These are questions that came up from one of our most thorough critics. We thought we’d reproduce them as a blog for anyone who has questions about our approach.
1. Our system is broken and people are dying: and veterans are dying: I know this too. This is why I feel like we need a whole new system, not just fixing the old system. But getting a very clear handle on what is broken and what works is useful. Also, I don’t think I’m leaving people in the lurch by building an alternative, because I’m not tearing down or working against the existing system in any way.
2. Who in the recovery movement cares about those of us who get sick? Hopefully an accessible peer support system will help our people too. But at some point if sometimes wants to isolate and not change their life, there is nothing outsiders can do short of force. Some people have told in their recovery stories how this “cocoon” or examination time has been important to the overall process. Other times I think this isolation is just a passive suicide attempt, and maybe force would be justified. We did a blog post about forced medication and forced treatment options concluding that rarely, if ever, is it the best option.
3. Who said everyone can recover – The Courtenay Harding articles are one of the best sources for this information. They say that up to 60% of people recovered from schizophrenia. These are people who came off the back wards of mental hospitals in Vermont got back the majority of their lives and needed no further treatment.
4. Open Dialogue is not a great model for the US. True, the Open Dialogue is labor intensive, slow, and requires skill but many peer supporters in the US already do this. Yes, I think everyone who does peer support does this kind of process. This is why I think that we need to provide an income source so that psychiatric survivors and community allies can help other people with this process. I think American culture is changing and using online forums can allow this to spread nationwide. Also, it’s the only model with good solid outcomes data.
5. All unusual thoughts are brain related and the brain is a starting point. Yes, I agree that the brain is run by chemicals and electrical signals. I did a blog on how emotional distress causes psychosis. Of course it’s brain related. But the real question is, do people with mental health labels who are not symptomatic have any different kind of brain structure, or chemistry than people who are not given those labels. No one has found this to be true.
Certain inputs can cause certain responses for anyone. Who gets ulcers vs. psychosis vs. arthritis in response to stress depends on their culture, their personality, the family patterns they’ve observed, etc. But it’s not a disease, and once better responses to stress like wellness techniques have been developed, then the maladaptive response doesn’t need to happen any more.
6. Saying distress is temporary is not more accurate than saying it’s permanent – Probably true. But to some extent if we choose to make the maladaptive mood, psychosis, fear, sadness etc. response to stress go away, we can. I’ll have to think on this.
7. Categories are not helpful – I think it’s important to have a name for the disease model and thus the opposite model. Maybe you are right that it’s not useful to put people in one camp or another. When I say someone is a “disease model advocate,” maybe this is an alienating term, but it also helps to identify a basic philosophy that I don’t share.