MY Schizophrenic!

I currently work, as a social work intern, at Legal Aid Society (LAS).  LAS is a non-profit public defender agency (AKA law firm).  Here is their mission:

The Legal Aid Society is a private, not-for-profit legal services organization, the oldest and largest in the nation, dedicated since 1876 to providing quality legal representation to low-income New Yorkers. It is dedicated to one simple but powerful belief: that no New Yorker should be denied access to justice because of poverty.

The Society handles 300,000 individual cases and matters annually and provides a comprehensive range of legal services in three areas: the Civil, Criminal and Juvenile Rights Practices. Unlike the Society’s Criminal and Juvenile Rights Practices, which are constitutionally mandated and supported by government, the Civil Practice relies heavily on private contributions.

My fancy intern cubicle opens to a main hallway where everyone seems to like to chat.  Maybe it’s because it’s between the kitchen and the bathrooms….?  Earlier today I head two attorneys walking by while in conversation, nothing new.  They stopped just out of sight and I heard one of the attorneys state

“My schizophrenic!  Who beat the nurse.”

Then the conversation continued but I didn’t catch much more of it because I had quickly grabbed a piece of scrap paper to write that one quote down so I would remember to blog about it.

“My schizophrenic.”  My schizophrenic!?  Really!?  We have taken the person out of it completely and on top of that they are YOUR’s.  Just wildly insensitive.  But I suppose these things may slip when making a joke or a point.  Unfortunately this client was entirely defined by the mental illness they may have been diagnosed with AND the negative behavior they took part in that may or may not have been related to that mental health diagnosis.  

Now I am making the assumption that the “schizophrenic” in question is a LAS client and that this attorney has been representing this individual.  I find it a little unnerving that the person paid to “defend” me would talk about me to colleagues in such a way.  Perhaps the attorney will still do an awesome job on behalf of his client but as an outsider I was caught off guard.

The unfortunate thing is that we tend to define people by their illnesses or the aspects of their identities that may set them apart, sometimes the illness is not considered an illness by everyone.  I don’t think I have heard of an instance when a Doctor has referred to their patient as “My cancer” or “My flu.”  Although due to my extensive experience in the medical field (AKA watching Grey’s Anatomy) I do know that surgeons may refer to their patients as the procedures they are about to have or have had such as “My appendectomy” or “My tumor removal.”  

So this issue of taking the PERSON out of it is not unique to mental health but I fear it is more rampant there.  “My schizophrenic,” “I work with schizophrenics,” “I work with bi polar adults,” etc.  I believe this is something most if not all people are guilty of whether it is in regards to mental illness or something else.


Batman is Batsh!t

10 Superheroes Who Undoubtedly Suffer From Mental Illness (By: Michael Lee)

I came across this randomly one day when indulging my “nerd” like sensibilities.  Mental health is a sensitive topic.  This editorial by Michael Lee on Nerdism Editorials is far from sensitive.  I am not overly concerned with the subjects of this editorial.  You see Mr. Lee is discussing how “crazy” different comic book characters are.  He lists what he believes would be an appropriate diagnosis for the likes of Spider-man, Wolverine, and the Hulk and talks about why he has come to such conclusions.  I am not worried about what the Hulk thinks of Mr. Lee’s opinions (though perhaps Mr. Lee should be).  But how do those with the diagnoses he throws out feel about his descriptions?  Below is an excerpt from his description of Peter Parker AKA Spider-man:

“Ahh, I’m depressed because my best friend’s dad wants to kill me. Wahhh!”, “Ahh, I’m depressed because I’m not good enough for my supermodel wife. Wahhh!”, “Ahh, I’m depressed because my boss doesn’t pay me enough to take photographs of myself! Wahhh!” If you really think about it, Peter Parker has the good life, and it’s only his depression that f*cks it up more and more. Nobody wants a crying superhero.

The message being sent here is the idea that if other people believe your life has more value than you do or if your life  looks good to other people then a mental health diagnosis like depression is unwarranted.  The funny thing about depression is that it does not discriminate.  You can be rich, poor, or middle class; you can have a supermodel wife; you can identify as homosexual, heterosexual or be against sexual labels; nerds, jocks, and artists; superheroes and super-villains are all susceptible to depression.  I think that depression or at least anxiety can potentially be exacerbated for forcing all these labels on people but that’s a discussion for another time.  If you are wealthy, “happily” married, or perhaps a simple wall-crawler who is dealing with depression reading this editorial certainly will not validated your experience.

Of course I must point out the description of Batman, one of two MAJOR American comic book icons known for being the darker side of the Batman/Superman coin.  Below is Mr. Lee’s diagnosis of the Dark Knight:

Just some of Batman’s mental illnesses to date include: Post-traumatic stress, depression, egomania, substance dependence, mild Munchhausen-by-proxy, anger management issues, OCD, sublimation of grief and bereavement disorder, coulrophobia, and split personality disorder. Matter of fact, Batman is so connected to his insanity that when you try to make him a gleeful character (1969 Batman) or a gay-esque ladies man (Batman & Robin), nobody respects the character and the re-imagining’s universally panned. Therefore, Batman is with out a doubt the most connected to his insane roots, and is literally bat sh*t crazy.

A few technical errors, there is no “split personality disorder” it is properly and clinically known as Dissociative Identity Disorder or DID.  (Please see my post called I’m Really Into DID.Also I am not sure how “mild” Munchausen by proxy syndrome manifests itself.  While we all may appreciate the pun (Batman is Batsh*t crazy) and I certainly took advantage of it for my post how demeaning.  Batman is certainly a dark character with a rough past.  If he were real there would be a number of issues a competent mental health clinician could address with him.  But I think it is worth noting that these issues were probably not laid out when he was created. 

Most mental health ‘disorders’ are common issues manifested to a point that they cause difficulty functioning within the confines of our societal expectations.  This also explains why mental health disorders are not standard across different communities.  Comic book characters, as with many fictional characters, are often exaggerations of human conditions.

Wack Job

Facebook post regarding the airplane captain on JetBlue who had to be subdued.  Unfortunately when a person’s mental function is involved the assumption is not medical.  If we assume that it’s not medical then we can easily write such behavior off as weird personality flaws.  How should society deal with “wack jobs”?  It probably doesn’t matter since it isn’t a medical issue.  Calling it a medical issue gives these situations a certain degree of legitimacy and at the very least that may result in services.  

What Counts As Crazy?

Click here to read the article in TIME Magazine.

Why does this article get people’s attention?  Well first off is the headline’s shock value.  It might not seem terribly “shocking” but the word “crazy” definitely gets your attention.  That is how the general public understands mental illness, it’s what “crazy people” have.  It is hard to find terminology that does not stigmatize this population and we, as humans, love to use language to separate ourselves from “others.”  For instance I said “this population,” a population that may or may not be MY population or your population.  Better yet, we should refer to them as THAT population, it helps to push them father away. Whether we say crazy, mentally ill, or even sick – it’s distancing. Though I am by no means posing a solution.  We need to use language to understand and communicate.  And magazines and newspapers need to use language to get people’s attention…so what does count as crazy?

Apparently anything in the Diagnostic and Statistical Manual of Mental Disorders, or as we in the business like to call it, the DSM.  As the article notes the upcoming revision to the DSM (we are currently on DSM 4.5 better known as DSM-IV-TR, the TR means text revision) “will literally redefine what’s normal.”  

The nice thing about the article is that it discusses the controversies surrounding the DSM and its revision.  It touches on the debate over whether something is a chemical issue or not, the importance of being able to bill insurance companies and how that drives the content of the DSM, and the issues former contributers to the DSM have with the current changes.

But mental illness is still framed as the “abnormal” despite the fact that one of the issues people have with the impending latest edition of the DSM is that it is widening the qualifications for being eligible for one of its many diagnoses.

Mentally Disordered

Intrinsically Disordered 8.5″x 11″ © William Donovan (http://www.fadingad.com/fadingadblog/?p=1222)

While researching for a paper I came across this article, Police Responses for Mental Health Assistance, written by Dr. Mark R. Pogrebin of the Graduate School of Public Affairs at the University of Colorado Denver and published in Psychiatric Quarterly [citation: Pogrebin, M.R. (1987) Police responses for mental health assistance.  Psychiatric quarterly, 58(1), 66-73.]. 

My paper is on the interactions of police officers with populations with mental illness.  Something that stood out to me immediately was a particular phrase Dr. Pogrebin used, see if you can spot it:

The observed increase in the number of mentally disordered people being arrested is believed to be the result of mental health efforts to deinstitutionalize psychiatric hospital patients over the last decade” (1987).

Some interesting issues are raised in that one sentence but the thing that stood out to me was “mentally disordered.”  Coming up with acceptable terms for any population is very difficult.  There is rarely consensus and someone is always offended.  Dr. Progrebin uses multiple phrases in his article including “mentally disordered,” “mentally ill,” and “citizens with mental health problems.”

I’m not saying I have an answer for the “correct” term.  I know it isn’t easy.  I think it is safe to say that “disordered” does not have any real positive connotations…but neither does “ill” and the “mentally ill” is used quite often. 

I have an anecdote that serves as an example of the struggle to come up with appropriate terminology.  A friend of mine and I were coming up with the title of a workshop that was ultimately called “Criminalization of People with Mental Illness.”  That title went through many different computations at one point, in a fit of frustration and the need to release I wrote this:

Criminalization of People With the experience of having a different mental awareness and capacity that adversely affects their way of interacting in the current accepted norms of society with regards to behavior currently deemed criminal by certain populations AKA crazy people get arrested!

Now that last part is absolutely not acceptable, the “AKA crazy people get arrested!” part.  The rest of it though written with some humor in mind and exceptionally wrong is full of qualifiers to make the language the least judgmental as possible.  It may have even been a slight critique of how social work school deals with such things.  Many people may look at that and think, “Whoa, this is crazy…oops.”  It does seem like overkill, I agree especially since I wrote it as a joke.  But I am fully aware that such things are not a joking matter and that language is important and can influence attitudes.

How Can We Fix You Today

The most important thing to remember if you experience depression is that this medicine will only MINIMALLY impact your sexual function.

Big Angry Face = Crazy Person Before Valium
Small Calm Face = Crazy Person After Valium
You Do the Math

See that blank faced, alien looking creature with no specific features.  That is someone who is depressed.  Depression, like other mental illnesses, is so foreign and strange it is kind of like you’re not even human or perhaps like you have no identity.

PsychoMedia

Check out the stigma of CineMania at http://www.mentalhealthstigma.com/

Psycho: mentally-ill (Roget’s New Millennium Thesaurus – 2007)

Media: 1. the means of communication, as radio and television, newspapers and magazines, that reach or influence people widely: The media are covering the speech tonight. (Dictionary.com Unabridged)  

PsychoMedia: the combined effect of exploitation movies and biased news reports which stereotype mental health recipients leading to the implied conclusion that all people labeled mentally-ill are violent and deranged

Things we can do to stop PsychoMedia:

  • Document stigma in the media whenever possible
  • Send letters, make phone calls, or e-mail the offending parties
  • Ask your local, regional, and national leaders to take a stand
  • Support efforts to actively expose stigma in the media
  • Educate yourself – the elimination of stigma begins with you

All the information stated above is from the website I mentioned above.  I like how possible “solutions” or actions are presented for dealing with the negative way mental illness is presented in media. 

Some of the examples of this mass produced stigma are from a while back but some are very recent:

Get the Violent Crazies off Our Streets, New York Daily News, November 19th, 1999, includes the deranged editorial: "Hospitalize the Deranged," which warned New Yorkers to beware of a terrifying new crime wave: "In our newfound complacency, we have forgotten a particular kind of violence to which we are still prey. The violence of the mentally-ill."

Section 8

Who is this lovely young thing?

Corporal (later Sergeant) Maxwell Q. Klinger from M*A*S*H, played by Jamie Farr.  I mentioned M*A*S*H in an earlier post.  It is a very important show for my family.  Klinger was a fun character, he often served as comic relief, at least for the beginning of the series.  The method with which he served as comic relief was through his particular way of trying to get out of the war.  During the majority of the series this character dressed in women’s clothing and uniforms in an effort to get discharged on a Section 8, when someone in the US military is judged mentally unfit for service.  It’s no longer in use but “He’s a Section 8” was, apparently, something said often at the time, whether a person received a Section 8 or not.  Those accused of “sexual perversion” often received a Section 8.

Originally Klinger was going to be an effeminate gay man, according to Wikipedia citing the book Watching M*A*S*H, Watching America.  It was decided that having Klinger be heterosexual and wear dresses in an attempt to get a Section 8 would be more interesting.  

Using mental illness as a tool or an excuse to get out of a bad or, at the very least, an undesirable situation.  There is an interesting mix of themes here.  I doubt it was a coincidence that the M*A*S*H producers decided that a man attempting to get a Section 8 would wear dresses.  Cross-dressing and homosexual behavior (which are neither linked nor mutually exclusive incidentally), these actions would have qualified an individual as “mentally unfit.”  

So this show (which I LOVE) took advantage of mental illness by using it as a tool for comic relief with a character who is PRETENDING to have a mental illness.  But it ALSO decided to play into the institutionalized homophobia of the time (and yes, I’m aware that it was a different time).  

Again, I love M*A*S*H but I definitely believed, growing up, that Klinger would wear dresses so people would think he was crazy so he could get out of the war.  It is worth noting that eventually Klinger stopped wearing dresses and was the only main character in the end to decide to stay in Korea.

Don’t Annoy the Crazy Person

“Don’t annoy the crazy person” makes me think of “Don’t feed the animals” or “Don’t make me angry, you wouldn’t like me when I’m angry.”  It’s funny and quippy and probably would make a good t-shirt.  I don’t know that I need to explain how stigmatizing it is, of course it’s stigmatizing.  But stigma does a great job at contributing to or fueling humor.  So would it be wrong to wear that as a t-shirt?  What if I thought of myself as crazy?  Or what if I was diagnosed with some DSM diagnosis (trying carefully here to avoid terms like illness, condition, etc.).  Wait, let’s elaborate on my parenthetical comment, what are some alternatives to that previous sentence:

Or what if I was diagnosed with some DSM diagnosis.
Or what if I had a mental illness.
Or what if I was diagnosed with a mental illness.
Or what if I was [insert diagnosis as an adjective i.e. schizophrenic] (we love messing with the grammatical status of mental health conditions into). 
Or what if I was a [insert diagnoses as a noun i.e. schizophrenic].
Or what if I had mental health issues. 

I’m sure there are more alternatives.  Language is fascinating isn’t it.  

It is worth noting that I found this image here, on a blog post that is addressing many of the same issues I am in this blog.  So no disrespect to Keith Adams AKA “Just your average gay bipolar writer in the Hollywood Hills.”

The Craziest Characters on TV

The Craziest Characters on TV at DishTV

No better way to encourage acceptance and understanding then making a “who’s who” list of characters embodying social stigma.  I’ll admit that I enjoy categorizing and making lists: my favorite Greek gods and goddesses, top 10 movie villains, etc.  So why not a list of TV’s craziest?  DishTV did it in a “critical” way by addressing the way TV handles these characters (handles?  maybe deals with?  nope, sounds bad too…………………….Addresses!  Addresses these characters!):

Like many other areas of concern, Hollywood really does a poor job at portraying mental illness. There are some exceptions, of course, but for the most part TV shows turn problems like Asperger’s Syndrome or Multiple Personality Disorder into a sensationalized and often “zany” condition. Yet, having characters being pumped down through your dish TV signal who are mentally ill does serve at least one positive purpose, and that is raising awareness of those conditions.

Did you notice the plug for DishTV in that paragraph?

The first person they mention is my recent favorite, Tara of United States of Tara.  

Tara. Tara Gregson is the title character for a relatively new program on Showtime. This character suffers from multiple personality disorder, and during the course of the program she’ll move from her identity as a mother to “Buck,” a beer-loving redneck man, or to one of her other identities. Multiple personality disorder (also formerly called “Dissociative Identity Disorder”) makes for great TV plots, but it’s also easy to become almost cartoonish.

Cartoonish.  Okay I’ll take it…for now.

The third character they mention is Dr. Sheldon Cooper from The Big Bang Theory.

Doctor Sheldon Cooper from Big Bang Theory. Jim Parsons’ portrayal of the brilliant – yet annoyingly quirky – physicist has won several awards. Although no diagnosis has been discussed on the show, it’s readily apparent that Sheldon suffers from Asperger’s Syndrome. The show’s portrayal is occasionally cartoonish, but Sheldon remains a somewhat enjoyable character as well.

This description is very interesting.  First off the show has not actually discussed an official diagnosis…but the mental health specialists at DishTV took care of that.  CLEARLY the character of Dr. Cooper SUFFERS from Asperger’s Syndrome.  Am I saying their diagnosis is wrong? No, I’m not expert enough to call such a thing…not like they are.  Also apparently one who has Asperger’s is suffering.  Now I shouldn’t be harsh on this, I am in fact in social work school and we are taught not to use such language.  The clinicians at DishTV, though qualified to diagnose, may not have gained that same awareness.  If Sheldon is an enjoyable character, and from what I’ve seen of the show he is a successful and confidant individual with a pseudo-girlfriend who bears a striking resemblance to early nineties TV icon, Blossom, then how is he suffering?  By the way…cartoonish again.

Lastly they decided to step into sacred territory!  Hawkeye Pierce from M*A*S*H, a family favorite in my house.

Doctor Hawkeye Pierce from M*A*S*H*. Few who saw the final episodes of this show will forget how Hawkeye struggled with depression, even to the point of psychosis, at the end of the Korean war. While this portrayal is dated in terms of the actual psychological ideas being tossed around, it still remains a powerful look at what depression does to a person.

Again the DishTV researchers have assessed the change through time of “the actual psychological ideas being tossed around.”  And yes, depression can have a very powerful effect on an individual.  So can being in the middle of a war-zone.  So can witnessing a woman smother her child to keep it quiet.  Perhaps there is more to someone’s change in behavior then depression.  No mention of trauma’s role in Hawkeye’s reactions.  DishTV specialists…I’m disappointed, things are not that simple.  By the way…no asterisk after the ‘H’ my friends.

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