Tuesday, March 10, 2015

Responding to the reaction to Are There Ways To Lessen The Violation That People Feel After Psychiatric Hospitalizations? Polarized responses!

I saw the Mad in America article about my post on

Are There Ways To Lessen The Violation That People Feel After Psychiatric Hospitalizations?

 I feel like it was misrepresentative to say that I wanted to give people cake and ice cream, as if that would undo the violation people might feel, especially after involuntary hospitalizations.  I was drawing on the example of what I saw in mental health court, that people who were incarcerated as criminals, then chose to participate in the MHC with all it's requirements (generally many: treatment, medications, often substance abuse treatment, requirements for day and residential programs) yet  end with a sense of being proud.  There is a graduation ceremony and they come if they want, invite their families, get certificates, take photos with the judges.  No one is forced to come, and the have fried chicken --which I somehow found humorous, but at the moment it's looking a lot better than the cake and pizza which are my favorite cheap foods.  Readers felt was demeaning and comparable to birthday party food for small children, and if I ever suggest food again for any event, it may be lobster.  I was trying to say that if something presumably traumatizing -- like getting arrested and labeled a criminal -- could later be turned to something that wasn't so shameful, maybe we should consider that sort of thing to help people feel less traumatized and shamed with hospitalization.  Without the mention of Mental Health Court's approach, it comes off as sounding like I want to feed people cake to make their pain go away and undo the violations they were subjected to, which I never meant.  I wanted just to ask if people felt that some validation of their distress would be helpful, and I think people like food with events. Or at least I like food with events.

I realize that some people who are involuntarily hospitalized are terribly traumatized, which is why I'm writing the book.  I don't think psychiatrists see that and I think if it were figured it into the equation, maybe less people would be involuntarily hospitalized (certainly, no one should be forcibly hospitalized for 'sadness' as one of the MIA commenters put it), other alternatives could be found, and more of an effort would be made to treat those where there are no options but involuntarily hospitalized with respect and kindness.  I thought the responses were polarizing, while commenters here and at Mad in America complained that I was lacking empathy, defensive, and just plain evil, Psychiatric Times deemed it one of the top 6 articles on psychiatry for the month! 

Monthly Roundup: Top 6 Psychiatry Articles in February

Monthly Roundup: Top 6 Psychiatry Articles in February

- See more at: http://www.psychiatrictimes.com/cultural-psychiatry/monthly-roundup-top-6-psychiatry-articles-february?cid=tw#sthash.VQvM5YjA.dpuf

Monthly Roundup: Top 6 Psychiatry Articles in February

Monthly Roundup: Top 6 Psychiatry Articles in February

- See more at: http://www.psychiatrictimes.com/cultural-psychiatry/monthly-roundup-top-6-psychiatry-articles-february?cid=tw#sthash.8fBy2dv3.dpuf

Monthly Roundup: Top 6 Psychiatry Articles in February

Monthly Roundup: Top 6 Psychiatry Articles in February

- See more at: http://www.psychiatrictimes.com/cultural-psychiatry/monthly-roundup-top-6-psychiatry-articles-february?cid=tw#sthash.VQvM5YjA.dpuf
I stopped publishing the comments on my own blog, because as horrible as I hear people can be treated during involuntary stays, these feelings are not the same for everyone, and the comments because insistent, repetitive, and I don't think they left room for anyone to voice another opinion .  Some people get better and appreciate being in the hospital, some get better and still understandably resent it, and some are just terribly distressed for years.  When they get too extreme, I worry that people stop listening -- so while I know people feel terribly violated, I wonder if it wouldn't upset the victims of war torture, rape, and kidnapping, to have their experience compared to being in the hospital where people presumably are at least trying to help them?  And I think some people shut down when they hear someone compare treatment to torture -- there are those who will stop listening and discount their opinions. We live in a democracy, and I think folks might get more traction by talking with their legislators and proposing new laws; it's more powerful then blog comments.  And most psych hospitalizations are voluntary -- some coerced, but many people ask to be in the hospital, repeatedly, and find it helpful.

  I'm sorry this blog post turned out to be so polarizing.  No one has ever called me "evil" before.  And one commenter on my blog (unpublished) insisted psychiatrists just need to admit that their work is useless and never helps anyone and that I should become a gardener.  If it doesn't help you (and I mean the metaphorical 'you', not you personally!) then I can see why you might think that, but it seems unfair to insist that everyone has the exact same reaction to being hospitalized, or even being offered outpatient psychotherapy on a voluntary basis.   I'm also sorry that some of my comments came off as being defensive. Often I'm responding to blog comments quickly, between activities, and I often don't measure every word or consider how they might be construed from a variety of different perspectives.  Anyone who regularly reads my blog knows that my posts are done quickly and often with typos, I'm just stretched a bit too thin to do the proof-reading to catch them, and in a similar way, I sometimes reply to comments without thinking through every angle.  I also often have completely different views than the commenters.  And I admit that I do close up a bit when people insist that everyone experiences things the same exact same way that they do.  It leaves no room for people to be human.

Hundreds of thousands of people are involuntarily hospitalized each year.  While I won't be suggesting acknowledgment events in the book after the feedback I've gotten, I do wonder if just one of those hundreds of thousands of people might like someone to notice how painful their experience was and how hard they worked to get better, and perhaps be offered the chance to have their kids come have a piece of pizza with them when they were ready to go home. 

I am well aware that offering someone a "party" or a piece of cake doesn't make the bad of it go away and I never intended that.  There are some people who come in very sick and very psychotic, and who feel a lot better.  And by the 'exit interview' I was thinking some about the comparison to being raped -- -what could be worse than being raped and having someone tell you it didn't happen or wasn't that bad?  Might it help to be heard and have your violation acknowledged?  I hear that some people feel that wouldn't be safe and that if they were ever admitted again, they could be the subject of retribution.  I never meant for either an exit interview or a the offer of an acknowledgement meeting to be something that is forced, simply offered.  Sometimes it seems our commenters pit the patient as always the sane one -- as though people can never be sick or psychotic, or dangerous, or violent-- and the staff as purposely sadistic.  Patients can be sick, and there are bad people in all fields And believe me, I feel anyone who is intentionally cruel should be fired. 

Please feel free to post this in the comment for me on Mad In America.  Commenting here will be closed for a bit.  

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