Category Archives: Stigma

Suicide at the Oscars, part one: ‘Crisis Hotline: Veterans Press 1’

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J.C. Schildbach, LMHC

The topic of suicide came up in at least three acceptance speeches at the latest edition of the Academy Awards on February 22, 2015. (Okay, yeah, I’m late to the party again). And perhaps even more astonishingly, two of those acceptance speeches were actually related to films about suicide prevention hotlines. First up is the documentary, Crisis Hotline: Veterans Press 1. (A post about the short film, The Phone Call will follow soon).

Having spent more than five years working full time for a crisis line, and continuing to work in a position sideways from, and occasionally overlapping with, such work, I can’t help but come to these films with something of a bias.

As a matter of fact, I first saw a portion of Crisis Hotline: Veterans Press 1 on a Sunday morning after coming home from an overnight shift at a call center where the crisis line calls represent only one of many mental health functions with which the staff is tasked. Having spent the bulk of my work week on understaffed shifts, I was perhaps a bit resentful at flipping on the TV to see a scene what Bob Hosk, one of the Veterans Crisis Line supervisors who features prominently in the documentary, described as “five hours here at the hotline” utilizing “about four personnel to help one guy.”

Now, don’t get me wrong. I think it’s great that the resources were available and the effort was made, with (spoiler alert) a positive outcome for an active duty service member in Hawaii.

In the time since I first saw that segment of the documentary, I’ve become more familiar with the workings of the military in addressing the epidemic of suicide among veterans and service members, and will say it is truly impressive to see the complete change that has taken place over roughly the last two decades—from an approach to suicide and mental health issues that could be described as ‘don’t ask don’t tell’ to one of increasing and highly-promoted access to counseling services, to working with suicide prevention specialists and investing in the crisis line depicted in the documentary, among many other avenues.

But, back on that summer morning, knowing that in similar situations (an unknown caller making a vaguely suicidal statement, then hanging up) rather than having a specific staff member on shift to call a special “law enforcement” phone number at cell phone company to get information on the caller’s location by pinging cell phone towers, and then being able to devote ‘five hours and four personnel’ to find the caller, whichever one of us took the call would typically end up trying to call back, and, failing any respone from that, doing a quick Internet search on the phone number (like they show in the documentary) and then making a call to 911 dispatch in whatever location the phone number (probably) originated, to report that somebody had called and threatened suicide—‘no, we don’t have a name; we don’t have an address; we don’t know how they might do it or if they tried anything yet; we don’t know if there are weapons involved; no, we don’t know much of anything about anything—we’re following our protocol, sorry to bother you.’ Then on to the next call—which could range from a hospital social worker inquiring about a client’s mental health history, to a client with chronic mental illness telling us about his dinner, to someone struggling to get help for a family member with a mental illness, to…

In the case of Crisis Hotline: Veterans Press 1, my sense is that the caller from Hawaii was truly coming from a place of desperation, and, perhaps, wasn’t aware of other options available to him, or just what sort of response might kick in as the result of the call he made. He may have thought that by hanging up, he could just drop the whole matter. He may have scared himself simply by voicing the thoughts he was having about ending his life, and so tried to walk away from that.

But beyond my initial reaction to the portion of the film I saw back on that sunny Sunday morning, and my somewhat-tempered-by-time-and-new-information response now, I have mixed reactions to the film.

I’ll say that, overall, I think it’s an excellent depiction of some of the most challenging types of work that happen at crisis lines, and at the Veteran’s Crisis Line Center in particular, which the film notes “is the only call center in the U.S. serving veterans in crisis.” (A more accurate description would be that it is the only call center in the U.S. specifically established to serve veterans, and specifically engaging the particular protocols of that call center in order to assist veterans. Any crisis line in the U.S. will take calls from veterans, and do what they can to help. Call centers affiliated with Lifeline routinely take calls from veterans and their families, in part because the callers don’t always ‘press 1’ when prompted to get transferred specifically to the Veterans Crisis Line Center. And, while Lifeline workers typically will explain to such callers that they have not reached the veteran’s line, they always offer to help.)

Semantics aside, not all calls to a crisis line are life and death—or even crises. Each time the phone rings, it’s not a given that the caller is a someone on the verge of taking her/his life, or a family member of such a person. But you wouldn’t know that from watching this film. You only get the slightest whiff of the lighter calls, when, early on, the camera moves through the call center, the sound of constantly ringing phones and poignant snippets of dialog, reaching the microphones at just the right time: “really proud of you…Where were you stationed?..So twice you tried to hang yourself before?…Do you want me to send someone there for you?…Did you get injured while you were out on active duty?…diagnosed with PTSD?…If there’s anything we can do for you…”

Okay, so those don’t come across as all that light. That particular scene is one of many subtle manipulations used by the filmmakers—layering audio to create a particular impression of an “always on” call center. For the sake of drama, the filmmakers leave out audio involving callers who are just seeking information or non-emergency services. They leave out the repeat callers who are really just touching base and giving a brief synopsis of their day. They leave out those calls having any of a number of angles that aren’t even remotely related to suicide.

The filmmakers also choose to escalate the drama in a completely unnecessary way. For instance, the music, most often quiet, involves drawn-out, high-pitched tones that add to the tension viewers are meant to feel—as if trying to talk a stranger out of suicide isn’t drama enough.

I love this woman: Maureen--Crisis Line Responder, Extraordinaire

I love this woman: Maureen–Crisis Line Responder, Extraordinaire

On top of that, the final segment of the film takes place on Christmas Eve. The scene opens with outside shots of the call center at night, American flag flying, trees wrapped in colorful, twinkling lights, as a soft jazz version of “Have Yourself a Merry Little Christmas” plays–the song adding a sting of dark humor with it’s ‘all our troubles will be miles away’ and ‘let your heart be light’ emotions. The timing of the scene was undoubtedly selected because of the heightened emotions many viewers are likely to have around the idea of a “Christmas miracle” or notions of family togetherness at the holidays. But it also serves to reinforce the popular, but ill-informed, notion that ‘the holidays’—Christmas in particular—are a time of heightened depression and increased suicide, an impression reinforced by a shot of the notepad where the crisis responder has written a quote from a suicidal veteran: “Holidays are depressing.”

There are other things that could be taken as manipulation, but which I think were not only clinically sound decisions, but also place the focus where the documentarians wanted it: on the people working at the crisis line. Not hearing the callers, for instance–while likely done just as much for clinical reasons, as for legal and artistic reasons–provides for greater control over how the information will be presented to the audience, and also removes any impressions viewers might have of the callers based on their voices, or the tones they are using.  While I obviously don’t know the specifics of how any of the callers in the documentary spoke or sounded, anybody who has spent time working on a crisis line knows that many of the callers can come across in a way that, shall we say, challenges empathy. Responders need to be aware of the potential biases they bring to calls, and need to develop skills for de-escalating and connecting with difficult callers. At any rate, difficult or not, hearing the callers’ voices would create a completely different film.

Still, one of the most valuable aspects of the film is in giving voice to the crisis line responders, not only in their moments of calm where they appear to be completely in control, but when they are giving voice to frustrations as well. During one call, Robert, a veteran himself, complains that the response time from police is “ridiculous.” In a separate interview segment, Robert expresses the anger that crisis line responders can feel toward callers: “How dare you take your own life?” But part of the reason Robert’s rawness comes across in a potentially endearing fashion is that the filmmakers also let him speak about his struggles with questions of his own abilities, whether or not he has made the right decisions, or whether he made them in time—questions born of situations where the interventions failed.

There are other responders in the film with whom I had a harder time connecting—feeling a sense of kinship, or understanding their particular reactions, or the ways they tried to connect with callers. I don’t want to dwell too much on my snotty, hypercritical reactions, though—or even mention them in any specificity. For one thing, I know only a very limited amount about what was happening in those particular situations. And I don’t know how those people move about in daily life, or in their routine work at the crisis line.

But why I will most back away from potentially harsh or nitpicky-sounding criticism of any of the responders is because I can’t imagine having to work a crisis call with the knowledge that cameras are on me, and that whatever I do could end up on HBO.

That said, there is one responder in particular, Maureen, who comes across as the undoubted ‘star’ of the film. Little is explained about Maureen or her background, except, perhaps, that she reveals that she has sons, as she is complimenting a caller on her handling of a difficult situation.

Beyond that, Maureen demonstrates the perfectly complicated balance of compassion and detachment that is rare in crisis line workers. She is able to connect to the callers, but does not get visibly drawn into the drama, despite mentioning calls that ‘stay with you.’ Early on, we hear her say, “It’s ultimately the veteran’s decision if they are going to live or die…and as a responder, you have to have a really good grasp of that.” Truer words have never been spoken.

Maureen is able to deliver lines of perfect connection to callers–lines that may seem odd to those unfamiliar with such situations. After asking a caller about how his friend (who died in combat) would react to news of the veteran’s suicidal intent, she listens for a bit, then says, “He’d kick your ass? So he’s a good friend.” Maureen is able to drably ‘contract for safety’ with callers, getting them to promise that they at least won’t kill themselves while they are on the line with her, and then works to expand on that promise.

Maureen is the responder featured in the final scene of the movie—the one that takes place on Christmas Eve. Against this backdrop of heightened emotion, she is tasked with drawing a soldier with a gun out of the desert, and back to his parents, despite much of his life unraveling. She is further challenged by limitations on her involvement—having to direct the veteran’s mother on how to bring him home, and then sitting silently, listening, and hoping it all works out.

In the end, Crisis Line: Veterans Press 1 leaves much to contemplate—whether from a clinical or technical perspective—or any of the other myriad perspectives that could be brought to the film. It is incredibly effective in that it is able to provoke a range of emotions, and could, potentially, be used as a tool for training crisis line workers and volunteers, service members and their families, or really anyone who wants a better understanding of how crisis lines work, how the mental health system can be accessed, or how the military is responding to concerns of suicide among its ranks.

It remains to be seen if the film will help draw more workers and volunteers to crisis services, or perhaps scare more of them off. And this is where I have the most difficulty with the film. How much is too much when trying to convey the intenstity of real-life situations? What level of manipulation and film-making technique serves to create understanding, and what level serves to drive only emotional response?

Granted, the vast majority of people who see Crisis Line: Veterans Press 1 will never work in a crisis line call center. But, there’s always a chance they might need one.

So (obligatory ending)…

If you are concerned that somebody you know may be struggling with thoughts of suicide, call (or get them to call) the National Suicide Prevention Lifeline at 1-800-273-8255—Veterans Press 1.

Yes, Gina, There is a Bipolar Disorder: Tom Sullivan’s Pretend Apology

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by JC Schildbach, LMHC

I have a hard time believing anybody really cares about anything Fox News Radio Host/Fox Business News Anchor Tom Sullivan said two weeks ago, or a week ago, or ten minutes ago. But, after a segment on his radio show, wherein Mr. Sullivan expressed his belief that Bipolar Disorder is a made up malady, Mr. Sullivan got a bit more attention than he maybe wanted.  And then he apologized.

I feel compelled to share Sullivan’s apology in all of it’s glory, because it is such a perfect example of a non-apology, the kind that one writes when one is drunk, and mad at the people to whom one is being made to apologize–the kind of apology that would properly elicit a playground response of “If you were really sorry, you wouldn’t have said it in the first place.”

You can hear the questionable five minute clip of Mr. Sullivan’s rant–mind you, on the web site for his own show–here: Bipolar “not a problem” and “not a disability” says Tom Sullivan.

To access his apology, you need only scroll down through the Facebook-linked comments on the same page.

Sullivan’s apology starts off thusly: “Gina, Thank you for your email.” From the get-go, it’s just plain weird. Sullivan is apologizing via Facebook to an (alleged) email that nobody can see. I’m not sure if Gina’s email is presented somewhere on Sullivan’s Facebook page, or elsewhere. I have the feeling he doesn’t want anybody to see the alleged email he is pretending to respond to, because Sullivan isn’t actually addressing any concerns that any real person has about what he said. He’s interested in presenting himself as the victim in the ruckus he started, as a means to reiterate some of the same obnoxious points he made in his original rant.

He continues: “May I tell you I have received a number of similar messages but usually laced with profanity. Your message stood out for the kindness of your words.” Oh, poor Mr. Sullivan, bombarded with bad language from nasty people. But, lo—here is one kind soul, just one person moved to express words of concern and seek clarification about just what happened in this horrible controversy that was visited upon the abused Mr. Sullivan.

“First,” Mr. Sullivan goes on (in sharp contrast to his original words for which he is now apologizing), “I need to tell you I do believe in bipolar disease.” I won’t hammer on Mr. Sullivan too much for not using the proper term “Bipolar Disorder” rather than “bipolar disease.” But I do have to question what he means when he says that he ‘believes in’ Bipolar Disorder. Bipolar Disorder isn’t some mythical creature like the Yeti or the Easter Bunny to entertain or scare people or to serve as a fun part of some childhood tradition. It’s not, as Mr. Sullivan says in his audio clip, some disease made up by pharmaceutical companies and the mental health industry for the purposes of financial gain. But, I suppose when you work for a network that promotes the idea that climate change is a hoax, and white privilege is mythical, your sense of reality can get knocked out of whack.

And speaking of having problems with reality, Sullivan then writes, “There is a two minute clip going around of my comments out of a two hour discussion. It is easy to take comments out of context.” Sullivan’s complaint of a two-minute, out-of-context clip is just a few scrolls down from a five minute clip, again, on the web site for his own show, in which he says he does not believe Bipolar Disorder is a real thing, but a ‘created’ illness.

He then repeats his newly-found belief system: “Of course I believe bipolar is real and is a mental illness that needs to be treated.” Well, of course, Tom! Why would anybody think you would have any other view–I mean, aside from the five-minute (not two-minute) clip where you repeatedly say that Bipolar Disorder didn’t even exist 25 years ago, and is completely made up?

Sullivan does a 180 and becomes a champion for those with mental illness--asks why people think he said things he plainly said.

Sullivan does a 180 and becomes a champion for those with mental illness–asks why people think he said things he plainly said.

Sullivan clarifies: “The program began with the subject being the huge increase in disability claims made to the Social Security Disability Fund which is going broke in 2016.” Never mind that what Sullivan means is that the Social Security Disability Fund could be insolvent as early as 2016 if changes aren’t made to the structure or funding of benefits—saying it is going broke in 2016 is much more alarmist and easier for his audience to understand, so that they can get angry like he wants them to.

Then, explaining (well, sort of) why he chose to target people with Bipolar Disorder, Sullivan writes, “The increase in claims is startling and the number one reason for the big increase in claims is mental illness and a subset (according the way Soc Security categorizes) of mood disorder.” Sullivan doesn’t bother to explain that what now comes under multiple categories of “Mental Disorders” used to be categorized as two separate categories: “Mental Retardation” and “Neuroses and Psychoses.” It wasn’t until 2010 that Social Security broke down those two categories any further, to include numerous items, including the “mood disorders” that so irk Sullivan.

Sullivan pouts, “All I was trying to do was to point out that out of that big increase I suspect there are people who are not sick but looking for a disability check.” Yes, “all” Mr. Sullivan was doing was accusing people on disability of trying to cheat the government. No big, deal. Everybody likes to take pot shots at people on disability, right? But Mr. Sullivan didn’t just voice his ‘suspicions.’ He outright said that Bipolar Disorder is “not a disability.” In other words, Mr. Sullivan said that anybody receiving disability payments due to a diagnosis of Bipolar Disorder is cheating the government. In fact, the title of the same page of Tom’s website where he posted his pretend apology is “Bipolar Woman Says She DESERVES Disability Benefits. Tom Tells Her She’s WRONG!”

The pout goes on: “My further point was by doing so, those people were hurting those who really are sick and need help, i.e. funding, treatments, etc.” In other words, people who get disability payments for mental illness are not really sick—people who can’t walk, or who have cancer are sick!! This is perhaps the best part of Sullivan’s whole apology—the part where he truly demonstrates that he’s learned nothing from the reaction he provoked with his ignorant comments by engaging in the exact type of behavior/speech/thinking that demonstrates classic stigmatization of people with mental health issues: the ‘you don’t really have an illness, you just feel bad’ way of thinking.

And then comes the righteous indignation of a true champion for those with mental illness: “I have for years advocated on my program for more funding and insurance coverage of mental illness. Too many have ignored it and as a result our jails are now the ‘mental institutions’ where the people get zero help.” First of all, if you have advocated so long for “more funding and insurance coverage of mental illness” but are now mad that there is more funding and insurance coverage of mental illness, what is it you really want? Where is this funding and insurance supposed to come from? What form is it supposed to take. Oh…I get it. You mean that when there have been mass shootings, you’ve complained that we do not need gun control, but we need more funding for mental illness. Got it. The jails…right. So, yeah, more mental health funding to stop people who might go on a shooting rampage—but anybody else can step off. Way to advocate, Tom.

Sullivan then writes, “I apologize to those who were hurt by the clip of my comments.” I think he might be apologizing to himself right here, as he seems to think he’s the victim in all of this, and the only one who was really hurt by the unfair “clip” of his comments—which he maintains is all out of context. It’s one of those classic ‘I’m sorry you got upset about what I did’ apologies. He doesn’t actually say he’s sorry for what he said—he says he’s sorry if you had a stupid reaction to it.

Mr. Sullivan then explains that he is just misunderstood: “I am a somewhat jaded person who thinks some people are gaming our system due to their greed.” Yes, plenty of people are out there pretending to have Bipolar Disorder because of their all-powerful greed–the kind of greed that drives them to want to live off of an $1100/month disability check. I can see how life as a corporate accountant and media figure has caused you to see the true evils in life and become hardened by them, Tom.

“But,” he goes on, returning to his sensitive side, “I also believe mental illness is a very serious problem that is ignored by too many.” Well, at least you aren’t ignoring it, Tom, like those “many” others.

Quick switch back to victim: “This episode shows how easy it is to distort a persons (sic) comments, especially when the subject is very important.” Wait, where’s the distortion, Tom? You do realize that there is a five-minute audio clip of you talking smack about people with Bipolar Disorder and mental health professionals, right on your web page, just slightly above your apology—don’t you?

Then, he brings the powerful close: “It will and has reinforced my commitment to making mental illness on a (sic) equal par with physical illnesses instead of the stigma it currently receives. Again, thank you for your email and your concern, Tom Sullivan.” Well, it’s a good thing Tom’s had his commitment reinforced, because in that five-minute clip there, it sounded a whole lot like he was super-supportive of stigmatizing people with mental illness—especially phony mental illnesses like Bipolar Disorder. And, really, could that sentence about stigma be any worse? It’s like somebody read over the rough draft and said—‘Not bad, just make sure you add in some bullshit about stigma and how mental illness is just as important as physical illness in there at the end,’ but Tom wasn’t quite sure how to properly use the word “stigma” in a sentence, and didn’t feel like taking the time to look it up.

In the end, Sullivan wants to be viewed as someone who is just the victim of vicious attacks, with his words taken out of context. Unfortunately, it’s hard to have much sympathy for someone claiming his words were taken out of context when, well, they weren’t, but also when he made no effort to provide any context for anything he said in the first place, such as by touching on the way Social Security disability operates, the different categories now used, and why those changes were made. The simplest explanation (although there are a wide range of factors) is that there has been an evolution in the way “disability” is viewed and understood—in terms of both physical and mental illnesses. And, in terms of Social Security disability, there have been changes in the ways statistics have been kept and various issues have been categorized.

To give some credit, there is support for Sullivan’s complaints that the number of disability claims for “mood disorders” is increasing substantially. However, that increase is not grossly out of proportion to the increase in overall numbers of disability cases, particularly when one considers that mood disorders such as Bipolar Disorder and various forms of Depressive Disorders are more widely understood today than they were 25 years ago (when Mr. Sullivan apparently thinks the mental health community, in cahoots with pharmaceutical companies, fabricated the idea of Bipolar Disorder as a way to make money).

So, as I said in an earlier piece about Sullivan’s original comments (which you can read here), we can either find legitimate ways to address issues like the funding of Social Security disability, and support those suffering from mental illness, or we can demonize them and…uh…let them…er…receive stigma like always. And now, at least we all know where Mr. Sullivan stands—right, Gina?

Bipolar Illusion: Tom Sullivan, Rand Paul, and the Economics of Disability

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by JC Schildbach, LMHC

Back on Wednesday, January 28, in a discussion of Social Security disability benefits on his Fox News Radio show, Tom Sullivan, who also serves as an anchor for Fox Business Network, said some incredibly stupid things about Bipolar Disorder. Sullivan, or whoever is responsible for the content of his web page, then proudly promoted Sullivan’s ignorance by posting what I can only hope is the worst part of that day’s show in a brief written piece, and a 5-minute audio clip, which you can see here: Tom Sullivan argues that Bipolar Disorder is a myth.

Among his statements, Sullivan called Bipolar Disorder “the latest fad,” adding, “We all have good days and we all have bad; and I don’t consider that an illness; and I don’t consider it a disability.”

Sullivan said plenty of other amazingly idiotic things, like suggesting people are talked into thinking they have Bipolar Disorder, and that it is a “made up” condition, as well as vilifying the entire “mental health business” and “big pharma.” (Wait–I thought Fox “News” liked big pharma.)

Broadcasting live from the Fox studios in the depths of hell, it's the Tom Sullivan Show. Today's topic: Yes, you should hate and fear your neighbors.

Broadcasting live from the Fox studios in the depths of hell, it’s the Tom Sullivan Show. Today’s topic: Yes, you should hate and fear your neighbors.

On top of that, Sullivan asked a question that anyone with the most rudimentary knowledge of psychology, or the skill to do an Internet search, could answer: “What were these people called 25 years ago before they came up with this Bipolar diagnosis?”  (He didn’t mean that as a question that had an actual answer, but in the sense that he believes Bipolar Disorder was dreamed up by psychologists and drug companies 25 years ago).

I could let Jimi Hendrix answer Sullivan’s question in a song from 48 years ago, but I’ll let the good people at Healthline take this one.  Read their answer here: Bipolar Disorder just may have been recognized more than 25 years ago.

In case you didn’t bother to check the Healthline article, it basically notes that the first modern diagnosis of the illness that was eventually deemed “Bipolar Disorder” was first established in the mid-1800s, but that the basic condition was recognized in one form or other going as far back as the time of Aristotle and even before.  And prior to the Bipolar Disorder moniker, it was common to call the condition Manic Depression or Manic Depressive Illness, among other, similar things.

Sullivan’s staggering ignorance of mental health issues (and classic rock) aside, the truly insidious question that he asked in all of this was, “So what are you going to do when the money runs out?” By “the money,” Sullivan meant the Social Security disability fund, which he claimed will be bankrupt by 2016.

Beyond the more obvious stigmatizing of people with mental health issues, Bipolar Disorder in particular, Sullivan’s big question, and his chosen targets, may just be another entry into the vast library of right-wing fear-mongering about Social Security, and why it needs to be privatized. I’m sure it is. But it’s also part of a discussion that’s (once again) rumbling up about “entitlements” and poor people defrauding the government.

In fact, it appears Sullivan’s ill-informed rant about Bipolar Disorder may have been inspired by earlier comments from Rand Paul. As “support” for the items on Sullivan’s show that day, Sullivan’s website features a clip of Rand Paul, Republican Senator from Kentucky/compassionate ophthalmologist, speaking to a crowd in New Hampshire about how at least half the people on disability payments are collecting those payments fraudulently. You can see the clip (from CNN of all places) on Sullivan’s website here: Rand Paul is a medical expert who knows you’re not hurt, you crybaby!

Paul tells the (New Hampshire) crowd that, “everybody in this room knows someone who’s gaming the system.” Now, I’m not the kind of person to show up at a Rand Paul event, but I have to wonder about the people who do, if they all know somebody who is “gaming” the disability system. Then again, maybe Paul is just jaded, since his home state of Kentucky ranks third among the states in terms of the percentage of total population collecting disability payments. (I got that information from looking at the actual source of some of the Social Security Administration stats that were posted in an incomplete image on the same page of Sullivan’s website with the Rand Paul video) One might also ask what those stats, and Paul’s claims of fraud, could possibly say about doctors in Kentucky, who are signing off on all those disability claims.

Among those actually deserving of disability payments, Paul counts only paraplegics, quadriplegics, and the “horrifically disabled,” noting that “half the people on disability” are no worse off than anyone else, only “anxious, or their back hurts.” Paul’s standard for not deserving any kind of disability payments: “if you look like me and you hop out of your truck.” So, I guess a whole lot of white males with trucks are headed toward losing their disability payments, unless they’re careful to avoid getting caught hopping out of said trucks.

One would think that Paul’s background in medicine, as well as his position as an elected official might lead him to realize it’s his job to productively address problems with the way government systems work—particularly if those systems are tied to an area of his expertise. Likewise, Sullivan’s background in economics, along with his national platforms on both radio and television, should mean that a discussion of how to fix the Social Security disability system’s funding problem might be in Sullivan’s wheelhouse.

But rather than seeking out ways to tackle, say, the potential of those receiving Social Security disability payments to find work through job training programs; or promoting ways of obtaining additional funding, like removing the income cap on Social Security taxes, we get more condemnation of the poor–calling them lazy thieves.

Instead of having an informed discussion about the needs of those on disability, and why somebody who doesn’t “look disabled” might actually be struggling with things that many of us take for granted, we get accusations that people coping with mental illness are faking it and claiming to have conditions that don’t even exist.

Hell, Sullivan and Paul could even look into ways to make the disability system more functional by addressing the ways disability payments are established and rewarded.

But, no—we get wealthy white guys complaining that people with disabilities are a bunch of cheats, stealing from their neighbors. We get those with tremendous privilege trying to pit the poor and middle class against those with disabilities—’Hey! Let’s all pile on people who’ve been injured! Let’s knock down those who suffer from mental illness!! Get ‘em!!’

There are plenty of other things absent from these discussions of the Social Security disability system, like that those receiving the payments have to periodically have their status as “disabled” validated by doctors or mental health professionals, or that many of them end up assigned to a “payee” who controls the way their money can be spent, or that they have limits on things like what portion of their disability check can be used for housing. They are often confined to extremely limited options for government-approved housing, where their homes are subject to inspections, including being warned with ‘corrective actions’ if they aren’t keeping things clean enough.

Perhaps Mr. Sullivan and Mr. Paul think that those taking in, say, $1100 a month for being diagnosed with Bipolar Disorder (which is roughly the average monthly payout) are scamming us all, and stealing our tax dollars because they’re lazy. But the amount of money one can earn is hardly worth the effort that goes into obtaining it in the first place, or keeping it over time.  It might be a fun and entertaining exercise to have either Paul or Sullivan attempt to live on that amount of money for a month, and under the same restrictions.

Yet when one is so completely ignorant or out of touch as to think that Bipolar Disorder is make believe, or that we are surrounded by people stealing from the government through the Social Security disability system, then one has given up any credibility in the discussion of how to address the problems of vulnerable populations in our society–or even the discussion of how to address the possibility of fraud in the Social Security disability system.

Demonizing fellow citizens by claiming they have phony injuries or fabricated mental illness is a great way to stir up righteous anger among the poorly-informed. It may even achieve the goals of getting votes, or making disability requirements even harder to meet, or of having Social Security privatized or partially privatized.

So, don’t be surprised if you start hearing more and more about scammers bankrupting the Social Security disability system, or even more about mental illnesses being phony. Even if Sullivan did attract the ‘wrong’ kind of attention with his obnoxious comments, all he needs to do is get the poison in the stream. Then, Rand Paul and his ilk can still seem educated and rational and folksy enough that they appear sensible by comparison.

Sylvia Frumkin’s Place

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by JC Schildbach, LMHC

I’d venture a guess that many who enter the mental health field, as with any potentially dramatic profession all the way from police to executives, do so with visions informed by Hollywood. One of the main Hollywood portrayals of the mental health worker is is that of the therapist/psychiatrist as a well-compensated genius, ensconced in a plush office, treating the worried well or other “eccentric” or “neurotic” types, while constantly being admired by clients for one’s observational skill and ability to call forth ‘breakthrough’ moments. The other end of the spectrum is the heroic social worker who, through sheer tenacity, overcomes all the problems an impoverished neighborhood can throw at her, overcoming multi-generational patterns, and very recent traumas, to really, really make a difference in the lives of an entire community.

Many in the field are drawn to books by Yalom, or Rogers, or perhaps even some acolytes of Oprah, who tell us that just by listening and accepting our clients, or by throwing the right bit of tough-love advice a client’s way, true transformation will take place, and clients will make huge leaps forward, forever changing their lives for the better.

Susan Sheehan’s “Is There No Place on Earth for Me?” is perhaps the perfect antidote to the pie-in-the-sky visions of one’s brilliance and dedication making all the clinical difference in the world. It balances out the ideas about the wondrous gift of therapy with the reality of chronic and severe mental illness, and its resistance to ‘ah-ha moments’ and dramatic progress. It pushes past that “we don’t need no medications” mantra, which can, in fairness, apply to a lot of mental health issues.

“Is There No Place on Earth for Me?” was first published as a four part series in The New Yorker in 1981, then published as a book in 1982. For it, Sheehan won the Pulitzer Prize for General Non-Fiction in 1983. A new edition of the book was released roughly a year ago, including a new afterword by Sheehan. On reading about the re-issue in the online version of the New York Times in January of 2014, and having never read it before, I put it on my ‘to read’ list, and eventually checked out an old edition from the library.

Frumkin cover

The book, written from the perspective of a journalist, and not of a therapist trying to convince the readers of the efficacy of particular approaches to treatment, is involved in ways that few case studies can be. Sheehan spent over two years with Sylvia Frumkin (not her real name), a woman diagnosed with schizophrenia. Sheehan had a great deal of access not only to the information on Frumkin’s treatment and behavior during the period when Sheehan shadowed Frumkin, but also to family members and others, getting a great deal of background on Frumkin’s life prior to her diagnosis, and the progress and setbacks that took place before Sheehan had ever met her.

Having had numerous contacts with clients diagnosed with schizophrenia, or suffering from other forms of psychosis, most often from a distance, it took me a while to get through the book. That is, the kinds of delusions, rants, and flights from treatment that plague Frumkin and those trying to help her, and which Sheehan documents in detail, were familiar to me—of course, with Frumkin’s behaviors being particular to her own case. Still, it was like trying to read about many of the most frustrating aspects of work during one’s down time.

For the uninitiated, I imagine the book is much more compelling, rather than overly familiar, and thus, somewhat draining. In discussing “Is There No Place on Earth for Me?” with colleagues, I’ve most often likened it to Kafka’s “The Trial”—a book that is deliberately tedious in its depiction of a bureaucracy more intent on sustaining itself than serving any clear purpose—although, that comparison probably has much more to do with what I bring to the reading of Sheehan’s book than to what she has documented in such depth of detail. Also, I don’t think the mental health system—either now or at the time—is deliberately set up to be frustrating…it just frequently is, particularly for those most in need of help.

In addition to capturing the daily details of the behavior of a (this) client with schizophrenia, Sheehan also does a masterful job of explaining, simply and concisely, some fairly complicated legal, medical, and treatment-related concepts. For instance, Sheehan outlines the concept of “least restrictive” forms of treatment, both the bane and the beauty of our mental health system, which has been around since well before the current lack of options made it so completely mandatory.  In doing so, she answers that most familiar of questions about why we can’t “just lock up” people suffering from chronic forms of mental illness who can become rather taxing to a variety of public and private resources.

The most fascinating elements of Frumkin’s story to me, though, were the ‘side treatments’—pointless, and sometimes dangerous, programs that Sylvia was subjected to. Without going into a great deal of detail, the treatments ranged from moving in with a relative and his family who believed that all Frumkin needed was a good dose of Jesus and discipline to overcome her laziness and wicked ways, to a doctor who felt that manipulating the insulin levels of patients to extreme degrees could cure them of schizophrenia.

Ultimately, what works for Frumkin (or worked back around 1980) is what still works for clients today: a small number of medications that prove effective in treating schizophrenia, as well as (to greatly simplify things) a structured environment and supportive professionals. Unfortunately, said medications can lose their effectiveness over time, or the side effects can become increasingly detrimental to the clients. It is also quite common for clients to simply quit taking their medications, feeling them unnecessary or viewing them as the root cause of various forms of discomfort or other troubles in their lives. In addition, the structured environments can only be maintained for as long as clients are compliant with treatment, and as long as the treatment remains effective, and as long as funding and various programs allow. On top of that, anything from the restructuring of institutions, to changes in law and other policy, to the career changes of providers, to differences of opinion between providers and family members, can lead to new doctors and other providers making changes, sometimes rather arbitrarily, to a client’s medication regimen or support systems. In Frumkin’s case, alterations to her treatment and medications were made numerous times, in the most haphazard of fashions, often by doctors and other providers who seemed ignorant of her case history, or of how the medications work.

One might also note that this book was written back before the U.S., under President Ronald Reagan, decided that people with chronic mental illness enjoy the freedom that homelessness brings. So, Frumkin’s movements within the system are relatively easy in terms of her various forays into decompensation leading to fairly quick, and relatively long-term inpatient placements, with step-downs to semi-independent housing, and other supports that are much rarer today (and for most of the last three decades).

Ideally, Sheehan’s book would be taught in graduate schools, or maybe at earlier levels, by instructors who are familiar with the clinical aspects of schizophrenia; the current and historical treatments for it; and the current and historical state of affairs with regard to mental health facilities, available inpatient beds for clients with mental health issues, and legal and systemic complications to accessing those beds or other program options.

To be clear, it is necessary, as therapists, or in other capacities in the mental health field, to come equipped with a belief that we can make a difference. Without a bit of the dreamer in us, we would never head down this path to begin with.

But it is also necessary for providers at all levels to understand just what they are up against, particularly given that almost all providers in the mental health field will end up doing at least a round or two in the public mental health system–from practicums/internships to early jobs to entire careers–where the most challenging of clients often end up by default—frequently after being abandoned by families and other support systems, including insurance companies.

Frumkin’s family, as dysfunctional as they are, and as frequently detrimental to her treatment as they can be, at least hang in there to the extent that they can—which I imagine was at least somewhat less difficult when hospital beds and supported living options weren’t at such a premium as they are today. In the end, though, this isn’t a story of a family hanging together and triumphing over a terrible disease. It’s the story of a debilitating mental illness, and the toll it takes on the client, as well as those around her, and the wildly inconsistent efforts by a variety of people and systems to help her cope.

Welcome to Sylvia’s Place.

Honey Boo Boo Needs Some Real TLC, Not Abandonment

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by JC Schildbach, LMHC, de-commissioned ASOTP

Not quite a month ago, The Learning Channel (TLC) announced plans to drop production of its ‘reality’ show, Here Comes Honey Boo Boo, as well as shelving an entire season that has been completed, but not aired. The reason? “Mama June” Shannon was photographed out and about with her former beau, convicted sex offender Mark McDaniel. Even worse, a few days after the original story broke, a photo surfaced showing June, Mark, and Alana “Honey Boo Boo” Thompson together.

McDaniel was convicted of “aggravated child molestation” for sexual contact with Anna Marie Cardwell, who is June’s daughter, and Alana’s half-sister. McDaniel served a ten-year sentence for the molestation, having been released from prison in March.

Now, I’m not a big fan of Here Comes Honey Boo Boo.   I’ve seen occasional clips on other shows, and watched most of one episode when I came across it while flipping channels. But in that episode, I saw that the family was accepting of Alana’s uncle, who is gay, without making a big deal about it. And, despite my unease at the general weirdness of the child pageant circuit, the family members seemed to enjoy each other’s company. And then the show concluded with Honey Boo Boo climbing up on a chair and sticking her butt in the air to fart loudly, which, strangely enough, served as the lead-in to a very somber, ‘feed the children’ infomercial.

At any rate, speaking of the weirdness of the child pageant circuit, having seen a few episodes of Toddlers in Tiaras, the TLC show that spawned Honey Boo Boo’s spinoff, I am disturbed by what can only be described as the sexualization of little girls on that show. The contestants are small children who are essentially treated identically to adult beauty pageant contestants—made to wear too much makeup, with piled-up hairdos, wearing a variety of—I guess you’d call them revealing, although that sounds weird when talking about children—dresses and bathing suits, while performing routines involving dance moves that I pray the girls don’t understand the origins/meaning of.

I’ve had offender clients specifically mention Toddlers in Tiaras as a kind of ‘gateway’ form of visual stimulation leading to seeking out even more exploitative material. And, while such ‘gateway’ comments are often spoken with the intent to limit the personal responsibility of those clients—the whole ‘society is sexualizing young girls, what am I to do?’ complaint—it is somewhat difficult to view the show without thinking, ‘Wow—pedophiles must really enjoy this.’

So, while I could start shaming Mama June for putting her daughter in the beauty pageant circuit, or for taking up with a man who molested one of her daughters; instead it seems a better course in all of this would be for TLC to invest some more effort and money in the show, and maybe take it in some completely different directions—maybe even directions that would involve some actual learning.

Broken portrait of an exploited family unit--Anna Marie, Mama June, Honey Boo Boo, and Mark McDaniel.

Broken portrait of an exploited family unit–Anna Marie, Mama June, Honey Boo Boo, and Mark McDaniel.

That is to say, it’s very odd to have a show built on the highjinks of a family that is portrayed as a bunch of unsophisticated rubes chasing a weird dream, and then to turn around and cancel the show when the matriarch of the family does something that shows she really doesn’t understand what’s at stake in a particular situation. According to Anna Marie’s own statements to the media, June minimized McDaniel’s behavior, telling Anna Marie that McDaniel wasn’t all that dangerous because Anna Marie was McDaniel’s only victim.

Such a statement is a big red flag that Mama June just might be buying a whole lot of lies from McDaniels—the kind of lies that offenders tell all too frequently. ‘It was just the one time;’ ‘I was drunk;’ ‘It was a mistake;’ ‘The victim did X first;’ ‘I paid the price/did my time;’ ‘I won’t ever do that again;’ etc, etc.

I don’t know what kind of treatment McDaniel may or may not have received in prison. But unless McDaniel has developed some understanding of his own behaviors, and unless Mama June has been educated on exactly what McDaniel did, how he did it, how he justified it to himself, what kinds of things Mama June needs to look out for in McDaniel’s behavior (preferably coming from McDaniel’s own confession); and unless she’s been given instruction in what McDaniel’s behavior means for the safety of her other children, and how to reduce risk (risk can never fully be eliminated), then it’s a little hypocritical of TLC executives to cut her off, claiming that it is in the best interest of the safety of the children involved.

And just for context, here’s the statement issued by the network at the time of the show’s cancellation: “TLC has cancelled the series HERE COMES HONEY BOO BOO and ended all activities around the series, effective immediately. Supporting the health and welfare of these remarkable children is our only priority. TLC is faithfully committed to the children’s ongoing comfort and well-being.”

Great, TLC, but where’s the support? I’ve seen many mothers of victims continue on in relationship with the men who molested those women’s children. And a supportive and appropriate relationship with an adult partner can actually reduce risk for re-offense. However, that risk isn’t (generally speaking) reduced when the offender is allowed back around likely victims, particularly without the partner being fully informed as to the nature of the offender’s behavior, and how to provide adequate support for the offender and for other family members. But maybe TLC executives are just looking at this as another example of the stereotypes they’re comfortable promoting–of poor, Southern folk accepting child molestation as a routine part of life.

It is potentially extremely damaging for victims of molestation, like Anna Marie, to see their mothers return to relationship with the offender, or to, in any way, be given the impression that they are being treated as secondary to the perpetrator of sexual violence. It definitely sends some disturbing messages about who is being given priority, and where the concern of the mother lies. It is possible to mitigate that damage, but only with some very involved, professionally-guided therapy.

I don’t want to over-simplify things here, but a major reason for women to continue on in relationship with offenders is economic. I don’t have any idea if McDaniel has any real way of providing for June’s family, but since TLC just cut off the family’s current main source of income, they are increasing Mama June’s likely reliance on someone who can provide support—and at a time when the person June is in relationship with is an offender who is very much putting Honey Boo Boo—that “remarkable child”—at risk.

So, again, why not take the show in a new direction? A learning direction? I don’t mean to advocate for making an offender a reality TV star, but TLC could at least build in scenes to Honey Boo Boo’s show, or maybe a spinoff, that follow McDaniel through treatment, and through all of the difficulties he now faces as a convicted offender trying to rebuild a life outside of prison, in conjunction with Mama June’s exposure to McDaniel’s treatment process.  The audience could see scenes of June attending sessions with McDaniel—scenes of McDaniel explaining his ‘offense cycle’ to June, of McDaniel explaining his actual offense to June, of June going through a chaperone class where she learns just what limits need to be placed on McDaniel and his contact with June’s children.

And what about making sure Anna Marie’s okay? How about, instead of channeling any income to McDaniel, any money involved in a standard TLC reality-star fee, over and above the cost of his evaluation and treatment—funded by TLC—goes to Anna Marie to make sure she can get some ongoing treatment herself?  Perhaps let Anna Marie gain some economic benefit from the exploitation she’s already suffered? She’s had various media outlets contacting her to ask how she feels about the man who molested her being released from prison. How about making sure Anna Marie’s not being re-traumatized by all of this? After all, how many victims of molestation really want the molestation being made public, and then want to have to address it, with complete strangers, for the purposes of having it blasted out all over the airwaves and the Internet?

Of course, TLC doesn’t have to do anything in this case. Perhaps TLC executives were grateful that a scandal of this sort came around when Here Comes Honey Boo Boo was pulling ratings of less than half of its peak performance, just so they had a good excuse to cut their losses. Then again, TLC could really do some good in this case. TLC could truly support the “health and welfare” of their child stars. TLC could really help advance public discourse on offenders, offender treatment, and victim advocacy.

Or TLC could just leave Mama June, Honey Boo Boo, and the rest of the clan dangling—dangling over a cliff where falling means families torn apart and potential acts of child sexual abuse—and move on to whatever other ‘reality’ show goofballs America wants to laugh at, until ‘reality’ creeps in and undoes them as well—leaving TLC to cut its losses, abandon its ‘stars,’ and run.

 

Three Frightening Movies that Aren’t Traditional Horror, or Suspense, or…

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Well, Halloween is over, but who cares? You can still keep on scaring yourself, right? Only, rather than the usual gore and mayhem, how about some unsettling horror, the kind that makes you question the reality of the movie, it’s characters, and your own thought processes?

Don’t get me wrong, I’m a big fan of the traditional monsters-and-bogeymen (bogeypeople?) style of horror. But sometimes it’s good to be scared by things that aren’t quite so over-the-top. And speaking of over-the-top, you’re probably already irritated with all the ‘Early Black Friday’ specials and the ‘Holiday’ ads anyway.

The movies listed here also get at some small bit of what it is/might be to cope with various forms of mental illness, or to deal with others who are struggling with it. They spotlight what it is like to be unsure about what is happening, and to have a difficult time understanding what constitutes legitimate forms of support. These are movies that cause a tightness in your chest, and not the kind that is alleviated by the next hissing cat springing out of a cabinet, or garden tool splitting open some body part or other.  They carry with them the kind of dread that has a real impact.

And I’m going to say there’s probably a good chance that these movies should come with some trigger warnings, in case that’s not obvious from the descriptions.

Safe (1995): From Todd Haynes, writer/director of Velvet Goldmine, I’m Not There, and Far From Heaven, Safe sees Julianne Moore as Carol White, a woman who, after much confusion from a wide range of medical, mental health, and ‘other’ providers, is diagnosed with Environmental Illness, a disease that makes her hypersensitive to various chemical agents that are common in everyday life in modern America.

But is she really suffering from anything, or is the disease a physical manifestation of the sheltered nothingness her life has become? The only people who claim to understand her and her disease have clear motivations for convincing her she’s sick, while those who tell her she’s fine seem to lack any concern for her whatsoever.

As much an indictment of the “American Dream” of being completely carefree (there’s no such thing as “safe”), as it is of various forms of mental and physical healthcare, and the lack of clear, irrefutable knowledge to address all maladies (despite ‘professional’ claims to the contrary) Safe will have you clearing your throat, checking your temperature, wondering just what that smell is, and…wait, that’s probably not the best way to encourage anybody to watch a movie.

Safe is a bit difficult to track down. They don’t have it available on Netflix in any format, and Amazon only has it for sale as a DVD or Blu-Ray. Here’s a trailer (that kinda sucks)…

Affliction (1997): Written and directed by Paul Schrader (writer of Taxi Driver, and writer and/or director of numerous other impressive works), based on a novel by Russell Banks, Affliction sees Wade Whitehouse (Nick Nolte) descending into unreality, or perhaps hyper-reality, during what should be the routine investigation of a hunting accident. Having grown up in the shadow of an abusive father, played in frightening fashion by James Coburn, Wade never quite makes it out into the light that might help him establish some reliable sense of self.

An occasionally brutal meditation on familial abuse, PTSD, and other forms of trauma, this one is a slow crawl over gravel, peppered with the occasional hot coal. It’s available right now streaming or by disc on Netflix, as well as on Amazon Prime.

Here’s a trailer (that isn’t all that bad…)

Take Shelter (2011): From Jeff Nichols, also writer/director of Mud, Take Shelter stars Michael Shannon, aka General Zod and numerous other amazing roles, as Curtis, a man convinced that tornado season is bringing something much more sinister than twisters. Curtis jeopardizes his job, his financial security (including money saved for a cochlear implant for his daughter), his friendships, and his marriage to Samantha, played by Jessica Chastain, to build a storm shelter that can keep his family safe from not only storms, but perhaps the end of the world.

Nichols keeps the audience off balance by providing plenty of information that is clearly accurate, or at least witnessed by people other than Curtis, and also including a number of elements we can’t be so sure of. Is Curtis the only one alert to the signs of danger all around? Or is he suffering a breakdown of some kind?

Take Shelter is currently available via disc on Netflix, via Amazon or AmazonPrime in multiple formats, and on Starz—both on-demand and in the regular schedule.

Here’s a trailer (which is pretty darn good)…

So, happy no-longer-Halloween season. And remember, Thanksgiving and Christmas are still a good, long way off…as well as being great times to share disturbing films with family and friends.

The Stigma of Mental Illness and the Noble Savage Myth

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Okay, I’m kind of cheating here.  I haven’t posted anything for a while, so I’m popping this up.

This is an article I worked on with Dr. Jeffrey Guterman, based in part on a post I did for this blog (which was a great deal snarkier, and which I will re-post at a later date).

Enjoy… The Stigma of Mental Illness and the Noble Savage Myth

noble savage photo

Sons of Guns & Daughters of Rapists

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by Jonathan C. Schildbach, MA, LMHC, ASOTP

The last several weeks have seen charges of molestation, “aggravated crimes against nature,” and rape of a child, among others, brought against Will Hayden of Red Jacket Firearms and the Discovery Channel’s “Sons of Guns” reality show. Hayden has protested that the alleged victim, his own 12-year-old daughter, made the accusations only after his angry ex-girlfriend put the child up to it. The police and many news sources are now walking back their identification of the victim as Hayden’s daughter under laws that protect the identity of minors…but since it’s already splashed all over the Internet, I’m not sure what good that’s supposed to do.

I’ll put forth the disclaimer that anyone accused of a crime in the U.S. is innocent until proven guilty. I’ll also say I’m all for keeping things like this out of the media—but that’s clearly not the world we’re living in, particularly when such charges involve a public figure. After all, Hayden’s show was abruptly cancelled, and his business partners openly distanced themselves from him as a form of damage control to keep their custom gun business afloat. In addition, in the time since the accusations from Hayden’s minor daughter first surfaced, multiple other alleged victims have come forward, including Hayden’s adult daughter Stephanie, who initially defended him against the charges, but is now reportedly slated to appear on the “Dr. Phil” show later this week to explain that she was molested and raped by Hayden when she was a child.

And to add to the various disclaimers and caveats, I must also say I don’t know enough about Hayden’s past, or his current behaviors, to suggest that I, in any way, know that he fits, or doesn’t fit, the general clinical conditions suggesting high-risk behaviors for pedophilia or sexual abuse of a minor.

Let me also put forward that as much as there is an assumption of innocence for the accused, if we really want to make any headway on addressing sexual abuse of children, the assumption needs to be that children who come forward to seek help for sexual abuse are not making things up. When children are lying, their stories do not hold up particularly well, although depending on how skilled or unskilled, careful or careless, someone is when interviewing children, plenty can go wrong with the information that is gathered. But if our first reaction to children who report sexual abuse is to shut them down, or leave them in the homes of the accused, they are potentially being put at further danger, and a likely increase in the level of that danger.

And speaking of making headway in addressing issues of sexual abuse, I’ve noticed, at least as indicated by Internet comments, that when it comes to stories like this, we can count on public opinion to fall into a small number of categories:

1) Kill ’em all: This just involves amped-up vitriol aimed at sex offenders, and those accused of having committed sex offenses. I understand the anger. But, seriously, if you think that killing more people, or addressing problems of abuse with violence is the way to move toward a better society, a more healthy understanding of human sexuality, or better protection for children, you’re taking an overly simplistic view of the way the world works. And if you think this approach has some merit, why weren’t you able to spot Hayden and bring him to justice earlier? Is that anger and all those demands for vengeance really accomplishing anything?

2) “He’s obviously a rapist because he does/likes/thinks X.” Whenever somebody is in trouble for being an (alleged or convicted) sex offender, people like to equate the offender’s other behaviors and beliefs (that don’t jibe with their own) with the offense behavior. In the case of Hayden, some have connected “gun culture” to sexual abuse of children. And while, as anybody who has read my other posts knows, I am no fan of guns, I just can’t see anything productive coming from conflating gun ownership or gun manufacture with child molestation. Of all the people I know, holding varying levels of support for gun ownership or gun control, none of them have ever expressed an endorsement of sexually abusing children. This lack of support for sexually abusing children is pretty universal, regardless of one’s political beliefs, religious beliefs or hobbies.

Furthermore, while I have worked with a few offenders who have had guns figure prominently or incidentally in their abuse behaviors, they have been the exception, not the rule. In terms of grooming behaviors, things like money, jewelry, candy, drugs/alcohol, video games, clothing, toys, and porn have been involved in many more of the offenses I’m aware of than have guns.  And I’m not going to advocate for the banning of any of those items based on the ability of abusers to involve them in abuse patterns. I’m more than happy to advocate for a ban on guns based on their use in—well, shootings—homicide and suicide and attempts at both, not to mention all manner of other crimes and accidental deaths, but as for their involvement in child molestation–not a huge concern, at least from what I’ve personally seen.

3) “How can somebody do this?” This is usually sideways of the “Kill ’em all” concept, and often involves plenty of name-calling. I get that it is very difficult to understand how somebody could rape their own daughter—or sexually abuse any child—but many of the factors involved are not beyond explanation. Most people just don’t want to hear the explanations…or deal with them…except in punitive, harsh ways once somebody has committed such acts.

Generally speaking, though, a person doesn’t sexually abuse a child because he or she is thinking clearly, or because he or she has just suddenly come up with such an idea after a long life of healthy relationships. If Hayden was engaging in sexual abuse of children, he wasn’t, one assumes, doing it out in the open, as such behaviors usually involve a great deal of secrecy and manipulation, like Hayden’s alleged warnings and threats to his daughter not to tell anyone, because, “I’m all you’ve got.”  In short, people who sexually abuse children are ill and engage in a number of behaviors to try and mask that illness, or keep others from learning of it.  I’m not sure how to properly emphasize this enough.  Sexual abusers of children are not just random guys who are bored and horny.  There are a lot of factors involved, including a huge number of elements (rationalizations, justifications, creating situations where one has access to children and is willing to take advantage of that access while plotting to keep anyone from finding out) that involve breaking down the normal barriers that prevent such sexual abuse.  In other words, “How does somebody do this?” is a question that involves a long and extended answer.

…And now for a clip of Hayden that seems weirdly re-contextualized, check this out–especially the last 20 seconds or so…y’know, where he talks about people becoming bad headlines and how he tends to his own conscience.

Anyway, let’s say that way back before Hayden had ever (assuming he did) touched his daughter or any other young girls in a sexually inappropriate manner, he realized he was having thoughts in that direction, and that he needed to do something to steer clear of that behavior. What would he do?

For those of you who know what kinds of resources are out there for dealing with someone who is having thoughts of sexually abusing a child, bravo. Please do what you can to make sure others know. I will say that over my years working on the crisis line, I have fielded a very small number of calls from people (both men and women) who were concerned about the nature of some of their sexual thoughts towards minors—either specific minors in specific situations, or more generalized sexual thoughts—and were seeking help.  In my years of dealing with offenders, I have seen numerous people who just might have sought help if they had any idea how to, and if they hadn’t felt like total garbage for acknowledging that they needed help.

But most people facing thoughts of sexual attraction to children do not have the wherewithal to seek help, much less have any idea where such help could be sought. It is a much more common reaction to deny that there is a problem, to try to push the thoughts away, or even to feed the thoughts (as in masturbating to inappropriate fantasies) while assuming that the actual offense behaviors can still be avoided.

Furthermore, treatment providers in the field of sexual abuse can have a difficult time promoting services. People tend to come to providers by referral from a lawyer or a community corrections officer (CCO) after they are already in trouble or have already served time, even though the same types of treatment could be just as effective before any offenses were committed. After all, just how welcome do you think a provider would be if they hung a sign out on their business that said “Sex Offender Treatment” or “Specializing in the Treatment of Sexual Deviancy,” or something similar? The stigma and shame that prevents people from seeking help for mental health issues as relatively common and accepted (and I mean relatively accepted) as depression, is increased a great deal for issues surrounding sexually inappropriate thoughts and behavior.

So, regardless of all that business about stigma and secrecy and providers protecting the privacy of their clients and confidentiality of their services…here’s a site that has a directory of providers throughout the U.S.  It’s basically set up for people who are already in trouble.  But it doesn’t have to be.  This is through “Stop It Now” which has referrals to the Association for the Treatment of Sexual Abusers (ATSA) and numerous other organizations.  Get help if you need it.  Get help for others if they need it.  That’s right, help, and try to discontinue the hurt.

http://www.stopitnow.org/faqs_treatment

Maybe if everybody calmed the f*ck down and decided they were more interested in actually protecting children than in getting angry at offenders, we might make some progress.  And maybe tend to that part of your conscience that’s problematic before you become a bad headline, or before you celebrate a bad headline.

Peace.

How About We All Stop Using “Schizophrenic” as an Insult?

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by J.C. Schildbach, LMHC, ASOTP

One night about two years ago, I challenged a friend for describing his behavior as “schizophrenic.” In an admittedly snide tone, I asked a quick barrage of questions referencing various types and symptoms of schizophrenia: Are you catatonic? Paranoid? Suffering from delusions? Auditory hallucinations? Visual hallucinations? And so on…

Somewhat unexpectedly, my friend responded with an apology for his use of the term, and didn’t engage in any kind of defensive posturing or attempts to justify his word choice. He clarified that he meant he had changed his mind back and forth several times in relation to a particular situation.

I was a little surprised that I had reacted in such a way to what was supposed to be a self-deprecating comment from a friend. But there were a number of things weighing on me at the time, not the least of which was that my friend was seeking advice on a matter that was best kept between him and his partner, and maybe a good couples counselor. As with most of the times he sought advice, he had already made up his mind about what he intended to do, and was looking to have his intentions validated, or to have them challenged with an argument so compelling that he would have no choice but to turn from that position.

Aside from my irritation with the immediate situation that evening, I had been in contact earlier in the week with a young man diagnosed with schizophrenia. He was in some pretty serious legal trouble, and did not appear to comprehend all that much about it except in the most concrete of terms. That is, he knew what law he had broken and why it was problematic. That information had been drilled into him during his time in court and a stay in jail. But his sense of what the crime meant, and how it was going to impact him, his connection to others, and the choices he was going to have to make, both short- and long-term, was murky at best. It struck me that he was so used to being marginalized that his current situation involved just one more bureaucratic system to interact with—as if this latest set of restrictions was little more than an additional cluster of tasks to occupy his time.

Working in crisis intervention, I also have fairly frequent (phone) contact with people coping with schizophrenia and other mental illnesses that involve psychotic symptoms of varying levels of severity, and which often fluctuate over time. There are few, if any, blanket statements that would accurately cover them all, or make a nice, tidy explanation of what they are dealing with. But, unlike the popular usage of the term “schizophrenic,” the way my friend had engaged it, the behavior, thoughts, and challenges of those dealing with schizophrenia are not simply a matter of being indecisive or changing their approach to an issue.

In the time since I first barked at that friend about his use of the word “schizophrenic,” I have seen it become more and more commonly used (or, perhaps, it was used a great deal before that, and I just hadn’t noticed). Currently, in addition to the way my friend used it, to describe his somewhat erratic decision-making behavior, it is used quite often in relation to politics, and often by writers and other figures I respect or at least tend to agree with. Such uses, though, are potentially offensive, and even insulting in a way that is beneath anyone attempting to make a serious point.

For example, in recent weeks it has been relatively easy to find articles, or to come across people on television news/opinion shows, complaining of politicians behaving in a “schizophrenic” fashion toward immigration policies. Generally, what the use of the term “schizophrenic” means in such a context is that the politicians are saying one thing and doing another, or that they have changed their position on an issue multiple times. It is basically used to mean that a politician or group of politicians have been inconsistent on an issue.

A quick Internet search can find all manner of uses of "schizophrenic" as a derogatory label--frequently in political discourse.

A quick Internet search can find all manner of uses of “schizophrenic” as a derogatory label–frequently in political discourse.

But the problem with using “schizophrenic” to describe contradictory political positions is that it suggests the politicians are suffering from a diagnosable mental illness that is beyond their immediate control, and which can interfere with their perceptions of reality, rather than that said politicians are making rational decisions based on what they think will get the most traction with their “base” or constituents. Politicians shifting their political positions is something that is done with the assistance of political strategists in an attempt to get a message out to voters in a way that might provoke support of a carefully crafted message, even if that message is inconsistent over time.

Schizophrenia, on the other hand, is not volitional. It is not deliberate. People who are living with schizophrenia are not choosing one day to deal with only minimal or well-managed psychotic symptoms, and the next day to pursue the exact opposite. People coping with schizophrenia do not, for example, determine that they will change the content and intensity of their auditory hallucinations based on political polling and messaging strategies. They are not thinking of the gains to be made by crafting an elaborate delusion wherein their friends and family are colluding with various government agencies to monitor and control them.

In short, saying that one’s political opponents are “schizophrenic” is just a different way of labeling one’s political opponents with the big, sloppy label of “crazy”—of indicating that their ideas do not merit any consideration because the people presenting those ideas are not grounded in reality. But, because “schizophrenic” is being used as an insult, as a way of accusing somebody of being worthy of ridicule and dismissal, by extension, it implies that people with schizophrenia are also worthy of ridicule and disrespect. Using “schizophrenic” as an insult encourages ongoing stigma towards those with mental illness. It encourages a lack of understanding of mental illness, and of how to address the needs of those struggling with it. It is dehumanizing in the way that all insults aimed at one’s “enemies” are intended to dehumanize.

And people with schizophrenia are not our enemies. They are people struggling with something that we only barely understand. They are people who, at the very least, do not deserve to be lumped in with politicians who are fine-tuning messages of anger and outrage to try and get votes.

Now, lest anyone think I’m engaging in “word policing,” let me say that I am. As much as language is a dynamic thing, there are still right and wrong ways to use words, or rather, more and less accurate ways of using them. We still make daily decisions about whether we are going to use words to clarify or to obscure, to increase understanding or to confuse. The word “schizophrenia,” unlike a number of other words used in mental health diagnoses (anxiety, narcissistic, etc.) was coined, by Eugen Bleuler around 1908, specifically to refer to the mental illness. It literally means “split mind.”

Arguably, the literal definition of schizophrenia could easily be applied to various other situations such as the one’s already described, and it would not be inaccurate. And, arguably, the mental illness or cluster of illnesses known as schizophrenia involves a broad enough range of symptoms and presentations that the diagnosis requires specifiers for clarification in individual cases. Still, rather than taking a word created to refer to a mental illness, one that will always have ties to that mental illness regardless of how one claims to be using it, and expanding the use of that word to include any behaviors one perceives as inconsistent or otherwise in opposition to one’s own beliefs about appropriate behavior, why not pursue more accurate understanding of the word, and a greater understanding of what the mental illness means, and does not mean?

It seems to me that, rather than calling politicians “schizophrenic,” it would be much more damning to say that one’s political opponents are completely inconsistent in their approach to an issue because they feel that they can achieve greater political gains by changing their position and their message, instead of sticking with real principles or working hard to find real solutions to complicated problems.

And instead of labeling our own actions, or the actions of others as “schizophrenic,” simply because they are inconsistent, appear contradictory, or we disagree with them, why not just acknowledge that most of us are not as steadfast and true as we like to imagine, and that we often don’t make decisions unless and until we have to? Why insult people with schizophrenia by suggesting our poor decision-making skills are the result of a serious mental illness, one that involves much deeper struggles than indecisiveness or occasional mild impulsivity?

How about we all stop using “schizophrenic” as an insult?