mental-disorder

The country is not growing because the mental state of the people are retarded

When preparing for Book One, I talked to a couple of psychiatrists about psychosomatic phenomena, neuroses and dissociative conditions, for example the so__alled hysterical blindness suffered by many who saw the Killing Fields in Pol Pot__ Cambodia: their eyes objectively see, but they are not aware of it and are blind because they believe they can__ see. One specialist told me that among modern Western people, __etaphorical_ symptoms such as Fredy or those Cambodians evince are much rarer now than earlier in the twentieth century or before. Nowadays most people are better equipped by education to verbalise their neuroses, and have lots of jargon in which to do so. For most of the dissociative dimension, I could draw on things I knew from within myself.

Interestingly, the patients who presented to me self-diagnosed [with Dissociative Identity Disorder had tried to tell previous therapists of their plight, but had been disbelieved. These therapists had used fallacious "capricious criteria" (KIuft, 1988) to discredit the diagnosis; e.g., that the patient could not possibly have MPD because _he was aware of the other alters [sic!].

Schizo. It didn't matter how many times Dr. Gill compared it to a disease or physical disability, it wasn't the same thing. It just wasn't. I had schizophrenia. If I saw two guys on the sidewalk, one in a wheelchair and one talking talking to himself, which would I rush to open a door for, and which would I cross the road to avoid?

Many people with Dissociative Disorders are very creative and used their creative capacities to help them cope with childhood trauma.p55

She fails to see who I am, even, for her eyes do not, will not, take me in. Instead they transmit a powerful message. She is like a billboard flashing, starkly: 'Keep Out'.

It is not unusual for subjects diagnosed with a Dissociative Disorder on the SCID-D to be surprised at having their symptoms validated by a clinician who understands the nature of their disorder.

Dissociative Disorders have a high rate of responsiveness to therapy and that with proper treatment, their prognosis is quite good.

Among DID individuals, the sharing of conscious awareness between alters exists in varying degrees. I have seen cases where there has appeared to be no amnestic barriers between individual alters, where the host and alters appeared to be fully cognizant of each other. On the other hand, I have seen cases where the host was absolutely unaware of any alters despite clear evidence of their presence. In those cases, while the host was not aware of the alters, there were alters with an awareness of the host as well as having some limited awareness of at least a few other alters. So, according to my experience, there is a spectrum of shared consciousness in DID patients. From a therapeutic point of view, while treatment of patients without amnestic barriers differs in some ways from treatment of those with such barriers, the fundamental goal of therapy is the same: to support the healing of the early childhood trauma that gave rise to the dissociation and its attendant alters.Good DID therapy involves promoting co­-consciousness. With co-­consciousness, it is possible to begin teaching the patient__ system the value of cooperation among the alters. Enjoin them to emulate the spirit of a champion football team, with each member utilizing their full potential and working together to achieve a common goal.Returning to the patients that seemed to lack amnestic barriers, it is important to understand that such co-consciousness did not mean that the host and alters were well-­coordinated or living in harmony. If they were all in harmony, there would be no __is­ease._ There would be little likelihood of a need or even desire for psychiatric intervention. It is when there is conflict between the host and/or among alters that treatment is needed.

The uncomfortable, as well as the miraculous, fact about the human mind is how it varies from individual to individual. The process of treatment can therefore be long and complicated. Finding the right balance of drugs, whether lithium salts, anti-psychotics, SSRIs or other kinds of treatment can be a very hit or miss heuristic process requiring great patience and classy, caring doctoring. Some patients would rather reject the chemical path and look for ways of using diet, exercise and talk-therapy. For some the condition is so bad that ECT is indicated. One of my best friends regularly goes to a clinic for doses of electroconvulsive therapy, a treatment looked on by many as a kind of horrific torture that isn__ even understood by those who administer it. This friend of mine is just about one of the most intelligent people I have ever met and she says, __ know. It ought to be wrong. But it works. It makes me feel better. I sometimes forget my own name, but it makes me happier. It__ the only thing that works._ For her. Lord knows, I__ not a doctor, and I don__ understand the brain or the mind anything like enough to presume to judge or know better than any other semi-informed individual, but if it works for her_. well then, it works for her. Which is not to say that it will work for you, for me or for others.

They called me mad, and I called them mad, and damn them, they outvoted me.

Stigma against mental illness is a scourge with many faces, and the medical community wears a number of those faces.

I couldn__ trust my own emotions. Which emotional reactions were justified, if any? And which ones were tainted by the mental illness of BPD? I found myself fiercely guarding and limiting my emotional reactions, chastising myself for possible distortions and motivations. People who had known me years ago would barely recognize me now. I had become quiet and withdrawn in social settings, no longer the life of the party. After all, how could I know if my boisterous humor were spontaneous or just a borderline desire to be the center of attention? I could no longer trust any of my heart felt beliefs and opinions on politics, religion, or life. The debate queen had withered. I found myself looking at every single side of an issue unable to come to any conclusions for fear they might be tainted. My lifelong ability to be assertive had turned into a constant state of passivity.

Psychological trauma is an affliction of the powerless. At the moment of trauma, the victim is rendered helpless by overwhelming force. When the force is that of nature, we speak of disasters. When the force is that of other human beings, we speak of atrocities. Traumatic events overwhelm the ordinary systems of care that give people a sense of control, connection, and meaning._ Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life._ They confront human beings with the extremities of helplessness and terror, and evoke the responses of catastrophe.

those glasses aren't for the sun they're for darkness, exclaims Rue. Sometimes when we harvest through the night, they'll pass out a few pairs to those of us highest in the trees. Where the torchlight doesn't reach. One time, this boy Martin, he tried to keep his pair. Hid it in his pants. They killed him on the spot. They killed a boy for taking these/ I say Yes. and everyone knew he was no danger. Martin wasn't right in the head. I mean he still acted like a three year old. He just wanted the glasses to play with, says Rue. Hearing this makes me feel like District 12 is some sort of safe haven. Of course, people keel over from starvation all the time, but I can't imagine the peacekeepers murdering a simpleminded child. There's a little girl, one of greasy sae's gradkids, who wanders around the Hob. She's not quite right but she's treated as a sort of pet. People toss her scraps and things.

Police intentionally murdering a mentally unstable person will always be unacceptable when there are numerous other non-lethal options available to them.

Patients with complex trauma may at times develop extreme reactions to something the therapist has said or not said, done or not done. It is wise to anticipate this in advance, and perhaps to note this anticipation in initial communications with the patient. For example, one may say something like, "It is likely in our work together, there will be a time or times when you will feel angry with me, disappointed with me, or that I have failed you. We should except this and not be surprised if and when it happens, which it probably will." It is also vital to emphasize to the patient that despite the diagnosis and experience of dividedness, the whole person is responsible and will be held responsible for the acts of any part. p174

Holding one's self responsible is a critical feature in stigma and in the generation of shame since violation of standards, rules, and goals are insufficient in its elicitation unless responsibility can be placed on the self. Stigma may differ from other elicitors of shame and guilt, in part because it is a social appearance factor. The degree to which the stigma is socially apparent is the degree to which one must negotiate the issue of blame, not only for one's self but between one's self and the other who is witness to the stigma. Stigmatization is a much more powerful elicitor of shame and guilt in that it requires a negotiation not only between one's self and one's attributions, but between one's self and the attributions of others.