sociatry91007
Adam Blatner
adam at blatner.com
Sun Sep 9 15:25:35 CDT 2007
Dear Patricia and all, that's a good example!
Alas, I fear this psychiatrist is NOT that much of an exception. I think there are many more holistic and thorough psychiatrists---I know this--- but as to what percentage this "many" may represent, I can't say. I also am aware that there are far too many who are quick on the draw for the prescription pad, and worse, I fear they may not have had sufficient training in careful and thorough diagnosis.
In the case you represent, I would double check a variety of themes, ranging from two minutes between classes, really? to what the sister/friend did for this lad. Mainly, I look at other ego strengths, what is required for the Bar Mitzvah (sometimes rabbis may ask for more than a boy can accomplish), levels of ability in different ways, issues of emerging sexuality, teasing, any deviations from the peer-group-norm, and on and on.
So, thanks. Warmly, Adam
----- Original Message -----
From: PATRICIA DESERT
To: GrouptalkNewAddress
Sent: Sunday, September 09, 2007 2:37 PM
Subject: Re: sociatry91007
One most recent specific. A former client of mine called me for some advice about his 12 yr old son who recently began having close to panic attacks when anticipating attending school. He needs his dad to accompany him at this point and his dad does.
This boy has a bar mitzvah coming up next month, his dear friend who is also his sister just left for Israel, the school he's in just began a new policy of bell ringing to signal end of class and the new 2-minutes requirement required to get to next class, and some other stressors that I can't remember right this minute. The psychiatrist who spoke to the father on the phone about this boy immediately wanted to put him on medication.
I like to think this psychiatrist is the exception. P.
----- Original Message -----
From: HV Psychodrama
To: Adam Blatner
Cc: list at grouptalkweb.org
Sent: Sunday, September 09, 2007 12:39 PM
Subject: Re: sociatry91007
dear Adam/ You want specifics and I do not have the energy to write
them....you are welcome to call me and we can have a conversation...but I
suspect that anyone working in the trenches these days, as you once referred
to my work, could come up with many examples of kids being diagnosed with
all sorts of disorders rather than look at the problems as being indicative
of the disorders of society.Or take the PhD psychologist who had his
daughter put on Ritalin because she was daydreamy and not getting straight
As in school. She was 7.
The director of a local child day treatment said to me that when children
get diagnoses bipolar, often the parental reaction is that because the
disease is biological there is nothing they, the parents, need to do, it is
the child's problem, no need for the family to be in treatment, etc.
----- Original Message -----
From: "Adam Blatner" <adam at blatner.com>
To: "HV Psychodrama" <hvpi at hvc.rr.com>
Cc: <list at grouptalkweb.org>
Sent: Sunday, September 09, 2007 1:17 PM
Subject: sociatry91007
> Dear Rebecca and all, reviewing your response, feeling much in resonance!
> 1. "The Politics of Therapy" and "Radical Therapy" -- Much of this was
> before the many writings on oppression were publicized.
> However, I find very few examples of people subjected to involuntary
> treatment today--- especially inappropriately. Yet there are occasional
> cases and it makes one think. I'm interested especially in what you all
> observe---specific issues in our practices. There was also a
> romanticization of schizophrenia as not being abnormal, out of control,
> but more a response to crazy family and society. I think this has been
> largely deconstructed. Admittedly, communications mixed messages (e.g.,
> the classical "double bind") and other family stress can make any mental
> illness worse, but that's far from being a cause.
>
> 2. Just read in the New Yorker a story of a bright music critic who was
> relieved to recognize that the diagnosis of Asperger's Syndrome made sense
> of much that was bewildering in his life, and it also helped his caring
> family. Yet he also notes that such folks have a website for being
> considered just different, and many would not give up their condition even
> if it could be "cured"---and there is (by the way) not the slightest hint
> of a cure known or offered.
>
> 3. "Revolution not Adjustment." On the dramatherapy listserve a
> re-discussion of the shifts in Gay, Lesbian, now linked to Trans-gendered,
> bisexual, and questioning in their advocacy identity... and a case of the
> proper way to address a 5 year old child who is very possibly a little boy
> fascinated with and half into being a little girl... I noted we have not
> only the social definition problems, but also the question of the "rights
> of parents"-- and how far those should be recognized.
>
> 4. Rebecca says, "we are still labeling and treating people for
> disorders that arise from asking them to adapt and adjust to unfair
> situations that need to be changed.
> AB: I am becoming concerned for personal responsibility being an
> issue here. Most people don't get mentally ill or become criminal from
> hard situations. I'm all for social action, and all for trying to remedy
> such situations, but there are also some folks who would excuse
> maladaptive behavior, or try to treat it by offering excuses to the
> addicted, the antisocial... what about that?
>
> 5. It would be helpful to offer three or four examples of people who are
> being medicated inappropriately. Also, there's a related problem of
> psychological "fascism." ... It is still much easier to give a person a
> pill then to help them look at how to make social changes.
> ab Help them look at... is the key phrase. I've found that a great
> many people, perhaps the majority, passionately resist consciousness,
> reflectiveness, thinking about thinking. This is so guilt-producing, and
> for many, so demanding, that it would be like strapping them down and
> pouring acid down their throats. No way do they want to look at anything
> about the situation, much less the seemingly overwhelming "how to make
> social changes." Hey, I find it hard to get healthy, thoughtful people to
> think such thoughts! Especially the how, the specifics.
>
> 6. RW It is much easier to look at an individual's emotional/psychiatric
> problem as being rooted in biology or poor upbringing then it is to look
> at it being rooted in societal ills.
> AB what if it's 50-50? What if the causation is mixed, rather than
> either-or. And rooted in .. okay, then what. How to effectively diagnose a
> societal ill that can and should be addressed? What can we say that hasn't
> already been said many times?
> (Are our readers aware of the movement to promote social and
> emotional learning in the classroom? How many are active in becoming
> informed about their own local school curriculum, the various school board
> advocates for each position, the politics in promoting people whose
> position fits our own, the activity of supplying these politicians with
> professional information that would support their position, and a score of
> other political adjunctive tasks. A major problem with politics is that it
> requires a major investment in time and energy.)
>
> 7. RW It asks less of us middle class practitioners, makes us less
> uncomfortable...it demands nothing other than we give some one an hour of
> paid time and/or a prescription.
> AB Also, that's all many patients want, all they can afford to
> pay for under the present health care system. Otherwise, we'd have to
> spend a great deal of free time doing social work unpaid ...
> And even if they can pay, they don't want more, so there's the
> mixed challenge of "educating" them and "overcoming their resistances" and
> wondering if that's ethical... etc.
> Sure, there are a few patients who appreciate a more holistic
> approach... but let's all remember the others, too..
>
> 8. RW It is also much easier to think of a person's problems as theirs,
> rather than the communities' ...that is one of the wonderful things about
> psychodrama in that it looks outside the individual. But interest in group
> therapy and family therapy is on the wane and individual therapy is now
> mostly solution focused short term work geared to helping the individual
> solve the personal problem du jour.
> ab: good point about fashions in therapy also adapt to
> socio-economic stresses. With the squeeze of the middle class and a major
> 4-fold escalation of fees charged by most professionals in last 30 years,
> "therapy" no longer is a benign procedure. Legal fines for misdemeanors
> are less than the cost of brief therapy!
>
> 9. Although I do think the discovery of the SRI medications has been a
> real and true godsend for many, many people, I can attest (through my work
> in the hospital) how they are being used/misused to treat depressions
> caused by situations that you or I or most adults would not put up with,
> in fact we would run from as fast as we could . So we use meds to help
> young people tolerate living in such situations.
> AB: The question is whether such situations are even being
> clearly and correctly diagnosed: Are the families informed, and are social
> services optimal? Even then, there are interesting social policy
> questions, collective ethical questions, as to how much can we force
> people to do this or that. Is it better to do what 35 years ago was called
> a "parent-ectomy," removing kids from their nuclear (and pathogenic)
> families? Where are the funds, who has the willingness even to offer
> really therapeutic milieux for foster kids? And so forth.
> (Also, what about when the diagnosis of family causation of mental
> illness was itself untrue?---see good book titled "Madness on the Couch"
> about the heyday of psychoanalysis and the pressures put on parents of
> autistic kids, for example. The presumption that therapists know best may
> itself be very mistaken!!)
>
> 9. RW Why are not we, as therapists, educators, community people
> agitating for the political and social change that would improve our
> clients/students/friends lives WITHOUT medicine.
> AB: For starters, we need to pick a single, specific issue; identify
> what exactly needs to be done; identify then how to proceed to follow this
> goal; and prioritize. There's also the "squeeze" of the middle class
> financially that leaves little surplus energy for participating even in
> ASGPP, much less community politics. (This squeeze has to do with the rich
> growing richer, the growth of China and the cost of oil, Thomas Friedman's
> book, "The Earth is Flat," and thousands of other factors.)
>
> 10. RW I get tired of going into work and being asked to use
> psychodrama to help children with their anger...which means teaching them
> not to explode but to ask/talk nicely....when talking nicely has not
> worked for them; when they are asking "nicely" of addicted parents or
> parents who have to work two jobs to pay the rent or parents who are
> keeping them inside the apartment all the time because there is too much
> danger on the streets...etc, etc... And we give the children medicine to
> 'calm them down." Isn't this what the Russians were accused of doing to
> dissenters? I am ranting. Obviously I do know that for some of the kids
> with whom I work medicine is making the difference between allowing them
> normal lives and living in a residence among other disturbed kids.
> AB: Yeah, and who can afford to maintain such residences? Often
> these "therapeutic" environments are staffed by young and not-so-young,
> not-so-educated people who can't get better jobs, and who are themselves
> inclined to engage in petty and authoritarian power struggles with the
> kids! Yikes!
>
> 11. RW But you get the point...I think Anath is correct about helping
> people learn to tolerate some level of despair/depression/anger as long as
> it doesn't cause the level of inaction that won't lead to change.
> AB: I agree that we need a level of what I call "creative
> discontent" that includes political and economic awareness, in contrast to
> complacency. We need to ask awkward questions. Forgive me for pushing for
> specifics, but that's the way I think more effectively. Too many
> generalizations gets me feeling, well, despair.
> Warmly, Adam
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