Part 6 in multipartite post, The ‘Madwoman’ v. the Madness of the State.
Mental health professional and support staff also remained largely blank-faced, indicating unfamiliarity or their apathy toward their own professional development, whenever I referenced Dr. Herman’s work, or the work of Annie Rogers, Ph.D., another Harvard-educated psychologist and current faculty at Hampshire College, whose clinical work with girls traumatized by early childhood sexual abuse taught me more about Lacanian theory than his academic translations by Juliet Mitchell and Jacqueline Rose. Her results with her patients are resoundingly similar to the results I was getting from my first year university drawing studio students who had suffered traumatic childhood or young adulthood experiences.
Still more troubling, Idaho mental health professional and support staff seemed further unaware of changes in the process of being implemented more broadly across their field, stimulated from research dating from the late 1990s, rather conclusively linking adult bad behaviors symptomatic of various mental illness labels to underlying early childhood traumatic experiences, i.e., my area of educated, published, exhibited, award-winning research.
From the website for the National Alliance on Mental Illness (NAMI), “The field of mental health has moved towards a more sophisticated understanding of how traumatic events can influence a person’s experience, and a movement towards trauma informed care…” (Emphasis added.)
Just not at Idaho’s mental health institutions.
Further, research contradicts the conclusion elsewhere on their site that family members are a reliable source for evaluating mental wellness, “the Adverse Childhood Experience (ACE) study demonstrated a relationship between self reported adverse childhood experiences and…” If the adverse family environment contributed to adult bad behaviors, then the perceptions of adverse family members should be held suspect without further evidence evaluating those family members’ adverse behaviors.
Buried in their badly organized, badly designed site that emphasizes medications over holistic psychotherapeutic care or other options beyond the expertise of the scientific community, NAMI admits the controversial and life-threatening hazards of pharmaceutical treatment:
“We have a great deal more to learn about the impact of antipsychotic medications on the brain. If medicines are useful for shorter-term symptom reduction but contribute to even subtle long term brain loss, that complicates the risk-benefit equation for the individuals who would be taking the medicines.”
And the harmful side effects for the drugs Intermountain Hospital and State Hospital South currently minister as sole treatment specifically for bipolar disorder, according to NAMI, include: frequent urination, excessive thirst, weight gain, memory problems, hand tremors, gastrointestinal problems, hair loss, acne, water retention, hypothyroidism, impaired kidney function, and a toxic skin condition that can result in death. As well, the warning that all anticonvulsants and antidepressants may increase the risk of suicidal thoughts or behaviors. Observable side effects from that list I observed in patient after patient involuntarily held at both psychiatric facilities.
“This is the treatment,” Dr. Abbasi snarled sullenly at me as she prescribed her favored meds.
The ACE study, funded in part by our federal Centers for Disease Control and Prevention (CDC), further confirms my conclusions obtained from my graduate research on critical theories of identity, trauma, and the taboo, linking “childhood experience of abuse, neglect, and family dysfunction” to adult bad behaviors currently labeled as various forms of “mental illness” by the psychiatric community. The scientific gaps indicated by the social scientists’ badly designed, visually illiterate infographic begin to be filled by my unfunded research:
Contradictions throughout NAMI’s site might be explained by a review of their annual reports, almost entirely funded by pharmaceutical companies, and including, in their First Quarter 2014, the parent company of Intermountain Hospital, Universal Health Services, that managed to contribute $85,000 to the charitable nonprofit after reducing their profits by their CEO $11,000,000 salary and benefits:
While NAMI rightly encourages moving away from the 1970s’ blame-the-mother research model, the nonprofit organization does not yet acknowledge, quite, the stereotypically gendered relations of psychosexual and economic power in the home as first defining early childhood development, later determining adult psychosocial behavior, despite, according to their own numbers, 10 million United States citizens currently diagnosed with bipolar disorder.
Without even factoring in the statistics for schizophrenia and psychosis, that’s 10 million abusive home environments in the United States.
Likewise, Idaho’s mental health professionals seemed unfamiliar with what human sexuality and gender have to do with human psychology, or how gendered relations of power play out on campuses nationwide. An Asian American Intermountain Hospital staff member, who boasted of reading three Robert Ludlum novels in their entirety before giving up reading altogether, was unfamiliar with both current events and Title IX legislation, yet nevertheless vehemently expressed his disapproval with any laws attempting to level the playing field or increase opportunities for women, people of color, or born into poverty, after he repeated Dr. Sonnenberg’s philosophical question, and I responded by comparing the brutal irony of my experiences versus Elliot Rodger’s freedom following police questioning, later accelerating his misogynistic tirades with violent behavior terrorizing staff and students of all colors and genders at UC Santa Barbara before killing himself, another headline that coincided with my involuntary mental health treatment from the State of Idaho, where the police got it wrong in that case too, but in the opposite direction:
Point being, if you are a violent, misogynistic man with history of mental illness in the State of California, you can talk your way out of further investigation by telling the police that your abusive behavior was “all a misunderstanding.” If you are an educated, compassionate, unemployed woman in the State of Idaho and you walk into the police station to report being victim of and witness to crimes, police refuse to investigate, and mental health professionals rationalize their own abusive behavior by validating an abusive relative’s narrative that you’re mentally ill-??
Of course there are unlimited possible answers to Dr. Sonnenberg’s question, “Why are you here?”
I might have chosen to echo the observation of another patient, a former US Banker, who thanked me for listening as she told and retold her trauma narrative stitching around a primal wound from a childhood that sounded very similar to my own, followed by a series of relationships with abusive men, exacerbated by sudden socioeconomic deprivation resulting from the Great Recession, and her current anxieties about a nephew who had disappeared under mysterious circumstances, presumed dead, “You’re here to help people, aren’t you? At first we thought you might be a doctor, or a therapist.”
Her speech was anxious and narcissistic, so now I know what Idaho psychiatrists label as mania I would join Dr. Herman in describing as that patient’s grimly repetitive trauma monologue. She spoke rapidly. Both one-on-one and in a group setting, she would quickly monopolize conversation, urgently telling and retelling her trauma. If she asked questions about others, it was only on the pretext of quickly returning the conversation back to herself, and she could not remember my answers from one dialogue to the next, so each of our conversations started nearly all over again from beginning introductions. Her speech jumped and skipped from one trauma to another, sharing no insight or self-awareness of the redundant characteristics between one relationship or event to the next. She sounded a lot like my mother, my siblings, and my brother-in-law during their excited or raging episodes. In their depressive phases, they express almost no affect, providing monosyllabic responses if any at all.
But while that patient’s experiences sounded horrific and quite serious, I did not categorically dismiss them as unreal or “delusional” just because they were different from my own experiences. Helping her work through those traumas might take years of intensive psychotherapy and art-making as tools for building self-awareness and, from there, developing healthy communication skills. Though she docilely accepted medications from staff, she displayed no change in behavior between the time I arrived and the time she departed Intermountain Hospital.
During the delay between judicial order decreeing my incarceration for up to one year and shackled transport to State Hospital South, I approached the nurses’ station and overheard a staff member repeating Dr. Sonnenberg’s same question while gossiping with her coworkers about their patients, “Why is she here? She has exhibited no symptoms in the two weeks that she has been here.”
At that time, I was the only patient on that unit who matched that description.
Required by the Department of Mental Health to supply a place to go as prerequisite to my eventual release from the state hospital, what else could I do besides network with other patients into receiving half a dozen offers of shelter in their homes? In the course of seeking domestic violence counseling for my brother-in-law and sister and/or alternative housing for myself, I had already interviewed the director of Boise’s downtown women’s shelter, Rosie Dice, who first mistook me for a bureaucratic inspector or investigator from law enforcement rather than a destitute woman seeking refuge from an abusive family. She gave me the biggest compliment of my life up to that point, so thoroughly healed from past traumatic experiences that I impressed her as being “a woman who could not have ever been abused. You’re too strong.”
To me, Ms. Dice presented as a deeply traumatized, middle-aged, artificially blonde white woman qualified to neither assist socioeconomically underprivileged women attain living wage jobs nor increase their skills for resolving family conflicts, despite sharing her judgments of herself as an expert in human behavior and skills with education from my hometown California State University at Chico, “but I had friends at Berkeley,” and further trained to assist victims “at risk” for domestic violence, “at so many places I can’t remember them all right now.” Many more public and private funds seemed to be invested in interior decorating her office space than the group dormitory facility next door, more revealing of her brand of Christianity than any Sunday sermon I would be required to attend in exchange for a cot inaccessible until 4:00 pm each afternoon, and there was no space for my desktop computer. Even the notion of a woman seeking work for more hours than permitted on the aging Windows machines in her facility seemed to terrify her. “There’s a woman out there,” she confided to her staff member after first carefully shutting a windowed door that separated us, her voice rising and trembling in panic, “Who wants to bring a hard drive in here.”
To Ms. Dice’s credit, she was at least visually literate enough to recognize, from my business card alone, the value that I add to any organization. What the director of Boise’s women’s shelter shares in common with Bill Gates: reluctance to offer me so much as a roof overhead, but, her eyes aglow with that same gleam of narcissistic greed, “You can volunteer!”
From the beginnings of my incarceration at Intermountain Hospital, then, I recognized the design challenge of finding a safe place to live and to work from the options within the available social network. While the counselors earning state-contracted paychecks regularly shamed their clients for feeling or expressing anger, oftentimes explicitly advising their patients to avoid anger, I am better educated to recognize that shaming is characteristic of adverse childhood family environments leading to adult behaviors labeled by the psychiatric industry as “mentally ill,” thus staff replicated or reinforced the cycle of traumatic experience and abusive behavior. Healthy parents/teachers/therapists acknowledge the anger of their children/students/patients while teaching methods of expressing their emotions and resolving conflict in healthier ways other than repressing that emotion until it explodes as rage or antisocial behavior that accelerates along a spectrum of violence that leads to crimes like rape and homicide or war in intimate or foreign affairs.
One patient impressed me, despite staff’s discouragement, for her ability to report her feelings of anger, “I am feeling angry,” she readily acknowledged in group, “Because I have spent 13 years figuring out the right meds, and Dr. Gant (sp?) just took me off my meds. He just hung a noose around my neck.”
Another time, with staff huddled behind the fishbowl windows that divided them from their clients, unable to resolve the urgent conflicts between patients and traveling psychiatric physicians to which we were arbitrarily assigned, that patient was able to communicate precisely what she needed from the mental health professionals, albeit at top volume, “I JUST NEED A FUCKING PSYCHIATRIST WHO KNOWS HOW TO TREAT THE FUCKING MENTALLY ILL!”
Afterward I murmured to an observing staff member, “You know, I’ve found that if you listen to people, they will usually tell you precisely what they need.”
“Precisely. Except that isn’t how you go about getting what you want,” she agreed, before adding reflectively, “You know how to get what you want.”
Of course, I could have argued with that mental health professional about how wrong she was, or snidely observed that I must not be very good at getting what I want, or the State of Idaho would not be violating my civil liberties, but as a healthy, ego-invested trauma survivor, I know that compliments should be received in the spirit with which they are intended. My job as a human being was to simply bask in the praise, “Thank you.”
Point being, during my month-long incarceration first at Intermountain Hospital and later at State Hospital South, while I continually observed and interacted with mental health professionals exhibiting passive aggressive behaviors at least as poor if not worse than many of their patients, on staff at both facilities you might also find many witnesses who observed my healthy interactions as long as they could be guaranteed freedom from fear of their employer’s or state supervisory employees’ retaliation.
A patient at the state hospital described to me her suffering paranoia so severe that, convinced other people were stealing her work, she had stopped the therapeutic practice of writing. She warned me against journal-keeping that might be confiscated and used against me in a court of law. Given that I tried to at least refer to my journal notes on the witness stand and will happily grasp any opportunity to retype, edit, and format my handwritten notes for experts in the fields of law or publishing, I decided to ignore her legal advice. But I still paid her the dignity of listening to a portion of her narrative. Her expert advice, to avoid the downtown homeless shelter, engaged in protracted legal battle with the City of Boise, pushing toward $2 million in legal costs with a $1-million judgment resulting from unhealthy communication between the two parties, still seems to me to be sound. And even that paranoid delusional trauma victim arrived at a conclusion missed by Dr. Abbasi, the state-sanctioned designated examiners, and Ada County’s mental health court judge, after observing my behavior:
“You don’t seem very psychiatric,” she said suspiciously.
What I look for in assessing psychological health is an ability to dialogue, which means listening to perspectives outside one’s own. Listening as active engagement, which means asking questions to better understand other perspectives, especially when those experiences differ from one’s own. Not passively or impatiently waiting for the very next opportunity to speak. Or worse, interrupting to insist on the “rightness” of one’s own narcissistic opinion. Remaining open or reserving judgment while listening. Ever-questioning the basis for our judgments. An ability to find commonality, or empathize with others, where narcissism is symptomatic of trauma, or abuse. The ability to engage in direct, or healthy, communication, rather than passive aggressive communication, which always rationalizes abusive behavior.