Tuesday, November 22, 2011

“Cutting Knowledge” to Recover Ourselves

I am incredibly excited to be joining the Foundation for Excellence in Mental Health Care as a blogger.  The Foundation’s vision, which states that “All People have hope, knowledge, tools, and community available to them to recover from mental health and trauma challenges”, is completely in line what I’ve come to believe in my heart after experiencing my own mental health recovery.  Had you asked me whether I thought recovery from “mental illness” was possible a little under two years ago, I would have shaken my head and said that it wasn’t.  Since that time, however, my life has utterly transformed, and I live today without a psychiatric diagnosis, off of all psychiatric medications, and no longer in psychotherapy, after spending thirteen years immersed in the mental health system. 

Some of you may know a bit about me through reading my blog on Robert Whitaker’s website, www.madinamerica.com, where I’ve been sharing my story of mental health recovery.  I will continue to share my story there, and focus my writing here on the current issues in mental health reform—from the labeling and pathologization of emotions, the Diagnostic and Statistical Manual (DSM), and the impact of stigma; to ideas about informed consent, shared decision-making, psychotropic medications, and agency; and to the peer movement, mental health recovery, and hope.  But let me take a minute here to tell you briefly about who I am today.

I am twenty-eight years old, live in Boston, Massachusetts, and work as a Peer Specialist in the traditional mental health system.  I am a recovering alcoholic who took her last drink in February 2010.  I take a holistic approach to my personal health, focusing on nutrition, exercise, meaningful human connections, and the cultivation of a spiritual life.  I still experience some of the same thoughts and intense emotions I felt during my years living with a psychiatric diagnosis, but I now relate to them in a profoundly different and non-pathologizing way—one of the keystones of my recovery.

Some in the medical profession might challenge my story and say that I must have been “misdiagnosed”— that someone must have made a mistake along the way in telling me I had bipolar disorder and borderline personality disorder, because once someone has a mental illness, that person has it for life.  Whatever the protestations I may hear, and whatever the factors that contributed to my thirteen-year relationship with psychiatry may have been, I stand firm in my belief today that no matter how far down the scale a person has fallen, the innate human capacity to heal never disappears.  I have full faith in that universal aspect of our nature— that each of us has a deep wellspring of hope that might dwindle to a drip but that never fully dries out and is always capable of being replenished.

When I think about the stark contrast between the emotional and psychological darkness that encompassed me during my years as a self-described person with “chronic mental illness” and the lightness and hope that surround my life today, I feel overwhelmed with gratitude.  This gratitude reminds me that I am one of the lucky ones to make it through to the other side of the mental health system, miraculously intact and healthy, and that it is my vital responsibility to carry a message of recovery to those who don’t yet believe it, whether because they don’t want to or because they’ve lost faith in themselves that they can attain it.   

When Gina Nikkel and I met at the annual conference for the International Society for Ethical Psychology and Psychiatry (ISEPP) in Los Angeles several weeks ago and she asked if I’d be interested in blogging for the Foundation, the timing couldn’t have been better.  As a newcomer in the world of mental health reform, I was in the midst of my first foray into the part of the movement occupied primarily by mental health professionals, and I was quite moved and energized by what I saw: a large room of people whose professional identity is deeply tied to the very thing they have come to question— the idea that biomedical language, maybe even science, itself, holds the key to our understanding of emotional suffering—and who are passionate about discussing alternatives. 

Challenging this predominant paradigm through which the majority of modern Western society understands thoughts and emotions requires dialoguing from numerous angles, including the philosophical/ethical, the medical/scientific, the spiritual, and the experiential/peer/survivor.  My goal in writing this blog is to use my lived experience with both “mental illness” and recovery to help create a space where such dialogue can take place.

When I think back to the many years in which I unquestioningly used biomedical language to make sense of my experiences, I can’t help but reflect on the deep-seated belief I held that I could never and would never recover.  This belief was reinforced by countless mental health practitioners, who told me I might be able to “manage”, but only if I listened to my doctors and trusted that they would eventually find the right combination of medications to “treat” my bipolar disorder.  It was suggested that I think about my bipolar disorder as a lifelong condition “just like diabetes”.  Until we separate ourselves from such a reductionist mindset—that emotional suffering is an incurable biological disease requiring medical treatment— I worry that the concept of recovery will never truly take hold in mental health care.
 
And just what do I mean by the concept of mental health ‘recovery’?  Let me begin by saying that I believe it means no one thing.  Each of us carries unique experiences that shape who we are; to throw a standardized description of recovery to such human diversity would be to operate in the same single-track mindset that biomedical psychiatry has in its belief in psycho-pharmaceutical treatment.  I believe that mental health recovery is achieved when one finds meaning in his or her suffering, and can thus begin to relate to that suffering in a way that is no longer disempowering and imprisoning.

I can truly say that I am happier, healthier, more hopeful, and more connected to the vitality of life today— medication-free, diagnosis-free, and therapist-free— than I’ve been since very early childhood.  By stating this, I am not suggesting that my own route out of psychiatry is the only way to achieve recovery; indeed, each individual goes down a unique path that may very well include facets of the traditional mental health system. 

My goal in writing this blog is not to convince others that they need to believe what I believe, but rather to challenge preexisting ‘truths’ about the nature of emotional suffering.  As my favorite philosopher-historian, Michel Foucault, once wrote, “Knowledge is not for knowing: knowledge is for cutting”.  Indeed, it is easy to use the seductively ‘objective’ language of medicine and science to explain in a black-and-white way what is inherently gray.  The simple fact that biomedical knowledge exists about the causes and conditions of emotional and psychological suffering shouldn’t make it an unquestionable truth.

That being said, there is one truth to which I will hold fast, for I believe it resides at a human level as primal as our need for oxygen: recovery from mental health issues, however “acute” or “chronic” they may be, is entirely possible.  I know this is true because it has happened for me, after nearly a decade of living with a “chronic mental illness”.  I know this is true because I have heard many stories from others who have been similarly graced.  I know this is true because human beings successfully lived with emotions for thousands upon thousands of years prior to the birth of Thorazine just sixty years ago. 

I held no chance at tapping into my potential for recovery— not just from “bipolar disorder”, but also from the all-encompassing language of pathologization that is part and parcel of biomedical psychiatry— until I discovered that my essence as an emotive human being lies deeper than any pill bottle or medical textbook.  It is upon such a foundation that this blog will be written, with an open mind and an open heart to explore what’s working and what isn’t in the mental health system.