The traumatic power struggle withing mental health

Filed under:Random notes — posted by Schizostroller on June 25, 2019 @ 6:24 am

An article I contributed to for the Morning Star


“ONE of the most vitriolic power struggles between professional groups is happening now and goes to the very essence of what is, or is not, mental illness.

Squaring off against each other are those who believe in a biomedical or genetic basis to mental illness (in the main, psychiatrists) and those who believe mental illness is a natural response to a threat or trauma (mainly psychologists).

At the root of it, is the battle between professions for legitimacy. Who should be controlling the narrative and who should be informing policy? Yet forgotten are the service users who are most affected by such policy arguments at this level.

The result is a confused message about mental health. For all the campaigns to reduce stigma for those with a mental illness, there is a significant crowd of voices rubbishing the very idea of mental illness, whether it is biological or from trauma

continue reading: https://morningstaronline.co.uk/article/f/traumatic-power-struggle-within-mental-health


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Kerplunk assemblages and unrecovery

Filed under:Random notes — posted by Schizostroller on June 21, 2019 @ 7:47 am

Some unrecovery analogy imagery:

We have all played Kerplunk I hope. But as a recap there is a tube with holes, sticks are crisscrossed holding up some balls, and the trick is to remove the sticks without all the balls falling.

Our mental health is like a game of Kerplunk, and our issues are a combination of the balls and sticks. ‘Recovery’ is the ability to remove the sticks without the balls falling. As a slight adaptation to this analogy some of the balls can be removed by moving sticks, and ‘life’ adds balls all the time. The sticks are ‘safety’ adaptations that stop all the balls falling at once.

This game of Kerplunk is mostly played by us alone (in our own minds), so in this analogy the game is played in a room on your own. But we can always hear people telling us which sticks we ‘should’ remove, whilst we are sitting there looking at the problem, even though these people are not in the room with us. Government policy also demands we remove sticks, and moreover can add balls (as can other aspects of life), as well as remove sticks if we don’t keep an eye on them.

Unrecovery practices are an ad hoc practice, that is a temporary solution to keep control of our own Kerplunk game, knowing that a wrong move can send all the balls falling. ‘Bad’ recovery is procrustean and insists on this or that stick must be removed, and then blames you when the balls fall. ‘Good’ Recovery, and other therapeutic practices, listens to your knowledge of what you can see of the game, and merely supports you with your autonomy whilst you play the game. This latter ideal however from our observation seems to be at odds with current government policy and market/ capitalist needs, as it doesn’t meet the outcomes measures of outside forces.

For those who don’t know the term, that I have added some changes to the games with sticks and balls being added and removed whilst you play, like a Heath Robinson machine, is what is called an assemblage. Unrecovery is an ad hoc practice with which to deal with such an assemblage.

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‘Sin your way to heaven and get slaughtered: A byzantine general problem of the self’ (part twenty-six)

Filed under:Sin your Way to Heaven and get Slaughtered — posted by Schizostroller on June 18, 2019 @ 12:21 pm

Blackman then turns her critical gaze to the relation of the psychological to the social. She points out that “psychology, like psychiatry, is not a unified discipline, and it’s made up of a range of disparate therapies, concepts, explanatory structures and techniques and understandings. Many different theories within psychology have been deployed in order to understand the problem of hallucination. Many of them have similarities with psychiatric understandings, attempting to locate the exact psychological, rather than strictly neurological mechanisms, which are seen to underpin the hallucinatory experience. Again, like psychiatry, only some concepts have the status of science-ready-made, and there is much dissent and controversy surrounding many of the theories offered to explain the nature of hallucination.” (p.43-44). It is worth looking at the British Psychological Society’s Power Threat Meaning Framework for an overview of both psychiatric and psychological theories of mental distress. According to Blackman, though, within the conceptual framework of psychology, hallucinations are viewed as a disorder of consciousness. These theories are called ‘seepage’ theories, that is they frame hallucinations as some kind of ‘seepage’ into consciousness of mental activity that would normally be preconscious. “Therefore, the problem of hallucination is construed within the terms of consciousness and its preconscious workings… within this framework hallucinations are experiences related to dreams, originating in the preconscious imaginary realm of the mind. When the rational mind is relaxed then these subterranean forces are brought into play… the difference between hallucinations and dreams within this framework is that the state of consciousness, which occurs during the dreamstate, is considered a normal function of sleep… however, the neuro-physiological mechanism underpinning hallucination is considered deficient, whereas during sleep the mechanism is merely relaxed.” (p.44-45).
Other theories base themselves on hyper-arousal, so whilst it is considered within the bounds of normality, a pseudo-hallucination to hear voices in hostage situations, “these theories suggest that schizophrenia is akin to a state of hyper-arousal, which deleteriously affects cognitive information-processing capacities. The state of hyper-arousal is used to explain attentional deficits, which lead the ‘schizophrenic’ to inadequately screen and process input from the external environment. It is this state which leads to the focus of the internal as opposed to the external, where a person misattributes and confuses the location of the stimuli.” (p.45-46).
Another framework is that of hallucinations as a continuum of ‘normal’ mental imagery. “’Normal’ mental imagery has been defined as a non-veridical experience involving the sensory or perceptual organs” (p.48). Blackman suggests this structure consists of two concepts, the first views hallucinations as extremely vivid mental imagery. So hallucinations are in some respects similar to normal forms of mental imagery such as ‘daydreaming, hypnosis, dreams’ etc., they are also paradoxically quantitatively different. “In other words, although hallucinations are viewed as proximate to other forms of imagery they are also, by definition, the negation of ‘normal’ mental imagery.” (p.48). However, Blackman points out that within this continuum theory, with regards the second concept “the ‘problem of hallucination’ is delimited further by incorporating and redeploying one of the main modes of psychiatric explanation, ‘a belief in the reality of the experience’.” (p.49). Thus “the empirical problem is individualised, and the two concepts conflated through attempting to classify and measure ‘reality testing’ (the ability to judge between real and imaginary events) and the ‘quality of mental imagery’.” (p.49). Blackman goes on to quote Rose saying “’they (psychologists) domesticate and discipline subjectivity, transforming the intangible, changeable, apparently free-willed conduct of people into manipulable, coded, materialised, mathematised, two-dimensional traces which may be utilised in any procedure of calculation’… The paradox is that nowhere in the literature are the norms of ‘normal’ mental functioning defined. Mental imagery is presumed to be a mental picture of the world as produced internally, thus not dependent upon actual representations of external events. However, the laws governing normal mental imagery functioning are not explained. The ‘norm’ of mental imagery is a lack of hallucination. Thus ‘abnormal’ mental imagery is a negation of ‘normal’ mental imagery, which in turn defines and classifies the limits of ‘normal’ mental imagery.” (p.50). In contrasting Hilgard’s 1965 definition of altered states of consciousness to the psychiatric definition of hallucination, both ‘focus upon the involvement of imagery or fantasy production whilst ‘awake’, or at least in a certain state of consciousness. However, hallucinations are differentiated from ‘normal’ mental imagery by invoking the notion of ‘self-conscious’ awareness. However, this criterion or mode of explanation does not suffice to delimit the definition of altered states of consciousness from the psychiatric definition of hallucination. In both definitions the subject loses volition, the willingness to act independently and attention becomes redistributed or refocused. Therefore, what is the conceptual difference between hallucinations and an altered state of consciousness such as hypnosis?” (p.50). It is here that Blackman questions the role of vividness in the distinction, not just ‘self-awareness’. As if vividness of imagery is present in both hallucination and hypnosis, then “the fundamental difference or division is that hallucinations are viewed as inherently pathological and hypnosis is not. Hypnosis is viewed as a transitory state or role, whereas hallucinations are a symptom or index of pathology, and become an integral part of the identity of the person. Thus, in order to understand why hallucinations are constituted within this framework as a continuum of ‘normal’ mental imagery, one needs to understand the antecedent for this statement to exist. Neisser has highlighted that there is no a priori reason for believing that imagery vividness is an underlying condition for a hallucinatory experience to occur – the paradox being that ‘normal’ mental imagery is defined by what is abnormal, i.e. hallucinations. Thus, although psychology aims to extend its knowledge of normal mental functioning to deal with what is constituted as individual and social pathology, the questions are posed in terms of deviation from certain norms. As Rose suggests, in relation to this argument, ‘individual psychology would seem to diagnose social pathology in terns of deviation from statistical norms. Its conception of normal and abnormal mental functioning would be constructed from the point of view of a theory of populations, averages and correlations, not from a conception of the psyche itself.’.” (p.51).  
Continuing Blackman’s argument with regards the alignment of concepts in psychology and psychiatry she states “they focus less on the brain and more on those cognitive capacities which are viewed as existing within the mind. They are attempts to locate the psychological, as opposed to the psychiatric mechanisms, which underpin the hallucinatory experience. They claim to be based upon general theories of mental functioning, which are then extended to understand these so-called deviations from normal functioning. However… it is actually the ways in which deviations, understood as pathology, are articulated, which make possible what we understand normal mental functioning to be.” (p.52). She cites Foucault, “it must not be forgotten that ‘objective’ or ‘positive’ or ‘scientific’ psychology founds its historical origin and its basis in pathological experience. It was an analysis of duplication that made possible a psychology of the personality; an analysis of compulsions and of the unconscious that provided the basis for a psychology of consciousness; an analysis of deficits that led to a psychology of intelligence”. (Blackman, p.52).
Blackman then turns to the social elements of the hallucinatory experience. But we will return to these later. Much of these debates as well as more contemporary one’s are covered by The British Psychology Society’s Power, Threat, Meaning Framework in the literature review that precedes the discussion on practice. I will be covering this Framework later, its relation to some problems of contemporary governance. But for now, I hope that my notes on Lisa Blackman cover some issues in what is considered the ‘problem of hallucination’, and in the next article I will return to some problems of phenomenology and the work of Ver Eecke, before returning to Rocjiewicz Jr and Rockjiewicz’s ‘intentional arc’.



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image: detail of installation by Bronwyn Lace