Go on. You can finish this one of yourself

This is probably the worst thing to say to a woman in bed. I've only said it once.
Oh god she deserved it though. I remember just getting so bored of her  poor sexual skills. I'm not great in bed myself. Just not enough practice. But I make an effort and I always want a woman to climax. She on the other hand was...well....lazy. Never made the effort. I think she thought sex was just fucking or something. Her idea of foreplay was what a man did.

I admit a degree of anger but more frustration. I suppose it's just a lack of my communication skills.

But I wonder what she told other people? I wonder if she told any of her female friends about what I'd said. I never told her she was crap in bed so she'd have thought "Go on. Finish yourself of" was said out of male
 laziness or something.

There's a time when a girl I loved who was a friend of hers looked at me awry when I made a joke along the lines of "Go on. You can finish this one off yourself" referring to a joke I couldn't be bothered finishing. Now she may have looked at me funny because she was amused by an off the cuff comment that made innuendo out of a normal phrase that could be mentioned in the office, or perhaps my ex-loved one had told this person what I'd said.

There's this thing called Theory of the Mind. It's interpretation of people's intentions often based on little gestures. Apparently schizophrenics have poor ToM. I stay away from attempting to interpret these little tells because they're not explicit. I'd like to ask the person I joked with but whose reaction to the joke I couldn't interpret but I don't trust her and she doesn't value me.

It's a shame because I'd like to know. Really just for a blog piece about a "How good are you in bed?" mobile phone application of the future. It's relevant because gossip becomes formalised using this sort
 of application. Imagine people could rate their partners and other people could access these. After all, we can rate companies and products. Why not public ratings of people once the technology matures?

2 articles I like on Breakdowns and Upbringing and Psychosis

Understanding Madness as Life Management Breakdown by Brian Davey

http://www.bgmi.us/web/bdavey/Breakdowns.htm

I like this so much I'd like to cut and paste the whole (short) article here. It's one of about interpretations of breakdowns.

The second one is from the Lecture to World Congress of Social Psychiatry, Hamburg, June 1994 by the same author.

Upbringing and Psychosis

http://www.bgmi.us/web/bdavey/Psychosis.htm

Here's one snip I like. The author puts his personal experience in brackets. I like the rest of both of these articles and I think many people who are going through a hard time might have something to learn from either of these pieces.

"

(One of my greatest frustrations eventually lay in trying to communicate my developing theory of madness - since this was mostly ignored by local medical psychiatrists. One of them said 'We don't have to listen to him, he's only a patient'. Others listened but it has made little difference to their practice. I knew I was on to something important and was desperate for the breakthrough when I hoped they would realise the value of what I was saying. The fact that they ignored what I had to say aroused powerful feelings that became too frustrating. The anger spilled over into all my relationships and periods in which I would withdraw from everyone. In isolation nearly all thinking is fantasy as there is no feedback to reality-check in conditions of intense aroused emotion. Later I saw I was rather 'father/teacher fixated' as I was appealing to local psychiatrists to support my attack on their work. I wanted them to accept me even as I attacked them - acting out repressed feelings as rebellious son/pupil. This was a reproduction of, and a failure to go beyond, chronically unsatisfactory childhood relationships. It was Professor Romme, who did see the value of my work, who advised me, very wisely, to address my ideas to those who would listen, not to those who would not).

"

Sadly I disagree with Prof Romme about presenting work to those who won't listen but then I'm a miserable loser who's pretty unhappy because of his own misadventures and Prof Romme...well...he's a professor. His work has been instrumental in getting other people to listen to the voices of patients, people who otherwise wouldn't bother to even look a severely mentally ill person in the eye nor consider their experiences to have any meaning.

Untreated depression seen through my self-harm scars

There's a really big scar from one of my self-harm attempts while I was going through hellish psychosis. It's a really big one that's described in an earlier blog post.

The scar is huge because it was untreated. I didn't know how to stitch it myself. I could have worked it out and done it but I'm not Rambo. I didn't think to take a needle and thread and DIY it.

There's an old study that shows that 85% of people recover from depression in a year without treatment. The study didn't really say enough about the actual outcomes.

Has my lack of treatment created a huge scar that will heal but leaves a big and permanent gash on my psyche and life? Yeah. Probably. C'est la vie.

Why did I smash my laptop

Paranoia or truth. I can not tell. Either someone was genuinely causing problems with my laptop like making the wireless disconnected unpredictably but with the intention of causing me discomfort and pain or through god/the other consciousness/non-corporeal entity that I fight with. The former is not so impossible but I can not discount the latter.

I also broke my 400mm lens in Friday and it was a similar cause. I think it was my own foolishness on that account. My camera and 70-200mm may also be broken in the self-destructive, self-harming drunken rampage that was triggered on Friday. It was all on a long walk from Holborn to East London.

I should have broken myself. I'm very close.

The hardest photos I've had to edit in a while

Canon 50D & Canon 50mm f1.8

Why do suicidal thoughts happen?

In the last few months I've had one person open up about suicidal thoughts and one person who won't tell me if they're experiencing suicidal thoughts. The first seemed to be toying with the idea as much as they didn't want to do anything about it. The second person has been
harder to get them to open up again. I've met someone else who's been suicidal for a long time like me. And another person who accidentally mentioned she'd felt suicidal in the past.

Between the four of them and me there's a range of experiences of suicidal thoughts. One person described theirs as though separate from themselves, as though they had no control over them. They seemed almost surprised at the question as to why they felt suicidal. Another seemed
to be trapped in an internal reality where ideals and philosophical thought seemed to be creating some sort of existentialist crisis and it seemed like there was little joy they took from their lives.

I've had suicidal thoughts on a regular basis. "I wish I was dead" and other phrases I can think and then move on from now I've had them appear so many times. These can be irrespective of mood, moment and events. At other times they can come through looking at life and seeing it lacking or seeing my life as a failure. I'm sure its a feeling many people experience.

Usually I can deal with those thoughts and feelings by either looking at the positive or accepting the truth of my life: it gets better, and we just keep surviving. At other times it was a way to deal with a life crisis like getting into what I thought was an irrecoverable financial situation or after the end of a relationship. Both those experiences were about the castle in the sky that is status (in all its forms), respect and self-respect (and others) collapsing or being percieved to
collapse. And now I've learnt that these things are simply constructs, fluid and intangible - they're very far from real and to be clung to like life should be. Those are also experiences other people have had though perhaps they reacted better than I.

Then there was the parasuicidal behaviour that was the war against the entity - the noncorporeal force or whatever that I feel in my life and in my heads. My sense of "I" discovered it wasn't in control of me, i.e. my sense of self came to be aware that it was not alone nor in control of my mind and body. I'm sure many a reader has a thought popping into their head at this moment like "schizophrenia" or "psycho" or "psychosis". Maybe those who read this who have understanding of this experience can sympathise and perhaps even empathise. This was a force I couldn't control so I fought with the only thing I thought I could control: my life. There were many recent attempts and prolific self-harm as a bizarre way to fight back and take
control. I'm out of that phase now and me and my entity are in a period of peace.

The point of this is there are many reasons why people kill themselves. There are also many experiences of suicidal thoughts. Another person I've met has told me they experience their suicidal thoughts as coming from the voice inside their head. It seems the opposite of my experience in the sense that I attempted to regain control or die trying as my will, whereas it seemed their path was for their "I" to fight against the command to kill themself. Perhaps it was the same experience however one person experienced themselves as one of the selves while my experience was the experience of the other self (this makes no sense without having experienced what I'm talking about or having a good understanding of madness).

There are lots of reasons why suicidal thoughts happen and why people kill themselves.

another rant on psychosis's mispathologisation

Some people believe mental distress or mental health problems or mental illness or madness to be an illness and that's the truth of the situation. Others consider the truth is that they're only illness because people call them illnesses, i.e. they are a false construction but real because people believe in them and they have real consequences (though these may be due to society, its maladapted systems and the morals of the time).

Heard of drapetomania? Its worth a google. Its an old diagnosis given to slaves who kept on running away. They were ill weren't they?

There's another piece of the history of mental illness also worth noting. In the Seventies the American diagnostic criteria (DSM) finally removed homosexuality as a mental illness and in the Nineties the WHO finally removed it from their criteria (ICD) which is used in the UK.

So a century ago people said that being gay was an illness and that they should be treated. Now you might be one of those people who still consider it an illness in which case my point is going to fall on deaf ears. Hearing voices, unshared perceptions, schizophrenia, psychosis and their ilk are not illnesses per se.

They can be thought of as illnesses but in the same way that skin colour could be called an illness, so my brown skin may be a disadvantage and I could paint myself white and be less 'ill'. I hope that makes sense: its an illness only as a non-real construct of society.

That's evidenced by a famous study conducted by the World Health Organisation in the Seventies which showed that outcomes for schizophrenia were better in the developing world than the developed world. There are many hypotheses to explain this seemingly paradoxical result. One is the other cultures have different interpretations to the experience of madness and don't use the medical paradigm of neurological brain dysfunction to be treated by antipsychotics and these produce better results. I'm not sure what the situation in 2010.

I've heard that mania is destigmatised in Spain. Hearing voices has a number of interpretations around the world. There are examples in the West too, for example many of the stories in the Bible are of people who heard the voice of god and its easy to see that the story of Abraham could be seen today as a story of a schizophrenic. Goth culture considers depression ok. Black rappers like Dizzie Rascal consider being "bonkers" a good thing. I've had an experience of revealing a previous bipolar diagnosis at a writing group and being told I was lucky.

But in the UK the general stigma of unshared perceptions is as deep rooted and pervasive as the stigma of madness itself. Its one I've seen even amongst antistigma campaigners. Its the thing we don't talk about in public. Its the thing that we associate with axe-wielding psychos and not great artists and thinkers. Its weird and its mad.

Its not surprising. The experience is incomprehensible if never having lived it. I have to admit that some psychiatrists have a modicum of understanding but many still dogmatically see the experience as illness.

The experience that leads to a diagnosis of schizophrenia is also one of the most distressing. Its sad that its often not recognised. Studies have shown up to a 10% completed suicide rate. The pain and suffering is like a rending asunder of everything you knew was real before, the very perceptions trusted from birth become unreal and yet more real at the same time. The very foundations of identity and consciousness are shattered. Terms like "ego death" are more elucidating. That's why it can be seen as an illness because mental healthcare may be necessary to treat the distress but not to tell the individual that there's something wrong with them. If they choose to believe that then its up to them.

This may all sound like an interesting and fairly abstract conversation but there's a harsh reality. Calling it an illness means it can be dogmatically treated like an illness. Its better than the past where unshared perceptions could be diagnosed as as possession, witchcraft or heresy (or canonisation if the voice hearing experience agreed with the paradigm of the Church).

In 2010 it invariably means antipsychotic treatment. Antipsychotic medication reduces life expectancy. Its one of those things the doctors don't tell people. They're an easy treatment to give and forget that a human being is more complex than biology. NICE's guidelines for schizophrenia recommend against therapies like supportive psychotherapy and counselling, preferring medication and CBT. Sadly its an improvement on previous guidelines and there are a a handful of other recommendations for therapies but scant few for the most disabling and distressing mental illness. Drugs are always the first options and they're an easily solution. They're cheap too whereas talking therapy is expensive.

Since the stigma is so high there's no public outcry about the deaths of so many people with this experience. When the evidence comes out about the number of older people dying prematurely when taking antipsychotics for dementia (which is not psychosis but shows antipsychotics used as a chemical cosh) there's a small public outcry. When the public see the figures on people dying from "killer" clozapine nothing happens. This is drug that's used to treat treatment resist

There's a long conversation to be had about what is normal and what is to be considered pathological but I've already rambled long ennough. One more study I'm afraid and that's it.. This one is one of my favourites. Its know to some as the "Thud" experiment. People who didn't hear voices said they did and were immediately hospitalised. When they got in they said they didn't hear them anymore but once they were in their behaviours were pathologised and they were given diagnoses of schizophrenia in remission. (http://web.archive.org/web/20041117175255/http://web.cocc.edu/lminorevans/on_being_sane_in_insane_places.htm)

A little bit of perspective on psychosis

I wish it would go away, for me and for others. But I know that's not an answer. I know the pain will always be part of my life as it is for others. I hate it but that doesn't change the fact that I must accept it. Its something that will kill me one day and that day will be a good day. In the meantime the struggle through it all is almost purpose in itself.

The struggleis with 'god' or whatever name people give to the entity and experience. The knowledge that there is a controlling, noncorporeal force or being in my life causing the harm and upset, controlling and manipulating everything, toying and playing with me and my life and my senses and my reality was a brutal awakening. The conventional view that this entity is responsible for the good only is incorrect. It saves the lives of people after the tsunami but also caused the tsunami.

Facing it alone was very hard. There was no one I could talk to about this experience. There was no one to help me cope. I couldn't open up while I was going through it because I didn't have the strength or resolve. I was afraid of being thought of as a psycho or a schizo. I didn't want people to think I was mad.

That's changed though. I now know I am mad. It makes me sad because I know the negative meaning of that term. I know the expectation is that I will become a social pariah looked after by the mental health system but I don't expect that to be true in my case. I know that expectation is only caused by stigma and society's maladaption to the full spectrum of the human experience. I know mad is just a word and the concept is only half the picture.

I know I am not alone in my madness. There are other people who go through the awakening or whatever it is called but are never seen by the mental health system or never reveal their true experience so never get the social label of weirdo or mad. My choice is to become more open about my madness and take the stigma of madness by the horns because there is nothing wrong nor ill about psychosis except that it is a distressing experience that is intensely, deeply stigmatised.

My hope is that through more openess from me there will be more openess. I see that as the way the stigma will change. Perhaps the fact that I can do it without (I hope) becoming a social pariah is a sign that the stigma is already changing. 40 years ago I'd have been immediately hospitalised were I to tell a psychiatrist that I have an unusual experience of consciousness.

It is an ill in society that can not be seen: the perscution, false pathologisation and stigmatisation of the same experiences that created the idea of god. It is an ill that creates the ill of psychosis. Post-Industrial Revolution society has forgotten what to do when psychosis happens. Less developed countries have better outcomes for schizophrenia because of their cultural alternative nonpsychatric explanations and perhaps also because of their lack of treatment with psychopharmaceuticals.

Friends and family are likely to tell a person to see a doctor because they have no idea what to do (a result of the 'great confinement' where the mad were housed in the asylums and removed from view (and this, again, was done for compassionate reasons)). Doctors are tell the person there is something wrong with them. They explain it as a problem with the person's brain and treat it with avolition and sedation-inducing medication that slowly kills the patient.

Few understand the sheer misery of the experience. Its not surprising the completed suicide rate is estimated at up to 10% of people with a diagnosis of schizophrenia. Depression is a walk in the park in comparison. Its not surprising people want to kill themselves when they go through this because the often face it alone and have no way to attempt to understand it other than as a malfunction of the brain.

I know it will change. I know it will get better. I know it takes time to shift this immense wrong that few can even see. I hope I can make that happen faster. There's purpose enough in that to keep me going.