First and foremost, do not conflate “Mental Health” with Serious Brain Function Disorders. Poor Mental Health and Serious So-Called ‘Mental Illness’ are increasingly talked about as if they mean the same thing but they do not!
It is common to see statements like this on the web :
Stigma surrounding mental health issues is a real problem in our society. Nearly one in five adult Americans has experienced mental illness in the past year.
A statement that starts out with the term “mental health” flows into talking about “mental illness” as if they mean the same thing. In some cases, this is done out of ignorance, but in other cases, it is a strategy stemming from the Mental Hygiene, Psychoanalytical, Consumer Movements that sought to blur the distinction between the terminologies in order to infuse the idea into the minds of the populace that so-called mental illness is a product of childhood adversity (a buzzword these days of “trauma-informed” ideology), psychological injury or maladaptation to life’s difficulties. It is also a falsehood that 1 in 5 Americans, adult or child, has experienced a “mental illness” – unless, of course, someone is using the term “mental illness” when what they really mean is mental health condition.
What is Mental Health?
Mental Health is about being well adjusted socially and emotionally and the ability to cope with life’s difficulties. Mental Health pertains to the psychosocial mind. The term Mental Health refers to non-medical psychological and emotional well-being.
What is (So-called) Mental Illness?
So-called “Mental Illness” pertains to the brain’s semblance of mind, the brain structures and the bioelectrical, chemical, metabolic, hormonal factors that regulate brain function, giving rise to consciousness, cognition, perceptions, the sense of selfhood, volition and its actualization, the sense of ones habitus, metacognition, the sense of others and their identities and the meanings attached to them, and so many other aspects of this semblance of mind. There are a host of medical disorders (such as seizure disorders, encephalopathies, metabolic disorders and disturbances, etc.) that can disorder the brain’s semblance of mind.
Symptoms such as hallucinations (auditory, command, gustatory, tactile, and visual), neurogenic dysmentation (a component of “psychosis”, disinhibitions, delusions, autism (such as in “schizophrenia”) misidentification syndromes (of the self and others), anosognosia (unawareness of that ones thinking and behaviors are disordered) are all neurologic phenomenon. These are not mental health conditions!
The term “mental illness” is a misnomer and it is also a metaphor just as the term mental health is a metaphor. The metaphorical use of the term health is what underlies the construct of parity between “mental health” and physical health. The “mind” is an abstract thing and cannot be ill. The brain’s semblance of mind can certainly be ill in that all the structural and systemic factors that enable and regulate this semblance can be disordered – physiologically. So-called mental illnesses are physical illnesses in that they affect the functioning of the brain organ. Cerebral illnesses (such as so-called schizophrenia, bipolar, and neurologic “depression”) should not require parity in health coverage because they are medical disorders just like epilepsy, parkinsons’s, dementia, and MS.
It is only because the faction of psychosocial psychiatry has held the diagnosis, treatment, and hypothesis generation about the cause and essential nature of these disorders captive of fallacious beliefs for generations, that these so-called mental disorders continue to be psychologized and strategically conflated with Mental Health.
The failure of the medical establishment to aggressively curtail these misguided ideas that have psychologized (meaning…attributing psychosocial causation to neurologic or biogenic symptomologies) cerebral illnesses has kept the populace steeped in ignorance about the behavioral consequences of these grave medical disorder, leading to warped, dysfunctional, and harmful public policies – and ultimately unjust punishment under the criminal adjudication system.
Hypothesis that “Schizophrenia” is an REM Disorder”
Take for example the fact that it has been observed over this long period of time since Freud split off from the neurology discipline that there are features of “psychosis” in general and so-called schizophrenia in particular that strongly resemble the REM state of the brain. This raises the possibility that “psychosis” is a disorder of consciousness. Some of the bizarre behaviors could all be explained by REM intrusion into a waking state of the brain, including unlawful or assaultive (whether paroxysmal or goal-directed) behaviors. Neurobehavioral symptoms that present with the most serious cerebral illnesses are what get people caught up in the criminal adjudication system – prosecuted, and punished unjustly. The idea that someone can be guilty but so-called mentally ill is a fiction, dreamed up by people whose concept of “psychosis” is a thousand miles away from the reality of how the brain’s semblance of mind operates.
Because people of this troubled psychological phenotype are unable to process (cognitively) this construct of “schizophrenia” as a biological disease with biological or hereditary root causes, they have continually grafted new scientific discoveries and observations onto their troubled belief systems of traumagenesis or stress. This translates to lack of progress in research and misunderstanding of cerebral illness within the criminal adjudication system.
Pathologic beliefs about the essential nature of so-called mental illnesses are holding research in a state of regression and are literally killing people due to the fact that healthcare models, public policies, and criminal justice are all informed by these fallacious belief systems.
Due Justice Project believes that ‘mental illness’ is a deeply problematic terminology. Part of the reason why the antipsychiatry movement came about is because the medical profession never ‘rescued’ people from having become victims of the psychologization of neurological illness that afflict the brain’s semblance of mind after it became clear to competent physicians and neuroscientists that the “schizophrenia” symptom complex was a neurodevelopmental disorder, not the product of trauma, childhood adversity, or bad parenting.
We are still living with the catastrophic legacy of Sigmund Freud and the psychoanalytical movement with its bizarre beliefs about psychogenic causation and the miseducation of medical doctors is it relates to functional vs organic “psychosis”. Today, we are in the throes of a crisis of misclassification, of lexicon, and of psychologization and traumatology (operationalized in the construct of trauma-informed). The broader scope of medicine beyond “psychiatry” is still operating under misguided notions of functional neurological disorders.
Right now, there is a resurgence of the strange mental hygiene movement – (the mental health industrial complex won’t call it that but that is exactly what it is), which is premised on the odd belief that mental health problems caused by trauma, abuse, and childhood adversity lead to “mental illness”. The mental health industrial complex, includes psychotherapists (psychologists), academics, a faction of the medical profession known as psychiatrists, practitioners prefixing their credentials with “forensic”, and the “peer specialists” who have pushed with ever-increasing assertiveness in the realm of the clinical. There are elements in the psychiatry and psychotherapy communities that have also run wild with the theory of epigenetics – unchecked by mainstream general medicine, as a mechanism of transgenerational trauma. People that believe these things may represent a psychological phenotype that is oriented toward psychological ideas and unable to conceptualize “psychosis” as a neurological disorder. When confronted with evidence that challenges their beliefs, they are not disabused of fallacious beliefs, they just graft the new information onto their psychologized perceptions and they confabulate ideas like transgenerational trauma as causation for “mental illness”.
Some Advocates are Calling for Reclassification of Serious so-called Mental Illnesses out of Psychiatry
DJP’s position is that the medical community needs to rename and reclassify these so-called mental illnesses as idiopathic encephalopathies or neurodevelopmental encephalopathies with other applicable qualifiers.
Advocates in the DJP founder’s network also disfavor the term psychiatric or even neuropsychiatric because these terms lead people to believe (despite the neuro prefix) that these are afflictions of the soul or the spirit…or manifestations of psychological injury or other environmental/psychosocial root causes amenable to psychotherapies and other grossly inappropriate non-medical interventions. We can only push the envelope so far without the leadership of the medical establishment, which thus far, does not even seem to be aware that there is a crisis.
This site has moved away from the term “mental illness” and as much as possible, away from neuropsychiatric. The problem is that the term psychiatric has a great of baggage and sometimes the mission of enlightenment calls for us to respect the powerful connotations attached to certain words in common parlance. Psychiatrists are medical doctors. Medical doctors should be concerned with the evaluation and management of the brain’s semblance of mind -and the semblance of mind concerns the neuro-electro-chemical and physiological functioning of the brain. Medical doctors should not want to call themselves “psychiatrists” given the historical roots of the profession by that name.
According to a wiki entry:
Neuropsychiatry: A branch of medicine that deals with mental disorders attributable to diseases of the nervous system. It preceded the current disciplines of psychiatry and neurology, which had common training, however, psychiatry and neurology have subsequently split apart and are typically practiced separately.
The problem is that when psychiatry branched off, it took neurological illnesses with it! An advocate in DJP’s network shared an account of a running joke between Chairs of the Departments of Psychiatry and Neurology at a prominent medical school – that ‘neurologists take psychiatric diagnoses and move them to neurology as soon as the pathophysiologies or etiologies are understood by researchers’.
That might be a joke but it is also a tragedy. Neurological symptoms like delusions, hallucinations, command hallucinations/automisms, disinhibitions, neuro-dysmentation, and anosognosia should translate to an implicit diagnosis of an ideopathic neurologic disorder or ideopathic encephalopathy in the absence of a more determinative diagnosis and not be classified as so-called Primary Psychiatric.
A very troublesome cohort of the psychiatry and psychology community thinks that illnesses like “Schizophrenia”, and Bipolar (unlike all of the encephalopathies that can cause neurogenic dysmentation) are in their domain. So-called Schizophrenia is theirs – they retain ownership over it to misconceptualize and mistreat therapeutically through endless theoretical perturbations.
A faction of that community is even misappropriating neuroscience in order to legitimize their misguided psychosocial ideologies. This commentary does not mean to cast aspersion upon the entire community of psychiatry…remembering the psychiatrists attend medical school and are medical doctors. Within that community there are competent medical doctors who conceptualize SNI in accordance with modern medical science. Too many others in the field continue to be influenced by historical psychoanalytical ideologies. Others believe in a hybrid theory, the biopsychosocial model (which involves nonsensical beliefs about the etiology of psychosis, psychosocial interventions, and CBT). It is ridiculous that there is any such concept as the so-called medical model in this day and age. We don’t speak of the “medical model” of heart disease, or cancer.
The purpose of this page is to drive home the message that these illnesses are not psychosocial, emotional, or behavioral disturbances in that those distinctly classified disturbances and disorders do not involve neurogenic dysmentation or altered states of waking consciousness. The medical community needs to stop using terminologies such as “mood disorder” and “depression” to describe altered states of consciousness caused by severe brain function illnesses. There is a crisis of classification and nomenclature that is directly responsible for destroying lives.
The only issue taken with this otherwise informative article about Delirium (which used to be called ICU Psychosis) is the statement that begins:
“In the ED setting, whether medical or psychiatric…”
If psychiatric refers to Schizophrenia, Bipolar, or any other Ideopathic Psychosis Spectrum Disorder, then these are in fact medical disorders. Also, Delirium involves psychosis (neurogenic dysmentation).
“PSYCHOSIS” IS A TRICKY TERMINOLOGY. Certain mental experiences such as hallucinations, “paranoia”, and bizarre thoughts are characterized as psychotic symptoms, however, psychosis is described as a break or separation from reality. Some people who are experiencing what are referred to as psychotic symptoms recognize that something is wrong – they are still neurocognitively connected to reality. A narrow definition of “psychosis” would exclude people who recognize that they are symptomatic (i.e. they are not yet experiencing the neurological symptom of anosognosia). Psychosis should generically describe an acute brain failure as does encephalopathy. The terminology has been in this murky zone for far too long so the medical community needs to introduce another terminology to define the state of being neurologically detached from reality. The term psychosis should be renamed with a term that is less tinged with freudianism.
Excerpt from the preceding link:
…Some comments suggested that any definition of “serious emotional disturbance” and “serious mental illness” must include specific language explaining that these are brain diseases with a neurobiological basis. Similarly, suggestions were made to narrow the definitions so that they include only those diagnoses whose etiology has been proven to be neurobiological. Other comments acknowledged that although there is growing scientific evidence suggesting that some disorders (e.g., schizophrenia and mood disorders) have a neurobiological component, it is still not always possible to discern definitively which disorders are exclusively biological in origin.
*Due Justice Project believes that it is high time for the government to exclude psychosis spectrum disorders from their SED definition, exclude emotional, psychological, and behavioral disturbances from their SMI definition, and furthermore, eliminate the age criteria for their SMI definition. We are no longer in that hinterland of 1993. SSA has recently made some strides to get its regulatory and policy language up to date with modern medicine, these classifications need to follow the same path. All of these mental disorders have some neural underpinnings, but, psychosis-spectrum disorders are overrepresented in the criminal justice system (this is acknowledged in the same document from 1993). More resources need to go to the case management of these disorders.
Due Justice Project has replaced SMI with SNI, however, it endorses Treatment Advocacy Center’s Definition of SMI:
“As you can see, the “official” definition of SMI is very inclusive—though I imagine that when people talk about SMI these days—they don’t have the Federal Register definition in mind”
DJP opposes the cobbling together of emotional and psychological disturbances with psychosis-spectrum disorders under the federal definitions of SMI and SED. Reference sources indicate that the SED definition was employed because SMI was considered to be too stigmatizing for children. Once again, those who are most concerned about the dimensions of stigma (negative stereotypes, devaluation, and discrimination) are the ones that participate in stigmatization. Distancing oneself from something that is stigmatized only perpetuates the problem. Moreover, using the terminology SED caused further confusion that continues to percolate to this day. Educators continued to grapple with the fact that SED excluded ‘social maladjustment under the SED or EBD (emotional behavioral disorder). Using SED in place of SMI constitutes socio-politicization of a biological disorder, in similar fashion to the doctor who gives a patient a less stigmatizing diagnosis of Bipolar in lieu of Schizophrenia.
*It is noted by DJP that a white paper which articulated prosecutor associations’ opposition to a ban on capital punishment for people with SMI used this troubling federal definition to support their arguments.
UNDERLYING NEUROPSYCHIATRIC DISORDER, NOT BULLYING IS CAUSE FOR VIOLENCE
People tend to look to psychological reasons for violence in youths. It is therefore, intuitive to see bullying as a causation for school violence. Young people who go on to develop serious neurobehavioral illness often exhibit socially awkward or odd behaviors that tend to attract bullying. This does not excuse bullying, but it is not rational to ignore what is likely to be the substantive cause of mass shootings, stabbings, or other forms of school violence. …This assertion is not a case of blaming the victim.
One of the causes of paroxysmal type violence is visual hallucinations. A person who is in a disordered state of waking consciousness can see horrific, terrifying images in the mind’s eye in place of the real imagery in the visual field. A person can be triggered to defend themselves against a frightening image produced by the brain. more….
As it has been said in other commentaries on this site, hallucinations do not fully explain why someone would attack a terrifying, grotesque figure produced by the brain. Most of us would flee in terror if confronted with such an image. What is different in the case of someone with SMI is that there is another complex factor involved, that is, consciousness disorder. A person in an abnormal state of waking consciousness will exhibit bizarre behaviors, even behaviors similar to those that are seen in arousal disorders (parasomnias).
Consider that the criminal justice system convicts and punishes people who have defended themselves while in this medical condition.
DJP wants to restate comments made on the blog page about trauma and abuse as they relate to mental health. Clearly, trauma and abuse, especially when experienced by children can have devastating and long-lasting effects on psychological health. These traumas can lead to situational depression, substance abuse, and other tragic consequences. It is also known that there is a strong mind-body connection between psychological and physical health. Acute stress and psychological traumas most likely can alter brain function. There is a strong relationship between military combat trauma and mental health issues, i.e. PTSD, however, there are controversies associated with the PTSD construct…also, instances of misdiagnosis of prodromal symptoms and other phases of psychosis-spectrum disorder. Individuals with genetic risks may respond abnormally to certain stressors. DJP does not subscribe to the trauma/abuse causation theory of psychosis-spectrum disorders. Traumatologists have stretched the diagnostic criteria for PTSD and have co-opted the construct in order to undergird the ideological contortions of other disorders. (Links to articles about the PTSD controversies will be added to the topics menu page.)
***One day in the distant future, the traumagenic theory of psychosis-spectrum illness may be known as “a strange belief” and the epigenetic/transgenerational trauma theory (that traumatologists have used to face down evidence of genetic root cause) may be characterized as a confabulation.***
“The chemicals win in these situations. The illness wins. It’s not about killing ourselves. It’s about an illness killing us.
That is a different kind of suicide”
Dr. Insel said in the interview that his motivation was not to disparage the D.S.M. as a clinical tool, but to encourage researchers and especially outside reviewers who screen proposals for financing from his agency to disregard its categories and investigate the biological underpinnings of disorders instead. He said he had heard from scientists whose proposals to study processes common to depression, schizophrenia and psychosis were rejected by grant reviewers because they cut across D.S.M. disease categories.
“They didn’t get it,” Dr. Insel said of the reviewers.
Exploring other neurological disorders, e.g. Seizures Disorders, Autism, Parasomnias -Considering how Schizophrenia and Delusional Disorder (Psychosis) overlap with other disorders that transiently or chronically cause (neurological) disorder of waking consciousness and violent behavioral symptoms. The most grave symptoms of Schizophrenia are neurological – not psychological.
Excerpt from Psychosis vs Criminal thinking:
Post deinstitutionalization: Between 1988 and 2008, the proportion of Vermont state hospital admissions accounted for by forensic patients increased 50 percent; in Massachusetts, 281 percent; in New York, 309 percent; and in Pennsylvania, 379 percent.
Violence as a symptom of neurological or brain dysfunction is almost always controversial. Human beings are conditioned to have difficulty accepting that biological defect or malfunction, rather than ‘evil (as some type of “disembodied” force controlling the mind and body) can be the cause for violent behaviors.
Research papers on almost any disorder affecting the brain will frequently insert the obligatory qualification that violence in association with the subject disorder is controversial. Whether the disorder is Autism, or traumatic brain injury (TBI), or seizure disorders, there will be skeptics and combatants against any association with violence (Although, in the case of these disorders, the violence may be paroxysmal rather than that which is indicative of pre-meditation…such as violence arising from sustained delusions…predatory or defensive aggression). Concessions will almost invariably be granted to skeptics: Individuals with medical or scientific credentials, stakeholders who are consumed with fighting stigma, and other operators who are driven by powerful prosecutorial proclivities. Violence is, of course, and rightfully, the most highly stigmatized type of human behavior. No one wants it to be beyond our control, even in the case of severe neurobehavioral illness.