This Week in Mentalists (106)

This week, we have posts on nurse education, therapy during social collapse, psychogenic illness, cartoons, and a library-themed Wildcard.

More from Peak Oil Blues, as they continue to explore ways to stay sane in the coming peak oil/climate change/credit cruch apocalypse. This week, they discuss therapy in a time of social collapse.

Right now, saying “YOU’RE MY NEIGHBOR” means very little. Pretty soon, it will mean a whole lot, and you won’t need people like me teaching you how to be neighborly. You’ll either learn how to get along with those you live around, or you’ll be really sorry you didn’t. Circumstances will influence us in unimaginable ways. It is true that our ethnic enclaves of the 1950’s and 1960’s were overall a healthier bunch psychologically. It is also true that as the children of those immigrants grew up, got educated, and wealthier, and moved to the suburbs, they developed all sorts of neurotic unhappiness that their parents didn’t suffer from. But all was not dreamland in those ethnic villages and those tight-knit communities. It was a ‘damned if you do/damned if you don’t’ situation. Our families were always messing in our business, and that messing and invasiveness and hovering and helping us, paradoxically kept us less clinically depressed, isolated, and alone. You did something wrong as a kid, and the neighbor physically disciplined you, and your mother knew about it before you got home, and beat you again. Those very connections we might think fondly of, brought the very parochial and intolerant attitudes many of us abhor today. They never forgot that your granddaddy danced naked in 1948, and they still call you “from that strange family” because of it. It was a time when ‘reputation’ mattered, and mattered a lot. You shut the windows when you had a marital fight, so the neighbors wouldn’t hear. It will be a long, strange road back to anything resembling that parochial neighborliness in our future communities.

When our neighborhoods are defined by the five-to-ten miles around our homes, we’ll be forced to learn new skills, and being diplomatic will count a whole lot more than honesty all by itself. As therapists, we’d do well to encourage our clients to appreciate the qualities of human connections and interactions by doing thoughtful, tangible and useful things for others in our neighborhood, without an expectation of an immediate payoff. When we learn to be helpful and constructive to others, our oddness or emotional damage will become less important than the way we go about salvaging our humanity. We may well find ourselves in a time when it will be a rare person who has escaped true hardship. Right now, one of every six workers in the U.S. are unemployed or underemployed. What will our job as psychotherapists be when that number grows to one in five or even one in three?

Aethelred the Unread is annoyed by uninformed opinions about mental illness.

I’ve had enough of the kind of people who, because they’ve experienced the slightest whisper of mental distress, think that they understand exactly what’s going on in the mind of someone who’s mentally ill. I’ve had enough of these people telling me that I’m not really ill, just suffering in the way that we all do. I’ve had enough of witless commentators who say that antidepressants are ‘the latest remedy for that incurable condition called life’. I’ve had enough of the people who – commenting on Incapacity Benefit – will say that depression is nothing but a made-up condition to let the work-shy con money out of taxpayers. I’ve had enough of the self-same people who – when they find out that Gordon Brown might be taking an AD – will say that depression makes him incapable of doing his job.

Wittgenstein put it more elegantly – whereof one cannot speak, thereof one must be silent – but I’m going to be more blunt because, like I say, I’ve had enough:

* If you think you know what mental illness is, even though you’ve never suffered from it, or talked to anyone who has, or even read a book written by someone who has – then STFU;

* If you think mental illness is just another name for normal experience – then STFU;

* If you think you’ve suffered from mental illness, even though you were able to carry on with your life in the ordinary way – then STFU;

* If you think you know how to cure mental illness, even though you’ve never actually suffered from it, or been involved in treating people who have – then STFU.

Remember: everyone may be entitled to an opinion, but opinions formed in the absence of knowledge aren’t worth jack-shit.

Fighting Monsters reflects on the suicide of German footballer Robert Enke.

Stigma, shame and misunderstanding of mental illness possibly are particularly burdensome in a ‘sporting’ environment where pressure is so intense and everything revolves around supreme conditioning of mind and body.

As the Times reports, suicide is the highest cause of death for men under 45 in the UK. I wonder how much the gender perceptions that women are more likely to want to talk through things than men play in the role of treatments. Sometimes depression can be perceived as a ‘women’s disease’ and men may be more likely to downplay the symptoms in general conversation until crisis level is reached.

So the general perceptions of mental illness and attitudes and assumptions about those who may suffer is not just thinking of terms of ‘the other’ – it is more than sympathy and empathy – it is about regarding seeking help and treatment for mental health in the same way that we might be guided to for physical health – and while I accept that it more likely to happen if you work in a supportive environment and have a strong network to support through difficulties, it might be more difficult in competitive environments that exist in the professional sporting circles. That makes it more painful, I would expect. Moving towards a more open discussion about mental illness has to be done for the sake of the societies and communities that we live in and work among.

In the meantime and for what it’s worth, I definitely have some positive thoughts towards Enke and his family and the pain that they have suffered and continue to.

Not Another Nursing Student vents her opinion on the moves to make nursing an all-degree profession.

Frankly, I don’t give a damn what they make us do to be nurses. To be brutally honest, I’m hoping it will put some of the thicker applicants off doing it; you can be as caring as you want, but if you can’t scrape a third in a degree with three attempts at every essay then there’s no fucking way you should have people’s lives in your hands.

Of course, the argument is that being able to write an assignment doesn’t make you a good nurse. This is true. Assignments only show how well you can write assignments. However, if you still can’t pass one on the third attempt after receiving feedback and support from tutors – and often just being told straight up what the hell to write – then that to me shows an inability to learn from your mistakes, to listen to and act appropriately on new information, and just an incredible density that means you should not be allowed to dish out potentially lethal drugs to sick people.

Pretty Like Drugs has a similar view on the thickos in her nursing class.

My university has a pass mark of 40%.
You need to achieve two units at over 60% during the second year to qualify for the BSc Hons – we have received the marks for 2 out of the 4 units which qualify for this.
I had a butchers at my course-mates marks – it anonymous, but I wanted to see if there will be enough of us to run the BSc Hons – if there isn’t, I’ll have to defer for 6 months and join the next cohort.

So, here goes…

4 people, including myself, have achieved 2 out of 2 units at 60% or more, and will be offered the BSc. Whether they accept it will be a financial decision, as you do not get the full bursary, and more people may achieve the required marks in the next 2 units.

6 people have failed to achieve 4o% in either of the 2 units for which we have received marks. These were not “near misses” either. None of their marks were above 30.

It concerns me. A lot. Not that don’t worry about failing, about having a bad day and ballsing it all up. But I already worry that 40% is still a low pass rate. And yet people still consistently fail. Why are people allowed on the course if they are unable to make the required grade? The university is allowing, or even encouraging them to waste 3 years of their lives.

A suitably seasonal cartoon from My Medicated Cartoon Life.

Meanwhile those walking, talking prozac pills at Prozacville tackle loneliness.

Neuroskeptic has a fascinating post on psychogenic illness.

For some weeks the problems were so bad that she was almost completely disabled, and feared the damage was permanent. Vaccines had destroyed her life. You can see a video here – American TV has covered the story in a lot of detail (the fact that she is quite… photogenic can’t have put them off). Desiree and the media described her illness as dystonia, a neurological condition characterised by uncontrollable muscle contractions. Dystonia is caused by damage to certain motor pathways in the brain.

However, Desiree Jennings does not have dystonia. The symptoms look a bit like dystonia to the untrained eye, but they’re not it. This is the unanimous opinion of dystonia experts who’ve seen the footage of Jennings. A blogger discovered that it was also seemingly the view of the neurologist who originally examined her.

So what’s wrong with her? The answer, according to experts, is that her symptoms are psychogenic – “neurological” or “medical” symptoms caused by psychological factors rather than organic brain damage. It’s important to be clear on what exactly this implies. It doesn’t mean that Jennings is “making up” or “faking” the symptoms or that they’re a “hoax”. The symptoms are as “real” as any others, the only thing psychological about them is the cause. Nor are psychogenic symptoms delusions – Jennings isn’t mentally ill or “crazy”.

This week’s non-mental health Wildcard blog is Awful Library Books, who blogs about…well, awful library books. Such as this one.

Erm, chapter one: clockwise; chapter two: anticlockwise?