Sarah Acree on Depression: “It’s a mental illness, it’s a disease of the brain…”

This YouTube video from Sarah Acree came to my attention a few minutes ago…

Top 5 Things to NEVER Say to Depressed People

I wrote this in response to Sarah:

“It’s a mental illness, it’s a disease of the brain…”

Have you ever considered that this claim increases stigma for people suffering with feelings of hopelessness and despair Sarah? There’s evidence to suggest that it does.

See here and here.

I agree that education is very important.  Working to increase people’s understanding about what we don’t understand about the brain is critical in dispelling disempowering narratives about the causes of different types of human suffering and distress, I think.  Isn’t it bad enough that some people are unlucky enough to feel as terrible as they do?  How is forcing suffering people to take on the “sick role” in society in order to receive professional help in reducing their suffering not patently insulting?

There is a lack of evidence to back up the claim that you’re making about depression, mental illness and the brain Sarah. Are you aware that the former director of the National Institute of Mental Health refocused the NIMH’s research away from the “mental disorder” categories in the DSM four years ago. You can read what Dr. Thomas Insel wrote about this seminal event in mental healthcare here.

Definitive claims about the brain’s role in a “disease of the mind” are best viewed skeptically, especially when powerful entities in a multi-billion dollar business are actively promoting them. You believe what you believe about “mental illness” because of the vast sums of money spent on trying to cause you to believe what you believe, I believe.  Moreover, I think you believing what you believe about depression and the brain is more beneficial to your care provider than it is to you.

I implore you to consider reading accounts about “mental illness” not propagated by pharmaceutical companies Sarah. Please consider reading Christopher Lane’s Shyness: How Normal Behavior Became a Sickness or anything by Robert Whitaker. There’s plenty of evidence in your video to suggest that you’re making the same mistake that I made back in 1998 after nearly killing myself. You can read more about that here.

I applaud anyone trying to make a positive difference for others, and that definitely includes you Sarah… so kudos to you for your courage and for sincerely working to help others in pain.  With that said, I still sincerely hope that you’re open to considering some of the ideas that I’ve written about here.

 

Maybe “mental illness” isn’t what you think it is…

A different version of this post was published by The Good Men Project where it has been shared almost 400 times so far.  Subsequently, this article was republished by Mad in America where it has been viewed over 1100 times.  I recently submitted it to The Mighty.  I received an email from them explaining why they would not be publishing it which included the line below.

Right now, we unfortunately don’t have the capacity to publish every story on our site.

I sincerely doubt “capacity” had anything to do with The Mighty’s editorial decision regarding this piece.

I’ve spent close to twenty years looking for reasons behind why I was compelled to think and act suicidally when I was twenty seven years old.  While my search has yielded more questions than definitive answers thus far, I’m convinced that sharing what I’ve learned so far will help others.

Events happen, and then people think and say things about those events—let’s call those stories.  No matter how accurate or truthful a story is seen to be, events that have occurred and the stories that people tell about those events, are never the same thing.  They can’t be because one is an occurrence in reality while it’s happening, and the other is an after the fact symbolic representation meant to describe a prior real occurrence.  I’m no linguist, but this is the nature of language, right?  We use language and stories to encapsulate and communicate meaning about our reality and our conscious experience of that reality—every word is a story unto itself making sense of existence.  Every diagnosis of every “mental disorder” relies on a translation of stories.  A person tells a psychiatrist a story, and the psychiatrist maps that natural language story onto a “mental disorder” language story from a book called the Diagnostic and Statistical Manual of Mental Disorders (DSM).  Millions of people assigned a “mental disorder” story or a “mental illness” diagnosis end up failing to see the basic event-story distinction I just pointed out.  They confuse their DSM diagnosis or “mental disorder story” with reality itself.  Unfortunately, many patients are also systematically misled to necessarily attribute the issue that prompted them to see a psychiatrist to a supposed specific brain pathology that mysteriously eludes accurate definition and explanation.

I made these mistakes after nearly killing myself nineteen years ago, in part, because of the forces of institutional corruption at work within our mental health care system written about by Robert Whitaker and Lisa Cosgrove in Psychiatry Under the Influence.  I share this true story as an anecdotal example of those corrupting forces in action.  It is my hope to decrease the likelihood that other people won’t be misled like I was.  I also hope to inspire the many well-intentioned but misguided “lived experience” mental health advocates who are confused like I was to think differently.  They are unwitting participants in this harmful confusion’s perpetuation.

A few days after I nearly killed myself a psychiatrist told me that I was suffering from a “mental illness” called Major Depressive Disorder after talking with me for less than fifteen minutes.  That’s all the time it took him to gather enough information to know which “mental illness” was plaguing me and how to treat it.  He prescribed me an antidepressant as he mentioned something vague about the amount of a neurotransmitter in my brain called serotonin and selective reuptake inhibition.  I also began seeing a psychologist for talk therapy twice a week.  In just three or four months I was feeling like my old self again—the same amount of time it had taken me to go from feeling fine to almost killing myself.  I believed the story my psychiatrist told me about the cause of my despair.  He gave me the name of an apparent disorder with my brain, and a pill to fix the problem.  Back then, it seemed to me that the medication I was taking did more to help me than anything the psychologist and I discussed.  That assumption was a costly one for me, and my family.  It led me to make two consequential mistakes that millions of other people diagnosed with a “mental illness” also make.  First, I failed to see my diagnosis as a view of reality, mistaking it for reality itself.  I conflated a series of actual events from my life with a boilerplate story about a “mental disorder” from a big book.  Doctors are trusted authorities.  When you’re unquestionably hurting, it’s comforting when a trusted authority gives you an officially-sanctioned medical reason for why you feel so horrible, and better yet, a remedy to help you.  My mistake was compounded when I came to believe that my diagnosis mapped onto a specific brain pathology necessarily responsible for my problematic thoughts, feelings and behaviors.  My doctor gave no serious consideration to any psychological, social or environmental factors that contributed to the mindset from which my suicidal behavior emerged.  He couldn’t have—he didn’t know enough about any of those factors.  It is no surprise that I blamed my brain for my problems, like millions of other “mental patients” do.  Our collective confusion about a specific brain pathology necessarily being the sole or at least primary causal culpability for our lack of ease is proof of the influence of the forces of institutional corruption within the mental health care system.

A deeper examination of my suicidal crisis subsequent to receiving my “mental illness” diagnosis revealed how childish, fearful, egocentric thinking and bad luck led me down a path towards self-destruction.  To clarify “egocentric” I’m not talking about arrogance, narcissism or even self-preoccupation.  At the heart of my egocentrism in my younger years was the failure to readily recognize that my view of reality, was a point of view at all.  Growing up I prided myself on being right.  I prided myself on objective, quantitative measures of just how right I was.  I was especially proud when I was deemed 100% right.  Egocentric people become attached to being right, and they often are.  I became so accustomed to being right, that I confused my view of reality with reality itself.  I almost killed myself, in part, because of this confusion, this conflation of what I thought was happening with what was actually happening.  There were four other types of childish and/or fearful thinking that led me from being involved in an awkward exchange during a routine business meeting in Toronto to genuinely believing that I was an unintelligent, overcompensated fraud of a human being destined to disappoint my father and myself.  Those types of thinking are called catastrophizing, overgeneralizing, black and white thinking and past counter-example blocking.  Cognitive behavioral therapy is an effective way to address these often disempowering ways of thinking.  This other narrative that describes the conditions and events that led to my psychological and emotional struggle is patently more accurate and more practically useful than anything my psychiatrist told me about my ostensibly malfunctioning brain.  Nineteen years later, it’s evident that me believing that my suicidal behavior necessarily resulted from a “mental illness” was more beneficial to the psychiatrist who told me that than it was for me.  I’m not claiming that this was a fault of my doctor or a sign of bad faith or ill-intent on his part.  His profession trained him to look for different nails to hit with different hammers, and I was a perfect fit for a hit from an antidepressant.  He was just doing his job—playing his role in a system.  Unfortunately, like millions of other people who are given a “mental illness” diagnosis, I came to see my diagnosis as a defining part of my identity because of my respect for my doctor’s authority, and my belief that my problem was necessarily in my brain.  This belief led me to seriously entertain the fallacy that I was biologically destined to suffer from despair over and over again.

My stay at the private mental hospital subsequent to nearly dying by suicide was five days long. I spoke with my psychiatrist on three separate occasions during my five day stay. We spoke briefly on the day I was admitted. We bumped into each other once, and spoke for less than five minutes. And we spoke for about ten minutes on the day I was discharged.  While reviewing my bill, after being released, I noticed that I was billed for “Individual psychotherapy” five times, one charge for each day of my stay. When I called the mental hospital to inform them of the obvious billing error, I was informed that every patient in the facility was charged in this manner. I explained how this seemed patently fraudulent and unethical to me given the literal definition of the word psychotherapy. The person I spoke with apologized but said there was nothing she could do, remarking something like, “That’s just how it works.” The first time I thought and behaved in a way that matched the diagnostic criteria for a “manic episode” found in the DSM occurred after taking an antidepressant. I’m aware this fact doesn’t prove that the antidepressant was the proximate cause of this development in my life, but given the wealth of evidence supporting the hypothesis that antidepressants often have iatrogenic effects on the people who take them, like inducing mania, for example, it’s reasonable to consider that my treatment for Major Depressive Disorder was a causal factor in me exhibiting behavior that led a different psychiatrist to diagnose me with Bipolar Disorder I.

I’m so grateful that someone was willing and able to inspire me to question the stories psychiatrists told me about the cause of my suffering.  Powerful authority figures implying that brain pathology is necessarily to blame for the suffering behind “mental illnesses” increases the chances of people believing that they need to buy pharmaceutical remedies to be well.  How else are psychiatrists who only prescribe psych meds going to their pay bills?  Ironically and probably unbeknownst to the vast majority of people diagnosed with a “mental illness” the National Institute of Mental Health ceased funding research based on the categories listed in the DSM in 2013.  When announcing that no more federal dollars would be spent on research based on the DSM going forward, Dr. Thomas Insel said that diagnosing a “mental illness” by asking a patient about her feelings was analogous to diagnosing a heart patient by asking her about her chest pain.  I’m not arguing that people don’t experience emotional distress.  I’m arguing that the words used to describe the causes of feeling a lack of ease or distress can perpetuate a person’s lack or ease, or worse, compound it.  I am committed to changing the world by changing the words that people use when they talk about “mental illness.”

Here’s an example:

You have a “mental illness” or a “mental defect” resulting from a specific, yet somehow unidentifiable, brain pathology that is causing you psychological and emotional distress.  You can treat your “mental disorder” with a chemical made in a lab that will hopefully mysteriously correct your brain pathology for as long as you can bear the undesirable effects of that chemical.

Learning more about yourself, the human condition and the many different approaches proven to help other people maximize their own well-being will help you to grow into a person who experiences less and less psychological and emotional distress over time.

Which is more empowering?

If I still haven’t convinced you, please consider this final example from history that hopefully more clearly illustrates my point that a “mental disorder” or a “mental illness” diagnosis is necessarily a subjective story about events, and not an objective description of a constellation of thoughts and behaviors that are necessarily caused by a specific brain pathology.

Imagine it’s 1972 and a man visits a psychiatrist because despite having a great relationship with his lover and a job he loves, he’s miserable.  He’s been estranged from his entire family, and he is suffering a great deal as a result.  He can’t sleep.  He’s constantly anxious, and he’s feeling quite hopeless about things ever getting better.  He explains that all of his problems arose when he admitted to his family, a few weeks ago, that his lover was a man.  Shocked by the revelation, his family said they never wanted to see or speak with him again.  The doctor tells the man that the source of his problem is a “mental disorder” in the DSM called Homosexuality.  The man is the son of a southern Baptist minister, and he has been ashamed of his attraction to men his whole life.  He respects his doctor, and his father too.  In fact, he thinks they’re both right.  He sees his love and sexual desire for men as sinful urges that he is supposed to resist, but he is incapable of doing so.  He sees his homosexual acts as mortal sins, and evidence of brain pathology. Feeling utterly hopeless, lost and beyond redemption, a month after being diagnosed with the Homosexuality “mental disorder” the man kills himself.

Please consider helping me spread the idea that “mental illness” is a harmfully misleading phrase that causes suffering by design.

Responding to Rudy Caseres “I Have Bipolar Disorder – This is What Manic Means to Me” video

In 2002 a psychiatrist unjustly stripped me of my liberty and the right to pursue happiness because I fit a description of a type of “episode” (manic) listed in the DSM, eleven years before the NIMH abandoned research oriented on the nosology.  I don’t argue that I did not exhibit some behaviors that matched some of the diagnostic criteria for mania as described in the DSM. That said, it’s a fact that my doctor patently mistreated me by claiming that I had delusions without ever asking me a single question related to my ostensible false beliefs guiding my presumed to be utterly unreasonable behavior (trespassing at the CIA with weed and a big poster of Albert Einstein with his tongue sticking out).

I recently wrote an open letter to the doctor that used the “Bipolar Disorder” “mental disorder” story as a justification for why I was in need of emergency psychiatric care.
Here’s an excerpt of the letter:
 

You necessarily took action to have the police waiting outside your office prior to your examination of me, and to this day, you and I have still never exchanged a single word about my unauthorized visit to CIA headquarters in 2002.  Four federal CIA police officers and a staffer from the CIA questioned me for about three hours with a degree of professionalism that still blows my mind, especially considering that I pulled this stunt just forty-one days before the first anniversary of the 9/11 attacks.  It’s worth pointing out that these men, despite the fact that I was in possession of a controlled substance when I illegally trespassed at the CIA, decided to release me on my own recognizance versus throw me into a jail cell for the night, pending arraignment.  Things played out the way they did for me at the CIA because the people there that I spoke with were open to hearing a reasonable explanation for my actions… which is precisely what they received from me… and precisely why they let me go.  

committal documentYou and Dr. Ekong on the other hand, were patently not open to even attempting to reason with me. You failed to give me a chance to explain my actions before stripping me of my liberty, and she treated me with a potentially life-threatening medication before ever meeting or speaking with me.  It is clear to me, as I am confident that it will be to many others, that the forces of institutional corruption in psychiatry were at work in your respective decisions.  The knowledge that you had about what happened at the CIA was the by-product of a five-person game of Telephone or Whisper Down the Lane.  I told my father some of what happened that day, without much explanation as to why at all.  My father told my mother.  My mother told my brother.  And then my afraid-for-the-life-of-her-son mother told you.  You did what you did, and then Dr. Ekong became Telephone/Whisper Down the Lane player number six. The assumptions that you both necessarily made about me are gross examples of professional misconduct.

While you were very sympathetic about the anxiety experienced by your patient’s mother, you failed to even try to understand me, your patient, whom I believe you assumed was psychotic.  The fact that I was exhibiting some of the symptoms of a “mental disorder” described in the Diagnostic and Statistical Manual of Mental Disorders—a nosology disavowed in 2013 by Dr. Thomas Insel, the former Director of the National Institute of Mental Health—is a pathetically inadequate justification for involuntarily subjecting me to forced care that could have ended my life.

You can read the whole letter here.

I applaud and champion your activism Rudy. You’re an inspiration.
 
That doesn’t stop me from thinking it’s reasonable to consider that continuing to use the “mental disorder” condition names themselves from the DSM without any qualification or mention of the fact that the NIMH no longer researches “mental illnesses” as described by the nosology, lacks nuance and depth.
 
Finding yourself in a “mental disorder” storybook and championing the notion that you necessarily have been or are sick, ill, diseased, etc. may be helping to perpetuate the ostensibly intractable problem of the stigma surrounding “mental illness.” Using the nosology’s “mental disorder” names without qualification or clarification certainly perpetuates the “mental illness” diagnostic narrative of non-normative human behavior to ill-effect for many people.

An open letter to Kevin Hines about how propagating the biomedical model of mental illness causes harm by increasing stigma

Dear Kevin,

Subsequent to un-friending and blocking me on Facebook you made the following comment about me:

Problem is I know the guy, he should have had the common decency to just call me, instead of this daily social media kevin bashing.

We have exchanged some tweets and emails, but we have never met.  We’ve never had a conversation in person or on the phone, and I don’t have your phone number.  Your statement to your Facebook audience is so misleading it’s very close to being a lie, if it isn’t already.  Plus it also leaves out the fact that I have been attempting to engage in an actual conversation with you on this topic and others like it for months. I’m not suggesting you owe me anything brother, but the comments you are posting publicly on Facebook paint a patently misleading picture of how often and how long I have been sincerely attempting to have this conversation with you.

I asked you a reasonable question about a post of yours on Facebook, and you claimed that I was invalidating your personal experience with mental illness although I did no such thing.  My words speak for themselves brother.  As do yours Kevin.  Last night, you leveled an ad hominem attack at me on Twitter, and then deleted it after I called it out as such.  

To review the question I asked.

You wrote on Facebook:

Ben believes in the idea that we “live” with mental illness just as one lives with any other true disease.

I asked:

Would you have told this to people diagnosed with the “homosexuality” mental disorder prior to 1973?

Here is your answer to that question:

I’m sorry Francesco Bellafante but I “live” with this every single day. Period. I live well with it most days. I work hard to stay mentally well. Often, I miss the mark. But you are completely invalidating my and Ben Higgs and others personal experiences by sticking so closely to the ideals of the (late) Einstein. Not everything he said, wrote down, or was quoted to have invented is gospel. I’ve read quite a bit of his work. In that regard (and in no way am I comparing myself to him) Neither is anything I’ve said. It’s really open to interpretation based on the individual and their experiences. You have not lived my life. This is the second article you’ve written while debunking words I say. Interesting… 

The question stands unanswered.  Worth noting here again, you don’t owe me a half a second of your time, let alone an answer.  This is precisely why I have been so sincerely grateful and appreciative Every Single Time you have engaged with me.  Except the ad hominem attack last night, of course.

I sincerely believe an interesting, potentially illuminating and valuable conversation could result from my question.  My aim is to contrast the biomedical model of mental illness that you propagate with your language…

“Ben believes in the idea that we “live” with mental illness just as one lives with any other true disease.”

“I wasn’t on that bridge from an external issue”

“I was not on that bridge for reasons outside of me.”

“I found myself on the 25th of September in the year 2000 at nineteen years of age ready to cease my own existence because of my brain.”

“my brain was trying to kill me”

“brain pain”

“brain health”

“my brain was trying to kill me”

“malfunctioning brain”

…with the biopsychosocial model, and to point that out:

“Despite good intentions, evidence actually shows that anti-stigma campaigns emphasizing the biological nature of mental illness have not been effective, and have often made the problem worse.”

I was not just sharing my opinion or view with you here Kevin.  I was trying to make you aware that scientists have studied how talking about mental illness the way that you do, and they have found that it causes harm.  I sent you the article with evidence from studies supporting this claim.

 You can click on the image above to review the footnotes and the scientific journal articles that provide evidence supporting the article’s argument.

Returning again to what you wrote about me, and more importantly about yourself on Facebook.

Problem is I know the guy, he should have had the common decency to just call me, instead of this daily social media kevin bashing.

I am assuming that you would characterize this Twitter post as “kevin bashing.”

Your words patently propagate the biomedical model of mental illness.  Your words create a ripple effect that leads people to believe that mental illness is a brain disease.  I genuinely believe that doing so causes harm by increasing stigma and not decreasing it as the aforementioned article clearly explains.

I’m not bashing you Kevin.  I’m cogently explaining how and why the words you use to describe mental illness can cause harm in spite of your undeniably unimpeachable motives.  I attempted to engage you in a conversation to ask you to consider to slightly tweak how you speak, so that you decrease the chances of unintentionally causing harm.  Subsequent to that, I was compelled to create the provocative image above to summarize my view while simultaneously reaffirming my love of you/your work and the inspiration and hope you create in the world.  You are my brother in the suicide prevention movement whether you acknowledge that fact or not, and regardless of what you think, say or write about me.  Up to this point, you haven’t said or written a single word responding to my view or claim.  For the third time, I do not claim that you owe me a response. You have every right to ignore me.

To say that my criticism of the propagation of the biomedical model of mental illness is “kevin bashing” is a telltale sign of having an egocentric outlook on life brother.  Note the highlighted text in the image below.

Egocentrism is something I am all too familiar with… it almost killed me in fact. Here’s the opening of my talk.

On the morning of March 2nd 1998, less than five years after graduating Magna Cum Laude from Notre Dame, I found myself inside of a completely pitch black space when I realized I had stopped breathing.  As it was happening… I had no idea where I was.  I couldn’t see a thing.  And all I could hear was the terrified voice in my head… yelling at first… then screaming… before eventually wailing… as I desperately tried to breathe.  I had unintentionally fallen asleep inside of a running car that I had intentionally turned into a makeshift gas chamber.  Based on medical records I obtained a couple of years later, the near death experience I had occurred in an ambulance, en route to the hospital.  Nineteen years later, I have asked for this opportunity to speak with all of you because I want a shot at decreasing the chances of you and anyone you love or know from either dying because of or ever having a suicidal impulse.

Putting myself in a position where falling asleep would likely result in my death was a desperate act arising from a twenty-seven year old, sleep-deprived, addled mind in the midst of psychological and emotional turmoil.  For reasons I can only surmise, at 27 years old, I was compelled to view life through a childish, fearful, egocentric lens prior to nearly killing myself.  To clarify egocentric, I’m not talking about arrogance, narcissism or even self-preoccupation.  At the heart of my egocentrism was the failure to readily recognize that my view of reality, was a point of view at all.  Growing up I prided myself on being right.  I prided myself on objective, quantitative measures of just how right I was.  I was especially proud when I was deemed 100% right.  Egocentric people become attached to being right, and in matters of fact they often are.  I became so accustomed to being right, that I confused my view of reality with reality itself.  I almost killed myself, in part, because of this confusion, this conflation of what I thought was happening with what was actually happening.  This talk is also about getting over and beyond your “self.”  Fair warning, tonight I will be trying to slightly alter your conception of that voice in your head that you likely think of as you, in order to increase the peace within you and the world around us.  

You, Des, DeQuincy and Leah Harris have all provided inspiration for me at key times in my journey leading up to truly dedicating myself to our cause.  I’ll be forever grateful to you for helping to cause me to fully engage in this life-saving work.  Every single word that I have sent your way is unequivocally aimed at doing just that brother:  decreasing the number of lives lost to suicide.

I would love to have this conversation if you’re open to it.  If not, then I implore you again to seriously consider slightly tweaking how you talk about mental illness as you continue to inspire hope and healing in the people you undoubtedly help, to ensure that you don’t unintentionally add to mental illness stigma.

Love,
Francesco

 

Regarding my attempts to engage Kevin in this conversation…

Trying to CHANGE the WORLD by changing the words that Kevin Hines uses when talking about “mental illness”

Kevin Hines is a suicide attempt survivor who is partially responsible for the fact that I write and speak about my suicidal crisis.  He’s a living inspiration.  That said, we don’t always necessarily see eye to eye on the subject of the most empowering way to talk about the suffering associated with “mental illness.”

Kevin published the following post this morning on Facebook from Australia. (emphasis mine):

Sat down with me ol’ pal, I today consider a brother… the incomparable, tattoo covered man himself, Ben Higgs he’s been through a lot, and has triumphed over great adversity. It’s an honor so share a cup of tea with him and talk all things #MentalHealth and #BrainWellbeing Ben believes in the idea that we “live” with mental illness just as one lives with any other true disease. He spreads his message right across Oz and soon around the globe! Ben is a proud member of #TeamRippleWorld & #TeamRippleOz & will very soon have a featured episode in our forthcoming show… #HopeTheRippleEffect Australia a series about stories like Mr. Higgs From all walks of life in Oz. He’ll be headed to America soon with #TeamRippleWorld for the National Council for Behavioral Health 2017 conference, and we are excited!

I will let Kevin correct me if I am mistaken, but he also “believes in the idea that we ‘live’ with mental illness just as one lives with any other true disease.”

I replied with the following comment:

“Ben believes in the idea that we ‘live’ with mental illness just as one lives with any other true disease.” Would you have told this to people diagnosed with the “homosexuality” mental disorder prior to 1973?  i.e., “Jim, You need to face the fact that your desire to have sex with Steve is a symptom of your diseased brain. These feelings are symptoms of your true disease called homosexuality just like your angina is a symptom of your heart disease.”

My concern is that you imply that the cause of “mental illness” is necessarily a brain pathology despite the fact that the DSM itself notes that the causes of “mental disorders” are believed to be biological, psychological and social or environmental. Leaving aside the fact that the NIMH stopped DSM-oriented research into the causes of “mental illness” four years ago, it seems clear to me that your message of hope about the nature of human suffering includes a potentially disempowering idea: you’re destined to live with this problem your whole life because your brain doesn’t work right. Your exact message or one like it propagated prior to 1973 undoubtedly led some? many? to die by suicide. I think it’s important to consider that it still can. Surely someone’s fallacious beliefs can lead them to engage in disordered thinking & behavior.  No brain pathology is necessary.  A person can exhibit the signs of “mental illness” with a brain that is functioning perfectly.

Kevin responded as follows:

I’m sorry Francesco Bellafante but I “live” with this every single day. Period. I live well with it most days. I work hard to stay mentally well. Often, I miss the mark. But you are completely invalidating my and Ben Higgs and others personal experiences by sticking so closely to the ideals of the (late) Einstein. Not everything he said, wrote down, or was quoted to have invented is gospel. I’ve read quite a bit of his work. In that regard (and in no way am I comparing myself to him) Neither is anything I’ve said. It’s really open to interpretation based on the individual and their experiences. You have not lived my life. This is the second article you’ve written while debunking words I say. Interesting… Margaret HinesLauren Kate Breen and others..thoughts ?

And I responded in turn as follows:

“But you are completely invalidating my and Ben Higgs and others personal experiences by sticking so closely to the ideals of the (late) Einstein.”

With all due respect Kevin, I didn’t write a single word that invalidates your personal experience brother, rather I am challenging the implications and/or claims that you guys are making based on your experience. This is an important difference. Plus, my comments made no mention of and do not rely on anything that Albert Einstein said, nor on my own free will skepticism. Words matter, and so do facts. I would respectfully disagree that facts are up for interpretation. Your messaging consistently implies that “mental illness” necessarily results from brain pathology. This claim doesn’t stand up to empirical scrutiny. If that’s not a belief of yours, then my confusion is important information for you, because that’s the message that I get from your communication, and as I said in my prior post… I think this is a potentially disempowering message. I.e., If you have a “mental illness” you need to accept that you are destined to live with this problem your whole life… because your brain doesn’t work right.
Events happen, and then people think and say things about those events—let’s call those stories. No matter how true a story is, events that have occurred and the stories that people tell about those events, are never the same thing. They can’t be. One is an occurrence in reality as it’s happening. The other is an after the fact symbolic representation. We use language, we use stories to encapsulate and communicate meaning about reality as it seems to us. Every word is a story unto itself making sense of existence. Every diagnosis of every “mental disorder” relies on a translation of stories. A person tells a psychiatrist a story, and the psychiatrist maps that natural language story onto a “mental disorder” story from a book called the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM. I failed to remember the basic event-story distinction I described a moment ago when I was told my “mental disorder” story about my past after nearly dying by suicide.

I confused my DSM diagnosis or “mental disorder story” with reality itself. I conflated a boilerplate story from a big book with a story about a series of events from my life. When you’re suffering, it’s comforting when a doctor, a trusted authority, gives you an officially-sanctioned medical reason for why you feel so horrible, and better yet, a remedy to help you. I made another critical mistake when I was diagnosed. I believed that my diagnosis mapped onto a specific brain pathology that was necessarily responsible for my problematic thoughts, feelings and behaviors. My psychiatrist didn’t know enough about the psychological and social or environmental factors in my life to seriously consider them before diagnosing and treating me. It is no surprise that I mistakenly blamed my brain for my problems, like millions of other “mental patients” do. I was so grateful that there was a pill that could repair the problem in my brain, and help me feel like myself again. “Diabetics take insulin to fix diabetes. I take Paxil to fix my brain, and to avoid feeling depressed!” I thought. Essentially, I was told and believed, that I was a mentally ill person who would have to cope with my mental illness for the rest of my life.

Nineteen years later, it’s evident that me believing that my suicidal behavior necessarily resulted from a “mental illness” was more beneficial to the psychiatrist who told me that than it was for me. I’m not claiming that this was the doctor’s fault or a sign of ill-intent on his part. He was trained to look for different “nails” to hit with different “hammers,” and I was a decidedly perfect fit for a hit from Paxil. He was just doing his job, and playing his role in a system whose approach to solving the problem of human suffering has evidently been corrupted by profit-maximizing motives. (See Whitaker’s and Cosgrove’s – Psychiatry Under the Influence.)

Unfortunately, like millions of other people diagnosed with a “mental illness” I came to see that diagnosis as a defining part of my identity for a period of time. I didn’t think that I had or was exhibiting the signs of a “mental illness” — rather I thought, “I am a mentally ill person.” A respected authority led me to believe that I had a brain disease, and I saw no reason to doubt him at the time. My belief led me to seriously entertain the fallacy that I was biologically destined to suffer from despair over and over again, unless of course I continued to ingest the Paxil tablets. I’m beyond grateful that someone was willing and able to inspire me to question my psychiatrist’s explanation for the cause of my suffering. White coat clad authority figures (and world famous advocates like you brother!!!) implying that brain pathology is necessarily to blame for the suffering behind “mental illnesses” increases the chances of people believing that they need to buy pharmaceutical remedies to be well.

I’m not arguing that “mental illness” doesn’t exist or that people should never consider taking a psych medication. I’m simply questioning if the medical paradigm of “mental illness” is the best way for us to address the problem of certain types of human suffering.

“Mental Illness” is a harmfully misleading phrase that causes suffering by design

I’ve spent close to twenty years looking for reasons behind why I was compelled to think and act suicidally when I was twenty seven years old.  While my search has yielded more questions than definitive answers thus far, I’m convinced that sharing what I’ve learned will help others.

Events happen, and then people think and say things about those events—let’s call those stories.  No matter how accurate or truthful a story is seen to be, events that have occurred and the stories that people tell about those events, are never the same thing.  They can’t be because one is an occurrence in reality while it’s happening, and the other is an after the fact symbolic representation meant to describe a prior real occurrence.  I’m no linguist, but this is the nature of language, right?  We use language and stories to encapsulate and communicate meaning about our reality and our conscious experience of that reality—every word is a story unto itself making sense of existence.  Every diagnosis of every “mental disorder” relies on a translation of stories.  A person tells a psychiatrist a story, and the psychiatrist maps that natural language story onto a “mental disorder” language story from a book called the Diagnostic and Statistical Manual of Mental Disorders (DSM).  Millions of people assigned a “mental disorder” story or a “mental illness” diagnosis end up failing to see the basic event-story distinction I just pointed out.  They confuse their DSM diagnosis or “mental disorder story” with reality itself.  If you don’t believe me visit TheMighty.com, click on “Mental Illness” and start reading.  Unfortunately, many patients are also systematically misled to necessarily attribute the issue that prompted them to see a psychiatrist to a supposed specific brain pathology that mysteriously eludes specific definition and explanation.  

I made these mistakes after nearly killing myself nineteen years ago, in part, because of the forces of institutional corruption at work within our mental health care system written about by Robert Whitaker and Lisa Cosgrove in Psychiatry Under the Influence.  I share this true story as an anecdotal example of those corrupting forces in action.  It is my hope that others won’t make the avoidable cognitive mistakes that I made during my treatment.  I also hope to inspire the many well-intentioned but misguided “lived experience” mental health advocates who are confused like I was to think differently.  They are unwitting participants in this harmful confusion’s perpetuation.  

A few days after I unintentionally fell asleep inside of a car that I had intentionally turned into a makeshift gas chamber, a psychiatrist told me that I was suffering from a “mental illness” called Major Depressive Disorder after talking with me for less than fifteen minutes.  That’s all the time it took him to gather enough information to know which “mental illness” was plaguing me and how to treat it.  He prescribed me a medication called Paxil as he mentioned something vague about the amount of a neurotransmitter in my brain called serotonin and selective reuptake inhibition.  I also began seeing a psychologist for talk therapy twice a week.  In just three or four months I was feeling like my old self again—the same amount of time it had taken me to go from feeling fine to putting myself in that rigged car.  I believed the story my psychiatrist told me about the cause of my despair.  He gave me the name of an apparent disorder with my brain, and a pill to fix the problem.  Back then, it seemed to me that the Paxil did more to help me than anything the psychologist and I discussed.  That assumption was a costly one for me, and my family.  

It led me to make two consequential mistakes that millions of other people diagnosed with a “mental illness” also make.  First, I failed to see my diagnosis as a view of reality, mistaking it for reality itself.  I conflated a series of actual events from my life with a boilerplate story about a “mental disorder” from a big book.  Doctors are trusted authorities.  When you’re unquestionably hurting, it’s comforting when a trusted authority gives you an officially-sanctioned medical reason for why you feel so horrible, and better yet, a remedy to help you.  My mistake was compounded when I came to believe that my diagnosis mapped onto a specific brain pathology necessarily responsible for my problematic thoughts, feelings and behaviors.  My doctor gave no serious consideration to any psychological, social or environmental factors that contributed to the mindset from which my suicidal behavior emerged.  He couldn’t have—he didn’t know enough about any of those factors.  It is no surprise that I blamed my brain for my problems, like millions of other “mental patients” do.  Our collective confusion about a specific brain pathology necessarily being the sole or at least primary causal culpability for our problems is proof of the influence of the forces of institutional corruption within the mental health care system.  

A deeper examination of my suicidal crisis subsequent to receiving my “mental illness” diagnosis revealed how childish, fearful, egocentric thinking and bad luck led me down a path towards self-destruction.  To clarify “egocentric” I’m not talking about arrogance, narcissism or even self-preoccupation.  At the heart of my egocentrism in my younger years was the failure to readily recognize that my view of reality, was a point of view at all.  Growing up I prided myself on being right.  I prided myself on objective, quantitative measures of just how right I was.  I was especially proud when I was deemed 100% right.  Egocentric people become attached to being right, and they often are.  I became so accustomed to being right, that I confused my view of reality with reality itself.  I almost killed myself, in part, because of this confusion, this conflation of what I thought was happening with what was actually happening.  Sounds familiar, right?  There were four other types of childish and/or fearful thinking that led me from being involved in an awkward exchange during a routine business meeting in Toronto to genuinely believing that I was an unintelligent, overcompensated fraud of a human being destined to disappoint my father and myself.  Those types of thinking are called catastrophizing, overgeneralizing, black and white thinking and past counter-example blocking.  Any cognitive behavioral therapy resource of value will explain each of these in detail.  This explanation of the factors that led to my psychological and emotional struggle is patently more accurate and more practically useful than anything my psychiatrist told me.

Nineteen years later, it’s evident that me believing that my suicidal behavior necessarily resulted from a “mental illness” was more beneficial to the psychiatrist who told me that than it was for me.  I’m not claiming that this was a fault of my doctor or a sign of bad faith or ill-intent on his part.  His profession trained him to look for different nails to hit with different hammers, and I was a perfect fit for a hit from Paxil.  He was just doing his job—playing his role in a system.  Unfortunately, like millions of other people who are given a “mental illness” diagnosis, I came to see my diagnosis as a defining part of my identity (only temporarily fortunately for me!) because of my respect for my doctor’s authority, and my belief that my problem was necessarily in my brain.  This belief led me to seriously entertain the fallacy that I was biologically destined to suffer from despair over and over again.  I’m so grateful that someone was willing and able to inspire me to question my psychiatrist’s story about the cause of my suffering.  Powerful authority figures implying that brain pathology is necessarily to blame for the suffering behind “mental illnesses” increases the chances of people believing that they need to buy pharmaceutical remedies to be well.  How else are psychiatrists who only prescribe meds going to their pay bills?  Ironically and probably unbeknownst to the vast majority of people diagnosed with a “mental illness” the DSM itself, the book that contains the rules governing their diagnosis, was disavowed as invalid by the Director of the National Institute of Mental Health four years ago.  When announcing that no more federal dollars would be spent on research based on the DSM going forward, Dr. Thomas Insel said that diagnosing a “mental illness” by asking a patient about her feelings was analogous to diagnosing a heart patient by asking her about her chest pain.  I’m not arguing that “mental illness” does not exist, and in defense of the DSM, I will grant that it explicitly states that the causes of “mental disorders” are believed to be biological, psychological and social or environmental.   My argument is that the words used to describe a problem, and the assumptions those words imply, by definition, can be a causal factor in the problem continuing to exist, or worse yet, new problems arising.  This is clearly the case with the term “mental illness.”  

President Trump continually reminds us of the importance of the language we use to describe problems, and how some language helps perpetuate problems and create new ones.  I am committed to changing the world by changing the words that people use when they talk about “mental illness.”

Here’s an example:

BEFORE

You have a “mental illness” or a “mental defect” resulting from a specific, yet somehow unidentifiable, brain pathology that is causing you psychological and emotional distress.  You can treat your “mental disorder” with a chemical made in a lab that will hopefully mysteriously correct your brain pathology for as long as you can bear the undesirable effects of that chemical.

AFTER

Learning more about yourself, the human condition and the many different approaches proven to help other people maximize their own well-being will help you to grow into a person who experiences less and less psychological and emotional distress over time.

 

If I still haven’t convinced you, please consider this final example from history that hopefully more clearly illustrates my point that a “mental disorder” or a “mental illness” diagnosis is necessarily a subjective story about events, and not an objective description of a constellation of thoughts and behaviors that are necessarily caused by a specific brain pathology.

Imagine it’s 1972 and a man visits a psychiatrist because despite having a great relationship with his lover and a great job, he’s miserable.  He’s been estranged from his entire family, and he is suffering a great deal as a result.  He can’t sleep.  He’s constantly anxious, and he’s feeling quite hopeless about things ever getting better.  He explains that all of his problems arose when he admitted to his family, a few weeks ago, that his lover was a man.  His family said that they never wanted to see or speak with him again.  The doctor tells the man that the source of his problem is a “mental disorder” in the DSM called Homosexuality.  The man is the son of a southern Baptist minister, and he has been ashamed of his attraction to men his whole life.  He respects his doctor, and his father too.  In fact, he thinks they’re both right.  He sees his love and sexual desire for men as sinful urges that he is supposed to resist, but he is incapable of doing so.  He sees his homosexual acts as mortal sins, and evidence of brain pathology. Feeling utterly hopeless, lost and beyond redemption, a month after being diagnosed with the Homosexuality “mental disorder” the man kills himself.

Please consider helping me spread the idea that “mental illness” is a harmfully misleading phrase that causes suffering by design.

3/9/2017 Update

Evidence supporting the claim that my belief that I had a brain disease in need of pharmaceutical treatment was more beneficial to my psychiatrist:

My stay at the private mental hospital subsequent to nearly dying by suicide was five days long.  I spoke with my psychiatrist on three separate occasions during my five day stay.  We spoke briefly on the day I was admitted.  We bumped into each other once, and spoke for less than five minutes.  And we spoke for about ten minutes on the day I was discharged, and went home.  While reviewing my bill, after being discharged, I noticed that I was billed for “Individual psychotherapy” five times, one charge for each day of my stay.  If memory serves, the charge was $125.  When I called the mental hospital to inform them of the obvious billing error, I was informed that every patient in the facility was charged in this manner.  I explained how this seemed patently fraudulent and unethical to me given the literal definition of the word psychotherapy.  The person I spoke with apologized but said there was nothing she could do, remarking something like, “That’s just how it works.”

The first time I thought and behaved in a way that matched the diagnostic criteria for a “manic episode” found in the DSM occurred after I ingested Paxil.  I’m aware this fact doesn’t prove that the Paxil was the proximate cause of this development in my life, but given the wealth of evidence supporting the hypothesis that anti-depressants like Paxil often have iatrogenic effects on the people who take them, like inducing mania, for example, it’s reasonable to consider that my treatment for Major Depressive Disorder was a causal factor in me exhibiting behavior that led a different psychiatrist to diagnose me with Bipolar Disorder I.

The brand new greatest story ever told is about Albert Einstein’s Unheralded Prescription for Peace

 

The brand new greatest story ever told… is about Albert Einstein’s Unheralded Prescription for Peace and why he was like @thedigitaljesus of our time.

I’m compelled to suggest that Albert Einstein’s free will skepticism–his belief that a person is mistaken in thinking that he or she could have done other than he or she did–is an unheralded prescription for peace that this insightful genius left for the benefit of humanity.

I’m compelled to champion this idea within the suicide prevention community. We have GPS technology and many other modern marvels because of Einstein’s genius insights about reality. It’s time to consider leveraging Einstein’s apparent genius insight into the human condition too.

A world full of people who genuinely view free will as an illusion, and who are committed to maximizing well-being is a world without shame. It’s a world without egotistical pride. It’s a world without revenge–a world without hate of self or others. It’s a world full of people being compassionate, loving and grateful.

Recognizing that we may have already extracted as much utility from the likely fictional idea that human beings are autonomous agents consciously controlling their thoughts, feelings, and actions and therefore their lives, is an important conversation that I don’t hear many people in suicide prevention and mental health advocacy having. I’m committed to changing that reality. Recognizing the likelihood that free will is an illusionary creation of humanity is a silver bullet capable of piercing the heart of the stigma surrounding “mental illness.”

It’s evident to me that Einstein would have said that believing in free will is a major risk factor for depression and becoming suicidal.

It’s time to seriously consider Einstein’s conception of what it means to be a human being. This guy was clever enough to notice that humanity was grossly misperceiving the foundational building blocks of our reality–time and space. Is it so incredible to fathom that Einstein might have had profound insights into the illusory nature of the “self” and free will worthy of our attention and consideration?

Einstein’s conception of what a human being is and how reality works would suggest that we reconsider how we approach describing the problem of human suffering, including the suffering that leads people to die by suicide.

Are people who die by suicide or attempt suicide selfish?

Thoughts from  about selfishness and suicide via TheMighty.com.

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When a Friend Said ‘Suicide Is Pretty Selfish When You Think About It’

“Like… I get that it’s not the person’s fault really but… suicide is pretty selfish when you think about it.”

Flash.

Instantly, it was like somebody lit that spark in my mind that never fails to ignite my passion for mental health advocacy. For me, there’s something about stigma that turns an ordinary passion into the sort of fire you can just see in someone’s eyes.

The above sentence was said to me (paraphrased, of course) a couple of years ago. I was tabling with a fellow Active Minds member and a friend of hers had joined us to hang out. I think we were tabling about suicide, which is why the subject came up.

My immediate reaction when she said this was to be offended. Did she really have the nerve to say that while we were tabling about suicide prevention? Once I took a step back from my emotion I realized that she didn’t mean to insult anyone. She probably didn’t understand how stigmatizing it can be to label suicide as “selfish.” How could I expect her to understand when the topic of suicide is so seldom discussed in our society?

“The thing about suicide is….” I paused, not wanting to offend her or make her think she offended me, “Even if we can call the act of attempting suicide selfish, the person behind it is not acting out of selfishness… if that makes sense.”

I could tell she was truly listening to what I was saying, so I continued. “When someone is so far into that dark place they want to end their life, they might not be thinking about who their actions are going to hurt. Maybe they are in too much pain to think about it. And even if they are aware of how it might impact their loved ones, the desire to end their pain may have become too great to bear anymore.”

If I remember correctly, that’s about all I said. I could’ve gone in-depth about the known risk factors for suicidal behavior. I could have explained how feeling like a burden (a common experience of those contemplating suicide) might make someone think they’re doing their loved ones a favor by taking their own life, which might completely negate any feelings of selfishness or guilt that they might have had. However, I could tell she was really considering what I had just said, and I didn’t want to go too far and overwhelm her.

The notion that suicide is selfish is something I had spent a great deal of time thinking about.

When I was 14 I felt so incredibly guilty for wanting to die, because I knew if I killed myself my family would be devastated. For years, that guilt and the selfishness I felt for thinking about suicide kept me from reaching out for help. All of the stigma about suicide — much of which I had internalized — had me convinced it was better to suffer in silence than to have someone else think what I did: that I was selfish for wanting to die. I’ll never know for sure if that guilt had pushed me closer to the edge or further from it, but I do know that I’m grateful to be alive.

Make no mistake, I didn’t lose any respect for this acquaintance because of her statement, and there was no animosity created between us. In fact I’m glad she said what she said, because it reminded me that the stigma we need to face is not just in the media and our larger social systems, but in the people around us who don’t even realize these ideas are stigmatizing.

It’s one of the things that make the work I do as an Active Minds member or in other advocacy settings that much more important. I also realized that it was important for me to listen and understand where she was coming from too, because a one-sided conversation is not a productive conversation, especially in the pursuit of social change.

Being part of the social movement against mental health stigma can be difficult and discouraging, especially with the seemingly endless sea of misinformation and disrespect shown in various media outlets, but it’s worth it. Thinking back, it makes me happy to remember how respectful and thoughtful that conversation was. It gives me hope to know that “fighting” the stigma doesn’t have to be a fight —sometimes it’s as simple as a conversation.

I wanted to share this story here because I hope to see a day in which we can completely put to rest the idea that victims of suicide are selfish, weak or otherwise bad people, and think instead with empathy by making an effort to understand what someone might be going through if they are contemplating suicide.

My thoughts on the subject:

As a fellow suicide awareness / mental health advocate, I think it’s important to have conversations like the one you describe in this piece. I shared some of the same feelings of guilt regarding my own suicidal intentions and behavior when I nearly died as a result of untreated depression in 1998.

I think the conversation around suicide and selfishness is an important one. I think it’s important to acknowledge the pain and suffering experienced by suicide loss survivors. I think it’s a completely normal reaction for a suicide loss survivor to wonder: how much consideration did my love one give to me before dying by suicide? I think it’s equally “wrong” to blame someone for being suicidal as it is to blame a suicide loss survivor for wondering about the thoughts and feelings of their loved one prior to their death.

I often turn to the dictionary definition of the word selfish in conversations like the one you had: (of a person, action, or motive) lacking consideration for others; concerned chiefly with one’s own personal profit or pleasure.

It seems apparent to me that some people who die by suicide may not give very much consideration to the impact of their actions on others. They do not see themselves as a burden to others, rather their suicidal crisis stems from feelings of shame, embarrassment and guilt. Sometimes simply for feeling and acting suicidal.

I know that some suicidal people go through a series of desperate mental gymnastics to try to think of anything else besides the impact of their death on family and friends. This is part of a process that some suicidal people go through to work up the nerve, to work up the courage to take suicidal action. I know this because I did it, and I don’t believe that my suicidal crisis was unique.

Here’s how I’ve described my thinking in the past about why it doesn’t make sense to think of suicide as a selfish act:

Many view suicidal people as selfish cowards, but I believe it takes courage, massive amounts of courage to turn suicidal thought into suicidal action. Trying to cause your heart to stop beating, while knowing, to some degree at least, how much pain and suffering your death will cause for those who love you requires a special kind of morbid audacity. I won’t claim that there has never been a person who has died by suicide who lived selfishly during his or her life, but I insist that anyone who thinks those two words: selfish and cowardly — about the suicidal act itself, has no first hand experience with the macabre deed. The biological instinct for self-preservation is an almost insurmountable force to overcome. Death is the greatest unknown and fear-inspiring phenomenon facing each of us, which explains why possessing an enormous amount of courage is a prerequisite for dying by suicide.

Suicide can’t be accurately described as selfish either, although it’s understandable why people are prone to do so. The dictionary defines selfish as: lacking consideration for others; concerned chiefly with one’s own personal profit or pleasure. I think it is unavoidable for survivors of suicide, the friends and family of people who die by suicide, to wonder how much consideration was given to them by their loved one or friend, prior to their suicide. Regardless of how much time and consideration someone who died by suicide gave to those left to deal with life after their death, the end of physical and psychic pain resulting from suicide can not bring pleasure nor profit to the deceased. So the suicidal act, by definition, cannot accurately be described as selfish. Suicide extinguishes any notion of the self. An act that causes the sense of self to no longer exist is inherently not selfish.