More Than “Three Hots and a Cot”

Three hots and a cot. A casual phrase, but one that provokes an immediate, visceral reaction for me. The first time I ever heard anyone use the phrase was when I taught freshman composition at a local community college. I had assigned my students  an article to read about prison reform or unjust sentencing, and the class was discussing the author’s ideas. One young man defended the existing state of prisons and concluded by saying something along these lines, “Look, they get three hots and a cot, TV, and a workout room. In lots of ways, life in prison is better than where those people come from.”

The River of Uncertainty

Those people. The very anonymity of the description renders imprisoned people faceless shells of who they actually are. And for the past three years, I’ve volunteered in a local prison and gotten to know a lot of “those people.” Getting to know several of the men and women who are incarcerated in our state prisons has erased any stereotypes I previously held of who they might be. And the food and living conditions in our prisons are far from being better than where anyone came from, at least in my experience.

So when I heard a new friend use the phrase “three hots and a cot” in relation to patients in a psychiatric hospital, I was shocked into silence. To be fair, this woman, a physician’s assistant, was talking about the need for in-patient psych facilities run by the state as opposed to our current situation that leaves many people wandering the streets or being imprisoned. But again, the phrase was casually tossed into the conversation where she advocated for “three hots and a cot, a safe place to regroup, counseling, and meds for two to three weeks to help people get back on their feet.”

My reaction was instinctive, but I was mute. I listened and pondered what I could say. “Better than putting those people in prison, which is what we do now,” one woman said. And while I agree that we have a need for more care for people who suffer from trauma-induced emotional distress (I refuse use the term depression because of what it connotes), I know that the solution is not as simple as providing in-patient facilities for emergency care. And I wondered if any of the women in my circle had ever been psychiatric patients themselves. Like I had been. Like my mother had been. But I was silent.

I didn’t want to get emotional–passionate, really–with my response. This is what I wanted to say:

No, we can’t just medicate people, hospitalize them for a week or so (if you are very, very lucky) and then discharge them without addressing the environment that they will be returning to.  Have any of you ever read about what psych drugs can do to people over the long-term? Do you know about the dangers and difficulties  of discontinuing psych drugsonce you start? Do you know there is no scientific proofthat a lack of serotonin or an excess of dopaminecauses depression, schizophrenia, or bipolar disorder? Do you know that sometimes taking antidepressants can actually causebipolar disorder?

And how about this admission (excerpted from “More on the Chemical Imbalance Theory”on the Mad in America website) from Dr. Ronald Pies, a highly-regarded psychiatrist?

The “little white lie” is, of course, a reference to the 2014 articleby the very eminent and influential psychiatrist Ronald Pies, MD.  In that article, Dr. Pies characterizes the chemical imbalance theory as “…this little white lie…”

Dr. Pies has also insisted – arguably delusionally – that psychiatry never promoted the chemical imbalance theory of mental illness.  In a 2011 articlehe  wrote:

“In truth, the ‘chemical imbalance’ notion was always a kind of urban legend – never a theory seriously propounded by well-informed psychiatrists.”

But Dr. Pies’ words haven’t filtered down into mainstream knowledge. Part of the reason I didn’t speak up is because I meet so much resistance when I present the information about lack of evidence for the chemical imbalance theory  and the harm that can come from psychiatric drugs. But I am convinced, based all the books and articles that I’ve read over the past five or more years. And I’m convinced by my own life-experiences and the experiences of other people that I know.

Because I know that there is a desperate need for compassionate, community-based care,  I’ll be posting a blog on what would I advocate for in the next few weeks. In the meantime, here is a poem of mine, recently published on the Mad in America website, about my experience visiting a friend in a local psychiatric hospital and recalling my own experience.

A Therapeutic Environment

I bring a small basket of flowers
for my friend in the psych unit,
the nurse buzzes me in.
She silently yanks
the plastic card-holder,
then chides me,
It has a pointy end.
My friend tells me later,
“No one gets flowers here.”

My friend wears
blue paper pajamas—the only thing that will fit over her cast—
until I bring new sweatpants
“No drawstrings,” she tells me. “The nurses will take them out.”
Other patients wander
as if in an endless maze
blankets over their heads,
eyes trained on the ground.

The nurses stare into computer screens
behind thick walls of safety glass
—barricaded against what danger?
Perhaps mindful that one day they too
might be lost
like the wandering “others”
in the blue paper pajamas.

My friend is hospitalized
because she tried
to hang herself. She had stopped eating.
Has your appetite returned? I ask.
“We had fish sticks for lunch.
They were so hard I couldn’t chew them.”

She recites the meds in her psych-cocktail—
Lexapro, Topomax, Prozac, and Zanax.
She shrugs and whispers
“I don’t feel any better,
and the weekend doctor
wants me to add Ritalin.”

We move into the dayroom
and I step across a stream of time
to the same place I left in 1997.
The same tattered furniture,
the same dull green walls,
punctuated by a lone picture hanging
crooked and uncentered.

Board games thrown on the shelves—
lids with no bottoms,
scattered pieces from the “Game of Life.”
“No one bothers
to start a puzzle—
we can’t find all the pieces,”
my friend tells me.
A bin of crayons
sits on the shelf,
but there’s no paper.

When I see the flip chart,
I flash back 18 years and remember
the goals’ group twice a day,
but still no art classes.
No dance, no movement
except the aimless wandering
of the blanket people.
No way to shape the confusion
churning inside.
No play dough.
No glue.

Two nursing assistants
fill chairs on the perimeter of the room.
They poke their heads up quickly,
like prairie dogs scanning for predators,
then return to the games
on their mobile phones.

References for further reading:

See The Hidden Epidemicby Robert Whitakerfor more information on the history of developing psychiatric drugs, long-and-short-term effects, trends in rates of mental illness and disability, and alternative treatments.

See Psychiatry Under the Influenceby Robert Whitaker & Lisa Cosgrove for an exploration of the mutually-beneficial relationship between the pharmaceutical industry and the psychiatric community, including medical schools and professional development.

See Prozac Backlashby Joseph Glenmullenfor research on the clinical trials related to antidepressants and the numerous side-effects that patients experience. The book also includes a section on alternative treatments for emotional distress (depression).

 

 

How Poetry Heals: A Personal Story

How can poetry help depression?  Aren’t medication and therapy the best ways to treat the illness? My story may surprise you.

When I suffered from depression in the early 1990s, Prozac was the new “miracle drug.” Along with this so-called “miracle drug came a physical explanation of causation: that depression is caused by a chemical imbalance in the brain. This thesis is still widely promulgated, though much research is coming to light that disputes and even negates this biomedical explanation for the darkness that is so prevalent in our modern world. More information on the research side can be found at the website Mad in America, curated by science reporter Robert Whitaker. As part of Whitaker’s work to educate the public, he invites doctors, psychologists, counselors, and patients from all over the world to share research, essays, and personal experiences on the issues of depression and its treatment.

Ancient doorway in Rome
The other door to healing

Even in the 1990s when I  struggled to climb out of depression and tried numerous medications for several years with no results, the idea that the chemicals in my brain were out of whack did not provide a solid answer. Instead, I pursued a more metaphysical explanation for the questions that haunted me:  “Why am I depressed?” and “What longings are unfulfilled?”

And that’s what led me to poetry. One of the most valuable resources I found to aid in making sense of the gifts of depression was poet David Whyte’s 1992 CD entitled The Poetry of Self Compassion. Whyte’s recitation of Mary Oliver’s poem “The Journey” confirmed my feelings of being on a perilous but necessary quest through darkness and confusion. And I was deeply confused by the all-encompassing psychological pain that I was experiencing. But once I heard Whyte recite “The Journey,” I knew that someone understood a piece of what I was experiencing. And that the way I was feeling  had nothing to do with messed up brain chemistry. My depression had everything to do with self-discovery and taking charge of my life.

The Journey

One day you finally knew
what you had to do, and began,
though the voices around you
kept shouting
their bad advice–
though the whole house
began to tremble
and you felt the old tug
at your ankles.
“Mend my life!”
each voice cried.
But you didn’t stop.
You knew what you had to do,
though the wind pried
with its stiff fingers
at the very foundations,
though their melancholy
was terrible.
It was already late
enough, and a wild night,
and the road full of fallen
branches and stones.
But little by little,
as you left their voices behind,
the stars began to burn
through the sheets of clouds,
and there was a new voice
which you slowly
recognized as your own,
that kept you company
as you strode deeper and deeper
into the world,
determined to do
the only thing you could do–
determined to save
the only life you could save.
~Mary Oliver

I remember listening to the poem over and over–as if rolling around a mysterious new food in my mouth, trying to figure out why it tasted familiar. What was it I was determined to do?  What else besides raise my children, serve my community, and be a good wife? I just knew there was more. And Mary Oliver’s words gave me the courage to make the journey that would save my life.

The answer was slow in coming, but I gradually began to  realize that my struggles with depression and a migraine headache exacerbated my ex-husband’s verbal abuse to the point where I could finally see his behavior for what it was. Depression and chronic pain became my crucible for change and my pathway to a new life. My body and my mind were finally aligned. Poetry became my way to unlock the profound secrets that illness led me to discover. Poetry helped me to have compassion for my journey and for all the mistakes I had made along the way.

Whyte ends on a note of great compassion in the poem “The Faces at Braga” as he compares surrendering to the fire of depression and embracing your flaws in this way: “If only we could give ourselves to the blows of the carver’s hands, the lines in our faces would be the trace lines of rivers feeding the sea” and we would “gather all our flaws in celebration, to merge with them perfectly…”  What a compelling call–to celebrate one’s flaws. What a gift of healing.

How Poetry Heals: A Personal Story

How can poetry help depression?  Aren’t medication and therapy the best ways to treat the illness? My story may surprise you.

When I suffered from depression in the early 1990s, Prozac was the new “miracle drug.” Along with this so-called “miracle drug came a physical explanation of causation: that depression is caused by a chemical imbalance in the brain. This thesis is still widely promulgated, though much research is coming to light that disputes and even negates this biomedical explanation for the darkness that is so prevalent in our modern world. More information on the research side can be found at the website Mad in America, curated by science reporter Robert Whitaker. As part of Whitaker’s work to educate the public, he invites doctors, psychologists, counselors, and patients from all over the world to share research, essays, and personal experiences on the issues of depression and its treatment.

Ancient doorway in Rome
The other door to healing

Even in the 1990s when I  struggled to climb out of depression and tried numerous medications for several years with no results, the idea that the chemicals in my brain were out of whack did not provide a solid answer. Instead, I pursued a more metaphysical explanation for the questions that haunted me:  “Why am I depressed?” and “What longings are unfulfilled?”

And that’s what led me to poetry. One of the most valuable resources I found to aid in making sense of the gifts of depression was poet David Whyte’s 1992 CD entitled The Poetry of Self Compassion. Whyte’s recitation of Mary Oliver’s poem “The Journey” confirmed my feelings of being on a perilous but necessary quest through darkness and confusion. And I was deeply confused by the all-encompassing psychological pain that I was experiencing. But once I heard Whyte recite “The Journey,” I knew that someone understood a piece of what I was experiencing. And that the way I was feeling  had nothing to do with messed up brain chemistry. My depression had everything to do with self-discovery and taking charge of my life.

The Journey

One day you finally knew
what you had to do, and began,
though the voices around you
kept shouting
their bad advice–
though the whole house
began to tremble
and you felt the old tug
at your ankles.
“Mend my life!”
each voice cried.
But you didn’t stop.
You knew what you had to do,
though the wind pried
with its stiff fingers
at the very foundations,
though their melancholy
was terrible.
It was already late
enough, and a wild night,
and the road full of fallen
branches and stones.
But little by little,
as you left their voices behind,
the stars began to burn
through the sheets of clouds,
and there was a new voice
which you slowly
recognized as your own,
that kept you company
as you strode deeper and deeper
into the world,
determined to do
the only thing you could do–
determined to save
the only life you could save.
~Mary Oliver

I remember listening to the poem over and over–as if rolling around a mysterious new food in my mouth, trying to figure out why it tasted familiar. What was it I was determined to do?  What else besides raise my children, serve my community, and be a good wife? I just knew there was more. And Mary Oliver’s words gave me the courage to make the journey that would save my life.

The answer was slow in coming, but I gradually began to  realize that my struggles with depression and a migraine headache exacerbated my ex-husband’s verbal abuse to the point where I could finally see his behavior for what it was. Depression and chronic pain became my crucible for change and my pathway to a new life. My body and my mind were finally aligned. Poetry became my way to unlock the profound secrets that illness led me to discover. Poetry helped me to have compassion for my journey and for all the mistakes I had made along the way.

Whyte ends on a note of great compassion in the poem “The Faces at Braga” as he compares surrendering to the fire of depression and embracing your flaws in this way: “If only we could give ourselves to the blows of the carver’s hands, the lines in our faces would be the trace lines of rivers feeding the sea” and we would “gather all our flaws in celebration, to merge with them perfectly…”  What a compelling call–to celebrate one’s flaws. What a gift of healing.

 

Harmony: A Three-Step Process

Brunswick Bay in Maine
Brunswick Bay in Maine

Have you chosen a word for the year? As I mentioned in my New Year’s blog post, my word for 2016 is harmony. So many thoughts come to mind when I say the word—thoughts usually related to music or to getting along with people in my life. But I’ve also been thinking about how I might harmonize all the elements of my life and am working on some practical steps. Here’s my initial three-step plan to work more harmony into 2016.

1.Follow a routine: I find that my days flow more smoothly when I follow some kind of a routine. But lately my routine of drinking coffee, reading the news, and then meditating is not yielding the results that I would like. I find myself endlessly looping back into websites, browsing articles in newspapers, and even checking my work email. I’m reading the news, but I’m not taking time to read the many books and articles that I routinely set aside “for later.” And I’ve been stuck here for quite awhile. I’m also not writing any new poems right now.

But when I look back on my routine from a few years ago, I see a clear path ahead. I need to tweak my routine just a bit and I think I’ll get out of this morning rut. When I was working revisions for my book, I set aside fifteen minutes a day for writing new poems. During one month I even managed to write a poem a day using my time this way. The beauty of this approach is that I usually spent more the fifteen minutes on my new poems, especially on the days when ideas were flowing. On my off days, and of course I had many of those, I wrote for fifteen minutes and then put the work aside, knowing that even if I was unhappy with the work, I could always revise the next day.

As for enjoying the books and articles I want to read, I can employ a similar approach. A few years ago I managed to read Your Brain at Work by David Rock by committing to 30 minutes a day of reading. Last summer I read Psychiatry Under the Influence by Robert Whitaker by reading for fifteen to twenty minutes every morning. So what’s my next book? I think I’m going to read Play: How It Shapes the Brain, Opens the Imagination, and Invigorates the Soul by Stuart Brown, M.D. I bought the book a few years ago and have been wanting to read it, so now is the time. I’ll let you know what I learn from Play!

Liquid gold
Liquid gold

2.Use a timer to stay focused: When I was growing up, my mother used a timer for everything, and it drove me crazy! I hated hearing that white plastic demon ticking away for how long the dryer needed to run or how long the potatoes needed to bake. I wanted to be a free spirit and not be ruled by some demonic device.

Fast forward to my adult life with many obligations and hobbies. The proverbial so many things, so little time. Now I use a timer, especially for anything that I don’t want to do—clean the house, grade papers, pay bills. I have found the timer incredibly useful in keeping me focused on the task at hand. Sometimes I even manage to finish ahead of time—an added bonus! I find I can usually do a weekly cleaning in about an hour if I stay on track and can pay the bills in about the same amount of time. I use the time on my cell phone which has a nice Zen chime as my timer-tone. What kinds of things can you see doing with the aid of a timer? Decluttering a drawer? Weeding the garden?

3.Write down your goals and ta-das! I like the idea of keeping a success journal with my goals and my record of successes—small and large. I am a regular journal writer, so every day I usually write some kind of goals for the day as well as celebrate my successes, which a former teacher of mine referred to as “ta-das.”

In the spirit of positive thinking, I write my goals as affirmations, which many people say is a better way to communicate with your subconscious. So instead of saying, “I will read for 15 minutes a day,” I leave out the “will” and write the affirmation. There is something about committing those words to paper that seems to make the tasks more manageable, and I find that as I go through the day, I can refer back to those affirmations to keep myself on track.

So what are some things that evoke harmony for you? I’d love to hear your ideas. And if you choose to try my three-step process, let me know of your ta-das!

Freedom to Question Authority

When I was a little girl, I asked lots of questions. My grandmother, who seemed too busy to bother with explanations, always answered, “Curiosity killed the cat, Ann.”

That response, which I heard over and over, probably kept me from questioning any further when I asked my first grade teacher to explain adultery to me as part of learning the Ten Commandments. Here’s a link so that you can listen to my “Adultery” poem and find out what happened and why I believe it’s vital for all of us to question authority.

One aspect of questioning authority has particular significance for me: questioning the need to take medication for depression and other mental health issues. The doctors I worked with all told me the same thing regarding medication and depression—it seemed to be the answer that science had found to ease the suffering of countless people.

“Depression is a chemical imbalance in the brain. You need to take medication to correct the imbalance, and you may need to take drugs for the rest of your life.”

When I questioned my doctors and expressed my reluctance to take any drug for the rest of my life, especially one that altered my brain chemistry, they spoke to me in a patronizing tone. “Depression is just like diabetes. You wouldn’t argue about taking insulin for the rest of your life, would you?”

That kind of response from a trusted authority figure will shut down questions every time. It did for me—but only when I was face to face with my doctors, and only because I had struggled for years to find a way out of a very deep depression. But the idea that chemicals could just go off in my brain for no apparent reason never satisfied my curiosity. I found more answers about reasons for my depression by working with a poetry therapist, journaling, reading poetry, and exploring the relationships in my life than I found in all the pat answers from my doctors.

But when I read Prozac Backlash by Dr. Joseph Glenmullen, a professor of psychiatry at Harvard Medical School, I found hard evidence to substantiate my fears of long-term medication. Dr. Glenmullen spends considerable time exploring the clinical trials of Prozac and other SSRIs that were conducted by the drug companies and he exposes many seriously questionable practices used to justify bringing the drugs to market. In addition, Dr. Glenmullen uses stories from his own research and his patients’ experiences to explore the very harmful side effects that can result from taking antidepressants:

“include[ing] neurological disorders, such as disfiguring facial and whole-body tics that can indicate brain damage; sexual dysfunction in up to 60 percent of users; debilitating withdrawal symptoms, including visual hallucinations, electric shock-like sensations in the brain, dizziness, nausea, and anxiety; and a decrease of antidepressant effectiveness in about 35 percent of long-term users.”

When I read this book in 2002, I had been depression-free for five years, but my psychiatrist insisted that I continue on a lifelong course of numerous psychiatric drugs: Wellbutrin, Elavil, Topomax, and Valium If you take a look at the side-effect profiles of these drugs, you’ll see that I was exposing myself to a lot of potential harm, especially if I were to continue on the drugs for life.

I worked with a social worked for over a year, exploring the reasons for my depression as well as looking at the other reasons for my continued healthy state. After more reading and many months of discussing the ideas with my therapist, I decided to stop all medication.

My psychiatrist warned me that because I had suffered from repeated bouts of depression, my brain was damaged and I could easily slip into depression. He cautioned that my next depression was likely to be much worse than the last. I’m happy to report that he was wrong. With using a combination of journaling, meditation, Heartmath (a combination of cognitive therapy and meditation), and poetry, I have remained medication and depression free for the past 13 years.

More recently, I’ve read two books by Robert Whitaker that take an exhaustive look at the studies behind psychiatric medications—including SSRIs, anti-anxiety drugs, ADHD medications, and antipsychotics—and my decision to discontinue my medications has been confirmed by the wealth of studies and analysis that Whitaker and co-author Lisa Cosgrove provide. Take a look at Anatomy of an Epidemic and Psychiarty Under the Influence for more information. Here are just a two pieces of information that I found especially compelling:

  • “Long-term antidepressant use may be depressogenic[cause depression]. It is possible that antidepressants modify the hardwiring of neuronal synapses [which] not only render antidepressants ineffective but also induce a resident, refractory, or depressive state.” R. El-Mallakh, 1999, Journal of Clinical Psychiatry (Anatomy of an Epidemic)
  • “Of the 1,1518 patients who had entered the follow-up study [of the effectiveness of Celexa vs Cognitive Behavioral Therapy or placebo], only 108 had stayed well throughout the 12 months. All of the others had either dropped out or relapsed back into moderate depression (or worse). Given that 4041 patients had entered the study, this represented a documented stay-well rate of 2.7 percent at the end of one year.” Ed Pigott, psychologist (Psychiatry Under the Influence)

I’m glad I’ve read books that challenged the prevailing wisdom of the day. I’m glad I explored my options and made decisions for myself. Most of all, I’m glad I questioned authority.

For more information on this topic, here is a good resource: CCHR International, The Mental Health Watchdog