungs all over again and rebuild my "self." I learned again how to socialize with "normal" folks. I learned again how to tolerate and even enjoy (have pride in) working. I reconnected with my family and took pride in them and in my roles as husband and father.
I took pride in overcoming and recovering from "mental illness." The saying, "One day at a time," became prominent as I learned to control my actions and behaviors. Much of the time the saying for me was more like, "One moment at a time." I learned that my thoughts, moods, feelings and emotions just are. They hold no magic power or ability to dictate my actions or behaviors. I learned that I might feel suicidal but I didn't have to act in ways that were self harming. As I exercised my abilities to control my actions and behaviors, I grew stronger and the unpleasant thoughts, moods, feelings and emotions grew less and less in both strength and number.
I don't pretend that my path was an easy one. I spent over ten years as a "mental patient." Ten years of my life are gone, given away to the mental illness system. Ten years of my life are missing and will never be returned. I also spent years in recovering. To learn to socialize again was difficult and painful at times. I was awkward but with each small success, I grew in self-confidence and pride and thus, I grew in my recovery. In some ways, the role of "mental patient" is easier. It can be easier to have others take care of you. It can be easier to not have to have any responsibility for yourself. However, I believe that each of us yearns for freedom, independence and self-determination. I believe that we seek and must have a sense of pride or else we walk through life soul dead. Our spirit yearns to be proud and free. (Spirit is that which drove Beethoven to write beautiful symphonies that his ears would never hear.)
I believe that all who have been labeled as having "mental illness" can recover. All who have been labeled based upon a diagnosis of their thoughts, moods, feelings or emotions can learn to be proud and free. Granted that there are physical issues that can occur within the human body that will cause people to exhibit unusual behaviors. However, these physical issues need to be properly identified, diagnosed and treated. A malfunctioning thyroid should not be diagnosed solely upon behaviors and thus treated as "bipolar disorder." That would be gross malpractice and yet it happens regularly. Psychiatrists need to remember and act first as physicians and not as social control agents. Psychiatric drugs need to be recognized as the "feel good" agents they are and placed on a continuum with a drink with friends at a local bar. The potential risk and harm of psychiatric drugs needs to be recognized and proclaimed loud and strong.
There is no panacea. There is no magic bullet. Recovery can and does happen, with or without the mental illness system's interference. Recovery is an individualized process. What makes one person feel proud or motivated to positive action is not necessarily what will work for another. I believe that each person can and will recover if they rediscover their self-pride.
DEFINITION OF A PEER (Recipient, consumer, ex-patient, survivor) by Pat Risser
This is something our movement has struggled with for over 25 years. Personally, I view a peer as someone who has endured similar oppression and is willing to stand and declare such publicly. Men are not peers to women because we haven't endured the oppression of being a woman in a male dominated society. White folks aren't peers to black folks because we haven't endured the oppression of being Black in a white dominated society.
Anyone who stands and declares that they are a peer of mine must know and have endured similar oppression from society and from the mental health system that treated me as a mental patient rather than as a person. If you haven't "been there, done that" you aren't a peer of mine. We can still be friends and colleagues but only a peer knows what it feels like to have walked a mile in my moccasins.
I have been hospitalized over twenty times, mostly involuntary, mostly following suicide attempts. I have lost peers to a system that really didn't understand my pain (or that of my friends). You needn't have been hospitalized, forcibly drugged, locked in seclusion and restraints, punished in day treatment, etc. but you better have felt that oppression somehow in your life. Only if you've endured the trauma and retraumatization and felt the weight of the system upon your shoulders as you struggled to heal from your own issues can you truly be a peer of mine.
Peers are special people. They have an expertise born of experience. It creates a bond and association that opens channels of communication and trust that transcend the system. I agree with another definition that declared: "A peer is not someone who has sought couples and/or individual counseling to resolve passing difficulties; who has engaged in therapy at a time of major life transition, who has used antidepressants or tranquilizers to ease discomfort at certain times of life. Nor do family members of individuals with diagnoses fit the definition of peer."
Others may empathize with our pain and suffering but their lives aren't at stake. That, to me, makes us the primary stakeholder in the system. We may be a pain in the butt to family members and we may cause them some discomfort but they aren't the ones whose lives are shortened (by 25 years!! on average) by our "care and treatment" at the hands of the system. Providers may be good and kindly souls who really want to appreciate our struggles but they're not the ones whose lives are at stake. They can always find other employment but we don't always get another shot at life and death.
I've rambled long enough. I guess you can tell it's something I feel strongly about. A few years ago when Dan Fisher (one of us) was appointed to the President's New Freedom Commission he said it was good that at least we got a seat at the table. I responded, "It's about damn time! It's OUR table!"
I am opposed to forced treatment. I don't believe that it is healthy or the best way to help someone. I believe that it's possible to have a therapeutic alliance and that alliance would be damaged or broken if the treating person resorts to the use of force or coercion. If treatment is to be most helpful, I believe it must be strictly voluntary.
I don't believe in "mental illness." Now before you write me off as some sort of kook, I'd like to suggest that you check me out. My web page is at http://home.att.net/~LetFreedomRing I have helped thousands of people over the years. I spent over ten years of my life as a "mental patient" and was hospitalized over twenty times including state hospital. I "recovered" and worked as an intensive case manager and then worked as a therapist on a locked acute inpatient unit. I have been a leader and activist in the mental patients liberation movement for over 25 years and have earned the respect of my peers through my hard work and efforts to help others. I've been recognized with the National Association of Case Management Award and the Clifford Beers Award from the National Mental Health Association. I served on a state NAMI Board of Directors for three years and I spent over a dozen years on the Board of Directors of NARPA (National Association for Rights Protection and Advocacy) including a term as President.
There are no biochemical markers, no biological tests, no hard evidence at all, to "prove" the existence of "mental illness." Proof = demonstrate a reliable association between a clearly specified pattern of observables and other reliably measurable event(s) which operate as antecedents. (This is same level of proof used for TB, cancer, diabetes, etc.) For those who adhere to the "chemical imbalance" theory; Which of the neurotransmitting brain chemical(s) is it that is/are out of balance? What is the nature of the imbalance(s) -- Too much, too little? In what part(s) of the brain is/are these imbalances occurring? What is the formula for determining the baseline "normal" amount of the offending chemical(s), given one's gender, age, weight, etc, and where can I find it referenced? I am interested in reading the articles where you obtained this information.
There are certainly things that can go wrong with the human body that can cause us to display unusual behaviors. We could suffer from early childhood trauma and develop brain pathways that cause us to display certain survival traits that seem dysfunctional. However, those can be changed and we are still able to control our actions and thus change those pathways. There are literally hundreds of other things that can go awry with the human body. See my web page at: http://home.att.net/~LetFreedomRing/updates/MedProbs.html Part of my issue with psychiatry is that they tend to judge based upon behavior rather than any physical basis. You could have a thyroid out of whack and behave very high energy. A "real" doctor would do a simple blood test and diagnose and treat this properly. A psychiatrist would tend to simply see the behavior and judge us as "manic" and prescribe lithium. (This is but one simple example.)
"Adults with serious mental illness treated in public systems die about 25 years earlier than Americans overall, a gap that's widened since the early '90s when major mental disorders cut life spans by 10 to 15 years." This is from the report from NASMHPD (National Association of State Mental Health Program Directors), May 7, 2007. I believe there are alternatives that have far less risk and just as high a probability of success if given a fair chance. I prefer to help individuals identify their chosen way of coping including diet, exercise, meditation, journaling, art, etc. For more about some of those I've helped through education, see some of their testimonies at: http://home.att.net/~PatRisser/
I've had lunch with E. Fuller Torrey and I know that the Treatment Advocacy Center supposedly "broke away" from NAMI but, I've seen interlocking corporations before and this is one of those behind the scenes continuing relationships. Torrey was a keynote speaker at the annual NAMI Conference last year and he spouted his usual inflammatory rhetoric. I'm amazed he has any credibility at all since his base claim is that schizophrenia is caused prenatally by cat urine. He incites NAMI and others to indulge in worst-case scenario fear mongering. He plays "if" games. "If this one did something bad and wasn't taking medication, it must have happened because they weren't taking the medication and therefore we must force everyone to take medication." This illogic is outlandish at best. He also makes up his own statistics and numbers (as NAMI has been inflating their membership numbers for years). I've documented some of this on my website.
To me, to ban psychiatry would mean to remove it from it's current place of prominence and place it where it properly belongs, with witch doctors and other charlatans. Perhaps it might even be placed on similar standing as voodoo, palm readers and other fortune-tellers. Maybe we could license it with other side show hucksters. Then you could freely participate in the practice of psychiatry and no one would be removing your free choice. But, then psychiatry wouldn't have the power to remove mine or the free choices of others. Since psychiatry lacks scientific proof of their claims, they should not have the power of civil commitment. Their testimony should not be considered "expert" in court and they should be dropped as a "medical" specialty. Perhaps they could find some minor following among some folks but they would mostly be rendered harmless and yet someone would still be able to worship at the altar of psychiatry if they so desired.