Smashing my head into a brick wall

Its a metaphor I sadly turned into practice once. It is perhaps better expressed in Chinese idioms or what Bruce Lee says..

It was something which might make sense to dedicated activists.

Try smashing your head against a brick wall. It hurts. Keep trying and the pain feels less. The blood is more though. Keep trying through the blood seeping and stinging your eyes. This is pure madness but the dedication pays off even if its a phyric victory.

Bruce Lee and others said it better. The metaphor is about continued pressure. My metaphor speaks of the pain. And the blindness too. Sometimes the dripping blood obscures vision and the pain messes up thought. We can become blinded by the pain of smashing our heads against supposedly immovable brick walls.

Just got to keep doing it. I don't have a rocket launcher. I have a skull which can take a beating and a wall which will, eventually, crumble.

I think long term campaigners understand. I think the rest call us mad. They think a cracked skull is dumb. They don't see the cracked wall which others can walk past without the blood and pain.

They're the smart ones. Us fools keep smashing our skulls and bleeding and dying to open up the holes in the wall.

Heroes

I've had to deal with an internal process which makes this accusation.

I must dismiss it. Its not just that even if it were true. Its that I don't do what I do for self aggrandisement. At least I try not to. Its a dark path. I don't do what I do to do anything but live. I can't allow the false label to be accepted because I fear it would start a path to being a total wanker instead of a partial one.

It is so hard though. Constantly there is a part of me which seems not me which puts this view forward. I which is the I I feel is I has to fight against this. Perhaps that's why I'm so hardened to the outside world. Battling the inside one is practice in a way.

Objectively I'm not a hero. I'm a failure in my goals. I've had little impact or good impact. I'm a tosser a lot of the time. The evidence of lost friendships and loved is enough. I live at home. I am lonely. Obsessed. A poor communicator. A turd you couldn't shine. Those things don't get in the way too much because through all the negativity I can still keep working, producing and fighting what I percieve to be the good fight.

Ultimately I'm probably just a megalomanic who's shit at it. I've been accused of this and I respect those who can see this aspect.

People like Gandhi are real heroes. They perfected the art of fighting without fighting.

I don't even want to be a hero. I want to be a drunk abd a drug addict happy with a high. That shit doesn't work for me. Not in the way I want it to.. my last hope is my work will at least provide me a reason to continue when the everlasting high of addiction didn't.

Who the fuck would even want to be a hero? They're things we see in movies and I admit when I watch them I do. But seriously? The films don't tell the truth.

Gandhi was beaten shitless. He starved and suiffered to make his point. His life was ended by a bullet.

Actually, if that's the end of a hero then damn it. I will work even harder.

An admission of bias about the idea below

Of course I would think of a solution which changes society rather than changes the individual. Making society better for the mentally ill and automotons by offering people satisfying jiobs rather than making them accept their shitty lives is totally biased.

In a small sense iapt is a way to stop society changing. Depression as a diagnosis means people don't consider unhappiness or where it comes from. Call it an illness and treat the individual rather than seeing the mess which is modern society. I'm against that.

See the hope that a scheme to promote satisfying jobs could make people happier and healthier. Then you're stepping into my bias. Read on dear friend.

The alternative to IAPT

The improved access to psychological therapies scheme was based on a health economics. Its probably more complicated but essentially keeping people in work is a cost saving which offsets the cost of a short course of CBT.

The health economics argument is what won over the government and they commissioned the landmark scheme. There are strong compassionate and patient choice reasons for the scheme but those wouldn't have been as persuasive.

In current times there's a better option. I've been very lazy and based my argument on a single systematic review. It's one I've promoted often. It's the one which shows very large effect sizes for physical and mental health for job satisfaction. The review covers a total of about 250,000 subjects.

The review itself is poor quality. The trials are probably heterogenous. The trials aren't proper experiments of the quality of a psychiatric trial. It doesn't only include double blind RCTs with good design and follow up not attempt to be careful in its use of meta-analysis. It also doesn't include a funnel plot. However when all this is taken into account for CBT it doesn't fair favourably either.

That's a weak argument of course and the best thing would be for this sort of high quality review of evidence to be done to establish truly if helping people into satisfying jobs would work.

From the review the evidence is strong. In fact what's surprising is how infrequent negative results are. There's a graph which maps confidence intervals. I don't quite understand them but the results are uniequivocal in that the studies rarely show negative results for subjects whereas CBT can have negative results.

The amazing thing isn't just the massive effect sizes in this one systematic review. Its that it works for physical and mental health. Its a double whammy.

The economics is pretty good too. There is a move to force ill people into work. It would make sense to offer help and if the work offered healthcare benefits then there is a cost saving in care. There is a long term cost saving because of the benefits for physical health too because people will be less ill over a longer period.

There's an argument for a job creation scheme which creates satisfying jobs because we're in a recession. The ill would have jobs they're happy with and be able to contribute as well as have their contributions recognised. Many ill people volunteer.

There's also the sort of obvious thing. Rather than offer people thought and behavioural modifciation to put up with the shit jobs many people have to endure this alternative seeks to address the root cause: the shit jobs.

There's more work to be done of course were this idea to be realised. For example what does job satisfaction really mean? Are the measues representative? How the hell to put this idea in to practice too?

However given that iapt is rolling up to 400 million pounds a year of funding in seems daft to not consider an alternative especially given the current climate of unemployment and the government forcing people into work who are ill when there's few jobs.

a little on my depression

A job application has taken me a week. It's been so hard because I feel low. I reflect upon my past and see the negative. I see requirements for the job and I see my past mistakes.

Worst of all, it feels like I'm lying because I have to cut out all the negative and write about the positive. I can do that and there are times when it's great to do a job application or my CV to be reminded of past successes.

Today the positives feel empty and I feel a failure. I think it's the latter which is colouring my view though I'm clearly unhappy aside from recent events.

My failure is something I don't perhaps deserve to feel except there is a sense of truth. I have failed. I have achieved virtually nothing in terms of impact.

Someone might say I am too hard on myself, too critical or set too high standards. They may even say it is part of my illness.

I would say it's part of me and who I am. For all the pain and misery and more pain my way of being is who I am. A counsellor modified this aspect of self-criticism and perfection then I ended up manic. I need my negativity to protect myself from being a total cunt.

But it is hard. It means I take little joy in what others might consider success. My 'racquet' is I won't let myself rest on my laurels but at the same time I languish on my failures.

This is all in sharp contrast to my external persona. There is the man and there is the mask. I don't think many people can understand it but I could be wrong.

I know my depression makes me hard to understand. It's cause and symptom of a lot of isolation. Some of it is self-inflicted and some of it isn't. Such are most things in life I guess.

I know it's a long time since I've felt happy or content or whatever the feeling is that helps other people. There have been brief periods recently thanks to a lady in my life but I don't want to hurt her.

I'm just a working machine now and that's all I care about. Obviously that's not great for how I feel but...well... why the fuck do I do drugs?

I work to live but in a way others wouldn't understand. I work to stay alive. My work is all that I think will stop me taking my life. I've tried drugs - all kinds - and other ways. I'm just trying to find this reason not to kill myself.

It's what I want though. The irony hit me. I want to know the feeling of never waking up again. Other people ask doctors to solve the problem but they don't help my kind. I've had to learn this path all on my own.

My solution isn't great. It's sort of like democracy. It's the best of a load of shit solutions.

“When assessing potential beneficial and harmful effects, patient-relevant endpoints and not their surrogates (i.e. disease-relevant aspects) should primarily be taken into consideration.”

That's a fucking great quote aunt it?

here's where I got it from.
http://chess.uchicago.edu/events/hew/fall08/bridges.pdf

IDENTIFYING PATIENT-RELEVANT ENDPOINTS AMONG INDIVIDUALS WITH
SCHIZOPHRENIA: AN APPLICATION OF PATIENT CENTERED HEALTH TECHNOLOGY
ASSESSMENT
Elizabeth T Kinter1, Annette Schmeding2, Ina Rudolph2, Susan dosReis1,3,
John FP Bridges

I've been a total psychiatrist recently. I've assumed that most patients
in first episode and some patients afterwards expect the cessation of
the delusions and hallucinations as a primary aspect for their care.
I've got no evidence for that assumpton apart from personal experience,
experience of a friend of mine and the experience of the brother of a
girl I met out one night (who'd just been stuck in a ward for
schizophrenia and have self-admitted problems with a commanding voice
and morbid thoughts).

It's so good i'm going post it twice.
"When assessing potential beneficial and harmful effects,
patient-relevant endpoints and not their surrogates (i.e.
disease-relevant aspects) should primarily be taken into consideration."
IQWiG Methods (2005) (15)

So PANSS and BPRS are pants. The psychiatric hegemony may be licking my
chocolate salty balls soon but this thread isn't about my own shit.

If patients want the delusions and halluncations to stop the n
psychiatrists and doctors need the evidence to allow this to happen.
What this means is they need evidence which only looks at the stuff
which is relevant to schizophrenics' expectations and their treatment.

They don't need to do a new trial. Just a reanalysis of old data.
Delusions and hallucinations are found as part of the multi-factor
measures used in psychiatric research. They just have to look at data
from old studies. But they have to look far and wide. It's not just
antipsychotics. It's food and mood and other stuff. Even talking
therapies which I expect don't reduce the delusions and halluncations
but they might do. The psyche is a strange thing. It might be something
totally unexpected which works. Not the 'antipsychotic' which may be
shown to be simply a major tranquiliser which offers nothing but the
sort of thing that psychiatrists want to do to schizophrenics: drug them
into docility and non-expression.

My current endeavour means I am empowering psychiatry to kill a phenotype

I'm no good. I understand the implications and I accept them. I'm not better than a murderer. I seek a scientific answer and I'm worse than scientists who don't know what they're doing.

If psychiatry finds the solution to the delusions then they will make a phenotype extinct. I'm against that but im ...I'm just no good. I might use the idea of patient measures but really all I care about is winning the battle against clozapine.

I do care for my friend though. She started this process in my subconsciousness. She knows a lot and she chose to have her delusion end. I couldn't help her. Neither could her psychiatrists. He'd just try different drugs. I had no answer to help her.

But fuck all that. I know that if this research about what reduces the delusions is successful then I will be responsible for the death of a phenotype. I will be responsible for the death of part of the human race.

Just wait till I fight against what I've created. Just know also that I'm a fucking cunt.

If I was going to research treatments then I would look for ones which cure mental illness

And in an ideal world I would first do no harm.

Schizophrenia is diagnosed by a cluster of symptoms. In a simplistic way I would measure treatments on their effectiveness and reducing the individual symptoms. In fact I would also research what patients want from treatment and ensure the reseaarch evidence allowed doctors to make those treatment decisions.

Let's take schizophrenia. Antipsychotics don't target all the symptoms. They don't regenerate lost brain matter or rectify the suppose brain deficits. The scary thing is they may not cease the delusions. There's no evidence to support medical decisions in this aspect. There's historically no attempt to find drugs which do this. The drugs were initially used because they sedated people without putting them to sleep. This is not treatment unless treatment is gagging a person who's in pain.

Depression has similar problems in that the research measures don't align with the cluster of symptoms used for clinical diagnosis. Again, they don't change the brain differences and while treatments may affect serotonin levels this may just help get people high. I'm all for that but the evidence in reviews which include unpublished data (which is usually negative) show the drugs don't work.

I'm not a psychiatrist though. I'm not interested in furthering their power. I'm not interest in their ways to manipulate research or misunderstand the human condition. I don't believe in pseudoscience either. And I'm a drunk.

My ideas must therefore be wrong and worthless. I'll find out soon enough. I applied to NICE and in my application I pointed out their evidence base on what the public and patients generally expect doesn't exist by which I mean the measures in trials of treatment bear little relation to what people expect of antipsychotics. Psychosis in lay terms means delusions and hallucinations. Treatment means the cessation of delusions and hallucinations...but the antipsychotic is in fact also know as the major tranquiliser.

I bet my bottom dollar that NICE will ignore the fact that they have no evidence base that, in lay people's terms and patient expectations, antipsychotics are antipsychotic. They probably don't even give a shit that if they bothered to reanalyse the studies they might find one of those shitty drugs which genuinely do reduce the delusions and hallucinations so patients who want this and doctors who care enough to seek this will have solutions which work. I could be wrong. I think this is the hook that will get them to do the important review of previous trials - a signifcant piece of work - so that they can offer patients what they want. I can bet they also fear that the significant effect size is based on the drug's chemical cosh ability. They may have to be honest to patients and the public if they find this to be true.

There is also the problem of a placebo controlled trial.

Why the fuck am I alone in trying to apply science to mental health? Why am I alone in pushing forth what people want?

Can mental illness be a good thing?

Some might say that's a stupid question. Of course nothing good can come from an illness.

This is the sort of thinking which psychopathology promotes. The term means the study of illness of the mind. It's sort of like negative thinking in that it sees only the negative side of the labels.

Depression for example. It is the clinicisation of misery. It has a negative prognosis. It causes social disability. It can lead to suicide.

It can also lead to self-reflection. It can be part of a change process. It is associated with critical thinking, the very quality which makes research psychiatrists good at their job. Certain types of intelligence are boosted by depression. Learning can also happen and it's my guess that people like Stephen Fry have so much knowledge because when they're low they may read more.

There are people who value schizophrenia. Martin Luther King was one. He saw its value for creativity. There are areas of employment where people with bipolar can be successful, for example in the media. Even psychopaths can flourish as lobbyists or entrepreneurs.

The mentally ill have also contributed to humanity from Jesus and other religious figures to world-changers like Lincoln and Churchill (both voice hearers). These people may have lived in times or cultures where their gift could be valued. Our society may not allow gifted people like van Gogh or Jean D'Arc to prosper as they did and contribute to the human race.

This doesn't mean the mentally ill should suffer or be allowed to suffer for the value of the experience. The acceptance of the suffering is a choice by those willing to see the experience for what it is. The pain is not something to be wrought on any person nor any person allowed to suffer when they ask for help.

Allowing doctors to take away these life experiences is a sad thing and an illness in society. So many gifted people have been drugged into normality and banality.

There are people who inflict mental illness on themselves. They do it to create joy and experiences by using drugs. They value the experiences and the suffer the punishment life doles out upon them because they value the positive of mental illness.

Naysayers to this would try to homogenise the human race into a placid group of things which could have been beautiful. They see the human condition as something which should be the same as a robot, that deviation from a 'happy' life is an illness and an abhorrence.

They have good intentions of course but they forget that they may be wrong. Other cultures have understood the value of emotional suffering. In places so does psychiatry. Grief, currently, is not depression. The misery - or the clinical syndrome - must be endured for 6 months at least because suffering has a purpose.

People endure physical pain to grow muscles. They go to the gym and break muscule sinew. The purpose of the pain and destruction is to create new, stronger fibre. Those naysayers to the positive of mental illness could apply their argument to physical exercise and the result would be a weak, flaccid human race where people would no longer be able to achieve the amazing feats which elite atheletes do.

There is a missing school of thought in psychiatry. The study of wellness of the mind, or psychosanology, and the interplay between wellness and illness.

Measuring lack of care by the nhs

There is a stastic collected by the NHS Information Service for the number of people who refuse secondary mental healthcare having been refused in a year. It is surprisingly high.

What isn't recorded is the number of people who have been refused secondary mental health services having been referred. It might be 1. Just me.

1 is too many and knowing psychologists I think the number is higher. They have fewer professional standards and, from my experience, are less compassionate than doctors. They can certainly refuse someone who is suicidal access to mental healthcare regardless of whether they often or rarely seek help from mental health services, in my personal experience.

Fuck

They'd call my suffering an illness. It's bizarre. They'd call beavhiour, personality and choice an illness. It's mad.

An illness has a biological component and a prognosis of negative outcomes. For real illnesses this is well studied.

Skin colour also has a negative prognosis and a biological component. My skin could be seen as an imbalance of pigment. The results of discrimination and subjugation could be used to define a negative prognosis. At least in a time and place where people with low melanin levels were dominant and discrimination of non-whites existed.

My skin colour is not an illness. It could be consider as such using the paradigm of medicine.

There are other ideas which are used to define mental illness but do not define mental illness. These include a disability or difference in a person's mind. It is not about illness because it disregards the etire biomedical concept and places this subjective judgement on what a normal mind is.

A person who has no emotions isn't normal. But they're not really a mental illness either. A person with many emotions, apparently, isn't normal and is mentally ill. This I do and don't understand.

Emotional people used to be considered weak. Society was constructed for people with no souls who felt no pain.

God. I can't even be fucking arse to finish this off. I'm starving, poor and unhappy.

All this theory doesn't matter. A person who asks for help shouldn't be refused help. I'm not a person who uses mental health services usually. I came out of desperation. A mental health professional denied me help because she didn't like my lifestyle. She thought it was making me the way I am and I guess she didn't like who I was.

That's it ultimately. Her judgement is what the mental health system is all about. People don't like me. Society doesn't accept me. The reason is because of who and what I am. She wouldn't allow me help unless I did what I was told and change my lifestyle. She didn't care at all that i'd come for help because I was suicidal and for the first time in a long time I didn't want to take my life.

I miust have clearly been mentally ill at that stage. The sort of dysfunction of my mind where I want to live through another minute of this shit of a life is clearly a mental illness. There are many who have this insane dysfunction that life is worth living. Good luck to them.

Love, prayer and willingness to accept suffering so another would be spared

About a year or so ago I prayed for someone who didn't love me. I hoped she would have a life unlike mine. I hoped for her and prayed for her. I loved her and I told my god, the god I hate, I would suffer to relieve her pain.

Is that not insane romantic love? The sort of thing people write about with passion in their hearts and deep sorrow in their minds.

Love is telling someone to stay with their partner and making them think it was all about sex so she would be protected, safe and happy. Its insane love of course. Others in my situation would have just taken what they wanted. I wanted her so much but I loved her.

Most of all...I had to protect her from a life with me.

I can feel my mental illness

My memory isn't great. My cognitive faculties in certain areas are rapidly degenerating. I'm alone. I'm dying and want to die sooner.

I can still dream though. I can still read and write. I can make people laugh and I suppose cry too. I can analyse. I can dance and feel.

Fear of looking gay or like a girl as a reason for not offering support for mental ill health

I've done this myself. To some people who needed support but were part of a masculine-type relationship. I didn't want to seem effeminate.

I'm somewhat different in that I don't feel totally inadequate when offering support. I think that's a factor too. I still feel inadequate when offering support though.

Wouldn't that be an interesting thing? Training people to be ok supporting other people and perhaps training people to take support rather than drugs and therapists.

Bah. What do I know? I'm just a posh, drunk tramp.

Patient measures and psychiatric ones: the value for treatment

I can't do a full rant on this. There can't be the usual suggestions about my chocolate salty balls. The reason is I haven't looked for the evidence I expect not to exist.

What I'm taking about is an evidence review which looks at patient measures for the treatment of psychosis. I mean a quantitative paper, not a qualitative one. I also mean a specific measure not related to comorbid common mental disorders such as depression and anxiety. What I'm taking about is a review of evidence which reanalyses previous studies but looks only at the measures which patients and the public expect from mental health treatments for psychosis: the cessation of the delusions or hallucinations which plague their life.

I'm most interested in the value of antipsychotics, specifically clozapine but other antipsychotics too including the typical antipsychotics which have lost favour.

This comes from a year or two of reading in the area of treatments for schizophrenia. Initially I discovered that PANSS was designed to be medication sensitive. This meant psychological therapies were less able to perform well in studies compared to antipsychotics.

I've come a little further. PANSS is a simple measure made up of a combination of 6 other measures. BPRS is another commonly used measure in psychosis studies and has 15 submeasures. In both these psychiatric measures there are 2 submeasures which are what patients primarily want. Patients experiencing psychosis for the first time and going to see a doctor about it want the delusions and hallucinations to stop. Their doctor gives them antipsychotics almost without exception (or psychiatrist because psychosis isn't usually dealt with in primary care as far as I am aware).

The problem is the antipsychotic may not be antipsychotic. It is also known as the major tranquiliser and also the chemical cosh. It is used in other conditions to sedate people without putting them to sleep. This is not the hope which patients have. They want antipsychotics.

In truth I know doctors want this too. The problem is they have no evidence base to go from because the measures are designed around psychiatric concepts of psychopathology, not what patients and good doctors want.

This means when a drug doesn't work for what the patient wants they either up the dose or switch drug. If they've switched drug once already then current clinical practice sort of says they need to use a drug called clozapine.

Apparently this is the most effective drug for treatment resistent schizophrenia. And yet in the only qualitative paper on clozapine in the BJPsych the authors say it only reduced the delusions and halucinations in some people. I fear therefore that the drug doesn't actually do what patients want but achieves psychiatric goals.

The other thing which is necessary is a placebo controlled trial of antipsychotics. These don't exist in modern times as far as I am aware. Ethically they can't allow patients to take a placebo. There is no other treatment for schizophrenia.

Except there is. Soteria is one paradigm and there are others which offer alternative treatment for psychosis and have had studies published (but I guess may suffer from publication bias too) which show better results for no dose, low dose or medication postponement. I've read 2 reviews, one a systematic review of Soteria and the other a review by John Bola which both inform my hope for an alternative to current medical practice based on evidence.

There's also an unusual incident which might offer an opportunity to establish just how strong the placebo effect can be. In the UK there was an incident where counterfeit Zyprexa - an antipsychotic - ended up in the supply chain. It was a scandal and eventually the culprits were caught. It provides an interesting opportunity for research because the counterfeits had much less of the active drug. Many peope would have had relapses without the placebo effect. Perhaps using modern science and a bit of detective work it could be guesstimated just how powerful this effect is.

What's most important is giving patients what they want. Ultimately there are recovered patients who'd prefer not to have to use the chemical cosh. It would be great to have treatment options for them too. But that's another battle.

The big threat from the change to GP commissioning of NHS services is the loss of the lobbying power of the mental health movement outside medicine

The study I've posted below is the sort of thing a GP with a basic
grounding in evidence could use to dismiss the potential of
psychological therapies.

The only stuff by the major UK mental health charities which a GP might
read are the information publications (either paper or online) to check
they're suitable before they give them to a patient.

GPs are likely to stick with evidence based medicine practice in mental
healthcare because they've come to know its effectiveness in physical
healthcare. EBM means a paper like this could damage commissioning of
psychological therapies across the nation.

The mental health lobby have protected the large Improved Access to
Psychological Therapies scheme through the cuts. They've helped increase
the span of provision to children and the elderly. They've stopped the
exclusion of people with severe mental illnesses (who experience the
comorbid common mental disorders which IAPT is aimed at but were
initially excluded when it was commissioned). They also got more funding
for it too.

I'm not sure that would be as easy with GP consortias. Older GPs favour
the older style of treatment: medication. Their early learning will mean
many are entrenched in this way of thinking about solutions in mental
healthcare. They also have very little knowledge and training in
psychiatry and social care.

Publication bias in psychological therapies for depression

Efficacy of cognitive–behavioural therapy and other psychological treatments for adult depression: meta-analytic study of publication bias
http://bjp.rcpsych.org/cgi/content/full/196/3/173?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=publication+bias+2010&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

"
Background

It is not clear whether the effects of cognitive–behavioural therapy and other psychotherapies have been overestimated becauseof publication bias.

Aims

To examine indicators of publication bias in randomised controlled trials of psychotherapy for adult depression.

Method

We examined effect sizes of 117 trials with 175 comparisons between psychotherapy and control conditions. As indicators of publication biaswe examined funnel plots, calculated adjusted effect sizes after publication had been taken into account using Duval & Tweedie’s procedure, and tested the symmetry of the funnel plots using the Begg & Mazumdar rank correlation test and Egger’s test.

Results

The mean effect size was 0.67, which was reduced after adjustment for publication bias to 0.42 (51 imputed studies). Both Begg & Mazumbar’s test and Egger’s test were highly significant (P<0.001).

Conclusions

The effects of psychotherapy for adult depression seem to be overestimated considerably because of publication bias.
"

Why am I paranoid?

...is also like asking why am I intelligent since people with paranoid
schizophrenia are also known to be more intelligent. One might ask why
am I gifted as easily as one might ask why am I bipolar.

Why am I mentally ill?

This is a question many patients want answered just as someone with a
real illness might want the question answered.

People give different reasons. I've heard a lot of therapists tell
clients it's because of what their parents did to them. A psychiatrists
might say a genetic predisposition expressed through a series of
environmental factors (parents, upbringing, friends, life experiences,
stuff you consumed etc). A priest might have said because god was
punishing you.

They'd all forget to explain something. You're mentally ill because
society says so. Specifically psychiatry as a system judging different
types of people however their system isn't without relevance to a
malformed society where certain types of people do less well in life.

The answer to why a person is mentally ill needs reference to the
construct of mental illness. A better question is why am I like or who I
am. Why am I an individual? The answers would be more relevant because
the question asks about the individual rather than the construct. It is
not about perjoratisation but recognising that good and bad facets come
from the same place.

If Ernest Hemingway asked why he was depressed he'd get the same answer
as why he was a great writer from anyone who understands how human
beings become.

If a homosexual fifty years ago asked why they were mentally ill they
would get an incorrect answer. The reason they were mentally ill was
because the psychiatric system at the time decided you were mentally ill
and used science to say so when in fact it wasn't true.

You are who you are and what you are because of lots of factors.
Society, people and psychiatry place judgements upon you and why they
place those judgements is complex. To answer the question of why you're
mentally ill - you're not. You're a human being. How you came to be a
human being as you are is perhaps explained by the
spirituobiopsychosocial model of cause but before you wander into that
area of understanding you need to realise something. There are positives
and negatives to all people. If you seek to focus on the pathologisation
of your being then you forget that from the same place comes the good
stuff (which you might not be able to see but others do and if
psychiatry was a true science it would get on investigating
psychosanology as well as psychopathology).

How do you commission for something you don't see?

Gps are about to be responsible for pretty much the entire of the nhs.

I assume part of the reason is their interaction with patients. But what about those they don't see?

A large number of people don't see their gp. Many suffer. Many need specially designed services. People in the policy field - I hope - recognise this. The gp on the other hand might guess their patients represent the local population. They don't. Only those who see gps. That's all. Most of my group end up dead sooner. Gps care about it but don't think about it. Its not their learning.

Its great to have services for people who acess services. What about those that don't. Its stupid to ask for services for people who don't access services but I'm stupid. How the fuck are they going to actually do a doctors job when they don't help those who don't access services.

I'm sure there are charities all around the world seeking to mae sure people die later. I really hope they care and campaign for the small number who chose not to access services. I couldn't tell you a solution because I only know the problem from personal experience. I've got a fucking PhD in that shit.

I have no way to finish this current post.

‎No one dies a virgin because life fucks everyone in the end.

What can unhappiness feel like?

I spent the morning thinking about death. My death. I stayed under the
bed covers and tried not to wake to another day. I wished for sleep
because I didn't want to wake. I wanted death and I thought about the
different ways I could die. Like people imagine a new car or a house or
something I think about my death.

I 9imagined the different ways to die. How it would feel then finally I
could not feel forever more. I thought about the film pi. It ends with
the main character taking a drill to his head. I thought that might be a
nice option. A way to remove my consciousness but leave the flesh.

Then I woke up. The day hasn't gotten any better since.

Music instead of the chemical cosh?

http://www.chinamusictherapy.org/file/doc/Is%20Music%20Therapy%20an%20Effective%20Intervention%20for%20Dementia_%20A%20Meta-Analytic%20Review%20of%20Literature.pdf

There are clearly alternatives to the chemical cosh in dementia. I still
feel it's a society which recognises tolerance of madness can save lives
might be the significant step forward. Just because a behaviour can be
'treated' with drugs doesn't mean that it's the right thing. Tolerance
for the diversity and breadth of the human condition and how it
expresses through out a person's life is perhaps the way forward.

Killing the elderly using unnecessary medication breaches the
Hippocratic Oath. First do no fucking harm you murdering cunts. That's
sort of how it goes. I paraphrase.

The above paper is just one alternative, one which had been established
long before the chemical cosh began to be used in the community. The
medical profession could have kept its right to use the Hippocratic Oath
if they thought of these evidence-based alternatives before killing the
elderly with major tranquilliser medication.

Leia Betts didn't need to die

It was just the immoral criminalisation of drugs which killed her. In fact it was what she did. Based on what's generally known about MDMA - it dehydrates - she drank so much water she drowned herself.

Let me explain. MDMA is a dangerous thing. It's almost as dangerous as a car in unlicensed hands.

The fear of the danger is what is the commonly cited argument used to justify criminalisation. The problem is this makes things worse.

Drugs aren't bad. Its what happens when some people get addicted or lose control that's bad. Then there's the problems of making certain drugs illegal.

If alcohol was still illegal it would still be available just like it is in muslim countries where it is outlawed. In these countries they can at least get safe alcohol smuggled in. But what if it were illegal everywhere?

Well the prohibition experiment shows the result. An illegal industry would be created. They'd switch to stronger drinks to reduce the problems of bulk. They'd be poorly brewed and full of nasty chemicals far nastier than the one people chose to take a risk on. Methanol would make people go blind. Crime would increase and criminal empires would be well funded. Tax revenue would decrease and the help for addicts would be poorly funded. Costs in policing would also increase and, like today, these efforts would be like pissing into the ocean.

Drugs represent a multibillion pound industry in the UK driven by one thing: demand. For our history we have done drugs. Legal ones like alcohol remain and psychiatry also prescribes drugs, some which become available illegally.

Practically it makes sense to legalise drugs but its on the morality aspect where society fails. Drugs enhance experience. Drugs help thinking and discover new modes of thinking. Durgs are fun and if you're too boring or, perhaps, too interesting to want or need them then fair enough. Don't apply your prejudices and choices on us. We chose to do drugs. We chose because they make us happy. It helps our subjective wellbeing and life journey. We don't need a fucking prescription to kno we need to get high.

It makes us a little crazy too. There's enough prejudice in that area. It's all about prejudice though. People on the wrong side of this argument have never tried drugs nor understand the joy or value. They're fucking tyrants who use their supposed moral stance to enforce laws and norms.

These result in more harms than legalisation. Anti-drug crusaders are partially responsible for Leia Bett's death. She chose to do a drug and she chose to do it safely. She had no access to the information which would have saved her life, unless drugs were legal.

The UKs senior drug scientist would agree with me. Or he would have if he still had a job. Sadly his scientific opinion was against political thinking. Those moral fuckheads fired him because he had an opinion and he cared. Of course he didn't retract his statement which is why he was fired. Morality, apparently, can't have naysayers.

It is an ad hominem arguement but nonetheless Hitler would be proud of what the 'moral' criminalisation of enthogens movement has done. It'd be better for his objectives if the criminalisation had caused excessive harm to the Jews. The antidrug movement can be proud to say they're different from Hitler: they ensure the harms affect everyone.

Suicide is no longer a crime but it doesn't matter if society shifts to considering this sole symptom a mental illness

Values on suicide aren't objective. There are different views held across the planet at different times.

In the UK suicide is not illegal anymore. It is also a symptom of mental illness. It is one of many used to make a diagnosis. 80% to 90% of suicde is mental illness apparently but here we have the problem of definitions. Those, out of compassion, who wanyt to control another person can attempt to say all suicide is mental illness. Such is the problem of the undefined concept.

I want to die and have done for a long time. Someone might say that's depression. It's not. But if they do then they can stick me in a psych ward and try to modify me. If the modification without consent doesn't work they can imprison me indefinitely, regardless of my mental state.

So nothing's really changed apart from the prison someone wakes up in after an attempt. At least prisoners have justice and human rights. People in psych wards don't. Prisoners serve their time. Patients have no fixed incarceration. Once a psychiatrist decides the mental disorder has gone then they're free. Once all brain washing and thought modification has been done a person is free except if it fails in which case UK law allows their indefinite incarceration.

Don't call it an illness because it's a lie and it allows psychiatry to make extinct a type of human being

There is a problem with the use of the paradigm of illness upon mental illness: it isn't true.

They're not really illnesses. Many people in countries outside the UK recognise this. They're mental health problems. This is language people in the UK might recognise. The mental health problematic is who we are.

It is amusing because the UK change in language wasn't about a step towards the truth of what psychiatry does and deals with. It was an attempt to change the language because mental illness was stigmatised.

Calling it an illness allows treatment for change. Calling it an illness also allows ideas of capacity and insight to be used to deny freedom of choice in treatment. Calling it an illness allows biological solutions which are no different from illegal drugs except they're usually one chemical to achieve the effect and they often take time to achieve the desired high.

Calling it an illness also allows the forgiveness which isn't available otherwise. It allows the support to reduce the disability. It is warm and fuzzy to call it an illness.

Mental health is a nebulous concept so any paradigm could be thought up. Psychiatry misuses science to inform its paradigm but most psychiatrists and real doctors know it's not an illness. It's about types of people and their behaviour. In fact emotion and experience of consciousness are almost secondary. Those are ok at any extreme as long as there is no impact.

The illness paradigm means someone can say you're not a manic depressive. You have a disease called manic depression and we can treat it. What they in truth mean is you are a manic depressive and society is fucked up and (often) I can't be arsed dealing with it so we can stop you being who and what you are. This applies to schizophrenics, depressives, homosexuals, black slaves who kept on running away and any other type of human being subjugated by psychiatrists.

I use the word phenotype to describe indivudals who fit a collective pattern of being. It is the human condition in my eyes. Straight or gay. Mad or automoton. Drunk or boring. Sighted or blind. It's all part of the human race's diversity.

Whereas loss of sight may be caused by a real illness the social disability isn't. It's caused by a fucked up society. Then psychiatrists make things worse by offering tools to make society more homogenous and slaughter phenotypes who differ from temporary norms. Temporary because as society evolves it learns to accept, except when psychiatry offers the science to enforce norms of being on our beautiful human race.

The Large Hadron Collider and homelessness

Looks like I was wrong about the homeless guy. Turns out he really is homeless. He's sleeping in the park. I'm sitting in another bit of the park writing.

He's told me a little of his life. He left on what sounds like a very long trek around the world. He's skilled as a builder and that's how he used to earn. He reutnred to the UK and found himself homeless. He's a UK citizen. He returned to where he was brought up and now sleeps in the park.

I don't understand how this is possible. I thought there were systems in place to prevent this. Clearly they're not working. He's asked me for £650. It's what he needs to get somewhere to live then, apparently, the council will pay for it afterwards.

What's this got to do with the Large Hadron Collider? This is the biggest, most expensive experiment ever. It pushes forth our understanding of the universe at a tiny scale.

I've love science. I love research and endeavour. The LHC is the modern equivalent of the Apollo programme.

Mankind reached the moon in the last century but we still can't house people. Scientists are attempting to solve great problems in science but there are still social problems yet to be solved.

He may drink. He may even be mentally ill, though he refers to us as schizos and psychos so I don't think he's ever been in mental healthcare. He is a person without a home. None but the park.

Risk averse versus risk/reward

Actually this is a title about a few concepts.

Risk and reward is an important one. Some people see risks. Some people see risks and weigh against the rewards. Understanding the chance of a risk falling through or a reward brought to fruitition is a fine art. Science finds predicition in this area is about as good as it is in mental health research. Some people manage it be it at the trading desks of an exotic derivatives portfolio or when buying a lottery ticket.

And some people are risk averse. An extreme is someone who rarely takes risks, with their hearts or their minds, and small risks are considered big ones. Risk aversion looses out on the big rewards. It's sort of like a pension portfolio compared to the futures market where fortunes can be lost or made in a day.

Those who seek big rewards need to be ready to take big risks. They also need to be aware of the results of failure, often as great as the rewards. They need to be able to handle them too.

Understanding and applying the risk-reward equation isn't easy. In life, in my belief, it is better than the risk averse way. Risk averse is safe but offers little reward but lack of failure. Some people may want a life free from failure but others are willing to risk for the hope of a greater reward.

This is about happiness and the pursuit of happiness as much as anything else.

I think 4 years is a reasonable amount of time to a suicide

In fact it's a bloody long time. 4 months might be better and for most people who want to kill themselves 4 days would be better still.

The point of waiting is only for the hope of an assisted death. This hope has been dashed. Those that take a person with physical illnesses life with a 5 day wait won't help a person who is willing to wait 4 years because he knows how people use mental illness to take a person's free choice away.

4 years was a reasonable time. 1 year would still be reasonable. 4 months would also be reasonable. Reasonable in the sense it showed the decision to die was not a quick one nor a rash decision. Reasonable in my thinking in that it gave me 4 years to find a solution to live too. Reasonable because I might take my life in those 4 years.

I've picked the day but will ruminate on the method. I don't have to wait since there's no option for a civilised death and this was the hope that drove me to wait. I haven't had much suicidal ideation recently nonetheless on reflection if my heart stopped now then today would be a good day.

When I decided to wait it was only with the hope of a peaceful death I could plan towards. I started to work towards it and I think I'll continue. There are many options.

4 years is a long time for anyone. Perhaps 1 year might be better. For the moment I'll stick with waiting 4 years but this may change.

People who listen to music are more depressed than those who read

I've ranted about this not being true even though the evidence might vageuly suggest so in another blog post.

But let me criticise myself for failing to see something obvious. Books take two forms: fiction and non-fiction. Music is of the latter type. It engages dreamers. Science can also but academia usually extinguishes any free thinking, the greatest high in science.

Music creates hopes, ideals and imagined perfection. Things which are unattainable goals in their purest form. Story books do the same. But science books usually don't.

Having hopes, dreams and desires which are unfullfilled is part of unhappiness.

An automoton would think to get rid of those things. Like I have. I tried to live by the wiser rule: those things come with pain.

It is easier to have never loved but it is richer to have loved and lost. It is easier but that doesn't make it right. Happiness usually means the absence of suffering...because that's easier. I just think that having tried hedonic escapism it's not as fulfilling. A different kind of happiness.

It's futile regardless. No plaster for the wound in the human condition lasts long. No solution fixes the condition but...

If you want to know about happiness ask someone who's poor

Outside Western countries people are a lot happier. Developing world nations score better than european ones in international psychiatric studies.

It's not just schizophrenia. Depression and anxiety are far less common.

I remember a story someone told me once. For some reason it seems relevant but I can't think why. A wild rabbit is standing near me in the park I'm sitting in.

Two business men went on holiday to somewhere near the sea. They rented a fishing boat and spoke with the captain. He was a genial type and he seemed surprisingly intelligent for a man who drives a fishing boat all day.

They asked him why he didn't get a proper job in the city. The man looked puzzled. He asked them why he would want that.

They said with a job he could have money. He could have a good job, a career and go on holiday. He could buy the best rods and fish in a tropical paradise 4 weeks a year.

He looked at them and paused. They looked puzzled.

Do people who have a callosumotomy (or whatever they call the operation which splits the two hemispheres) have an internal dualogue

First of all it's not a typo. A dualogue is a conversation between two people. A dialogue is between two or more people.

This isn't just me showing off with my vocabulary and stuff. Theories of consciousness rarely tap into the realms of the inner dualogue, dialogue, conversation etc. We inside your head is agreeing or disagreeing as you read this. Who are you speaking with inside your thoughts? These questions have not been answered by science and a small part of the eperience is pathologised. "Hearing voices" may for some be a way of communicating a distressing internal dialogue.

The anal retentiveness to the accuracy of the use of the words is because I wonder if our hemispheres connecting create the dualogue. Just two though.

People who've had the operation where their brains are split in two usually have incurrable epilepsy. The operation works but people have had unusual experience. Its called alien hand syndrome or something. One hand can have a mind of its own. The hemisphere controlling it becomes rebellious. It can take on a personality.

This is forced upon the neuropsychological system by the out of parameter event of the separation of the hemispheres but the organism survives. Evolving didn't build the brain and mind to survive what modern medicine can do. It's an example of the extraordinary surviability of human consciousness.

What if it's possible for two consciousnesses to inhabit one mind without this operation to divide them and force their maturation. We all have this internal dialogue whether we are aware of it or are even ready to be aware of it.

The inner voice finds itself cropping up in literature but there seems to be little investigation into it.

They must have done this study into clozapine

How potent is the monthly blood monitoring? This trial could perhaps be done for patients new to clozapine. They'd be entered into a trial with 3 initial groups. One would be an atypical antipsychotic in injectible (depot?) form. The other would be a combination of medications designed at hitting the same neurotransmitters as clozapine.

All three would be adminstered as if they were clozapine. The second phase would be for non-responders who could be adminstered clozapine at three months into the trial if any of the other two groups fail. There'd be a TAU group where patients would be kept off clozapine for three months.

This isn't a totally pointless experiment. The reason is not to recommend blood monitoring if it proves to have a beneficial effect. It is to further evidence unexplained effects or at least effects of social contact and contact with medical personnel (which is my guess rather than the explanation for this hypothetical effect).

The relevance for the disorder versus patient-based measures used in psychosis research

The measures in trials of antipsychotics are not good measures. PANSS is
a commonly used one however it is designed to be sensitive to the effect
of medication. It's not surprising psychological therapies don't work if
they're measured with measures which advantage the effects of medication.

Another scale is BPRS. BPRS and PANSS each have 2 or 3 of the 15 (it's
debateable whether bizarre behaviour is a patient measure or a
psychiatric/judging person's measure) and 2 of 6 respectively which are
measures of the delusions and hallucinations which have typified
schizophrenia and psychosis in the public and patient understanding.

A patient accepts antipsychotics because a doctor tells them it will
cure their illness. If the patient probes any further the doctor will
probably have to answer the question: will it reduce the delusions and
hallucinations. Many patients have found the drugs don't do this. Many
have found they do but there has been no placebo controlled comparison
on this specific measure.

Regardless of the problems of truth and science there is an important
thing which a review of data could discover: which of the drugs actually
do reduce the delusions and hallucinations best. This is what patients
want. Frankly I think if they solved this they could extinguish the
schizophrenic phenotype if they found a 100% chemical solution to the
'problem'. The argument that schizophrenics must exist because they're
part of the human race is often something people who're going through
psychosis or the negative outcomes of schizophrenia is about as useful
as a chocolate teapot. But giving patients and the public what they want
from drugs called "antipsychotics" should be supported by the evidence
and potentially there's the hope that treatments which change the part
of the 'illness' which patients wants can be discovered within the
typical and atypical antipsychotics. It may be discovered that drugs
like clozapine aren't as good as patients expect on patient measures
(only the reduction of delusions and hallucinations) and other drugs are
truly antipsychosis.

I wonder how many ex-psychiatric patients work at the national mental health charities?

There is no hierachy. At the same time there is. I've yuve done 'time' then that's an easy measure of severity. Twice or more affords more reliability. I prefer the term classically mentally ill because that's really what two or more hospitalisations is a sign of. I think it's unimportant whether these were under section or voluntarily.

My guess is that numbers would be small and percentages tiny. Hospitalisation usually indicates a downward path in life. This prognosis has dogged my life. Few have bettered the predicted outcomes.

The thing is...I'm not ill...which puts me in control...I am responsible and capable though I live life to the edge...but though I know the research and I can see it true in my life I also know that I have a choice and I...have gone totally off topic.

So...how many psychiatric patients get paying jobs at major mental health charities. My hope is that it's a lot. We know the edges of the system where the mainstream need to keep fighting against. We know mental health more than someone with a PhD too because we have life to teach us. No book can teach better and no knowledge other than lived experience can truly inform because it's about things 'normal' people can barely imagine.

The psychiatric ward is a unique teacher. The value is endless if you chose to listen.

I have no doubt

That many psychiatrists would agree with me when I said their job was to extinguish phenotypes or human phenomena. Certain ones which they give labels to.

At least given half an hour.

Their methods include psychosurgery: the permanent changing of an individual's being. They still use it. As the science gets better and better I'm sure they could 'treat' homosexuality.

I return to pondering the question what is mental illness?

I have no good answer. At least nothing elegant nor concise nor complete.

The dual continua model of distress and psychopathology separated into two dimensions is just the beginning of a confusing journey.

Biology and course are essential to the application of the paradigm of medical illness. This are is deeply confusing because it's not really a medical illness but behaviour, emotions and consciousness can have biological cause and presence.

Disability covers real and not real (mental) illnesses. Where I see the weakness in thinking is to focus on treatment and homogenousiation of indiviudals. A diagnosis enacts treatment to make a person normal. So do treatments in physical medicine but here lies the funky bit. Blindless is a right and is normal. The blind are a part of society and the day when people try to eradicate the blind, with the best of intentions, there will be people like me fighting for their right to exist. The blind and those with other physical disabilities are normal. I sound cold and heartless because there exists a social disability. But changes in society and individuals to make us more accepting of each other and our differences means this disablility lessons but the type of individual or human being, I chose the term phenotype, survives.

Sadness, mood swings, psychosis and other pathologised symptoms may also have a purpose for the individual and greater societty. Love or hate religion it has influenced the course of human development. Every nation has had religion inextricably linked to its history. It is the creation of psychosis in my opinion and it was the old mental health system.

I admit a perspective which sees psychiatry as having usurped religion when spiritual and religious explanations won't do. Now that we have science...

The new dogma is most useless in mental health because the very foundations of the use of science are flawed. Psychiatry is fundamentally the study and implementation of treatments for psychopathology. Illness. Little research is done in the area of psychosanaology. The study of wellness of the mind (whatever that nebulous concept means).

Few published papers look into wellness or are considered in psychiatric manuals and the general recommendations for treatment. It is all still to change the phenotype and reduce the experience.

I would love to think psychiatry is the study of the human condition. I was that was what mental health was all about. The change in language is about a change in concepts. It's to move away from illness and medical thinking. It's to understand that there's a spectrum of colours in the human condition and life experiences (and probably more) which turn genotypes into phenotypes.

That's the science. What we chose to do with 'abhorrent' or 'deviant' or 'abnormal' or normal phenotypes that are disadvantaged by a malformed modern Western society (3 perjoratives for mental illness and one way which I like to think) is about something different at the moment.

Biological proof was not required when psychiatry was incieved. Social labels and the proof of being outcast were what were the informal, unwritten diagnostic criteria. Religion offers one explanation for these vagries in human behaviour but as it waned society had no reason to show acceptance. The asylum system housed the rejected and outcast. There was no diagnosis but rejection from society to live out a life incarcerated in one of the old leper colonies.

The medical paradigm was applied later but doctors are still honest in their textbooks.

And still I have no answer!

The sad story of how hard it is to keep an advanced psychiatric unit running

http://bvmh.co.uk/kayahouse.htm

Kaya House was a small house in North London. It looked no different
from any other. It had 4 bedrooms for people to use as an altnerative to
psychiatric hospitalisation.

This could have been the future model of hospitalisation fora large
number of the people who voluntarily use a psychiatric ward. It offered
things impossible to find in most psychatirc wards. A sense of normality
for example.

The problem is when cut backs are made it's these sorts of facilities
which are slashed. They didn't have a strong economics argument though
75% of the people using the facility said it stopped their entry into a
psychiatric ward where care is worse, costs can be higher and trauma can
occur.

Modern psychiatric wards are not therapeutic places no matter how high
the doses of antipsychotics they use to knock people out. They're
challenging environments which are underfunded and understaffed. People
are cast together in confined surroundings little different from a low
security prison.

Kaya House offered a sane alternative to the systematic lunacy of the
current psychiatric ward system. It closed two years ago.

A blog that's meant to be on non duality and mental health but isn't

http://miraclesawake.wordpress.com/

Another study on suicide and natural disasters I can't read

This study only uses one dataset but it looks at suicidality rather than
completed suicides. This covers the pre-states which lead people to make
attemtps.

http://www.ncbi.nlm.nih.gov/pubmed/21319554

I can't read the study so I really should post the conclusions but it's
important to show how one study says shit all.

"
CONCLUSIONS: There was a reported increase of suicidal cognitions and
attempts within 12 months following a natural disaster. Awareness of
increased suicidality, attention to associated risk factors, and support
regarding these may help in the prevention of suicide following disasters.
"

A tiny review of mental health epidemiological studies after disasters

http://www.ncbi.nlm.nih.gov/pubmed/18450280

Can't bloody read it though. What the fuck is the point of doing
research if people can't read it?

Earthquake in American don't increase the suicide rate

http://www.nejm.org/doi/full/10.1056/NEJM199901143400213

That's the retraction.
This is a copy of the original paper.

http://www.hawaii.edu/hivandaids/Suicide%20after%20Natural%20Disasters.pdf

Think about Suicide website

This is a long way from completion. It should be interesting though. The
author's PhD was on suicide. He's a modern sociologist.

http://thinkingaboutsuicide.org/

Free online graph and presentation software (like Visio)

www.jgraph.com

MX graph was the one I was looking for

What was going through Oppenheimers mind when he dropped the bomb

http://en.wikipedia.org/wiki/J._Robert_Oppenheimer

He was the scientific director on the Manhattan bomb project. Someone
recently posted up what he said when they dropped the first bomb. The
Trinity nuclear test was the first time a nuclear bomb was released.
This was the technology which remade world peace, in a sense, which
still lasts today through the same sort of thing as Pax Romana (the
longest period of peace between superpower nations in the history of
humanity thus far).

"Now I am become Death, the destroyer of worlds."

This is a quote from the Hindu god Shiva (the god of death and
considered important in the triumvirate of gods in Hinduism.

That's it. He recognised the destructive potential of what he'd created.
As a lead scientist he could see the devastating power of an
uncontrolled nuclear blast.

I've also been watching a documenrary about brain science. One of the
most important people was a patient with epilepsy. A doctor guessed the
hippocampus was the area which was the problem so he removed it with a
silver straw. He literally sucked out the bit of this man's brain which
was associated with memory. It created a unique person with no ability
to form new memories. The documentary says thousands of papers have been
written on the studies done on this man. He may have found perfect
happiness by the destructiion of his ability to form new memories so
they turned his life into a lab experiment. Day after day psychologists
came to examine this man.

There are other cases. The scientists who work on weapons research. What
goes through these scientists minds?

I remember studying a lecture course which was on nuclear and other
missile science. I remember hearing how certain "mobile robots" can
follow parapoblic paths from one point on a sphere to another point on a
sphere. My fellow students silently noted this down and got on with
their work. I was somewhat aghast and also somewhat intrigued. A mobile
robot is an intercontinental ballistic missile.

http://en.wikipedia.org/wiki/Intercontinental_ballistic_missile

Thanks to MIRV technology one of these can decimate a small country.
Just one. We were being taught how their guidance system works. The
sphere was the Earth and the target the mobile robot had to reach was
where it would detonate.

A few of my course friends may have ended up in the industry. Lots of
electronic engineers end up in the weapons industry.

There's probably a good word for this. A big one. Perhaps there's even a
concept. Is this about human blindness to what is our individual work
does? Or is it about the forced blindness some people need to fulfill
certain roles in life, blindness which becomes conditioned. Oppenheimer
would have justified what he did as necessary to save lives. He was a
brilliant scientist. He could have never predicted the Cuban missile
crisis which almost started World War 3. By a hair's breath he's not
responsible for a cataclysm the human race may never recover from.

But what is that power in men and sometimes in women not to be able to
see how their work fits into the bigger picture. how we're all part of a
chain of events.

A story of love

http://www.indianexpress.com/news/filing-of-criminal-cases-by-wife-not-mental-cruelty-hc/774700/?sms_ss=facebook&at_xt=4da5dce508b0be41,0
<http://www.indianexpress.com/news/filing-of-criminal-cases-by-wife-not-mental-cruelty-hc/774700/?sms_ss=facebook&at_xt=4da5dce508b0be41,0>

This is an extraordinary story. The wife has issued criminal cases
against her husband and his family. He gets a divorce but she gets it
overturned on appeal by the Indian High Court.

A site to get Tramadol and other prescription medication

http://www.spanienexpress.org/index.php?page=shop.product_details&flypage=shop.flypage&product_id=18&category_id=6&manufacturer_id=0&option=com_virtuemart&Itemid=1
<http://www.spanienexpress.org/index.php?page=shop.product_details&flypage=shop.flypage&product_id=18&category_id=6&manufacturer_id=0&option=com_virtuemart&Itemid=1>

Find out where the things that make things come from

http://www.sourcemap.org/

This allows supply change data to be accessed and visualised really
easily. It's interesting and may have potential applications for ethical
shoppers. In actual fact it's pretty pointless but with a bit of work
might be able to make carbon calculations.

I buy most of my stuff second hand. It's got an even smaller carbon
footpirnt.

I have delusions of grandeur

I dream of fighting thr good fight. I cast to the wind for the hope of change.

I am a fool with problems. I am a failure in too many respects. I am incapable, foolish and an ongoing failure. I'm like someone who has a choice about disability but choses it.

I am the greatest fool that ever lived.

How can I stop myself being an arsehole?

A simple but strange rule is I don't fight for myself. At least consciously. I will fight tooth and nail for principles, equality and my fellow human being.

I have learned not to fight for me. The simple reason is if I did I would be a manipulative psychopathy. Instead my ability is there to serve others.

I enforce this hard. I could, by my life story alone, be a terror. My acceptablity and frankly my belief is based on separating my evil ways from value for my self.

There are exceptions. They usually involve far greater loss or risk of loss to me though. No one gets this path to being an arsehole, one I chose. I chose because that's what it takes.

I have come to be used to being an arsehole. But I do my utmost to ensure while being an arsehole I do good and I don't do it for my benefit.

I do it for a cause I'm alienated from. There are many of those. I know people who are professionals in this area of making change may hate me and my kind. They do it for money though. I aim to protect what I do by m.aking sure that it has no value for me. None but making a difference. Somehow. Anyhow.

My ability is sadly being an arsehole. And I deliver. And if I were different my ability would be used for my benefit. I'm who I am though.

Just a drunk.

A fairly brutal cbt technique for ptsd

I'm currently reading through treatment stuff for ptsd. A common technique in cbt treatment is exposure therapy. This is about confronting fears.

What it means is putting people through controlled psychological distress. Its about inflicitng pain to get people used to it. Sort of like beating to make people get used to being beaten.

There must be another way.

The problem with gender studies

So ptsd affects women more than men. It's fairly useless information in the sense that men still get ptsd.

On the other hand mental gender has a much bigger effect in one study. What I mean is disregarding biological gender as the variable and measuring psychiological gender may produce much higher correlations. It's still fairly useless but less useless than considering biological gender in psychiatric researcher.

On natural reactions

I cried a bit this morning. It's not fair. it's just not fair.

I work damn hard. I don't have much of a life. I make many sacrifices.
These are things other people do too. I just don't get paid for it. They do.

I work for better stuff in Japan after the quake but I have no resources
and at the moment little energy. I'm mentally ill to a point where it's
getting in the way of my life but when I went for help the NHS wouldn't
help me, even though I volunteered and was a tiny part of the movement
which got massive amounts of funding for psychological therapies in the UK.

I give to charity and refuse it for me. I give to the homeless knowing
that often I'm being ripped off. I do it to myself but that is just
self-stigma.

I'm so fucking tired. It's just not fair. Having a little cry at this is
pretty damn sane. Anyone else in my state, after what I've been
through...they'd have killed themselves already.

Unity 3D

http://bx.businessweek.com/virtual-worlds/view?url=http://www.hypergridbusiness.com/2011/03/unity-3d-training-simulations-get-recognition/

Virtual environments which create simulations. One application is
medical simulations to train better doctors.

Something I just wrote to Avaaz.org to promote psychiatric rights

Some background. Avaaz are an amazing internal ecampaigns organisation. They can get a million signatures on some of their petitions.

They put one out recently which I signed and reposted. He is facing degrading treatment because he was a whistleblower.
http://www.avaaz.org/en/bradley_manning_1/?cl=1007676179&v=8809

--
"
First of all thank you for all the great work you do. You help many causes and make the world a better place.

I'd like to highlight a campaign area you may not know about. It's a hard campaign area. It's the rights of the mentally ill. You've recently put out a petition against humiliating treatment which I signed and shared on my Facebook profile.

I usually share things about mental health. These are very small petitions. Hundreds and at best thousands of people sign these. They're petitions against forced treatment and degradation. One of these treatments is the forced electrocution of an individual to change their behaviour. The aim is to induce a seizure. Electro-convulsive therapy is used across the world. Many have died in the past. Many have it forced upon them. A recent review of evidence showed that after treatment sham ECT (where no electricity is used but the patient thinks they've been electrocuted) works as well as ECT and benefits are small during treatment.

Perhaps if I highlight a story the problem might be a little clearer? This is about children who are tethered to a wall. This is done legally.
http://www.helium.com/items/2074233-tethered-teenage-psychiatric-patient-shocks-netherlands

Perhaps if I told you that two or three hundred years ago waterboarding was used not on prisoners of war but on psychiatric patients you might get a sense of where I'm coming from. Doctors and nurses did it rather than prison wardens. There was no oversight because the assumption is doctors only do good things. Remember that up until 1992 the World Health Organisation considered homosexuality a mental illness and there have been some inhumane, unethical things done to people who were simply different because the WHO chose to consider their sexuality an illness.

There are cases of black activists incarcerated in psychiatric wards in the US in the 1970s and pathologised with schizophrenia because of their activism published in a recent book. The UK and the US overdiagnose black men with schizophrenia about 3 times more than white men; this doesn't happen in the West Indies. They use strong chemicals called major tranquilises to sedate them. When these were used on the elderly in the UK with dementia a Royal College of Psychiatry report stated that 1,800 old people were killed unnecessarily every year (this was in the last year and the government has revised their dementia strategy however the use of the antipsychotic drug on the elderly to sedate them still continues at lower levels).

Today in the UK a person can be punished with incaceration without justice. The changes to the UK's medico-legal framework (the Mental Health Act 1983 amended in 2007) allow a mentally ill person to be hospitalised without treatment (which is little different from imprisonment but the individual has fewer rights) based on the risk of homicide but having committed no serious crime. They can be incarcerated indefinitely without any judicial procedure. It is incarceration in a psychiatric ward rather than a prison however some prisons in the UK are better than some psychiatric wards. People who've been charged with no crime other than mental illness can be incarcerated in facilities worse than those where people who've been charged with a serious crime are punished. They have fewer protections too, for example there are far fewer human rights inspections. I am unaware if this loop hole in justice has been exploited yet.

You may be unaware of these injustices. Many people aren't. There are many other examples.

I've copied Mind Freedom International into this email. They're one of the few international organisations who stand against this oppression. They fight against the humiliating, degrading and often forced treatment which happens to people all around the world. They fight for psychiatric rights.

I just wanted to highlight these details to you in the hope that one day I see an Avaaz petition against the brutal treatment of the mentally ill.
"

Notes on Japan, suicide and mental health after the earthquake

So I spent my time reading about Post Traumatic Stress Disorder. I find
reading psychiatric literature really interesting. The symptoms of this
diagnosis can easily be other diagnoses however the important thing is
the traumatising event. if it's a minor event then the differential
suggests an adjustment disorder diagnosis. PTSD is about a life
threatening situation which triggers a short term natural reaction of
psychiatric symptoms which in the long term may not subside and cause a
problem to the person's life which is when it becomes PTSD. So an
earthquake is obviously a life threatening event. The diagnosis also
allows PTSD for certain circumstances such as a woman who watches her
husband go through lots of amputations.

Japanese psychiatrists would obviously be able to best understand how
the symptoms of PTSD would present in Japan. Reading DSM or ICD criteria
and assuming these are what Japaense people would experience may be a
false assumption.

Detection should be relatively easy for Japanese people who stay in
Japan. Some may leave and psychiatrist across the world need to be
watchful for Japanese patients (or other people who lived in Japan at
the time) who they see later on this year or next year presenting with
symptoms.

I didn't get very far in my reading yesterday because I ended up
chatting to the pseudo-homeless man. (We agreed to meet up tomorrow
evening in the same place and I'll try to confirm more about my
suspicions. I can be wrong.) One thing which is obvious but I wouldn't
think about is people who've been injured are significantly more likely
to get disabling PTSD in the long term. It means Japanese mental
healthcare services need to screen these people six months, a year and
two years (or whatever is suitable) for symptoms which may develop as a
result of their injuries and the real fear of their life being ended.

What's been hardest is reading this information and thinking about
someone I care about very deeply. She went through a very physical
health crisis last year. The doctors still don't know what's up. She's
had some therapy and it's helped in some ways but she's still presenting
with problems of insomnia. There are other symptoms which someone might
pathologise but I don't. It's just how she is and I love her for it. Her
sleep problems she's explained to me may be coming from the trauma of
the event which lead to her treatment and the problems of treatment for
her physical health. I'm no doctor but I ain't stupid either and neither
is she. I think she understand that her sleeping problems are related to
her treatment and physical illness crisis. My love for her wants me to
be ok but I know her suffering may also be an important part of a
developmental process essential to her life. Thank fuck I'm not a
psychiatrist. They have to make real decisions about this.

I'ved not yet got to the bit on the book on treatment yet.

Onwards ever onwards.

A stroke of luck

I met someone yesterday pretending he was homeless. I say pretending and
it's an educated guess. He was drinking Tennants Super, the ironic beer
of the homless, but slowly. He misquoted the system for hostels as far
as I am aware and I think he was hoping to scam me out of money.

I chatted to him about my suicidal desires. He'd had them as well. He
offered to help me. In fact he offered to kill me.

I'd been so hopeful that Dignitas could help me but even they deny the
mentally ill the rights of others. I wanted a peaceful death but was
faced with the prospect of a messy end, one where my organs couldn't be
recycled.

There are always other ways. I'd forgotten what an old friend once told
me. He was reputed to be a hitman but he never told me that story. He
was involved in the world of crime and helped me get drugs. He explained
bits of the world of crime. Basically if I could find a crack addict I
could get anything done. I tried crack cocaine once so I undersrtand
why. Just once. It's the most addictive drug I've ever tried. To fund
their habit crack addcits often turn to crime and prostitution.
Hopefully I can find one who's willing to help me for a fee.