Gnosis, Prognosis, Diagnosis

[NB: My bias is based in existentialism and humanism—if ideas herein come across as advancing a spiritual or metaphysical outlook this is only insofar as I view the phenomenal power of experience which is holistic or super-sensual as a basic part of human conscious life.]


Diagnosis (Greek: διάγνωση, from δια dia- "apart-split", and γνώση gnosi "to learn, knowledge") is the identification of the nature of anything, either by process of elimination or other analytical methods.

Gnosis (γνῶσις) is the spiritual knowledge of a saint or mystically enlightened human being. Within the cultures of the term's provenance (Byzantine and Hellenic) gnosis was a special knowledge or insight into the infinite, divine and uncreated in all and above all, rather than knowledge strictly into the finite, natural or material world which is called Epistemological knowledge.


My theory is that Recovery is about putting the human being at the forefront of all his or her interactions with services that would, on face, be designed to help them. (I say on face because psychiatric care and mental health services serve multiple aims and masters both and historically, e.g. male privelege, ‘public safety’, ideologies and hierarchies of power, the hegemony of medical science, even future public prosperity as evidenced by the mass implementation of ‘eugenic’ sterilization in US hospitals.)

I believe it is the human being, in fact it is Being Human, that is at stake in the success of the Recovery Revolution.

The Recovery Revolution mirrors a return to the humanistic tradition of psychology begun in the late 70s as the ‘cognitive’ revolution. In this latter the bleak search for the pure machine of behaviorism was finally abandoned as the major avenue of psychological science with the realization that, no matter how frustrating it is from a positivist outlook to explain or even identify the human mind, it nonetheless plays a significant role in the functioning and lives of human beings, a role which cannot be discounted.

Recovery has now been found and acknowledged worldwide as not simply a good idea but as something actually common and natural. This is to say that even in areas which have little to no contemporary psychiatric treatment or even the most basic of psycho-meds, most people who have significantly debilitating symptoms of the most serious mental illness, recover functionally within 6 months of onset. What’s more people recover faster and better apparently in less industrialized nations. Don’t believe me on this one –believe the World Health Organization. http://www.mindfreedom.org/kb/mental-health-global/sartorius-on-who

Similarly the principal tool of the psychiatrist’s belt, the psychopharmaceutical, has been revealed in most cases to be at best as good as a robust placebo, or actually worse, at least insofar as they give people nasty side effects. This does not stop our pharma companies of course from marketing both disorders and medicines to fix them on a daily basis.

Diagnosis

What we are in fact recovering from is the main project of 20th century psychiatric science itself, an experiment based in a systematic fascination with science and social engineering that swept whole generations into a distorted view of the nature of the human being. This project, like most social epidemics, was wrought largely without malicious intent but also without forethought or insight into its global effects.

What are the effects? We could list them as graves of the unmourned, unmarked and ignored, as families torn apart, suicides completed, ‘missing’ relatives, children sequestered, forced abortions and death or trauma by insulin, lobotomy, restraint, coercion, depection and ECT. We could enumerate or at least estimate the numbers of rapes, functional tortures, dehumanizing conditions. But that would only speak to the parts of this effect.

I feel that the effect is more generalized, the disease more systemic if you will. My diagnosis is schizophrenia, chronic, undifferentiated.

I believe that modern medical psychiatry has caused schizophrenia to occur on a massive scale. A schizophrenia in the true sense of the word, which afflicts most of industrialized civilization. Schizophrenia which has split our people from each other, our families, our being from its uniqueness. This schizophrenia has worst of all divided human beings from that thing which makes us both human and being, our consciousness.

Even as the dead-end of behaviorist science gave way to the cognitive rediscovery of the mind, medical psychiatry must die in order for people to regain their humanity, in order to heal the split that it has caused.

It is dying but it is not going without a fight. I wish I were more convinced that the Recovery Revolution was bound to succeed, that humanity in its grandest sense would ultimately prevail over the forces of fear, discrimination, atomistic science and conformity. That we would all someday embrace the diversity of experience that makes some of us crazy one day, prophetic the next, learned the following.

But power does not cede to other values easily, even where many in power agree with them.

So the transformation goes on. And in the heat of it we cannot know what will finally emerge.

My prognosis is for an unstable course, with an uncertain outcome. But I know I want the patient to live.

Practicing Paradigm Shift

Practicing Paradigm Shift: OR Finding capital-R Recovery in the mental health system.

 Part I 

I have come to believe that Recovery with a capital R is not a theory, an approach or a concept, but that it is a a mode of being, or a practice. It is an active internal resource to fuel, ideally, all one’s interactions with oneself and other humans. (Though in fact, like other practices spiritual or metaphysical nature, few if any could reach that 24-7 ideal.)

 I have also come to believe it takes any person associated with mental health services in the U.S., whether they are a consumer, family member, provider or psychiatrist, at least 5 years to grasp Recovery at this active level.

By five years I mean five from the time that person has fully and positively embraced the Recovery approach.  Five years of thinking about it daily, living with it, working to integrate it into one’s life and work.

There is no science to this five year assertion—it is based on my experience and what I have observed in people around me. But it took me that long—and, unlike many program staff, family or mental patients who may not be ready for ‘new thing’, I wanted to believe it from day one.  You could say my life depended on it.

To get to the place where Recovery is an active part of your response to life you have to unpack a lot of other things. And you have to give up a lot, things that are hard for people to give up. You have to give up many ideas, some of which are among our most intimate cherished concepts. Ideas about who we are and what we can be, about the nature of caring, about what we can do for and with others, about the nature of consciousness itself.

What we think we know, what we believe about the power of science, medicine and statistics, what we may believe about society itself and how it functions, the icons and myths of modernity and rationalism, the very words we use unconsciously when speaking to ourselves, when dreaming. All these and more ideas and values have to shift within our consciousness in order for the paradigm of Recovery to take root.

The concrete of what people have been taught about being human in the last two hundred years is thick and strong—it is the foundation of contemporary civilization in many ways, certainly of the science and method of approaching problems both physical and social. The idea for instance that one’s person resides in one’s mind, and that one’s mind resides in one’s brain. That sanity is essential and desirable and that is is defined by a specified set  and range of experiences. That aberrations from norms of behavior and understanding are dangerous, exciting, or meaningless. That healthy minds and people are analoguos to healthy bodies—that you could look inside them and see they were all the same.

This concrete undergirds all sorts of important things we have been taught, things we are attached to. But it must be broken. It must crack in many places to allow Recovery to grow through and restructure a new conceptual environment in which the lunatics can, should, will control the asylum.

Reflecting Recovery

A zen garden in Kamakura, Japan






INTRODUCTION
Seeds of Recovery,  Flowers of Transformation

Recovery is both a process of personal transformation and a way of relating to the world. A path of Claiming and Reclaiming personal dignity and meaningfulness from the effects, shame and stigma associated with being disabled by symptoms of mental illness and its treatment.

Recovery is a catchword these days for many things and interpreted in many ways.  At base Recovery it is only 'real' in the lived experience of human beings. Of people themselves. People who are sometimes called, or call themselves, clients, consumers, patients, ex-patients. (Many believe however that Recovery has nothing to do with these labels.)

At the same time this vision of Recovery as a way of thinking, acting and being has fueled a powerful social movement, one that I hope to be able to contribute to in my work. This social movement inspired originally by consumer activists has finally driven the recognition and establishment of a national program for mental health systems transformation.

"Transformation" is a word easily used without respect for its deeply catastrophic sense.  I believe the Recovery Transformation of mental health systems represents a powerful shift in the way people are viewed and treated, one that is essential in advancing a more just and humane society. This is no simple thing however and powerful in its implications. To my view the Recovery Transformation presents a radical agenda for social change beginning at the level of the inner person but ultimately effecting even the world's most cherished and monied institutions.

Both the personal human level and the social change movement of Recovery is something that I will discuss here, from the frame of my work attempting to be a change agent inspired by this vision. I will also hope to try to keep the frame of these together as much as possible, because I believe that if the two are uncoupled -- the human is taken out of the theory or policy, or vice versa if our personal work and experience does not seek to advance larger progress in this area, the potential for positive transformation is limited.

At this page then I do not claim or intend to be authoritative, comprehensive or even internally consistent. Its my hope here to capture and distill the essence of consumer voices participating in this process, to observe parts of the journey of this worldwide project and to notice roadsigns on the way of transforming attitudes and ideas, practices and approaches of mental health and other systems.

The idea for this blog began as simply a place for me to put my random musings, rants and thoughts on  my  own work and life. The goal was to reflect on this mental health Recovery transformation as I experience it in my own life and work, to say what I really think and why I do this, and why I think it is important, partly to remind myself but also with the hope of inspiring you, readers and colleagues.

But I hope to expand upon this by building a community of thinkers, a place for dialogue and discussion of the difficult, critical and finer points this work that so many are dedicated beyond reason, beyond hope, perhaps beyond their own best interests a times. I will invite specific peopel to write in at times as well as present here relevant comments. Recovery and Transformation Journal may have the chance to evolve then into a genuine e-zine or print journal.

The dialogue of the Recovery movement is reshaping the world around us -- it is not always easy or even a peaceful conversation. Nor should we expect it to be-- all things important and powerful generate controversy, passion, resistance, sometimes even conflict.

Yet I believe that in this dialogue exists true power for change, change which makes  healthier  more actualized people and which also advances social justice. It's my hope you will join me with your thoughts on this complex and important issue. That you will add your reflections and knowledge, that we can thereby contribute to the dialogue and keep it growing.

If we keep this garden of thoughts seeded and watered, if we work together to grow new possibilities, if we protect it against the elements with our hearts and hands, we will all gain. We will gain strength from work, nourishment from the fruits and joy in hope and color of many flowers to come.