Transcript Towards a Genuine Needs-Based System

DSM Diagnoses
Schizophrenia (with a number of subtypes)
Schizoaffective disorder
Bipolar disorder (with subtypes)
Mood disorders with psychotic features
Delusional Disorders
Psychotic Experiences and Behaviors
Delusions
Hallucinations
Mania (or other apparently “bizarre” affect)
Delusions of Grandeur
Paranoia
Catatonia (bizarre movement or lack of movement)
A disease of the brain likely to be caused by a . . .
• Genetic disorder
• Biochemical Imbalance
• Faulty brain structure
• Virus
 Encourage a lifelong regimen of antipsychotic
drug use, resorting to coercion if necessary
 Encourage “insight” that they have
a “mental illness” (i.e., lifelong
brain disease)
 Encourage the person to let
go of serious aspirations
and generally “lay low”
Unfortunately, no. This is a
lifelong degenerative brain
disease.
But if one diligently remains
on their meds, they can
manage their symptoms and
reduce the risk of full relapse.
• WHO study covering 13 countries
• Using their strictest criteria for recovery
Global DAS (Excellent/Good)
57%
28%
"Developed" Countries
"Developing" Countries
• WHO study covering 11 countries
• U.S. and N.Z have the 2 highest rates and are the only Western
nations allowing direct-to-consumer drug advertising
4.4%
3.9%
.1%
.3%
United States
New Zealand
India
Bulgaria
Graph as printed in “Anatomy of an Epidemic” by Robert Whitaker
• *Rates of disability due to mental health conditions have
increased radically, in direct correlation with the increase in
psychiatric drug treatment (*For adults age 18-64)
1 in 168
(23,142)
New Zealand
(2000)
1 in 137
Australia
(2001)
1 in 90
(48,899)
New Zealand
(2010)
1 in 98
Australia
(2010)
Organismic Wisdom: All living organisms have
the innate desire and capacity to survive and
thrive
Organismic Process:
Needs
Assessment
Response /
Action
in an attempt to
meet one’s needs
Emotion /
Motivation
To meet one’s needs

Resources are simply unavailable

Resources are simply unavailable

Resources available but unable to be utilized

Lack of self connection (to one’s needs)

Limiting beliefs preventing nourishment
(i.e., Nourishment Barriers)
Misinformation
(fixation on “disease” rather than needs)
Needs
Assessment
Response /
Action
in an attempt to
meet one’s needs
Emotion /
Motivation
To meet one’s needs
Suppression of Emotion / Motivation
Needs
Assessment
Response /
Action
in an attempt to
meet one’s needs
Emotion /
Motivation
To meet one’s needs
“Killing the Messenger”
(fixation on suppressing experience rather than
listening to its message and targeting the needs)
Needs
Assessment
Response /
Action
in an attempt to
meet one’s needs
Emotion /
Motivation
To meet one’s needs
Support person in identifying the unmet need(s)
Needs
Assessment
Response /
Action
in an attempt to
meet one’s needs
Emotion /
Motivation
To meet one’s needs
Foster healthy relationship with one’s inner
world experiences and emotions
Needs
Assessment
Response /
Action
in an attempt to
meet one’s needs
Emotion /
Motivation
To meet one’s needs
Support person in developing effective,
sustainable strategies for meeting their needs
Needs
Assessment
Response /
Action
in an attempt to
meet one’s needs
Emotion /
Motivation
To meet one’s needs
Unresolved
Peace/Existence Dialectic
Unresolved
Peace/Existence Dialectic
Unable to maintain the experience
of a secure and stable sense of self
living in relatively secure and
predictable world.
“I don’t have a right to exist”
“The world is not safe enough”
“I don’t know who I am and what my needs and
values are”
“There is something fundamentally wrong with me”
Unresolved
Autonomy/Connection Dialectic
Unresolved
Autonomy/Connection Dialectic
Unable to feel secure with both
one’s autonomy and one’s
belonging & connection with
others.
“I don’t belong here”
“I am ashamed of who I am”
“Others don’t love and accept me for who I am”
“My needs are not as important as those of others”
“I don’t matter”
Resolved
Peace/Existence Dialectic
To arrive at the experience of
myself as a relatively secure and
stable self living in a relatively
secure and predictable world…
“I have a right to exist”
“The world is safe enough”
“I know who I am and what my needs and values are”
“I am intrinsically a whole person”
Resolved
Autonomy/Connection Dialectic
To arrive at a way of being in
which I am loved and accepted
for who I am:
“I belong here”
“I love and accept myself for who I am”
“I am loved and accepted by others for who I am”
“My needs are just as important as those of others”
“I matter!”
Recovery Factors
Factors
supporting
recovery
Factor
hindering
recovery
Finding hope
Connecting with one’s aliveness
Finding meaning in life
Arriving at a more hopeful
understanding of their psychosis
Developing healthy relationships;
Healing or distancing from unhealthy
relationships
Harm from the psychiatric system
hindering recovery
Redefine Our Priorities
Prioritise Health
over Profit:
Remove corporate and
private interests from
health care system—a
true common-owned
nonprofit health care
system.
From the Mind/Brain Debate
to a Holistic Systems Perspective

An organism consists of many systems working
synergistically:




Social
Physiological
Psychological


Spiritual
Ecological
Overwhelming distress on any one system can
affect the whole, leading to various psychological
disturbances and potentially even psychosis…
Prevention & Maintenance
Ensure that everyone’s basic needs are met:






Healthy food
Clean water
Adequate shelter
Education (without industry sponsorship)
Meaningful work/activity
General health and relationship support
Empathy-based Crisis Support






Noncoercive
Holistic needs-based
Honoring expertise via “lived experience”
Individual and relationship-based support
Empathy-based noncoercive residential facilities
Freely available in every community
Drugs take the back seat…
A healthier use of drugs:

Accurate information about the short and longterm harms and benefits
Only as a last resort & for minimum duration

Never without consent

Support with tapering

A Continuum of Care
Ordinary Human Distress
Ordinary
Psychosocial
Support
Full Psychotic Process
Intensive Outpatient Support
• Peer support
• Traditional therapy
(individual, family, group)
• Making peace with the
experiences
(CBT, ACT, Traumafocused, Somatic/
Mindfulness)
Intensive
Residential or
Family support
• Soteria homes
• Peer Respite
• Open
Dialogue
• etc.
Full Dissertation:
gradworks.umi.com/34/54/3454336.html
Website:
RethinkingMadness.com