Continentalist Blithering - Feel Free to Practice Your Textual Hermeneutics

I feel obliged* to warn you all that this post has a high content of continental philosophy, pseudo-structuralism and a dash of queer theory tossed in for "funsies".

After the last post, I have Foucault's Madness and Civilisation on the brain. The question I keep returning to is how one might live out one's madness as a valid instantiation of being in the world whilst also not doing so in a manner that is alienating.

My reading of Foucault comes through the filter of the bias footnoted below and I make no claim as to it's being particularly the best reading. Because of this, I intend to stick to the ideas that reading Foucault has given me rather than trying to elucidate the text. Here endeth the disclaimer.

Rights talk is more than a little incoherent philosophically but it is a very useful way of talking about the privileged space that should be accorded the individual within a society. Because of the way human rights play into the way in which the mad are treated, it is perhaps the most appropriate way for me to approach this question of how to live out madness validly.

Oh God: It has just become stunningly clear and perspicuous to me that this is going to take much longer to write than I intended and it's late. I'm copping out.

I will stop with a question. Might the mad have a human right to be mad insofar as it is subjectively desirable and does not lead to harming others? If so, how would this work? The axiom I take for this is that madnesses are unique, that they are not total and as such are a valuable, non-fungible individual experience. Our current ways of treating madness implicitly devalue madness and deny that the content of madness has in it anything relevant to the human experience. Is this right? Does this infringe on the right to self-expression?

No, this is not going to be an anti-psychiatry rant. Psychiatry has done great things for me. But it's not perfect and it's worth using new ways to analyse it as a whole.

More soon and in the meantime, I welcome everyone's thoughts on the matter.

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*I am obliged by my increasing Anglo-American Analytic Philosophy bias - the LSE tends to entrench any such tendencies. In real life, these distinctions matter less and less but they do persist in that we study the philosophers who wrote when the distinction was more real.

Final Run-in With State Run Mental Health Services in North Carolina

For those of you who live in more civilised countries, let me first explain that in the US, state run mental health services are only for the uninsured and poor. In my home state, they were disastrously privatised in 2003 with more or less exactly the results one would expect.

I have been lucky that by pitching battle with them I have managed to stay under the care of a single psychiatrist for about a year and a half. He turned out to be a good one, which is more than I can say for some of his colleagues and co-workers. You can read, if you like, about one specific case worker I had who was worse than useless and more generally about the difficulties of engaging with these people. All of my readers in the UK may feel free to laugh at me but I am really looking forward to having access to the NHS next year. However bad it might be, and it doesn't sound idyllic, I have often found myself agog with envy at various descriptions even of being in hospital (they're allowed outside? they are allowed to go to the shops? they have crisis intervention teams? they have the option to see a therapist, even with a long waiting list?)

That short list of my own incredulity should give you some idea of what it's like here. Am I now a potential target for BNP anti-immigrant attacks for expressing an interest in the NHS? Or will they hold off because I'm white and English-speaking? Oh dear. I can't imagine, though, that anyone would wonder at it if they had to deal with the state of things in this country - or maybe I don't need to imagine it, just read the papers and see what the Republicans have been up to lately. It does seem to me that as I grow saner, the world has gone a bit farther off its rocker.

Anyhow, all I need do now is swing by there to pick up a copy of my chart (that will be interesting to see) to take with me and I'll be done! No more worrying that they will drop low need patients such as myself, no more worrying that the agency I'm currently enrolled with will go bankrupt (as happened last December - it took me six weeks and repeated phone calls that I would not have been able to make had I not been more or less well to get into a new one), no more worrying that I'll get a job only to have to pay for all this myself since most health insurance policies in the US don't cover mental health at all, or, if they do, have a lifetime limit that I would get through in about six months, a year at the outside.

I'm not going to miss this part of life in the US.

Radioland Visits Broadmoor

I am a regular listener to This American Life on the public radio here in the US. Their last show, titled Pro Se after the legal term for representing oneself in court, really caught my attention. The first long story in it is about a man, here given the pseudonym Tony, who faked mental illness to avoid prison for committing grievous bodily harm. He ended up in one of the highest security units at Broadmoor and has been there for twelve years.

The story goes into detail about the difficulty of shaking a psychiatric diagnosis, especially within the context of a psychiatric hospital. There was a well known study done about the 'stickiness' of psychiatric diagnoses back in the 70's; I can't remember who just now but there is a copy of it somewhere in my research folder and I will find it. The story also includes something new to me - perhaps I've been under a rock and this isn't news to anyone else - which is the Scientologists' campaign against psychiatry. Now that I know about it, I wonder whether that might be behind some of the comments I've seen.

Anyhow, I can't write a proper post about this just now because I am off to my parents' today and I won't have the necessary books with me to write what I want to about it. The reason I have gone ahead and put this up is that This American Life will let you download their shows for free for one week so I thought I'd give anyone interested the chance to do so. If you're reading this after Saturday, you can always listen to any of their shows for free by streaming.




"Brian says Tony's story demonstrates that no two psychiatrists can agree on anything and they basically just make it up as they go along. I think his story demonstrates that it is a huge mistake to screw with psychiatrists and you should be careful not to tell people you're crazy, because you might turn out to be way too convincing about it."

Tony's story is told by Jon Ronson.

Continuing to Exist

I haven't been so sure about continuing this blog but I've found that I really miss it. So here I am.
Everything is a bit at sixes and sevens here; beyond personal life drama, I am also in the process of moving. I'm off to London for grad school in the fall to study philosophy and public policy - I can't remember whether I've said that before, so please forgive me if I'm repeating myself.

Either way, I'm very excited to be headed back to a country where 23 C counts as a heatwave. Where I sit, in urban Appalachia, we are having the exact same weather with the same lack of air-conditioning and all anyone can talk about is what a cold spring and summer we've had so far. From what I've been reading in the Guardian, the same weather is causing everyone to wilt across the Atlantic.

It's a little unfair of me to make mock. I remember the first summer after I moved here: I couldn't leave the house during the day from June til late September because the heat was overwhelming. I'm still not fully re-acclimatised. It certainly wasn't any warmer than this summer during the last summer I was in London (2003) but I seem to remember spending a lot of time on the 46 bus to get to Hampstead Heath and go swimming and eating unholy amounts of ice cream and thinking that I would sweat to death before the heat broke. However, after six years of being teased over my pusillanimous response to summer heat of the American south, it's hard to resist tittering in a friendly fashion.

I'm going to go spend about six weeks with my parents before I move overseas, which means that I'm in the odd process of dissolving my household now, still more than two months before I'll be heading overseas. The hardest part was finding a new home for my cat. I was there when he was born and brought him home exactly 5 years ago tomorrow, on the fourth of July. Now I'll be dropping him off at his new home in eleven days. Happily, he's going to a friend of mine whom I know to be good to cats. Still, it makes me upset to think about.

The fun part of this is giving away all my stuff. One of my friends (there are a bunch of us going to grad school this fall, including two who are also off to England) was joking about how it had all started to feel like an early Christian community, with everyone selling or giving away all they have. We've been swapping climate appropriate clothes and there's a lot of furniture changing hands. I've been putting together surprise boxes for various friends - filling them up with things that I think the recipient would enjoy having or make good use of. It's so nice not to have to make arrangements to move the furniture. I will easily be able to get myself and my books and clothes and paintings up to my parents' in my car.

The idea of not being here for next year's farm tour or this year's apple season and not being at Our Lady of the Holy Smokes for Easter (no more church choir!) is disturbing. However, whatever melancholia this premature nostalgia brings on is easily dispelled when I remember all things in London I like to do - there are so very many. I'll be back in the same town as some of my friends whom I haven't seen in six years and there will be tops of buses from which to stare out of the windows again and the Tate Modern and lunchtime concerts in the City churches and Primrose Hill and I won't have to drive everywhere. Walking will be easier, too, what with London being on an alluvial plane while I currently live in the mountains. You can't just go out and walk for a couple of hours here as you can there, and I miss it.

It's going to be nice to leave the ranks of America's uninsured too: due to state budget cuts, the mental health clinic I go to is now open only three days a week and they're about to dump patients like me, who aren't in a state of acute mental illness. I'm glad I won't have to figure out how to find appropriate care here next year.

I'm going to stop here for now with two requests:

1) There's no way for me to pretend that wretched things have happened in my personal life and that I am quite unhappy over the state of things. The world hasn't ended, however, and no one has died and I haven't lost my mind, so it will all be okay in the end. I just can't talk about it, so, though I know any enquiries would be friendly ones, please don't ask me about it.

2) I need to find a church in London: C of E, high, pref. Anglo-Catholic, and friendly to women and gay people. If you know of one (or of a way to try and find one - the diocese of London website is distinctly unhelpful), please tell me.

It's nice to be back.

Happiness and Illness

What a funny, lovely year this has been so far. I feel as though I have landed in an alternate reality. For one, we have a president who keeps doing good things; for another, I am about to graduate from university. All the time life gets more and more stressful and I seem to be getting more and more well in response. I've gotten through nearly the entire semester without staying up all night or even late, really, and I've just finished my comprehensive exams and my thesis defense without even taking a klonopin.

As though all this, the wellness, the graduating, weren't enough, I seem to have fallen in love. It seems to soon to say that but it is nonetheless true. I see no sense in pretending to myself or anyone else that I feel otherwise. I have no idea what to do about it; certainly, this is going to upset my plans in some measure but I don't seem to mind about that. I'm just happy.

It is the happiness that makes me wonder whether the world I live in now can be the same as the world I lived in last spring. Nothing, no object nor word seems to have the same significance as it did. Even the colors seem different. I hope that I will not fall into the ranks of the healthy and chauvinistic, despising illness and unconvinced of its reality. When I remember - and it takes effort - I can see how overwhelming it was, how very real and very horrible it was. I wasn't ever being lazy or weak. I wish I had let myself be ill instead of twisting everything around and trying to convince myself that I wasn't really or that any rate I ought not to be, or ought not to take it into account. I wish that I had been able to say to myself, anyway, that I was ill and that it was wrong and unreasonable to expect myself to be able to do even the simple things as easily or as well as others. I think that it is probably inevitable that there will be people who would think me lazy or malingering and I doubt that I will ever live in such an ideal world that I would truly be allowed to be ill whilst ill and convalescent while convalescent but I hope that the next time I will be able to tell myself the truth, even if nobody else believes it. It was a cruelty to have done otherwise and I wish I had not felt it necessary to be so mean to myself: after all, isn't that what mental health professionals are for? I shouldn't try to do their job for them, especially if I'm not getting paid for it. Not that I'm cynical or anything...

16 Things

There's a "16 Random Facts About Me" thing floating around on facebook these days and I feel inspired in my fretful sleepless on a school night state to make my own version, which I shall call:
16 Random Things About My Madness

1. Medication-induced acne on previously unblemished skin will eventually go away if you use heavy-duty Clearisil face scrub long enough; in my case, three months.
2. Baking is very relaxing provided you remember to set the timer.
3. Any spending urge caused by the hypomania (or proper mania, if you have it) can easily be satisfied by the constant need to buy larger clothes as the medication continues to help pile on the pounds.
4. You don't have to do anything but smile prettily at looks of confusion when you tell someone you have a chronic illness and they try to puzzle out how that can be true when you look so young and physically healthy.
5. The standard of care with Nurse Practioners is highly variable.
6. Sometimes klonopin is the best choice.
7. I like having a psychiatrist who is younger than I am (only by a year but I find it tremendously amusing for some inscrutable reason.)
8. Most books on coping with bipolar disorder are enormously depressing.
9. There can be a fantastic rush when going out at four in the morning for a cigarette while very hungry and looking up at the stars.
10. Pretending that you are someone else who had a mental illness can take the strain off and provide mild entertainment on depressive days: sometimes I like to sit in my armchair and pretend I'm Virginia Woolf; sometimes I like to lie in bed and pretend to be Anais Nin; sometimes I walk to the next neighborhood over and pretend I'm Zelda Fitzgerald. That's actually a bit strange, isn't it?
11. Ancient Greek and hypomania are a great match for each other.
12. Chasing pills with mint tea soothes the nausea.
13. If you are depressed long enough, at some point you will realize that you have memorized all the lines of at least three of your favorite movies.
14. Much to my annoyance, my father turns out to have been correct in his assertion that if I would just keep the house tidier I'd feel better.
15. It is worth calling as many people as you can when you have happy news.
16. It is easy to cause a landslide in the minds of state-mental health services personnel when making your next appointment if you take out your day planner and have your own pen. They will look at you in awe, as though you are a creature from another planet.

So that's my 16. What are yours?

Healing Dialogue

This is a very close rewrite of the conversation I had this afternoon with my new caseworker. It was the second time I'd seen him. I'm just going to let the dialogue, which is foreshortened but remains representative and is in many parts verbatim, speak for itself, as it were.

I have changed the names.

Scene: a rabbit's warren like office building containing dark, narrow corridors set at illogical angles, dark amber glass, industrial carpet. Inside are three different mental health agencies, a pharmacy service and the office of the local congressional representative. Enter a young woman (that is, me) tired and a bit harassed looking.

Receptionist slides open glass panel
Me: Hi, I’m here to see Owen.
Receptionist slides closed the glass panel and nods dismissively
The young woman sits down on the plastic covered lobby couch and picks up one of the medication leaflets and starts reading it. Five minutes goes by.

A man in his approximate forties opens the door to the sanctum sanctorum of mental healing, revealing employees indulging in what can only be described as loud yakking and ferrying reams of paper from one closet-like room to another.

Owen: Hi, there. Not late this time!
Me: No. Hello.
thinks: wasn’t late last time, either

They walk around the corridors for a minute trying to find an unoccupied office. One is located and several foot high stacks of papers are rearranged to make enough room for two people to sit down.

Owen: How are you today? [shuffles papers]
Me: Doing well, doing well. A little stressed out. A little tired.
Owen: Well what’s up that you’re tired and stressed?
Me: It’s been a long week. The semester started last week. . .
Owen: Semester? But I thought Local County Tech started this week?
Me: They may have. I’m up at the state university, though, and we started last Wednesday. We talked about this last Friday.
Owen: Ah, that’s right. Philosophy. I took a philosophy class in college. That was when I didn’t know what I was doing with my life. You don’t need to know what you’re doing with your life yet when you’re still in college, as you know. My professor, oh man, he was a character. You know those people who always answer all the questions, with their little hands up in the air?
Me: Yes. I am one of those people. But I try to have a sense of humor about it.
Owen: Oh.
Me: It’s okay. Don’t worry, it’s not like I don’t know what . . .
Owen: Well one day the professor said “Whoever answers this next question will get a jawbreaker.” Like a candy, you know. So this guy raises his hand and answers the question and the professor like, you know, just slugs this piece of candy at him and it hits the wall, and oh man, it just like breaks into a bunch of pieces and I mean just like this huge thwack, BAM! Yeah, I still don’t know what that was about.
Me: Hmm. Neither do I.
Owen: So let’s see. [shuffles papers] And you’re graduating when?
Me: Well, that’s part of why I’m so exhausted this week. I’ll be graduating…
Owen: It’s not a race, you know. You’ll get there when you get there.
Me: I know. But I’m going to graduate this spring. I just got the registration worked out yesterday morning. And I think that having borne with all the stress of it this week and still sleeping and going to class and getting my work done, I really think that I’m going to be able to get through the semester.
Owen: That’s great. And you’ve been doing the mantras like we talked about last week?
Me: Well, no, because like I told you last week, that doesn’t really help me very much. But I have been doing other things to relax.
Owen: The great thing about mantras is that they center your breathing which is at the core of the way you feel. You have to say them breathing in and breathing out and it just takes you out of yourself. In fact, I spent about ten minutes doing that this morning and it was amazing. I was kinda still half asleep, kinda drifting in and out of being awake, you know, and it was like I just left myself, I really got outside of myself. And that’s all related to what this guy I know’s brother in law who was in a monastery in Vermont, real religious guy but he died real young, like fifty-two or something. Anyhow, he said in a poem that I can’t really remember how it goes, but it’s about how the core of everything is love. That that’s the real truth about everything. With your philosophy, I guess, you’d call that the meaning of life, right?
Me: Well, the idea that love is at the center of everything is certainly a very religious idea about the essential nature of the world.
Owen: Yeah, yeah. Well, that’s why the mantras are so important because they take you out of yourself. And this guy, this monk guy, said that hell is full of all the boring people, the people who never get outside of themselves and what they’re thinking and that’s why they go to hell.
Me: Hmm.
Owen: But you don’t use the mantras. What do you do?
Me: Taking baths, reading. . .walking, when it’s a bit warmer, or sitting in the sun. Sometimes I… Owen: And you take [peering down at file] klonopin?
Me: Yes.
Owen: How often do you take that?
Me: [sighing internally] Not very often.
Owen: Once a week, or?
Me: Well, it depends on the week. This last week, I’ve taken it pretty often. But when things are less stressful, maybe once a month or something.
Owen: You have to be careful with that. Those pills can be addictive. But you’re only taking half a milligram?
Me: That’s right. And I really don’t take it often enough to get dependent on it, though I realize, believe me, that that’s something to worry about.
Owen: I was talking to my officemate, you met her, Rachel, and we’re not sure that you need to be on CST. In fact, another of my colleagues overheard us talking last week and asked me whether you really needed to be on CST. Do you think about stepping down to med management?
Me: I have been, but with school starting and having had to change agencies, I thought it would be best to get to know things here before stepping down to med management.
Owen: I can see that. But what with all the restructuring we’re doing, I’m not sure that we’ll be able to keep you as a CST client. And they’re talking about doing away with the med management program because we can’t get any money from the state for it.
Me: What?
Owen: Yeah, well, I guess they expect you to get your own doctor.
Me: Well…I can’t afford that. That’s why I’m here. Psychiatrists are expensive. I have no health insurance. What am I supposed to do if that happens.
Owen: Oh, don’t get stressed about this. I didn’t mean to stress you out.
Me: Well, it’s a little late now.
Owen: Nah, they’ll never do away with it. I’m going to go ask Beth. [stands up, sticks head out of the door and shouts] Hey Beth? They’re not going to stop the med management program are they?
Beth: [offstage] No. I mean, they want to and they’re going to review it in February but we’ve got 112 clients in it and I don’t think they’ll be able to get rid of it.
Owen: [to Beth] Thanks! [to me] See, they’re not going to do away with it. So don’t stress.
Me: Well, with all due respect, I have heard that before. It was the same at the last agency and then they went out of business and gave us only two weeks’ notice and then it took me eight weeks to get in over here after they told me that they would take care of the transition work for me. It was eight weeks of people not returning my phone calls or saying that they will call me and then not calling me and being given misleading information. Even if you’re going to find a private doctor it can take a couple of months and for me to find someone I could afford to go to would take at least that long. So if they’re even thinking about stopping that, I have to wonder whether I should go ahead and start looking around now.
Owen: Well, that might not be a bad idea. But they’re not going to stop the program. But people do go through a lot to find a doctor. When I was first out of college, a friend of mine got me a job in a mental institution and, I was telling you about this last week, about how everyone was being involuntarily committed and I got to see all kinds of crazy diagnosisses [sic], man it was crazy out there. [laughs ruefully] Well, there was this pregnant girl, pregnant and fourteen, fifteen and psychotic and they had her on all kinds, just all kinds of different drugs – thorazine and neurontin and all that – and none of it was working so her parents just took her out and said they were going to take her to the root doctor. You know what a root doctor is? Like, there was a band called the Root Doctors? You must have heard of them.
Me: No, I haven’t, I don’t really know all that…
Owen: Man, why am I even telling you about this? This is your time, you should be doing most of the talking. But you don’t know what one is?
Me: No.
Owen: Never heard of a root doctor? It’s funny who does and who doesn’t. Well, they’re like witch doctors, like voodoo doctors. And they put these things in like cheesecloth, well I don’t know if they really use cheesecloth, but they put these things in and her parents took her out and said that if it worked, they’d bring her back and if it didn’t work, they’d bring her back. So after a like long weekend, they brought her back and she was fine. No problems anymore. I’m not saying it worked but it did have an effect and I guess you with your philosophy would say that it was about belief.
Me: Well, the placebo effect has been very well-documented in a number of well run drug studies over the past century, so yes, I suppose that could have been about…
Owen: Now when are you seeing Dr. Perry?
Me: I think it’s the 16th.
Owen: I have, let’s see, the 19th.
Me: I’m willing to bet you’re right. I have it in my planner but I don’t know it off the top of my head.
Owen: I’ll just look it up. [taps at the computer] The 19th. Well, that philosophy’s great stuff. One of the most interesting classes I took, although I thought it was a whole lot of bull at the time you know. See you next week. Good to talk to you.
Me: Yes. Next week, then.