Thursday, November 27, 2014

My Mind is Not My Enemy

Look. Look. That's the place for us. High, lonely hills, where the wind and the sound carry, and the ground's as dry as straw in a barn. That's where we ought to be. That's where we have to get to. Fiver (Watership Down)
Someone asked me a little while ago why I named this blog, A High, Lonely Place. You see, very early on, psychiatrist tried to teach me that my mind was broken, that it was my enemy... but my mind has never been my enemy. In my mind, I have been to Hogwarts, down the rabbit hole to tea with the mad hatter and the March hare, solved cases with Sherlock, heard the call of the Tardis in the darkness, and alternated between saving the world and needing to be saved from it. You see, that's what it's really all about. It's what it has always been about... saving myself.
I never built hedges against the night... my mind built those for me. It created this high, lonely place, where I could see for miles, both ahead and behind me. Unlike many people who have been classified as mentally ill, I have never been afraid of being alone. I am not terrified of the sound of the voice in my head or the reflection of my life in my mind's eye. I'm safe there. I've always been safe there. It's out there with the rest of you that I falter, and that's not controlling behavior or agoraphobia, that's life experience.

Friday, November 14, 2014

I want to clear some things about mass shootings in the US... Facts that are particularly hard to see when the news media is showing back to back coverage with constant commentary and bodies on every channel. 0.2 % of all homicides in this country are mass killings. Of that 0.2 %, only 10% are public killings (like Aurora, Newtown, etc) Though 2012 was a bad year, representing the highest number of these victims of this type of homicides (killed and wounded) since 1929, the average is 30 events a year, and that number has been declining steadily. It's also important to understand that Familicides alone are responsible for nearly half of the 0.2%. The majority are committed by a white, male, head of household. These killers are roughly 60% more likely to be suffering from a mental illness, but when you look at a crime that ends in suicide with no other strategy in place, you are more likely to be dealing with mental illness or what would be viewed in the aftermath as mental illness. Mass murder is not rising.
Another fact we need to clarify: the profile of this killer defies all the promises made by politicians and psychiatrists. The killer is most likely white, between 20-30, and unlikely to have many responsibilities. He is also unlikely to have a a criminal record or a lengthy psychiatric record. In short, Dr, Torrey has no more idea of what he is looking for than you do. They are not usually under the influence of narcotics, and they are frustrated, outraged, or disappointed by a series of slights or grievances that may be real and may be imagined. They target strangers, but they are not random. Their victims are a representation to them. It could be they embody what the killer covets or that the victim possesses certain attributes or characteristics that make he/or she important to the killer on a personal level. There is a stressor or trigger that occurs, but since it is just as likely to exist only in the killer's head there is really no way to be aware.

The 4 major characteristics are: 
  • they give little thought or concern to inevitable capture or death
  • they commit crime in public places
  • their motive is retaliatory; based in rejection, failure, and loss of autonomy
  • the offense is an effort to regain a degree of control over their lives Hickey
    (2009)

Gray et al. studied adolescent mass murderers and found the following characteristics:

  • male
  • 17 years old
  • described as "loners" by others
  • abused alcohol or drugs
  • had been bullied by others in the past
  • gave depressive symptoms and historical antisocial behaviors
  • recently suffered a perceived failure in love or school (Turvey 2008)
The FBI states that workplace violence is evolutionary in nature, but I think all violence, particularly heinous acts, are evolutionary. No one wakes up randomly, in the midst of a perfect life, and decided to murder multiple people and then, usually kill themselves. FBI studies have found that most actors in workplace mass murders are not psychotic at the time of murders, but obsessive compulsive characteristics are more common in mass killings that mimic serials. Mass murder is older and more wide spread than serial murder, but very little insight exists regarding motivation because most perpetrators kill themselves or commit suicide by cop before they can be taken into custody. 


These facts tell me that no amount of forced commitment or medication or psychiatry could have prevented them. That's a scary idea for a lot of people because it means there is no way to protect yourself. 

In 2012, DHS and ReadyHouston released a public service announcement on how to survive a mass shooting incident.  Their suggestions revolved around three things that can make a difference: RUN, HIDE, or FIGHT:
RUN
1. If there is an escape path, attempt to evacuate
2. Evacuate whether others agree to or not
3. Leave your belongings behind
4. Help others escape if possible
5. Prevent others from entering the area
6. Call 911 when you are safe
HIDE
1. Lock or blockade the door
2. Turn off lights and silence your cell phone
3. Try to hide behind large objects
4. Do not trap yourself or restrict your options for movement
5. Remain very quiet   

FIGHT (as a last resort)
1. Improvise weapons
2. Commit to taking the shooter down, no matter what
3. Act with physical aggression
4. Attempt to incapacitate the shooter

Remember that a mass killer may be very deliberate, and he may be random. 

And above all, remember that you are more likely to be struck by lightning than killed by a mass shooter. The news media creates a false impression that these type of murders are a daily occurrence through back to back coverage and misinformation and fear mongering. 


Random truths:
1. Mental illness is only likely to show an increase in violent tendencies if it also involves substance abuse and only with severe mental illness, but normal people who abuse narcotics are also more notably more likely to be violent, and these characteristics on their own show such a small added risk that it can't establish clinical validity. In fact, any of these characteristics show either the same added risk or more: 


  • Growing up in a unstable, antisocial household
  • Parental history of physical abuse
  • Parental history of neglect
  • Parental history of both physical abuse and neglect
  • Binge drinking
  • Stressful life events
  • Being male

  • 2. Psychiatric drugs have actually been shown to increase violent and suicidal behaviors in patients. Most of the perpetrators of the recent "school shootings" were being treated for mental illness at the time of the murders.

  • MOST IMPORTANTLY: Dr. E Fuller Torrey states, "Stigma is created by the sort of headlines that result when a person is not being treated for mental illness and shoots two Capitol police officers to death or pushes an innocent victim in front of a speeding subway train. Some 20 years of research, in fact, has proven this point."

  • This is effectively the same as demanding all men be placed on the sex offenders list because most sexual predators are male.

  • The rate of violence in the mentally ill has been almost constant level since the 90's.

  • "People with psychiatric disabilities are far more likely to be victims than perpetrators of violent crime (Appleby, et al., 2001). People with severe mental illnesses, schizophrenia, bipolar disorder or psychosis, are 2 ½ times more likely to be attacked, raped or mugged than the general population (Hiday, et al.,1999)."

  • Fact 2: The public is misinformed about the link between mental illness and violence.
    A longitudinal study of American’s attitudes on mental health between 1950 and 1996 found, “the proportion of Americans who describe mental illness in terms consistent with violent or dangerous behavior nearly doubled.” Also, the vast majority of Americans believe that persons with mental illnesses pose a threat for violence towards others and themselves (Pescosolido, et al., 1996, Pescosolido et al., 1999).

  • Between 4 and 5 % of violent crimes are committed by the mentally ill in this country.

  • However, completely sane people who abuse alcohol or narcotics are 7 times more likely to commit acts of violence. 

  • Delvecchio said, “Violence by those with mental illness is so small that even if you could somehow cure it all, 95 percent of violent crime would still exist.
  • A cure of substance abuse would solve 1/3 of all violent crime in the US.
  • All of the statistics against the mentally ill go up substantially when they are calculated by someone who aims to make a profit from pharmaceuticals. (Most actually include the rate of suicides in with the rates of violent crime.) 



  • It's old, but it seemed important to put here

    I remember when I was young; there were so many possibilities. Hell, I was a possibility. In my mind, I grew up to be an actress, a writer, a musician, an artist. In my mind, these accomplishments seemed easy: obtainable. The problem was, I never really grew up. I could blame my parents. They gave me everything, but that's the easy way out. The simple fact is that I never had to work for anything. I was smart, I was pretty, I was gifted, and I raged against these gifts just as I raged against everyone who cared about me. I was a destructive force to my family and myself.
        As a small child, I remember being afraid of the dark. I had an unwavering belief that if all my stuffed animals weren't securely tucked in, their feelings would be hurt. I would place them all in my bed, tucking the sheets firmly in on all sides, then carefully slide into the middle of the bed. It's interesting, looking back, that it's these fears that I remember clearest; as if they had more to do with shaping who I am than anything else.
        I had this friend, and I use the term 'friend' loosely because she was really just this girl, Valerie, I did coke with. We would blather away about nothing and nonsense, but when it came down to it, we weren't friends after the coke ran out. Her mother died one night while we were tweaking, and she was too fucked up to drive home. Her mom had Lupus; a disease that causes your body to destroy its own organs and tissue. I wondered if she died calling her name, softly at first, and then screaming for her as death pressed in around her. At times, I love the romance of that. I think, at least if you died screaming, you died knowing you were alive: if only for that moment.
        There was nothing remarkable about the day I took my own life. It was years before any of this, and years before I really began to live. I suppose everyone has a reason; it depends on whether they decide to share it. Personally, it came down to a fourteen-year-old boy's revenge. I was only seventeen. I didn't know he was in love with me. I didn't notice that he followed behind me. Sometimes, it's the things we don't notice that make all the difference. At a hay ride with my sisters, I finally noticed. He tried to sit in my lap, and I lost my temper. What I didn't realize is how ugly love really is. When my mother told me that he had accused me of being sexual with him, I couldn't grasp the idea that someone might believe it was true, but my mother already believed. In the years that followed, I placed the responsibility of my decision on both of them. Looking back, I guess it wasn't either. It was the fact that I was such a bad person that someone could believe it was true.
        I divide suicide into three different categories: The Drama Students, The Damsels in Distress, and The Accepting. I was the third one. The Drama Students are never going to kill themselves. They will call you and keep you up all night, but they will never actually go through with it. The most common suicides are The Damsels. They want someone to save them up till the last. The problem is that other people are unreliable. They wait for the prince to show up, and either the pills kick in too soon , or they feel abandoned because no one is there yet. The Dramas and the The Damsels act suicidal. They want other people to feel badly. They imagine their funerals with hundreds of people looking on; every person would be sorry for what they had done. The Accepting are a different breed. They do none of these things because they aren't looking for vengeance. I didn't alert the news media. In fact, I didn't even leave a note.
        I mindlessly moved through my mother's bathroom. I found Amitriptyline, Prozac, Xanax, Dilantin, Valium, and Vicodin. I don't remember taking them. I wandered to the kitchen where I added Depakote, Wellbutrin, Lithium, and Benadryl to the list. I didn't blame anyone. I didn't cry for the life I had lost. I didn't hesitate. That's what makes the difference. Everyone hesitates. I've seen it a million times. It's part of the Fight or Flight Reflex. It didn't happen with me though. I stood in the field with the horses until I got tired, and then I went to bed. I didn't have any reason to think I would wake up, but I did. I remember thinking my mother would kill me if I puked on her carpet. My father found me on my bedroom floor. The last thing, and the creepiest thing about the whole experience was how calm my voice sounded, "If you don't take me to the hospital now, I am going to die." There was no regret in that voice. It was cold and indifferent.
        Everything else is a blur. They had to perform dialysis because some of the medications would stop your heart if your stomach was pumped. When I saw the doctor he told me if it had been fifteen minutes later, there would have been nothing he could have done. While I was in the hospital, the boy admitted that he had lied. Did you know that one lie can equate to the choice between life and death?
        I didn't really know I was alive until my sister died. I'd been too busy killing myself to notice. Then, all of a sudden, there had to be a future because she didn't have one. I had never thought about a future for myself, because I'd never though I'd live long enough to worry about one.
        My mother had prepared herself for that call; the one that comes in around 3 a.m. when they ask you to identify a body. She wouldn't have had to watch those hazy screens under the greenish glow of the hospital lights. She would have known it was me. The call about Corinne wasn't suppose to happen. The things in life that mean the most, that tear at the very core of you, never are.
        I worked as a funeral assistant for two years, but I never got used to the way the dead look. They seem so unreal, more like mannequins that people. Perhaps, that's what divine intervention really is; the gift of being able to deny that the person you are about to put in a hole is the person you love.
        She had been afraid that she would wake up underground, so we were having her cremated. When you're embalmed, funeral homes add color to the fluids that they pump through your veins. When you are to be cremated, they don't embalm you. Her makeup had been applied thickly, Her skin, under the orangey foundation, was colorless like rice paper. I reapplied her makeup; I couldn't let my mother see my beautiful sister, freezing cold and painted to look like a hooker. I combed serum through her waist length hair. Everyone said the funeral home had done a beautiful job. I never told them the truth.
        I gave the eulogy, not because I am particularly talented, but because no one else could imagine getting through it. I have always been thought of as cold. I walked along the graves outside and swore I wouldn't cry. I couldn't stand the idea of her death overshadowing her life. My mother never understood this promise. "Even Elise was choked up." she said after we watched the home videos Denise had made. I sat alone, then again, I suppose everyone in my family sat alone that day. Much later, as I sat with my sister, I cried. I cried because her body smelled so heavily of disinfectant, and I wondered what they had thought they could wash away. I cried for her infant son who she never had the chance to hold. I cried because I had been jealous of her. I cried because she had been ashamed of me and loved me at the same time, but most of all, I cried because I had tried to reason with any god that would hear, but I knew that none of them would accept a trade. My soul wasn't worth enough.
        I don't know how long I talked to her. I know that enough time passed that her hand grew warm, and for a moment I believed it was all a lie. The woman who had brought me into the room to see my sister tried to look concerned as she went to close the casket, and for the first time since my father had called, I was angry. I was furious. The woman's face looked shocked as a I slapped at her hand. The concern slid from her face like it had been built of wax. Just like my family couldn't close the casket because it would be she was really gone, I couldn't let a stranger put my sister in the dark where she would be alone and scared.
        What the doctor didn't tell me was that even though he could restart my heart and keep me breathing, something more important in me had died. That part of me was simply waiting for my body to catch up. Sometimes, it even helped it along. That cold empty voice that frightened me that night when my body was still struggling was truly all that was left. It protected me from being hurt and naive, but it also shielded me from love and hope.
        The months that followed Corinne's death were heart wrenching, but the same empty voice that assured me that I was nothing, demanded that I be punished. Because of that, I never though of suicide; I never considered getting high to grant me peace. I just let it all wash over me. What I was left with was nothing like the person I had been. For the first time I was afraid. I looked out at the world from bright green eyes, that would change to a deep forest; the color of her eyes. I would see my hair, which had been so straight a perm would fall out of it, begin to form her curls. I saw the pieces of her in me, and I wanted to protect them. Things were different though. Fear has a way of catching up to you, and I am always afraid now. I can't be near open closets. I am terrified of the dark, boats, trains, buses, being alone, dying, other people... I alphabetize and measure in an effort to maintain order in the chaos, but I feel. My sister's death awakened something in me, and most of it is hard and scarring, but I feel my love for her.
        Valerie's mother didn't die because Valerie was high, though Valerie would probably be thinking that months later when she found her father's gun. She never called anyone either. By then, I thought it was the best decision she could make. Valerie killed herself for forgiveness.
        Corinne died so that her baby could live. I don't know if she knew that when she made the decisions that she did. She had said the only thing she had ever really wanted was to be a mother. Her aorta, which should have given out years before, had somehow managed to allow her to be one. Corinne died for love.
        And me? I nearly ended my life because I didn't like myself. When you line the three up, it sounds so selfish. I didn't think I could live through Corinne’s death, but I never even considered ending my life. I am still getting used to the person I have become, and in all likelihood, I will always be afraid, but just as there are things that are worth dying for, there are things you have to survive to truly live.



    I stood watching her lips move in the mirror. It’s a degree of separation that I know I need. “I was prepared for it to be you,” she said as she zipped her black dress. “I just knew it would be. This was never supposed to happen>”
    And in that moment, I could hear the things she wasn’t saying; all of the pointless words in between. It should have been you. And even now, when my life has purpose and someone really loves me, I still find myself believing that. Then my father intervened before she would have to hear it too: protecting her. A lot of my life has been about protecting my mother. Parents tell themselves they love their children equally, but we know better. Corinne had been my mother’s favorite. She was beautiful, easy-going, and, most of all,  kind.

    Alicia was my father’s because she was the most like him with her quick temper and surrounded by absolutes. 

    Saturday, November 8, 2014

    Grappling with Suicide

    In my life, I've lost a lot of people. Suicide is a common element, and personally, I have always been outspoken in my belief that suicide should be a personal choice. Then, a few years ago, I got a call from my sister. It was the day before my birthday, and the first man I had ever loved had taken his own life. His wife and year old daughter had been sleeping in the adjacent bedroom. I struggled with blame, mourning, and all the things I never got to say... When I mentioned this to an one of my ex law professors, he told me I should write it as a dialogue between himself and me. This is the result.


    He waited patiently for the answer to his question stirring his coffee in perfect time without a glance. It was a well practiced ritual. If he looked away, she would change the subject, and he wouldn't allow that. The girl, on the other hand, stared resolutely beyond him, past the little café, and out into the distance to a place the man could never go.
    She was outspoken, confrontational, and blunt to a fault, but he knew her conversations only seemed random. In truth, it was a well orchestrated ruse. There were just too many things she could not share. Those truths belonged to her alone, and she guarded them selfishly and hated them absolutely. “Do I think it was my fault?” She repeated the question.
    The man smiled warmly, “That was the question.”
    She continued to stare into the distance, and when she finally spoke, her voice seemed to come from far away: her words slow and controlled.
    “Did I ever tell you how I met Jay? My father, against my mother’s wishes, had driven to Memphis and brought me to live with them. I had been on my own for two years by then. I was successful if there are success stories for people who take their clothes off for money.”
    She looked at the man rebelliously, but there was no judgment in his eyes. “I used to wonder why all attractive women didn't dance. That was in the beginning when I still believed the girls were strong and glamorous…”
    “They weren't?” he asked.
    She laughed, but it was sad and empty. “At first, it’s a role we play for the customers. After a while, it’s easier to be that girl because the real you isn't equipped to protect you from that lifestyle.”
    “The reason that every beautiful girl doesn't dance is because most of them don’t need colored lights and one dollar bills to believe they have value. On the nights you do well, you feel untouchable. They define how you see yourself, and you tell yourself, they paid you because you are beautiful, but that’s not true. They pay you because you sold them the lie they were looking for. It’s not you they are paying to see. You have flaws and opinions and needs. The reality is they’re paying you not to be obligated to know you. Deep down, you know it, and that knowledge is infectious. Drugs and alcohol aren't allowed in upscale clubs, but all the girls are using. A lot of them really are beautiful, but they don’t know that anymore, and they wonder why every guy they meet beats the shit out of them, cheats, doesn't work… When you see yourself as worthless, people treat you that way.”
    “So, my dad decided to save me.” And for a moment, an expression of sadness and regret touched her face. Then, it was gone. Safely caged again before it could give her away.
    The man leaned forward on his elbows, and he wondered what this girl would have been had someone acted before she needed saving. “It must have been difficult to adjust to life at home after that.”
    “No, it wasn't actually because I never did adjust. I just didn't fit anymore. I hadn't been part of the family for so long, but it was more than that. We were privileged and sheltered. Money and influence afford you certain opportunities, but they also make you weak and dependent. You strive to meet other people’s expectations because you know you can’t survive on your own. I was damaged then, not as much as I would be, but enough, and damaged people are dangerous. You see, they know they can survive. For the first month, I tried to pretend. I went to church. I tried dating a nice, unimaginative boy. I could only be real around some of my sister’s friends. You know, the ones my parents didn't like having inside the house. “You should meet Jay Compton,” one of them said while we were smoking in the two foot area of our yard that you could slip through without triggering the alarm and flood lights my father had had installed. “You are exactly alike.”
    “And the idea of fitting somewhere,” the man placed his chin in his hand and looked back at her, “that must have been compelling. How old were you?”
    “Nineteen,” the girl said.
    “By then, you had been alone for quite a while, hadn't you?”
    The man wondered what she was actually thinking behind the well practiced smile. He also knew she wouldn't tell him, but the smile froze for just a moment too long. She answered his question with a single nod of her head as she looked away again as though she didn't quite trust her own words.
    “So fate brought you together?” he asked smiling.
    She laughed. A real laugh this time. “Even on my best day, I don’t have the patience to wait for fate. He was in the phone book.”
    He laughed. “What did you say? How do you even begin that conversation?”
    This time she looked him straight in the eyes, “Simple. I said, ‘I’m Deena, and you must be the Jay that everyone keeps saying I have to meet.’”
    “Does that normally work?” the man began still laughing.
    “There was never anything normal about us,” she answered.
    “And were you exactly alike?”
    “If people can be broken in the same manner…” she answered quietly.
    “Did you know that he was “broken” in the beginning?”
    “From the very first moment.”
    The man nodded reassuringly, but she saw through it easily.
    “I know you would have left as soon as you realized. That’s what normal people do. Of course, being normal, you wouldn't have seen it. It would have taken a few months for you to notice just how damaged he was, but once you did… A rational person would make the right excuses and begin distancing themselves.”
    “Why…” And for the first time, the man’s self assurance failed him. “Why did you stay?”
    He said this in a half whisper. The man asked questions for a living. Each question perfectly enunciated and spoken at a volume reserved for those who don’t have to second guess or retract their statements, not because he needed an answer. Questions were merely a well crafted tool to establish the answer he already knew to be true. This time, he didn't have an answer.
    “I used to say I wanted to fix him. People find that answer reassuring, but that’s not really true. Courtney and Kurt, Sid and Nancy… we’re all aware of the general “wrongness” of those relationships. It’s what draws us together in the first place, but there’s never any illusion that someone’s getting out alive. When I met Jay, I was already actively killing myself. It was just slower and more painful than a bullet. I just didn't want to do it alone.”
    The man leaned back in his chair. “If you were this aware of how “damaged” Jay was when you first met, you must also know you couldn't have caused that damage,” he said quietly.
    The girl opened her mouth to speak, and for the first time since she had met the man, he cut her off. “This whole conversation… it’s just a means to avoid my question. Normally, I might assume you were avoiding a painful subject. In that case, I would let the matter drop, but that’s not the case. Instead, you seem perfectly willing to cause yourself pain, reliving these moments in your life, as long as your suffering allow that question to go unanswered. So again, do you feel guilty for his death?”
    His voice was both determined and kind. The words seemed to hang in the air before them.
    The girl looked down at her hands. “I could not have saved him. There were things I could have done differently, but even if I had, it would've been a matter of time: not a solution. I regret my decision to stop taking his calls, but regret isn't guilt, and it’s a selfish regret. I simply wish I had had the opportunity to hear his voice one more time.”
    The man looked at her thoughtfully and asked the only question that really mattered, “Since you know you could not save him and you aren't burdened by a mistaken feeling of guilt or responsibility, then why are you so willing to punish yourself to avoid that realization?”
    Her face was no longer guarded beneath that practiced smile, but she looked directly at him anyway, and a glimpse of all those things she kept so well hidden crossed her face, “If no one could have saved him, if sobriety, treatment, a loving wife, that little girl… If none of those things could stop the chaos we live with, what does that say about my future?”

    Monday, November 3, 2014

    Defining Mental Illness

    The DSM V defines mental illness as
    A behavioral or psychological syndrome or pattern that occurs in an individual
    That reflects an underlying psychobiological dysfunction
    The consequences of which are clinically significant distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning)
    Must not be merely an expectable response to common stressors and losses (for example, the loss of a loved one) or a culturally sanctioned response to a particular event (for example, trance states in religious rituals)
    That is not primarily a result of social deviance or conflicts with society
    I have some problems with this definition from the start. You see, we all have behaviors, syndromes, and patterns that occur in our psychology regardless of our mental state, but that's just so you ignore how sneaky point 2. is. There are many schools of psychology, but in American and especially with the APA, only the medical model matters because it is profitable, and the DSM is attempting to make it science. The sneaky part is in the wording:
    A behavioral or psychological syndrome or pattern that occurs in an individual.
    psychobiological dysfunction.
    This syndrome is inside you and caused by a biological irregularity. That's what the DSM is trying to clarify. The problem is that there is no evidence to support such a claim. There are no biological tests or makers or x-rays, and your psychiatrist will continue to diagnose patients using behavioral criteria alone. They will continue to use drugs to treat these disorders, even though they aren't sure how the drug treats the disorder because they don't know what causes it anyway. What they are sure of  is that, in a few years, the general public will believe beyond a shadow of a doubt that any and all disorders are biological and must be treated with medications.
    In fact, the DSM V has done more advertising than it has actual defining, and what I take away from this new definition is that a mental illness is defined by the total possible profit the APA and the Pharmaceutical companies see to be made in the diagnosis.