Crooked Beauty

I purchased and watched Crooked Beauty yesterday.  It is a film by and about the Icarus Project.  Icarus Project began as a vision by two wonderful souls Jacks Ashley MacNamara and Sascha Altman DuBrul.  According to the website (which started it all) they say,"We are a network of people living with and/or affected by experiences that are commonly diagnosed and labeled as psychiatric conditions. We believe these experiences are mad gifts needing cultivation and care, rather than diseases or disorders. By joining together as individuals and as a community, the intertwined threads of madness, creativity, and collaboration can inspire hope and transformation in an oppressive and damaged world. Participation in The Icarus Project helps us overcome alienation and tap into the true potential that lies between brilliance and madness."  The movie Crooked Beauty is a soft, sad, honest look at mental illness and it shows a new way to look at all things mental.  I am amazed at the artwork and music of this film.  If you have the time to view this please do.

Two scary types

     There are two people that I'd like to mention: Psychiatrists and Gun Shop Sales Associates.  Both seem to operate in the same way and for many of the same purposes.  In my years of working with Psychiatrists I have found these people, by and large, to be psychotic.  Some more than others and there have been a few who were nice and quite stable.  The majority have been rude, power-tripping, unethical and scary.  In what ways?  Well, I have had some physically abuse a person in front of me, yell at people in my presence, prescribe mind numbing medications to people who do not need or want it, send people into the hospital for no reason and prescribe medication and diagnose people incorrectly for no other reason than they have been visited by the pharmaceutical representative minutes earlier.   Scary indeed.  You can see how these people put a therapist in an awkward situation.  What can you do?  It is a choice between tolerating abuse and splitting with your "team", the field, and the professional alliance, which in turn confuses and scares your "client."  It is a dilemma and I have had situations get real ugly.
     Gun shop dudes.  What can I say?  You walk into a shop with questions typically.  Not everyone who likes firearms owns every single one or has read enough Guns and Ammo back issues to know all the ins and outs of all guns.  But boy, look out if you don't act like you know it all.  You see, you are shopping, purchasing from someone who is selling, but in their world you are taking a test.  A big SAT, LSAT, Navy Seals, test is what you are taking in their mind.  Then you get the tough guy treatment also.  I have yet to meet one of these great patriots who can just tell you the facts and act like they are there to help you.  Most are experts and the research shows that playing it off as "the expert" only builds resistance to change, resistance in general.
   Where do they come together?  Perhaps it is the clientele.  I'd imagine rich Psychiatrists are rather classist and don't really like poorer people getting anything seemingly free.  Also, they have to deal with these parasites called HMOs (more on this later).  Last but not least, they have to deal with being sued, and they are sued often.  Kid gets a rash, lawyer is the one reporting it.  Person commits suicide, lawyer is telling them the news.  It is obscene the amount of sewage that flows in this profession.  That must get tiresome and thus, this is their rationale for the abuse.  It is sad.  Gun dudes have to deal with real jerks quite often.  I have personally seen people sweep the guy behind the counter with a loaded rifle, not a good practice, that could get annoying fast.  I have seen Rambo-types come in to the shops acting like fools and play shooting their friends across the store with unloaded weapons, all the same, annoying.  I have seen many rude macho-people, male and female, insult, aggravate and take advantage of the person's space in gun shops frequently.  Both professions are stuck either behind a counter or in a small office most of the day and typically the same space every day of work, that gets tiresome.  Both Psychiatrists and  Gun Store Sales Reps. are selling a product of about the same utility.  For some they take it as life and death, a necessity.  My only question is how did people survive prior to both becoming so frustrating of a profession? 

A few words about Therapists.

     Finding a good therapist is much like finding a good mechanic.  You can go to Pep Boys or you can go to the trusted person that friends and family recommend.  There is a wide gap in the quality of services you will end up with.  My humble advice is to always trust your intuition.  If something does not feel right when you see a therapist, remember, they are just people, human beings.  If it feels uncomfortable then it is only going to get worse.  Then again don't judge a book by it's cover.  I have known the supposed "best and brightest" with every configuration of letters after their name imaginable, who are just awful, inexperienced, and socially awkward people.  I have also met and worked with people who wear flannel shirts to work and harvest honey for fun who are the most effective and talented therapists going.  It is a personal preference, but all in all, you can tell the hacks from the pros if you know what to look for.
     This raises a good issue though who are the pros?  A wonderful study has been done, on therapists, asking them to rate themselves A - F, just like in school.  The results were that 90% considered themselves in the top 25%, 2/3 considered themselves an A or better, 66% considered themselves "above average" and 0 considered themselves "below average."  This should tell you something.  The moral of the story is that often, very often, what the therapist is thinking of their effectiveness is not accurate. Bell Curve anyone? It is the power of denial.  Also, without getting your feedback in some way, shape or form, they have no clue what the truth is about how therapy is going.
   Another interesting thing to consider is the results of another mega-study called Project Match.  I'll spare the boring details, but one finding (in a nutshell) is that when looking at therapy outcomes, how well it works, the study showed that no single treatment modality (style/approach) CBT, DBT, Psychoanalysis, talk therapies of all sorts, do not influence the outcome any more than the next.  So Dr. Whoseewhatsit from Green Budz Healthcare Inc. with all his/her ideas about what to do to you is irrelevant in this regard.  What matters is two things.  With youngsters, if the parent or family member (support) is involved in the therapy process - better outcomes.  Overall, the most important factor is rapport.  How well do you click with your therapist?  That is the #1 indicator of positive therapy outcomes, better situations, problems managed, goodness.
   It doesn't matter how "professional" your therapist is also.  A PhD. versus a case manager.  No difference in outcomes.  People think that a therapist must be like Gabriel Byrne of "In Treatment" to be effective.  Not true.  The lowliest case manager at the shittiest agency in the worst part of the worst city could have a stronger rapport with the person they are working with and the outcomes vary on that one factor.  So don't go see some tightwad who looks and acts like a Wall St. banker just because of the mystique and fantasy that he/she is good because she seems professional.  Go to someone who knows their shit! And who can best relate to your life and understand your experience.
   Beware of "suggestions" which are sometimes coercions.  I have worked amongst some people, therapists, who are all about confrontation.  They seem to be angry at human beings in general, especially those who use substances of one sort or another, and they can get real abusive towards people.  Avoid that.  If it seems bad, it is, get out.  You can always, always, always request a therapist change or just leave and get another one.  Therapy should never be forced.  It never works that way.  Medication is another "suggested" thing.  Many therapists have ulterior motives for making referrals for medications.  They are paid by pharmaceutical companies, some have private practice agreements with Psychiatrists, some just think medication is the wonder candy.  They jack so many people up on these medications that all you need to do as a therapist is dust off the person's leaves and water them once a month and you get paid, because you have numbed that person out.  How lovely? 
   Last, this has been quite deficit based of a blog post.  I write this just as a warning of things that "they" might not tell you, whoever "they" are.  Overall, most, the majority of therapists are very capable people, do get good results, do collaborate with you in your care, do go the extra mile, and are looking out for your best interests.  I personally have learned so much from my colleagues about health, life, happiness and how to achieve whatever it is in life that you so desire.  Good mental health is arguably one of the most important things in life and these fine people can help achieve that by establishing a good collaboration with you.

Take care,

~ Schneidlomat

I'm Back

After 6 years I decided to start blogging again.  Why?  Well, I have changed considerably not only in appearance (older) also in opinion.  Re-reading this blog brought some inner laughter at the level of, well, Communist I was at one time!  I have changed my opinions in that regard considerably.  My hope for the "new" blog is to be as helpful to my fellow life-travelers as possible, particularly when addressing so-called "mental illness."  I would be real happy to have you enjoy the posts that will be coming up soon.  

Take care,

~ Schneidlomat

What is Anti-oppressive Social Work?

(reprinted from AOSW website)

Within Canadian social work, the term “anti-oppressive practice” is generally understood as an umbrella term that encompasses a variety of practice approaches including, but not limited to, radical, structural, feminist, anti-racist, critical, and liberatory frameworks (Bailey & Brake, 1975; Dominelli, 1988; Dominelli & McLeod, 1989; Fook,2002; Leonard, 2001; Moreau, 1993; Roche, Dewees, Trailweaver, Alexander, Cuddy & Handy, 1999). Therefore, rather than being seen as one “practice approach”, anti-oppressive social work can be more accurately understood as a stance or perspective toward practice. The term ‘anti-oppressive social work’ represents the current nomenclature for a range of theories and practices that embrace a social justice perspective.

For Dominelli (1998) anti-oppressive social work is a form of social work practice which addresses social divisions and structural inequalities in the work that is done with ‘clients’ (users) or workers. Anti-oppressive practice aims to provide more appropriate and sensitive services by responding to people’s needs regardless of their social status. Anti-oppressive practice embodies a person-centered philosophy, an egalitarian value system concerned with reducing the deleterious effects of structural inequalities upon people’s lives; a methodology focusing on both process and outcome; and a way of structuring relationships between individuals that aims to empower users by reducing the negative effects of hierarchy in their immediate interaction and the work they do together. (p.24)

Carniol (2000) also articulates a key element of anti-oppressive practice, the linking of personal matters and public issues:
For social workers who engage in anti-oppression practice, there is a strong connection between, on the one hand, providing individual assistance to people belonging to disempowered groups, and, on the other hand, working with social movements connected to these disempowered groups. By linking these two ways of working, social service providers are challenging social services from the ground up. We are reframing ‘private’ problems as public issues. (p. 115)
Thompson (1993) contends that anti-discriminatory practice is good practice and defines it as
An approach to social work practice which seeks to reduce, undermine or eliminate discrimination and oppression, specifically in terms of challenging sexism, racism, ageism, and disablism... and other forms of discrimination encountered in social work. Social workers occupy positions of power and influence, and so there is considerable scope for discrimination and oppression, whether this is intentional of by default. Anti-discriminatory practice is an attempt to eradicate discrimination from our own practice and challenge it in the practice of others and institutional strictures in which we operate.

Dalrymple and Burke (1995) describe a framework based on:

personal self knowledge
knowledge and an understanding of the majority social systems;
knowledge and understanding of different groups and cultures;
knowledge fo how do challenge and confront issues on a personal and structural level;
awareness of the need to be ‘research minded’ (Everitt et. al., 1992)
commitment to action and change. (p. 18)
and contend that
These six points, together with an understanding of power and oppression, contribute to the development of anti-oppressive practice. The framework enables links to be made between individual action and social structures. It informs practice by enabling the worker to evaluate differences that exist at an individual level and within society and how these impact on each other. It provides the means of making accurate assessments by taking account the inequalities that texture the lives of those denied access to society’s resources because of their defined social status and the exclusionary practices of the dominant system. It demands that we constantly engage in the process of critical self examination, which in turn enable us to engage in the process of change. (p. 18)

The Context of Radical Practice

(reprinted from A Paradigm for Radical Practice by Peter Leonard)

1. Contradiction - In capitalist society, social work operates as part of a social-welfare system which is located at the centre of the contradictions arising from the dehumanizing consequences of capitalist economic production. Social workers, although situated ina largely oppressive organizational and professional context, have the potential for recognizing these contradictions and, though working at the point of interation between peopleand thier social environment, of helping to increase the control by people over economic and political structures.

2. Dialectic of people and systems - The relationship between people and the various systems which compromise thier social environment is a dialectical one. "It is as transforming and creative beings that men, in their permanent relations with realityproduce not only material goods - tangible objects - but also social institutions, ideas and concepts. Through thier continuing praxis, ment simultaneously create history and become historical-social beings" (Friere, 1972.) Although it is true to say that men both create and are created by thier social world, the concept of social work provides an opportunity for enhancing the creative, determining, potential of people.

3. Systems: oppressive and supportive - The social environment with which people interact and which is the focus of social-work intervention, can be seen as consisiting of a number of systems whichare the source of both oppression and support. In capitalist society these systems - the family, the neighborhood, the trade union, the school, the factory, the hospital, the social-welfare agency and others - all carry to a greater or lesser degree the marks of economic exploitation and the cultural hegemony of the ruling class. The oppression of women in the family, the fatalism of people in a neighborhood when faced with planned cultural elimination, the socialization of children in school to the demands of the labor market, the alienation of factory workers, the elitism and exclusiveness of trade unions, and the bureaucratic, controlling and dehumanizing features of hospitals and social-welfare organizations, are all examples of this oppression. Social work has the potential of enhancing the supportive features of some of the systems in the interests of people.

4. Individual consciousness - The understanding of the interation between people and systems in the social environment musct include a recognition of the individual's own consciousness, of what social institutions mean to them, and of thier pain and suffering, hape and despair. In social work an understanding of the effects of past and current experiences on the consciousness, intentions and behavior of individuals is crucial. Appreciation of these effects on the social worker themselves, as well as on other people, is of vital importance to the development of radical practice. "Discovering himself to be an oppressor may cause considerable anguish, but it does necessarily lead to socildarity with the oppressed. Rationalizing his guilt through paternalistic treatment of the oppressed, all the while holding them fast in a position of dependence, will not do. Solidarity requires that one enter into the situation of those with shome one is identifying:it is a radical posture" (Friere, 1972b, 26.)

Direct Practice - Direct Action

On the level of direct practice in the clinical setting the radical perspective is also applicable. One former professor and social worker Jeffry Galper, who wrote probably the most comprehensive book on radical social work titled Social Work Practice: A Radical Perspective, states “Workers may also find a variety of ways to encourage people to engage in collective political activity through existing political organizations.” Many such organizations exist, for instance, DARE (Direct Action for Rights and Equality) whose mission statement says “DARE's mission is to organize low income families in communities of color to win economic, social and political justice. A key to DARE's success is the understanding these campaigns built of the ways racism and sexism are a fundamental part of oppression in low income communities.” (DARE website, 2005). Much like the Black Panthers in the 1970’s, DARE has set up grassroots organizing campaigns, public day care facilities, youth programs, environmental empowerment projects and police accountability actions. The work of this organization is often seen by those in social work as being a fringe element and often not embraced as a viable referral in regard to solutions for inequality and oppression problems that clients indeed face on a daily basis. I believe the reason is another failure to adhere to the NASW Code of Ethics in good faith, i.e. that “Social workers continually strive to increase their professional knowledge and skills and to apply them in practice. Social workers should aspire to contribute to the knowledge base of the profession.” (NASW Code of Ethics). This does not mean exclusivity to CEU seeking cruises or seminars that are primarily skills based (not knowledge based) that the typical concept of fulfilling this obligation entails. Rather, the outreach to such organizations seems reasonable, consistent if viewed through a radical perspective, to be the appropriate action for a social worker to approach with many clients. It is part of the aforementioned spiritual transformation that must occur, which in my opinion, entails changing one’s reality in a way that sees social justice clearly, honestly, practically and seriously. This includes policy, clinical, management and even research interpretations.