Wednesday, 31 January 2007

Caring, Mental Health Problems, and Empowerment

A friend of mine recently told me that he had run out of his psychiatric medication, and he was feeling a bit unwell because he had been lowering his dosage.  Luckily, the chemists let him have two days supply of tablets.Whilst he was in the chemists, he noticed a woman who had been crying, and when she saw him she fixated on him and seemed to want to talk to him.  He looked at her with kindness, but started to feel worried, because he got thefeeling that she would freak out on him and insult him because he was a man.He thought that maybe her husband had been beating her up or some other terrible trouble like that, but he wasn't feeling strong enough to help herso he avoided her eyes.

What occurs to me about what he said, is that he was caring in his feelings and concern for her, but that he didn't feel strong enough to put that care and concern into action.  In other words, he didn't feel empowered.

It's a shame that he didn't feel able to help the woman in the chemists whohad been crying, but maybe just looking at her kindly was sufficient enough for her to feel a bit better about herself.  It's sometimes hard to know when and how to help strangers who are in distress.  I've seen strangers cry and in distress before and not known how to help them, whilst other times I have intervened and asked them if they were OK.  I agree with my friend that we should try to befriend and help people who are in distress though.

It says a lot about our society when there is a lack of good samaritanship around, but not being able to put caring and concern into action is a social and a CULTURAL problem, and not just a personal one, unless we all just rely upon the Police and Social workers to do this for us.  There's always the Samaritans for people in trouble or distress, but nothing beats real face-to-face empathy, sympathy, and interactive understanding andcompassion.

The story of the good Samaritan in the Bible was about two individuals from different racial groups, one who helped the other, but would not normally even talk to one another.  The person who helped the individual who was beaten and robbed, also paid an in-keeper so the person had somewhere to stay for the night, and so empowerment can also mean economic help, independence, or mutual support.

I told my friend not to blame himself if he wasn't feeling too well to talkto the woman in the chemists.  I personally still think that you can carefor someone whilst having mental health problems, but one thing that Survivors Speak Out used to protest a lot about, is that people who have mental health problems and are parents or carers are not given any or enough practical and emotional support to be carers; because psychiatry has a false notion that you can't have mental health problems and have emotional and intellectual care and concern for others at the same time.

It's as if they are saying that we're robots with no kindness and feelings, which is completely untrue.  It's also as though they're saying that only they have the authority and status to care in society, and so therefore we can't care for and support each other as ordinary and diagnosed people. It's an argument and ideological view which is political as well, and it tends to go against collective self-help and personal empowerment in mental health.

I think it's possible to care and still be powerless though, like my friend was with the woman in the chemists, but then what the diagnosed person needs is some kind of individual or collective empowerment, and not just to be told that they are incapable of caring and being a carer.  I think we can all care for each other in society really, and I'm opposed to unequal power relationships of caring, and hierarchies of authority where one person is doing the caring and the other person is just like a subject who is considered can't be caring or having no mutual human emotions.

Saturday, 27 January 2007

Nimbyism and awareness of mental health issues

I spoke to someone in a pub who expressed the so-called NIMBY viewpoint or mentality. NIMBYISM comes from the term Not In My Back Yard, and although it's sometimes a view which is valid on grounds against institutionalisation, and which can be part of it's protest, often people who hold the NIMBY view have some extreme solutions such as closing all half-way houses down, contradictory notions about their own social and emotional lives, and extreme social dogma's about society being too individualistic.

Often people who hold NIMBY views have had valid experiences of seeing half-way house areas as run-down, clinical, and unfit for long-term housing, but the first blame is sometimes put upon the ex-patients as "not being real people" or "not having social or unique problems which are in some ways common to us all". Discipline is seen in terms of getting people out of half-way houses, and that may not be such a bad thing, but we also have to take many things into consideration, and it's a very complex issue.

Social workers are often used to get psychiatric diagnosed-people into half-way houses with a very disciplined approach, but I agree with some people that social workers should also use their quaint charms to get those people reintegrated back into society as well. Re-housing is a complex issue, and some people don't really understand what's involved in it, and I can understand why they may get angry and frustrated. So so-called NIMBY people may agree that half-houser's should be reintegrated and re-housed, but they have really got no idea what the solutions could be for that to be achieved.

Some so-called NIMBYISM may have some genuine concerns behind it, and it would be stupid to censor the language or terminology of anyone who expresses what might be termed a NIMBY view. The NIMBY view is also protesting against the slum society and mentality, and I agree to some extent with that argument as well, because half-way houses are a form of ghettoisation and it does turn areas into slums.

This person I spoke to in a pub about this, said that if the half-houser's have got problems on in the inside, then they're weak on the outside. Whilst I question what he means by "weak", he is obviously addressing issues of emotional strength, and dealing with social problems that way in order to survive. He then went on to say that they can't handle too many problems - perhaps other people's mental health problems - but if they can handle it, then they're fine.

Whilst I initially thought that his idea of "strength" and "weakness" was solely to do with physical strength or very masculine orientated strength of will, he described feebleness as a lack of emotional strength, role-playing, and allowing other people to repress, distort, and walk all over us.

I agree with him about having or developing realistic emotional strength, but I think he's in some ways too idealistic, although he said "It's not people who are weak, it's the world". That's his view of survival, he's an emotional realist; although he wasn't very clear about what sort of emotional and social support is required if any.

Not everyone has the right sort of family to support them emotionally and socially, and I thought his political idealism and emotional realism dwindled into fatalism, because he just said that there was nothing he could do to help those people, but that he thought everyone potentially had emotional and social strength. He's an emotional realist, and which is valid, but he's also a political idealist, and he doesn't seem to have very clear views on social or interpersonal solutions, and he falls into fatalism and the very same individualism that he originally criticised about society and others.

Thursday, 18 January 2007

A summary of the book : "Foucault for Beginners"

Foucault (pronounced foo-co) was a famous French intellectual who wrote onphilosophy, history, psychology, sociology, medicine, gender studies, andliterary or cultural criticism.  What held together his wide field of studywas an interest in Power and Knowledge and how they work together.  Youmight say he started with the truism "KNOWLEDGE IS POWER", took it apart,analysed it, and put it back together.  He was particularly interested inKnowledge of human beings, and Power that acts on human beings.

Suppose we start with the statement "KNOWLEDGE IS POWER" but doubt that wehave any knowledge of absolute truth.  If you take away the idea of absolutetruth, what does knowledge mean?  Maybe knowledge would be just what a groupof people get together and decide is true.  According to Foucault, the mightof "MIGHT MAKES RIGHT" may not be all that different from the power in"KNOWLEDGE IS POWER".
In one case physical force, in the other mental force, is exerted by apowerful minority who are thus able to impose their idea of the right, orthe true, on the majority.  When we're talking about knowledge of humanbeings, the social sciences, or, as Foucault called them, "the humansciences", then the people deciding what is true (constructing Truth) aredeciding matters that define humanity, and affect people in general.  Ifthey can get enough people to believe what they have decided, then that maybe more important than some unknowable truth.
How do some people get the rest of us to accept their ideas of who we are?That involves some power to create belief.  And these same people who decidewhat is knowledge in the first place can easily claim to be the mostknowledgeable - to know more about us than we do ourselves.  But how doesknowledge/power get its work done?  Often knowledge/power and physical forceare allied, as when a child is spanked to teach her a lesson.  But primarilyknowledge/power works through language.  At a basic level, when a childlearns to speak, she picks up the basic knowledge and rules of her cultureat the same time.  As when a father says to a daughter "Take good care ofyour Mother, Father's off to work", the knowledge and rules conveyed of thatspoken language are "Daddy work, Mummy stay home".

On a more specialised level, all the human sciences (psychology, sociology,economics, linguistics, even medicine) define human beings at the same timeas they describe them, and work together with such institutions as mentalhospitals, prisons, factories, schools, and law courts to have specific andserious effects on people.  Foucault focuses throughout his work on acentral mechanisms of the social sciences - the categorisation of peopleinto NORMAL & ABNORMAL.  His books study different forms of abnormality:madness, criminality, perverted sexuality, and illness.

We would naturally tend to define ABNORMAL as everything which differssignificantly from the NORMAL.  Normal is the basic term, and what is normalshould be perfectly obvious - it's all around us.  We might also assume thatthe difference is easy to tell, and tends to remain the same over time.  Butby looking at a wide variety of historical documents, Foucault challengesall of these assumptions.  He shows that definitions of madness, illness,criminality, and perverted sexuality vary greatly over time.  Behaviour thatgot people locked up or put in hospitals at one time was glorified inanother.

Societies, knowledge/power, and the human sciences have since the 18thcentury carefully defined the difference between normal and abnormal, andthen used these definitions all the time to regulate behaviour.Distinguishing between the two may appear to be easy, but is in factextremely difficult - there is always a hazy and highly contestedborderline.

Our society has increasingly locked up, excluded, and hidden abnormalpeople, while nevertheless watching, examining, questioning them carefully.It has not always been this way.  In earlier times madmen were an acceptedpart of the community; sick people were treated at home; no one expecteddisabled or disfigured people to stay out of sight; and criminals werepunished as publicly as possible.  This exclusion of abnormal people doesnot make these people unimportant to the culture.  The normal is not definedfirst, with the abnormal established in contrast!  We actually define thenormal through the abnormal; only through abnormality do we know what normalis.  Therefore, although abnormality is excluded and supposedly hidden, theremaining people, normal people, study and question it incessantly,obsessively.

The study of abnormality is one of the main ways that power relations areestablished in society.  When as abnormality and its corresponding norm aredefined, somehow it is always the normal person who has power over theabnormal.  The psychologist tells us about the madmen, the physician aboutthe patients, the criminologist (or the legal theorist, or the politician)talks about the criminals, but we never expect to hear the latter talk aboutthe former - what they have to say has already been ruled irrelevant,because by definition they have no knowledge (but that is code for notwanting them to have any power).